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Cook E, Laycock J, Sivapathasuntharam D, Maturana C, Hilton C, Doherty L, Hewitt C, McDaid C, Torgerson D, Bates P. Surgical versus non-surgical management of lateral compression type-1 pelvic fracture in adults 60 years and older: the L1FE RCT. Health Technol Assess 2024; 28:1-67. [PMID: 38512076 PMCID: PMC11017634 DOI: 10.3310/lapw3412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Background Lateral compression type-1 pelvic fractures are a common fragility fracture in older adults. Patients who do not mobilise due to ongoing pain are at greater risk of immobility-related complications. Standard treatment in the United Kingdom is provision of pain relief and early mobilisation, unlike fragility hip fractures, which are usually treated surgically based on evidence that early surgery is associated with better outcomes. Currently there is no evidence on whether patients with lateral compression type-1 fragility fractures would have a better recovery with surgery than non-surgical management. Objectives To assess the clinical and cost effectiveness of surgical fixation with internal fixation device compared to non-surgical management of lateral compression type-1 fragility fractures in older adults. Design Pragmatic, randomised controlled superiority trial, with 12-month internal pilot; target sample size was 600 participants. Participants were randomised between surgical and non-surgical management (1 : 1 allocation ratio). An economic evaluation was planned. Setting UK Major Trauma Centres. Participants Patients aged 60 years or older with a lateral compression type-1 pelvic fracture, arising from a low-energy fall and unable to mobilise independently to a distance of 3 m and back due to pelvic pain 72 hours after injury. Interventions Internal fixation device surgical fixation and non-surgical management. Participants, surgeons and outcome assessors were not blinded to treatment allocation. Main outcome measures Primary outcome - average patient health-related quality of life, over 6 months, assessed by the EuroQol-5 Dimensions, five-level version utility score. Secondary outcomes (over the 6 months following injury) - self-rated health, physical function, mental health, pain, delirium, displacement of pelvis, mortality, complications and adverse events, and resource use data for the economic evaluation. Results The trial closed early, at the end of the internal pilot, due to low recruitment. The internal pilot was undertaken in two separate phases because of a pause in recruitment due to the coronavirus disease 2019 pandemic. The planned statistical and health economic analyses were not conducted. Outcome data were summarised descriptively. Eleven sites opened for recruitment for a combined total of 92 months. Three-hundred and sixteen patients were assessed for eligibility, of whom 43 were eligible (13.6%). The main reason for ineligibility was that the patient was able to mobilise independently to 3 m and back (n = 161). Of the 43 eligible participants, 36 (83.7%) were approached for consent, of whom 11 (30.6%) provided consent. The most common reason for eligible patients not consenting to take part was that they were unwilling to be randomised to a treatment (n = 10). There were 11 participants, 5 randomised to surgical management with internal fixation device and 6 to non-surgical management. The average age of participants was 83.0 years (interquartile range 76.0, 89.0) and the EuroQol-5 Dimensions, five-level version utility score at 6 months post randomisation (n = 8) was 0.32 (standard deviation 0.37). A limitation of the trial was that study objectives were not addressed due to poor recruitment. Conclusions It was not feasible to recruit to this trial in the current context. Further research to understand the treatment and recovery pathways of this group of patients, along with their outcomes, would be needed prior to undertaking a future trial. Future work Exploration of equipoise across different healthcare professional groups. Investigate longer-term patient outcomes. Trial registration This trial is registered as ISRCTN16478561. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/167/57) and is published in full in Health Technology Assessment; Vol. 28, No. 15. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Elizabeth Cook
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Joanne Laycock
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Camila Maturana
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Laura Doherty
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Peter Bates
- Bart's Health NHS Trust, The Royal London Hospital, London, UK
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2
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Whitehead PJ, Belshaw S, Brady S, Coleman E, Dean A, Doherty L, Fairhurst C, Francis-Farrell S, Golding-Day M, Gray J, Martland M, McAnuff J, McCarthy A, McMeekin P, Mitchell N, Narayanasamy M, Newman C, Parker A, Rapley T, Rodgers S, Rooney L, Russell R, Sheard L, Torgerson D. Bathing Adaptations in the Homes of Older Adults (BATH-OUT-2): study protocol for a randomised controlled trial, economic evaluation and process evaluation. Trials 2024; 25:75. [PMID: 38254164 PMCID: PMC10802044 DOI: 10.1186/s13063-023-07677-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/26/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The onset of disability in bathing is particularly important for older adults as it can be rapidly followed by disability in other daily activities; this may represent a judicious time point for intervention in order to improve health, well-being and associated quality of life. An important environmental and preventative intervention is housing adaptation, but there are often lengthy waiting times for statutory provision. In this randomised controlled trial (RCT), we aim to evaluate the effectiveness and cost-effectiveness of bathing adaptations compared to no adaptations and to explore the factors associated with routine and expedited implementation of bathing adaptations. METHODS BATH-OUT-2 is a multicentre, two-arm, parallel-group RCT. Adults aged 60 and over who are referred to their local authority for an accessible level access shower will be randomised, using pairwise randomisation, 1:1, to receive either an expedited provision of an accessible shower via the local authority or a usual care control waiting list. Participants will be followed up for a maximum of 12 months and will receive up to four follow-ups in this duration. The primary outcome will be the participant's physical well-being, assessed by the Physical Component Summary score of the Short Form-36 (SF-36), 4 weeks after the intervention group receives the accessible shower. The secondary outcomes include the Mental Component Summary score of the SF-36, self-reported falls, health and social care resource use, health-related quality of life (EQ-5D-5L), social care-related quality of life (Adult Social Care Outcomes Toolkit (ASCOT)), fear of falling (Short Falls Efficacy Scale), independence in bathing (Barthel Index bathing question), independence in daily activities (Barthel Index) and perceived difficulty in bathing (0-100 scale). A mixed-methods process evaluation will comprise interviews with stakeholders and a survey of local authorities with social care responsibilities in England. DISCUSSION The BATH-OUT-2 trial is designed so that the findings will inform future decisions regarding the provision of bathing adaptations for older adults. This trial has the potential to highlight, and then reduce, health inequalities associated with waiting times for bathing adaptations and to influence policies for older adults. TRIAL REGISTRATION ISRCTN Registry ISRCTN48563324. Prospectively registered on 09/04/2021.
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Affiliation(s)
- Phillip J Whitehead
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Stuart Belshaw
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK
| | - Samantha Brady
- Department of Health Sciences, University of York, York, UK
| | | | - Alexandra Dean
- Department of Health Sciences, University of York, York, UK
| | - Laura Doherty
- Department of Health Sciences, University of York, York, UK
| | | | | | - Miriam Golding-Day
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK
| | - Joanne Gray
- Department of Nursing, Midwifery and Health, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | | | - Jennifer McAnuff
- Department of Social Work, Education and Community Wellbeing, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | - Andrew McCarthy
- Department of Nursing, Midwifery and Health, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | - Peter McMeekin
- Department of Nursing, Midwifery and Health, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | | | - Melanie Narayanasamy
- Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK
| | - Craig Newman
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Adwoa Parker
- Department of Health Sciences, University of York, York, UK
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University Newcastle, Newcastle Upon Tyne, UK
| | - Sara Rodgers
- Department of Health Sciences, University of York, York, UK
| | - Leigh Rooney
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Laura Sheard
- Department of Health Sciences, University of York, York, UK
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3
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Parker A, Arundel C, Clark L, Coleman E, Doherty L, Hewitt CE, Beard D, Bower P, Cooper C, Culliford L, Devane D, Emsley R, Eldridge S, Galvin S, Gillies K, Montgomery A, Sutton CJ, Treweek S, Torgerson DJ. Undertaking Studies Within A Trial to evaluate recruitment and retention strategies for randomised controlled trials: lessons learnt from the PROMETHEUS research programme. Health Technol Assess 2024; 28:1-114. [PMID: 38327177 PMCID: PMC11017159 DOI: 10.3310/htqw3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
Background Randomised controlled trials ('trials') are susceptible to poor participant recruitment and retention. Studies Within A Trial are the strongest methods for testing the effectiveness of strategies to improve recruitment and retention. However, relatively few of these have been conducted. Objectives PROMoting THE Use of Studies Within A Trial aimed to facilitate at least 25 Studies Within A Trial evaluating recruitment or retention strategies. We share our experience of delivering the PROMoting THE Use of Studies Within A Trial programme, and the lessons learnt for undertaking randomised Studies Within A Trial. Design A network of 10 Clinical Trials Units and 1 primary care research centre committed to conducting randomised controlled Studies Within A Trial of recruitment and/or retention strategies was established. Promising recruitment and retention strategies were identified from various sources including Cochrane systematic reviews, the Study Within A Trial Repository, and existing prioritisation exercises, which were reviewed by patient and public members to create an initial priority list of seven recruitment and eight retention interventions. Host trial teams could apply for funding and receive support from the PROMoting THE Use of Studies Within A Trial team to undertake Studies Within A Trial. We also tested the feasibility of undertaking co-ordinated Studies Within A Trial, across multiple host trials simultaneously. Setting Clinical trials unit-based trials recruiting or following up participants in any setting in the United Kingdom were eligible. Participants Clinical trials unit-based teams undertaking trials in any clinical context in the United Kingdom. Interventions Funding of up to £5000 and support from the PROMoting THE Use of Studies Within A Trial team to design, implement and report Studies Within A Trial. Main outcome measures Number of host trials funded. Results Forty-two Studies Within A Trial were funded (31 host trials), across 12 Clinical Trials Units. The mean cost of a Study Within A Trial was £3535. Twelve Studies Within A Trial tested the same strategy across multiple host trials using a co-ordinated Study Within A Trial design, and four used a factorial design. Two recruitment and five retention strategies were evaluated in more than one host trial. PROMoting THE Use of Studies Within A Trial will add 18% more Studies Within A Trial to the Cochrane systematic review of recruitment strategies, and 79% more Studies Within A Trial to the Cochrane review of retention strategies. For retention, we found that pre-notifying participants by card, letter or e-mail before sending questionnaires was effective, as was the use of pens, and sending personalised text messages to improve questionnaire response. We highlight key lessons learnt to guide others planning Studies Within A Trial, including involving patient and public involvement partners; prioritising and selecting strategies to evaluate and elements to consider when designing a Study Within A Trial; obtaining governance approvals; implementing Studies Within A Trial, including individual and co-ordinated Studies Within A Trials; and reporting Study Within A Trials. Limitations The COVID-19 pandemic negatively impacted five Studies Within A Trial, being either delayed (n = 2) or prematurely terminated (n = 3). Conclusions PROMoting THE Use of Studies Within A Trial significantly increased the evidence base for recruitment and retention strategies. When provided with both funding and practical support, host trial teams successfully implemented Studies Within A Trial. Future work Future research should identify and target gaps in the evidence base, including widening Study Within A Trial uptake, undertaking more complex Studies Within A Trial and translating Study Within A Trial evidence into practice. Study registration All Studies Within A Trial in the PROMoting THE Use of Studies Within A Trial programme had to be registered with the Northern Ireland Network for Trials Methodology Research Study Within A Trial Repository. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 13/55/80) and is published in full in Health Technology Assessment; Vol. 28, No. 2. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Arundel
