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Milross L, Hunter B, McDonald D, Merces G, Thomson A, Hilkens CMU, Wills J, Rees P, Jiwa K, Cooper N, Majo J, Ashwin H, Duncan CJA, Kaye PM, Bayraktar OA, Filby A, Fisher AJ. Distinct lung cell signatures define the temporal evolution of diffuse alveolar damage in fatal COVID-19. EBioMedicine 2024; 99:104945. [PMID: 38142637 PMCID: PMC10788437 DOI: 10.1016/j.ebiom.2023.104945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Lung damage in severe COVID-19 is highly heterogeneous however studies with dedicated spatial distinction of discrete temporal phases of diffuse alveolar damage (DAD) and alternate lung injury patterns are lacking. Existing studies have also not accounted for progressive airspace obliteration in cellularity estimates. We used an imaging mass cytometry (IMC) analysis with an airspace correction step to more accurately identify the cellular immune response that underpins the heterogeneity of severe COVID-19 lung disease. METHODS Lung tissue was obtained at post-mortem from severe COVID-19 deaths. Pathologist-selected regions of interest (ROIs) were chosen by light microscopy representing the patho-evolutionary spectrum of DAD and alternate disease phenotypes were selected for comparison. Architecturally normal SARS-CoV-2-positive lung tissue and tissue from SARS-CoV-2-negative donors served as controls. ROIs were stained for 40 cellular protein markers and ablated using IMC before segmented cells were classified. Cell populations corrected by ROI airspace and their spatial relationships were compared across lung injury patterns. FINDINGS Forty patients (32M:8F, age: 22-98), 345 ROIs and >900k single cells were analysed. DAD progression was marked by airspace obliteration and significant increases in mononuclear phagocytes (MnPs), T and B lymphocytes and significant decreases in alveolar epithelial and endothelial cells. Neutrophil populations proved stable overall although several interferon-responding subsets demonstrated expansion. Spatial analysis revealed immune cell interactions occur prior to microscopically appreciable tissue injury. INTERPRETATION The immunopathogenesis of severe DAD in COVID-19 lung disease is characterised by sustained increases in MnPs and lymphocytes with key interactions occurring even prior to lung injury is established. FUNDING UK Research and Innovation/Medical Research Council through the UK Coronavirus Immunology Consortium, Barbour Foundation, General Sir John Monash Foundation, Newcastle University, JGW Patterson Foundation, Wellcome Trust.
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Affiliation(s)
- Luke Milross
- Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - Bethany Hunter
- Newcastle University Biosciences Institute, Newcastle upon Tyne, UK; Innovation Methodology and Application Research Theme, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - David McDonald
- Newcastle University Biosciences Institute, Newcastle upon Tyne, UK; Innovation Methodology and Application Research Theme, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - George Merces
- Newcastle University Biosciences Institute, Newcastle upon Tyne, UK; Innovation Methodology and Application Research Theme, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Amanda Thomson
- Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK; Newcastle University Biosciences Institute, Newcastle upon Tyne, UK; Innovation Methodology and Application Research Theme, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catharien M U Hilkens
- Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
| | - John Wills
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Paul Rees
- Department of Biomedical Engineering, Swansea University, Wales, UK; Imaging Platform, Broad Institute of MIT and Harvard, 415 Main Street, Boston, Cambridge, MA, USA
| | - Kasim Jiwa
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nigel Cooper
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Joaquim Majo
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Helen Ashwin
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Christopher J A Duncan
- Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK; Department of Infection and Tropical Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Paul M Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | | | - Andrew Filby
- Newcastle University Biosciences Institute, Newcastle upon Tyne, UK; Innovation Methodology and Application Research Theme, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Andrew J Fisher
- Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK; Institute of Transplantation, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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Hunter B, Nicorescu I, Foster E, McDonald D, Hulme G, Fuller A, Thomson A, Goldsborough T, Hilkens CMU, Majo J, Milross L, Fisher A, Bankhead P, Wills J, Rees P, Filby A, Merces G. OPTIMAL: An OPTimized Imaging Mass cytometry AnaLysis framework for benchmarking segmentation and data exploration. Cytometry A 2024; 105:36-53. [PMID: 37750225 PMCID: PMC10952805 DOI: 10.1002/cyto.a.24803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
Analysis of imaging mass cytometry (IMC) data and other low-resolution multiplexed tissue imaging technologies is often confounded by poor single-cell segmentation and suboptimal approaches for data visualization and exploration. This can lead to inaccurate identification of cell phenotypes, states, or spatial relationships compared to reference data from single-cell suspension technologies. To this end we have developed the "OPTimized Imaging Mass cytometry AnaLysis (OPTIMAL)" framework to benchmark any approaches for cell segmentation, parameter transformation, batch effect correction, data visualization/clustering, and spatial neighborhood analysis. Using a panel of 27 metal-tagged antibodies recognizing well-characterized phenotypic and functional markers to stain the same Formalin-Fixed Paraffin Embedded (FFPE) human tonsil sample tissue microarray over 12 temporally distinct batches we tested several cell segmentation models, a range of different arcsinh cofactor parameter transformation values, 5 different dimensionality reduction algorithms, and 2 clustering methods. Finally, we assessed the optimal approach for performing neighborhood analysis. We found that single-cell segmentation was improved by the use of an Ilastik-derived probability map but that issues with poor segmentation were only really evident after clustering and cell type/state identification and not always evident when using "classical" bivariate data display techniques. The optimal arcsinh cofactor for parameter transformation was 1 as it maximized the statistical separation between negative and positive signal distributions and a simple Z-score normalization step after arcsinh transformation eliminated batch effects. Of the five different dimensionality reduction approaches tested, PacMap gave the best data structure with FLOWSOM clustering out-performing phenograph in terms of cell type identification. We also found that neighborhood analysis was influenced by the method used for finding neighboring cells with a "disc" pixel expansion outperforming a "bounding box" approach combined with the need for filtering objects based on size and image-edge location. Importantly, OPTIMAL can be used to assess and integrate with any existing approach to IMC data analysis and, as it creates .FCS files from the segmentation output and allows for single-cell exploration to be conducted using a wide variety of accessible software and algorithms familiar to conventional flow cytometrists.
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Affiliation(s)
- Bethany Hunter
- Flow Cytometry Core Facility, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Biosciences Institute, Innovation, Methodology and Application (IMA) Research Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Ioana Nicorescu
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Emma Foster
- Image Analysis Unit, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - David McDonald
- Flow Cytometry Core Facility, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Biosciences Institute, Innovation, Methodology and Application (IMA) Research Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Gillian Hulme
- Flow Cytometry Core Facility, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Biosciences Institute, Innovation, Methodology and Application (IMA) Research Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Andrew Fuller
- Flow Cytometry Core Facility, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Biosciences Institute, Innovation, Methodology and Application (IMA) Research Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Amanda Thomson
- Flow Cytometry Core Facility, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | | | - Catharien M. U. Hilkens
- Translational and Clinical Research Institute, Immunity and Inflammation Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Joaquim Majo
- Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - Luke Milross
- Transplantation and Regenerative Medicine, Newcastle University Translational and Clinical Research Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Andrew Fisher
- Transplantation and Regenerative Medicine, Newcastle University Translational and Clinical Research Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Peter Bankhead
- Centre for Genomic and Experimental Medicine, CRUK Scotland Centre, and Edinburgh PathologyUniversity of EdinburghEdinburghUK
| | - John Wills
- Department of Veterinary MedicineCambridge UniversityCambridgeUK
- Department of Biomedical EngineeringSwansea UniversitySwansea, WalesUK
| | - Paul Rees
- Department of Biomedical EngineeringSwansea UniversitySwansea, WalesUK
- Imaging PlatformBroad Institute of MIT and HarvardCambridgeMassachusettsUSA
| | - Andrew Filby
- Flow Cytometry Core Facility, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Biosciences Institute, Innovation, Methodology and Application (IMA) Research Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - George Merces
- Biosciences Institute, Innovation, Methodology and Application (IMA) Research Theme, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
- Image Analysis Unit, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
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Beal MA, Chen G, Dearfield KL, Gi M, Gollapudi B, Heflich RH, Horibata K, Long AS, Lovell DP, Parsons BL, Pfuhler S, Wills J, Zeller A, Johnson G, White PA. Interpretation of in vitro concentration-response data for risk assessment and regulatory decision-making: Report from the 2022 IWGT quantitative analysis expert working group meeting. Environ Mol Mutagen 2023. [PMID: 38115239 DOI: 10.1002/em.22582] [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: 06/04/2023] [Revised: 09/15/2023] [Accepted: 12/16/2023] [Indexed: 12/21/2023]
Abstract
Quantitative risk assessments of chemicals are routinely performed using in vivo data from rodents; however, there is growing recognition that non-animal approaches can be human-relevant alternatives. There is an urgent need to build confidence in non-animal alternatives given the international support to reduce the use of animals in toxicity testing where possible. In order for scientists and risk assessors to prepare for this paradigm shift in toxicity assessment, standardization and consensus on in vitro testing strategies and data interpretation will need to be established. To address this issue, an Expert Working Group (EWG) of the 8th International Workshop on Genotoxicity Testing (IWGT) evaluated the utility of quantitative in vitro genotoxicity concentration-response data for risk assessment. The EWG first evaluated available in vitro methodologies and then examined the variability and maximal response of in vitro tests to estimate biologically relevant values for the critical effect sizes considered adverse or unacceptable. Next, the EWG reviewed the approaches and computational models employed to provide human-relevant dose context to in vitro data. Lastly, the EWG evaluated risk assessment applications for which in vitro data are ready for use and applications where further work is required. The EWG concluded that in vitro genotoxicity concentration-response data can be interpreted in a risk assessment context. However, prior to routine use in regulatory settings, further research will be required to address the remaining uncertainties and limitations.
