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Carrera JM, Aktepe TE, Earnest L, Christiansen D, Wheatley AK, Tan HX, Chung AW, Collett S, McPherson K, Torresi J, Mackenzie JM, Simmons CP. Adenovirus vector produced Zika virus-like particles induce a long-lived neutralising antibody response in mice. Vaccine 2023:S0264-410X(23)00757-0. [PMID: 37391311 DOI: 10.1016/j.vaccine.2023.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
Countermeasures against Zika virus (ZIKV) epidemics are urgently needed. In this study we generated a ZIKV virus-like particle (VLP) based vaccine candidate and assessed the immunogenicity of these particles in mice. The ZIKV-VLPs were morphologically similar to ZIKV by electron microscopy and were recognized by anti-Flavivirus neutralising antibodies. We observed that a single dose of unadjuvanted ZIKV-VLPs, or inactivated ZIKV, generated an immune response that lasted over 6 months, but did not neutralize ZIKV infection of cells in vitro. However, when we co-administered the ZIKV VLPs with either Aluminium hydroxide (Alhydrogel®; Alum), AddaVax or Pam2Cys we observed that Alum was the most effective in a single dose regime, since it not only produced antibodies that neutralized the virus, but also generated a greater number of antigen-specific memory B cells. We additionally observed that the generation of the neutralising antibodies persisted for up to 6 months. Our results suggest that a single dose ZIKV VLPs could be a suitable single dose vaccine candidate for use in outbreak settings.
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Affiliation(s)
- Julio M Carrera
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia; Institute of Vector-Borne Diseases, Monash University, Clayton, VIC 3800, Australia
| | - Turgut E Aktepe
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Linda Earnest
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Dale Christiansen
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Hyon-Xhi Tan
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Amy W Chung
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Simon Collett
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, VIC 3000, Australia
| | - Kirsty McPherson
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Joseph Torresi
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia
| | - Jason M Mackenzie
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty for Infection and Immunity, Parkville, Melbourne, VIC 3010, Australia.
| | - Cameron P Simmons
- Institute of Vector-Borne Diseases, Monash University, Clayton, VIC 3800, Australia.
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Rana D, Wu O, Cheed V, Middleton LJ, Moss J, Lumsden MA, McKinnon W, Daniels J, Sirkeci F, Manyonda I, Belli AM, McPherson K. Uterine artery embolisation or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: a cost-utility analysis of the FEMME trial. BJOG 2021; 128:1793-1802. [PMID: 34053154 DOI: 10.1111/1471-0528.16781] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the cost-effectiveness of uterine artery embolisation (UAE) and myomectomy for women with symptomatic uterine fibroids wishing to avoid hysterectomy. DESIGN Economic evaluation alongside the FEMME randomised controlled trial. SETTING 29 UK hospitals. POPULATION Premenopausal women who had symptomatic uterine fibroids amenable to UAE or myomectomy wishing to avoid hysterectomy. 254 women were randomised to UAE (127) and myomectomy (127). METHODS A within-trial cost-utility analysis was conducted from the perspective of the UK NHS. MAIN OUTCOME MEASURES Quality-adjusted life years (QALYs) measured using the EuroQoL EQ-5D-3L, combined with costs to estimate cost-effectiveness over 2 and 4 years of follow-up. RESULTS Over a 2-year time horizon, UAE was associated with higher mean costs (difference £645; 95% CI -1381 to 2580) and lower QALYs (difference -0.09; 95% CI -0.11 to -0.04) when compared with myomectomy. Similar results were observed over the 4-year time horizon. Thus, UAE was dominated by myomectomy. Results of the sensitivity analyses were consistent with the base case results for both years. Over 2 years, UAE was associated with higher costs (difference £456; 95% CI -1823 to 3164) and lower QALYs (difference -0.06; 95% CI -0.11 to -0.02). CONCLUSIONS Myomectomy is a cost-effective option for the treatment of uterine fibroids. The differences in costs and QALYs are small. Women should be fully informed and have the option to choose between the two procedures.
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Affiliation(s)
- D Rana
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - O Wu
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - V Cheed
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - L J Middleton
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - J Moss
- School of Medicine, University of Glasgow, Glasgow, UK
| | - M-A Lumsden
- School of Medicine, University of Glasgow, Glasgow, UK
| | - W McKinnon
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - J Daniels
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - F Sirkeci
- Department of Obstetrics and Gynaecology, Whipps Cross Hospital, London, UK
| | - I Manyonda
- Department of Gynaecology, St George's Hospital and Medical School, London, UK
| | - A-M Belli
- Department of Radiology, St George's Hospital and Medical School, London, UK
| | - K McPherson
- Department of Primary Care, University of Oxford, Oxford, UK
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Elgie LD, McPherson K, Yeung J, Marshall L, Windsor R, Bandula S. In-circuit high-frequency jet ventilation to reduce organ motion in a child undergoing sarcoma ablation. Anaesth Rep 2021; 9:55-58. [PMID: 33860230 DOI: 10.1002/anr3.12107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/06/2022] Open
Abstract
Patients with primary or metastatic solid tumours can be treated with minimally invasive image-guided procedures as an alternative to surgical resection. Reducing organ motion during these procedures is crucial so that tumours can be accurately targeted and treatment delivered within a small margin, limiting potential damage to adjacent structures. As ventilation is the main cause of motion, there has been a shift from conventional ventilation towards the use of in-circuit high-frequency jet ventilation techniques for these procedures. We present the case of a 7-year-old who required computed tomography-guided microwave ablation of a right lung metastatic nodule under general anaesthesia. The patient's lungs were ventilated with in-circuit high-frequency jet ventilation in order to provide optimum conditions for ablation. The treatment was successfully completed and she was discharged home the following day. High-frequency jet ventilation is regularly used in our institution for adult computed tomography-guided treatments and to our knowledge, this application has not been described yet in a child this young. Our experience suggests that this technique can be safely used in paediatric patients, though further investigation of the optimum parameters for in-circuit high-frequency jet ventilation in this population is warranted.