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Laura Clark
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Elizabeth Coleman
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Laura Doherty
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - David Beard
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, NIHR Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Peter Bower
- National Institute for Health Research School for Primary Care Research, Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Cindy Cooper
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lucy Culliford
- Bristol Trials Centre, Clinical Trials and Evaluation Unit, University of Bristol, Bristol Royal Infirmary, Bristol, UK
| | - Declan Devane
- School of Nursing and Midwifery, University of Galway, Galway, Republic of Ireland
- Health Research Board-Trials Methodology Research Network, Galway, Republic of Ireland
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sandra Eldridge
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Sandra Galvin
- School of Nursing and Midwifery, University of Galway, Galway, Republic of Ireland
- Health Research Board-Trials Methodology Research Network, Galway, Republic of Ireland
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Foresthill, Aberdeen, UK
| | - Alan Montgomery
- University of Nottingham, Nottingham Clinical Trials Unit, University Park Nottingham, Nottinghamshire, UK
| | | | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Foresthill, Aberdeen, UK
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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4
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Disis ML, Adams SF, Bajpai J, Butler MO, Curiel T, Dodt SA, Doherty L, Emens LA, Friedman CF, Gatti-Mays M, Geller MA, Jazaeri A, John VS, Kurnit KC, Liao JB, Mahdi H, Mills A, Zsiros E, Odunsi K. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer. J Immunother Cancer 2023; 11:e006624. [PMID: 37295818 PMCID: PMC10277149 DOI: 10.1136/jitc-2022-006624] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/12/2023] Open
Abstract
Advanced gynecologic cancers have historically lacked effective treatment options. Recently, immune checkpoint inhibitors (ICIs) have been approved by the US Food and Drug Administration for the treatment of cervical cancer and endometrial cancer, offering durable responses for some patients. In addition, many immunotherapy strategies are under investigation for the treatment of earlier stages of disease or in other gynecologic cancers, such as ovarian cancer and rare gynecologic tumors. While the integration of ICIs into the standard of care has improved outcomes for patients, their use requires a nuanced understanding of biomarker testing, treatment selection, patient selection, response evaluation and surveillance, and patient quality of life considerations, among other topics. To address this need for guidance, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline. The Expert Panel drew on the published literature as well as their own clinical experience to develop evidence- and consensus-based recommendations to provide guidance to cancer care professionals treating patients with gynecologic cancer.
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Affiliation(s)
- Mary L Disis
- Cancer Vaccine Institute, University of Washington, Seattle, Washington, USA
| | - Sarah F Adams
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | - Jyoti Bajpai
- Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Marcus O Butler
- Department of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Tyler Curiel
- Dartmouth-Hitchcock's Norris Cotton Cancer Center, Dartmouth Medical School, Hanover, New Hampshire, USA
| | | | - Laura Doherty
- Program in Women's Oncology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
| | - Leisha A Emens
- Department of Medicine, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Claire F Friedman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Margaret Gatti-Mays
- Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University, Columbus, Ohio, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology & Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amir Jazaeri
- Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Veena S John
- Department of Medical Oncology & Hematology, Northwell Health Cancer Institute, Lake Success, New York, USA
| | - Katherine C Kurnit
- University of Chicago Medicine Comprehensive Cancer Center, University of Chicago, Chicago, Illinois, USA
| | - John B Liao
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Haider Mahdi
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anne Mills
- Department of Pathology, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Emese Zsiros
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Kunle Odunsi
- The University of Chicago Medicine Comprehensive Cancer Center, Chicago, Illinois, USA
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5
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Doherty L, Wan M, Peterson A, Youngstrom DW, King JS, Kalajzic I, Hankenson KD, Sanjay A. Wnt-associated adult stem cell marker Lgr6 is required for osteogenesis and fracture healing. Bone 2023; 169:116681. [PMID: 36708855 PMCID: PMC10015414 DOI: 10.1016/j.bone.2023.116681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023]
Abstract
Despite the remarkable regenerative capacity of skeletal tissues, nonunion of bone and failure of fractures to heal properly presents a significant clinical concern. Stem and progenitor cells are present in bone and become activated following injury; thus, elucidating mechanisms that promote adult stem cell-mediated healing is important. Wnt-associated adult stem marker Lgr6 is implicated in the regeneration of tissues with well-defined stem cell niches in stem cell-reliant organs. Here, we demonstrate that Lgr6 is dynamically expressed in osteoprogenitors in response to fracture injury. We used an Lgr6-null mouse model and found that Lgr6 expression is necessary for maintaining bone volume and efficient postnatal bone regeneration in adult mice. Skeletal progenitors isolated from Lgr6-null mice have reduced colony-forming potential and reduced osteogenic differentiation capacity due to attenuated cWnt signaling. Lgr6-null mice consist of a lower proportion of self-renewing stem cells. In response to fracture injury, Lgr6-null mice have a deficiency in the proliferation of periosteal progenitors and reduced ALP activity. Further, analysis of the bone regeneration phase and remodeling phase of fracture healing in Lgr6-null mice showed impaired endochondral ossification and decreased mineralization. We propose that in contrast to not being required for successful skeletal development, Lgr6-positive cells have a direct role in endochondral bone repair.
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Affiliation(s)
- Laura Doherty
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, School of Medicine, USA; School of Dental Medicine, UConn Health, Farmington, CT 06030, USA
| | - Matthew Wan
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, School of Medicine, USA
| | - Anna Peterson
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, School of Medicine, USA
| | - Daniel W Youngstrom
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, School of Medicine, USA
| | - Justin S King
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, School of Medicine, USA
| | - Ivo Kalajzic
- School of Dental Medicine, UConn Health, Farmington, CT 06030, USA; Department of Reconstructive Sciences, School of Dental Medicine, UConn Health, Farmington, CT 06030, USA
| | - Kurt D Hankenson
- Department of Orthopaedic Surgery, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Archana Sanjay
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, School of Medicine, USA.
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6
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Cook E, Laycock J, Acharya M, Backhouse MR, Corbacho B, Doherty L, Forward D, Hewitt C, Hilton C, Hull P, Kassam J, Maturana C, Mcdaid C, Roche J, Sivapathasuntharam D, Torgerson D, Bates P. Lateral compression type 1 fracture fixation in the elderly (L1FE): study protocol for a randomised controlled trial (with internal pilot) comparing the effects of INFIX surgery and non-surgical management for treating patients with lateral compression type 1 (LC-1) fragility fractures. Trials 2023; 24:78. [PMID: 36732808 PMCID: PMC9893645 DOI: 10.1186/s13063-022-07063-5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/30/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Lateral compression type1 (LC-1) fragility fractures are a common, painful injury in older adults resulting in reduced mobility. The incidence of these fractures is increasing with the growing older adult population. The current standard of care is non-surgical management; however, patients with this injury are at risk of long-term immobility and related complications. INFIX is a pelvic fixation device used in younger patients with high-energy fractures. The device is fitted via a percutaneous technique with no external pin sites and has good purchase even in osteoporotic bone. It therefore has the potential to be well tolerated in patients with LC-1 fragility fractures. INFIX could improve patients' ability to mobilise and reduce the risk of immobility-related complications. However, there is a risk of complications related to surgery, and robust evidence is required on patient outcomes. This study will investigate the clinical and cost-effectiveness of surgical fixation with INFIX compared to non-surgical management of LC-1 fragility fractures in older adults. METHODS A multi-centre randomised controlled trial of 600 patients allocated 1:1 to non-surgical management or INFIX surgery. The study will have a 12-month internal pilot to assess recruitment and trial feasibility. The primary outcome will be the patient quality of life over 6 months, measured by the patient-reported EQ-5D-5L. The secondary outcomes will include physical function, mental health, pain, delirium, imaging assessment, resource use, and complications. DISCUSSION The L1FE study aims to compare the clinical and cost-effectiveness of surgical and non-surgical management of people aged 60 years and older with LC-1 fragility fractures. The trial is sufficiently powered and rigorously designed to inform future clinical and patient decision-making and allocation of NHS resources. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number Registry ISRCTN16478561. Registered on 8 April 2019.
