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Munien K, Ravichandran K, Flynn H, Shugg N, Flynn D, Chambers J, Desai D. Catheter-associated meatal pressure injuries (CAMPI) in patients with long-term urethral catheters-a cross-sectional study of 200 patients. Transl Androl Urol 2024; 13:42-52. [PMID: 38404556 PMCID: PMC10891379 DOI: 10.21037/tau-23-445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/22/2023] [Indexed: 02/27/2024] Open
Abstract
Background Indwelling urethral catheters (IDC) are ubiquitous to healthcare settings, and are associated with many familiar risks like haematuria, infections, bladder spasms and stones. However, a less known complication is catheter-associated meatal pressure injury (CAMPI), especially in those with long-term IDCs. The objective of this study was to explore the prevalence, associated features and management of CAMPI in adults with a long-term IDC. Methods A cross-sectional multi-centre study was undertaken of 200 adults with a long-term IDC across regional south-west Queensland, Australia between June 2019 to June 2021. The prevalence of CAMPI was determined by clinical examination, voluntary surveys completed by participants and documentation in medical records. Key IDC statistics included total duration of IDC, location of IDC changes, IDC size, type and fixation. Results Out of 200 adults with a long-term IDC, 9% (18/200) had a CAMPI. There was a higher prevalence of male CAMPI (17/169, 10%) compared to female CAMPI (1/31, 3%). The median time to identification of a CAMPI after initial IDC insertion was 12 weeks (2-136 weeks), but occurred as soon as 2 weeks. CAMPI formation was associated with IDC changes in the community, impaired mobility and congestive cardiac failure (CCF). CAMPI were mostly treated by conservative means given the frailty of the population. Conclusions Poor mobility, community-managed IDCs, and CCF were all found to have statistically significant associations with the development of CAMPI. CAMPI represents an important and underserved iatrogenic complication within urology practice, and greater awareness is needed to prevent it in vulnerable patients with long-term IDCs.
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Affiliation(s)
- Kale Munien
- Department of Urology, Toowoomba Hospital, Toowoomba, QLD, Australia
| | | | - Hannah Flynn
- Department of Urology, Toowoomba Hospital, Toowoomba, QLD, Australia
| | - Nathan Shugg
- Department of Urology, Toowoomba Hospital, Toowoomba, QLD, Australia
| | - David Flynn
- Department of Surgery, The Royal Brisbane & Women’s Hospital, Herston, QLD, Australia
| | | | - Devang Desai
- Department of Urology, Toowoomba Hospital, Toowoomba, QLD, Australia
- Department of Medical Sciences, University of Queensland, Brisbane, QLD, Australia
- Department of Medical Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
- Department of Medical Sciences, Griffith University, Brisbane, QLD, Australia
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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Romanello M, Napoli CD, Green C, Kennard H, Lampard P, Scamman D, Walawender M, Ali Z, Ameli N, Ayeb-Karlsson S, Beggs PJ, Belesova K, Berrang Ford L, Bowen K, Cai W, Callaghan M, Campbell-Lendrum D, Chambers J, Cross TJ, van Daalen KR, Dalin C, Dasandi N, Dasgupta S, Davies M, Dominguez-Salas P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Freyberg C, Gasparyan O, Gordon-Strachan G, Graham H, Gunther SH, Hamilton I, Hang Y, Hänninen R, Hartinger S, He K, Heidecke J, Hess JJ, Hsu SC, Jamart L, Jankin S, Jay O, Kelman I, Kiesewetter G, Kinney P, Kniveton D, Kouznetsov R, Larosa F, Lee JKW, Lemke B, Liu Y, Liu Z, Lott M, Lotto Batista M, Lowe R, Odhiambo Sewe M, Martinez-Urtaza J, Maslin M, McAllister L, McMichael C, Mi Z, Milner J, Minor K, Minx JC, Mohajeri N, Momen NC, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Obradovich N, O'Hare MB, Oliveira C, Oreszczyn T, Otto M, Owfi F, Pearman O, Pega F, Pershing A, Rabbaniha M, Rickman J, Robinson EJZ, Rocklöv J, Salas RN, Semenza JC, Sherman JD, Shumake-Guillemot J, Silbert G, Sofiev M, Springmann M, Stowell JD, Tabatabaei M, Taylor J, Thompson R, Tonne C, Treskova M, Trinanes JA, Wagner F, Warnecke L, Whitcombe H, Winning M, Wyns A, Yglesias-González M, Zhang S, Zhang Y, Zhu Q, Gong P, Montgomery H, Costello A. The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms. Lancet 2023; 402:2346-2394. [PMID: 37977174 DOI: 10.1016/s0140-6736(23)01859-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 08/31/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Marina Romanello
- Institute for Global Health, University College London, London, UK.
| | - Claudia di Napoli
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Carole Green
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | - Pete Lampard
- Department of Health Sciences, University of York, York, UK
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | - Maria Walawender
- Institute for Global Health, University College London, London, UK
| | - Zakari Ali
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Nadia Ameli
- Institute for Sustainable Resources, University College London, London, UK
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Paul J Beggs
- School of Natural Sciences, Macquarie University, Sydney, NSW, Australia
| | | | | | - Kathryn Bowen
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Diarmid Campbell-Lendrum
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Jonathan Chambers
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Troy J Cross
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | | | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Niheer Dasandi
- International Development Department, University of Birmingham, Birmingham, UK
| | - Shouro Dasgupta
- Euro-Mediterranean Center on Climate Change Foundation, Lecce, Italy
| | - Michael Davies
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | | | - Robert Dubrow
- School of Public Health, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Matthew Eckelman
- Department of Civil & Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Chris Freyberg
- Department of Information Systems, Massey University, Palmerston North, New Zealand
| | - Olga Gasparyan
- Department of Political Science, Florida State University, Tallahassee, FL, USA
| | | | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Samuel H Gunther
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Yun Hang
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | | | - Stella Hartinger
- Carlos Vidal Layseca School of Public Health and Management, Cayetano Heredia Pervuvian University, Lima, Peru
| | - Kehan He
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - Julian Heidecke
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Jeremy J Hess
- Centre for Health and the Global Environment, University of Washington, Washington, DC, USA
| | - Shih-Che Hsu
- Energy Institute, University College London, London, UK
| | - Louis Jamart
- Institute for Global Health, University College London, London, UK
| | - Slava Jankin
- Centre for AI in Government, University of Birmingham, Birmingham, UK
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Patrick Kinney
- Department of Environmental Health, Boston University, Boston, MA, USA
| | - Dominic Kniveton
- School of Global Studies, University of Sussex, Brighton and Hove, UK
| | | | - Francesca Larosa
- Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Jason K W Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bruno Lemke
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | - Zhao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Melissa Lott
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | - Rachel Lowe
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- Environmental Studies Program, Denison University, Granville, OH, USA
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Zhifu Mi
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - James Milner
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, NY, USA
| | - Jan C Minx
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Nahid Mohajeri
- Bartlett School of Sustainable Construction, University College London, London, UK
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Kris A Murray
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, London, UK
| | - Tara Neville
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | - Maria Nilsson
- Department for Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Megan B O'Hare
- Institute for Global Health, University College London, London, UK
| | - Camile Oliveira
- Institute for Global Health, University College London, London, UK
| | | | - Matthias Otto
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Tehran, Iran
| | - Olivia Pearman
- Center for Science and Technology Policy, University of Colorado Boulder, Boulder, CO, USA
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organisation, Geneva, Switzerland
| | | | | | - Jamie Rickman
- Institute for Sustainable Resources, University College London, London, UK
| | - Elizabeth J Z Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science, London, UK
| | - Joacim Rocklöv
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Renee N Salas
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jan C Semenza
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jodi D Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | | | - Grant Silbert
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Marco Springmann
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Meisam Tabatabaei
- Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Marina Treskova
- Interdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Joaquin A Trinanes
- Department of Electronics and Computer Science, University of Santiago de Compostela, Santiago, Spain
| | - Fabian Wagner
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Laura Warnecke
- International Institute for Applied Systems Analysis Energy, Climate, and Environment Program, Laxenburg, Austria
| | - Hannah Whitcombe
- Institute for Global Health, University College London, London, UK
| | - Matthew Winning
- Institute for Sustainable Resources, University College London, London, UK
| | - Arthur Wyns
- Melbourne Climate Futures, The University of Melbourne, Melbourne, VIC, Australia
| | - Marisol Yglesias-González
- Centro Latinoamericano de Excelencia en Cambio Climatico y Salud, Cayetano Heredia Pervuvian University, Lima, Peru
| | - Shihui Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Ying Zhang
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Qiao Zhu
- Gangarosa Department of Environmental Health, Emory University, Atlanta, GA
| | - Peng Gong
- Department of Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hugh Montgomery
- Department of Experimental and Translational Medicine and Division of Medicine, University College London, London, UK
| | - Anthony Costello
- Institute for Global Health, University College London, London, UK
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Dimech A, Isabelle A, Sylvain K, Liu C, Cheng L, Bussière B, Chouteau M, Fabien-Ouellet G, Bérubé C, Wilkinson P, Meldrum P, Chambers J. A multiscale accuracy assessment of moisture content predictions using time-lapse electrical resistivity tomography in mine tailings. Sci Rep 2023; 13:20922. [PMID: 38017002 PMCID: PMC10684595 DOI: 10.1038/s41598-023-48100-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
Accurate and large-scale assessment of volumetric water content (VWC) plays a critical role in mining waste monitoring to mitigate potential geotechnical and environmental risks. In recent years, time-lapse electrical resistivity tomography (TL-ERT) has emerged as a promising monitoring approach that can be used in combination with traditional invasive and point-measurements techniques to estimate VWC in mine tailings. Moreover, the bulk electrical conductivity (EC) imaged using TL-ERT can be converted into VWC in the field using petrophysical relationships calibrated in the laboratory. This study is the first to assess the scale effect on the accuracy of ERT-predicted VWC in tailings. Simultaneous and co-located monitoring of bulk EC and VWC are carried out in tailings at five different scales, in the laboratory and in the field. The hydrogeophysical datasets are used to calibrate a petrophysical model used to predict VWC from TL-ERT data. Overall, the accuracy of ERT-predicted VWC is [Formula: see text], and the petrophysical models determined at sample-scale in the laboratory remain valid at larger scales. Notably, the impact of temperature and pore water EC evolution plays a major role in VWC predictions at the field scale (tenfold reduction of accuracy) and, therefore, must be properly taken into account during the TL-ERT data processing using complementary hydrogeological sensors. Based on these results, we suggest that future studies using TL-ERT to predict VWC in mine tailings could use sample-scale laboratory apparatus similar to the electrical resistivity Tempe cell presented here to calibrate petrophysical models and carefully upscale them to field applications.
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Affiliation(s)
- Adrien Dimech
- Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn Noranda, QC, J9X 5E4, Canada.
- Research Institute of Mines and Environment (RIME), Montréal, QC, Canada.
| | - Anne Isabelle
- Polytechnique Montréal, Montréal, QC, H3T 1J4, Canada
- Research Institute of Mines and Environment (RIME), Montréal, QC, Canada
| | - Karine Sylvain
- Polytechnique Montréal, Montréal, QC, H3T 1J4, Canada
- Research Institute of Mines and Environment (RIME), Montréal, QC, Canada
| | - Chong Liu
- Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn Noranda, QC, J9X 5E4, Canada
| | - LiZhen Cheng
- Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn Noranda, QC, J9X 5E4, Canada
- Research Institute of Mines and Environment (RIME), Montréal, QC, Canada
| | - Bruno Bussière
- Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn Noranda, QC, J9X 5E4, Canada
- Research Institute of Mines and Environment (RIME), Montréal, QC, Canada
| | - Michel Chouteau
- Polytechnique Montréal, Montréal, QC, H3T 1J4, Canada
- Research Institute of Mines and Environment (RIME), Montréal, QC, Canada
| | | | | | - Paul Wilkinson
- British Geological Survey (BGS), Environmental Science Centre, Keyworth, Nottingham, NG12 5GG, UK
| | - Philip Meldrum
- British Geological Survey (BGS), Environmental Science Centre, Keyworth, Nottingham, NG12 5GG, UK
| | - Jonathan Chambers
- British Geological Survey (BGS), Environmental Science Centre, Keyworth, Nottingham, NG12 5GG, UK
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Cope V, Chambers J, Kingdon S, Cole N. Is a 14-day Pathway From Decision to Treat to Radiotherapy for Head and Neck Cancer Patients Feasible in the National Health Service? The Torbay Experience 5 Years On. Clin Oncol (R Coll Radiol) 2023; 35:756-758. [PMID: 37679231 DOI: 10.1016/j.clon.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Affiliation(s)
- V Cope
- Torbay Hospital, Lowes Bridge, Torquay, UK
| | - J Chambers
- Torbay Hospital, Lowes Bridge, Torquay, UK
| | - S Kingdon
- Torbay Hospital, Lowes Bridge, Torquay, UK
| | - N Cole
- Torbay Hospital, Lowes Bridge, Torquay, UK.
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7
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Romanello M, Di Napoli C, Drummond P, Green C, Kennard H, Lampard P, Scamman D, Arnell N, Ayeb-Karlsson S, Ford LB, Belesova K, Bowen K, Cai W, Callaghan M, Campbell-Lendrum D, Chambers J, van Daalen KR, Dalin C, Dasandi N, Dasgupta S, Davies M, Dominguez-Salas P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Escobar LE, Georgeson L, Graham H, Gunther SH, Hamilton I, Hang Y, Hänninen R, Hartinger S, He K, Hess JJ, Hsu SC, Jankin S, Jamart L, Jay O, Kelman I, Kiesewetter G, Kinney P, Kjellstrom T, Kniveton D, Lee JKW, Lemke B, Liu Y, Liu Z, Lott M, Batista ML, Lowe R, MacGuire F, Sewe MO, Martinez-Urtaza J, Maslin M, McAllister L, McGushin A, McMichael C, Mi Z, Milner J, Minor K, Minx JC, Mohajeri N, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Obradovich N, O'Hare MB, Oreszczyn T, Otto M, Owfi F, Pearman O, Rabbaniha M, Robinson EJZ, Rocklöv J, Salas RN, Semenza JC, Sherman JD, Shi L, Shumake-Guillemot J, Silbert G, Sofiev M, Springmann M, Stowell J, Tabatabaei M, Taylor J, Triñanes J, Wagner F, Wilkinson P, Winning M, Yglesias-González M, Zhang S, Gong P, Montgomery H, Costello A. The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels. Lancet 2022; 400:1619-1654. [PMID: 36306815 DOI: 10.1016/s0140-6736(22)01540-9] [Citation(s) in RCA: 280] [Impact Index Per Article: 140.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Marina Romanello
- Institute for Global Health, University College London, London, UK.