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Affiliation(s)
- Marc A Beal
- Bureau of Chemical Safety, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Guangchao Chen
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Utrecht, the Netherlands
| | - Kerry L Dearfield
- Retired from US Environmental Protection Agency and US Department of Agriculture, Washington, DC, USA
| | - Min Gi
- Department of Environmental Risk Assessment, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | | | - Robert H Heflich
- National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas, USA
| | - Katsuyoshi Horibata
- Division of Genetics and Mutagenesis, National Institute of Health Sciences, Kawasaki, Kanagawa, Japan
| | - Alexandra S Long
- Existing Substances Risk Assessment Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - David P Lovell
- St George's Medical School, University of London, London, UK
| | - Barbara L Parsons
- National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas, USA
| | - Stefan Pfuhler
- Global Product Stewardship - Human Safety, Procter & Gamble, Cincinnati, Ohio, USA
| | - John Wills
- Genetic Toxicology and Photosafety, GSK Research & Development, Stevenage, UK
| | - Andreas Zeller
- Pharmaceutical Sciences, pRED Innovation Center Basel, Hoffmann-La Roche Ltd, Basel, Switzerland
| | - George Johnson
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Paul A White
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
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Mills T, Grimes J, Caddick E, Jenkins CL, Evans J, Moss A, Wills J, Sykes S. 'Odds Are: They Win': a disruptive messaging innovation for challenging harmful products and practices of the gambling industry. Public Health 2023; 224:41-44. [PMID: 37714065 PMCID: PMC10627150 DOI: 10.1016/j.puhe.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE This paper presents an evidence informed rationale for focussing on harmful gambling products and industry practices in public health messaging through the example of a recent innovation called 'Odds Are: They Win'. METHODS 'Odds Are: They Win' was initially developed through coproduction involving public health professionals and people with lived experience of gambling harms and implemented across a city-region area. A review of relevant evidence was undertaken, upon which the research team reflected to draw out the implications of 'Odds Are: They Win' for gambling harms messaging. RESULTS Evidence is mounting that safer gambling campaigns framed in terms of individual responsibility are ineffective and can generate stigma. 'Odds Are: They Win' presents an alternative focus that is not anti-gambling but raises awareness of industry manipulation of the situational and structural context of gambling. This is in-keeping with historical lessons from the stop smoking field and emerging research in critical health literacy. The latter highlights the potential of education on the social and commercial determinants of health to stimulate behaviour change and collective action. CONCLUSION 'Odds Are: They Win' is a potentially disruptive innovation for the gambling harms field. Research is required to robustly evaluate this intervention across diverse criteria, target audiences, and delivery settings.
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Affiliation(s)
- T Mills
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK.
| | - J Grimes
- Gambling with Lives - The Circle, 33 Rockingham Lane, Sheffield S1 4FW, UK
| | - E Caddick
- Greater Manchester Combined Authority - Tootal, 56 Oxford St, Manchester M1 6EU, UK
| | - C L Jenkins
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
| | - J Evans
- Greater Manchester Combined Authority - Tootal, 56 Oxford St, Manchester M1 6EU, UK
| | - A Moss
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
| | - J Wills
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
| | - S Sykes
- PHIRST South Bank, London South Bank University, 103 Borough Rd, London SE1 0AA, UK
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Tonnessen R, Samavat H, Rigassio Radler D, Wills J, Brody R. The Relationship between Grit and Growth Mindset and Educational and Professional Characteristics in Clinical Nutrition Graduate Students. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.168] [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: 10/15/2022]
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Aird R, Wills J, Roby KF, Bénézech C, Stimson RH, Wabitsch M, Pollard JW, Finch A, Michailidou Z. Hypoxia-driven metabolic reprogramming of adipocytes fuels cancer cell proliferation. Front Endocrinol (Lausanne) 2022; 13:989523. [PMID: 36329893 PMCID: PMC9623062 DOI: 10.3389/fendo.2022.989523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/15/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Obesity increases the risk of certain cancers, especially tumours that reside close to adipose tissue (breast and ovarian metastasis in the omentum). The obesogenic and tumour micro-environment share a common pathogenic feature, oxygen deprivation (hypoxia). Here we test how hypoxia changes the metabolome of adipocytes to assist cancer cell growth. METHODS Human and mouse breast and ovarian cancer cell lines were co-cultured with human and mouse adipocytes respectively under normoxia or hypoxia. Proliferation and lipid uptake in cancer cells were measured by commercial assays. Metabolite changes under normoxia or hypoxia were measured in the media of human adipocytes by targeted LC/MS. RESULTS Hypoxic cancer-conditioned media increased lipolysis in both human and mouse adipocytes. This led to increased transfer of lipids to cancer cells and consequent increased proliferation under hypoxia. These effects were dependent on HIF1α expression in adipocytes, as mouse adipocytes lacking HIF1α showed blunted responses under hypoxic conditions. Targeted metabolomics of the human Simpson-Golabi-Behmel syndrome (SGBS) adipocytes media revealed that culture with hypoxic-conditioned media from non-malignant mammary epithelial cells (MCF10A) can alter the adipocyte metabolome and drive proliferation of the non-malignant cells. CONCLUSION Here, we show that hypoxia in the adipose-tumour microenvironment is the driving force of the lipid uptake in both mammary and ovarian cancer cells. Hypoxia can modify the adipocyte metabolome towards accelerated lipolysis, glucose deprivation and reduced ketosis. These metabolic shifts in adipocytes could assist both mammary epithelial and cancer cells to bypass the inhibitory effects of hypoxia on proliferation and thrive.
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Affiliation(s)
- R. Aird
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
| | - J. Wills
- MRC Institute of Genetics and Molecular Medicine, Edinburgh University, Edinburgh, United Kingdom
| | - K. F. Roby
- University of Kansas Medical Center, Kansas City, Kansas, KS, United States
| | - C. Bénézech
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
| | - R. H. Stimson
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
| | - M. Wabitsch
- University Medical Center Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - J. W. Pollard
- Medical Research Council (MRC) Centre for Reproductive Health, Edinburgh University, Edinburgh, United Kingdom
| | - A. Finch
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Z. Michailidou
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
- *Correspondence: Z. Michailidou,
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Abstract
Gender variations in health literacy have implications for engagement in preventive behaviours and the uptake of health services, especially in areas such as the Caribbean where there are marked disparities in life expectancy and health service utilization. A self-reported questionnaire was used to examine men's concepts of health, their help-seeking behaviours and their functional and interactive health literacy. Two hundred and forty-eight men across the life course participated at three sites in Trinidad. Data were analysed using descriptive statistics, with free-text responses analysed thematically. Men were concerned about, and accepted responsibility for their own health but social norms concerning sickness and masculinity were barriers to accessing health services. Almost one-third (31.5%) sought advice from a healthcare service when they were last sick because they were prompted to do so by their wife/partner or family. Levels of functional and interactive health literacy were not high among older men, who were reliant on healthcare professionals to communicate health messages. There was an age divide in e-health literacy. There is little published evidence on men's health literacy, particularly from Caribbean countries such as Trinidad and Tobago. This study highlights the importance of the design and implementation of specific policies focusing on men's health. A major challenge is to engage with men who do not access health services.
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Affiliation(s)
- J Wills
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - S Sykes
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - S Hardy
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - M Kelly
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - C Moorley
- London South Bank University, 101 Borough Road, London SE1 0AA, UK
| | - O Ocho
- University of West Indies, Cor. College and St Cecelia Roads, El Dorado, Trinidad and Tobago
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Wills J, Hancock C, Nuttall M. The health of the nursing workforce. A survey of National Nurse Associations. Int Nurs Rev 2020; 67:294-299. [PMID: 32367661 DOI: 10.1111/inr.12586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/20/2020] [Accepted: 03/12/2020] [Indexed: 12/01/2022]
Abstract
AIM This investigation explored the extent to which nurses' own health is a priority for global National Nursing Associations. BACKGROUND There is a growing body of evidence linking staff health and well-being and key dimensions of service quality, including patient safety, patient experience and the effectiveness of patient care. INTRODUCTION The International Council of Nurses is a federation of more than 130 National Nurses Associations, representing more than 20 million nurses worldwide. Representatives from these Associations attended a Congress in Singapore in 2019 at which a survey was conducted. METHODS A convenience sample of 37 leaders of National Nurse Associations from 33 countries and 61 nurse representatives took part in a survey. RESULTS The majority of nurse leaders and participants believed that nurses' own health should be a priority to be addressed, principally because a healthy nurse is better able to provide good patient care. All of the examples offered about how these Associations address nurses' own health were about actions to prompt individual health behaviour change. DISCUSSION The National Nurses Associations did not have a common terminology to talk about nurses' own health. Taking care of one's own health was included as part of the professional role and most nurse leaders thought that working conditions contributed to ill health. CONCLUSIONS There is widespread agreement that nurses' own health matters but for most National Nurses Associations it is not a current priority. IMPLICATIONS FOR NURSING POLICY Going forward nurse health and wellbeing should be a core principle for health services and professional associations, and additional research is needed that demonstrates if improving working environments contributes to nurse retention and recruitment.
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Affiliation(s)
- J Wills
- London South Bank University, London, UK
| | - C Hancock
- C3 Collaborating for Health, London, UK
| | - M Nuttall
- C3 Collaborating for Health, London, UK
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Cortés A, Wills J, Su X, Hewitt RE, Robertson J, Scotti R, Price DRG, Bartley Y, McNeilly TN, Krause L, Powell JJ, Nisbet AJ, Cantacessi C. Infection with the sheep gastrointestinal nematode Teladorsagia circumcincta increases luminal pathobionts. Microbiome 2020; 8:60. [PMID: 32354347 PMCID: PMC7193420 DOI: 10.1186/s40168-020-00818-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 03/02/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND The multifaceted interactions between gastrointestinal (GI) helminth parasites, host gut microbiota and immune system are emerging as a key area of research within the field of host-parasite relationships. In spite of the plethora of data available on the impact that GI helminths exert on the composition of the gut microflora, whether alterations of microbial profiles are caused by direct parasite-bacteria interactions or, indirectly, by alterations of the GI environment (e.g. mucosal immunity) remains to be determined. Furthermore, no data is thus far available on the downstream roles that qualitative and quantitative changes in gut microbial composition play in the overall pathophysiology of parasite infection and disease. RESULTS In this study, we investigated the fluctuations in microbiota composition and local immune microenvironment of sheep vaccinated against, and experimentally infected with, the 'brown stomach worm' Teladorsagia circumcincta, a parasite of worldwide socio-economic significance. We compared the faecal microbial profiles of vaccinated and subsequently infected sheep with those obtained from groups of unvaccinated/infected and unvaccinated/uninfected animals. We show that alterations of gut microbial composition are associated mainly with parasite infection, and that this involves the expansion of populations of bacteria with known pro-inflammatory properties that may contribute to the immunopathology of helminth disease. Using novel quantitative approaches for the analysis of confocal microscopy-derived images, we also show that gastric tissue infiltration of T cells is driven by parasitic infection rather than anti-helminth vaccination. CONCLUSIONS Teladorsagia circumcincta infection leads to an expansion of potentially pro-inflammatory gut microbial species and abomasal T cells. This data paves the way for future experiments aimed to determine the contribution of the gut flora to the pathophysiology of parasitic disease, with the ultimate aim to design and develop novel treatment/control strategies focused on preventing and/or restricting bacterial-mediated inflammation upon infection by GI helminths. Video Abstract.