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Affiliation(s)
- Elizabeth Cook
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Joanne Laycock
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Mehool Acharya
- grid.416201.00000 0004 0417 1173Pelvic and Acetabular Reconstruction Unit, Southmead Hospital, Bristol, BS10 5NB UK
| | - Michael Ross Backhouse
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK ,grid.7372.10000 0000 8809 1613Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Belen Corbacho
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Laura Doherty
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Daren Forward
- grid.240404.60000 0001 0440 1889Nottingham University Hospitals, Derby Road, Nottingham, NG7 2UH UK
| | - Catherine Hewitt
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Catherine Hilton
- grid.416041.60000 0001 0738 5466Bart’s Health NHS Trust, The Royal London Hospital, Whitechapel Road, Whitechapel, London, E1 1BB UK
| | - Peter Hull
- grid.24029.3d0000 0004 0383 8386Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ UK
| | - Jamila Kassam
- grid.416041.60000 0001 0738 5466Bart’s Health NHS Trust, The Royal London Hospital, Whitechapel Road, Whitechapel, London, E1 1BB UK
| | - Camila Maturana
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Catriona Mcdaid
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Jenny Roche
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Dhanupriya Sivapathasuntharam
- grid.416041.60000 0001 0738 5466Bart’s Health NHS Trust, The Royal London Hospital, Whitechapel Road, Whitechapel, London, E1 1BB UK
| | - David Torgerson
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Peter Bates
- grid.416041.60000 0001 0738 5466Bart’s Health NHS Trust, The Royal London Hospital, Whitechapel Road, Whitechapel, London, E1 1BB UK
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7
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Byrne AK, Scantlebury A, Jones K, Doherty L, Torgerson DJ. Communication interventions for medically unexplained symptom conditions in general practice: A systematic review and meta-analysis of randomised controlled trials. PLoS One 2022; 17:e0277538. [PMID: 36374916 PMCID: PMC9662736 DOI: 10.1371/journal.pone.0277538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Medically unexplained symptoms (MUS) account for 3–50% of all General Practitioner (GP) consultations and are difficult to diagnose due to their unknown aetiology, symptom overlap between conditions, and lack of effective treatment options. MUS patients’ and primary care clinicians frequently face challenges during consultations, with GPs reporting difficulty identifying and classifying MUS, whilst patients report stigma and feeling illegitimised by clinicians. Communication interventions have been proposed as a method to facilitate the doctor-patient relationship and aid the management of MUS. Aim This systematic review aims to evaluate the effectiveness of primary care based communication interventions at improving MUS patients’ and/or clinician outcomes. Method Four electronic databases were searched from inception to November 2021. Two researchers independently undertook screening, data extraction and quality appraisal. Given the heterogeneous nature of the studies identified, narrative syntheses were conducted, along with meta-analyses where possible to pool data. Results 9 papers from 10 Randomised Controlled Trials were included. The included studies displayed considerable risk of bias and poor reporting. Some limited evidence suggests that communication interventions tailored to MUS and not following a pre-specified model (such as reattribution) could improve pain, mental and physical functioning whilst reattribution training may improve clinician confidence treating MUS. However, methodological limitations mean that these findings should be interpreted with caution. Conclusion A range of interventions for improving communication with MUS patients in primary care have been evaluated. However, the heterogeneous nature of existing evidence and poor study quality mean we cannot conclude whether these interventions are effective. Before considering further randomised controlled trials researchers should focus on developing a new or modified communication intervention for MUS patients and their clinicians. Trail registration The systematic review was prospectively registered with PROSPERO (registration record CRD42020206437).
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Affiliation(s)
- Ailish Katherine Byrne
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
- * E-mail:
| | - Arabella Scantlebury
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
| | - Katherine Jones
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
- Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom
| | - Laura Doherty
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
| | - David J. Torgerson
- Department of Health Sciences, York Trials Unit, University of York, Heslington, York, United Kingdom
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8
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Doherty L, Sangpo T, Tsvetkov P, Davis J, Dianati N, Schwede W, Zimmermann K, Evans L, Amatucci A, Seidel H, Kamburov A, Akcay G, Golub T, Eheim A, Burkhardt N, Eis K, Christian S, Rees M, Roth J. Abstract 2682: Small molecule targeting the lipoic acid post-translational modification impacts proliferation of colorectal and PIK3CA-mutant cell lines. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
To identify novel therapeutic targets, we utilize the PRISM platform, a multiplexed cell line viability technology of 500 solid tumor cell lines and correlate responses to functional genomic and baseline genetic data. We describe ESD0140656, a small molecule with selective anti-proliferative effect on colorectal and PIK3CA-mutant cell lines. Response to ESD0140656 is correlated to sensitivity to CRISPR/Cas9 KO of components of the protein lipoylation pathway and OGDH complex members, which catalyze a step of the TCA cycle. Lipoylation is a rare post-translational modification attached to just four enzymes in humans, including the OGDH complex. Knockout of the protein that transfers lipoic acid to these four enzymes (LIPT1) sensitizes cells to ESD0140656, and ESD0140656 treatment leads to reduction of lipoic acid in cells. These results suggest ESD0140656 targets the lipoylation pathway and may represent a novel therapeutic angle for colorectal and PIK3CA-mutant tumors.
Citation Format: Laura Doherty, Tenzin Sangpo, Peter Tsvetkov, John Davis, Navid Dianati, Wolfgang Schwede, Katja Zimmermann, Laura Evans, Aldo Amatucci, Henrik Seidel, Atanas Kamburov, Gizem Akcay, Todd Golub, Ashley Eheim, Nils Burkhardt, Knut Eis, Sven Christian, Matt Rees, Jennifer Roth. Small molecule targeting the lipoic acid post-translational modification impacts proliferation of colorectal and PIK3CA-mutant cell lines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2682.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Knut Eis
- 2Bayer Pharmaceuticals, Cambridge, MA
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9
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Ambridge B, Doherty L, Maitreyee R, Tatsumi T, Zicherman S, Mateo Pedro P, Kawakami A, Bidgood A, Pye C, Narasimhan B, Arnon I, Bekman D, Efrati A, Fabiola Can Pixabaj S, Marroquín Pelíz M, Julajuj Mendoza M, Samanta S, Campbell S, McCauley S, Berman R, Misra Sharma D, Bhaya Nair R, Fukumura K. Testing a computational model of causative overgeneralizations: Child judgment and production data from English, Hebrew, Hindi, Japanese and K'iche'. Open Res Eur 2022; 1:1. [PMID: 37645154 PMCID: PMC10446094 DOI: 10.12688/openreseurope.13008.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 08/31/2023]
Abstract
How do language learners avoid the production of verb argument structure overgeneralization errors ( *The clown laughed the man c.f. The clown made the man laugh), while retaining the ability to apply such generalizations productively when appropriate? This question has long been seen as one that is both particularly central to acquisition research and particularly challenging. Focussing on causative overgeneralization errors of this type, a previous study reported a computational model that learns, on the basis of corpus data and human-derived verb-semantic-feature ratings, to predict adults' by-verb preferences for less- versus more-transparent causative forms (e.g., * The clown laughed the man vs The clown made the man laugh) across English, Hebrew, Hindi, Japanese and K'iche Mayan. Here, we tested the ability of this model (and an expanded version with multiple hidden layers) to explain binary grammaticality judgment data from children aged 4;0-5;0, and elicited-production data from children aged 4;0-5;0 and 5;6-6;6 ( N=48 per language). In general, the model successfully simulated both children's judgment and production data, with correlations of r=0.5-0.6 and r=0.75-0.85, respectively, and also generalized to unseen verbs. Importantly, learners of all five languages showed some evidence of making the types of overgeneralization errors - in both judgments and production - previously observed in naturalistic studies of English (e.g., *I'm dancing it). Together with previous findings, the present study demonstrates that a simple learning model can explain (a) adults' continuous judgment data, (b) children's binary judgment data and (c) children's production data (with no training of these datasets), and therefore constitutes a plausible mechanistic account of the acquisition of verbs' argument structure restrictions.
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Affiliation(s)
- Ben Ambridge
- University of Liverpool, Liverpool, UK
- ESRC International Centre for Language and Communicative Development (LuCiD), Liverpool, UK
| | | | | | | | | | | | | | | | | | | | - Inbal Arnon
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dani Bekman
- Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amir Efrati
- Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | | | - Soumitra Samanta
- University of Liverpool, Liverpool, UK
- ESRC International Centre for Language and Communicative Development (LuCiD), Liverpool, UK
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10
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Knowlson C, Dean A, Doherty L, Fairhurst C, Brealey S, Torgerson DJ. Recruitment patterns in multicentre randomised trials fit more closely to Price's Law than the Pareto Principle: A review of trials funded and published by the United Kingdom Health Technology Assessment Programme. Contemp Clin Trials 2021; 113:106665. [PMID: 34968767 DOI: 10.1016/j.cct.2021.106665] [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: 07/14/2021] [Revised: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This review investigates whether the distribution of recruitment to multicentre randomised controlled trials (RCTs) fits the "Pareto Principle", i.e. 80% of participants are recruited by 20% of sites, or Price's Law, i.e. 50% of participants are recruited by the square root of the total number of sites. METHODS A review of HTA reports published between 2017 and 2019. RESULTS 40 RCTs conducted face-to-face recruitment, five recruited via mail-outs and one used both methods. For face-to-face recruitment (n = 41 studies), 80% of participants were recruited by the top recruiting 42.6% of sites; for mail-out methods (n = 6 studies) this was 52.0%. From the square root of sites, 51.3% and 31.8% of participants were recruited for the two recruitment approaches, respectively. Specifically, 3 (7.3%, 95% CI 2.5% to 19.4%) and 20 (48.8%, 95% CI 34.3% to 63.5%) RCTs followed Pareto Principle and Price's Law, respectively. One mail-out recruitment study followed one of these principles, Price's Law. Chief Investigator (CI) sites (n = 24) in face-to-face recruitment studies recruited 18.1% of participants. CONCLUSION Face-to-face recruitment to HTA-funded RCTs fits more closely to Price's Law than the Pareto Principle, with the CI's site recruiting nearly a fifth of participants. Since we focussed on HTA-funded RCTs with ≥9 recruiting sites and for which the recruitment method and number recruited by site were known, our findings are limited in their generalizability. However, this trend could be used as a guide to aid in estimating how many sites RCTs need. More accurate estimation may prevent the need for recruitment extensions.