| | - Claudia Di Napoli
- School of Agriculture Policy and Development, University of Reading, Reading, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Carole Green
- Department of Global Health, Centre for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Harry Kennard
- UCL Energy Institute, University College London, London, UK
| | - Pete Lampard
- Department of Health Sciences, University of York, York, UK
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | - Nigel Arnell
- Department of Meteorology, University of Reading, Reading, UK
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | | | - Kristine Belesova
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kathryn Bowen
- School of Population Health, University of Melbourne, Melbourne, VIC, Australia
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Diarmid Campbell-Lendrum
- Department of Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
| | - Jonathan Chambers
- Institute of Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Kim R van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Niheer Dasandi
- School of Government, University of Birmingham, Birmingham, UK
| | - Shouro Dasgupta
- Economic Analysis of Climate Impacts and Policy Division, Centro Euro-Mediterraneo sui Cambiamenti Climatici, Venice, Italy
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - Robert Dubrow
- Department of Environmental Health Sciences and Yale Center on Climate Change and Health, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, Centre for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Matthew Eckelman
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Samuel H Gunther
- NUS Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Ian Hamilton
- UCL Energy Institute, University College London, London, UK
| | - Yun Hang
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Stella Hartinger
- Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kehan He
- Bartlett Faculty of the Built Environment, University College London, London, UK
| | - Jeremy J Hess
- Department of Global Health, Centre for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Shih-Che Hsu
- UCL Energy Institute, University College London, London, UK
| | - Slava Jankin
- Data Science Lab, Hertie School, Berlin, Germany
| | | | - Ollie Jay
- Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | | | - Patrick Kinney
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Tord Kjellstrom
- Health and Environmental International Trust, Nelson, New Zealand
| | | | - Jason K W Lee
- NUS Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Bruno Lemke
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Melissa Lott
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Martin Lotto Batista
- Barcelona Supercomputing Center, Centro Nacional de Supercomputacion, Barcelona, Spain
| | - Rachel Lowe
- Catalan Institution for Research and Advanced Studies and Barcelona Supercomputing Center, Barcelona, Spain
| | - Frances MacGuire
- Institute for Global Health, University College London, London, UK
| | - Maquins Odhiambo Sewe
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | | | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- Center for Energy Markets, Technical University of Munich, Munich, Germany
| | - Alice McGushin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Zhifu Mi
- Barlett School of Sustainable Construction, University of London, London, UK
| | - James Milner
- Department of Public Health, Environment, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Kelton Minor
- Copenhagen Center for Social Data Science, University of Copenhagen, Copenhagen, Denmark
| | - Jan C Minx
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Nahid Mohajeri
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Maziar Moradi-Lakeh
- Preventative Medicine and Public Health Research Centre, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- Department of Technology, Management and Economics Sustainability, Technical University of Denmark, Lyngby, Denmark
| | | | - Kris A Murray
- MRC Unit The Gambia at LSHTM, London School of Hygiene & Tropical Medicine, London, UK
| | - Tara Neville
- Department of Environment, Climate Change, and Health, World Health Organization, Geneva, Switzerland
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Nick Obradovich
- Centre for Humans and Machines, Max Planck Institute for Human Development, Berlin, Germany
| | - Megan B O'Hare
- Institute for Global Health, University College London, London, UK
| | - Tadj Oreszczyn
- UCL Energy Institute, University College London, London, UK
| | - Matthias Otto
- Department of Arts, Media, and Digital Technologies, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Fereidoon Owfi
- Iranian Fisheries Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Olivia Pearman
- Cooperative Institute of Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
| | - Mahnaz Rabbaniha
- Iranian Fisheries Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Elizabeth J Z Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science, London, UK
| | - Joacim Rocklöv
- Heidelberg Institute for Global Health and Interdisciplinary Centre forScientific Computing, University of Heidelberg, Heidelberg, Germany
| | - Renee N Salas
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jan C Semenza
- Heidelberg Institute for Global Health and Interdisciplinary Centre forScientific Computing, University of Heidelberg, Heidelberg, Germany
| | - Jodi D Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | - Liuhua Shi
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Grant Silbert
- Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | | | - Marco Springmann
- Environmental Change Institute, University of Oxford, Oxford, UK
| | - Jennifer Stowell
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Meisam Tabatabaei
- Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Malaysia
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | - Joaquin Triñanes
- Department of Electronics and Computer Science, Universidade de Santiago de Compostela, Santiago, Spain
| | - Fabian Wagner
- Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Paul Wilkinson
- Department of Public Health, Environment, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Winning
- Institute for Sustainable Resources, University College London, London, UK
| | - Marisol Yglesias-González
- Centro Latinoamericano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Shihui Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Peng Gong
- Department of Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hugh Montgomery
- Centre for Human Health and Performance, University College London, London, UK
| | - Anthony Costello
- Institute for Global Health, University College London, London, UK
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van Daalen KR, Romanello M, Rocklöv J, Semenza JC, Tonne C, Markandya A, Dasandi N, Jankin S, Achebak H, Ballester J, Bechara H, Callaghan MW, Chambers J, Dasgupta S, Drummond P, Farooq Z, Gasparyan O, Gonzalez-Reviriego N, Hamilton I, Hänninen R, Kazmierczak A, Kendrovski V, Kennard H, Kiesewetter G, Lloyd SJ, Lotto Batista M, Martinez-Urtaza J, Milà C, Minx JC, Nieuwenhuijsen M, Palamarchuk J, Quijal-Zamorano M, Robinson EJZ, Scamman D, Schmoll O, Sewe MO, Sjödin H, Sofiev M, Solaraju-Murali B, Springmann M, Triñanes J, Anto JM, Nilsson M, Lowe R. The 2022 Europe report of the Lancet Countdown on health and climate change: towards a climate resilient future. Lancet Public Health 2022; 7:e942-e965. [PMID: 36306805 PMCID: PMC9597587 DOI: 10.1016/s2468-2667(22)00197-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Kim R van Daalen
- Institute for Global Health, University College London, London, UK; Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Joacim Rocklöv
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jan C Semenza
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Niheer Dasandi
- School of Government, University of Birmingham, Birmingham, UK
| | - Slava Jankin
- Data Science Lab, Hertie School, Berlin, Germany
| | - Hicham Achebak
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Joan Ballester
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | | | - Max W Callaghan
- Priestley International Centre for Climate, University of Leeds, Leeds, UK; Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Jonathan Chambers
- Energy Efficiency Group, Institute for Environmental Sciences (ISE), University of Geneva, Switzerland
| | - Shouro Dasgupta
- Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy; Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Sciences (LSE), UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Zia Farooq
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Risto Hänninen
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | | | - Vladimir Kendrovski
- European Centre for Environment and Health, WHO Regional Office for Europe, Bonn, Germany
| | - Harry Kennard
- Energy Institute, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Simon J Lloyd
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Martin Lotto Batista
- Barcelona Supercomputing Center (BSC), Barcelona, Spain; Helmholtz Centre for Infection Research, Department of Epidemiology, Brunswick, Germany
| | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carles Milà
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jan C Minx
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Marcos Quijal-Zamorano
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Elizabeth J Z Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Sciences (LSE), UK
| | - Daniel Scamman
- Institute for Sustainable Resources, University College London, London, UK
| | - Oliver Schmoll
- European Centre for Environment and Health, WHO Regional Office for Europe, Bonn, Germany
| | | | - Henrik Sjödin
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | | | - Marco Springmann
- Oxford Martin Programme on the Future of Food and Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Joaquin Triñanes
- Department of Electronics and Computer Science, Universidade de Santiago de Compostela, Santiago, Spain
| | - Josep M Anto
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Rachel Lowe
- Barcelona Supercomputing Center (BSC), Barcelona, Spain; Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
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9
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Dimech A, Cheng L, Chouteau M, Chambers J, Uhlemann S, Wilkinson P, Meldrum P, Mary B, Fabien-Ouellet G, Isabelle A. A Review on Applications of Time-Lapse Electrical Resistivity Tomography Over the Last 30 Years : Perspectives for Mining Waste Monitoring. Surv Geophys 2022; 43:1699-1759. [PMID: 36285292 PMCID: PMC9587091 DOI: 10.1007/s10712-022-09731-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/02/2022] [Indexed: 06/16/2023]
Abstract
Mining operations generate large amounts of wastes which are usually stored into large-scale storage facilities which pose major environmental concerns and must be properly monitored to manage the risk of catastrophic failures and also to control the generation of contaminated mine drainage. In this context, non-invasive monitoring techniques such as time-lapse electrical resistivity tomography (TL-ERT) are promising since they provide large-scale subsurface information that complements surface observations (walkover, aerial photogrammetry or remote sensing) and traditional monitoring tools, which often sample a tiny proportion of the mining waste storage facilities. The purposes of this review are as follows: (i) to understand the current state of research on TL-ERT for various applications; (ii) to create a reference library for future research on TL-ERT and geoelectrical monitoring mining waste; and (iii) to identify promising areas of development and future research needs on this issue according to our experience. This review describes the theoretical basis of geoelectrical monitoring and provides an overview of TL-ERT applications and developments over the last 30 years from a database of over 650 case studies, not limited to mining operations (e.g., landslide, permafrost). In particular, the review focuses on the applications of ERT for mining waste characterization and monitoring and a database of 150 case studies is used to identify promising applications for long-term autonomous geoelectrical monitoring of the geotechnical and geochemical stability of mining wastes. Potential challenges that could emerge from a broader adoption of TL-ERT monitoring for mining wastes are discussed. The review also considers recent advances in instrumentation, data acquisition, processing and interpretation for long-term monitoring and draws future research perspectives and promising avenues which could help improve the design and accuracy of future geoelectric monitoring programs in mining wastes.
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Affiliation(s)
- Adrien Dimech
- Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, Québec J9X 5E4 Canada
- Research Institute of Mines and Environment (RIME), Québec, Canada
| | - LiZhen Cheng
- Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, Québec J9X 5E4 Canada
- Research Institute of Mines and Environment (RIME), Québec, Canada
| | - Michel Chouteau
- Polytechnique Montréal, Montréal, Québec H3T 1J4 Canada
- Research Institute of Mines and Environment (RIME), Québec, Canada
| | - Jonathan Chambers
- British Geological Survey (BGS), Environmental Science Centre, Nottingham, NG12 5GG United Kingdom
| | - Sebastian Uhlemann
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720 United States
| | - Paul Wilkinson
- British Geological Survey (BGS), Environmental Science Centre, Nottingham, NG12 5GG United Kingdom
| | - Philip Meldrum
- British Geological Survey (BGS), Environmental Science Centre, Nottingham, NG12 5GG United Kingdom
| | - Benjamin Mary
- Department of Geosciences, University of Padua, Padua, 35122 Italy
| | | | - Anne Isabelle
- Polytechnique Montréal, Montréal, Québec H3T 1J4 Canada
- Research Institute of Mines and Environment (RIME), Québec, Canada
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Di Napoli C, McGushin A, Romanello M, Ayeb-Karlsson S, Cai W, Chambers J, Dasgupta S, Escobar LE, Kelman I, Kjellstrom T, Kniveton D, Liu Y, Liu Z, Lowe R, Martinez-Urtaza J, McMichael C, Moradi-Lakeh M, Murray KA, Rabbaniha M, Semenza JC, Shi L, Tabatabaei M, Trinanes JA, Vu BN, Brimicombe C, Robinson EJ. Tracking the impacts of climate change on human health via indicators: lessons from the Lancet Countdown. BMC Public Health 2022; 22:663. [PMID: 35387618 PMCID: PMC8985369 DOI: 10.1186/s12889-022-13055-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/22/2022] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND In the past decades, climate change has been impacting human lives and health via extreme weather and climate events and alterations in labour capacity, food security, and the prevalence and geographical distribution of infectious diseases across the globe. Climate change and health indicators (CCHIs) are workable tools designed to capture the complex set of interdependent interactions through which climate change is affecting human health. Since 2015, a novel sub-set of CCHIs, focusing on climate change impacts, exposures, and vulnerability indicators (CCIEVIs) has been developed, refined, and integrated by Working Group 1 of the "Lancet Countdown: Tracking Progress on Health and Climate Change", an international collaboration across disciplines that include climate, geography, epidemiology, occupation health, and economics. DISCUSSION This research in practice article is a reflective narrative documenting how we have developed CCIEVIs as a discrete set of quantifiable indicators that are updated annually to provide the most recent picture of climate change's impacts on human health. In our experience, the main challenge was to define globally relevant indicators that also have local relevance and as such can support decision making across multiple spatial scales. We found a hazard, exposure, and vulnerability framework to be effective in this regard. We here describe how we used such a framework to define CCIEVIs based on both data availability and the indicators' relevance to climate change and human health. We also report on how CCIEVIs have been improved and added to, detailing the underlying data and methods, and in doing so provide the defining quality criteria for Lancet Countdown CCIEVIs. CONCLUSIONS Our experience shows that CCIEVIs can effectively contribute to a world-wide monitoring system that aims to track, communicate, and harness evidence on climate-induced health impacts towards effective intervention strategies. An ongoing challenge is how to improve CCIEVIs so that the description of the linkages between climate change and human health can become more and more comprehensive.
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Affiliation(s)
- Claudia Di Napoli
- School of Agriculture, Policy and Development, University of Reading, Reading, UK. .,Department of Geography and Environmental Science, University of Reading, Reading, UK.
| | - Alice McGushin
- Institute for Global Health, University College London, London, UK
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London, London, UK.,School of Global Studies, University of Sussex, Brighton Falmer, UK.,United Nations University, Institute for Environment and Human Security, Bonn, Germany
| | - Wenjia Cai
- Ministry of Education Key Laboratory for Earth System modeling, Department of Earth System Science, Tsinghua University, Beijing, 100084, China
| | - Jonathan Chambers
- Institute for Environmental Science, University of Geneva, Geneva, Switzerland
| | - Shouro Dasgupta
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK.,Centro Euro-Mediterraneo sui Cambiamenti Climatici (CMCC), Venice, Italy.,Università Ca' Foscari, Venice, Italy
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK.,Institute for Risk and Disaster Reduction, University College London, London, UK.,University of Agder, Kristiansand, Norway
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | - Dominic Kniveton
- School of Global Studies, University of Sussex, Brighton Falmer, UK
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Zhao Liu
- Ministry of Education Key Laboratory for Earth System modeling, Department of Earth System Science, Tsinghua University, Beijing, 100084, China
| | - Rachel Lowe
- Barcelona Supercomputing Center, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.,Centre on Climate Change & Planetary Health and Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, The University of Melbourne, Melbourne, Australia
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.,MRC Unit The Gambia At London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Jan C Semenza
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Liuhua Shi
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Meisam Tabatabaei
- Higher Institution Centre of Excellence (HICoE), Institute of Tropical Aquaculture and Fisheries (AKUATROP), Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia.,Henan Province Forest Resources Sustainable Development and High-value Utilization Engineering Research Center, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China
| | - Joaquin A Trinanes
- Department of Electronics and Computer Science, Universidade de Santiago de Compostela, Santiago, Spain
| | - Bryan N Vu
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Chloe Brimicombe
- Department of Geography and Environmental Science, University of Reading, Reading, UK
| | - Elizabeth J Robinson
- Grantham Research Institute on Climate Change and the Environment, London School of Economics and Political Science (LSE), London, UK
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11
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Florido Ngu F, Kelman I, Chambers J, Ayeb-Karlsson S. Correlating heatwaves and relative humidity with suicide (fatal intentional self-harm). Sci Rep 2021; 11:22175. [PMID: 34782650 PMCID: PMC8593067 DOI: 10.1038/s41598-021-01448-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Empirical evidence suggests that the effects of anthropogenic climate change, and heat in particular, could have a significant impact on mental health. This article investigates the correlation between heatwaves and/or relative humidity and suicide (fatal intentional self-harm) on a global scale. The covariance between heat/humidity and suicide was modelled using a negative binomial Poisson regression with data from 60 countries between 1979-2016. Statistically significant increases and decreases in suicide were found, as well as many cases with no significant correlation. We found that relative humidity showed a more significant correlation with suicide compared to heatwaves and that both younger age groups and women seemed to be more significantly affected by changes in humidity and heatwave counts in comparison with the rest of the population. Further research is needed to provide a larger and more consistent basis for epidemiological studies; to understand better the connections among heat, humidity and mental health; and to explore in more detail which population groups are particularly impacted and why.
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Affiliation(s)
- Fernando Florido Ngu
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Ilan Kelman
- Institute for Risk and Disaster Reduction, University College London, London, UK.
- Institute for Global Health, University College London, London, UK.