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Affiliation(s)
- Alba Cortés
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - John Wills
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Xiaopei Su
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Rachel E Hewitt
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Jack Robertson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Riccardo Scotti
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Daniel R G Price
- Moredun Research Institute, Pentlands Science Park, Edinburgh, EH26 0PZ, UK
| | - Yvonne Bartley
- Moredun Research Institute, Pentlands Science Park, Edinburgh, EH26 0PZ, UK
| | - Tom N McNeilly
- Moredun Research Institute, Pentlands Science Park, Edinburgh, EH26 0PZ, UK
| | | | - Jonathan J Powell
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Alasdair J Nisbet
- Moredun Research Institute, Pentlands Science Park, Edinburgh, EH26 0PZ, UK
| | - Cinzia Cantacessi
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK.
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da Silva AB, Miniter M, Thom W, Hewitt RE, Wills J, Jugdaohsingh R, Powell JJ. Gastrointestinal Absorption and Toxicity of Nanoparticles and Microparticles: Myth, Reality and Pitfalls explored through Titanium Dioxide. Curr Opin Toxicol 2020; 19:112-120. [PMID: 32566805 PMCID: PMC7305030 DOI: 10.1016/j.cotox.2020.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Daily oral exposure to vast numbers (>1013/adult/day) of micron or nano-sized persistent particles has become the norm for many populations. Significant airborne particle exposure is deleterious, so what about ingestion? Titanium dioxide in food grade form (fgTiO2) , which is an additive to some foods, capsules, tablets and toothpaste, may provide clues. Certainly, exposed human populations accumulate these particles in specialised intestinal cells at the base of large lymphoid follicles (Peyer's patches) and it's likely that a degree of absorption goes beyond this- i.e. lymphatics to blood circulation to tissues. We critically review the evidence and pathways. Regarding potential adverse effects, our primary message, for today's state-of-art, is that in vivo models have not been good enough and at times woeful. We provide a 'caveats list' to improve approaches and experimentation and illustrate why studies on biomarkers of particle uptake, and lower gut/mesenteric lymph nodes as targets, should be prioritized.
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Affiliation(s)
- Alessandra Barreto da Silva
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - Michelle Miniter
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - William Thom
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - Rachel E Hewitt
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - John Wills
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - Ravin Jugdaohsingh
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
| | - Jonathan J Powell
- Biomineral Research Group, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
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11
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Ilett M, Wills J, Rees P, Sharma S, Micklethwaite S, Brown A, Brydson R, Hondow N. Application of automated electron microscopy imaging and machine learning to characterise and quantify nanoparticle dispersion in aqueous media. J Microsc 2019; 279:177-184. [PMID: 31823372 PMCID: PMC7496512 DOI: 10.1111/jmi.12853] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/06/2019] [Accepted: 12/07/2019] [Indexed: 12/11/2022]
Abstract
For many nanoparticle applications it is important to understand dispersion in liquids. For nanomedicinal and nanotoxicological research this is complicated by the often complex nature of the biological dispersant and ultimately this leads to severe limitations in the analysis of the nanoparticle dispersion by light scattering techniques. Here we present an alternative analysis and associated workflow which utilises electron microscopy. The need to collect large, statistically relevant datasets by imaging vacuum dried, plunge frozen aliquots of suspension was accomplished by developing an automated STEM imaging protocol implemented in an SEM fitted with a transmission detector. Automated analysis of images of agglomerates was achieved by machine learning using two free open‐source software tools: CellProfiler and ilastik. The specific results and overall workflow described enable accurate nanoparticle agglomerate analysis of particles suspended in aqueous media containing other potential confounding components such as salts, vitamins and proteins. Lay Description In order to further advance studies in both nanomedicine and nanotoxicology, we need to continue to understand the dispersion of nanoparticles in biological fluids. These biological environments often contain a number of components such as salts, vitamins and proteins which can lead to difficulties when using traditional techniques to monitor dispersion. Here we present an alternative analysis which utilises electron microscopy. In order to use this approach statistically relevant large image datasets were collected from appropriately prepared samples of nanoparticle suspensions by implementing an automated imaging protocol. Automated analysis of these images was achieved through machine learning using two readily accessible freeware; CellProfiler and ilastik. The workflow presented enables accurate nanoparticle dispersion analysis of particles suspended in more complex biological media.
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Affiliation(s)
- M Ilett
- School of Chemical and Process Engineering, University of Leeds, Leeds, U.K
| | - J Wills
- Department of Veterinary Medicine, University of Cambridge, Cambridge, U.K
| | - P Rees
- Centre for Nanohealth, Swansea University, College of Engineering, Swansea, U.K
| | - S Sharma
- School of Chemical and Process Engineering, University of Leeds, Leeds, U.K
| | - S Micklethwaite
- School of Chemical and Process Engineering, University of Leeds, Leeds, U.K
| | - A Brown
- School of Chemical and Process Engineering, University of Leeds, Leeds, U.K
| | - R Brydson
- School of Chemical and Process Engineering, University of Leeds, Leeds, U.K
| | - N Hondow
- School of Chemical and Process Engineering, University of Leeds, Leeds, U.K
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12
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Abstract
Abstract
Background
There is increasing reliance on the internet as a source of health information including for those seeking information about fertility. This study investigates how people access, understand and process online fertility information and engage with digital services.
Methods
Purposive sampling was used to recruit 27 participants from a range of groups including those diagnosed with infertility, those who successfully conceived after a period of infertility, same sex couples, those over 40 and younger people making decisions about delaying parenthood. Semi structured telephone interviews explored information seeking behaviour and ehealth literacy competencies. Data were analysed using thematic analysis.
Results
Digital platforms were identified as a primary source of information but presented barriers including gaps in content, and concerns about relevancy and complexity. Source credibility was a priority alongside a recognition that emotional drivers led to the active seeking of specific information. Participants described a journey from general information to specific, detailed and tailored content. Participants moved between conversational forums on social media sites and information based internet platforms as part of an ongoing process of identifying and understanding information. However, participants were typically purveyors of information in their real world relationships. Information was used to prepare for and understand interactions with health professionals.
Conclusions
Sources of digital information need to respond to the ehealth literacy competencies of users. Users go beyond the passive accessing of information through digital platforms and are actively engaged as contributors of information through social media and app based technology. The value placed on other people in accessing and understanding fertility information, through online forums and virtual communities, shows the importance and complexity of distributed health literacy.
Key messages
Digital platforms are a key source of information around fertility. Interaction with digital platforms is complex and requires the digital environment to respond to their ehealth literacy needs.
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Affiliation(s)
- S Sykes
- London South Bank University, London, UK
| | - J Wills
- London South Bank University, London, UK
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13
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Meehan J, Gray M, Turnbull AK, Martinez-Perez C, Bonello M, Ward C, Langdon SP, McLaughlin S, MacLennan M, Dixon JM, Wills J, Quinn N, Finich AJ, von Kriegsheim A, Cameron D, Kunkler IH, Murray A, Argyle D. Abstract P3-12-24: Tumor-secreted predictive biomarkers of response to radiotherapy in breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-12-24] [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: 11/16/2022]
Abstract
Abstract
Background:In breast cancer (BC), radiotherapy (RT) is used adjuvantly to prevent recurrence and also in the palliative setting. Clinical signs of RT response are often not apparent for several weeks post-treatment and we currently lack tools to predict or monitor tumor response to RT early during treatment. The aim was to identify tumor-secreted biomarkers whose release reflects response to RT, which could be monitored during treatment in the blood or intratumorally by an implantable biosensor, currently under development within the Implantable Microsystems for Personalised Anti-Cancer Therapy (IMPACT) program.
Methods: A series of experiments assessed the effect of different radiation doses (2-10Gy) on 3 human BC cell lines – MDA-MB-231 (ER-), MCF-7 (ER+) and HBL-100 (ER-) –, 1 canine breast cancer and 2 sheep lung cancer lines. Culture media was collected from each dose experiment at a range of post-radiation time-points (1-24 hours). Proteins were isolated from collected media for secretome mass spectrometry (MS) analysis. A subset of treatment/time conditions were repeated in the same BC cell lines and radioresistant (RR) derivatives from which RNA was extracted and analysed using Lexogen QuantSeq for whole-genome transcriptomics.In-lab candidate biomarker validation was carried out using immuhistochemistry (IHC), immunofluorescence (IF) and western blotting (WB) using validated antibodies. Levels of candidate biomarkers were also assessed in normal and untreated BC tissues using IHC. ELISA-based methods are currently under investigation for detection of the lead candidate biomarkers in the blood of large animal cancer models treated with RT.
Results: Biomarker discovery using the MS data revealed 4 promising candidates: EIF3G, SEC24C, YBX3 and TK1. These are released from BC and animal cancer cells sensitive to radiation in a dose-dependent manner 24 hours after treatment. Analysis of the transcriptomic data showed an 8-fold higher expression of the genes encoding the 4 candidates in the radio-sensitive parental cell lines compared to the RR cell lines. IF and WB confirmed lower intracellular expression of the 4 proteins in RR cells compared to the parental lines. WB of collected culture media confirmed release of each of the 4 candidates 24 hours after a 2Gy dose of radiation in only the parental lines. GAPDH was not found in these media samples, demonstrating that protein release was not due to cell lysis.