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Affiliation(s)
- Catherine Knowlson
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, York YO10 5DD, UK.
| | - Alexandra Dean
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, York YO10 5DD, UK
| | - Laura Doherty
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, York YO10 5DD, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, York YO10 5DD, UK
| | - Stephen Brealey
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, York YO10 5DD, UK
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, ARRC Building, University of York, York YO10 5DD, UK
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11
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Coleman E, Arundel C, Clark L, Doherty L, Gillies K, Hewitt C, Innes K, Parker A, Torgerson D, Treweek S. Bah humbug! Association between sending Christmas cards to trial participants and trial retention: randomised study within a trial conducted simultaneously across eight host trials. BMJ 2021; 375:e067742. [PMID: 34906985 PMCID: PMC8669570 DOI: 10.1136/bmj-2021-067742] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To determine the effectiveness of sending Christmas cards to participants in randomised controlled trials to increase retention rate at follow-ups, and to explore the feasibility of doing a study within a trial (SWAT) across multiple host trials simultaneously. DESIGN Randomised SWAT conducted simultaneously across eight host trials. SETTING Eight randomised controlled trials researching various areas including surgery and smoking cessation. PARTICIPANTS 3223 trial participants who were still due at least one follow-up from their host randomised controlled trial. INTERVENTION Participants were randomised (1:1, separately by each host trial) to either received a Christmas card in mid-December 2019 or to not receive a card. MAIN OUTCOME MEASURE Proportion of participants completing their next follow-up (retention rate) within their host randomised controlled trial. RESULTS 1469 participants (age 16-94 years; 70% (n=1033) female; 96% (813/847) white ethnicity) across the eight host randomised controlled trials were involved in the analysis (cut short owing to covid-19). No evidence was found of a difference in retention rate between the two arms for any of the host trials when analysed separately or when the results were combined (85.3% (639/749) for cards versus 85.4% (615/720) for no card; odds ratio 0.96, 95% confidence interval 0.71 to 1.29; P=0.77). No difference was observed when comparing just participants who were due a follow-up in the 30 days after receiving the card (odds ratio 0.96, 0.42 to 2.21). No evidence of a difference in time to complete the questionnaire was found (hazard ratio 1.01, 95% confidence interval 0.91 to 1.13; P=0.80). These results were robust to post hoc sensitivity analyses. The cost of this intervention was £0.76 (€0.91; $1.02) per participant, and it will have a carbon footprint of approximately 140 g CO2 equivalent per card. One benefit of this approach was the need to only submit one ethics application. CONCLUSIONS Sending Christmas cards to participants in randomised controlled trials does not increase retention. Undertaking a SWAT within multiple randomised controlled trials at the same time is, however, possible. This approach should be used more often to build an evidence base to support selection of recruitment and retention strategies. Although no evidence of a boost to retention was found, embedding a SWAT in multiple host trials simultaneously has been shown to be possible. STUDY REGISTRATION SWAT repository https://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/FileStore/Filetoupload,846275,en.pdf#search=SWAT%2082.
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Affiliation(s)
- Elizabeth Coleman
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catherine Arundel
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Laura Clark
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Laura Doherty
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Karen Innes
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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12
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Miller K, Doherty L, Robison K. Integration of survivorship program into outpatient gynecologic oncology office setting. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01010-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Yang J, Weisberg EL, Liu X, Magin RS, Chan WC, Hu B, Schauer NJ, Zhang S, Lamberto I, Doherty L, Meng C, Sattler M, Cabal-Hierro L, Winer E, Stone R, Marto JA, Griffin JD, Buhrlage SJ. Small molecule inhibition of deubiquitinating enzyme JOSD1 as a novel targeted therapy for leukemias with mutant JAK2. Leukemia 2021; 36:210-220. [PMID: 34326465 DOI: 10.1038/s41375-021-01336-9] [Citation(s) in RCA: 8] [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] [Received: 04/18/2021] [Revised: 06/14/2021] [Accepted: 06/22/2021] [Indexed: 01/30/2023]
Abstract
Mutations in the Janus Kinase 2 (JAK2) gene resulting in constitutive kinase activation represent the most common genetic event in myeloproliferative neoplasms (MPN), a group of diseases involving overproduction of one or more kinds of blood cells, including red cells, white cells, and platelets. JAK2 kinase inhibitors, such as ruxolitinib, provide clinical benefit, but inhibition of wild-type (wt) JAK2 limits their clinical utility due to toxicity to normal cells, and small molecule inhibition of mutated JAK2 kinase activity can lead to drug resistance. Here, we present a strategy to target mutated JAK2 for degradation, using the cell's intracellular degradation machinery, while sparing non-mutated JAK2. We employed a chemical genetics screen, followed by extensive selectivity profiling and genetic studies, to identify the deubiquitinase (DUB), JOSD1, as a novel regulator of mutant JAK2. JOSD1 interacts with and stabilizes JAK2-V617F, and inactivation of the DUB leads to JAK2-V617F protein degradation by increasing its ubiquitination levels, thereby shortening its protein half-life. Moreover, targeting of JOSD1 leads to the death of JAK2-V617F-positive primary acute myeloid leukemia (AML) cells. These studies provide a novel therapeutic approach to achieving selective targeting of mutated JAK2 signaling in MPN.
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Affiliation(s)
- Jing Yang
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Ellen L Weisberg
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Xiaoxi Liu
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Robert S Magin
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Wai Cheung Chan
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Bin Hu
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Nathan J Schauer
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Shengzhe Zhang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Ilaria Lamberto
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Laura Doherty
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Chengcheng Meng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Martin Sattler
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lucia Cabal-Hierro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Eric Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Richard Stone
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jarrod A Marto
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - James D Griffin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | - Sara J Buhrlage
- Department of Cancer Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. .,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA.
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14
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Abstract
Diabetics are at increased risk for fracture, and experience severely impaired skeletal healing characterized by delayed union or nonunion of the bone. The periosteum harbors osteochondral progenitors that can differentiate into chondrocytes and osteoblasts, and this connective tissue layer is required for efficient fracture healing. While bone marrow-derived stromal cells have been studied extensively in the context of diabetic skeletal repair and osteogenesis, the effect of diabetes on the periosteum and its ability to contribute to bone regeneration has not yet been explicitly evaluated. Within this study, we utilized an established murine model of type I diabetes to evaluate periosteal cell differentiation capacity, proliferation, and availability under the effect of a diabetic environment. Periosteal cells from diabetic mice were deficient in osteogenic differentiation ability in vitro, and diabetic mice had reduced periosteal populations of mesenchymal progenitors with a corresponding reduction in proliferation capacity following injury. Additionally, fracture callus mineralization and mature osteoblast activity during periosteum-mediated healing was impaired in diabetic mice compared to controls. We propose that the effect of diabetes on periosteal progenitors and their ability to aid in skeletal repair directly impairs fracture healing.
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Affiliation(s)
- Laura Doherty
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, UConn Health, Farmington, CT, USA
| | - Matthew Wan
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, UConn Health, Farmington, CT, USA
| | - Ivo Kalajzic
- Department of Reconstructive Sciences, UConn School of Dental Medicine, Farmington, CT, USA
| | - Archana Sanjay
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, UConn Health, Farmington, CT, USA.
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15
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Abstract
AIMS Bone demonstrates good healing capacity, with a variety of strategies being utilized to enhance this healing. One potential strategy that has been suggested is the use of stem cells to accelerate healing. METHODS The following databases were searched: MEDLINE, CENTRAL, EMBASE, Cochrane Database of Systematic Reviews, WHO-ICTRP, ClinicalTrials.gov, as well as reference checking of included studies. The inclusion criteria for the study were: population (any adults who have sustained a fracture, not including those with pre-existing bone defects); intervention (use of stem cells from any source in the fracture site by any mechanism); and control (fracture healing without the use of stem cells). Studies without a comparator were also included. The outcome was any reported outcomes. The study design was randomized controlled trials, non-randomized or observational studies, and case series. RESULTS In all, 94 eligible studies were identified. The clinical and methodological aspects of the studies were too heterogeneous for a meta-analysis to be undertaken. A narrative synthesis examined study characteristics, stem cell methods (source, aspiration, concentration, and application) and outcomes. CONCLUSION Insufficient high-quality evidence is available to determine the efficacy of stem cells for fracture healing. The studies were heterogeneous in population, methods, and outcomes. Work to address these issues and establish standards for future research should be undertaken.Cite this article: Bone Joint Open 2020;1-10:628-638.