- University of Agder, Kristiansand, Norway.
| | - Jonathan Chambers
- Institute for Environmental Science, University of Geneva, Geneva, Switzerland
| | - Sonja Ayeb-Karlsson
- University of Sussex, Brighton, UK
- United Nations University's Institute for Environment and Human Security, Bonn, Germany
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12
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Romanello M, McGushin A, Di Napoli C, Drummond P, Hughes N, Jamart L, Kennard H, Lampard P, Solano Rodriguez B, Arnell N, Ayeb-Karlsson S, Belesova K, Cai W, Campbell-Lendrum D, Capstick S, Chambers J, Chu L, Ciampi L, Dalin C, Dasandi N, Dasgupta S, Davies M, Dominguez-Salas P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Escobar LE, Georgeson L, Grace D, Graham H, Gunther SH, Hartinger S, He K, Heaviside C, Hess J, Hsu SC, Jankin S, Jimenez MP, Kelman I, Kiesewetter G, Kinney PL, Kjellstrom T, Kniveton D, Lee JKW, Lemke B, Liu Y, Liu Z, Lott M, Lowe R, Martinez-Urtaza J, Maslin M, McAllister L, McMichael C, Mi Z, Milner J, Minor K, Mohajeri N, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Obradovich N, Sewe MO, Oreszczyn T, Otto M, Owfi F, Pearman O, Pencheon D, Rabbaniha M, Robinson E, Rocklöv J, Salas RN, Semenza JC, Sherman J, Shi L, Springmann M, Tabatabaei M, Taylor J, Trinanes J, Shumake-Guillemot J, Vu B, Wagner F, Wilkinson P, Winning M, Yglesias M, Zhang S, Gong P, Montgomery H, Costello A, Hamilton I. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. Lancet 2021; 398:1619-1662. [PMID: 34687662 DOI: 10.1016/s0140-6736(21)01787-6] [Citation(s) in RCA: 410] [Impact Index Per Article: 136.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Alice McGushin
- Institute for Global Health, University College London, London, UK
| | - Claudia Di Napoli
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Nick Hughes
- Institute for Sustainable Resources, University College London, London, UK
| | - Louis Jamart
- Institute for Global Health, University College London, London, UK
| | - Harry Kennard
- UCL Energy Institute, University College London, London, UK
| | - Pete Lampard
- Department of Health Sciences, University of York, York, UK
| | | | - Nigel Arnell
- Department of Meteorology, University of Reading, Reading, UK
| | - Sonja Ayeb-Karlsson
- Institute for Environment and Human Security, United Nations University, Bonn, Germany
| | - Kristine Belesova
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Diarmid Campbell-Lendrum
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Stuart Capstick
- Centre for Climate Change and Social Transformations, School of Psychology, Cardiff University, Cardiff, UK
| | - Jonathan Chambers
- Institute for Environmental Sciences, World Health Organization, Geneva, Switzerland
| | - Lingzhi Chu
- Yale Center on Climate Change and Health, Yale University, New Haven, CT, USA
| | - Luisa Ciampi
- The Walker Institute, University of Reading, Reading, UK
| | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Niheer Dasandi
- School of Government, University of Birmingham, Birmingham, UK
| | - Shouro Dasgupta
- Economic analysis of Climate Impacts and Policy, Centro Euro-Mediterraneo sui Cambiamenti Climatici, Venice, Italy
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - Robert Dubrow
- Yale Center on Climate Change and Health, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Matthew Eckelman
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | - Delia Grace
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Samuel H Gunther
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Stella Hartinger
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kehan He
- The Bartlett School of Sustainable Construction, University College London, London, UK
| | - Clare Heaviside
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Jeremy Hess
- Centre for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Shih-Che Hsu
- UCL Energy Institute, University College London, London, UK
| | - Slava Jankin
- Data Science Lab, Hertie School, Berlin, Germany
| | - Marcia P Jimenez
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Patrick L Kinney
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, USA
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | | | - Jason K W Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Bruno Lemke
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Melissa Lott
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- Center for Energy Markets, Technical University of Munich, Munich, Germany
| | - Celia McMichael
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Zhifu Mi
- The Bartlett School of Sustainable Construction, University College London, London, UK
| | - James Milner
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Kelton Minor
- Copenhagen Center for Social Data Science, University of Copenhagen, Copenhagen, Denmark
| | - Nahid Mohajeri
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- Department of Technology, Management and Economics, Technical University of Denmark, Copenhagen, Denmark
| | | | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK; MRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Tara Neville
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Nick Obradovich
- Centre for Humans and Machines, Max Planck Institute for Human Development, Berlin, Germany
| | - Maquins Odhiambo Sewe
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tadj Oreszczyn
- UCL Energy Institute, University College London, London, UK
| | - Matthias Otto
- Department of Arts, Media & Digital Technologies, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Olivia Pearman
- Cooperative Institute of Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - David Pencheon
- College of Medicine and Health, Exeter University, Exeter, UK
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Elizabeth Robinson
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Joacim Rocklöv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Renee N Salas
- Harvard Medical School, Harvard University, Boston, MA, USA
| | | | - Jodi Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Meisam Tabatabaei
- Higher Institution Centre of Excellence, Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Terengganu, Malaysia
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | - Joaquin Trinanes
- Department of Electronics and Computer Science, Universidade de Santiago de Compostela, Santiago, Spain
| | | | - Bryan Vu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Fabian Wagner
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Paul Wilkinson
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Winning
- Institute for Sustainable Resources, University College London, London, UK
| | - Marisol Yglesias
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Shihui Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Peng Gong
- Department of Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hugh Montgomery
- Centre for Human Health and Performance, University College London, London, UK
| | - Anthony Costello
- Institute for Global Health, University College London, London, UK
| | - Ian Hamilton
- UCL Energy Institute, University College London, London, UK.
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13
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Stowell C, Howard J, Cole G, Ananthan K, Demetrescu C, Pearce K, Rajani R, Sehmi J, Vimalesvaran K, Kanaganayagam S, Ghosh A, Chambers J, Rana B, Francis D, Shun-Shin M. Automated left ventricular dimension assessment using artificial intelligence. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and purpose
Artificial intelligence (AI) has the potential to greatly improve efficiency and reproducibility of quantification in echocardiography, but to gain widespread use it must both meet expert standards of excellence and have a transparent methodology. We developed an online platform to enable multiple collaborators to annotate medical images for training and validating neural networks.
Methods
Using our online collaborative platform 9 expert echocardiographers labelled 2056 images that comprised the training dataset. They labelled the four points from where the standard parasternal long axis (PLAX) measurements (interventricular septum, posterior wall, left ventricular dimension) would be made. Using these labelled images we trained a 2d convolutional neural network to replicate these labels. Separately, we curated an external validation dataset of the systolic and diastolic frames of 100 PLAX acquisitions. Each of these images were labelled twice by 13 different experts, and the average of the 26 measurements was taken as the consensus standard.
We then compared the individual experts and the AI measurements on the external validation dataset to the consensus standard, and calculated the precision standard deviation (SD) of the signed differences from the consensus standard.
Results
For diastolic septum thickness, the AI had a precision SD of 1.8 mm (ICC 0.81; 95% CI 0.73 to 0.97), compared with 2.0 mm for the individual experts (ICC 0.64; 95% CI 0.57 to 0.72). For diastolic posterior wall thickness, the AI had a precision SD 1.4 mm (ICC 0.54; 95% CI 0.38 to 0.66), and the individual experts 2.2 mm (ICC 0.37; 95% CI 0.29 to 0.46).
The AI's precision SD for left ventricular internal dimension was 3.5 mm (ICC 0.93, 95% CI 0.90 to 0.94), and for individual experts was 4.4mm (ICC 0.82, 95% CI 0.78 to 0.95). Both the experts and AI performed better in diastole than systole (precision SD AI 2.5mm vs 4.3mm, p<0.0001; experts 3.3mm vs 5.3mm, p<0.0001).
Conclusions
AI trained by a group of echocardiography experts was able to perform PLAX measurements which matched the reference standard more closely than any individual expert's own measurements.
This open, collaborative approach may be a model for the development of AI that is explainable to, and trusted by clinicians.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHR Imperil BRC ITMATDr Howard was additionally funded by Wellcome. Online collaborative platformResults of AI and experts
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Affiliation(s)
- C Stowell
- Imperial College London, NHLI, London, United Kingdom
| | - J Howard
- Imperial College London, NHLI, London, United Kingdom
| | - G Cole
- Imperial College London, NHLI, London, United Kingdom
| | - K Ananthan
- Imperial College London, London, United Kingdom
| | - C Demetrescu
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - K Pearce
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - R Rajani
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - J Sehmi
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | | | - S Kanaganayagam
- Chelsea and Westminster Hospital NHS Trust, London, United Kingdom
| | - A Ghosh
- Barts Heart Centre, London, United Kingdom
| | - J Chambers
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | - B Rana
- Hammersmith Hospital, London, United Kingdom
| | - D Francis
- Imperial College London, NHLI, London, United Kingdom
| | - M Shun-Shin
- Imperial College London, NHLI, London, United Kingdom
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14
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Dalan R, Mina T, Nur Azizah NA, Tong T, Loh M, Wansaicheong G, Chambers J. Sex modifies the association between body mass index and carotid artery intima media thickness in the multi-ethnic Singapore population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aims
Globally cardiovascular disease (CVD) risk is higher in men than in women in the younger age group but the risk is attenuated in later life with an unexpected higher risk in women in some populations. A better understanding of sex differences in CVD is needed. Carotid artery intima-media thickness (CIMT) has been proposed for CVD risk assessment in individuals at intermediate risk. We study the gender interactions in the associations of the traditional cardiovascular risk factors with CIMT.
Methods
We performed carotid ultrasonography in the large population health study-HELIOS conducted in Singapore. Measurements were performed as per Mannheim consensus, at the far wall of bilateral common carotid artery at 8 sites in each participant. We report the average of all measurements (avgCIMT) and maximum value (maxCIMT). We analysed 2061 healthy participants recruited between 2018–2020. Inclusion criteria for this analysis: non-smokers, not known to have diabetes, hypertension, hyperlipidemia or ischemic heart disease. Individuals with systolic blood pressure >160 mm Hg or fasting glucose >7.0 mmol/L on recruitment were excluded. Multivariable linear regression analysis was performed to examine the association between CIMT and cardiovascular risk factors in the healthy population adjusting for age, sex and ethnicity. All analysis was performed using Stata version 16.0.
Results
After exclusion, 1407 healthy participants were included in the analysis. Median (IQR) avgCIMT: 0.56 (0.50, 0.65) in men; 0.54 (0.50, 0.58) in women. Median (IQR) maxCIMT: 0.64 (0.57, 0.76) in men; 0.61 (0.54, 0.70) in women. The avgCIMT and the maxCIMT were higher in males when compared to women and all traditional cardiovascular risk factors associated with CIMT after adjustment for age, sex and ethnicity (P<0.05) (Table 1). Interaction tests in multivariable model adjusted for age, ethnicity, pulse pressure, non HDL-C and HbA1c showed a significant interaction between sex and body mass index (BMI) with predicted effects on avgCIMT and maxCIMT being relatively higher in males at the same BMI when compared to females (P-interaction <0.01) (Figure 1).
Conclusion
Sex modifies the relationship between BMI and CIMT in Singapore's multi-ethnic population. Understanding the intermediary mechanisms involved will help in developing personalized preventive strategies.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- R Dalan
- Tan Tock Seng Hospital, Endocrinology, Singapore, Singapore
| | - T Mina
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | - N A Nur Azizah
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | - T Tong
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | - M Loh
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
| | | | - J Chambers
- Lee Kong Chian School of Medicine, Cardiovascular Epidemiology, Singapore, Singapore
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15
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Vasiliadou I, Noble D, Hartley A, Moleron R, Sanghera P, Urbano TG, Schipani S, Gujral D, Foran B, Bhide S, Haridass A, Nathan K, Michaelidou A, Sen M, Geropantas K, Joseph M, O'Toole L, Griffin M, Pettit L, Chambers J, Jankowska P, De Winton E, Goranova R, Singh N, Shah K, Kong Conceptualisation A. A multi-centre survey reveals variations in the standard treatments and treatment modifications for head and neck cancer patients during Covid-19 pandemic. Clin Transl Radiat Oncol 2021; 30:50-59. [PMID: 34226880 PMCID: PMC8242198 DOI: 10.1016/j.ctro.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic necessitated rapid changes to the practice of head and neck oncology in UK. There was a delay between the onset of the pandemic and the release of guidelines from cancer societies and networks, leading to a variable response of individual centres. This survey was conducted to assess the pre-Covid-19 pandemic standard of practice for head and neck oncology patients and the treatment modifications introduced during the first wave of the pandemic in UK. METHODOLOGY The UK National Cancer Research Institute (NCRI) Head and Neck Clinical Studies Group initiated a multi-centre survey using questionnaire to investigate the effect on feeding tube practice, radiotherapy (RT) fractionation and volumes, use of chemotherapy in the neo-adjuvant, concurrent and palliative setting, the use of immunotherapy in the palliative setting, access to radiology and histopathology services, and availability of surgical procedures. RESULTS 30 centres were approached across UK; 23 (76.7%) centres responded and were included in the survey. There were differences in the standard practices in feeding tube policy, RT dose and fractionation as well as concurrent chemotherapy use. 21 (91%) participating centres had at least one treatment modification. 15 (65%) centres initiated a change in radical RT; changing to either a hypofractionation or acceleration schedule. For post-operative RT 10 centres (43.5%) changed to a hypofractionation schedule. 12 (52.2%) centres stopped neo-adjuvant chemotherapy for all patients; 13 (56.5%) centres followed selective omission of chemotherapy in concurrent chemo-radiotherapy patients, 17 (73.9%) centres changed first-line chemotherapy treatment to pembrolizumab (following NHS England's interim guidance) and 8 (34.8%) centres stopped the treatment early or offered delays for patients that have been already on systemic treatment. The majority of centres did not have significant changes associated with surgery, radiology, histopathology and dental screening. CONCLUSION There are variations in the standard of practice and treatment modifications for head and neck cancer patients during Covid-19 pandemic. A timely initiative is required to form a consensus on head and neck cancer management in the UK and other countries.
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Affiliation(s)
| | - David Noble
- Edinburgh Cancer Centre, Edinburgh, United Kingdom
| | - Andrew Hartley
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | - Paul Sanghera
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | | | - Dorothy Gujral
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Bernie Foran
- Weston Park Cancer Centre, Sheffield, United Kingdom
| | - Shree Bhide
- Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | | | - Kannon Nathan
- Kent Oncology Centre, Maidstone and Canterbury, United Kingdom
| | | | - Mehmet Sen
- Leeds Cancer Centre, Leeds, United Kingdom
| | | | - Mano Joseph
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | | | | | - Laura Pettit
- Lingen Davie Cancer Centre, Shrewsbury, United Kingdom
| | | | | | | | | | | | - Ketan Shah
- Oxford University Hospitals, Oxford, United Kingdom
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16
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Wyborn C, Montana J, Kalas N, Clement S, Davila F, Knowles N, Louder E, Balan M, Chambers J, Christel L, Forsyth T, Henderson G, Izquierdo Tort S, Lim M, Martinez‐Harms MJ, Merçon J, Nuesiri E, Pereira L, Pilbeam V, Turnhout E, Wood S, Ryan M. An agenda for research and action toward diverse and just futures for life on Earth. Conserv Biol 2021; 35:1086-1097. [PMID: 33244774 PMCID: PMC8359367 DOI: 10.1111/cobi.13671] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/14/2020] [Accepted: 11/20/2020] [Indexed: 06/11/2023]
Abstract
Decades of research and policy interventions on biodiversity have insufficiently addressed the dual issues of biodiversity degradation and social justice. New approaches are therefore needed. We devised a research and action agenda that calls for a collective task of revisiting biodiversity toward the goal of sustaining diverse and just futures for life on Earth. Revisiting biodiversity involves critically reflecting on past and present research, policy, and practice concerning biodiversity to inspire creative thinking about the future. The agenda was developed through a 2-year dialogue process that involved close to 300 experts from diverse disciplines and locations. This process was informed by social science insights that show biodiversity research and action is underpinned by choices about how problems are conceptualized. Recognizing knowledge, action, and ethics as inseparable, we synthesized a set of principles that help navigate the task of revisiting biodiversity. The agenda articulates 4 thematic areas for future research. First, researchers need to revisit biodiversity narratives by challenging conceptualizations that exclude diversity and entrench the separation of humans, cultures, economies, and societies from nature. Second, researchers should focus on the relationships between the Anthropocene, biodiversity, and culture by considering humanity and biodiversity as tied together in specific contexts. Third, researchers should focus on nature and economies by better accounting for the interacting structures of economic and financial systems as core drivers of biodiversity loss. Finally, researchers should enable transformative biodiversity research and action by reconfiguring relationships between human and nonhuman communities in and through science, policy, and practice. Revisiting biodiversity necessitates a renewed focus on dialogue among biodiversity communities and beyond that critically reflects on the past to channel research and action toward fostering just and diverse futures for human and nonhuman life on Earth.