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Affiliation(s)
- L D Elgie
- Department of Anaesthesia University College London Hospitals NHS Foundation Trust London UK
| | - K McPherson
- Department of Anaesthesia University College London Hospitals NHS Foundation Trust London UK
| | - J Yeung
- Department of Imaging University College London Hospitals NHS Foundation Trust London UK
| | - L Marshall
- Children and Young People's Unit The Royal Marsden NHS Foundation Trust London UK
| | - R Windsor
- Department of Oncology University College London Hospitals NHS Foundation Trust London UK
| | - S Bandula
- UCL Centre for Medical Imaging University College London Hospitals NHS Foundation Trust London UK
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McPherson K, Smith J, Schoeppler K, Gray A. Survival in Lung Transplant Recipients on a Calcineurin Free Regimen: Is It Possible? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.726] [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: 10/24/2022] Open
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Barbera L, Zwaal C, Elterman D, McPherson K, Wolfman W, Katz A, Matthew A. Interventions to address sexual problems in people with cancer. Curr Oncol 2017; 24:192-200. [PMID: 28680280 PMCID: PMC5486385 DOI: 10.3747/co.24.3583] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 01/08/2023] Open
Abstract
BACKGROUND Sexual dysfunction in people with cancer is a significant problem. The present clinical practice guideline makes recommendations to improve sexual function in people with cancer. METHODS This guideline was undertaken by the Interventions to Address Sexual Problems in People with Cancer Expert Panel, a group organized by the Program in Evidence-Based Care (pebc). Consistent with the pebc standardized approach, a systematic search was conducted for existing guidelines, and the literature in medline and embase for the years 2003-2015 was systematically searched for both systematic reviews and primary literature. Evidence found for men and for women was evaluated separately, and no restrictions were placed on cancer type or study design. Content and methodology experts performed an internal review of the resulting draft recommendations, which was followed by an external review by targeted experts and intended users. RESULTS The search identified 4 existing guidelines, 13 systematic reviews, and 103 studies with relevance to the topic. The present guideline provides one overarching recommendation concerning the discussion of sexual health and dysfunction, which is aimed at all people with cancer. Eleven additional recommendations made separately for men and women deal with issues such as sexual response, body image, intimacy and relationships, overall sexual functioning and satisfaction, and vasomotor and genital symptoms. CONCLUSIONS To our knowledge this clinical practice guideline is the first to comprehensively evaluate interventions for the improvement of sexual problems in people with cancer. The guideline will be a valuable resource to support practitioners and clinics in addressing sexuality in cancer survivors.
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Affiliation(s)
- L. Barbera
- Department of Radiation Oncology, University of Toronto, Toronto
| | - C. Zwaal
- Program in Evidence-Based Care, Cancer Care Ontario, Hamilton
| | - D. Elterman
- Department of Surgery, Division of Urology, University of Toronto, Toronto
| | - K. McPherson
- Patient and Family Advisory Council, Cancer Care Ontario, Hamilton; and
| | - W. Wolfman
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON; and
| | - A. Katz
- CancerCare Manitoba, Winnipeg, MB
| | - A. Matthew
- Department of Surgery, Division of Urology, University of Toronto, Toronto
| | - The Interventions to Address Sexual Problems in People with Cancer Guideline Development Group
- Department of Radiation Oncology, University of Toronto, Toronto
- Program in Evidence-Based Care, Cancer Care Ontario, Hamilton
- Department of Surgery, Division of Urology, University of Toronto, Toronto
- Patient and Family Advisory Council, Cancer Care Ontario, Hamilton; and
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON; and
- CancerCare Manitoba, Winnipeg, MB
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Barbera L, Zwaal C, Elterman D, Wolfman W, Katz A, McPherson K, Matthew A. EP-1415: Interventions to Address Sexual Problems in People with Cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Yerlikaya G, Akolekar R, McPherson K, Syngelaki A, Nicolaides KH. Prediction of stillbirth from maternal demographic and pregnancy characteristics. Ultrasound Obstet Gynecol 2016; 48:607-612. [PMID: 27561693 DOI: 10.1002/uog.17290] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 08/09/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To develop a model for prediction of stillbirth based on maternal characteristics and components of medical history and to evaluate the performance of screening with this model for all stillbirths and those due to impaired placentation and to unexplained causes. METHODS This was a prospective screening study of 113 415 singleton pregnancies at 11 + 0 to 13 + 6 weeks' gestation and at 19 + 0 to 24 + 6 weeks. The study population included 113 019 live births and 396 (0.35%) antepartum stillbirths; 230 (58%) were secondary to impaired placentation and 166 (42%) were due to other or unexplained causes. Multivariable logistic regression analysis was used to determine the factors from maternal characteristics and medical history which provided a significant contribution to the prediction of stillbirth. RESULTS The risk for stillbirth increased with maternal weight (odds ratio (OR), 1.01 per kg above 69 kg), was higher in women of Afro-Caribbean racial origin (OR, 2.01), those with assisted conception (OR, 1.79), cigarette smokers (OR, 1.71), and in those with a history of chronic hypertension (OR, 2.62), systemic lupus erythematosus/antiphospholipid syndrome (OR, 3.61) or diabetes mellitus (OR, 2.55) and was increased in women with a history of previous stillbirth (OR, 4.81). Screening with the model predicted 26% of unexplained stillbirths and 31% of those due to impaired placentation, at a false-positive rate of 10%; within the impaired-placentation group the detection rate of stillbirth < 32 weeks' gestation was higher than that of stillbirth ≥ 37 weeks (38% vs 28%). CONCLUSIONS A model based on maternal characteristics and medical history recorded in early pregnancy can potentially predict one-third of subsequent stillbirths. The extent to which such stillbirths could be prevented remains to be determined. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- G Yerlikaya
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - R Akolekar
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Department of Fetal Medicine, Medway Maritime Hospital, Gillingham, UK
| | - K McPherson
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - A Syngelaki
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Abstract
The OPCS scales of disability were developed as a survey tool to estimate the prevalence of disability amongst adults in the UK. This study evaluates the use of the OPCS scales in a clinical setting. A total of 265 patients attending a rehabilitation unit and wheelchair centre were assessed. The OPCS scales were validated against the standard Barthel Index and sensitivity to change over time was examined. An inter-rater reliability study was also performed. The results showed good correlation between the OPCS scales and Barthel Index (0.82, p < 0.001, n = 265) and it was shown that the OPCS scales were sensitive to clinical change over a six-month period. Inter-rater reliability was also good (0.96, p < 0.001, n = 120). The 95% confidence limits were also examined. The 'ceiling' effect of the Barthel Index is not found in the OPCS scales of disability. The results of the study support further use of the OPCS scales and suggest that it has a place in the assessment of rehabilitation outcome.