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Affiliation(s)
- Andrew Mott
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Alex Mitchell
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Melissa Harden
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Rachael Grupping
- Department of Trauma and Orthopaedics, Hull University Teaching Hospitals, Hull, UK
| | - Alexandra Dean
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Ailish Byrne
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Laura Doherty
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Hemant Sharma
- Department of Trauma and Orthopaedics, Hull University Teaching Hospitals, Hull, UK
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16
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Ambridge B, Maitreyee R, Tatsumi T, Doherty L, Zicherman S, Pedro PM, Bannard C, Samanta S, McCauley S, Arnon I, Bekman D, Efrati A, Berman R, Narasimhan B, Sharma DM, Nair RB, Fukumura K, Campbell S, Pye C, Pixabaj SFC, Pelíz MM, Mendoza MJ. The crosslinguistic acquisition of sentence structure: Computational modeling and grammaticality judgments from adult and child speakers of English, Japanese, Hindi, Hebrew and K'iche'. Cognition 2020; 202:104310. [PMID: 32623135 PMCID: PMC7397526 DOI: 10.1016/j.cognition.2020.104310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/31/2020] [Accepted: 04/13/2020] [Indexed: 11/16/2022]
Abstract
This preregistered study tested three theoretical proposals for how children form productive yet restricted linguistic generalizations, avoiding errors such as *The clown laughed the man, across three age groups (5-6 years, 9-10 years, adults) and five languages (English, Japanese, Hindi, Hebrew and K'iche'). Participants rated, on a five-point scale, correct and ungrammatical sentences describing events of causation (e.g., *Someone laughed the man; Someone made the man laugh; Someone broke the truck; ?Someone made the truck break). The verb-semantics hypothesis predicts that, for all languages, by-verb differences in acceptability ratings will be predicted by the extent to which the causing and caused event (e.g., amusing and laughing) merge conceptually into a single event (as rated by separate groups of adult participants). The entrenchment and preemption hypotheses predict, for all languages, that by-verb differences in acceptability ratings will be predicted by, respectively, the verb's relative overall frequency, and frequency in nearly-synonymous constructions (e.g., X made Y laugh for *Someone laughed the man). Analysis using mixed effects models revealed that entrenchment/preemption effects (which could not be distinguished due to collinearity) were observed for all age groups and all languages except K'iche', which suffered from a thin corpus and showed only preemption sporadically. All languages showed effects of event-merge semantics, except K'iche' which showed only effects of supplementary semantic predictors. We end by presenting a computational model which successfully simulates this pattern of results in a single discriminative-learning mechanism, achieving by-verb correlations of around r = 0.75 with human judgment data.
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Affiliation(s)
- Ben Ambridge
- University of Liverpool, United Kingdom of Great Britain and Northern Ireland; ESRC International Centre for Language and Communicative Development (LuCiD).
| | - Ramya Maitreyee
- University of Liverpool, United Kingdom of Great Britain and Northern Ireland
| | | | - Laura Doherty
- University of Liverpool, United Kingdom of Great Britain and Northern Ireland
| | | | | | - Colin Bannard
- University of Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Soumitra Samanta
- University of Liverpool, United Kingdom of Great Britain and Northern Ireland; ESRC International Centre for Language and Communicative Development (LuCiD)
| | | | | | | | | | | | | | | | | | - Kumiko Fukumura
- University of Stirling, United Kingdom of Great Britain and Northern Ireland
| | | | - Clifton Pye
- University of Kansas, United States of America
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17
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Kelly C, Mason-Mohan C, Doherty L. Cervical screening for HIV-positive women in the transition to primary HPV testing in Ireland. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
CervicalCheck, Ireland's national cervical cancer screening programme, will transition to primary HPV testing in March 2020. CervicalCheck sought an evidence review to inform the screening pathway for HIV-positive women in this context, with regard to age of initiation and frequency of screening. Currently, HIV-positive women commence cervical screening at age 20 in Ireland with annual screening thereafter.
Methods
An electronic literature search was conducted to identify relevant peer-reviewed publications using the database Pubmed. A hand search of reference lists of suitable articles and international cervical screening guidelines was conducted to check for additional material. Publications pertaining to international cervical screening guidance and practice were sourced via internet searches using Google. The relevant grey literature was also explored.
Results
The prevalence of multiple and more persistent high-risk HPV types is higher among HIV-positive women compared to HIV-negative women. HIV-positive women are also at an increased risk of progression and post-treatment recurrence of HPV-associated cervical lesions. The degree of immunosuppression is a key factor in the relationship between HPV and HIV. There is significant heterogeneity internationally as regards cervical screening pathways for HIV-positive women. Many programmes commence screening at the time of diagnosis with HIV. Most developed countries screen HIV-positive women more frequently than HIV-negative women, although the screening interval varies.
Conclusions
HIV-positive women warrant special attention within an organised population-based cervical screening programme. The evidence synthesised in this review was used to inform change to the screening pathway for HIV-positive women as part of the planned transition to primary HPV testing. Cervical screening for these women using primary HPV testing will now commence at the time of diagnosis with HIV, with annual screening thereafter.
Key messages
HIV-positive women warrant special attention within an organised population-based cervical screening programme. The evidence synthesised in this review was used to inform change to the screening pathway for HIV-positive women as part of the planned transition to primary HPV testing in Ireland.
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Affiliation(s)
- C Kelly
- Department of Public Health, Health Service Executive West, Galway, Ireland
| | - C Mason-Mohan
- National Screening Service, Health Service Executive, Dublin, Ireland
| | - L Doherty
- CervicalCheck, National Screening Service, Health Service Executive, Dublin, Ireland
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Doherty L, Sanjay A. LGRs in Skeletal Tissues: An Emerging Role for Wnt-Associated Adult Stem Cell Markers in Bone. JBMR Plus 2020; 4:e10380. [PMID: 32666024 PMCID: PMC7340442 DOI: 10.1002/jbm4.10380] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/18/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
Leucine‐rich repeat‐containing G protein‐coupled receptors (LGRs) are adult stem cell markers that have been described across various stem cell niches, and expression of LGRs and their corresponding ligands (R‐spondins) has now been reported in multiple bone‐specific cell types. The skeleton harbors elusive somatic stem cell populations that are exceedingly compartment‐specific and under tight regulation from various signaling pathways. Skeletal progenitors give rise to multiple tissues during development and during regenerative processes of bone, requiring postnatal endochondral and intramembranous ossification. The relevance of LGRs and the LGR/R‐spondin ligand interaction in bone and tooth biology is becoming increasingly appreciated. LGRs may define specific stem cell and progenitor populations and their behavior during both development and regeneration, and their role as Wnt‐associated receptors with specific ligands poses these proteins as unique therapeutic targets via potential R‐spondin agonism. This review seeks to outline the current literature on LGRs in the context of bone and its associated tissues, and points to key future directions for studying the functional role of LGRs and ligands in skeletal biology. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Laura Doherty
- Department of Orthopaedic Surgery UConn Health Farmington CT USA
| | - Archana Sanjay
- Department of Orthopaedic Surgery UConn Health Farmington CT USA
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19
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Grobman WA, Sandoval G, Reddy UM, Tita AT, Silver RM, Mallett G, Hill K, Rice MM, El-Sayed YY, Wapner RJ, Rouse DJ, Saade GR, Thorp JM, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA, Peaceman A, Plunkett B, Paycheck K, Dinsmoor M, Harris S, Sheppard J, Biggio J, Harper L, Longo S, Servay C, Varner M, Sowles A, Coleman K, Atkinson D, Stratford J, Dellermann S, Meadows C, Esplin S, Martin C, Peterson K, Stradling S, Willson C, Lyell D, Girsen A, Knapp R, Gyamfi C, Bousleiman S, Perez-Delboy A, Talucci M, Carmona V, Plante L, Tocci C, Leopanto B, Hoffman M, Dill-Grant L, Palomares K, Otarola S, Skupski D, Chan R, Allard D, Gelsomino T, Rousseau J, Beati L, Milano J, Werner E, Salazar A, Costantine M, Chiossi G, Pacheco L, Saad A, Munn M, Jain S, Clark S, Clark K, Boggess K, Timlin S, Eichelberger K, Moore A, Beamon C, Byers H, Ortiz F, Garcia L, Sibai B, Bartholomew A, Buhimschi C, Landon M, Johnson F, Webb L, McKenna D, Fennig K, Snow K, Habli M, McClellan M, Lindeman C, Dalton W, Hackney D, Cozart H, Mayle A, Mercer B, Moseley L, Gerald J, Fay-Randall L, Garcia M, Sias A, Price J, Hale K, Phipers J, Heyborne K, Craig J, Parry S, Sehdev H, Bishop T, Ferrara J, Bickus M, Caritis S, Thom E, Doherty L, de Voest J. Health resource utilization of labor induction versus expectant management. Am J Obstet Gynecol 2020; 222:369.e1-369.e11. [PMID: 31930993 DOI: 10.1016/j.ajog.2020.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization. OBJECTIVE The objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY DESIGN This is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management. We assessed resource utilization after randomization in 3 time periods: antepartum, delivery admission, and discharge through 8 weeks postpartum. RESULTS Of 6096 women with data available, those in the induction of labor group (n = 3059) were significantly less likely in the antepartum period after randomization to have at least 1 ambulatory visit for routine prenatal care (32.4% vs 68.4%), unanticipated care (0.5% vs 2.6%), or urgent care (16.2% vs 44.3%), or at least 1 antepartum hospitalization (0.8% vs 2.2%, P < .001 for all). They also had fewer tests (eg, sonograms, blood tests) and treatments (eg, antibiotics, intravenous hydration) prior to delivery. During the delivery admission, women in the induction of labor group spent a longer time in labor and delivery (median, 0.83 vs 0.57 days), but both women (P = .002) and their neonates (P < .001) had shorter postpartum stays. Women and neonates in both groups had similar frequencies of postpartum urgent care and hospital readmissions (P > .05 for all). CONCLUSION Women randomized to induction of labor had longer durations in labor and delivery but significantly fewer antepartum visits, tests, and treatments and shorter maternal and neonatal hospital durations after delivery. These results demonstrate that the health outcome advantages associated with induction of labor are gained without incurring uniformly greater health care resource use.