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Affiliation(s)
- C. Wyborn
- Luc Hoffmann InstituteIUCN Conservation CentreRue Mauverney 28Gland1196Switzerland
- Institute for Water Futures, Fenner School of Environment and SocietyAustralian National UniversityCanberraACT0200Australia
| | - J. Montana
- School of Geography and the EnvironmentUniversity of OxfordSouth Parks RoadOxfordOX1 3QYU.K.
| | - N. Kalas
- Department of Environmental Systems ScienceETH ZürichUniversitätstrasse 8‐22Zürich8092Switzerland
| | - S. Clement
- Geography and PlanningUniversity of LiverpoolLiverpoolL69 3BXU.K.
| | - F. Davila
- Institute for Sustainable FuturesUniversity of Technology Sydney253 Jones StreetUltimoNSW2007Australia
| | - N. Knowles
- Department of Geography and Environmental ManagementUniversity of Waterloo200 University Ave WWaterlooONN2L 3G1Canada
| | - E. Louder
- School of Geography and DevelopmentUniversity of ArizonaENR2 Building, South 4th floor 1064 E. Lowell StreetTucsonAZ85721U.S.A.
| | - M. Balan
- The Forest WayNo 8, 2nd St, D P Nagar, KotturpuramChennaiTamil Nadu600085India
| | - J. Chambers
- Forest and Nature Conservation Policy GroupWageningen UniversityP.O. Box 47Wageningen6700 AAThe Netherlands
| | - L. Christel
- School of Politics and Government (EPyG)National University of San MartinAvenida 25 de Mayo 1021San MartínProvincia de Buenos Aires1650Argentina
| | - T. Forsyth
- Department of International DevelopmentLondon School of Economics and Political ScienceHoughton StreetLondonWC2A 2AEU.K
| | - G. Henderson
- Harry Ransom CenterThe University of Texas at AustinP.O. Drawer 7219, 300 W 21st StreetAustinTX78712U.S.A.
| | - S. Izquierdo Tort
- Institut des Sciences de la Forêt TempéréeUniversité du Québec en Outaouais58 rue PrincipaleRiponQCJ0V 1V0Canada
- Natura y Ecosistemas Mexicanos A.C.Plaza San Jacinto 23D, San Ángel, Álvaro ObregónMexico City01000Mexico
| | - M. Lim
- Centre for Environmental Law, Macquarie Law SchoolMacquarie University6 First WalkSydneyNSW2109Australia
| | - M. J. Martinez‐Harms
- Center for Applied Ecology and Sustainability (CAPES)Pontificia Universidad Católica de ChileSantiago, Avd. Libertador Bernardo O'Higgins 340SantiagoChile
| | - J. Merçon
- Instituto de Investigaciones en EducasiónUniversidad VeracruzanaPaseo 112, Nuevo JalapaXalapa‐Enríquez91193Mexico
| | - E. Nuesiri
- Social Science FacultyAfrican Leadership University (ALU)Powder Mill RoadPamplemousses21001Mauritius
| | - L. Pereira
- Stockholm Resilience CentreStockholm UniversityKräftriket 2BStockholmSE‐10691Sweden
- Copernicus Institute of Sustainable DevelopmentUtrecht UniversityPrincetonlaan 8aUtrecht3584 CBThe Netherlands
- Centre for Complex Systems in TransitionStellenbosch University19 Jonkershoek Rd, MostertsdriftStellenbosch7600South Africa
| | - V. Pilbeam
- Clear Horizon Consulting132B Gwynne StCremorneVIC3121Australia
| | - E. Turnhout
- Forest and Nature Conservation Policy GroupWageningen UniversityP.O. Box 47Wageningen6700 AAThe Netherlands
| | - S. Wood
- Future Earth1250 Guy St, MontrealQuebecONH3H 2L3Canada
| | - M. Ryan
- Luc Hoffmann InstituteIUCN Conservation CentreRue Mauverney 28Gland1196Switzerland
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17
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Wyborn C, Montana J, Kalas N, Clement S, Davila F, Knowles N, Louder E, Balan M, Chambers J, Christel L, Forsyth T, Henderson G, Izquierdo Tort S, Lim M, Martinez-Harms MJ, Merçon J, Nuesiri E, Pereira L, Pilbeam V, Turnhout E, Wood S, Ryan M. An agenda for research and action toward diverse and just futures for life on Earth. Conserv Biol 2021; 35:1086-1097. [PMID: 33244774 DOI: 10.13140/rg.2.2.12086.52804/2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/14/2020] [Accepted: 11/20/2020] [Indexed: 05/18/2023]
Abstract
Decades of research and policy interventions on biodiversity have insufficiently addressed the dual issues of biodiversity degradation and social justice. New approaches are therefore needed. We devised a research and action agenda that calls for a collective task of revisiting biodiversity toward the goal of sustaining diverse and just futures for life on Earth. Revisiting biodiversity involves critically reflecting on past and present research, policy, and practice concerning biodiversity to inspire creative thinking about the future. The agenda was developed through a 2-year dialogue process that involved close to 300 experts from diverse disciplines and locations. This process was informed by social science insights that show biodiversity research and action is underpinned by choices about how problems are conceptualized. Recognizing knowledge, action, and ethics as inseparable, we synthesized a set of principles that help navigate the task of revisiting biodiversity. The agenda articulates 4 thematic areas for future research. First, researchers need to revisit biodiversity narratives by challenging conceptualizations that exclude diversity and entrench the separation of humans, cultures, economies, and societies from nature. Second, researchers should focus on the relationships between the Anthropocene, biodiversity, and culture by considering humanity and biodiversity as tied together in specific contexts. Third, researchers should focus on nature and economies by better accounting for the interacting structures of economic and financial systems as core drivers of biodiversity loss. Finally, researchers should enable transformative biodiversity research and action by reconfiguring relationships between human and nonhuman communities in and through science, policy, and practice. Revisiting biodiversity necessitates a renewed focus on dialogue among biodiversity communities and beyond that critically reflects on the past to channel research and action toward fostering just and diverse futures for human and nonhuman life on Earth.
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Affiliation(s)
- C Wyborn
- Luc Hoffmann Institute, IUCN Conservation Centre, Rue Mauverney 28, Gland, 1196, Switzerland
- Institute for Water Futures, Fenner School of Environment and Society, Australian National University, Canberra, ACT, 0200, Australia
| | - J Montana
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford, OX1 3QY, U.K
| | - N Kalas
- Department of Environmental Systems Science, ETH Zürich, Universitätstrasse 8-22, Zürich, 8092, Switzerland
| | - S Clement
- Geography and Planning, University of Liverpool, Liverpool, L69 3BX, U.K
| | - F Davila
- Institute for Sustainable Futures, University of Technology Sydney, 253 Jones Street, Ultimo, NSW, 2007, Australia
| | - N Knowles
- Department of Geography and Environmental Management, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - E Louder
- School of Geography and Development, University of Arizona, ENR2 Building, South 4th floor 1064 E. Lowell Street, Tucson, AZ, 85721, U.S.A
| | - M Balan
- The Forest Way, No 8, 2nd St, D P Nagar, Kotturpuram, Chennai, Tamil Nadu, 600085, India
| | - J Chambers
- Forest and Nature Conservation Policy Group, Wageningen University, P.O. Box 47, Wageningen, 6700 AA, The Netherlands
| | - L Christel
- School of Politics and Government (EPyG), National University of San Martin, Avenida 25 de Mayo 1021, San Martín, Provincia de Buenos Aires, 1650, Argentina
| | - T Forsyth
- Department of International Development, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, U.K
| | - G Henderson
- Harry Ransom Center, The University of Texas at Austin, P.O. Drawer 7219, 300 W 21st Street, Austin, TX, 78712, U.S.A
| | - S Izquierdo Tort
- Institut des Sciences de la Forêt Tempérée, Université du Québec en Outaouais, 58 rue Principale, Ripon, QC, J0V 1V0, Canada
- Natura y Ecosistemas Mexicanos A.C., Plaza San Jacinto 23D, San Ángel, Álvaro Obregón, Mexico City, 01000, Mexico
| | - M Lim
- Centre for Environmental Law, Macquarie Law School, Macquarie University, 6 First Walk, Sydney, NSW, 2109, Australia
| | - M J Martinez-Harms
- Center for Applied Ecology and Sustainability (CAPES), Pontificia Universidad Católica de Chile, Santiago, Avd. Libertador Bernardo O'Higgins 340, Santiago, Chile
| | - J Merçon
- Instituto de Investigaciones en Educasión, Universidad Veracruzana, Paseo 112, Nuevo Jalapa, Xalapa-Enríquez, 91193, Mexico
| | - E Nuesiri
- Social Science Faculty, African Leadership University (ALU), Powder Mill Road, Pamplemousses, 21001, Mauritius
| | - L Pereira
- Stockholm Resilience Centre, Stockholm University, Kräftriket 2B, Stockholm, SE-10691, Sweden
- Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, Utrecht, 3584 CB, The Netherlands
- Centre for Complex Systems in Transition, Stellenbosch University, 19 Jonkershoek Rd, Mostertsdrift, Stellenbosch, 7600, South Africa
| | - V Pilbeam
- Clear Horizon Consulting, 132B Gwynne St, Cremorne, VIC, 3121, Australia
| | - E Turnhout
- Forest and Nature Conservation Policy Group, Wageningen University, P.O. Box 47, Wageningen, 6700 AA, The Netherlands
| | - S Wood
- Future Earth, 1250 Guy St, Montreal, Quebec, ON, H3H 2L3, Canada
| | - M Ryan
- Luc Hoffmann Institute, IUCN Conservation Centre, Rue Mauverney 28, Gland, 1196, Switzerland
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18
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Tee JL, Chambers J, Strutton G. Bladder perivascular epithelioid cell tumour and tuberous sclerosis complex: a rare association. BMJ Case Rep 2021; 14:14/5/e241635. [PMID: 34039545 DOI: 10.1136/bcr-2021-241635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Bladder perivascular epithelioid cell tumours (PEComas) associated with tuberous sclerosis complex (TSC) are rare, with only one other case report in the literature to date. We present our case of a bladder PEComa in a young adult female with TSC arising de novo. Histopathology showed features in keeping with an angiomyolipoma and confirmatory immunohistochemical stains were positive for both melanocytic and smooth muscle markers. She was well at the 6-month follow-up post-surgical resection. Given the rarity of such lesions in the bladder, we discuss the diagnostic and prognostic challenges, clinical implications and a brief review of the literature to date.
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Affiliation(s)
- Jo Lin Tee
- Anatomical Pathology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
| | | | - Geoffrey Strutton
- Anatomical Pathology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
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19
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Mitchell AL, Ovadia C, Syngelaki A, Souretis K, Martineau M, Girling J, Vasavan T, Fan HM, Seed PT, Chambers J, Walters J, Nicolaides K, Williamson C. Re-evaluating diagnostic thresholds for intrahepatic cholestasis of pregnancy: case-control and cohort study. BJOG 2021; 128:1635-1644. [PMID: 33586324 DOI: 10.1111/1471-0528.16669] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To determine the optimal total serum bile acid (TSBA) threshold and sampling time for accurate intrahepatic cholestasis of pregnancy (ICP) diagnosis. DESIGN Case-control, retrospective cohort studies. SETTING Antenatal clinics, clinical research facilities. POPULATION Women with ICP or uncomplicated pregnancies. METHODS Serial TSBA measurements were performed pre-/postprandially in 42 women with ICP or uncomplicated pregnancy. Third-trimester non-fasting TSBA reference ranges were calculated from 561 women of black, south Asian and white ethnicity. Rates of adverse perinatal outcomes for women with ICP but peak non-fasting TSBA below the upper reference range limit were compared with those in healthy populations. MAIN OUTCOME MEASURES Sensitivity and specificity of common TSBA thresholds for ICP diagnosis, using fasting and postprandial TSBA. Calculation of normal reference ranges of non-fasting TSBA. RESULTS Concentrations of TSBA increased markedly postprandially in all groups, with overlap between healthy pregnancy and mild ICP (TSBA <40 μmol/l). The specificity of ICP diagnosis was higher when fasting, but corresponded to <30% sensitivity for diagnosis of mild disease. Using TSBA ≥40 μmol/l to define severe ICP, fasting measurements identified 9% (1/11), whereas non-fasting measurements detected over 91% with severe ICP. The highest upper limit of the non-fasting TSBA reference range was 18.3 µmol/l (95% confidence interval: 15.0-35.6 μmol/l). A re-evaluation of published ICP meta-analysis data demonstrated no increase in spontaneous preterm birth or stillbirth in women with TSBA <19 µmol/l. CONCLUSIONS Postprandial TSBA levels are required to identify high-risk ICP pregnancies (TSBA ≥40 μmol/l). The postprandial rise in TSBA in normal pregnancy indicates that a non-fasting threshold of ≥19 µmol/l would improve diagnostic accuracy. TWEETABLE ABSTRACT Non-fasting bile acids improve the diagnostic accuracy of intrahepatic cholestasis of pregnancy diagnosis.
