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Spanakis P, Wadman R, Walker L, Heron P, Mathers A, Baker J, Johnston G, Gilbody S, Peckham E. Measuring the digital divide among people with severe mental ill health using the essential digital skills framework. Perspect Public Health 2024; 144:21-30. [PMID: 35929589 PMCID: PMC10757390 DOI: 10.1177/17579139221106399] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 11/15/2022]
Abstract
AIMS Amid the vast digitalisation of health and other services during the pandemic, people with no digital skills are at risk of digital exclusion. This risk might not abate by the end of the pandemic. This article seeks to understand whether people with severe mental ill health (SMI) have the necessary digital skills to adapt to these changes and avoid digital exclusion. METHODS Two hundred and forty-nine adults with SMI across England completed a survey online or offline. They provided information on their digital skills based on the Essential Digital Skills (EDS) framework, sociodemographic information, and digital access. This is the first time that the EDS is benchmarked in people with SMI. RESULTS 42.2% had no Foundation Skills, and 46.2% lacked skills for daily life (lacking Foundation or Life Skills). 23.0% of those working lacked skills for professional life (lacking Foundation or Work Skills). The most commonly missing skills were handling passwords and using the device settings (Foundation Skills) and online problem solving (Skills for Life). People were interested in learning more about approximately half of the skills they did not have. People were more likely to lack Foundation Skills if they were older, not in employment, had a psychosis-spectrum disorder, or had no Internet access at home. CONCLUSION A significant portion of people with SMI lacked Foundation Skills in this objective and benchmarked survey. This points to a high risk for digital exclusion and the need for focused policy and tailored health sector support to ensure people retain access to key services and develop digital skills and confidence. To our knowledge, this is the first time this has been described using the EDS framework. Services, including the National Health Service (NHS), need to be aware of and mitigate the risks.
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Affiliation(s)
- P Spanakis
- Department of Health Sciences, University of York, ARRC Building, Heslington, York YO10 5DD, UK Department of Psychology, University of Crete, Rethymnon, Greece
- School of Psychology, Mediterranean College, Athens, Greece
| | - R Wadman
- Department of Health Sciences, University of York, York, UK
| | - L Walker
- Department of Health Sciences, University of York, York, UK
| | - P Heron
- Department of Health Sciences, University of York, York, UK
| | - A Mathers
- The Good Things Foundation, Sheffield, UK; Royal Society of Arts, London, UK
| | - J Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - G Johnston
- Independent Peer Researcher, Clackmannan, UK
| | - S Gilbody
- Department of Health Sciences, University of York, York, UK
| | - E Peckham
- Department of Health Sciences, University of York, York, UK
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Spanakis P, Lorimer B, Newbronner E, Wadman R, Crosland S, Gilbody S, Johnston G, Walker L, Peckham E. Digital health literacy and digital engagement for people with severe mental ill health across the course of the COVID-19 pandemic in England. BMC Med Inform Decis Mak 2023; 23:193. [PMID: 37752460 PMCID: PMC10523616 DOI: 10.1186/s12911-023-02299-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/16/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND An unprecedented acceleration in digital mental health services happened during the COVID-19 pandemic. However, people with severe mental ill health (SMI) might be at risk of digital exclusion, partly because of a lack of digital skills, such as digital health literacy. The study seeks to examine how the use of the Internet has changed during the pandemic for people with SMI, and explore digital exclusion, symptomatic/health related barriers to internet engagement, and digital health literacy. METHODS Over the period from July 2020 to February 2022, n = 177 people with an SMI diagnosis (psychosis-spectrum disorder or bipolar affective disorder) in England completed three surveys providing sociodemographic information and answering questions regarding their health, use of the Internet, and digital health literacy. RESULTS 42.5% of participants reported experiences of digital exclusion. Cochrane-Q analysis showed that there was significantly more use of the Internet at the last two assessments (80.8%, and 82.2%) compared to that at the beginning of the pandemic (65.8%; ps < 0.001). Although 34.2% of participants reported that their digital skills had improved during the pandemic, 54.4% still rated their Internet knowledge as being fair or worse than fair. Concentration difficulties (62.6%) and depression (56.1%) were among the most frequently reported symptomatic barriers to use the Internet. The sample was found to have generally moderate levels of digital health literacy (M = 26.0, SD = 9.6). Multiple regression analysis showed that higher literacy was associated with having outstanding/good self-reported knowledge of the Internet (ES = 6.00; 95% CI: 3.18-8.82; p < .001), a diagnosis of bipolar disorder (compared to psychosis spectrum disorder - ES = 5.14; 95% CI: 2.47-7.81; p < .001), and being female (ES = 3.18; 95% CI: 0.59-5.76; p = .016). CONCLUSIONS These findings underline the need for training and support among people with SMI to increase digital skills, facilitate digital engagement, and reduce digital engagement, as well as offering non-digital engagement options to service users with SMI.
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Affiliation(s)
- P Spanakis
- Department of Health Sciences, University of York, York, UK.
- Department of Psychology, University of Crete, Rethymnon, Greece.
| | - B Lorimer
- Department of Health Sciences, University of York, York, UK
| | - E Newbronner
- Department of Health Sciences, University of York, York, UK
| | - R Wadman
- Department of Health Sciences, University of York, York, UK
| | - S Crosland
- Department of Health Sciences, University of York, York, UK
| | - S Gilbody
- Department of Health Sciences, University of York, York, UK
| | - G Johnston
- Independent Peer Researcher, Clackmannan, UK
| | - L Walker
- School of Health and Psychological Sciences, City, University of London, London, UK
| | - E Peckham
- School of Medical and Health Sciences, Bangor University, Bangor, UK
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Aldalati A, Garcia S, Jonsson B, Canterbury E, Clements C, Walker L. 295 Updating Patient Care: Where Do We Begin. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Loveday C, Garrett A, Law P, Hanks S, Poyastro-Pearson E, Adlard JW, Barwell J, Berg J, Brady AF, Brewer C, Chapman C, Cook J, Davidson R, Donaldson A, Douglas F, Greenhalgh L, Henderson A, Izatt L, Kumar A, Lalloo F, Miedzybrodzka Z, Morrison PJ, Paterson J, Porteous M, Rogers MT, Walker L, Eccles D, Evans DG, Snape K, Hanson H, Houlston RS, Turnbull C. Analysis of rare disruptive germline mutations in 2,135 enriched BRCA-negative breast cancers excludes additional high-impact susceptibility genes. Ann Oncol 2022; 33:1318-1327. [PMID: 36122798 DOI: 10.1016/j.annonc.2022.09.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/15/2022] [Accepted: 09/01/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Breast cancer has a significant heritable basis, of which approximately 60% remains unexplained. Testing for BRCA1/BRCA2 offers useful discrimination of breast cancer risk within families, and identification of additional breast cancer susceptibility genes could offer clinical utility. PATIENTS AND METHODS We included 2,135 invasive breast cancer cases recruited via the BOCS study, a retrospective UK study of familial breast cancer. ELIGIBILITY CRITERIA female, BRCA-negative, white European ethnicity, and one of: i) breast cancer family history, ii) bilateral disease, iii) young age of onset (<30 years), iv) concomitant ovarian cancer. We undertook exome sequencing of cases and performed gene-level burden testing of rare damaging variants against those from 51,377 ethnicity-matched population controls from gnomAD. RESULTS 159/2135 (7.4%) cases had a qualifying variant in an established breast cancer susceptibility gene, with minimal evidence of signal in other cancer susceptibility genes. Known breast cancer susceptibility genes PALB2, CHEK2 and ATM were the only genes to retain statistical significance after correcting for multiple testing. Due to the enrichment of hereditary cases in the series, we had good power (>80%) to detect a gene of BRCA1-like risk (odds ratio = 10.6) down to a population minor allele frequency of 4.6 x 10-5 (1 in 10,799, less than one tenth that of BRCA1)and of PALB2-like risk (odds ratio = 5.0) down to a population minor allele frequency of 2.8 x 10-4 (1 in 1,779, less than half that of PALB2). Power was lower for identification of novel moderate penetrance genes (odds ratio = 2-3) like CHEK2 and ATM. CONCLUSIONS This is the largest case-control whole-exome analysis of enriched breast cancer published to date. Whilst additional breast cancer susceptibility genes likely exist, those of high penetrance are likely to be of very low mutational frequency. Contention exists regarding the clinical utility of such genes.