Conclusions:
· We have identified 4 promising biomarkers which are released from cancer cells sensitive to RT and not released from RR derivatives.
· All 4 candidates are released 24 hours after a 2Gy radiation dose, which fits with the current clinical dosing schedule where radiation is administered at 24 hour intervals. Ongoing work will elucidate if these biomarkers can be reliably detected in blood or intratumorally using implantable biosensors.
· There are currently no validated predictive tools to monitor RT response during treatment. If successfully validated, these biomarkers could have a clinical role in personalising RT dosing schedules and durations for solid tumors in the neoadjuvant and palliative setting, thus optimising treatment and preventing the administration of ineffective RT and its associated side effects.
Citation Format: Meehan J, Gray M, Turnbull AK, Martinez-Perez C, Bonello M, Ward C, Langdon SP, McLaughlin S, MacLennan M, Dixon JM, Wills J, Quinn N, Finich AJ, von Kriegsheim A, Cameron D, Kunkler IH, Murray A, Argyle D. Tumor-secreted predictive biomarkers of response to radiotherapy in breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-24.
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Affiliation(s)
- J Meehan
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - M Gray
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - AK Turnbull
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - C Martinez-Perez
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - M Bonello
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - C Ward
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - SP Langdon
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - S McLaughlin
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - M MacLennan
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - JM Dixon
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - J Wills
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - N Quinn
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - AJ Finich
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - A von Kriegsheim
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - D Cameron
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - IH Kunkler
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - A Murray
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - D Argyle
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Institute of Sensors, Signals and Systems, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom; School of Engineering, Faraday Building, King's Buildings, University of Edinburgh, Edinburgh, United Kingdom; The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
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14
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Abstract
Background There is evidence that the prevalence of overweight and obesity among nurses is increasing. As well as the impact on health, the costs associated with obesity include workplace injury, lost productivity and sickness absence. Finding ways to address obesity in nurses may be a challenge because of the barriers they face in leading a healthy lifestyle. Aims To identify the available evidence for interventions to address obesity in nurses. Methods Databases searched included CINAHL, SCOPUS (which encompasses the Cochrane Database of Systematic Reviews), PsycINFO, MEDLINE and British Nursing Index. Ancillary searching of the grey literature was conducted for case studies of weight management interventions in National Health Service (NHS) settings. Inclusion criteria were studies involving nurses that reported on interventions addressing health behaviours that contribute to obesity and included at least one obesity-related outcome measure. Results Eleven primary studies were found concerning lifestyle interventions for nurses. There was no strong evidence for any particular intervention to address obesity, although integrating interventions into nurses' daily working lives may be important. Case studies from the grey literature showcased a range of interventions, but very few studies reported outcomes. Conclusions The review demonstrates that there is insufficient good-quality evidence about successful interventions to address obesity in nurses. Evidence does indicate that interventions should be designed around the specific barriers nurses may face in leading a healthy lifestyle.
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Affiliation(s)
- M Kelly
- School of Health and Social Care, London South Bank University, London, UK
| | - J Wills
- School of Health and Social Care, London South Bank University, London, UK
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15
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Turnbull AK, Fernando A, Martinez-Perez C, Finch AJ, von Kriegsheim A, Wills J, Quinn N, Selli C, Mosley D, Langdon SP, Sims AH, Dixon JM. Abstract P4-08-02: Understanding the mechanisms of action underlying the role of IL6ST, a key biomarker for prediction of response to endocrine therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-08-02] [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: 11/16/2022]
Abstract
Abstract
Introduction: IL6ST is regarded as a putative ER target gene. Recently it has been recognised as a key biomarker for prediction of response to endocrine therapy (ET), having been included as the primary biomarker in our EA2Clin test and as an ER-signalling gene in the EndoPredict test. In both tests higher IL6ST expression is associated with a better response to ET and better prognosis. Despite its importance as a biomarker, little is known about its functional role in breast cancer (BC).
Methods: Pre- and on-treatment (at 14-days and at surgery) samples were collected from 102 post-menopausal women with ER+ BC, treated with 3-6 months of neoadjuvant ET. RNA was extracted for whole-genome expression analysis. From a subset with available fresh frozen tissue (28 patients, 83 samples) protein was extracted and proteome analysis using mass spectrometry is currently underway – results available for SABCS 2017. Immunohistochemistry was performed on FFPE tissue microarrays (TMAs) comprising pre-treatment samples from 102 patients. Cytoplasmic/membrane staining was scored using a graduated scale (0-3+) and nuclear staining was graded using an Immunoscore.
Results: IL6ST exists in membrane-bound and soluble forms of varying size. The full-length membrane bound molecule comprises 8 domains: 6 extracellular, 1 transmembrane and 1 cytoplasmic. In the EA2Clin test, pre-treatment BC tissues are stained for IL6ST with an antibody specific for a region spanning the transmembrane and cytoplasmic domains. TMAs were stained for IL6ST with both this and a second antibody binding the extracellular part, detecting both full-length and most soluble isoforms. Levels of both were correlated (R=0.82, P<0.0001).
IL6ST is known to mediate the action of cytokines including IL6, OSM and LIF via downstream regulation of pathways such as JAK/STAT. TMAs were stained for antibodies against IL6ST, OSM, IL6, total STAT3, pSTAT3 (Tyr705) and pSTAT3 (Ser727). IL6ST was scored as low (0/1+) or high (2+/3+). There was a positive association between levels of IL6ST and IL6 (P=0.02) and total STAT3 (P=0.003). There was no association between IL6ST and OSM or either pSTAT3.
Supervised gene expression analysis comparing pre-treatment samples with high and low IL6ST levels revealed increased levels of STAT3-regulated genes: cell cycle (CEBPD, CDKN1B), apoptosis (NFIL3, ATF3, BCL2), extracellular matrix remodelling (ADM, SEPRINE1-3) and interferon signalling (IFIT1, IFI44, IFI27). Unsupervised gene enrichment analysis revealed increased expression of genes involved with JAK/STAT, PI3K, mTOR and ERBB1 signalling in tumours expressing higher IL6ST levels. Lower levels were associated with increased energy generation, cellular metabolism and epithelial-mesenchymal transition.
Conclusions:
• This is the first matched whole-genome and mass spectrometry proteome analysis of sequential ET-treated BC patients
• IL6ST predicts response to ET – it is used in2 independent assays
• Levels of full-length IL6ST appear to be the most important for ET response prediction
• IL6ST may have an active role in BC cells, mediating signalling of cytokines such as IL6 through the JAK/STAT pathway and subsequent downstream transcriptional regulation.
Citation Format: Turnbull AK, Fernando A, Martinez-Perez C, Finch AJ, von Kriegsheim A, Wills J, Quinn N, Selli C, Mosley D, Langdon SP, Sims AH, Dixon JM. Understanding the mechanisms of action underlying the role of IL6ST, a key biomarker for prediction of response to endocrine therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-08-02.
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Affiliation(s)
- AK Turnbull
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - A Fernando
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - C Martinez-Perez
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - AJ Finch
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - A von Kriegsheim
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - J Wills
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - N Quinn
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - C Selli
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - D Mosley
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - SP Langdon
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - AH Sims
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
| | - JM Dixon
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Breast Unit, Western General Hospital, Edinburgh, United Kingdom
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Bouwmeester S, Verkoeijen PPJL, Aczel B, Barbosa F, Bègue L, Brañas-Garza P, Chmura TGH, Cornelissen G, Døssing FS, Espín AM, Evans AM, Ferreira-Santos F, Fiedler S, Flegr J, Ghaffari M, Glöckner A, Goeschl T, Guo L, Hauser OP, Hernan-Gonzalez R, Herrero A, Horne Z, Houdek P, Johannesson M, Koppel L, Kujal P, Laine T, Lohse J, Martins EC, Mauro C, Mischkowski D, Mukherjee S, Myrseth KOR, Navarro-Martínez D, Neal TMS, Novakova J, Pagà R, Paiva TO, Palfi B, Piovesan M, Rahal RM, Salomon E, Srinivasan N, Srivastava A, Szaszi B, Szollosi A, Thor KØ, Tinghög G, Trueblood JS, Van Bavel JJ, van 't Veer AE, Västfjäll D, Warner M, Wengström E, Wills J, Wollbrant CE. Registered Replication Report: Rand, Greene, and Nowak (2012). Perspect Psychol Sci 2017; 12:527-542. [PMID: 28475467 PMCID: PMC5453400 DOI: 10.1177/1745691617693624] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In an anonymous 4-person economic game, participants contributed more money to a common project (i.e., cooperated) when required to decide quickly than when forced to delay their decision (Rand, Greene & Nowak, 2012), a pattern consistent with the social heuristics hypothesis proposed by Rand and colleagues. The results of studies using time pressure have been mixed, with some replication attempts observing similar patterns (e.g., Rand et al., 2014) and others observing null effects (e.g., Tinghög et al., 2013; Verkoeijen & Bouwmeester, 2014). This Registered Replication Report (RRR) assessed the size and variability of the effect of time pressure on cooperative decisions by combining 21 separate, preregistered replications of the critical conditions from Study 7 of the original article (Rand et al., 2012). The primary planned analysis used data from all participants who were randomly assigned to conditions and who met the protocol inclusion criteria (an intent-to-treat approach that included the 65.9% of participants in the time-pressure condition and 7.5% in the forced-delay condition who did not adhere to the time constraints), and we observed a difference in contributions of -0.37 percentage points compared with an 8.6 percentage point difference calculated from the original data. Analyzing the data as the original article did, including data only for participants who complied with the time constraints, the RRR observed a 10.37 percentage point difference in contributions compared with a 15.31 percentage point difference in the original study. In combination, the results of the intent-to-treat analysis and the compliant-only analysis are consistent with the presence of selection biases and the absence of a causal effect of time pressure on cooperation.