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Affiliation(s)
- A L Mitchell
- Department of Women and Children's Health, King's College London, Guy's Campus, London, UK
| | - C Ovadia
- Department of Women and Children's Health, King's College London, Guy's Campus, London, UK
| | - A Syngelaki
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - K Souretis
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - M Martineau
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, London, UK
| | - J Girling
- Obstetrics and Gynaecology Department, West Middlesex University Hospital, Middlesex, UK
| | - T Vasavan
- Department of Women and Children's Health, King's College London, Guy's Campus, London, UK
| | - H M Fan
- Department of Women and Children's Health, King's College London, Guy's Campus, London, UK
| | - P T Seed
- Department of Women and Children's Health, King's College London, St Thomas' Campus, London, UK
| | - J Chambers
- Women's Health Research Centre, Imperial College London, London, UK
| | - Jrf Walters
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, London, UK
| | - K Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - C Williamson
- Department of Women and Children's Health, King's College London, Guy's Campus, London, UK
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20
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Malhi G, Mikail M, Minhas G, Chambers J, Khanna R, Wilson A. A103 PIVOTING IN A PANDEMIC: THE IMPACT OF COVID-19 ON THE PROVISION OF CARE FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A PRELIMINARY ANALYSIS. J Can Assoc Gastroenterol 2021. [PMCID: PMC7989229 DOI: 10.1093/jcag/gwab002.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, also known as COVID-19, was declared a worldwide pandemic in March of 2020. Since the onset of the pandemic, the focus of many healthcare systems has shifted toward limiting non-essential visits to hospitals in order to prioritize and allocate resources toward treating those affected by COVID-19, and preventing further exposures. While the effect of COVID-19 has been felt amongst many patient populations, those with inflammatory bowel disease (IBD) have been particularly impacted through delayed appointments and endoscopy, which is critical in disease monitoring. Aims We aimed to determine how changes to the provision of IBD care due to the COVID-19 pandemic have affected IBD patients. Methods A retrospective cohort study was conducted using administrative data comparing IBD patients admitted to the gastroenterology ward from March 17 to August 31 2019, with IBD patients admitted from March 17 to August 31 2020 at a tertiary care centre in London, Ontario. Patients were reviewed to assess differences in care utilization and IBD-related outcomes such as hospitalization, surgery and length of stay and in-patient drug therapy. Results A total of 538 patients (259 in 2019 cohort and 279 in 2020 cohort) were reviewed with 48 and 60 IBD patients meeting the inclusion criteria for 2019 and 2020 respectively. Patient demographics were similar between 2019 and 2020 cohort for age, sex, rurality, disease type, and biologic exposure. A greater proportion of patients were admitted with IBD flares in 2020 (86.7% vs 75%, p=0.03). Furthermore, the 2020 cohort also had a 45% increase in in-patient surgical consultations (p=0.07), a 50% increase in in-patient IBD-related surgeries (p=0.39), a 69% increase in inpatient Remicade prescription (p=0.13) and a 70% increase in infectious complications at presentation to hospital (p=0.21). A shorter median length of stay was reported for patients in the 2020 cohort (4 days IQR 3.95 vs 5.85 IQR 4.65, p=0.09). Conclusions Preliminary data suggest that during the COVID-19 pandemic, we have seen more deleterious outcomes in our IBD patients such as increased flares necessitating hospital admission. There was also a non-significant trend toward increased infectious complications as well as in-patient surgeries and need for in-patient Remicade. Though these results cannot be fully interpreted due to the need for further sampling, they suggest that IBD patients may be at-risk for poor outcomes in the current climate of medical care. Completion of this study will help define the full impact of care shifts related to reducing the spread of the novel coronavirus on IBD patients and highlight areas of care that need careful assessment and consideration to protect IBD patient health. Funding Agencies None
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Affiliation(s)
- G Malhi
- Western University, London, ON, Canada
| | - M Mikail
- Western University, London, ON, Canada
| | - G Minhas
- Western University, London, ON, Canada
| | | | - R Khanna
- Western University, London, ON, Canada
| | - A Wilson
- Western University, London, ON, Canada
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21
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Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Beagley J, Belesova K, Boykoff M, Byass P, Cai W, Campbell-Lendrum D, Capstick S, Chambers J, Coleman S, Dalin C, Daly M, Dasandi N, Dasgupta S, Davies M, Di Napoli C, Dominguez-Salas P, Drummond P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Escobar LE, Georgeson L, Golder S, Grace D, Graham H, Haggar P, Hamilton I, Hartinger S, Hess J, Hsu SC, Hughes N, Jankin Mikhaylov S, Jimenez MP, Kelman I, Kennard H, Kiesewetter G, Kinney PL, Kjellstrom T, Kniveton D, Lampard P, Lemke B, Liu Y, Liu Z, Lott M, Lowe R, Martinez-Urtaza J, Maslin M, McAllister L, McGushin A, McMichael C, Milner J, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Sewe MO, Oreszczyn T, Otto M, Owfi F, Pearman O, Pencheon D, Quinn R, Rabbaniha M, Robinson E, Rocklöv J, Romanello M, Semenza JC, Sherman J, Shi L, Springmann M, Tabatabaei M, Taylor J, Triñanes J, Shumake-Guillemot J, Vu B, Wilkinson P, Winning M, Gong P, Montgomery H, Costello A. The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises. Lancet 2021; 397:129-170. [PMID: 33278353 DOI: 10.1016/s0140-6736(20)32290-x] [Citation(s) in RCA: 670] [Impact Index Per Article: 223.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 01/18/2023]
Abstract
For the Chinese, French, German, and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Nick Watts
- Institute for Global Health, University College London, London, UK.
| | - Markus Amann
- Air Quality and Greenhouse Gases Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Nigel Arnell
- Department of Meteorology, University of Reading, Reading, UK
| | - Sonja Ayeb-Karlsson
- Institute for Environment and Human Security, United Nations University, Bonn, Germany
| | - Jessica Beagley
- Institute for Global Health, University College London, London, UK
| | - Kristine Belesova
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maxwell Boykoff
- Environmental Studies Program, University of Colorado Boulder, Boulder, CO, USA
| | - Peter Byass
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Diarmid Campbell-Lendrum
- Environment, Climate Change and Health Department, World Health Organization, Geneva, Switzerland
| | | | - Jonathan Chambers
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Samantha Coleman
- Institute for Global Health, University College London, London, UK
| | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Meaghan Daly
- Department of Environmental Studies, University of New England, Biddeford, ME, USA
| | - Niheer Dasandi
- School of Government, University of Birmingham, Birmingham, UK
| | - Shouro Dasgupta
- Centro Euro-Mediterraneo sui Cambiamenti Climatici, Venice, Italy
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Claudia Di Napoli
- School of Agriculture, Policy, and Development, University of Reading, Reading, UK
| | - Paula Dominguez-Salas
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Robert Dubrow
- Yale Center on Climate Change and Health, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Matthew Eckelman
- Department of Civil & Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | - Su Golder
- Department of Health Sciences, University of York, York, UK
| | - Delia Grace
- CGIAR Research Program on Agriculture for Human Nutrition and Health, International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Environmental Studies, University of New England, Biddeford, ME, USA
| | - Paul Haggar
- School of Psychology, Cardiff University, Cardiff, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Stella Hartinger
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jeremy Hess
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Shih-Che Hsu
- Energy Institute, University College London, London, UK
| | - Nick Hughes
- Institute for Sustainable Resources, University College London, London, UK
| | | | - Marcia P Jimenez
- Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Harry Kennard
- Energy Institute, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Patrick L Kinney
- Department of Environmental Health, Boston University, Boston, MA, USA
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | | | - Pete Lampard
- Department of Health Sciences, University of York, York, UK
| | - Bruno Lemke
- School of Health, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Melissa Lott
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jaime Martinez-Urtaza
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- Center for Energy Markets, Technical University of Munich, Munich, Germany
| | - Alice McGushin
- Institute for Global Health, University College London, London, UK
| | - Celia McMichael
- School of Geography, University of Melbourne, Melbourne, VIC, Australia
| | - James Milner
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- European Centre for Environment and Human Health, University of Exeter, Exeter, UK
| | | | - Kris A Murray
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK; Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Bakau, The Gambia
| | - Tara Neville
- Environment, Climate Change and Health Department, World Health Organization, Geneva, Switzerland
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | | | - Matthias Otto
- Department of Arts, Media and Digital Technologies, Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Olivia Pearman
- Environmental Studies Program, University of Colorado Boulder, Boulder, CO, USA
| | - David Pencheon
- Medical and Health School, University of Exeter, Exeter, UK
| | - Ruth Quinn
- Department of Civil and Structural Engineering, University of Sheffield, Sheffield, UK
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Elizabeth Robinson
- School of Agriculture, Policy, and Development, University of Reading, Reading, UK
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Jan C Semenza
- Scientific Assessment Section, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jodi Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Atlanta, GA, USA
| | | | - Meisam Tabatabaei
- Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Terengganu, Malaysia
| | - Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
| | - Joaquin Triñanes
- Department of Electronics and Computer Science, CRETUS Institute, Universidade de Santiago de Compostela, Santiago, Spain
| | | | - Bryan Vu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paul Wilkinson
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Winning
- Institute for Sustainable Resources, University College London, London, UK
| | - Peng Gong
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Hugh Montgomery
- Institute for Human Health and Performance, University College London, London, UK
| | - Anthony Costello
- Office of the Vice Provost for Research, University College London, London, UK
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22
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Garner JM, Chambers J, Barnes AK, Datta S. Expression of concern: Changes in Brain-Derived Neurotrophic Factor Expression Influence Sleep-Wake Activity and Homeostatic Regulation of Rapid Eye Movement Sleep. Sleep 2020; 44:6028388. [PMID: 33294910 PMCID: PMC7879409 DOI: 10.1093/sleep/zsaa212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Fleminger J, Seed PT, Smith A, Juszczak E, Dixon PH, Chambers J, Dorling J, Williamson C, Thornton JG, Chappell LC. Ursodeoxycholic acid in intrahepatic cholestasis of pregnancy: a secondary analysis of the PITCHES trial. BJOG 2020; 128:1066-1075. [PMID: 33063439 PMCID: PMC8246759 DOI: 10.1111/1471-0528.16567] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate whether a particular group of women with intrahepatic cholestasis of pregnancy (ICP), based on their presenting characteristics, would benefit from treatment with ursodeoxycholic acid (UDCA). DESIGN Secondary analysis of the PITCHES trial (ISRCTN91918806). SETTING United Kingdom. POPULATION OR SAMPLE 527 women with ICP. METHODS Subgroup analyses were performed to determine whether baseline bile acid concentrations or baseline itch scores moderated a woman's response to treatment with UDCA. MAIN OUTCOME MEASURES Bile acid concentration and itch score. RESULTS In women with baseline bile acid concentrations less than 40 μmol/l, treatment with UDCA resulted in increased post-randomisation bile acid concentrations (geometric mean ratio 1.19, 95% CI 1.00-1.41, P = 0.048). A test of interaction showed no significance (P = 0.647). A small, clinically insignificant difference was seen in itch response in women with a high baseline itch score (-6.0 mm, 95% CI -11.80 to -0.21, P = 0.042), with a test of interaction not showing significance (P = 0.640). Further subgroup analyses showed no significance. Across all women there was a weak relationship between bile acid concentrations and itch severity. CONCLUSIONS There was no subgroup of women with ICP in whom a beneficial effect of treatment with UDCA on bile acid concentration or itch score could be identified. This confirms that its routine use in women with this condition for improvement of bile acid concentration or itch score should be reconsidered. TWEETABLE ABSTRACT PITCHES: No group of women with ICP has been found in whom UDCA reduces bile acid concentrations or pruritus.
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Affiliation(s)
- J Fleminger
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - P T Seed
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - A Smith
- National Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - E Juszczak
- National Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - P H Dixon
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | | | - J Dorling
- Division of Neonatal-Perinatal Medicine, IWK Health Centre, Halifax, NS, Canada
| | - C Williamson
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - J G Thornton
- Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
| | - L C Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
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Sharma V, Al Saikhan L, Park C, Hughes A, Gu H, Saeed S, Boguslavskyi A, Carr-White G, Chambers J, Chowienczyk P, Jain M, Jessop H, Turner C, Bassindale-Maguire G, Baig W, Kidambi A, Abdel-Rahman ST, Schlosshan D, Sengupta A, Fitzpatrick A, Sandoval J, Hickman S, Procter H, Taylor J, Kaur H, Knowles C, Wheatcroft S, Witte K, Gatenby K, Willis JA, Kendler-Rhodes A, Slegg O, Carson K, Easaw J, Kandan SR, Rodrigues JCL, MacKenzie-Ross R, Hall T, Robinson G, Little D, Hudson B, Pauling J, Redman S, Graham R, Coghlan G, Suntharalingam J, Augustine DX, Nowak JWM, Masters AT. Report from the Annual Conference of the British Society of Echocardiography, October 2018, ACC Liverpool, Liverpool. Echo Res Pract 2020; 7:M1. [PMID: 33112840 PMCID: PMC8693154 DOI: 10.1530/erp-20-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- V Sharma
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - L Al Saikhan
- MRC Unit for Lifelong Health and Aging at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK.,Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - C Park
- MRC Unit for Lifelong Health and Aging at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - A Hughes
- MRC Unit for Lifelong Health and Aging at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - H Gu
- British Heart Foundation Centre, King's College London, London, UK
| | - S Saeed
- Haukeland University Hospital, Bergen, Norway
| | - A Boguslavskyi
- British Heart Foundation Centre, King's College London, London, UK
| | - G Carr-White
- British Heart Foundation Centre, King's College London, London, UK.,Cardiothoracic Centre, St Thomas' Hospital, London, UK
| | - J Chambers
- Cardiothoracic Centre, St Thomas' Hospital, London, UK
| | - P Chowienczyk
- British Heart Foundation Centre, King's College London, London, UK
| | - M Jain
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK
| | - H Jessop
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK
| | - C Turner
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK.,Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - W Baig
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK
| | - A Kidambi
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK
| | | | - D Schlosshan
- Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK
| | - A Sengupta
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Fitzpatrick
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Sandoval
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Hickman
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Procter
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Taylor
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Kaur
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - C Knowles
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Wheatcroft
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K Witte
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K Gatenby
- Department of Cardiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J A Willis
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | | | - O Slegg
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - K Carson
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - J Easaw
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - S R Kandan
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | | | | | - T Hall
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - G Robinson
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - D Little
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - B Hudson
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - J Pauling
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - S Redman
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - R Graham
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - G Coghlan
- Department of Cardiology, Royal Free Hospital, London, UK
| | - J Suntharalingam
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK.,University of Bath, Bath, UK
| | - D X Augustine
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - J W M Nowak
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - A T Masters
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Chambers J. Computationally scalable geospatial network and routing analysis through multi-level spatial clustering. MethodsX 2020; 7:101072. [PMID: 33014716 PMCID: PMC7522122 DOI: 10.1016/j.mex.2020.101072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022] Open
Abstract
Network analysis finds natural applications in geospatial information systems for a range of applications, notably for thermal grids, which are important for decarbonising thermal energy supply. These analyses are required to operate over a large range of geographic scales. This is a challenge for existing approaches, which face computational scaling challenges with the large datasets now available, such as building and road network data for an entire country. This work presents a system for geospatial modelling of thermal networks including their routing through the existing road network and calculation of flows through the network. This is in contrast to previous thermal network analysis work which could only work with simplified aggregated data.We apply multi-level spatial clustering which enables parallelisation of work sets. We develop algorithms and data processing pipelines for calculating network routing. We use cluster-level caching to enable rapid evaluation of model variants.
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26
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Tso CHM, Johnson TC, Song X, Chen X, Kuras O, Wilkinson P, Uhlemann S, Chambers J, Binley A. Integrated hydrogeophysical modelling and data assimilation for geoelectrical leak detection. J Contam Hydrol 2020; 234:103679. [PMID: 32693365 DOI: 10.1016/j.jconhyd.2020.103679] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/17/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
Time-lapse electrical resistivity tomography (ERT) measurements provide indirectobservations of hydrological processes in the Earth's shallow subsurface at high spatial and temporal resolution. ERT has been used in the past decades to detect leaks and monitor the evolution of associated contaminant plumes. Specifically, inverted resistivity images allow visualization of the dynamic changes in the structure of the plume. However, existing methods do not allow the direct estimation of leak parameters (e.g. leak rate, location, etc.) and their uncertainties. We propose an ensemble-based data assimilation framework that evaluates proposed hydrological models against observed time-lapse ERT measurements without directly inverting for the resistivities. Each proposed hydrological model is run through the parallel coupled hydro-geophysical simulation code PFLOTRAN-E4D to obtain simulated ERT measurements. The ensemble of model proposals is then updated using an iterative ensemble smoother. We demonstrate the proposed framework on synthetic and field ERT data from controlled tracer injection experiments. Our results show that the approach allows joint identification of contaminant source location, initial release time, and solute loading from the cross-borehole time-lapse ERT data, alongside with an assessment of uncertainties in these estimates. We demonstrate a reduction in site-wide uncertainty by comparing the prior and posterior plume mass discharges at a selected image plane. This framework is particularly attractive to sites that have previously undergone extensive geological investigation (e.g., nuclear sites). It is well suited to complement ERT imaging and we discuss practical issues in its application to field problems.