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Affiliation(s)
- C Loveday
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - A Garrett
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - P Law
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - S Hanks
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - E Poyastro-Pearson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - J W Adlard
- Yorkshire Regional Genetics Service, St James's University Hospital, Leeds, UK
| | - J Barwell
- Leicestershire Genetics Centre, University Hospitals of Leicester National Health Service (NHS) Trust, Leicester, UK
| | - J Berg
- Division of Medical Sciences, Human Genetics, University of Dundee, Dundee, UK
| | - A F Brady
- North West Thames Regional Genetics Service, Kennedy Galton Centre, London, UK
| | - C Brewer
- Peninsula Regional Genetics Service, Royal Devon & Exeter Hospital, Exeter, UK
| | - C Chapman
- West Midlands Regional Genetics Service, Birmingham Women's Hospital, Birmingham, UK
| | - J Cook
- Sheffield Regional Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - R Davidson
- West of Scotland Regional Genetics Service, Ferguson Smith Centre for Clinical Genetics, Glasgow, UK
| | - A Donaldson
- South Western Regional Genetics Service, University Hospitals of Bristol NHS Foundation Trust, Bristol, UK
| | - F Douglas
- Northern Genetics Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - L Greenhalgh
- Cheshire and Merseyside Clinical Genetics Service, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - A Henderson
- Northern Genetics Service (Cumbria), Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - L Izatt
- South East Thames Regional Genetics Service, Guy's and St. Thomas NHS Foundation Trust, London, UK
| | - A Kumar
- North East Thames Regional Genetics Service, Great Ormond St. Hospital, London, UK
| | - F Lalloo
- University Department of Medical Genetics & Regional Genetics Service, St. Mary's Hospital, Manchester, UK
| | - Z Miedzybrodzka
- University of Aberdeen and North of Scotland Clinical Genetics Service, Aberdeen Royal Infirmary, Aberdeen, UK
| | - P J Morrison
- Belfast Health and Social Care (HSC) Trust & Department of Medical Genetics, Northern Ireland Regional Genetics Service, Queen's University Belfast, Belfast, UK
| | - J Paterson
- East Anglian Regional Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M Porteous
- South East of Scotland Clinical Genetics Service, Western General Hospital, Edinburgh, UK
| | - M T Rogers
- All Wales Medical Genetics Service, University Hospital of Wales, Cardiff, UK
| | - L Walker
- Oxford Regional Genetics Service, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
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- Individual collaborators and their affiliations are listed in the Appendix
| | - D Eccles
- Faculty of Medicine, University of Southampton, Southampton University Hospitals NHS Trust, Southampton, UK
| | - D G Evans
- University Department of Medical Genetics & Regional Genetics Service, St. Mary's Hospital, Manchester, UK
| | - K Snape
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.; South West Thames Regional Genetics Service, St. George's Hospital, London, UK
| | - H Hanson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.; South West Thames Regional Genetics Service, St. George's Hospital, London, UK
| | - R S Houlston
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - C Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.; Royal Marsden NHS Foundation Hospital, London, UK.
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Walker L, Gardner C, Bodenlos K, Sachdev D, Wang S, Laskin D, Aleksunes L. SOC-II-10 Human placental macrophages as targets of cadmium toxicity. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Best K, Alderson S, Alldred D, Bonnet L, Buchan I, Butters O, Farrin A, Foy R, Johnson O, McInerney C, Mehdizadeh D, Lawton T, Lawton R, Rodgers S, Teale E, Walker L, West R, Young B, Pirmohamed M, Clegg A. 825 DEVELOPMENT OF THE ANTICHOLINERGIC MEDICATION INDEX (ACMI). Age Ageing 2022. [DOI: 10.1093/ageing/afac035.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Medications with Anticholinergic (AC) properties, are prescribed to treat a range of conditions. Older people are increasingly likely to be prescribed multiple AC medications, but are also more likely to experience unwanted adverse effects, such as falls and delirium. The risks of adverse outcomes increase with the number and potency of AC medications prescribed. The aim of this study was to use a prognostic modelling approach to develop an AC Medication Index (ACMI) that identifies patients at high risk of AC medication side effects.
Methods
The prognostic model was developed using data on patients aged 65–95 years, registered with a general practice contributing data to ‘Connected Bradford’ in 2019. A Time-dependent Cox model was fitted, with hospital admission for delirium or falls as the composite outcome and AC medications, age, sex and important clinical factors (e.g. dementia, arthritis, urinary incontinence) as predictors. Concordance and Negalkerke’s R2 derived from five-fold cross-validation were used to assess model performance.
Results
There were 151,604 patients included in the study, of whom 47,035 (31.0%) were prescribed ≥1 AC medication during 2019. Codeine, Prednisolone, Furosemide and Amitriptyline were most commonly prescribed with 7.4%, 4.0%, 3.8% and 3.1% of patients prescribed these medications at least once in 2019, respectively. During 2019, 6,078 (4.0%) patients experienced a hospital admission with delirium or a fall, with the rate being increased in those prescribed ≥1 AC medication during 2019 (4.8% vs 3.7%; p < 0.001). The prognostic model yielded a discrimination statistic of 0.86 with an R2 of 0.1.
Conclusion
The model used to develop the ACMI shows good discrimination. External validation will soon be performed using data from the SAIL databank and the ACMI will be further developed as a tool for use in primary care.