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Ratcliffe S, Jugdaohsingh R, Vivancos J, Marron A, Deshmukh R, Ma JF, Mitani-Ueno N, Robertson J, Wills J, Boekschoten MV, Müller M, Mawhinney RC, Kinrade SD, Isenring P, Bélanger RR, Powell JJ. Identification of a mammalian silicon transporter. Am J Physiol Cell Physiol 2017; 312:C550-C561. [PMID: 28179233 PMCID: PMC5451523 DOI: 10.1152/ajpcell.00219.2015] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 12/30/2022]
Abstract
Silicon (Si) has long been known to play a major physiological and structural role in certain organisms, including diatoms, sponges, and many higher plants, leading to the recent identification of multiple proteins responsible for Si transport in a range of algal and plant species. In mammals, despite several convincing studies suggesting that silicon is an important factor in bone development and connective tissue health, there is a critical lack of understanding about the biochemical pathways that enable Si homeostasis. Here we report the identification of a mammalian efflux Si transporter, namely Slc34a2 (also termed NaPiIIb), a known sodium-phosphate cotransporter, which was upregulated in rat kidney following chronic dietary Si deprivation. Normal rat renal epithelium demonstrated punctate expression of Slc34a2, and when the protein was heterologously expressed in Xenopus laevis oocytes, Si efflux activity (i.e., movement of Si out of cells) was induced and was quantitatively similar to that induced by the known plant Si transporter OsLsi2 in the same expression system. Interestingly, Si efflux appeared saturable over time, but it did not vary as a function of extracellular HPO42− or Na+ concentration, suggesting that Slc34a2 harbors a functionally independent transport site for Si operating in the reverse direction to the site for phosphate. Indeed, in rats with dietary Si depletion-induced upregulation of transporter expression, there was increased urinary phosphate excretion. This is the first evidence of an active Si transport protein in mammals and points towards an important role for Si in vertebrates and explains interactions between dietary phosphate and silicon.
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Affiliation(s)
- Sarah Ratcliffe
- Medical Research Council Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Ravin Jugdaohsingh
- Medical Research Council Elsie Widdowson Laboratory, Cambridge, United Kingdom.,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Julien Vivancos
- Département de Phytologie-Faculté des Sciences de l'Agriculture et de l'Alimentation, Centre de Recherche en Horticulture, Université Laval, Quebec City, Quebec, Canada
| | - Alan Marron
- Department of Zoology, University of Cambridge, Cambridge United Kingdom
| | - Rupesh Deshmukh
- Department of Zoology, University of Cambridge, Cambridge United Kingdom
| | - Jian Feng Ma
- Institute of Plant Science and Resources, Okayama University, Kurashiki, Japan
| | - Namiki Mitani-Ueno
- Institute of Plant Science and Resources, Okayama University, Kurashiki, Japan
| | - Jack Robertson
- Medical Research Council Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - John Wills
- Mechanistic Studies Division, Environmental Health Sciences & Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Mark V Boekschoten
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Michael Müller
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | - Stephen D Kinrade
- Department of Chemistry, Lakehead University, Thunder Bay, Canada; and
| | - Paul Isenring
- Nephrology Group L'Hôtel-Dieu de Québec Institution, Department of Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Richard R Bélanger
- Département de Phytologie-Faculté des Sciences de l'Agriculture et de l'Alimentation, Centre de Recherche en Horticulture, Université Laval, Quebec City, Quebec, Canada
| | - Jonathan J Powell
- Medical Research Council Elsie Widdowson Laboratory, Cambridge, United Kingdom; .,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Wills J, Wills J, Waqar M, Conright K. You Left Me Speechless: A Case of Valproic Acid Induced Aphasia. J Am Med Dir Assoc 2016. [DOI: 10.1016/j.jamda.2015.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Manshian BB, Soenen SJ, Brown A, Hondow N, Wills J, Jenkins GJS, Doak SH. Genotoxic capacity of Cd/Se semiconductor quantum dots with differing surface chemistries. Mutagenesis 2015; 31:97-106. [PMID: 26275419 PMCID: PMC4696518 DOI: 10.1093/mutage/gev061] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Quantum dots (QD) have unique electronic and optical properties promoting biotechnological advances. However, our understanding of the toxicological structure–activity relationships remains limited. This study aimed to determine the biological impact of varying nanomaterial surface chemistry by assessing the interaction of QD with either a negative (carboxyl), neutral (hexadecylamine; HDA) or positive (amine) polymer coating with human lymphoblastoid TK6 cells. Following QD physico-chemical characterisation, cellular uptake was quantified by optical and electron microscopy. Cytotoxicity was evaluated and genotoxicity was characterised using the micronucleus assay (gross chromosomal damage) and the HPRT forward mutation assay (point mutagenicity). Cellular damage mechanisms were also explored, focusing on oxidative stress and mitochondrial damage. Cell uptake, cytotoxicity and genotoxicity were found to be dependent on QD surface chemistry. Carboxyl-QD demonstrated the smallest agglomerate size and greatest cellular uptake, which correlated with a dose dependent increase in cytotoxicity and genotoxicity. Amine-QD induced minimal cellular damage, while HDA-QD promoted substantial induction of cell death and genotoxicity. However, HDA-QD were not internalised by the cells and the damage they caused was most likely due to free cadmium release caused by QD dissolution. Oxidative stress and induced mitochondrial reactive oxygen species were only partially associated with cytotoxicity and genotoxicity induced by the QD, hence were not the only mechanisms of importance. Colloidal stability, nanoparticle (NP) surface chemistry, cellular uptake levels and the intrinsic characteristics of the NPs are therefore critical parameters impacting genotoxicity induced by QD.
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Affiliation(s)
- Bella B Manshian
- Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Biomedical NMR Unit-MoSAIC, Department of Medicine, KU Leuven, B-3000 Leuven, Belgium and
| | - Stefaan J Soenen
- Biomedical NMR Unit-MoSAIC, Department of Medicine, KU Leuven, B-3000 Leuven, Belgium and
| | - Andy Brown
- Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Nicole Hondow
- Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - John Wills
- Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Gareth J S Jenkins
- Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Shareen H Doak
- Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK,
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Avancini D, Menzies GE, Morgan C, Wills J, Johnson GE, White PA, Lewis PD. MutAIT: an online genetic toxicology data portal and analysis tools. Mutagenesis 2015. [PMID: 26208916 DOI: 10.1093/mutage/gev050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Assessment of genetic toxicity and/or carcinogenic activity is an essential element of chemical screening programs employed to protect human health. Dose-response and gene mutation data are frequently analysed by industry, academia and governmental agencies for regulatory evaluations and decision making. Over the years, a number of efforts at different institutions have led to the creation and curation of databases to house genetic toxicology data, largely, with the aim of providing public access to facilitate research and regulatory assessments. This article provides a brief introduction to a new genetic toxicology portal called Mutation Analysis Informatics Tools (MutAIT) (www.mutait.org) that provides easy access to two of the largest genetic toxicology databases, the Mammalian Gene Mutation Database (MGMD) and TransgenicDB. TransgenicDB is a comprehensive collection of transgenic rodent mutation data initially compiled and collated by Health Canada. The updated MGMD contains approximately 50 000 individual mutation spectral records from the published literature. The portal not only gives access to an enormous quantity of genetic toxicology data, but also provides statistical tools for dose-response analysis and calculation of benchmark dose. Two important R packages for dose-response analysis are provided as web-distributed applications with user-friendly graphical interfaces. The 'drsmooth' package performs dose-response shape analysis and determines various points of departure (PoD) metrics and the 'PROAST' package provides algorithms for dose-response modelling. The MutAIT statistical tools, which are currently being enhanced, provide users with an efficient and comprehensive platform to conduct quantitative dose-response analyses and determine PoD values that can then be used to calculate human exposure limits or margins of exposure.
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Affiliation(s)
| | | | | | - John Wills
- Environmental Health Sciences and Research Bureau, Environmental and Radiation Health Sciences Directorate, Healthy Environments and Consumer Safety Branch, Health Canada, Tunney's Pasture Building 8 (P/L 0803A), 50 Colombine Driveway, Ottawa, Ontario K1A 0K9 Canada
| | | | - Paul A White
- Environmental Health Sciences and Research Bureau, Environmental and Radiation Health Sciences Directorate, Healthy Environments and Consumer Safety Branch, Health Canada, Tunney's Pasture Building 8 (P/L 0803A), 50 Colombine Driveway, Ottawa, Ontario K1A 0K9 Canada
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Hieke S, Kuljanic N, Wills J, Miklavec K, Pravst I. Prevalence of nutrition and health claims on baby foods in 5 EU Member States. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Manshian BB, Soenen SJ, Al-Ali A, Brown A, Hondow N, Wills J, Jenkins GJS, Doak SH. Cell type-dependent changes in CdSe/ZnS quantum dot uptake and toxic endpoints. Toxicol Sci 2015; 144:246-58. [PMID: 25601991 PMCID: PMC4372665 DOI: 10.1093/toxsci/kfv002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [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] [Indexed: 11/13/2022] Open
Abstract
Toxicity of nanoparticles (NPs) is often correlated with the physicochemical characteristics of the materials. However, some discrepancies are noted in in-vitro studies on quantum dots (QDs) with similar physicochemical properties. This is partly related to variations in cell type. In this study, we show that epithelial (BEAS-2B), fibroblast (HFF-1), and lymphoblastoid (TK6) cells show different biological responses following exposure to QDs. These cells represented the 3 main portals of NP exposure: bronchial, skin, and circulatory. The uptake and toxicity of negatively and positively charged CdSe:ZnS QDs of the same core size but with different surface chemistries (carboxyl or amine polymer coatings) were investigated in full and reduced serum containing media following 1 and 3 cell cycles. Following thorough physicochemical characterization, cellular uptake, cytotoxicity, and gross chromosomal damage were measured. Cellular damage mechanisms in the form of reactive oxygen species and the expression of inflammatory cytokines IL-8 and TNF-α were assessed. QDs uptake and toxicity significantly varied in the different cell lines. BEAS-2B cells demonstrated the highest level of QDs uptake yet displayed a strong resilience with minimal genotoxicity following exposure to these NPs. In contrast, HFF-1 and TK6 cells were more susceptible to toxicity and genotoxicity, respectively, as a result of exposure to QDs. Thus, this study demonstrates that in addition to nanomaterial physicochemical characterization, a clear understanding of cell type-dependent variation in uptake coupled to the inherently different capacities of the cell types to cope with exposure to these exogenous materials are all required to predict genotoxicity.