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Doherty L, Yu J, Wang X, Hankenson KD, Kalajzic I, Sanjay A. A PDGFRβ-PI3K signaling axis mediates periosteal cell activation during fracture healing. PLoS One 2019; 14:e0223846. [PMID: 31665177 PMCID: PMC6821073 DOI: 10.1371/journal.pone.0223846] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/30/2019] [Indexed: 12/21/2022] Open
Abstract
Insufficient and delayed fracture healing remain significant public health problems with limited therapeutic options. Phosphoinositide 3-kinase (PI3K) signaling, a major pathway involved in regulation of fracture healing, promotes proliferation, migration, and differentiation of osteoprogenitors. We have recently reported that knock-in mice with a global increase in PI3K signaling (gCblYF) show enhanced femoral fracture healing characterized by an extraordinary periosteal response to injury. Interestingly, of all growth factor receptors involved in fracture healing, PI3K directly binds only to PDGFR. Given these findings, we hypothesized a PDGFR-PI3K interaction is necessary for mediating robust periosteal cell activation following fracture. In this study, we isolated primary periosteal cells from gCblYF mice to analyze cross-talk between the PDGFRβ and PI3K signaling pathways. We found PDGFRβ signaling contributes to robust Akt phosphorylation in periosteal cells in comparison with other growth factor signaling pathways. Additionally, we performed femoral fractures on gCblYF mice with a conditional removal of PDGFRβ in mesenchymal progenitors using inducible alpha smooth muscle actin (αSMA) CreERT2 mice. Our studies showed that depletion of PDGFRβ signaling within these progenitors in the early phase of fracture healing significantly abrogates PI3K-mediated periosteal activation and proliferation three days after fracture. Combined, these results suggest that PDGFRβ signaling through PI3K is necessary for robust periosteal activation in the earliest phases of fracture healing.
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Affiliation(s)
- Laura Doherty
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, United States of America
| | - Jungeun Yu
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, United States of America
| | - Xi Wang
- Department of Reconstructive Sciences, UConn Health, Farmington, Connecticut, United States of America
| | - Kurt D. Hankenson
- Department of Orthopaedic Surgery, School of Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ivo Kalajzic
- Department of Reconstructive Sciences, UConn Health, Farmington, Connecticut, United States of America
| | - Archana Sanjay
- Department of Orthopaedic Surgery, UConn Health, Farmington, Connecticut, United States of America
- * E-mail:
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Abstract
Effective bone resorption by osteoclasts is critical for balanced bone remodeling. We have previously reported that mice harboring a substitution mutation of tyrosine 737 to phenylalanine in the adapter protein Cbl (CblY737F, YF) have increased bone volume partly due to decreased osteoclast-mediated bone resorption. The CblY737F mutation abrogates interaction between Cbl and the p85 subunit of PI3K. Here, we studied the mechanism for defective resorptive function of YF mutant osteoclasts. The YF osteoclasts had intact actin cytoskeletons and sealing zones. Expression and localization of proteins needed for acidification of the resorptive lacunae were also comparable between the WT and YF osteoclasts. In contrast, secretion of Cathepsin K, a major protease needed to degrade collagen, was diminished in the conditioned media derived from YF osteoclasts. The targeting of Cathepsin K into LAMP2-positive vesicles was also compromised due to decreased number of LAMP2-positive vesicles in YF osteoclasts. Further, we found that in contrast to WT, conditioned media derived from YF osteoclasts promoted increased numbers of alkaline phosphatase positive colonies, and increased expression of osteogenic markers in WT calvarial cultures. Cumulatively, our results suggest that the Cbl-PI3K interaction regulates Cathepsin K secretion required for proper bone resorption, and secretion of factors which promote osteogenesis.
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Affiliation(s)
- Jungeun Yu
- Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, United States of America
| | - Naga Suresh Adapala
- Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, United States of America
| | - Laura Doherty
- Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, United States of America
| | - Archana Sanjay
- Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, United States of America.
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Abstract
A study was undertaken in Northern Ireland (NI) prisons to (i) determine prevalence of bloodborne viruses among inmates, (ii) estimate the extent of self-reported risk behaviours. All three prisons in NI were included in the study. Outcome measures included (i) antibodies to hepatitis C (HCV), hepatitis B (HBV) core antigen, HIV, (ii) self-reported risk behaviour. Five prisoners (0.75%) tested positive for HBV, seven (1.1%) for HCV and none for HIV. Eleven per cent reported ever having injected drugs. Of these, 20% had started injecting while in prison, and 12% shared injecting equipment in prison. Two per cent had completed HBV immunisation. Injecting drugs was associated with HCV (adjusted prevalence ratio=5.2; 95% CI 0.9-16) and HBV infection (adjusted prevalence ratio=4.1; 95% CI 0.7-23). The low prevalence of bloodborne viruses within NI prisons is not consistent with findings of studies in other countries, possibly reflecting the unique sociopolitical situation in NI. In spite of knowledge of the risks of transmission of bloodborne viruses in prison, high-risk practices are occurring. Preventing risk behaviours and transmission of infection in prisons now poses a challenge for health services in the United Kingdom.
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Affiliation(s)
- K Danis
- European Programme for Intervention Epidemiology Training (EPIET)
| | - L Doherty
- Communicable Disease Surveillance Centre (CDSC-NI), Belfast, Northern Ireland
| | - M McCartney
- Department of Health, Social Services and Public Safety (DHSSPS), Belfast, Northern Ireland
| | - J McCarrol
- Eastern Health and Social Services Board (EHSSB), Belfast, Northern Ireland
| | - H Kennedy
- Eastern Health and Social Services Board (EHSSB), Belfast, Northern Ireland
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Doherty L, Poynter SJ, Aloufi A, DeWitte-Orr SJ. Fish viruses make dsRNA in fish cells: characterization of dsRNA production in rainbow trout (Oncorhynchus mykiss) cells infected with viral haemorrhagic septicaemia virus, chum salmon reovirus and frog virus 3. J Fish Dis 2016; 39:1133-1137. [PMID: 26775727 DOI: 10.1111/jfd.12443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 06/05/2023]
Affiliation(s)
- L Doherty
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - S J Poynter
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
- Department of Biology, University of Waterloo, Waterloo, ON, Canada
| | - A Aloufi
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - S J DeWitte-Orr
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
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24
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Xie H, Doherty L, O'Boyle C. The Positive Impact of Bariatric Surgery on Sleep. Ir Med J 2016; 109:328-330. [PMID: 26904786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Between June 2009 and July 2012, Apnoea-Hypopnoea Index (AHI) and Functional Outcomes of Sleep Questionnaires Scores (FOSQ) were prospectively evaluated pre- and post-operatively in patients undergoing bariatric surgery. A total of 167 subjects were studied, 75.4% were females. The median age was 46 (14-75) years and BMI 49 (36-69) kg/m2. Ninety two (55.0%) patients were diagnosed with Obstructive Sleep Apnoea (OSA) preoperatively. Fifty (54.0%) required positive airway pressure (PAP) therapy. The mean reduction in BMI post bariatric surgery was 12.2 ± 4.52 kg/m2 at 6.56 ± 2.70 months. Eighty (87.9%) reported improved sleep quality reflected in improved scores in all domains of the FOSQ (p < 0.001, paired t-test). Improvement in FOSQ scores remained significant (p < 0.05) in those with and without OSA. Thirty-nine (90.7%) patients discontinued PAP due to resolution of daytime sleepiness. In conclusion, weight loss following bariatric surgery has a positive impact on sleep in-patients with and without OSAS.
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Affiliation(s)
| | - Laura Doherty
- South Devon Healthcare Trust; Diabetes and Endocrinology; Torbay UK
| | - Jamie Smith
- South Devon Healthcare Trust; Diabetes and Endocrinology; Torbay UK
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26
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Patterson L, Irvine N, Wilson A, Doherty L, Loughrey A, Jessop L. Outbreak of invasive pneumococcal disease at a Belfast shipyard in men exposed to welding fumes, Northern Ireland, April-May 2015: preliminary report. ACTA ACUST UNITED AC 2015; 20. [PMID: 26062559 DOI: 10.2807/1560-7917.es2015.20.21.21138] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report an outbreak of four confirmed cases of invasive pneumococcal disease (IPD) in individuals occupationally exposed to welding fumes, at a Belfast shipyard (Northern Ireland). All cases were hospitalised. A high-risk sub-group of 679 workers has been targeted for antibiotic prophylaxis and pneumococcal vaccination. Physicians and public health institutions outside Northern Ireland should be alert to individuals presenting with pneumonia or IPD and recent links to the shipyard, to facilitate early assessment and treatment.