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Affiliation(s)
| | - S Alderson
- University of Leeds
- NHS Greater Huddersfield CCG
| | | | | | | | | | | | | | | | | | | | - T Lawton
- Bradford Teaching Hospitals NHS Foundation Trust
| | | | | | - E Teale
- University of Leeds
- Bradford Teaching Hospitals NHS Foundation Trust
| | | | | | | | | | - A Clegg
- University of Leeds
- Bradford Teaching Hospitals NHS Foundation Trust
- NHS Leeds CCG
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Borrelli S, Walker L, Coolin K, Fumagalli S, Karema A, Konstantinidis S, Mets-Oja S, Nespoli A, Smit AM, Van Oost M, Spiby H. Midwifery students' perspectives of physical and virtual mobility activities including preferences for e-learning: A cross-sectional survey. Nurse Educ Today 2022; 109:105214. [PMID: 34799193 DOI: 10.1016/j.nedt.2021.105214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Contemporary higher education requires that all midwifery students have insight and understanding of global health practice and demonstrate intercultural sensitivity. However, the mobility models currently offered do not often fit the lives of large numbers of midwifery students. OBJECTIVES To investigate midwifery students' international physical mobility activities and factors that affect mobility; to determine midwifery students' learning needs and preferences for related e-learning packages. DESIGN Multi-centre, descriptive quantitative survey. SETTINGS Four European Higher Education Institutions based in the United Kingdom, Estonia, Italy and the Netherlands offering an undergraduate midwifery programme. PARTICIPANTS The sample included 205 midwifery students from Italy (n = 93), the Netherlands (n = 51); United Kingdom (n = 35) and Estonia (n = 26). METHODS Data were collected in June-July 2020 through an online cross-sectional, bespoke questionnaire and analysed using summary statistical analysis. RESULTS There is a high level of interest across a range of mobility opportunities, especially those of shorter duration. Barriers to mobility comprised finance, caring responsibilities, concerns about fitting mobility activities into the midwifery programme, negative impact on studies and language barriers. The most frequently identified facilitators of mobility included professional perspectives such as interest in other cultures and midwifery in other settings and an endorsement that mobility would add value to their development as a midwife. When engaging in virtual learning, the most preferred resources mentioned by the students were videos, video calls with peers, choice quiz and discussion forum. CONCLUSIONS The barriers identified require new approaches to enable all midwifery students to benefit from transnational learning. The survey findings provide insights into midwifery students' perspectives from which a new mobility model can be developed.
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Affiliation(s)
- S Borrelli
- University of Nottingham, School of Health Sciences, Medical School, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom of Great Britain and Northern Ireland.
| | - L Walker
- University of Nottingham, School of Health Sciences, Medical School, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom of Great Britain and Northern Ireland.
| | - K Coolin
- University of Nottingham, School of Health Sciences, Medical School, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom of Great Britain and Northern Ireland.
| | - S Fumagalli
- University of Milano Bicocca, Dipartimento di Medicina e Chirurgia (School of Medicine and Surgery), U38, Piano V, Stanza 5.36 Via Cadore 48, 20900 Monza, MB, Italy.
| | - A Karema
- Tallinn Health Care College, Kännu 67, Tallinn, Estonia.
| | - S Konstantinidis
- University of Nottingham, School of Health Sciences, Medical School, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom of Great Britain and Northern Ireland.
| | - S Mets-Oja
- Tallinn Health Care College, Kännu 67, Tallinn, Estonia.
| | - A Nespoli
- University of Milano Bicocca, Dipartimento di Medicina e Chirurgia (School of Medicine and Surgery), U38, Piano V, Stanza 5.36 Via Cadore 48, 20900 Monza, MB, Italy.
| | - A-M Smit
- Amsterdam Universitair Medische Centra, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Vlaardingenlaan 1, 1059, GL, Amsterdam, the Netherlands.
| | - M Van Oost
- Amsterdam Universitair Medische Centra, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Vlaardingenlaan 1, 1059, GL, Amsterdam, the Netherlands.
| | - H Spiby
- University of Nottingham, School of Health Sciences, Medical School, Queen's Medical Centre, Nottingham NG7 2HA, United Kingdom of Great Britain and Northern Ireland.
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Walker L, Constant J, Pollock C, Evans D, Jones A. An evaluation of a neuro out-patient physiotherapy service: Are we helping our patients to self-manage? Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ghafouri K, Paton J, Coley K, White M, Day V, Wilson A, Hussein A, Wilson A, Walker L, Simms L, Mackin G, Timmins K, Stiles M. The Use of Pacemaker Impedance Data for Breath-by-Breath Respiration Sensing. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gerritsen SE, van Bodegom LS, Dieleman GC, Overbeek MM, Verhulst FC, Wolke D, Rizopoulos D, Appleton R, van Amelsvoort TAMJ, Bodier Rethore C, Bonnet-Brilhault F, Charvin I, Da Fonseca D, Davidović N, Dodig-Ćurković K, Ferrari A, Fiori F, Franić T, Gatherer C, de Girolamo G, Heaney N, Hendrickx G, Jardri R, Kolozsvari A, Lida-Pulik H, Lievesley K, Madan J, Mastroianni M, Maurice V, McNicholas F, Nacinovich R, Parenti A, Paul M, Purper-Ouakil D, Rivolta L, de Roeck V, Russet F, Saam MC, Sagar-Ouriaghli I, Santosh PJ, Sartor A, Schulze UME, Scocco P, Signorini G, Singh SP, Singh J, Speranza M, Stagi P, Stagni P, Street C, Tah P, Tanase E, Tremmery S, Tuffrey A, Tuomainen H, Walker L, Wilson A, Maras A. Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services. Soc Psychiatry Psychiatr Epidemiol 2022; 57:973-991. [PMID: 35146551 PMCID: PMC9042957 DOI: 10.1007/s00127-022-02238-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians' advice to continue treatment at AMHS. METHODS Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians' transition recommendations. RESULTS Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. CONCLUSION Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.