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Affiliation(s)
- Bella B Manshian
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Stefaan J Soenen
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Abdullah Al-Ali
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Andy Brown
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Nicole Hondow
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - John Wills
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Gareth J S Jenkins
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
| | - Shareen H Doak
- *Institute of Life Science, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK, Department of Medicine, Biomedical NMR Unit-MoSAIC, KU Leuven, B-3000 Leuven, Belgium and Institute for Materials Research, SCaPE, University of Leeds, Leeds LS2 9JT, UK
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Al-Ali A, Singh N, Manshian B, Wilkinson T, Wills J, Jenkins GJS, Doak SH. Quantum dot induced cellular perturbations involving varying toxicity pathways. Toxicol Res (Camb) 2015. [DOI: 10.1039/c4tx00175c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Quantum dots (QD) with varying surface chemistry can have an impact on cellular uptake and a range of indicators for cell perturbation.
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Affiliation(s)
- Abdullah Al-Ali
- Institute of Life Science
- College of Medicine
- Swansea University
- Swansea
- UK
| | - Neenu Singh
- Institute of Life Science
- College of Medicine
- Swansea University
- Swansea
- UK
| | - Bella Manshian
- Biomedical NMR unit-MoSAIC
- Department of Medicine
- KU Leuven
- B-3000 Leuven
- Belgium
| | - Tom Wilkinson
- Institute of Life Science
- College of Medicine
- Swansea University
- Swansea
- UK
| | - John Wills
- Institute of Life Science
- College of Medicine
- Swansea University
- Swansea
- UK
| | | | - Shareen H. Doak
- Institute of Life Science
- College of Medicine
- Swansea University
- Swansea
- UK
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25
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Parker MB, Wills J, Wills GB. Reconstructed Living Lab: supporting drug users and families through co-operative counselling using mobile phone technology. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2010.10873982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Seager AL, Shah UK, Brusehafer K, Wills J, Manshian B, Chapman KE, Thomas AD, Scott AD, Doherty AT, Doak SH, Johnson GE, Jenkins GJS. Recommendations, evaluation and validation of a semi-automated, fluorescent-based scoring protocol for micronucleus testing in human cells. Mutagenesis 2014; 29:155-64. [DOI: 10.1093/mutage/geu008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Traill WB, Mazzocchi M, Niedźwiedzka B, Shankar B, Wills J. The EATWELL project: Recommendations for healthy eating policy interventions across Europe. NUTR BULL 2013. [DOI: 10.1111/nbu.12048] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - J. Wills
- European Food Information Council (EUFIC); Brussels; Belgium
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Abstract
BACKGROUND Environmental health practice in the field of occupational health and safety is traditionally concerned with protecting health relating to the workplace. However, little is currently known about environmental health officers' (EHOs) perceptions of their role in workplace health improvement, a pertinent topic in light of the recent government agenda for improving the health of the workforce in the UK. AIMS To explore how EHOs perceive workplace health improvement and its relevance to their professional role. METHODS A qualitative methodology was employed, using a case-study design with thematic analysis of 15 transcripts of in-depth telephone interviews with EHOs working in London, UK. RESULTS EHOs view themselves primarily as enforcement officers, with legislation guiding their understandings of workplace health. Many interpret work-related ill health in terms of safety and physical injury and do not feel competent in assessing broader psychosocial elements of ill health. However, a few EHOs welcomed the opportunity to promote health in the workplace, recognizing the importance of prevention. CONCLUSIONS This study indicates a gap between the contemporary EHO role framed by professional bodies as holistic and contributing to public health goals and the role perceived by EHOs 'on the ground'. A more traditional, protective and enforcement-based approach persists among EHOs in this sample, and few feel they have skills to address determinants beyond physical hazards to health. Yet, a minority of EHOs adopted a more health-promoting approach, suggesting that the potential contribution of EHOs to the workplace health improvement agenda should be explored further.
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Affiliation(s)
- J Reynolds
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
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29
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Taheri S, Gasparovic C, Huisa BN, Adair JC, Edmonds E, Prestopnik J, Grossetete M, Shah NJ, Wills J, Qualls C, Rosenberg GA. Blood-brain barrier permeability abnormalities in vascular cognitive impairment. Stroke 2011; 42:2158-63. [PMID: 21719768 DOI: 10.1161/strokeaha.110.611731] [Citation(s) in RCA: 167] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Disruption of the blood-brain barrier has been proposed to be important in vascular cognitive impairment. Increased cerebrospinal fluid albumin and contrast-enhanced MRI provide supporting evidence, but quantification of the blood-brain barrier permeability in patients with vascular cognitive impairment is lacking. Therefore, we acquired dynamic contrast-enhanced MRI to quantify blood-brain barrier permeability in vascular cognitive impairment. Method- We studied 60 patients with suspected vascular cognitive impairment. They had neurological and neuropsychological testing, permeability measurements with dynamic contrast-enhanced MRI, and lumbar puncture to measure albumin index. Patients were separated clinically into subcortical ischemic vascular disease (SIVD), multiple and lacunar infarcts, and leukoaraiosis. Twenty volunteers were controls for the dynamic contrast-enhanced MRI studies, and control cerebrospinal fluid was obtained from 20 individuals undergoing spinal anesthesia for nonneurological problems. RESULTS Thirty-six patients were classified as SIVD, 8 as multiple and lacunar infarcts, and 9 as leukoaraiosis. The albumin index was significantly increased in the SIVD group compared with 20 control subjects. Permeabilities for the patients with vascular cognitive impairment measured by dynamic contrast-enhanced MRI were significantly increased over control subjects (P<0.05). Patient age did not correlate with either the blood-brain barrier permeability or albumin index. Highest albumin index values were seen in the SIVD group (P<0.05) and were significantly increased over multiple and lacunar infarcts. K(i) values were elevated over control subjects in SIVD but were similar to multiple and lacunar infarcts. CONCLUSIONS There was abnormal permeability in white matter in patients with SIVD as shown by dynamic contrast-enhanced MRI and albumin index. Future studies will be needed to determine the relationship of blood-brain barrier damage and development of white matter hyperintensities.
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Affiliation(s)
- Saeid Taheri
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-0001, USA
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Candelario-Jalil E, Thompson J, Taheri S, Grossetete M, Adair JC, Edmonds E, Prestopnik J, Wills J, Rosenberg GA. Matrix metalloproteinases are associated with increased blood-brain barrier opening in vascular cognitive impairment. Stroke 2011; 42:1345-50. [PMID: 21454822 DOI: 10.1161/strokeaha.110.600825] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Subcortical ischemic vascular disease (SIVD) is a major form of vascular cognitive impairment (VCI) due to small vessel disease. Matrix metalloproteinases (MMPs) are neutral proteases that disrupt the blood-brain barrier and degrade myelin basic protein under conditions of neuroinflammation. Brain tissues and cerebrospinal fluid (CSF) of patients with VCI have increased levels of MMPs. We hypothesized that patients with SIVD have increased MMPs in the CSF, which are associated with increased CSF albumin. METHODS We studied 60 patients with suspected VCI. Twenty-five were classified as SIVD, whereas other groups included mixed Alzheimer disease and VCI, multiple strokes, and leukoaraiosis when white matter lesions were present and the diagnosis of VCI was uncertain. MMP-2 and MMP-9 in CSF and plasma were measured by gel zymography and indexed to CSF and plasma albumin. MMP-3 activity was measured by fluorescent assay. RESULTS We found reduced MMP-2 index (P<0.001) in the CSF for the full group of patients (SIVD, multiple strokes, mixed Alzheimer disease and VCI, and leukoaraiosis) compared with control subjects, whose CSF was obtained during spinal anesthesia. MMP-3 activity was increased in VCI compared with control subjects (P<0.01). In SIVD, MMP-2 index showed a negative correlation with albumin index, which was absent with the MMP-9 index. Combining MMP-2 index and MMP-3 activity separated the patients with SIVD from the control subjects with high specificity (P<0.0005). CONCLUSIONS Our results support the hypothesis that MMPs are associated with increased CSF albumin and suggest that they may contribute to the pathophysiology of SIVD.
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Affiliation(s)
- Eduardo Candelario-Jalil
- Department of Neurology, MSC 10 5620, 1 University of New Mexico Health Sciences Center, Albuquerque, NM 87131-0001, USA
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Traill WB, Shankar B, Brambila-Macias J, Bech-Larsen T, Aschemann-Witzel J, Strand M, Mazzocchi M, Capacci S, Verbeke W, Perez-Cueto FJA, D'Addesa D, Saba A, Turrini A, Niedźwiedzka B, Kozioł-Kozakowska A, Kijowska V, Piórecka B, Infantes M, Wills J, Smillie L, Chalot F, Lyle D. Interventions to promote healthy eating habits: evaluation and recommendations. Obes Rev 2010; 11:895-8. [PMID: 20202134 DOI: 10.1111/j.1467-789x.2010.00717.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although in several EU Member States many public interventions have been running for the prevention and/or management of obesity and other nutrition-related health conditions, few have yet been formally evaluated. The multidisciplinary team of the EATWELL project will gather benchmark data on healthy eating interventions in EU Member States and review existing information on the effectiveness of interventions using a three-stage procedure (i) Assessment of the intervention's impact on consumer attitudes, consumer behaviour and diets; (ii) The impact of the change in diets on obesity and health and (iii) The value attached by society to these changes, measured in life years gained, cost savings and quality-adjusted life years. Where evaluations have been inadequate, EATWELL will gather secondary data and analyse them with a multidisciplinary approach incorporating models from the psychology and economics disciplines. Particular attention will be paid to lessons that can be learned from private sector that are transferable to the healthy eating campaigns in the public sector. Through consumer surveys and workshops with other stakeholders, EATWELL will assess the acceptability of the range of potential interventions. Armed with scientific quantitative evaluations of policy interventions and their acceptability to stakeholders, EATWELL expects to recommend more appropriate interventions for Member States and the EU, providing a one-stop guide to methods and measures in interventions evaluation, and outline data collection priorities for the future.