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Affiliation(s)
- K. McPherson
- Rehabilitation Medicine Unit and Vehicles (For the Disabled) Centre, Astley Ainslie Hospital, Edinburgh
| | - RL Sloan
- Rehabilitation Medicine Unit and Vehicles (For the Disabled) Centre, Astley Ainslie Hospital, Edinburgh
| | - J. Hunter
- Rehabilitation Medicine Unit and Vehicles (For the Disabled) Centre, Astley Ainslie Hospital, Edinburgh
| | - CM Dowell
- Rehabilitation Medicine Unit and Vehicles (For the Disabled) Centre, Astley Ainslie Hospital, Edinburgh
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Manokaran G, McPherson K, Simmons CP. Stopping dengue: recent advances and new challenges. Microbiol Aust 2016. [DOI: 10.1071/ma16017] [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: 11/23/2022] Open
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McPherson K, West S. Percutaneous emergency airway access: prevention, preparation, technique and training. Br J Anaesth 2015; 116:143-4. [PMID: 26675962 DOI: 10.1093/bja/aev417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Simmons CP, McPherson K, Van Vinh Chau N, Hoai Tam DT, Young P, Mackenzie J, Wills B. Recent advances in dengue pathogenesis and clinical management. Vaccine 2015; 33:7061-8. [PMID: 26458808 DOI: 10.1016/j.vaccine.2015.09.103] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 12/31/2022]
Abstract
This review describes and commentates on recent advances in the understanding of dengue pathogenesis and immunity, plus clinical research on vaccines and therapeutics. We expand specifically on the role of the dermis in dengue virus infection, the contribution of cellular and humoral immune responses to pathogenesis and immunity, NS1 and mechanisms of virus immune evasion. Additionally we review a series of therapeutic intervention trials for dengue, as well as recent clinical research aimed at improving clinical diagnosis, risk prediction and disease classification.
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Affiliation(s)
- Cameron P Simmons
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Viet Nam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria 3010, Australia.
| | - Kirsty McPherson
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Nguyen Van Vinh Chau
- Hospital for Tropical Diseases, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Viet Nam
| | - D T Hoai Tam
- University of Medicine and Pharmacy, 217 Hong Bang, District 5, Ho Chi Minh City, Viet Nam
| | - Paul Young
- School of Chemistry and Molecular Biosciences, University of Queensland, Australia
| | - Jason Mackenzie
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Bridget Wills
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 764 Vo Van Kiet street, District 5, Ho Chi Minh City, Viet Nam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Signal N, McPherson K, Lewis G, Taylor D. Training intensity: a barrier or facilitator to engagement in rehabilitation following stroke? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McPherson K, Mythen M. Anesthesia and Perioperative Care of the High Risk Patient. Br J Anaesth 2015. [DOI: 10.1093/bja/aev079] [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: 11/14/2022] Open
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Pellicci DG, Uldrich AP, Le Nours J, Ross F, Chabrol E, Eckle SBG, de Boer R, Lim RT, McPherson K, Besra G, Howell AR, Moretta L, McCluskey J, Heemskerk MHM, Gras S, Rossjohn J, Godfrey DI. The molecular bases of δ/αβ T cell-mediated antigen recognition. ACTA ACUST UNITED AC 2014; 211:2599-615. [PMID: 25452463 PMCID: PMC4267242 DOI: 10.1084/jem.20141764] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Godfrey, Rossjohn, and colleagues define a population of T cells in healthy humans that express T cell receptors (TCRs) comprised of δ variable gene segments fused to α joining and constant domains and paired with a variety of TCR-β chains. Functional and structural analyses reveal how components of αβ and γδ TCR gene loci combine to create T cells with unique patterns of antigen recognition. αβ and γδ T cells are disparate T cell lineages that can respond to distinct antigens (Ags) via the use of the αβ and γδ T cell Ag receptors (TCRs), respectively. Here we characterize a population of human T cells, which we term δ/αβ T cells, expressing TCRs comprised of a TCR-δ variable gene (Vδ1) fused to joining α and constant α domains, paired with an array of TCR-β chains. We demonstrate that these cells, which represent ∼50% of all Vδ1+ human T cells, can recognize peptide- and lipid-based Ags presented by human leukocyte antigen (HLA) and CD1d, respectively. Similar to type I natural killer T (NKT) cells, CD1d-lipid Ag-reactive δ/αβ T cells recognized α-galactosylceramide (α-GalCer); however, their fine specificity for other lipid Ags presented by CD1d, such as α-glucosylceramide, was distinct from type I NKT cells. Thus, δ/αβTCRs contribute new patterns of Ag specificity to the human immune system. Furthermore, we provide the molecular bases of how δ/αβTCRs bind to their targets, with the Vδ1-encoded region providing a major contribution to δ/αβTCR binding. Our findings highlight how components from αβ and γδTCR gene loci can recombine to confer Ag specificity, thus expanding our understanding of T cell biology and TCR diversity.