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Affiliation(s)
- S E Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - L S van Bodegom
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
| | - G C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
| | - M M Overbeek
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - D Rizopoulos
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - T A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands
- Mondriaan Mental Health Care, Heerlen, The Netherlands
| | | | | | - I Charvin
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - D Da Fonseca
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - N Davidović
- University Hospital Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - K Dodig-Ćurković
- Faculty for Dental Care and Health, Osijek, Croatia
- University Health Center Osijek, Osijek, Croatia
- Unit for Child and Adolescent Psychiatry, Osijek, Croatia
| | - A Ferrari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- DISM, ULSS 16, SOPROXI Onlus, Padua, Italy
| | - F Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - T Franić
- University Hospital Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - C Gatherer
- Warwick Medical School, University of Warwick, Coventry, UK
| | - G de Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - N Heaney
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - G Hendrickx
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - R Jardri
- Lille Neurosciences and Cognitions, Plasticity and Subjectivity Team, CURE Platform, Université de Lille, INSERM (U-1172), Fontan Hospital, CHU Lille, Lille, France
| | | | | | - K Lievesley
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - J Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - M Mastroianni
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - V Maurice
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - F McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland
- Lucena CAMHS, SJOG, Dublin, Republic of Ireland
| | - R Nacinovich
- Child and Adolescent Neuropsychiatry Unit, ASST Monza, Monza, Italy
- Università Degli Studi Milano Bicocca, Milan, Italy
| | - A Parenti
- Centre Hospitalier Universitaire de Lille, Lille, France
| | - M Paul
- Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - D Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
- INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
| | - L Rivolta
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
- Department of Mental Health, Psychiatry Unit, San Gerardo Hospital, Monza, Monza Brianza, Italy
| | - V de Roeck
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Child and Youth Studies, Campus Social School, University Colleges Leuven Limburg, Heverlee, Belgium
| | - F Russet
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - M C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - I Sagar-Ouriaghli
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - P J Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - A Sartor
- Josefinum Augsburg, Klinik für Kinder- und Jugenspsychiatrie und Psychotherapie, Augsburg, Germany
| | - U M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - P Scocco
- Department of Mental Health, ULSS 6 Euganea, Padua, Italy
- SOPROXI Onlus, Padua, Italy
| | - G Signorini
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - S P Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - M Speranza
- INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France
| | - P Stagi
- Child and Adolescent Neuropsychiatry Unit, AUSL Modena, Modena, Italy
| | - P Stagni
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Child and Adolescent Neuropsychiatry, Department of Mental Health, Modena, Italy
| | - C Street
- Warwick Medical School, University of Warwick, Coventry, UK
| | - P Tah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - E Tanase
- Abteilung für Psychiatrie und Psychotherapie des Kindes-und Jugendalters Weissenau, ZfP Südwürttemberg, Ravensburg, Germany
| | - S Tremmery
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - A Tuffrey
- Warwick Medical School, University of Warwick, Coventry, UK
| | - H Tuomainen
- Warwick Medical School, University of Warwick, Coventry, UK
| | - L Walker
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Wilson
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Maras
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
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Gerritsen SE, Maras A, van Bodegom LS, Overbeek MM, Verhulst FC, Wolke D, Appleton R, Bertani A, Cataldo MG, Conti P, Da Fonseca D, Davidović N, Dodig-Ćurković K, Ferrari C, Fiori F, Franić T, Gatherer C, De Girolamo G, Heaney N, Hendrickx G, Kolozsvari A, Levi FM, Lievesley K, Madan J, Martinelli O, Mastroianni M, Maurice V, McNicholas F, O'Hara L, Paul M, Purper-Ouakil D, de Roeck V, Russet F, Saam MC, Sagar-Ouriaghli I, Santosh PJ, Sartor A, Schandrin A, Schulze UME, Signorini G, Singh SP, Singh J, Street C, Tah P, Tanase E, Tremmery S, Tuffrey A, Tuomainen H, van Amelsvoort TAMJ, Wilson A, Walker L, Dieleman GC. Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe. BMJ Open 2021; 11:e053373. [PMID: 34916319 PMCID: PMC8679118 DOI: 10.1136/bmjopen-2021-053373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. PARTICIPANTS Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. FINDINGS TO DATE This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be 'markedly ill', 'severely ill' or 'among the most extremely ill' by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. FUTURE PLANS Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. TRIAL REGISTRATION NUMBER NCT03013595.
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Affiliation(s)
- Suzanne E Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Athanasios Maras
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
| | - Larissa S van Bodegom
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
| | - Mathilde M Overbeek
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Warwick, UK
| | - Rebecca Appleton
- Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Maria G Cataldo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Child and Adolescent Neuropsychiatry Unit, ASST di Lecco, Lecco, Italy
| | | | - David Da Fonseca
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - Nikolina Davidović
- University Hospital Center Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - Katarina Dodig-Ćurković
- Faculty for Dental Care and Health, Osijek, Croatia
- University Health Center Osijek, Osijek, Croatia
- Unit for Child and Adolescent Psychiatry, Osijek, Croatia
| | - Cecilia Ferrari
- Teenagers' Outpatient Unit, Child and Adolescent Mental Health Services, Niguarda Metropolitan Great Hospital, Milan, Italy
| | - Federico Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - Tomislav Franić
- University Hospital Center Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | | | | | - Natalie Heaney
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gaëlle Hendrickx
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | | | - Flavia Micol Levi
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Psychiatric Unit, ASST Santi Paolo e Carlo, Milano, Italy
| | - Kate Lievesley
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jason Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Mathilde Mastroianni
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Virginie Maurice
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Fiona McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Lucena CAMHS, SJOG, Dublin, Ireland
| | - Lesley O'Hara
- Saint John of God Research Foundation, Dublin, Ireland
| | - Moli Paul
- Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Diane Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Veronique de Roeck
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium
- Child and Youth Studies, Campus Social School, University College Leuven-Limburg, Heverlee, Belgium
| | - Frédérick Russet
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Ilyas Sagar-Ouriaghli
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paramala J Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Anne Sartor
- Josefinum Augsburg, Klinik für Kinder- und Jugenspsychiatrie und Psychotherapie, Augsburg, Germany
| | - Aurélie Schandrin
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
- Department of Adult Psychiatry, Nimes University Hospital, University of Montpellier, Nimes, France
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Giulia Signorini
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Swaran P Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jatinder Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Cathy Street
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Priya Tah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Elena Tanase
- Abteilung für Psychiatrie und Psychotherapie des Kindes-und Jugendalters Weissenau, ZfP Südwürttemberg, Ravensburg, Germany
| | - Sabine Tremmery
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Amanda Tuffrey
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Therese A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
- Mondriaan Mental Healthcare Group, Heerlen, The Netherlands
| | - Anna Wilson
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Leanne Walker
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Gwen C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
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Essa H, Oguguo E, Douglas H, Foster A, Walker L, Hadcroft J, Bellieu J, Kahn M, Rao A, Cuthbertson D, Akpan A, Wong C, Sankaranarayanan R. One year outcomes of heart failure multispecialty multidisciplinary team virtual meetings. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Heart Failure is frequently associated with several comorbidities such as ischaemic heard disease, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease and frailty. This level of complexity is best dealt with by a multispecialty multidisciplinary team (MDT) model.
This was a single centre observational study (January 2020-December 2020) that was undertaken in a British university hospital looking at effect of HF multispecialty virtual MDT meetings on HF outcomes. Patients acted as their own controls outcomes compared for equal period pre versus post MDT meeting. The multi-specialty meeting was conducted once monthly via video-conferencing. It consisted of heart failure cardiologists (from primary secondary and tertiary care), heart failure specialist nurses (hospital and community), nephrologist, endocrinologist, palliative care specialists, chest physician, pharmacist, pharmacologist and geriatrician. Recommendations were made as consensus from the multispecialty meeting. The main outcome measures were 1) number of hospitalisations and 2) outpatient clinic attendances 3) cost savings.