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Affiliation(s)
- W B Traill
- Department of Agricultural and Food Economics, University of Reading, Reading, UK.
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Lewis PD, Lewis KE, Ghosal R, Bayliss S, Lloyd AJ, Wills J, Godfrey R, Kloer P, Mur LAJ. Evaluation of FTIR spectroscopy as a diagnostic tool for lung cancer using sputum. BMC Cancer 2010; 10:640. [PMID: 21092279 PMCID: PMC3000851 DOI: 10.1186/1471-2407-10-640] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [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: 03/26/2010] [Accepted: 11/23/2010] [Indexed: 01/27/2023] Open
Abstract
Background Survival time for lung cancer is poor with over 90% of patients dying within five years of diagnosis primarily due to detection at late stage. The main objective of this study was to evaluate Fourier transform infrared spectroscopy (FTIR) as a high throughput and cost effective method for identifying biochemical changes in sputum as biomarkers for detection of lung cancer. Methods Sputum was collected from 25 lung cancer patients in the Medlung observational study and 25 healthy controls. FTIR spectra were generated from sputum cell pellets using infrared wavenumbers within the 1800 to 950 cm-1 "fingerprint" region. Results A panel of 92 infrared wavenumbers had absorbances significantly different between cancer and normal sputum spectra and were associated with putative changes in protein, nucleic acid and glycogen levels in tumours. Five prominent significant wavenumbers at 964 cm-1, 1024 cm-1, 1411 cm-1, 1577 cm-1 and 1656 cm-1 separated cancer spectra from normal spectra into two distinct groups using multivariate analysis (group 1: 100% cancer cases; group 2: 92% normal cases). Principal components analysis revealed that these wavenumbers were also able to distinguish lung cancer patients who had previously been diagnosed with breast cancer. No patterns of spectra groupings were associated with inflammation or other diseases of the airways. Conclusions Our results suggest that FTIR applied to sputum might have high sensitivity and specificity in diagnosing lung cancer with potential as a non-invasive, cost-effective and high-throughput method for screening. Trial Registration ClinicalTrials.gov: NCT00899262
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Traill WB, Pérez-Cueto FJA, Shankar B, Brambila-Macias J, Bech-Larsen T, Aschemann-Witzel J, Strand M, Mazzocchi M, Capacci S, D'Addesa D, Saba A, Turrini A, Niedzwiedzka B, Kijowska V, Piorecka B, Infantes M, Wills J, Smillie L, Chalot F, Lyle D, Verbeke W. EATWELL project: approaching European healthy eating policies from a multi-disciplinary perspective. NUTR HOSP 2010; 25:867-868. [PMID: 21336449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
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Wills J, Ellison GTH. Integrating services for public health: challenges facing multidisciplinary partnership working. Public Health 2007; 121:546-8. [PMID: 17462681 DOI: 10.1016/j.puhe.2007.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2005] [Revised: 12/30/2006] [Accepted: 01/05/2007] [Indexed: 11/23/2022]
Affiliation(s)
- J Wills
- Institute of Primary Care and Public Health, London South Bank University, Borough Road, London SE1 0AA, UK.
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Abstract
The Grand Canyon is a vast place. It is almost incomprehensible in size. And yet it can also seem strangely crowded. Millions of tourists flock to the Grand Canyon in northern Arizona every year. In 1999, almost 5 million people visited, the highest figure in Canyon history. And each one of them expected to see a wild, free and untrammelled landscape. Despite the obvious natural resources, this expectation has proved anything but easy to satisfy. The US National Park Service (NPS), responsible for the management of most large North American parks (along with several historic sites and museums), has struggled to make or keep the canyon "grand". Park rangers have grappled with a multitude of issues during the past century, including automobile congestion, drying of the Colorado River and uranium mining inside the park. Conservation has posed a unique set of challenges. On a fundamental level, "restoring" the Grand Canyon to its "original" wilderness setting has proved intensely problematic. In the field of wildlife management, restoring the Canyon to its pre-Columbian splendour has entailed some tough decisions--none more so than a 1976 plan to eliminate a sizeable population of feral burros (wild donkeys) roaming the preserve, animals classified as exotics by the NPS.
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Affiliation(s)
- John Wills
- School of History, University of Kent, Canterbury CT2 7NX, Kent, UK.
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Wills J, Schwend RM, Paterson A, Albin MS. Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis. Spine (Phila Pa 1976) 2005; 30:E629-35. [PMID: 16227882 DOI: 10.1097/01.brs.0000182347.85827.0c] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. OBJECTIVES To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. SUMMARY OF BACKGROUND DATA Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. METHODS Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. RESULTS Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. CONCLUSIONS Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.
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Affiliation(s)
- John Wills
- Department of Anesthesia, University of New Mexico, Albuquerque, NM, USA
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Wills J, Dolphin S, Albiston L, Parmar P, Westgate GE, Harrap GJ. Free internal lipids in hair from pre- and post-menopausal women. Int J Cosmet Sci 2005. [DOI: 10.1111/j.1467-2494.2005.00259_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
We report a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of population migration, appearing in the USA. This disease predominantly affects the heart and the gastrointestinal system. This report discusses the parasite, the acute and chronic phases of Chagas' disease and highlights its medical implications, including maternal-fetal transfer of Trypanosoma cruzi.
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Affiliation(s)
- H B Martin
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, University of New Mexico, Albuquerque, NM 87131-5216, USA
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Abstract
Amidst the winds of change that are blowing across the UK public health (PH) landscape in relation to the essential abilities and national standards that are required for the 'art and science' of PH, the preparation for a new cadre of 'PH professionals' is already underway. Several postgraduate masters programmes in public health (MPH) have taken on board the challenge of addressing the requisite sets of skills and expertise as a guide to their content and delivery. Although there are recommendations regarding teaching PH to undergraduate medical students, little consensus seems to exist on teaching postgraduate PH to non-medically qualified professionals, health managers and administrators. Employing a case study approach, this article analyses the methods used, philosophies and processes, structure and organization, outcomes to date, and lessons learnt from MPH programmes implemented at two institutions in the UK. The programmes have been initiated recently, and have had the opportunity to take on board the recent national guidelines about training standards. The findings indicate that preparatory work of the programmes, and the challenges and strengths in meeting the recent policy developments in PH training are pertinent points. The MPH programmes highlight key issues in interprofessional education and its purpose, its process and its outcomes in relation to multidisciplinary specialist practice. These programmes provide a variety of models for others wishing to develop or restructure their postgraduate PH teaching programmes. The finalization of the national standards for specialist practice in PH in the UK is encouraged, along with clearer working definitions of the domains of expertise required. Collectively, attention to these measures can ensure that the processes which teaching programmes embrace to refine their content and delivery will equip tomorrow's professionals with PH knowledge and skills.
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Affiliation(s)
- W El Ansari
- School of Health and Social Care, Oxford Brookes University, Heritage Gate, Sandringham House, Sandy Lane West, Oxford OX4 6LB, UK.
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Moran P, Duffield C, Beutel J, Bunt S, Thornton A, Wills J, Cahill P, Franks H. Nurse managers in Australia: mentoring, leadership and career progression. Can J Nurs Leadersh 2002; 15:14-20. [PMID: 12102238 DOI: 10.12927/cjnl.2002.19148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Identification of those leadership qualities which nurses believe led to their successful attainment of a nursing management position may help in understanding how to identify and foster leadership potential amongst nursing staff. This study asked nurse managers to indicate the important factors which influenced and facilitated their entry to management positions with a particular reference to the development of leadership characteristics. The results suggest that the leadership qualities we expect nurse managers to display evolve in a largely random way. Additionally, there is evidence that the development of leadership skills and attainment of management positions remains fragmented and random in nature. Because of this, individual nurse managers develop leadership skills almost by default using informal strategies to learn and develop. These findings should provide direction to educational providers and senior managers who seek to develop future leaders and managers.
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Affiliation(s)
- P Moran
- University of Technology, Sydney
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Duffield C, Moran P, Beutel J, Bunt S, Thornton A, Wills J, Cahill P, Franks H. Profile of first-line nurse managers in New South Wales, Australia, in the 1990s. J Adv Nurs 2001; 36:785-93. [PMID: 11903708 DOI: 10.1046/j.1365-2648.2001.02036.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To determine a demographic profile, employment history and career plans of a sample of nursing unit managers (first-line managers) in New South Wales (NSW), Australia in 1999. To compare the profile of first-line nurse managers in 1999 with those in 1989. BACKGROUND This study replicates another undertaken a decade earlier (see Duffield 1992). Tracking the changes to nurse manager positions is important, given changes to the educational preparation of nurses and restructuring within hospitals which have occurred in the past decade. METHOD The same questionnaire was used in both studies, with minor amendments and the addition of two items to reflect changes to organizational structures, whereby nurse managers are now responsible for non-nursing staff. In 1999 all first-line nurse managers in the largest health service in NSW were invited to participate in the study. RESULTS A response rate of 77% was achieved. There were few differences of note in the demographic profile from 1989 to 1999. However educationally, first-line nurse managers in 1999 were more highly qualified. A greater proportion had higher degrees and increasingly, in the management discipline. CONCLUSION Perhaps reflecting these qualifications, more managers in 1999 indicated their intention to move to more senior management positions in the next decade. The mode for experience in this role of 1 year in both 1989 and 1999 reflects a worrying trend of high turnover and inexperience amongst this group of managers. While maternity relief might account for this result, further research needs to determine more precise reasons. The ad hoc bases on which expert clinicians (clinical nurse specialists) act as the manager in his/her absence need to be critically examined. Alternative strategies such as introducing a formal second- in-charge position may ensure more successful recruitment and retention of staff to these critical management positions.