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Affiliation(s)
- Daniel G Pellicci
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Adam P Uldrich
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Jérôme Le Nours
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia
| | - Fiona Ross
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Eric Chabrol
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia
| | - Sidonia B G Eckle
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Renate de Boer
- Department of Hematology, Leiden University Medical Center, 2300 RC Leiden, Netherlands
| | - Ricky T Lim
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Kirsty McPherson
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Gurdyal Besra
- School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, England, UK
| | - Amy R Howell
- Department of Chemistry, University of Connecticut, Storrs, CT 06269
| | | | - James McCluskey
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Mirjam H M Heemskerk
- Department of Hematology, Leiden University Medical Center, 2300 RC Leiden, Netherlands
| | - Stephanie Gras
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia
| | - Jamie Rossjohn
- Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia Department of Biochemistry and Molecular Biology, School of Biomedical Sciences and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria 3800, Australia Institute of Infection and Immunity, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, Wales, UK
| | - Dale I Godfrey
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity and Australian Research Council Centre of Excellence in Advanced Molecular Imaging, University of Melbourne, Parkville, Victoria 3010, Australia
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Le Nours J, Uldrich A, Pellicci D, Gherardin N, McPherson K, Lim R, Patel O, Beddoe T, Gras S, Rossjohn J, Godfrey D. CD1d lipid-antigen recognition by the γδ TCR. Acta Crystallogr A Found Adv 2014. [DOI: 10.1107/s2053273314097551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The T lymphocytes repertoire is divided into two major lineages, αβ and γδ T cells, which are defined by their T cell receptor (TCR) gene-segment usage. To date, the key discoveries on human CD1d restricted T cells have focussed on the type I Natural Killer T cells (NKT) subset that express an invariant TCR α chain (Vα24Jα18) which pairs with a β chain (Vβ11). The structural basis for the recognition of CD1d-lipid antigen by type I NKT cells is also now well established [1, 2]. However, there are other subsets of NKT cells that exhibit reactivity towards lipid-antigen presenting molecules (CD1d) but that do no express the typical Vα24Jα18 TCR. We identify human NKT cell subsets that express Vδ1+ γδ TCRs that recognize CD1d presenting the lipid-antigen α-galactosylceramide (α-Galcer). Here, we describe the first crystal structure of a CD1d/γδ TCR ternary complex [3] and provide structural insights into the binding mode of a γδ TCR with CD1d-αGalcer. The γδ TCR binds orthogonally over the A' pocket of CD1d, that is in clear contrast with the typical type I parallel docking mode in which the αβ TCR is perched over the F' pocket of CD1d. The germ line-encoded CDR1δ loop dominates the contacts with the CD1d molecule while the CDR3γ loop represents the main structural determinant for the antigen specificity. These findings highlight the emergence of diverse populations of NKT TCRs that exhibit different binding mode and lipid antigen specificity.
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Stoumpos S, McNeill SH, McPherson K, Gorrie M, Mark PB, Brennand JE, Geddes CC, Deighan CJ, Gerasimovska Kitanovska B, Zafirovska K, Bogdanovska S, Gerasimovska V, Sikole A. PREGNANCY AND THE KIDNEY. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu115] [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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Zheng Y, McPherson K, Smith PF. Effects of early and late treatment with L-baclofen on the development and maintenance of tinnitus caused by acoustic trauma in rats. Neuroscience 2013; 258:410-21. [PMID: 24291770 DOI: 10.1016/j.neuroscience.2013.11.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 10/05/2013] [Revised: 11/01/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
Abstract
Subjective tinnitus is a chronic neurological disorder in which phantom sounds are perceived. Recent evidence supports the hypothesis that tinnitus is related to neuronal hyperactivity in auditory brain regions, and consequently drugs that increase GABAergic neurotransmission in the CNS, such as the GABA(B) receptor agonist L-baclofen, may be effective as a treatment. The aim of this study was to investigate the effects of early (5 mg/kg s.c., 30 min and then every 24 h for 5 days following noise exposure) and late treatment (3 mg/kg/day s.c. for 4.5 weeks starting at 17.5 weeks following noise exposure) with l-baclofen on the psychophysical attributes of tinnitus in a conditioned lick suppression model following acoustic trauma in rats. Acoustic trauma (a 16-kHz, 115-dB pure tone presented unilaterally for 1h) resulted in a significant decrease in the suppression ratio (SR) compared to sham controls in response to 20-kHz tones at 2, 10 and 17.5 weeks post-exposure (P ≤ 0.009, P ≤ 0.02 and P ≤ 0.03, respectively). However, l-baclofen failed to prevent the development of tinnitus when administered during the first 5 days following the acoustic trauma and also failed to reverse it when treatment was carried out every day for 4.5 weeks. We also found that treatment with L-baclofen did not alter the expression of the GABA(B)-R2 subunit in the cochlear nucleus of noise-exposed animals.
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Affiliation(s)
- Y Zheng
- Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - K McPherson
- Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - P F Smith
- Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, University of Otago, Dunedin, New Zealand.
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Bierl M, Marsh T, Webber L, Brown M, McPherson K, Rtveladze K. Apples and oranges: a comparison of costing methods for obesity. Obes Rev 2013; 14:693-706. [PMID: 23650980 DOI: 10.1111/obr.12044] [Citation(s) in RCA: 15] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 03/04/2013] [Accepted: 03/22/2013] [Indexed: 02/01/2023]
Abstract
Obesity has escalated to epidemic proportions over the past 30 years resulting in increased disease burden and healthcare costs. The aim of this paper was to analyse different costing methods for obesity. Several databases have been searched to identify eligible literature estimating obesity cost. These were categorized into databases, patient-attributable fraction (PAF) and modelling studies. Studies from the United States were used to explore effects of study designs on cost outcomes. Our results show that cost outcomes are largely affected by underlying study designs, such as population size, age, cost categories (medical expenditure vs. total costs), length of the data collection and body mass index cut-offs. Three study types are likely to have an impact on reported costs, with modelling studies providing the most conservative estimates. Database studies can help to increase the overall awareness of the economic burden of obesity. PAF studies can make the obesity disease more tangible by drawing connections to diseases. Decision makers need to be aware of the different purposes and weaknesses of the studies when interpreting cost outcomes. Further research is needed to refine the existing methods and provide high-quality data accounting for the complexity of the disease.