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Affiliation(s)
| | - Tim C Johnson
- Pacific Northwest National Laboratory, Richland, WA, USA
| | - Xuehang Song
- Pacific Northwest National Laboratory, Richland, WA, USA
| | - Xingyuan Chen
- Pacific Northwest National Laboratory, Richland, WA, USA
| | | | | | | | | | - Andrew Binley
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
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27
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Davies A, Tack J, Fernandez A, Chambers J, Sanz JL. Naloxegol for patients with cancer pain diagnosed with opioid induced constipation (OIC): NACASY observational study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e19350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19350 Background: Opioids have been the cornerstone of analgesic treatment for severe chronic pain. OIC is the most commonly reported adverse effect associated with opioids, and compromises patient satisfaction and adherence to analgesic treatment and also quality of life. Naloxegol is a PEGylated derivative of the µ-opioid receptor antagonist naloxone indicated for the treatment of opioid-induced constipation (OIC) in adult patients who have had an inadequate response to laxatives. This real-world (RW) study (NCT03638440) aims to evaluate safety and efficacy of Naloxegol in patients with cancer pain diagnosed with OIC. Methods: This is a single-arm, multinational, prospective, RW observational study in adult subjects receiving treatment with opioids for at least 4 weeks, diagnosed with OIC that receive naloxegol in routine clinical practice. This study will recruit patients from 25 European hospitals. Data for efficacy are collected through the patient's diary during a 4-week period. Results: One hundred fifty-two patients, median age 66 years, 54% women, have been included in this analysis. Main cancer locations were lung (26%), breast (21%), prostate (10%), pancreas (9%) and head and neck (9%), and 67% had metastasis, mainly in bone (37%). Most frequent opioid treatments were fentanyl (29%), oxycodone (22%), and morphine (15%). Most frequent previous laxatives were osmotic (61%) and stimulant (27%) laxatives. Over 109 patients with at least one BFI score available after baseline, change in BFI score was ≥12 points in 61% of patients and 33% had BFI score <30 points after 4 weeks of treatment. There were statistically significant differences between baseline and final visit in BFI overall score as well as in the score of each of the three questions. Most common adverse reactions to naloxegol were abdominal pain (7.9%), diarrhea (2.6%), flatulence (1.3%) and nausea (1.3%), most of them grade 1-2. Eight patients had adverse reactions leading to study discontinuation: abdominal pain (5), diarrhea (2), intestinal perforation (1) and fatigue (1). Only one patient died due to an adverse reaction: intestinal perforation. Conclusions: Preliminary results show a promising efficacy of naloxegol in this RW treatment study. Toxicity profile was as expected. RW evidence seems to be a useful methodology to assess the real-life use of naloxegol and its efficacy in cancer patients.
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Affiliation(s)
- Andrew Davies
- Royal Surrey County Hospital, St. Luke's Cancer Centre, Guildford, United Kingdom
| | - Jan Tack
- University Hospital Gasthuisberg, Leuven, Belgium
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28
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Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Boykoff M, Byass P, Cai W, Campbell-Lendrum D, Capstick S, Chambers J, Dalin C, Daly M, Dasandi N, Davies M, Drummond P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Escobar LE, Fernandez Montoya L, Georgeson L, Graham H, Haggar P, Hamilton I, Hartinger S, Hess J, Kelman I, Kiesewetter G, Kjellstrom T, Kniveton D, Lemke B, Liu Y, Lott M, Lowe R, Sewe MO, Martinez-Urtaza J, Maslin M, McAllister L, McGushin A, Jankin Mikhaylov S, Milner J, Moradi-Lakeh M, Morrissey K, Murray K, Munzert S, Nilsson M, Neville T, Oreszczyn T, Owfi F, Pearman O, Pencheon D, Phung D, Pye S, Quinn R, Rabbaniha M, Robinson E, Rocklöv J, Semenza JC, Sherman J, Shumake-Guillemot J, Tabatabaei M, Taylor J, Trinanes J, Wilkinson P, Costello A, Gong P, Montgomery H. The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. Lancet 2019; 394:1836-1878. [PMID: 31733928 DOI: 10.1016/s0140-6736(19)32596-6] [Citation(s) in RCA: 548] [Impact Index Per Article: 109.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/03/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Nick Watts
- Institute for Global Health, University College London, London, UK.
| | - Markus Amann
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Nigel Arnell
- Department of Meteorology, University of Reading, Reading, UK
| | | | - Kristine Belesova
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maxwell Boykoff
- Cooperative Institute for Research in Environmental Sciences and Environmental Studies, University of Colorado Boulder, Boulder, CO, USA
| | - Peter Byass
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | | | | | - Jonathan Chambers
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Carole Dalin
- Institute for Sustainable Resources, University College London, London, UK
| | - Meaghan Daly
- Department of Environmental Studies, University of New England, Biddeford, ME, USA
| | - Niheer Dasandi
- School of Government, University of Birmingham, Birmingham, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Robert Dubrow
- Yale Climate Change and Health Initiative, Yale University, New Haven, CT, USA
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Matthew Eckelman
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | - Luis E Escobar
- Department of Fish and Wildlife Conservation, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | | | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Paul Haggar
- School of Psychology, Cardiff University, Cardiff, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Stella Hartinger
- The Integrated Development, Health and Environment Unit, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jeremy Hess
- Centre for Health and the Global Environment, University of Washington, Washington, DC, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | | | - Bruno Lemke
- Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Yang Liu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melissa Lott
- Center on Global Energy Policy School of International and Public Affairs, Columbia University, New York City, NY, USA
| | - Rachel Lowe
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- History and Society Division, Babson College, Wellesley, MA, USA
| | - Alice McGushin
- Institute for Global Health, University College London, London, UK
| | | | - James Milner
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- European Centre for Environment and Human Health, University of Exeter, Exeter, UK
| | - Kris Murray
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | | | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Tara Neville
- Department of Public Health and the Environment, WHO, Geneva, Switzerland
| | | | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Olivia Pearman
- Center for Science and Technology Policy Research, University of Colorado Boulder, Boulder, CO, USA
| | | | - Dung Phung
- School of Medicine, Griffith University, Brisbane, QLD, Australia
| | - Steve Pye
- Energy Institute, University College London, London, UK
| | - Ruth Quinn
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Elizabeth Robinson
- School of Agriculture, Policy, and Development, University of Reading, Reading, UK
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jan C Semenza
- Scientific Assessment Section, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jodi Sherman
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | | | - Meisam Tabatabaei
- Faculty of Plantation and Agrotechnology, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Joaquin Trinanes
- Physical Oceanography Division, Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration, Miami, FL, USA
| | - Paul Wilkinson
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Anthony Costello
- Office of the Vice Provost for Research, University College London, London, UK
| | - Peng Gong
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Hugh Montgomery
- Institute for Human Health and Performance, University College London, London, UK
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29
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Manna LB, Ovadia C, Lövgren-Sandblom A, Chambers J, Begum S, Seed P, Walker I, Chappell LC, Marschall HU, Williamson C. Enzymatic quantification of total serum bile acids as a monitoring strategy for women with intrahepatic cholestasis of pregnancy receiving ursodeoxycholic acid treatment: a cohort study. BJOG 2019; 126:1633-1640. [PMID: 31483939 PMCID: PMC6899621 DOI: 10.1111/1471-0528.15926] [Citation(s) in RCA: 21] [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] [Accepted: 08/09/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate enzymatic total serum bile acid quantification as a monitoring strategy for women with intrahepatic cholestasis of pregnancy (ICP) treated with ursodeoxycholic acid (UDCA). DESIGN Cohort. SETTING One UK university hospital. POPULATION 29 ICP cases treated with UDCA. METHODS Serial samples were collected prospectively throughout gestation. Total serum bile acids were measured enzymatically and individual bile acids by high-performance liquid chromatography-tandem mass spectrometry. Data were log-transformed and analysed with random effects generalised least square regression. MAIN OUTCOME MEASURES The relationship between enzymatic total bile acid measurements and individual bile acid concentrations after UDCA treatment. RESULTS In untreated women, cholic acid was the principal bile acid (51%) and UDCA concentrations were <0.5%, whereas UDCA constituted 60% (IQR 43-69) of serum bile acids following treatment and cholic acid fell to <20%. Changes in the total bile acid measurement reflected similar alterations in the concentrations of the pathologically elevated bile acids, e.g. a two-fold increase in enzymatic total bile acids is accompanied by approximately a two-fold increase in cholic acid and chenodeoxycholic acid at most UDCA doses (P < 0.001). Most of the effects of UDCA on cholic acid occur in the first week of treatment (60% relative reduction, P = 0.025, 95% CI 0.2-0.9, from 10 micromol/l (4.7-17.6) to 3.5 micromol/l (1.4-7.5). CONCLUSION Ursodeoxycholic acid becomes the main component of the bile acid measurement after treatment. Enzymatic total bile acid assays are good predictors of both cholic acid and chenodeoxycholic acid, the primary bile acids that are raised prior to treatment. TWEETABLE ABSTRACT Ursodeoxycholic acid constitutes approximately 60% of the bile acid measurement and reduces pathological cholic acid in treated women.
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Affiliation(s)
- L B Manna
- Division of Women and Children's Health, King's College London, London, UK
| | - C Ovadia
- Division of Women and Children's Health, King's College London, London, UK
| | - A Lövgren-Sandblom
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - J Chambers
- Division of Women and Children's Health, King's College London, London, UK.,Women's Health Research Centre, Imperial College Healthcare NHS Trust, London, UK
| | - S Begum
- Division of Women and Children's Health, King's College London, London, UK
| | - P Seed
- Division of Women and Children's Health, King's College London, London, UK
| | - I Walker
- Clinical Biochemistry, Frimley Health NHS trust, Wexham Park Hospital, Slough, UK
| | - L C Chappell
- Division of Women and Children's Health, King's College London, London, UK
| | - H-U Marschall
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Williamson
- Division of Women and Children's Health, King's College London, London, UK
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30
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Olson A, Jahdami VA, Timmons M, Perin E, Chambers J, Willerson J, Rezvani K, Mendt M, Durand J, Shpall E. A clinical trial of intravenous mesenchymal stem cells for treatment of anthracycline associated cardiomyopathy. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.408] [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: 10/26/2022]
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31
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Chambers J, Gibbs T, Speers D, Riley T. The laboratory diagnosis of Clostridium difficile infection. Pathology 2019. [DOI: 10.1016/j.pathol.2018.12.128] [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: 10/27/2022]
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32
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Rawlins MDM, Raby E, Sanfilippo FM, Douglass R, Chambers J, McLellan D, Dyer JR. Adaptation of a hospital electronic referral system for antimicrobial stewardship prospective audit and feedback rounds. Int J Qual Health Care 2019; 30:637-641. [PMID: 29733352 DOI: 10.1093/intqhc/mzy088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/09/2018] [Indexed: 01/04/2023] Open
Abstract
Objective To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Design Retrospective, single-centre observational study between March 2015 and February 2016. Setting A new quaternary referral centre. Study Participants Adults referred for antimicrobial rounds outside of the intensive care and haematology units. Intervention Adaptation of an electronic referral application used by medical and allied health staff. A questionnaire-style referral form was designed to capture patient clinical details using a combination of free text and dropdown menus. Clinical pharmacists were educated and granted access to the system. Main Outcome Measures The proportion of completed electronic referrals of total round reviews by month for the 12 months after implementation. The time from request to completion of reviews. The impact on adherence to advice provided on rounds. The impact on the institutional usage of broad-spectrum antibiotics: glycopeptides, carbapenems, third and fourth generation cephalosporins, fluoroquinolones and piperacillin/tazobactam. Results Over the study period, the proportion of electronic referrals of completed antimicrobial round reviews increased from 59% to 88% (P < 0.001); 75.7% of accepted electronic referrals were seen within 48 h of request. The proportion of advice ignored fell from 18% to 8.5% (P < 0.001). Piperacillin/tazobactam, fluoroquinolone and glycopeptide usage decreased. Conclusions The adaptation of an electronic referral application for antimicrobial rounds was associated with increased adherence to advice and reduction in use in target antibiotics. Our model is now used at other institutions.
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Affiliation(s)
- Matthew D M Rawlins
- Department of Pharmacy, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, Australia
| | - Edward Raby
- Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Frank M Sanfilippo
- Department of Pharmacy, Royal Perth Perth Hospital, Wellington St, Perth, WA, Australia.,School of Population and Global Health, University of Western Australiam, Hackett Drive, Crawley, WA, Australia
| | - Rae Douglass
- Health Support Services, St Georges Terrace, Perth, WA, Australia
| | - Jonathan Chambers
- Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Duncan McLellan
- Western Diagnostic Pathology, McCoy Road, Myaree, WA, Australia
| | - John R Dyer
- Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA, Australia
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33
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Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Berry H, Bouley T, Boykoff M, Byass P, Cai W, Campbell-Lendrum D, Chambers J, Daly M, Dasandi N, Davies M, Depoux A, Dominguez-Salas P, Drummond P, Ebi KL, Ekins P, Montoya LF, Fischer H, Georgeson L, Grace D, Graham H, Hamilton I, Hartinger S, Hess J, Kelman I, Kiesewetter G, Kjellstrom T, Kniveton D, Lemke B, Liang L, Lott M, Lowe R, Sewe MO, Martinez-Urtaza J, Maslin M, McAllister L, Mikhaylov SJ, Milner J, Moradi-Lakeh M, Morrissey K, Murray K, Nilsson M, Neville T, Oreszczyn T, Owfi F, Pearman O, Pencheon D, Pye S, Rabbaniha M, Robinson E, Rocklöv J, Saxer O, Schütte S, Semenza JC, Shumake-Guillemot J, Steinbach R, Tabatabaei M, Tomei J, Trinanes J, Wheeler N, Wilkinson P, Gong P, Montgomery H, Costello A. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet 2018; 392:2479-2514. [PMID: 30503045 DOI: 10.1016/s0140-6736(18)32594-77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/30/2018] [Accepted: 10/12/2018] [Indexed: 05/27/2023]
Affiliation(s)
- Nick Watts
- Institute for Global Health, University College London, London, UK.