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Affiliation(s)
- C Duffield
- Nursing and Health Services Management, Centre for Health Services Management, University of Technology, Sydney, Australia.
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Wills J. Coenurosis in a pet rabbit. Vet Rec 2001; 148:188. [PMID: 11258733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Homer CS, Davis GK, Brodie PM, Sheehan A, Barclay LM, Wills J, Chapman MG. Collaboration in maternity care: a randomised controlled trial comparing community-based continuity of care with standard hospital care. BJOG 2001; 108:16-22. [PMID: 11212998 DOI: 10.1111/j.1471-0528.2001.00022.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To test whether a new community-based model of continuity of care provided by midwives and obstetricians improved maternal clinical outcomes, in particular a reduced caesarean section rate. DESIGN Randomised controlled trial. SETTING A public teaching hospital in metropolitan Sydney, Australia. Sample 1089 women randomised to either the community-based model (n = 550) or standard hospital-based care (n = 539) prior to their first antenatal booking visit at an Australian metropolitan public hospital. MAIN OUTCOME MEASURES Data were collected on onset and outcomes of labour, antenatal, intrapartum and postnatal complications, antenatal admissions to hospital and neonatal mortality and morbidity. RESULTS There was a significant difference in the caesarean section rate between the groups, 13.3% (73/550) in the community-based group and 17.8% in the control group (96/539). This difference was maintained after controlling for known contributing factors to caesarean section (OR = 0.6, 95% CI 0.4-0.9, P = 0.02). There were no other significant differences in the events during labour and birth. Eighty babies (14.5%) from the community-based group and 102 (18.9%) from the control group were admitted to the special care nursery, but this difference was not significant (OR 0.75, 95% CI 0.5-1.1, P = 0.12). Eight infants died during the perinatal period (four from each group), for an overall perinatal mortality rate of 7.3 per 1000 births. CONCLUSION Community-based continuity of maternity care provided by midwives and obstetricians resulted in a significantly reduced caesarean section rate. There were no other differences in clinical outcomes.
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Affiliation(s)
- C S Homer
- Centre for Family Health and Midwifery, NSW, Australia
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Homer CS, Matha DV, Jordan LG, Wills J, Davis GK. Community-based continuity of midwifery care versus standard hospital care: a cost analysis. AUST HEALTH REV 2001; 24:85-93. [PMID: 11357746 DOI: 10.1071/ah010085] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This paper reports the costs of providing a new model of maternity care compared to standard care in anAustralian public hospital. The mean cost of providing care per woman was lower in the group who had the newmodel of care compared with standard care ($2 579 versus $3 483). Cost savings associated with new model of carewere maintained even after costs associated with admission to special care nursery were excluded. The cost saving wasalso sustained even when the caesarean section rate in the new model of care increased to beyond that of the standardcare group.
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Affiliation(s)
- C S Homer
- Midwifery Practice and Research Centre (Centre for Family Health and Midwifery, UTS and St George Hospital), Sydney
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46
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Oda Y, Sanders J, Evans M, Kiddie A, Munkley A, James C, Richards T, Wills J, Furmaniak J, Smith BR. Epitope analysis of the human thyrotropin (TSH) receptor using monoclonal antibodies. Thyroid 2000; 10:1051-9. [PMID: 11201849 DOI: 10.1089/thy.2000.10.1051] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A panel of thyrotropin (TSH) receptor (TSHR) monoclonal antibodies (mAbs), produced using highly purified Chinese hamster ovary (CHO) cell-produced TSHR, has been used to study TSHR structure. All 41 mAbs recognized full-length TSHR containing complex carbohydrate (120 kDa), and 40 mAbs recognized full-length precursor-containing high mannose sugars (100 kDa). The mAbs also recognized TSHR cleavage products with three types of reactivity: type 1 mAbs reacting with bands at 70 kDa and 58 kDa, type 2 with bands at 70 kDa and 52 kDa, and type 3 with bands at 52 kDa and 40 kDa. Deglycosylation studies showed that the 70-kDa and 58-kDa bands contained complex carbohydrate, whereas the 52-kDa and 40-kDa bands were unglycosylated. These results are consistent with TSHR cleavage occurring at two sites. Cleavage at both sites gives rise to glycosylated A subunit (58 kDa) corresponding to the extracellular domain of the receptor and nonglycosylated B subunit (40 kDa) corresponding to the C-terminal transmembrane domain. Cleavage only at site 1 gives rise to the 58-kDa A subunit and a large B subunit (52 kDa). Cleavage only at site 2 gives rise to a large A subunit (70 kDa) and the B subunit (40 kDa). Four of the mAbs inhibited 125I-labeled TSH binding to solubilized full-length TSHR. TSH binding was inhibited by (a) two type 3 mAbs reactive with the N-terminal region of the B subunit (epitopes between amino acids 381 and 385 and between 380 and 418, respectively) and (b) two type 2 mAbs reactive with epitopes on the A subunit (between amino acids 246 and 260). These results together with previous studies on the direct binding of TSH to the TSHR A subunit suggest that at least two distinct regions of the TSHR sequence, including one region on the A subunit and one region on the B subunit, fold together to form part of a complex TSH binding site.
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Affiliation(s)
- Y Oda
- FIRS Laboratories, RSR Ltd., Llanishen, Cardiff, United Kingdom
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Briggs DJ, de Hoogh C, Gulliver J, Wills J, Elliott P, Kingham S, Smallbone K. A regression-based method for mapping traffic-related air pollution: application and testing in four contrasting urban environments. Sci Total Environ 2000; 253:151-67. [PMID: 10843339 DOI: 10.1016/s0048-9697(00)00429-0] [Citation(s) in RCA: 196] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Accurate, high-resolution maps of traffic-related air pollution are needed both as a basis for assessing exposures as part of epidemiological studies, and to inform urban air-quality policy and traffic management. This paper assesses the use of a GIS-based, regression mapping technique to model spatial patterns of traffic-related air pollution. The model--developed using data from 80 passive sampler sites in Huddersfield, as part of the SAVIAH (Small Area Variations in Air Quality and Health) project--uses data on traffic flows and land cover in the 300-m buffer zone around each site, and altitude of the site, as predictors of NO2 concentrations. It was tested here by application in four urban areas in the UK: Huddersfield (for the year following that used for initial model development), Sheffield, Northampton, and part of London. In each case, a GIS was built in ArcInfo, integrating relevant data on road traffic, urban land use and topography. Monitoring of NO2 was undertaken using replicate passive samplers (in London, data were obtained from surveys carried out as part of the London network). In Huddersfield, Sheffield and Northampton, the model was first calibrated by comparing modelled results with monitored NO2 concentrations at 10 randomly selected sites; the calibrated model was then validated against data from a further 10-28 sites. In London, where data for only 11 sites were available, validation was not undertaken. Results showed that the model performed well in all cases. After local calibration, the model gave estimates of mean annual NO2 concentrations within a factor of 1.5 of the actual mean (approx. 70-90%) of the time and within a factor of 2 between 70 and 100% of the time. r2 values between modelled and observed concentrations are in the range of 0.58-0.76. These results are comparable to those achieved by more sophisticated dispersion models. The model also has several advantages over dispersion modelling. It is able, for example, to provide high-resolution maps across a whole urban area without the need to interpolate between receptor points. It also offers substantially reduced costs and processing times compared to formal dispersion modelling. It is concluded that the model might thus be used as a means of mapping long-term air pollution concentrations either in support of local authority air-quality management strategies, or in epidemiological studies.
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Affiliation(s)
- D J Briggs
- Department of Epidemiology and Public Health, Imperial College of Science, Technology and Medicine, London, UK.
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Kaufman A, Derksen D, McKernan S, Galbraith P, Sava S, Wills J, Fingado E. Managed care for uninsured patients at an academic health center: a case study. Acad Med 2000; 75:323-330. [PMID: 10893113 DOI: 10.1097/00001888-200004000-00007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In 1997, the University of New Mexico Health Sciences Center ("the Center") created a managed care plan ("the Plan") for its uninsured patients who were county residents. The Plan's features include pooling the resources of existing county safety-net providers, enrolling patients with primary care providers at easily accessible neighborhood-based clinics, and investing in social support services, case management, and 24-hour telephone triage. After two years of the Plan's operation, the utilization of ambulatory care services by Plan enrollees, the number of discharges per 1,000 enrollees from the Center-affiliated University Hospital, and the number of hospital days per 1,000 enrollees had all dropped significantly (p < .001 for all). For the 13,114 enrollees in the Plan, University Hospital saved an estimated $1,904,872 per year in costs. The replacement of unpaid hospital days with paying patients is estimated to have yielded over $695,000 in additional revenues per year. The authors conclude that managing the care of uninsured patients in an academic health center can reduce ambulatory care and inpatient utilization and reduce the cost of care. To achieve these favorable outcomes requires the organization of services to meet the unique needs of the uninsured and underserved population.
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Affiliation(s)
- A Kaufman
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque 87131, USA.
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Wills J. Inner strength. Nurs Times 1998; 94:36-7. [PMID: 9866577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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McDonnell JM, Fushman D, Cahill SM, Zhou W, Wolven A, Wilson CB, Nelle TD, Resh MD, Wills J, Cowburn D. Solution structure and dynamics of the bioactive retroviral M domain from Rous sarcoma virus. J Mol Biol 1998; 279:921-8. [PMID: 9642071 DOI: 10.1006/jmbi.1998.1788] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A biologically active construct of the retroviral M domain from the avian Rous sarcoma virus is defined and its solution structure described. This M domain is fully active in budding and infectivity without myristylation. In spite of a sequence homology level that suggests no relationship among M domains and the family of matrix proteins in mammalian retroviruses, the conserved structural elements of a central core allow an M domain sequence motif to be described for all retroviruses. The surface of the M domain has a highly clustered positive patch comprised of sequentially distant residues. An analysis of the backbone dynamics, incorporating rotational anisotropy, is used to estimate the thermodynamics of proposed domain oligomerization.
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Affiliation(s)
- J M McDonnell
- The Rockefeller University, 1230 York Avenue, New York, NY 10021, USA
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