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Affiliation(s)
- M Bierl
- Modelling Department, UK Health Forum, London, UK
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Rtveladze K, Marsh T, L W, M B, McPherson K, Konstevaya A, Staradubova A, Goryakin YE. PP03 A Big Problem for a Big Country. The Health and Economic Burden of Cardiovascular Diseases in Russia. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.102] [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: 11/04/2022]
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20
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Theadom A, Mahon S, Barker-Collo S, McPherson K, Rush E, Vandal AC, Feigin VL. Enzogenol for cognitive functioning in traumatic brain injury: a pilot placebo-controlled RCT. Eur J Neurol 2013; 20:1135-44. [PMID: 23384428 DOI: 10.1111/ene.12099] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 12/11/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Enzogenol, a flavonoid-rich extract from Pinus radiata bark with antioxidant and anti-inflammatory properties has been shown to improve working memory in healthy adults. In traumatic brain injury (TBI), oxidation and inflammation have been linked to poorer cognitive outcomes. Hence, this phase II, randomized controlled trial investigated safety, compliance and efficacy of Enzogenol for improving cognitive functioning in people following mild TBI. METHODS Sixty adults, who sustained a mild TBI, 3-12 months prior to recruitment, and who were experiencing persistent cognitive difficulties [Cognitive Failures Questionnaire (CFQ) score > 38], were randomized to receive Enzogenol (1000 mg/day) or matching placebo for 6 weeks. Subsequently, all participants received Enzogenol for a further 6 weeks, followed by placebo for 4 weeks. Compliance, side-effects, cognitive failures, working and episodic memory, post-concussive symptoms and mood were assessed at baseline, 6, 12 and 16 weeks. Simultaneous estimation of treatment effect and breakpoint was effected, with confidence intervals (CIs) obtained through a treatment-placebo balance-preserving bootstrap procedure. RESULTS Enzogenol was found to be safe and well tolerated. Trend and breakpoint analyses showed a significant reduction in cognitive failures after 6 weeks [mean CFQ score, 95% CI, Enzogenol versus placebo -6.9 (-10.8 to -4.1)]. Improvements in the frequency of self-reported cognitive failures were estimated to continue until week 11 before stabilizing. Other outcome measures showed some positive trends but no significant treatment effects. CONCLUSIONS Enzogenol supplementation is safe and well tolerated in people after mild TBI, and may improve cognitive functioning in this patient population. This study provides Class IIB evidence that Enzogenol is well tolerated and may reduce self-perceived cognitive failures in patients 3-12 months post-mild TBI.
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Affiliation(s)
- A Theadom
- National Institute for Stroke and Applied Neurosciences, School of Rehabilitation and Occupation Studies, AUT University, Auckland, New Zealand
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Langenhorst D, Gogishvili T, Ribechini E, Kneitz S, McPherson K, Lutz MB, Hünig T. Sequential induction of effector function, tissue migration and cell death during polyclonal activation of mouse regulatory T-cells. PLoS One 2012; 7:e50080. [PMID: 23226238 PMCID: PMC3511437 DOI: 10.1371/journal.pone.0050080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 10/16/2012] [Indexed: 11/18/2022] Open
Abstract
The ability of CD4(+)Foxp3(+) regulatory T-cells (Treg) to produce interleukin (IL)-10 is important for the limitation of inflammation at environmental interfaces like colon or lung. Under steady state conditions, however, few Tregs produce IL-10 ex vivo. To investigate the origin and fate of IL-10 producing Tregs we used a superagonistic mouse anti-mouse CD28 mAb (CD28SA) for polyclonal in vivo stimulation of Tregs, which not only led to their numeric expansion but also to a dramatic increase in IL-10 production. IL-10 secreting Tregs strongly upregulated surface receptors associated with suppressive function as compared to non-producing Tregs. Furthermore, polyclonally expanding Tregs shifted their migration receptor pattern after activation from a CCR7(+)CCR5(-) lymph node-seeking to a CCR7(-)CCR5(+) inflammation-seeking phenotype, explaining the preferential recruitment of IL-10 producers to sites of ongoing immune responses. Finally, we observed that IL-10 producing Tregs from CD28SA stimulated mice were more apoptosis-prone in vitro than their IL-10 negative counterparts. These findings support a model where prolonged activation of Tregs results in terminal differentiation towards an IL-10 producing effector phenotype associated with a limited lifespan, implicating built-in termination of immunosuppression.
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MESH Headings
- Animals
- Antibodies/immunology
- Antibodies/pharmacology
- Apoptosis/drug effects
- CD28 Antigens/agonists
- CD28 Antigens/immunology
- Cell Differentiation/drug effects
- Cell Movement/drug effects
- Cells, Cultured
- Clone Cells
- Gene Expression/drug effects
- Inflammation/immunology
- Inflammation/metabolism
- Interleukin-10/biosynthesis
- Interleukin-10/immunology
- Lymph Nodes/cytology
- Lymph Nodes/drug effects
- Lymph Nodes/immunology
- Lymphocyte Activation/drug effects
- Mice
- Mice, Inbred C57BL
- Receptors, CCR5/genetics
- Receptors, CCR5/immunology
- Receptors, CCR7/genetics
- Receptors, CCR7/immunology
- T-Lymphocytes, Cytotoxic/cytology
- T-Lymphocytes, Cytotoxic/drug effects
- T-Lymphocytes, Cytotoxic/immunology
- T-Lymphocytes, Regulatory/cytology
- T-Lymphocytes, Regulatory/drug effects
- T-Lymphocytes, Regulatory/immunology
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Affiliation(s)
- Daniela Langenhorst
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Tea Gogishvili
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Eliana Ribechini
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Susanne Kneitz
- Interdisciplinary Centre for Clinical Research (IZKF), University of Würzburg, Würzburg, Germany
| | - Kirsty McPherson
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia
| | - Manfred B. Lutz
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Thomas Hünig
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
- * E-mail:
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Kapetanakis V, Brown M, McPherson K, Webber L, Rtveladze K, Marsh T. OP26 By-State Comparison of Obesity Trends in The Adult Population of the United States of America. Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Obesity has increased at an alarming rate across the world and, in turn, rates of non-communicable diseases have escalated. In Eastern Europe, this epidemic has probably occurred at a later stage than the West due to the economic transition following the demise of communism. Knowing how these trends will change is important. We used a micro-simulation model to project obesity trends and related incidence of coronary heart disease and stroke, cancer and type 2 diabetes 20 and 40 years into the future. Where nationally representative data were available, obesity levels were shown to increase with most prominent increases seen amongst men in Latvia and Estonia, and amongst women in Croatia and Latvia. The exception was Lithuania where a decrease in overweight and obesity was observed in both men and women. We showed that interventions effective in reducing obesity would have a significant impact upon the number of new cases of each disease. It is necessary to improve surveillance of obesity and disease incidence as well as implement policies that are effective in reducing body fat.