| | - Markus Amann
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Nigel Arnell
- Department of Meteorology, University of Reading, Reading, UK
| | | | - Kristine Belesova
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen Berry
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Timothy Bouley
- Health and Climate Change Unit, World Bank, Washington, DC, USA
| | - Maxwell Boykoff
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
| | - Peter Byass
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | | | | | - Meaghan Daly
- Department of Environmental Studies, University of New England, Biddeford, ME, USA
| | - Niheer Dasandi
- School of Government and Society, University of Birmingham, Birmingham, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Anneliese Depoux
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité and Université Paris Sorbonne, Paris, France
| | - Paula Dominguez-Salas
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | | | - Helen Fischer
- Department of Psychology, Heidelberg University, Heidelberg, Germany
| | | | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Ian Hamilton
- UCL Energy Institute, University College London, London, UK
| | | | - Jeremy Hess
- Centre for Health and the Global Environment, University of Washington, Washington, DC, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | | | - Bruno Lemke
- Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Lu Liang
- University of North Texas, Denton, TX, USA
| | - Melissa Lott
- Asia Pacific Energy Research Centre, Tokyo, Japan
| | - Rachel Lowe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Maquins Odhiambo Sewe
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- History and Society Division, University of Colorado Boulder, Boulder, CO, USA
| | | | - James Milner
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- European Centre for the Environment and Human Health, University of Exeter, Exeter, UK
| | - Kris Murray
- Faculty of Medicine, School of Public Health, Imperial college London, London, UK
| | - Maria Nilsson
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tara Neville
- Department of Public Health and the Environment, WHO, Geneva, Switzerland
| | - Tadj Oreszczyn
- UCL Energy Institute, University College London, London, UK
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Olivia Pearman
- Centre for Science and Technology Policy Research, University of Colorado Boulder, Boulder, CO, USA
| | | | - Steve Pye
- UCL Energy Institute, University College London, London, UK
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Elizabeth Robinson
- School of Agriculture, Policy, and Development, University of Reading, Reading, UK
| | - Joacim Rocklöv
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Olivia Saxer
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité and Université Paris Sorbonne, Paris, France
| | - Stefanie Schütte
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité and Université Paris Sorbonne, Paris, France
| | - Jan C Semenza
- European Centre for Disease Control and Prevention, Solna, Sweden
| | | | - Rebecca Steinbach
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Meisam Tabatabaei
- Agricultural Biotechnology Research Institute of Iran, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Julia Tomei
- Institute for Sustainable Resources, University College London, London, UK
| | - Joaquin Trinanes
- Physical Oceanography Division, Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration, Miami, FL, USA
| | - Nicola Wheeler
- Institute for Global Health, University College London, London, UK
| | - Paul Wilkinson
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Peng Gong
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Hugh Montgomery
- Centre for Human Health and Performance, Department of Medicine, University College London, London, UK
| | - Anthony Costello
- Office of the Vice-Provost (Research), University College London, London, UK
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Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Berry H, Bouley T, Boykoff M, Byass P, Cai W, Campbell-Lendrum D, Chambers J, Daly M, Dasandi N, Davies M, Depoux A, Dominguez-Salas P, Drummond P, Ebi KL, Ekins P, Montoya LF, Fischer H, Georgeson L, Grace D, Graham H, Hamilton I, Hartinger S, Hess J, Kelman I, Kiesewetter G, Kjellstrom T, Kniveton D, Lemke B, Liang L, Lott M, Lowe R, Sewe MO, Martinez-Urtaza J, Maslin M, McAllister L, Mikhaylov SJ, Milner J, Moradi-Lakeh M, Morrissey K, Murray K, Nilsson M, Neville T, Oreszczyn T, Owfi F, Pearman O, Pencheon D, Pye S, Rabbaniha M, Robinson E, Rocklöv J, Saxer O, Schütte S, Semenza JC, Shumake-Guillemot J, Steinbach R, Tabatabaei M, Tomei J, Trinanes J, Wheeler N, Wilkinson P, Gong P, Montgomery H, Costello A. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet 2018; 392:2479-2514. [PMID: 30503045 DOI: 10.1016/s0140-6736(18)32594-7] [Citation(s) in RCA: 328] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/30/2018] [Accepted: 10/12/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Nick Watts
- Institute for Global Health, University College London, London, UK.
| | - Markus Amann
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Nigel Arnell
- Department of Meteorology, University of Reading, Reading, UK
| | | | - Kristine Belesova
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen Berry
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Timothy Bouley
- Health and Climate Change Unit, World Bank, Washington, DC, USA
| | - Maxwell Boykoff
- Cooperative Institute for Research in Environmental Sciences, University of Colorado Boulder, Boulder, CO, USA
| | - Peter Byass
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | | | | | - Meaghan Daly
- Department of Environmental Studies, University of New England, Biddeford, ME, USA
| | - Niheer Dasandi
- School of Government and Society, University of Birmingham, Birmingham, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Anneliese Depoux
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité and Université Paris Sorbonne, Paris, France
| | - Paula Dominguez-Salas
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Drummond
- Institute for Sustainable Resources, University College London, London, UK
| | - Kristie L Ebi
- Department of Global Health, University of Washington, Washington, DC, USA
| | - Paul Ekins
- Institute for Sustainable Resources, University College London, London, UK
| | | | - Helen Fischer
- Department of Psychology, Heidelberg University, Heidelberg, Germany
| | | | - Delia Grace
- International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Ian Hamilton
- UCL Energy Institute, University College London, London, UK
| | | | - Jeremy Hess
- Centre for Health and the Global Environment, University of Washington, Washington, DC, USA
| | - Ilan Kelman
- Institute for Global Health, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Programme, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson, New Zealand
| | | | - Bruno Lemke
- Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - Lu Liang
- University of North Texas, Denton, TX, USA
| | - Melissa Lott
- Asia Pacific Energy Research Centre, Tokyo, Japan
| | - Rachel Lowe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Maquins Odhiambo Sewe
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Lucy McAllister
- History and Society Division, University of Colorado Boulder, Boulder, CO, USA
| | | | - James Milner
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Karyn Morrissey
- European Centre for the Environment and Human Health, University of Exeter, Exeter, UK
| | - Kris Murray
- Faculty of Medicine, School of Public Health, Imperial college London, London, UK
| | - Maria Nilsson
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tara Neville
- Department of Public Health and the Environment, WHO, Geneva, Switzerland
| | - Tadj Oreszczyn
- UCL Energy Institute, University College London, London, UK
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Olivia Pearman
- Centre for Science and Technology Policy Research, University of Colorado Boulder, Boulder, CO, USA
| | | | - Steve Pye
- UCL Energy Institute, University College London, London, UK
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Elizabeth Robinson
- School of Agriculture, Policy, and Development, University of Reading, Reading, UK
| | - Joacim Rocklöv
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Olivia Saxer
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité and Université Paris Sorbonne, Paris, France
| | - Stefanie Schütte
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité and Université Paris Sorbonne, Paris, France
| | - Jan C Semenza
- European Centre for Disease Control and Prevention, Solna, Sweden
| | | | - Rebecca Steinbach
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Meisam Tabatabaei
- Agricultural Biotechnology Research Institute of Iran, Agricultural Research, Education, and Extension Organisation, Tehran, Iran
| | - Julia Tomei
- Institute for Sustainable Resources, University College London, London, UK
| | - Joaquin Trinanes
- Physical Oceanography Division, Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration, Miami, FL, USA
| | - Nicola Wheeler
- Institute for Global Health, University College London, London, UK
| | - Paul Wilkinson
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Peng Gong
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Hugh Montgomery
- Centre for Human Health and Performance, Department of Medicine, University College London, London, UK
| | - Anthony Costello
- Office of the Vice-Provost (Research), University College London, London, UK
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Chambers J, Page-Sharp M, Salman S, Dyer J, Davis TME, Batty KT, Manning L. Ertapenem for osteoarticular infections in obese patients: a pharmacokinetic study of plasma and bone concentrations. Eur J Clin Pharmacol 2018; 75:511-517. [PMID: 30511329 DOI: 10.1007/s00228-018-2597-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/04/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Ertapenem is used off-label to treat osteoarticular infections but there are few pharmacokinetic (PK) data to guide optimal dosing strategies in patients who may be obese with multiple co-morbidities including diabetes and peripheral vascular disease. METHODS Participants undergoing lower limb amputation or elective joint arthroplasty received a dose of intravenous ertapenem prior to surgery. Eight plasma samples were collected over 24 h, together with at least one bone sample per patient. Ertapenem concentrations in plasma and bone were measured using liquid-chromatography/mass-spectroscopy and analysed using non-linear mixed effects PK modelling. RESULTS Plasma and bone concentrations were obtained from 10 participants. The final population PK model showed that a fat free body mass was the most appropriate body size adjustment. Ertapenem diffused rapidly into bone but concentrations throughout the 24 h dosing period were on average 40-fold higher in plasma, corresponding to a bone to plasma ratio of 0.025, and highly variable between individuals. Simulations demonstrated a high probability of target attainment (PTA) for free plasma concentrations when the minimum inhibitory concentrations (MIC) were ≤ 0.25 mg/L. By contrast, at MICs of 0.5 mg/L and ≥ 1 mg/L, the fractions of patients attaining this target was ~ 80% and 40%, respectively. In bone, the PTA was ≤ 45% when the MIC was ≥ 0.25 mg/L. CONCLUSION Local bone and free plasma concentrations appear adequate for osteoarticular infections where Enterobacteriaceae are the main causative pathogens, but for Staphylococcus aureus and other bacteria, conventional dosing may lead to inadequate PTA.
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Affiliation(s)
- Jonathan Chambers
- Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Madhu Page-Sharp
- School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Sam Salman
- Faculty of Health and Medical Sciences, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - John Dyer
- Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Timothy M E Davis
- Faculty of Health and Medical Sciences, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Kevin T Batty
- School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Laurens Manning
- Faculty of Health and Medical Sciences, Harry Perkins Research Institute, Fiona Stanley Hospital, University of Western Australia, PO Box 404, Bull Creek 6149, Murdoch, Western Australia, Australia.
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Watts N, Amann M, Ayeb-Karlsson S, Belesova K, Bouley T, Boykoff M, Byass P, Cai W, Campbell-Lendrum D, Chambers J, Cox PM, Daly M, Dasandi N, Davies M, Depledge M, Depoux A, Dominguez-Salas P, Drummond P, Ekins P, Flahault A, Frumkin H, Georgeson L, Ghanei M, Grace D, Graham H, Grojsman R, Haines A, Hamilton I, Hartinger S, Johnson A, Kelman I, Kiesewetter G, Kniveton D, Liang L, Lott M, Lowe R, Mace G, Odhiambo Sewe M, Maslin M, Mikhaylov S, Milner J, Latifi AM, Moradi-Lakeh M, Morrissey K, Murray K, Neville T, Nilsson M, Oreszczyn T, Owfi F, Pencheon D, Pye S, Rabbaniha M, Robinson E, Rocklöv J, Schütte S, Shumake-Guillemot J, Steinbach R, Tabatabaei M, Wheeler N, Wilkinson P, Gong P, Montgomery H, Costello A. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet 2018; 391:581-630. [PMID: 29096948 DOI: 10.1016/s0140-6736(17)32464-9] [Citation(s) in RCA: 418] [Impact Index Per Article: 69.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/31/2017] [Accepted: 09/08/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Nick Watts
- Institute of Global Health, University College London, London, UK.
| | - Markus Amann
- Air Quality and Greenhouse Gases Program and Greenhouse Gas Initiative, International Institute for Applied Systems Analysis, Vienna, Austria
| | - Sonja Ayeb-Karlsson
- Environmental Migration, Social Vulnerability and daptation section (EMSVA), Institute for Environment and Security, United Nations University, Bonn, Germany
| | - Kristine Belesova
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Timothy Bouley
- Climate Change Department, World Bank, Washington, DC, USA
| | - Maxwell Boykoff
- Center for Science and Technology Policy, University of Colorado-Boulder, Boulder, CO, USA
| | - Peter Byass
- Epidemiology & Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Wenjia Cai
- School of Environment, Tsinghua University, Beijing, China
| | - Diarmid Campbell-Lendrum
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | | | - Peter M Cox
- College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, UK
| | - Meaghan Daly
- Center for Science and Technology Policy, University of Colorado-Boulder, Boulder, CO, USA
| | - Niheer Dasandi
- International Development Department, University of Birmingham, Birmingham, UK
| | - Michael Davies
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - Anneliese Depoux
- Centre Virchow-Villermé for Public Health Paris-Berlin, Paris, France
| | - Paula Dominguez-Salas
- Department of Production and Population Health, Royal Veterinary College, London, UK
| | - Paul Drummond
- UCL Institute of Sustainable Resources, University College London, London, UK
| | - Paul Ekins
- UCL Institute of Sustainable Resources, University College London, London, UK
| | - Antoine Flahault
- Centre Virchow-Villermé for Public Health Paris-Berlin, Paris, France
| | - Howard Frumkin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | | | - Mostafa Ghanei
- Chemical Injuries Research Center, University of Medical Sciences, Tehran, Iran
| | - Delia Grace
- Food Safety and Zoonoses Program, International Livestock Research Institute, Nairobi, Kenya
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Rébecca Grojsman
- Centre Virchow-Villermé for Public Health Paris-Berlin, Paris, France
| | - Andy Haines
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Hamilton
- UCL Energy Institute, University College London, London, UK
| | - Stella Hartinger
- Unidad de Desarrollo Integral, Ambiente y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Anne Johnson
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ilan Kelman
- UCL Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Gregor Kiesewetter
- Air Quality and Greenhouse Gases Program and Greenhouse Gas Initiative, International Institute for Applied Systems Analysis, Vienna, Austria
| | | | - Lu Liang
- School of Forestry and Natural Resources, University of Arkansas at Monticello, Monticello, AR, USA
| | - Melissa Lott
- UCL Institute of Sustainable Resources, University College London, London, UK
| | - Robert Lowe
- UCL Energy Institute, University College London, London, UK
| | - Georgina Mace
- Department of Genetics, Evolution and Environment, University College London, London, UK
| | - Maquins Odhiambo Sewe
- Epidemiology & Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mark Maslin
- Department of Geography, University College London, London, UK
| | - Slava Mikhaylov
- Institute for Analytics and Data Science, University of Essex, Colchester, UK
| | - James Milner
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Ali Mohammad Latifi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Karyn Morrissey
- European Centre for Environment & Human Health, University of Exeter, Exeter, UK
| | - Kris Murray
- Grantham Institute-Climate Change and the Environment, Imperial College London, London, UK
| | - Tara Neville
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Maria Nilsson
- Epidemiology & Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tadj Oreszczyn
- Bartlett School of Environment, Energy and Resources, Bartlett Faculty of the Built Environment, University College London, London, UK
| | - Fereidoon Owfi
- Iranian Fisheries Science Research Institute, AREEO, Tehran, Iran
| | | | - Steve Pye
- UCL Energy Institute, University College London, London, UK
| | - Mahnaz Rabbaniha
- Iranian Fisheries Science Research Institute, AREEO, Tehran, Iran
| | - Elizabeth Robinson
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Joacim Rocklöv
- Epidemiology & Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Stefanie Schütte
- Centre Virchow-Villermé for Public Health Paris-Berlin, Paris, France
| | - Joy Shumake-Guillemot
- WHO/WMO Joint Climate and Health Office, World Meteorological Organization, Geneva, Switzerland
| | - Rebecca Steinbach
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Meisam Tabatabaei
- Biofuel Research Team, Agricultural Biotechnology Research Institute of Iran, AREEO, Karaj, Iran
| | - Nicola Wheeler
- Institute of Global Health, University College London, London, UK
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Peng Gong
- Centre for Earth System Science, Tsinghua University, Beijing, China
| | - Hugh Montgomery
- Centre for Human Health and Performance, Division of Medicine, University College London, London, UK
| | - Anthony Costello
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
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Macbeth A, Tomlinson J, Messenger A, Moore-Millar K, Michaelides C, Shipman A, Kassim J, Brockley J, Szczecinska W, Farrant P, Robinson R, Rodgers J, Chambers J, Upadhyaya S, Harries M. 设立针对脱发(斑秃除外)预防、诊断和治疗的研究问题并安排优先顺序:脱发优先设定合作伙伴关系. Br J Dermatol 2018. [DOI: 10.1111/bjd.16308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Macbeth A, Tomlinson J, Messenger A, Moore-Millar K, Michaelides C, Shipman A, Kassim J, Brockley J, Szczecinska W, Farrant P, Robinson R, Rodgers J, Chambers J, Upadhyaya S, Harries M. Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership. Br J Dermatol 2018. [DOI: 10.1111/bjd.16290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Macbeth A, Tomlinson J, Messenger A, Moore-Millar K, Michaelides C, Shipman A, Kassim J, Brockley J, Szczecinska W, Farrant P, Robinson R, Rodgers J, Chambers J, Upadhyaya S, Harries M. Establishing and prioritizing research questions for the prevention, diagnosis and treatment of hair loss (excluding alopecia areata): the Hair Loss Priority Setting Partnership. Br J Dermatol 2018; 178:535-540. [DOI: 10.1111/bjd.15810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. Macbeth
- Department of Dermatology; Norfolk and Norwich University Hospitals NHS Foundation Trust; Colney Lane Norwich NR4 7UY U.K
| | | | - A. Messenger
- Department of Dermatology; University of Sheffield; Royal Hallamshire Hospital; Sheffield U.K
| | - K. Moore-Millar
- Department of Design, Manufacturing and Engineering; University of Strathclyde; Glasgow U.K
| | | | - A. Shipman
- Department of Dermatology; Warwick Hospital; Warwick Warwickshire U.K
| | - J. Kassim
- Dermatology Centre; St Mary's Hospital; Portsmouth U.K
| | - J. Brockley
- Department of Dermatology; Cannock Chase Hospital; Cannock U.K
| | - W. Szczecinska
- Department of Dermatology; Heart of England NHS Foundation Trust Standard Institution; Birmingham U.K
| | - P. Farrant
- Department of Dermatology; Brighton and Sussex University Hospitals NHS Trust; Brighton U.K
| | - R. Robinson
- Department of Dermatology; Harrogate and District NHS Foundation Trust; Harrogate North Yorkshire U.K
| | | | | | | | - M. Harries
- The Dermatology Centre; University of Manchester; Salford Royal NHS Foundation Trust; Salford Greater Manchester U.K
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Garner JM, Chambers J, Barnes AK, Datta S. Changes in Brain-Derived Neurotrophic Factor Expression Influence Sleep-Wake Activity and Homeostatic Regulation of Rapid Eye Movement Sleep. Sleep 2017; 41:4643005. [PMID: 29462410 PMCID: PMC6018753 DOI: 10.1093/sleep/zsx194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Study Objectives Brain-derived neurotrophic factor (BDNF) expression and homeostatic regulation of rapid eye movement (REM) sleep are critical for neurogenesis and behavioral plasticity. Accumulating clinical and experimental evidence suggests that decreased BDNF expression is causally linked with the development of REM sleep-associated neuropsychiatric disorders. Therefore, we hypothesize that BDNF plays a role in sleep–wake (S–W) activity and homeostatic regulation of REM sleep. Methods Male and female wild-type (WT; BDNF +/+) and heterozygous BDNF (KD; BDNF +/−) rats were chronically implanted with S–W recording electrodes to quantify baseline S–W activity and REM sleep homeostatic regulatory processes during the light phase. Results Molecular analyses revealed that KD BDNF rats had a 50% decrease in BDNF protein levels. During baseline S–W activity, KD rats exhibited fewer REM sleep episodes that were shorter in duration and took longer to initiate. Also, the baseline S–W activity did not reveal any sex difference. During the 3-hour selective REM sleep deprivation, KD rats failed to exhibit a homeostatic drive for REM sleep and did not exhibit rebound REM sleep during the recovery S–W period. Conclusion Interestingly, both genotypes did not reveal any sex difference in the quality and/or quantity of REM sleep. Collectively, these results, for the first time, unequivocally demonstrate that an intact BDNF system in both sexes is a critical modulator for baseline and homeostatic regulation of REM sleep. This study further suggests that heterozygous BDNF knockdown rats are a useful animal model for the study of the cellular and molecular mechanisms of sleep regulation and cognitive functions of sleep.