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Affiliation(s)
- L Patterson
- UK Field Epidemiology Training Programme, Public Health England, United Kingdom
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27
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Abstract
Examination of tone (increased resistance to the passive movement of a joint) is a clinically useful and occasionally neglected part of the neurological examination. Rigidity and spasticity are two distinct types of hypertonia that arise from distinct anatomical pathways. The ability to differentiate between these two entities therefore gives important information regarding localization. Whereas spasticity arises as a result of damage to the corticoreticulospinal (pyramidal) tracts, rigidity is caused by dysfunction of extrapyramidal pathways, most commonly the basal ganglia, but also as a result of lesions of the mesencephalon and spinal cord. Spasticity is characterized by abnormally high muscle tone, which often asymmetrically affects antagonistic muscle groups. It is both amplitude and velocity dependent and is therefore best assessed using rapid movements of the relevant joint to effect abrupt stretching of the muscle group involved. When a threshold velocity, angle, or amplitude is reached, a sudden increase in tone can be detected as a characteristic "catch." Rigidity differs from spasticity in that the increased tone remains constant throughout the range of movement of the joint. It is independent of velocity and should even be detectable with very slow movements. It is present in flexors and extensor muscle groups equally, giving rise to a uniform quality in all directions often described as "lead pipe" rigidity. Given that rigidity frequently arises in diseases of the basal ganglia, a tremor can coexist, giving rise to an interrupted "cogwheeling" effect. We herein describe an approach to the examination of patients with rigidity and spasticity.
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Affiliation(s)
- Conor Fearon
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | - Laura Doherty
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
| | - Tim Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland
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28
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O'Carroll G, Doody E, Vaughan C, Doherty L. Can you die from obstructive sleep apnoea syndrome (OSAS)? Ir Med J 2015; 108:40-43. [PMID: 25803953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Studies suggest an independent association between Obstructive Sleep Apnoea Syndrome (OSAS) and cardiovascular death. The purpose of our study is to examine doctors' awareness of this association and to determine whether this correlates with recording of OSAS on death certificates. We contacted the Central Statistics Office (CSO) and obtained relevant mention of OSAS on death certificates. We surveyed doctors on their view of OSAS-related deaths, CSO data from 2008-2011 reveal two deaths with OSAS documented as a direct cause and 52 deaths with OSAS as a contributory cause. Seventy-five doctors' surveyed (41%) believe OSAS can be a direct cause of death and 177 (96%) believe OSAS can be an indirect cause of death. Only 22 (12%) had putdown OSAS as a cause of death. OSAS is seldom recorded on death certificates. This is at odds with epidemiological forecasts and contrary to an opinion poll from a selection of doctors.
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29
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Lee E, Muzikansky A, Kesari S, Wong E, Fadul C, Reardon D, Norden A, Nayak L, Rinne M, Alexander B, Arvold N, Doherty L, LaFrankie D, Pulverenti J, Smith K, Gaffey S, Kenney A, Hammond S, Drappatz J, Wen P. SM-03 * A RANDOMIZED, PLACEBO-CONTROLLED PILOT TRIAL OF ARMODAFINIL FOR FATIGUE IN PATIENTS WITH GLIOMAS UNDERGOING RADIOTHERAPY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou277.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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30
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Gay DL, Yang CC, Plikus MV, Ito M, Rivera C, Treffeisen E, Doherty L, Spata M, Millar SE, Cotsarelis G. CD133 expression correlates with membrane beta-catenin and E-cadherin loss from human hair follicle placodes during morphogenesis. J Invest Dermatol 2014; 135:45-55. [PMID: 25010141 PMCID: PMC4465595 DOI: 10.1038/jid.2014.292] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 05/21/2014] [Accepted: 06/04/2014] [Indexed: 12/30/2022]
Abstract
Genetic studies suggest that the major events of human hair follicle development are similar to those in mice, but detailed analyses of this process are lacking. In mice, hair follicle placode ‘budding’ is initiated by invagination of Wnt-induced epithelium into the underlying mesenchyme. Modification of adherens junctions is clearly required for budding. Snail-mediated downregulation of adherens junction component E-cadherin is important for placode budding in mice. Beta-catenin, another adherens junction component, has been more difficult to study due to its essential functions in Wnt signaling, a prerequisite for hair follicle placode induction. Here, we show that a subset of human invaginating hair placode cells expresses the stem cell marker CD133 during early morphogenesis. CD133 associates with membrane beta-catenin in early placodes and its continued expression correlates with loss of beta-catenin and E-cadherin from the cell membrane at a time when E-cadherin transcriptional repressors Snail and Slug are not implicated. Stabilization of CD133 via anti-CD133 antibody treatment of human fetal scalp explants depresses beta-catenin and E-cadherin membrane localization. We discuss this unique correlation and suggest a hypothetical model whereby CD133 promotes morphogenesis in early hair follicle placodes through the localized removal of membrane beta-catenin proteins and subsequent adherens junction dissolution.
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Affiliation(s)
- Denise L Gay
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chao-Chun Yang
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Maksim V Plikus
- Department of Developmental and Cell Biology, Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, California, USA
| | - Mayumi Ito
- Department of Dermatology, New York University Langone Medical Center, New York, New York, USA
| | - Charlotte Rivera
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elsa Treffeisen
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Doherty
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michelle Spata
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah E Millar
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - George Cotsarelis
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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31
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Guy R, Williams C, Irvine N, Reynolds A, Coelho J, Saliba V, Thomas D, Doherty L, Chalker V, von Wissmann B, Chand M, Efstratiou A, Ramsay M, Lamagni T. Increase in scarlet fever notifications in the United Kingdom, 2013/2014. ACTA ACUST UNITED AC 2014; 19:20749. [PMID: 24698137 DOI: 10.2807/1560-7917.es2014.19.12.20749] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Increases in scarlet fever above usual seasonal levels are currently being seen across the United Kingdom. Medical practitioners have been alerted to the exceptional increase in incidence. Given the potential for this to signal a population increase in invasive group A streptococcal disease, close monitoring of invasive disease is essential.
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Affiliation(s)
- R Guy
- Public Health England, London, United Kingdom
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32
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Doherty C, Wallock D, Doherty L, Clarke D, Govan J, Campopiano D. WS17.3 Allicin revisited: Antimicrobial activity against the Burkholderia cepacia complex and interaction with a peroxidase target. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60105-8] [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: 11/17/2022]
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Ali M, Schifano F, Robinson P, Phillips G, Doherty L, Melnick P, Laming L, Sinclair A, Dhillon S. Impact of community pharmacy diabetes monitoring and education programme on diabetes management: a randomized controlled study. Diabet Med 2012; 29:e326-33. [PMID: 22672148 DOI: 10.1111/j.1464-5491.2012.03725.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [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] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate the impact of a pharmacist-led patient education and diabetes monitoring programme on HbA(1c) and other cardiovascular risk factors in the community setting. METHODS Patients with Type 2 diabetes (n = 46) attending two community pharmacies in Hertfordshire, UK were randomized to one of two groups. Patients in the intervention group (n = 23) received a programme of education about diabetes, its treatment and associated cardiovascular risk factors. These patients were seen for monitoring/counselling by a community pharmacist on six occasions over a 12-month period. Measures included HbA(1c), BMI, blood pressure, blood glucose and lipid profile. Patients in the control group (n = 23) underwent these measurements at baseline and at 12 months only, without specific counselling or education over and above usual care. RESULTS HbA(1c) fell from 66 mmol/mol (8.2%) to 49 mmol/mol (6.6%) (P < 0.001) in intervention group, compared with reduction from 65 mmol/mol (8.1%) to 59 mmol/mol (7.5%) in the control group (P = 0.03). Blood pressure fell from 146/87 to 126/81 mmHg in the intervention group (P = 0.01) compared with no significant change in the control group (136/86 to 139/82 mmHg). Significant reductions in BMI (30.8 to 27 kg/m(2), P < 0.001) and blood glucose (8.8 to 6.9 mmol/l, P < 0.001) were also observed in the intervention group as compared with no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes-related quality of life (P = 0.001), diabetes knowledge (P = 0.018), belief about the need for medication (P = 0.004) and reduced concerns regarding medication (P < 0.001). CONCLUSIONS Education and counselling by community pharmacists can result in favourable improvements to the cardiovascular risk profile of patients with Type 2 diabetes.
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Affiliation(s)
- M Ali
- School of Pharmacy, University of Hertfordshire, Hatfield, UK.
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Doherty C, Doherty L, Govan J. 93 Do swarming and twitching motility in Pseudomonas aeruginosa have a role in early infection of cystic fibrosis airways and in the enhanced transmissibility of epidemic strains? J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60263-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Doherty C, Wallock D, Doherty L, Clarke D, Campopiano D, Govan J. 72 Antimicrobial activity of stable allicin against multiresistant cystic fibrosis pathogens. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hammond S, Drappatz J, Lee E, Muzikansky A, Weiss S, Kesari S, Wong E, Fadul C, Norden A, Beroukhim R, Alexander B, Ruland S, Ciampa A, Lafrankie D, Doherty L, McCluskey C, Smith K, Gerard M, Wen P. Interim Analysis of a Randomized Placebo-Controlled Pilot Trial of Armodafinil for Fatigue in Patients with Malignant Gliomas Undergoing Radiotherapy with or without Standard Chemotherapy Treatment (P07.104). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.104] [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: 11/15/2022] Open
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Durlach R, McIlvenny G, Newcombe R, Reid G, Doherty L, Freuler C, Rodríguez V, Duse A, Smyth E. Prevalence survey of healthcare-associated infections in Argentina; comparison with England, Wales, Northern Ireland and South Africa. J Hosp Infect 2012; 80:217-23. [DOI: 10.1016/j.jhin.2011.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 12/02/2011] [Indexed: 10/14/2022]
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Troughton JA, Millar G, Smyth ETM, Doherty L, McMullan R. Ciprofloxacin use and susceptibility of Gram-negative organisms to quinolone and non-quinolone antibiotics. J Antimicrob Chemother 2011; 66:2152-8. [DOI: 10.1093/jac/dkr264] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [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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Dhar R, Anwar GA, Bourke SC, Doherty L, Middleton P, Ward C, Rutherford RM. Efficacy of nebulised colomycin in patients with non-cystic fibrosis bronchiectasis colonised with Pseudomonas aeruginosa. Thorax 2010; 65:553. [PMID: 20522858 DOI: 10.1136/thx.2008.112284] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Smithson R, Irvine N, Hutton C, Doherty L, Watt A. Spotlight on measles 2010: Ongoing measles outbreak in Northern Ireland following an imported case, September-October 2010. Euro Surveill 2010; 15. [DOI: 10.2807/ese.15.43.19698-en] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report an ongoing outbreak of measles with five laboratory-confirmed and four epidemiologically linked cases in Northern Ireland as at 26 October 2010. The index case was an unvaccinated non-Northern Ireland resident with subsequent genotyping suggesting that infection originated in the usual country of residence of this case. Confirmed cases include one patient with a history of two measles-mumps-rubella vaccine doses.