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Affiliation(s)
- L Webber
- National Heart Forum, London, UK
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Marsh T, McPherson K, Brown M, Rtveladze K. P1-38 Modelling the future burdens of chronic disease the lessons from foresight and beyond. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976c.31] [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: 11/04/2022]
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McPherson K, Marsh T, Brown M. P2-185 Is the rise in obesity prevalence in England and Wales flattening? Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Marsh T, McPherson K, Brown M, Rtveladze K. P2-451 What will be the impact of current trends of obesity in Brazil and Mexico on their future healthcare demands. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976l.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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McPherson K, Brown M, Marsh T, Rtveladze K. P1-239 How changes in the rates of obesity and smoking prevalence in England will have an impact on the future incidence of coronary heart disease? Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976e.32] [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: 11/04/2022]
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Abstract
OBJECTIVES To determine changes in the prevalence and duration of use of hormone replacement therapy (HRT) by women doctors over 10 years. METHODS Questionnaire survey of 1234 UK women doctors (randomized, stratified sample), compared with a similar survey in 1993. RESULTS In women aged 50-64 years, the age-standardized prevalence of ever-use of HRT had increased from 53.4% in 1993 to 66.2% in 2003 (p<0.001). There was a marked reduction in uptake by women under 50 years, while the age-standardized prevalence of current use in women aged 50-64 years was unchanged at 38.1%. The discontinuation rate in this age group had increased from 27.8% to 42.4% (p<0.001). Over 20% of women aged 65-74 years were still using HRT. The median duration of HRT use was 8.1 years by current users and 5 years by past users. The major indications were symptom relief and osteoporosis prevention. Current users of HRT tended to have more definite views about the potential risks and benefits of long-term use than past or never-users. CONCLUSIONS The proportion of women doctors starting HRT increased after 1993, but uptake and continuation rates have now both declined, consistent with prescription data, probably reflecting the changing nature of the evidence base. However, many women doctors still intended to continue long-term HRT.
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Affiliation(s)
- A J Isaacs
- Department of Health and Social Sciences, Middlesex University, London, UK
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Lamb LS, Gee AP, Hazlett LJ, Musk P, Parrish RS, O'Hanlon TP, Geier SS, Folk RS, Harris WG, McPherson K, Lee C, Henslee-Downey PJ. Influence of T cell depletion method on circulating gammadelta T cell reconstitution and potential role in the graft-versus-leukemia effect. Cytotherapy 2009; 1:7-19. [PMID: 19746645 DOI: 10.1080/0032472031000141295] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Our laboratory previously reported that leukemia patients who developed > or = 10% gammadelta+ T cells during the first six months after receiving an anti-TCRalphabeta T-cell-depleted (TCD) graft from a partially mismatched related donor (PMRD) had a disease-free survival (DFS) advantage. These gammadelta+ T cells were V81+CD3+CD4-CD8-CD69+HLADR+ and are cytotoxic to K562 cells. METHODS In order to determine whether the anti-alphabeta TCD regimen was associated with these findings, we compared the reconstitution of gammadelta+ T cells from patients who received TCD PMRD grafts using the anti-TCRc4 MAb TIOB9-1A31 (previously reported) with similar patients who received grafts using the anti-CD3 MAb OKT3. RESULTS Increased cytotoxic Vdelta1+ T cells were seen in 10 of 43 T10B9 TCD patients compared to 7 of 100 in the OKT3 TCD group (23% versus 7%, p = 0.010). T10B9 patients with increased gammadelta+ T cells also exhibited a higher range of increased gammadelta+ T cells and the length of time the gammadelta+ T cells remained high was longer when compared to OKT3 patients. Patients with increased gammadelta+ T cells whose grafts were T-cell depleted with T10B9 showed a significant decrease in relapse (p = 0.038). Similar rates and reduction in relapse were seen in OKT3 TCD patients, although significance was not reached due to the small number of patients with increased gammadelta+ T cells. Estimated 3 year disease-free survival was significantly improved in T10B9 patients with increased gammadelta+ T cells (0.79 versus 0.31, p = 0.009), a trend also seen in OKT3 patients (p = 0.091). DISCUSSION These observations indicate that Vdelta1+CD4-CD8-cytotoxic T cells are associated with lower relapse rates and improved survival, and thus may have a role in a graft-versus-leukemia effect.
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Affiliation(s)
- L S Lamb
- Division of Transplantation Medicine, Palmetto Richland Memorial Hospital, Center for Cancer Treatment and Research, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA
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Robison J, Wiles R, Ellis-Hill C, McPherson K, Hyndman D, Ashburn A. Resuming previously valued activities post-stroke: who or what helps? Disabil Rehabil 2009; 31:1555-66. [DOI: 10.1080/09638280802639327] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ellis-Hill C, Robison J, Wiles R, McPherson K, Hyndman D, Ashburn A, On Behalf Of The Stroke Association. Going home to get on with life: Patients and carers experiences of being discharged from hospital following a stroke. Disabil Rehabil 2009; 31:61-72. [DOI: 10.1080/09638280701775289] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
We have examined the contribution of hysterectomy, compared with less invasive surgery, for dysfunctional uterine bleeding (DUB) on the prevalence of bladder problems five years after surgery. We report a prospective cohort study of over 25,000 women treated for benign cause menorrhagia by three types of surgery - transcervical endometrial resection/ablation and hysterectomy with or without bilateral oophorectomy. Postal questionnaires were sent five years after surgery investigating satisfaction with surgery and bladder function. When adjusted for confounders the odds of severe urinary incontinence (OR = 1.59, CI 95%, 1.35 - 1.87), urinary frequency (1.23 (1.04 - 1.45)), and nocturia (1.19, (1.03 - 1.38)) - were increased for women who had a hysterectomy compared with endometrial ablation. Hysterectomy with bilateral oophorectomy was not as strongly associated with severe bladder problems. Women who had the LAVH were most likely to report severe urinary incontinence (2.02, CI 95% 1.32 - 3.07), but not severe frequency or nocturia.
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Affiliation(s)
- K McPherson
- Nuffield Department of Obstetrics and Gynaecology, Oxford, UK.