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Affiliation(s)
- Jennifer M Garner
- Department of Anesthesiology, Graduate School of Medicine, University of Tennessee, Knoxville, TN.,Department of Psychology, College of Arts and Sciences, Knoxville, TN
| | - Jonathan Chambers
- Department of Anesthesiology, Graduate School of Medicine, University of Tennessee, Knoxville, TN
| | - Abigail K Barnes
- Department of Anesthesiology, Graduate School of Medicine, University of Tennessee, Knoxville, TN.,Department of Psychology, College of Arts and Sciences, Knoxville, TN
| | - Subimal Datta
- Department of Anesthesiology, Graduate School of Medicine, University of Tennessee, Knoxville, TN.,Department of Psychology, College of Arts and Sciences, Knoxville, TN.,Program in Comparative and Experimental Medicine; University of Tennessee, Knoxville, TN
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Armstrong A, Bui C, Fitch K, Sawhney TG, Brown B, Flanders S, Balk M, Deangelis J, Chambers J. Docetaxel chemotherapy in metastatic castration-resistant prostate cancer: cost of care in Medicare and commercial populations. Curr Med Res Opin 2017; 33:1133-1139. [PMID: 28318331 DOI: 10.1080/03007995.2017.1308919] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To estimate the healthcare costs and characteristics of docetaxel chemotherapy episodes of care for men with metastatic castration-resistant prostate cancer (mCRPC). METHODS This study used the Medicare 5% sample and MarketScan Commercial (2010-2013) claims data sets to identify men with mCRPC and initial episodes of docetaxel treatment. Docetaxel episodes included docetaxel claim costs from the first claim until 30 days after the last claim, with earlier termination for death, insurance disenrollment, or the end of a 24-month look-forward period from initial docetaxel index date. Docetaxel drug claim costs were adjusted for 2011 generic docetaxel introduction, while other costs were adjusted to 2015 values using the national average annual unit cost increase. RESULTS This study identified 281 Medicare-insured and 155 commercially insured men, with 325 and 172 docetaxel episodes, respectively. The average number of cycles (unique docetaxel infusion days) per episode was 6.9 for Medicare and 6.3 for commercial cohorts. The average cost per episode was $28,792 for Medicare and $67,958 for commercial cohorts, with docetaxel drug costs contributing $2,588 and $13,169 per episode, respectively. The average cost per episode on docetaxel infusion days was $8,577 (30%) for Medicare and $28,412 (42%) for commercial. Non-docetaxel infusion day costs included $7,074 (25%) for infused or injected drugs for Medicare, $10,838 (16%) for commercial cohorts, and $6,875 (24%) and $9,324 (14%) for inpatient admissions, respectively. LIMITATIONS The applicability is only to the metastatic castration-resistance clinical setting, rather than the metastatic hormone-sensitive setting, and the lack of data on the cost effectiveness of different sequencing strategies of a range of systemic therapies including enzalutamide, abiraterone, radium-223, and taxane chemotherapy. CONCLUSION The majority of docetaxel episode costs in Medicare and commercial mCRPC populations were non-docetaxel drug costs. Future research should evaluate the total cost of care in mCPRC.
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Affiliation(s)
| | - C Bui
- b Astellas Pharma, Inc. , Northbrook , IL , USA
| | - K Fitch
- c Milliman, Inc. , New York, NY , USA
| | | | - B Brown
- b Astellas Pharma, Inc. , Northbrook , IL , USA
| | - S Flanders
- b Astellas Pharma, Inc. , Northbrook , IL , USA
| | - M Balk
- d Formerly of Medivation, Inc., which was acquired by Pfizer, Inc. in September 2016 , San Francisco , CA , USA
| | - J Deangelis
- b Astellas Pharma, Inc. , Northbrook , IL , USA
| | - J Chambers
- e Tufts Medical Center , Boston , MA , USA
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Macbeth A, Tomlinson J, Messenger A, Moore-Millar K, Michaelides C, Shipman A, Kassim J, Brockley J, Szczecinska W, Farrant P, Robinson R, Rodgers J, Chambers J, Upadhyaya S, Harries M. Establishing and prioritizing research questions for the treatment of alopecia areata: the Alopecia Areata Priority Setting Partnership. Br J Dermatol 2017; 176:1316-1320. [DOI: 10.1111/bjd.15099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A.E. Macbeth
- Department of Dermatology; Norfolk and Norwich University Hospitals NHS Foundation Trust; Colney Lane; Norwich NR4 7UY U.K
| | | | - A.G. Messenger
- Dermatology; University of Sheffield; Royal Hallamshire Hospital; Sheffield U.K
| | - K. Moore-Millar
- Design, Manufacturing and Engineering; University of Strathclyde; Glasgow U.K
| | | | | | - J.M. Kassim
- Dermatology Centre; St Mary's Hospital; Portsmouth U.K
| | - J.R. Brockley
- Cannock Chase Hospital; The Royal Wolverhampton NHS Trust; Cannock U.K
| | - W. Szczecinska
- Dermatology Department; Solihull Hospital; Heart of England NHS Foundation Trust; Solihull U.K
| | - P. Farrant
- Department of Dermatology; Brighton and Sussex University Hospitals NHS Trust; Brighton U.K
| | - R. Robinson
- Harrogate and District NHS Foundation Trust; Harrogate U.K
| | | | | | | | - M.J. Harries
- The Dermatology Centre; University of Manchester; Salford Royal NHS Foundation Trust; Salford U.K
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Gossage JA, Ali T, Chambers J, Burnand KG. Peripheral Arterial Embolism: Prevalence, Outcome, and the Role of Echocardiography in Management. Vasc Endovascular Surg 2016; 40:280-6. [PMID: 16959721 DOI: 10.1177/1538574406291820] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 11/16/2022]
Abstract
The aims of this study were to review the prevalence and outcome of all surgically treated upper and lower limb emboli presenting to one vascular unit in the last 3 years and to compare transthoracic with transesophageal echocardiography for defining the source of the embolus. All patients who underwent surgical embolectomy for acute limb ischemia from January 2001 to June 2004 were reviewed. Transthoracic and transesophageal echocardiography were carried out on a subset of consecutive unselected patients. Forty-two patients, with a mean age of 80 years, underwent surgical embolectomy from January 2001 to June 2004 (M/F 1:1.8): 27 for lower limb ischemia and 15 for upper limb ischemia. Two thirds of these patients were found to be in atrial fibrillation at presentation (n=28), of whom less than a third were receiving anticoagulants or antiplatelet agents (n=8). The mean hospital stay was 15 days with 36 patients (86%) being fully anticoagulated before discharge from hospital. The 30-day mortality rate was 11% (n=3/27) with 5 patients requiring fasciotomies (12%) and 3 patients requiring an amputation of the lower limb (11%). Postoperatively, 34 patients (81%) had transthoracic echocardiography (TTE), which demonstrated a source or potential source for thrombus in 19 (56%). Fifteen patients (36%) had transesophageal echocardiography (TEE), which changed the subsequent management in 3 patients. All patients in whom TEE altered clinical management would have required this investigation if standard clinical guidelines were followed. TEE did not identify any additional patients with cardiac embolic sources that were not detected by TTE. Arterial limb emboli are still prevalent, but limb salvage and mortality rates appear to be improving. Despite clear guidelines on anticoagulation for patients in atrial fibrillation, many are not receiving appropriate treatment. Transthoracic echocardiography is a good screening tool for detecting a potential cardiac source for peripheral embolism, with transesophageal echocardiography being reserved for specific indications.
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He L, Tuomilehto J, Qiao Q, Söderberg S, Daimon M, Chambers J, Pitkäniemi J. Impact of classical risk factors of type 2 diabetes among Asian Indian, Chinese and Japanese populations. Diabetes Metab 2015; 41:401-9. [PMID: 26381573 DOI: 10.1016/j.diabet.2015.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 07/17/2015] [Accepted: 07/24/2015] [Indexed: 01/10/2023]
Abstract
AIMS This review investigated the population impact of major modifiable type 2 diabetes (T2D) risk factors, with special focus on native Asian Indians, to estimate population attributable risks (PARs) and compare them with estimates from Chinese and Japanese populations. METHODS Information was obtained on risk factors in 21,041 Asian Indian, 17,774 Chinese and 17,986 Japanese populations from multiple, large, cross-sectional studies (the DECODA project) of T2D. Crude and adjusted PARs were estimated for the major T2D risk factors. RESULTS Age had the highest crude and adjusted PARs among Asian Indians and Chinese in contrast to waist-hip ratio among Japanese. After adjusting for age, the PAR for body mass index (BMI) in Asian Indians (41.4% [95% CI: 37.2%; 45.4%]) was second only to triglycerides (46.4% [95% CI: 39.5%; 52.8%]) compared with 35.8% [95% CI: 29.9%; 41.4%] in Japanese and 38.4% [95% CI: 33.5%; 43.2%] in Chinese people. The PAR for BMI adjusted for age, LDL and triglycerides (39.7% [95% CI: 31.6%; 47.2%]) was higher than for any other factor in Asian Indians, and was much higher than in the Chinese (16.8% [95% CI: 3.0%; 30.9%]) and Japanese (30.4% [95% CI: 17.5%; 42.2%]) populations. CONCLUSION This review provides estimates of the association between major risk factors and prevalences of T2D among Asian populations by examining their PARs from large population-based samples. From a public-health point of view, the importance of BMI in Asian Indians is especially highlighted in comparison to the other Asian populations. Given these results and other recent findings on the causality link between BMI and T2D, it can be postulated that obesity may be involved in the aetiology of T2D through interaction with ethnic-specific genetic factors, although ethnicity itself is not a direct risk factor for T2D as people of all ethnic backgrounds develop diabetes.
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Affiliation(s)
- L He
- Department of Public Health, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland.
| | - J Tuomilehto
- Centre for Vascular Prevention, Danube-University Krems, 3500 Krems, Austria; Chronic Disease Prevention Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
| | - Q Qiao
- Department of Public Health, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland
| | - S Söderberg
- Department of Public Health and Clinical Medicine, Cardiology, Umeå University, Umeå, Sweden
| | - M Daimon
- Department of Neurology, Metabolism, Endocrinology and Diabetology, Faculty of Medicine, Yamagata University, Yamagata, Japan; Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - J Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1NY, United Kingdom; Imperial College Healthcare NHS Trust, Hammersmith Hospital, London W12 0HS, United Kingdom; Royal Brompton and Harefield Hospitals NHS Trust, London SW3 6NP, United Kingdom; Ealing Hospital NHS Trust, Southall, Middlesex UB1 3HW, United Kingdom
| | - J Pitkäniemi
- Department of Public Health, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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Holdsworth DA, Mulae J, Williams A, Jackson S, Chambers J. Valvular heart disease and the military patient. J ROY ARMY MED CORPS 2015; 161:223-9. [PMID: 26240189 DOI: 10.1136/jramc-2015-000508] [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: 06/28/2015] [Accepted: 06/29/2015] [Indexed: 11/03/2022]
Abstract
Valvular heart disease refers to all inherited and acquired abnormalities impairing the function of one or more of the four cardiac valves. Pathology may be of the valve leaflets themselves, of the subvalvular apparatus or of the annulus or other surrounding structures that influences valve function. This paper examines the most common valve lesions, with specific reference to a military population; it focuses on detection and initial management of valve disease in a young adult population and specifically describes how the diagnosis and treatment of valve disease impacts military medical grading.
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Affiliation(s)
- D A Holdsworth
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - J Mulae
- Horton General Hospital, Banbury, Oxfordshire, UK
| | - A Williams
- Cardiology Department, Royal Gwent Hospital, Newport, South Wales, UK
| | - S Jackson
- Department of Occupational Medicine, Army Medical Directorate, Andover, UK
| | - J Chambers
- Guy's and St Thomas' Hospital, London, UK
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Chiu K, Chambers J, Chandler I, Osborne M. P-250 Clinical Impact and Cost Implication of Routine MMR Protein Immunohistochemistry in High Risk Dukes B Colon Cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.247] [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: 11/13/2022] Open
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Affiliation(s)
- J Chambers
- From the British Heart Valve Society, Society for Cardiological Science and Technology, British Association of Nursing for Cardiac Care and Royal College of General Practitioners
| | - B Campbell
- From the British Heart Valve Society, Society for Cardiological Science and Technology, British Association of Nursing for Cardiac Care and Royal College of General Practitioners
| | - J Wilson
- From the British Heart Valve Society, Society for Cardiological Science and Technology, British Association of Nursing for Cardiac Care and Royal College of General Practitioners
| | - C Arden
- From the British Heart Valve Society, Society for Cardiological Science and Technology, British Association of Nursing for Cardiac Care and Royal College of General Practitioners
| | - S Ray
- From the British Heart Valve Society, Society for Cardiological Science and Technology, British Association of Nursing for Cardiac Care and Royal College of General Practitioners
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Chambers J. Introduction to the British Heart Valve Society reviews. Int J Clin Pract 2014; 68:1179-80. [PMID: 25269947 DOI: 10.1111/ijcp.12224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- J Chambers
- Cardiothoracic Centre, St Thomas' Hospital, London, UK.
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