A total of 189 patients were discussed from January-December 2020. This was uninterrupted during the COVID-19 pandemic. The mean age was 70.3±18.1 years and median follow-up 6 months (range 1–13 months). The mean Charlson Co-morbidity score was 5.3±1.2 and Rockwood Frailty Score was 4.9±1. The mean number of outpatient clinic attendances avoided was 1.7±0.4. This reduced inconvenience to patients, saved patients money (transport and parking costs) and led to carbon footprint reduction. The MDT meeting total costs were £15,400 and the 31 clinic appointments they generated cost an estimated £3720. However, the MDT meetings prevented 277 clinic appointments (cost saving £33,352). Finally, the mean number of hospitalisations pre-MDT was 0.7 Vs 0.2 post MDT (p<0.01) with a saving of around 730 bed days (estimated cost-saving £260,000).
The HF multispecialty virtual MDT approach provides seamless integration of primary care community services with secondary and tertiary care. Consensus decision from MDT meetings provides holistic approach for HF patients with comorbidities and frailty, and reduces inconvenience to patients by preventing the need to attend multiple specialty clinics. This approach can also lead to significant cost-savings to the healthcare system.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Essa
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - E Oguguo
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - H Douglas
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Foster
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - L Walker
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - J Hadcroft
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - J Bellieu
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - M Kahn
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - A Rao
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | - D Cuthbertson
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Akpan
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - C Wong
- Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
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Onal E, Knier K, Campbell R, Walker L, Sadosty A, Mullan A, Jeffery M, Bellamkonda V. 338 Comparison of Emergency Department Utilization and Throughput Between Male and Female Patients: A Retrospective Cohort Investigation. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Matthew AG, Trachtenberg LJ, Yang ZG, Robinson J, Petrella A, McLeod D, Walker L, Wassersug R, Elliott S, Ellis J, Jamnicky L, Fleshner N, Finelli A, Singal R, Brock G, Jarvi K, Bender J, Elterman D. An online Sexual Health and Rehabilitation eClinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study. Support Care Cancer 2021; 30:1253-1260. [PMID: 34463836 PMCID: PMC8407130 DOI: 10.1007/s00520-021-06510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/15/2021] [Indexed: 11/29/2022]
Abstract
Purpose The primary objective was to determine the feasibility of implementing the TrueNTH SHAReClinic as a pan-Canadian sexual health and rehabilitation intervention for patients treated for localized prostate cancer. Methods The feasibility study was designed to evaluate the accessibility and acceptability of the intervention. Participants from five institutions across Canada were enrolled to attend one pre-treatment and five follow-up online clinic visits over 1 year following their prostate cancer (PC) treatment. Results Sixty-five patients were enrolled in the intervention. Website analytics revealed that 71% completed the intervention in its entirety, including the educational modules, with an additional 10% completing more than half of the intervention. Five thousand eighty-three views of the educational modules were made along with 654 views of the health library items. Over 1500 messages were exchanged between participants and their sexual health coaches. At 12 months, the intervention received an overall average participant rating of 4.1 out of 5 on a single item satisfaction measure. Conclusion Results support the TrueNTH SHAReClinic as highly acceptable to participants as defined by intervention adherence and engagement. The TrueNTH SHAReClinic demonstrated promise for being a feasible and potentially resource-efficient approach to effectively improving the sexual well-being of patients after PC treatment.
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Affiliation(s)
- A G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada.
| | - L J Trachtenberg
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - Z G Yang
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - J Robinson
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - A Petrella
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - D McLeod
- Dalhousie University, Halifax, NS, Canada
| | - L Walker
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - R Wassersug
- Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - S Elliott
- Departments of Urologic Sciences, Vancouver Prostate Centre, Vancouver, BC, Canada
| | - J Ellis
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Jamnicky
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - N Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - A Finelli
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - R Singal
- Toronto East Health Network Michael Garron Hospital, Toronto, ON, Canada
| | - G Brock
- Department of Surgery, Western University, London, ON, Canada
| | - K Jarvi
- Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada
| | - J Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - D Elterman
- Division of Urology, University of Toronto, Toronto, ON, Canada
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15
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Bekaii-Saab T, Kang V, Walker L, Nakamura Y. P-37 SGNTUC-019: Phase 2 basket study of tucatinib and trastuzumab in previously treated solid tumors with HER2 alterations: Biliary tract cancer cohort (trial in progress). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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16
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Veit JGS, Poumay Y, Mendes D, Kreitinger J, Walker L, Paquet A, Menigot C, Zolezzi F, Paller AS, Diaz P. Preclinical assessment of dual CYP26[A1/B1] inhibitor, DX308, as an improved treatment for keratinization disorders. Skin Health Dis 2021; 1:e22. [PMID: 35664983 PMCID: PMC9060145 DOI: 10.1002/ski2.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
Background Retinoid‐based therapies are commonly used in the treatment of disorders of keratinization and other skin disorders but can result in non‐specific effects and adverse reactions. Use of retinoic acid metabolism blocking agents (RAMBAs) such as DX308 may address these shortcomings. Objectives Characterize the therapeutic potential of recently discovered, CYP26‐selective RAMBA, DX308. Materials and Methods Preliminary in vitro assessment of potential off‐target activity, metabolic and toxicologic profiling. Studies to assess safety and efficacy of topical treatment in correcting abnormal skin morphology in rhino mice. Extensive gene expression profiling by RNA sequencing and qPCR in 3D epidermis grown with keratinocytes (KCs) from keratinization disorders and healthy controls, to investigate modulation of retinoid biopathways. Results In vitro, DX308 does not interact with off‐target nuclear receptors or CYP450s, is not genotoxic, and is stable in skin, despite vigorous hepatic metabolism. In vivo, topical DX308 induces comedolysis and epidermal thickening without apparent adverse effects. Gene expression profiling shows potent modulation of retinoid‐responsive genes by DX308 in both healthy and keratinization disorder KCs. Pathway analysis suggests DX308 may inhibit inflammatory and immune responses in KCs. Conclusions These preliminary studies suggest that DX308 is an efficacious topical therapeutic with a favourable metabolic and safety profiles. DX308 may present an improved therapeutic alternative for the treatment of keratinization disorders and other retinoid‐responsive skin ailments.