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Affiliation(s)
- R Smithson
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - N Irvine
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - C Hutton
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - L Doherty
- Health Protection Service, Public Health Agency, Belfast, Northern Ireland
| | - A Watt
- Regional Virology Service, Royal Victoria Hospital, Belfast, Northern Ireland
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Clarke JL, Ennis MM, Lamborn KR, Prados MD, Puduvalli VK, Penas-Prado M, Gilbert MR, Groves MD, Hess KR, Levin VA, de Groot J, Colman H, Conrad CA, Loghin ME, Hunter K, Yung WK, Chen C, Damek D, Liu A, Gaspar LE, Waziri A, Lillehei K, Kavanagh B, Finlay JL, Haley K, Dhall G, Gardner S, Allen J, Cornelius A, Olshefski R, Garvin J, Pradhan K, Etzl M, Goldman S, Atlas M, Thompson S, Hirt A, Hukin J, Comito M, Bertolone S, Torkildson J, Joyce M, Moertel C, Letterio J, Kennedy G, Walter A, Ji L, Sposto R, Dorris K, Wagner L, Hummel T, Drissi R, Miles L, Leach J, Chow L, Turner R, Gragert MN, Pruitt D, Sutton M, Breneman J, Crone K, Fouladi M, Friday BB, Buckner J, Anderson SK, Giannini C, Kugler J, Mazurczac M, Flynn P, Gross H, Pajon E, Jaeckle K, Galanis E, Badruddoja MA, Pazzi MA, Stea B, Lefferts P, Contreras N, Bishop M, Seeger J, Carmody R, Rance N, Marsella M, Schroeder K, Sanan A, Swinnen LJ, Rankin C, Rushing EJ, Hutchins LF, Damek DM, Barger GR, Norden AD, Lesser G, Hammond SN, Drappatz J, Fadul CE, Batchelor TT, Quant EC, Beroukhim R, Ciampa A, Doherty L, LaFrankie D, Ruland S, Bochacki C, Phan P, Faroh E, McNamara B, David K, Rosenfeld MR, Wen PY, Hammond SN, Norden AD, Drappatz J, Phuphanich S, Reardon D, Wong ET, Plotkin SR, Lesser G, Mintz A, Raizer JJ, Batchelor TT, Quant EC, Beroukhim R, Kaley TJ, Ciampa A, Doherty L, LaFrankie D, Ruland S, Smith KH, Wen PY, Chamberlain MC, Graham C, Mrugala M, Johnston S, Kreisl TN, Smith P, Iwamoto F, Sul J, Butman JA, Fine HA, Westphal M, Heese O, Warmuth-Metz M, Pietsch T, Schlegel U, Tonn JC, Schramm J, Schackert G, Melms A, Mehdorn HM, Seifert V, Geletneky K, Reuter D, Bach F, Khasraw M, Abrey LE, Lassman AB, Hormigo A, Nolan C, Gavrilovic IT, Mellinghoff IK, Reiner AS, DeAngelis L, Omuro AM, Burzynski SR, Weaver RA, Janicki TJ, Burzynski GS, Szymkowski B, Acelar SS, Mechtler LL, O'Connor PC, Kroon HA, Vora T, Kurkure P, Arora B, Gupta T, Dhamankar V, Banavali S, Moiyadi A, Epari S, Merchant N, Jalali R, Moller S, Grunnet K, Hansen S, Schultz H, Holmberg M, Sorensen MM, Poulsen HS, Lassen U, Reardon DA, Vredenburgh JJ, Desjardins A, Janney DE, Peters K, Sampson J, Gururangan S, Friedman HS, Jeyapalan S, Constantinou M, Evans D, Elinzano H, O'Connor B, Puthawala MY, Goldman M, Oyelese A, Cielo D, Dipetrillo T, Safran H, Anan M, Seyed Sadr M, Alshami J, Sabau C, Seyed Sadr E, Siu V, Guiot MC, Samani A, Del Maestro R, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine VE, Parfenov VE, Poverennova IE, Hau P, Jachimczak P, Heinrichs H, Schlingensiepen KH, Shibui S, Kayama T, Wakabayashi T, Nishikawa R, de Groot M, Aronica E, Vecht CJ, Toering ST, Heimans JJ, Reijneveld JC, Batchelor T, Mulholland P, Neyns B, Nabors LB, Campone M, Wick A, Mason W, Mikkelsen T, Phuphanich S, Ashby LS, DeGroot JF, Gattamaneni HR, Cher LM, Rosenthal MA, Payer F, Xu J, Liu Q, van den Bent M, Nabors B, Fink K, Mikkelsen T, Chan M, Trusheim J, Raval S, Hicking C, Henslee-Downey J, Picard M, Reardon D, Kaley TJ, Wen PY, Schiff D, Karimi S, DeAngelis LM, Nolan CP, Omuro A, Gavrilovic I, Norden A, Drappatz J, Purow BW, Lieberman FS, Hariharan S, Abrey LE, Lassman AB, Perez-Larraya JG, Honnorat J, Chinot O, Catry-Thomas I, Taillandier L, Guillamo JS, Campello C, Monjour A, Tanguy ML, Delattre JY, Franz DN, Krueger DA, Care MM, Holland-Bouley K, Agricola K, Tudor C, Mangeshkar P, Byars AW, Sahmoud T, Alonso-Basanta M, Lustig RA, Dorsey JF, Lai RK, Recht LD, Reardon DA, Paleologos N, Groves M, Rosenfeld MR, Meech S, Davis T, Pavlov D, Marshall MA, Sampson J, Slot M, Peerdeman SM, Beauchesne PD, Faure G, Noel G, Schmitt T, Kerr C, Jadaud E, Martin L, Taillandier L, Carnin C, Desjardins A, Reardon DA, Peters KB, Herndon JE, Kirkpatrick JP, Friedman HS, Vredenburgh JJ, Nayak L, Panageas KS, Deangelis LM, Abrey LE, Lassman AB. Ongoing Clinical Trials. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s9] [Citation(s) in RCA: 2] [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: 11/14/2022] Open
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Morelli E, McIlvenny G, Reid G, Crookshanks H, Doherty L, Smyth E. P28.11 Post discharge surveillance following caesarean section: incidence of surgical site infection. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60260-5] [Citation(s) in RCA: 2] [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: 11/27/2022]
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Abstract
At last year's London Marathon, St John Ambulance (SJA) volunteers treated almost 6,200 casualties from among more than 35,000 runners. In this article, emergency nurse Hazel Mortimer, who regularly works as a volunteer emergency nurse with the SJA, describes her experiences at this year's event and her expectations of the 2012 Olympics.
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Doherty L, Crowe C, Sweeney B. National narcolepsy survey. Ir Med J 2010; 103:110-113. [PMID: 20486314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Narcolepsy is characterised by excessive daytime sleepiness and cataplexy and has a prevalence of 25 per 100,000. We suspect this is higher than presently seen in the Republic of Ireland. We aimed to calculate the Irish prevalence of Narcolepsy and to examine current management practices. We conducted an online survey of respiratory physicians, neurologists, paediatric neurologists, and psychiatrists with an interest in sleep disorders (73% response rate). Of this group, a total of 16 physicians managed 180 patients prior to January 2009. A clinical diagnosis alone was reached in 67 (41%) patients, the remainder by polysomnography or multiple sleep latency testing. No patients were diagnosed by cerebro-spinal fluid analysis of hypocretin levels. While 70 (42%) patients received modafanil, only 7 (4%) were treated with sodium oxybate. Even allowing for missing data it is apparent that Narcolepsy is hugely under-diagnosed in Ireland, however, current practises adhere with new international guidelines.
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Affiliation(s)
- L Doherty
- Bon Secours Hospital, College Road, Cork.
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Doherty L. Nurses' network shines light on the health issues of Traveller and Gypsy children. Paediatr Nurs 2010; 22:6-7. [PMID: 20426352 DOI: 10.7748/paed.22.3.6.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Doherty L. Looking again at role revision. Nurs Manag (Harrow) 2010; 16:6-7. [PMID: 27753372 DOI: 10.7748/nm.16.10.6.s9] [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: 06/06/2023]
Abstract
NURSES IN advanced roles can provide care and produce clinical outcomes of the same standards as doctors, according to a recently published report.
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Doherty L. Looking again at role revision. Nurs Manag (Harrow) 2010; 16:6-7. [PMID: 20373645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Doherty L, Berry L. Poor record on end of life care of older patients found in acute hospitals. Nurs Older People 2009; 21:7. [PMID: 27736502 DOI: 10.7748/nop.21.10.7.s5] [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: 11/09/2022]
Abstract
ONE THIRD of patients expected to die after admission to an acute hospital did not receive end of life care, according to a report. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report is based on a review of 3,000 patients who died within four days of admission to acute hospitals. Many of the patients were aged over 66. patients were aged over 66.
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