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38
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Howell A, Mason AS, Brown E, Watts RW, Chanarin I, McPherson K, Ridler MA. Red cell size and uric acid in Down's syndrome. Scand J Haematol 2009; 11:140-7. [PMID: 4272676 DOI: 10.1111/j.1600-0609.1973.tb00108.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Gogishvili T, Elias F, Emery JL, McPherson K, Okkenhaug K, Hünig T, Dennehy KM. Proliferative signals mediated by CD28 superagonists require the exchange factor Vav1 but not phosphoinositide 3-kinase in primary peripheral T cells. Eur J Immunol 2008; 38:2528-33. [PMID: 18792405 DOI: 10.1002/eji.200838223] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Almost all responses of naive T cells require co-stimulation, i.e. engagement of the clonotypic TCR with relevant antigen/MHC and the co-stimulatory molecule CD28. How CD28 contributes to T-cell proliferation remains poorly understood, with widely conflicting reports existing which may reflect different methods of co-ligating receptors. Some CD28 mAb, however, can stimulate T-cell proliferation without the need for TCR co-ligation, and thus provide unique tools to dissect proliferative signals mediated through CD28 alone. Using primary peripheral T cells from CD28-transgenic mice, we show that both the YMNM and Lck-binding motifs, but not the Itk-binding motif, in CD28 are required for proliferation. Given that the YMNM motif recruits both phosphoinositide 3-kinase (PI3K) and the exchange factor Vav1, we investigated the role of these two molecules in CD28-mediated proliferation. In p110delta(D910A/D910A) transgenic T cells, which are defective in PI3K activation following CD28 ligation, proliferation was comparable to that in wild-type cells. By contrast, T-cell proliferation was abolished in Vav1(-/-) cells. Although we did not address the role of Grb2 in CD28 signalling, these results indicate that CD28 can mediate Lck- and Vav1-dependent proliferative signals independently of PI3K.
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Affiliation(s)
- Tea Gogishvili
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
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Stebbing J, Powles T, McPherson K, Shamash J, Wells P, Sheaff MT, Slater S, Rudd RM, Fennell D, Steele JPC. The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma. Lung Cancer 2008; 63:94-7. [PMID: 18486273 DOI: 10.1016/j.lungcan.2008.04.001] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Revised: 03/30/2008] [Accepted: 04/02/2008] [Indexed: 12/23/2022]
Abstract
Malignant pleural mesothelioma (MPM) is a rapidly progressive invariably lethal tumor. Treatment options remain limited and the outcome in relapsed disease is poor warranting new therapeutic options. Following our previous experience in the first-line setting, we conducted a phase 2 open-label non-comparative study to assess the safety and efficacy of weekly vinorelbine chemotherapy, each cycle consisting of 30 mg/m(2) for 6 weeks, in patients with previous exposure to chemotherapy. In 63 individuals with relapsed MPM who had not received previous vinorelbine, we observed an objective response rate of 16% and an overall survival of 9.6 months (95% confidence interval 7.3-11.8 months). The main grade III/IV toxicity observed was neutropenia and toxicity was similar to weekly vinorelbine when used in the first-line setting. Weekly vinorelbine appeared to have a reasonable response rate with an acceptable toxicity profile in the second-line treatment of MPM. Its use should be prospectively evaluated in a randomised trial in the first or second-line therapy of MPM.
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Affiliation(s)
- Justin Stebbing
- Department of Medical Oncology, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
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Hirst A, Dutton S, Wu O, Briggs A, Edwards C, Waldenmaier L, Maresh M, Nicholson A, McPherson K. A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. The HOPEFUL study. Health Technol Assess 2008; 12:1-248, iii. [DOI: 10.3310/hta12050] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - K McPherson
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, UK
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McPherson K. Commentary: James Alison Glover (1874-1963), OBE (1919) CBE (1941) MD (1905) DPH (1905) FRCP (1933): health care variations research then and now. Int J Epidemiol 2008; 37:19-23. [DOI: 10.1093/ije/dym260] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wu O, Briggs A, Dutton S, Hirst A, Maresh M, Nicholson A, McPherson K. Uterine artery embolisation or hysterectomy for the treatment of symptomatic uterine fibroids: a cost-utility analysis of the HOPEFUL study. BJOG 2007; 114:1352-62. [PMID: 17949377 DOI: 10.1111/j.1471-0528.2007.01525.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the relative cost-effectiveness of uterine artery embolisation (UAE) and hysterectomy in women with symptomatic uterine fibroids from the perspective of the UK NHS. DESIGN Cost-utility analysis. SETTING Eighteen UK NHS hospital trusts. POPULATION OR SAMPLE Women who underwent UAE (n= 649; average follow up of 8.6 years) or hysterectomy (n= 459; average follow up of 4.6 years) for the treatments of symptomatic fibroids. METHODS A probabilistic decision model was carried out based on data from a large comparative cohort and the literature. The two interventions were evaluated over the time horizon from the initial procedure to menopause. Extensive sensitivity analysis was carried out to test model assumptions and parameter uncertainties. MAIN OUTCOME MEASURES Costs of procedures and complications and quality of life expressed as quality-adjusted life years (QALYs). RESULTS Overall, UAE was associated with lower mean cost (2536 pounds sterling versus 3282 pounds sterling) and a small reduction in quality of life (8.203 versus 8.241 QALYs) when compared with hysterectomy. However, when the quality of life associated with the conservation of the uterus was incorporated in the model, UAE was shown to be the dominant strategy--lower costs and greater QALYs. CONCLUSIONS UAE is a less expensive option to the health service compared with hysterectomy, even when the costs of repeat procedures and associated complications are factored in. The quality of life implications in the short term are also predicted to favour UAE; however, this advantage may be eroded over time as women undergo additional procedures to deal with recurrent fibroids. Given the hysterectomy is the current standard treatment for symptomatic fibroids, offering women UAE as an alternative treatment for fibroids is likely to be highly cost-effective for those women who prefer uterus-conserving treatment.
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Affiliation(s)
- O Wu
- Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, Glasgow, UK.
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Affiliation(s)
- K McPherson
- Nuffield Dept of Obstetrics & Gynaecology, Research Institute, Churchill Hospital, Roosevelt Drive, Headington, Oxford OX3 7BN, UK.