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Affiliation(s)
- J G S Veit
- Department of Biomedical and Pharmaceutical Sciences University of Montana Missoula Montana USA.,URPHYM-NARILIS University of Namur Namur Belgium.,R&D DermaXon LLC Missoula Montana USA
| | - Y Poumay
- URPHYM-NARILIS University of Namur Namur Belgium
| | - D Mendes
- R&D DermaXon LLC Missoula Montana USA
| | | | - L Walker
- R&D DermaXon LLC Missoula Montana USA
| | | | | | | | - A S Paller
- Department of Dermatology Northwestern University Feinberg School of Medicine Chicago Illinois USA
| | - P Diaz
- Department of Biomedical and Pharmaceutical Sciences University of Montana Missoula Montana USA.,R&D DermaXon LLC Missoula Montana USA
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Rahnemai-Azar A, Rajeswaran H, Hashmi A, Kondray V, Walker L, Al-Natour M, Davidson J. Abstract No. 542 Factors associated with increased fluoroscopy time during inferior vena cava retrieval procedure. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Eaton C, Tarver J, Shirazi A, Pearson E, Walker L, Bird M, Oliver C, Waite J. A systematic review of the behaviours associated with depression in people with severe-profound intellectual disability. J Intellect Disabil Res 2021; 65:211-229. [PMID: 33426741 DOI: 10.1111/jir.12807] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/09/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
The assessment of depression in people with severe to profound intellectual disability (severe-profound ID) is challenging, primarily due to inability to report internal states such as mood, feelings of worthlessness and suicidal ideation. This group also commonly presents with challenging behaviours (e.g. aggression and self-injury) with debate about whether these behaviours should be considered 'depressive equivalents' or are sensitive for, but not specific to, depression in severe-profound ID. We conducted a systematic review exploring behaviours associated with depression and low mood in individuals with severe-profound ID. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2009) guidelines. Three electronic databases were searched (Embase, PsycINFO and Ovid MEDLINE), and 13 studies were included and rated for quality. Few studies were rated as having high methodological quality. Behaviours captured by standard diagnostic schemes for depression (e.g. Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases) showed a relationship with depression in severe-profound ID, including the two core symptoms (depressed affect and anhedonia), as well as irritability, sleep disturbance, psychomotor agitation, reduced appetite and fatigue. Challenging behaviours such as aggression, self-injury, temper tantrums, screaming and disruptive behaviour were associated with depression. Challenging behaviours show a robust relationship with depression. Whilst these behaviours may suggest an underlying depression, study limitations warrant caution in labelling them as 'depressive equivalents'. These limitations include not controlling for potential confounds (autism, other affective disorders and pain) and bias associated with comparing depressed/non-depressed groups on the same behavioural criteria used to initially diagnose and separate these groups. Future studies that use depressive measures designed for ID populations, which control for confounds and which explore low mood irrespective of psychiatric diagnosis, are warranted to better delineate the behaviours associated with depression in this population (PROSPERO 2018: CRD42018103244).
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Affiliation(s)
- C Eaton
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
- Department of Child Life and Health, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Tarver
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - A Shirazi
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - E Pearson
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - L Walker
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - M Bird
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - J Waite
- School of Life and Health Sciences, Aston University, Birmingham, UK
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Dutta A, Smith B, Goldman T, Walker L, Streets M, Eden B, Dirmeier R, Bowman JS. Understanding Microbial Community Dynamics in Up-Flow Bioreactors to Improve Mitigation Strategies for Oil Souring. Front Microbiol 2020; 11:585943. [PMID: 33343524 PMCID: PMC7744764 DOI: 10.3389/fmicb.2020.585943] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/09/2020] [Indexed: 01/04/2023] Open
Abstract
Oil souring occurs when H2S is generated in oil reservoirs. This not only leads to operational risks and health hazards but also increases the cost of refining crude oil. Sulfate-reducing microorganisms are considered to be the main source of the H2S that leads to oil souring. Substrate competition between nitrate-reducing and sulfate-reducing microorganisms makes biosouring mitigation via the addition of nitrate salts a viable strategy. This study explores the shift in microbial community across different phases of biosouring and mitigation. Anaerobic sand-filled columns wetted with seawater and/or oil were used to initiate the processes of sulfidogenesis, followed by mitigation with nitrate, rebound sulfidogenesis, and rebound control phases (via nitrate and low salinity treatment). Shifts in microbial community structure and function were observed across different phases of seawater and oil setups. Marine bacterial taxa (Marinobacter, Marinobacterium, Thalassolituus, Alteromonas, and Cycloclasticus) were found to be the initial responders to the application of nitrate during mitigation of sulfidogenesis in both seawater- and oil- wetted columns. Autotrophic groups (Sulfurimonas and Desulfatibacillum) were found to be higher in seawater-wetted columns compared to oil-wetted columns, suggesting the potential for autotrophic volatile fatty acid (VFA) production in oil-field aquifers when seawater is introduced. Results indicate that fermentative (such as Bacteroidetes) and oil-degrading bacteria (such as Desulfobacula toluolica) play an important role in generating electron donors in the system, which may sustain biosouring and nitrate reduction. Persistence of certain microorganisms (Desulfobacula) across different phases was observed, which may be due to a shift in metabolic lifestyle of the microorganisms across phases, or zonation based on nutrient availability in the columns. Overall results suggest mitigation strategies for biosouring can be improved by monitoring VFA concentrations and microbial community dynamics in the oil reservoirs during secondary recovery of oil.
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Affiliation(s)
- Avishek Dutta
- Integrative Oceanography Division, Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, United States
| | - Ben Smith
- BP Upstream Technology, London, United Kingdom
| | | | - Leanne Walker
- Rawwater Engineering Company Ltd., Culcheth, United Kingdom
| | | | - Bob Eden
- Rawwater Engineering Company Ltd., Culcheth, United Kingdom
| | | | - Jeff S. Bowman
- Integrative Oceanography Division, Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
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Masuda N, Hurvitz S, Vahdat L, Harbeck N, Wolff A, Tolaney S, Loi S, O'Shaughnessy J, Xie D, Walker L, Rustia E, Borges V. 67TiP HER2CLIMB-02: A randomized, double-blind, phase III study of tucatinib or placebo with T-DM1 for unresectable locally-advanced or metastatic HER2+ breast cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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McAleese KE, Walker L, Erskine D, Johnson M, Koss D, Thomas AJ, Attems J. Concomitant LATE-NC in Alzheimer's disease is not associated with increased tau or amyloid-β pathological burden. Neuropathol Appl Neurobiol 2020; 46:722-734. [PMID: 32896913 DOI: 10.1111/nan.12664] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/23/2020] [Accepted: 08/22/2020] [Indexed: 12/14/2022]
Abstract
AIMS Limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) is present in approximately 50% of Alzheimer's disease (AD) cases and is associated with accelerated cognitive decline. Studies indicate a potential synergistic relationship between LATE-NC and hyperphosphorylated tau. It is unknown if LATE-NC is an independent driver of cognitive impairment or exerts its influence through synergistic relationships with tau. This cliniconeuropathological study investigated the impact of LATE-NC on quantified measures of AD-associated pathology and its impact on clinical measures. METHODS A total of 61 AD cases underwent neuropathological assessment for LATE-NC and quantitative assessment [area covered by immunoreactivity (IR)] for early conformational tau (MC-1), late-stage hyperphosphorylated tau (AT8) and amyloid-β in the amygdala and five neocortical regions. Clinical measures included age of disease onset, final Mini-Mental State Examination (MMSE) score and rate of cognitive decline. RESULTS LATE-NC was present in 41 AD cases (AD/LATE-NC; 67.2%). No significant differences in MC-1-IR, AT8-IR or 4G8-IR were observed in any region between AD/LATE-NC and AD without LATE-NC, indicating no accelerated aggregation or hyperphosphorylation of tau proteins in the AD/LATE-NC cases. Final MMSE was significantly lower in AD/LATE-NC cases and was significantly associated with LATE-NC score even when controlled for the presence of both MC-1-IR and AT8-IR (P = 0.009). CONCLUSION The presence of LATE-NC in AD is not associated with an increase in the burden of early or late tau or Aβ pathology. LATE-NC is associated with a lower final MMSE score independent of tau pathology.
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Affiliation(s)
- K E McAleese
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - L Walker
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - D Erskine
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - M Johnson
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - D Koss
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - A J Thomas
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - J Attems
- Translation and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
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Walker L, Kreitinger J, Wageling N, Fields K, Rodan K, Craw J, Falla T, Crane C, Diaz P. 254 AKR1B10 inhibition in keratinocytes as a strategy to improve retinaldehyde efficacy and increase endogenous atRA. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Herring AMR, Craven MP, Mughal F, Rawsthorne M, Rees K, Walker L, Wolpert M. Potential of using visual imagery to revolutionise measurement of emotional health. Arch Dis Child 2020; 105:690-693. [PMID: 31974299 DOI: 10.1136/archdischild-2019-317758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 01/02/2020] [Accepted: 01/06/2020] [Indexed: 11/04/2022]
Abstract
Appropriate measurement of emotional health by all those working with children and young people is an increasing focus for professional practice. Most of the tools used for assessment or self-assessment of emotional health were designed in the mid-20th century using language and technology derived from pen and paper written texts. However, are they fit for purpose in an age of pervasive computing with increasingly rich audiovisual media devices being in the hands of young people? This thought piece explores how the increased use of visual imagery, especially forms that can be viewed or created on digital devices, might provide a way forward for more effective measuring of emotional health, including smiley faces, other emojis and other potential forms of visual imagery. The authors bring together perspectives from healthcare, counselling, youth advocacy, academic research, primary care and school-based mental health support to explore these issues.
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Affiliation(s)
| | - Michael P Craven
- Institute of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Faraz Mughal
- School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, UK
| | - Mat Rawsthorne
- Institute of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, UK
| | | | | | - Miranda Wolpert
- Clinical, Educational and Health Psychology, Brain Sciences, University College London, London, UK.,Mental Health Priority Area, Wellcome Trust, London, United Kingdom
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Kreitinger J, Walker L, Gadotti V, Wageling N, Zamponi G, Diaz F, Diaz P. 606 Small molecule blockade of T-type calcium channels by DX416 inhibits itch and reduces corresponding inflammation in acute and chronic itch mouse models. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Walker L, Azeze S, Alencherry E, Jones R, Kardan A, Al-Natour M, Sutter C, McLoney E, Tavri S. Abstract No. 558 Quantitative comparison of liver tumor perfusion of Yttrium 90 (Y-90) using balloon occlusion versus end-hole microcatheter. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.619] [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] Open
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Rahnemai-Azar A, Azeze S, Rajeswaran H, Hashmi A, Walker L, Davidson J, Al-Natour M. Abstract No. 671 The effect of inferior vena cava size on filter complications: one size does not fit all. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Mapson R, Walker L. Review of multi-disciplinary working and parent engagement at a school-based clinic for enterally-fed children. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Matthew A, Robinson J, Ellis J, Elliott S, Singal R, McLeod D, Elterman D, Petrella A, Yang G, Jamnicky L, Finelli A, Fleshner N, Perlis N, Walker L, Bender J, Fergus K, Wassersug R. 160 Canadian TrueNTH Sexual Health and Rehabilitation eClinic (SHAReClinic) for Prostate Cancer Patients: Results of a Feasibility Study. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Leader A, Maier B, Grout J, Chang C, Walker L, Davila M, Lanksy A, Marron T, Flores R, Beasley M, Salmon H, Rahman A, Kenigsberg E, Merad M. P2.04-04 CITEseq Characterization in Early Stage NSCLC Patients Identifies Distinct Patterns of Immune Infiltrate. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Alexandris AS, Walker L, Liu AKL, McAleese KE, Johnson M, Pearce RKB, Gentleman SM, Attems J. Cholinergic deficits and galaninergic hyperinnervation of the nucleus basalis of Meynert in Alzheimer's disease and Lewy body disorders. Neuropathol Appl Neurobiol 2019; 46:264-278. [PMID: 31454423 DOI: 10.1111/nan.12577] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 02/12/2019] [Accepted: 08/17/2019] [Indexed: 12/27/2022]
Abstract
AIMS Galanin is a highly inducible neuroprotective neuropeptide and in Alzheimer's disease (AD), a network of galaninergic fibres has been reported to hypertrophy and hyperinnervate the surviving cholinergic neurons in the basal forebrain. We aimed to determine (i) the extent of galanin hyperinnervation in patients with AD and Lewy body disease and (ii) whether galanin expression relates to the neuropathological burden and cholinergic losses. METHODS Galanin immunohistochemistry was carried out in the anterior nucleus basalis of Meynert of 27 Parkinson's disease (PD) cases without cognitive impairment (mild cognitive impairment [MCI]), 15 with PD with MCI, 42 with Parkinson's disease dementia (PDD), 12 with Dementia with Lewy bodies (DLB), 19 with AD, 12 mixed AD/DLB and 16 controls. Galaninergic innervation of cholinergic neurons was scored semiquantitatively. For a subgroup of cases (n = 60), cholinergic losses were determined from maximum densities of choline acetyltransferase positive (ChAT+ve) neurons and their projection fibres. Quantitative data for α-synuclein, amyloid beta and tau pathology were obtained from tissue microarrays covering cortical/subcortical regions. RESULTS Significant losses of cholinergic neurons and their projection fibres were observed across all diseases. Galaninergic hyperinnervation was infrequent and particularly uncommon in established AD and DLB. We found that hyperinnervation frequencies are significantly higher in the transition between PD without MCI to PDD and that higher burdens of co-existent AD pathology impair this galaninergic response. CONCLUSIONS Our results suggest that galanin upregulation represents an intrinsic response early in Lewy body diseases but which fails with increasing burdens of AD related pathology.