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Dutton S, Hirst A, McPherson K, Nicholson T, Maresh M. A UK multicentre retrospective cohort study comparing hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids (HOPEFUL study): main results on medium-term safety and efficacy. BJOG 2007; 114:1340-51. [DOI: 10.1111/j.1471-0528.2007.01526.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Williams V, Bruton A, Ellis-Hill C, McPherson K. What really matters to patients living with chronic obstructive pulmonary disease? An exploratory study. Chron Respir Dis 2007; 4:77-85. [PMID: 17621574 DOI: 10.1177/1479972307078482] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [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: 11/17/2022] Open
Abstract
There is limited published research into what really matters to people living with chronic obstructive pulmonary disease (COPD). Most previous research in this area focuses on the impact of the symptoms of COPD, rather than on the issues defined as important by patients themselves. This paper describes an exploratory study investigating what is most important to people living with COPD. A qualitative approach employing in-depth interviews with COPD patients was chosen. Thematic analysis was used to code and categorize data. Six patients with 'moderate' to 'very severe' COPD were recruited. They considered engagement in specific activities to be very important (walking, household maintenance and driving), even though these activities were mainly centred around the home environment, or within confined spaces, due to their physical limitations. This restriction led to feelings of social isolation that these patients tried to overcome through social participation (holidays, social interaction). People with COPD often experience physical restrictions, which can lead to reduced community mobility and social isolation. In this study, despite their physical limitations, these patients had a strong desire to participate and be engaged in various activities. The importance of enabling patients to 'participate' rather than just 'do' should be considered when planning and delivering patient-centred interventions across the whole spectrum of severity of COPD.
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Affiliation(s)
- V Williams
- University of Southampton, School of Health Professions and Rehabilitation Sciences, UK
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Affiliation(s)
- K McPherson
- Nuffield Dept of Obstetrics & Gynaecology, Research Institute, Churchill Hospital, Roosevelt Drive, Headington, Oxford OX3 7BN, UK.
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Roddam AW, Pirie K, Pike MC, Chilvers C, Crossley B, Hermon C, McPherson K, Peto J, Vessey M, Beral V. Active and passive smoking and the risk of breast cancer in women aged 36-45 years: a population based case-control study in the UK. Br J Cancer 2007; 97:434-9. [PMID: 17579618 PMCID: PMC2360334 DOI: 10.1038/sj.bjc.6603859] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Active smoking has little or no effect on breast cancer risk but some investigators have suggested that passive smoking and its interaction with active smoking may be associated with an increased risk. In a population based case-control study of breast cancer in women aged 36-45 years at diagnosis, information on active smoking, passive smoking in the home, and other factors, was collected at interview from 639 cases and 640 controls. Women were categorised jointly by their active and passive smoking exposure. Among never smoking controls, women who also reported no passive smoking exposure were significantly more likely to be nulliparous and to be recent users of oral contraceptives. Among those never exposed to passive smoking, there was no significant association between active smoking and breast cancer, relative risk (RR) of 1.12 (95% confidence interval (CI) 0.72-1.73) for past smokers and RR of 1.19 (95% CI 0.72-1.95) for current smokers, nor was there an association with age started, duration or intensity of active smoking. Compared with women who were never active nor passive smokers, there was no significant association between passive smoking in the home and breast cancer risk in never smokers, RR of 0.89 (95% CI 0.64-1.25), in past smokers, RR of 1.09 (95% CI 0.75-1.56), or in current smokers, RR of 0.93 (95% CI 0.67-1.30). There was no trend with increasing duration of passive smoking and there was no heterogeneity among any of the subgroups examined. In this study, there was no evidence of an association between either active smoking or passive smoking in the home and risk of breast cancer.
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Affiliation(s)
- A W Roddam
- Cancer Research UK Epidemiology Unit, Richard Doll Building, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
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Koch I, McPherson K, Smith P, Easton L, Doe KG, Reimer KJ. Arsenic bioaccessibility and speciation in clams and seaweed from a contaminated marine environment. Mar Pollut Bull 2007; 54:586-94. [PMID: 17241645 DOI: 10.1016/j.marpolbul.2006.12.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2006] [Accepted: 12/03/2006] [Indexed: 05/13/2023]
Abstract
The bioaccessible concentration and speciation of arsenic (soluble in a gastrointestinal medium and available for absorption into the bloodstream) were determined in softshell clams (Mya arenaria), harvested by local residents until 2005, and in seaweed (Fucus sp.) from an arsenic-contaminated marine site in Seal Harbour, Nova Scotia, Canada. Bioaccessibility extractions to simulate the human gastrointestinal environment (pH 1.5 and glycine for 1h followed by pancreatin, bile extract and pH adjustment to 7 for an additional 4h) and speciation of arsenic in extracts (HPLC-HG-AAS to target inorganic arsenic species) and whole samples (XANES) were carried out. Total arsenic for the clams from the contaminated area ranged from 218 to 228 ppm wet weight, with a bioaccessible fraction of 34-46%, and the major bioaccessible species of arsenic were inorganic. The seaweed from the contaminated area contained 27-43 ppm wet weight total arsenic, with the bioaccessible fraction ranging from 63% to 81%, and inorganic arsenic was also predominant. The predominantly inorganic nature of arsenic in the whole samples was confirmed by XANES. In concurrence with the closure of the area for clam harvesting, the clams and seaweed from Seal Harbour should probably not be used for human consumption.
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Affiliation(s)
- I Koch
- Environmental Sciences Group, Royal Military College of Canada, PO Box 17000 Station Forces, Kingston, ON, Canada K7K 7B4
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Kaplan H, Clopton M, Kaplan M, Messbauer L, McPherson K. Snoezelen multi-sensory environments: task engagement and generalization. Res Dev Disabil 2006; 27:443-55. [PMID: 16122905 DOI: 10.1016/j.ridd.2005.05.007] [Citation(s) in RCA: 18] [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: 12/20/2004] [Revised: 05/02/2005] [Accepted: 05/09/2005] [Indexed: 05/04/2023]
Abstract
These experiments explored whether behavioral improvements observed during Snoezelen OT treatment sessions carried over to two different settings for three people with moderate/severe intellectual disability, autism and severe challenging behaviors. Experiment 1 explored engagement during a functional task immediately following the treatment sessions while experiment 2 explored changes in the frequencies of challenging behaviors on the days after treatment sessions. Investigators found carryover for two of the three participants to both post-session engagement as well as to the daily frequency of challenging behaviors on days following the OT sessions.
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Affiliation(s)
- H Kaplan
- Lifespire, Woodhaven, NY 11421, USA.
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