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Affiliation(s)
- A S Alexandris
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Neuropathology Unit, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK.,Division of Neuropathology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L Walker
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - A K L Liu
- Neuropathology Unit, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - K E McAleese
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - M Johnson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - R K B Pearce
- Neuropathology Unit, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - S M Gentleman
- Neuropathology Unit, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - J Attems
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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Lombardo MN, G-Dayanandan N, Keshipeddy S, Zhou W, Si D, Reeve SM, Alverson J, Barney P, Walker L, Hoody J, Priestley ND, Obach RS, Wright DL. Structure-Guided In Vitro to In Vivo Pharmacokinetic Optimization of Propargyl-Linked Antifolates. Drug Metab Dispos 2019; 47:995-1003. [PMID: 31201212 PMCID: PMC7184189 DOI: 10.1124/dmd.119.086504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/23/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022] Open
Abstract
Pharmacokinetic/pharmacodynamic properties are strongly correlated with the in vivo efficacy of antibiotics. Propargyl-linked antifolates, a novel class of antibiotics, demonstrate potent antibacterial activity against both Gram-positive and Gram-negative pathogenic bacteria, including multidrug-resistant Staphylococcus aureus. Here, we report our efforts to optimize the pharmacokinetic profile of this class to best match the established pharmacodynamic properties. High-resolution crystal structures were used in combination with in vitro pharmacokinetic models to design compounds that not only are metabolically stable in vivo but also retain potent antibacterial activity. The initial lead compound was prone to both N-oxidation and demethylation, which resulted in an abbreviated in vivo half-life (∼20 minutes) in mice. Stability of leads toward mouse liver microsomes was primarily used to guide medicinal chemistry efforts so robust efficacy could be demonstrated in a mouse disease model. Structure-based drug design guided mitigation of N-oxide formation through substitutions of sterically demanding groups adjacent to the pyridyl nitrogen. Additionally, deuterium and fluorine substitutions were evaluated for their effect on the rate of oxidative demethylation. The resulting compound was characterized and demonstrated to have a low projected clearance in humans with limited potential for drug-drug interactions as predicted by cytochrome P450 inhibition as well as an in vivo exposure profile that optimizes the potential for bactericidal activity, highlighting how structural data, merged with substitutions to introduce metabolic stability, are a powerful approach to drug design.
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Affiliation(s)
- M N Lombardo
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - N G-Dayanandan
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - S Keshipeddy
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - W Zhou
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - D Si
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - S M Reeve
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - J Alverson
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - P Barney
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - L Walker
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - J Hoody
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - N D Priestley
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - R S Obach
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
| | - D L Wright
- Department of Pharmaceutical Sciences, University of Connecticut, Storrs, Connecticut (M.N.L., N.G.-D., S.K., W.Z., D.S., S.M.R., D.L.W.); Pfizer Worldwide Research & Development, Pharmacokinetics, Dynamics, and Metabolism, Groton, Connecticut (R.S.O.); and Department of Chemistry and Biochemistry, University of Montana, Missoula, Montana (J.A., P.B., L.W., J.H., N.D.P.)
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Walker L, Santos-Iglesias P. 048 A Closer Examination of the Relationship between Erectile Function and Sexual Distress in Men with Prostate Cancer. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Matthew A, Robinson J, McLeod D, Elliott S, Ellis J, Singal R, Elterman D, Gentile A, Yang G, Walker L, Wassersug R, Fergus K, Gajewski J, Brock G, Bender J, Jamnicky L, Berlin A, Perlis N, Fleshner N, Finelli A. 048 Canadian TrueNTH Sexual Health and Rehabilitation eClinic (SHAReClinic): Online Education and Support for Prostate Cancer Patients and their Partners. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.059] [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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Kumari D, Walker L, Kondray V, Rajdev M, Patel I. 03:27 PM Abstract No. 76 Denver peritoneovenous shunting: large population retrospective review of complications. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kowalkowski F, Walker L, Frantz N, Khalili H, Patel I. 03:00 PM Abstract No. 353 Urgency of percutaneous thrombectomy/thrombolysis for thrombosed dialysis arteriovenous grafts and fistulas: does time interval to intervention really affect the clinical outcome. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.425] [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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Kumari D, Dambaeva, Walker L, Patel I, Davidson J. Abstract No. 536 Surefire catheter versus standard end-hole microcatheter in liver-directed therapy: a retrospective study. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Kumari D, Walker L, Dambaeva, Azar N, Nakamoto D, Haaga J. Abstract No. 501 Celiac plexus cryoablation: retrospective review of efficacy and complications in palliative care. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Paplomata E, Borges V, Loi S, Abramson V, Hamilton E, Hurvitz S, Lin N, Walker L, Murthy RK. Abstract OT2-07-08: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-07-08] [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
This abstract was withdrawn by the authors.
Citation Format: Paplomata E, Borges V, Loi S, Abramson V, Hamilton E, Hurvitz S, Lin N, Walker L, Murthy RK. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-07-08.
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Affiliation(s)
- E Paplomata
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - V Borges
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Loi
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - V Abramson
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E Hamilton
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Hurvitz
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N Lin
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Walker
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - RK Murthy
- Emory Winship Cancer Institute, Atlanta, GA; University of Colorado Cancer Center, Aurora, CO; Peter MacCallum Cancer Centre, Victoria, Australia; Vanderbilt-Ingram Cancer Center, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN; University of California, Los Angeles (UCLA), Los Angeles, CA; Dana-Farber Cancer Institute, Boston, MA; Seattle Genetics, Inc., Bothell, WA; The University of Texas MD Anderson Cancer Center, Houston, TX
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Bruns D, Kovacs E, Jeong M, Buttrick P, Walker L. NOVEL AND DIRECT MYOFILAMENT-MEDIATED ACTION OF METFORMIN IN THE AGING RIGHT HEART. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Bruns
- University of Colorado Denver, Aurora, Colorado, United States
| | - E Kovacs
- University of Colorado Denver, United States
| | - M Jeong
- University of Colorado Denver, United States
| | - P Buttrick
- University of Colorado Denver, United States
| | - L Walker
- University of Colorado Denver, United States
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Duimering A, Turner J, Andrews E, Driga A, Ayume A, Robinson J, Walker L, Wiebe E. A Multidisciplinary Clinical Experience in Sexual Health Care for Oncology Patients. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Spicer J, Kwatra V, Verma C, Ioannou K, Goldstein R, Brier T, Eremin J, Zareian N, Walker L, Lobo D, Farzaneh F, Eremin O. Phase I trial of a novel hTERT vaccination strategy addressing T effector cells and immune-suppressor mechanisms. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cross AS, Helen Kemp E, White A, Walker L, Meredith S, Sachdev P, Krone NP, Ross RJ, Wright NP, Elder CJ. International survey on high- and low-dose synacthen test and assessment of accuracy in preparing low-dose synacthen. Clin Endocrinol (Oxf) 2018; 88:744-751. [PMID: 29392744 DOI: 10.1111/cen.13559] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 12/14/2017] [Revised: 01/12/2018] [Accepted: 01/24/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The short synacthen test (SST) is widely used to assess patients for adrenal insufficiency, but the frequency and protocols used across different centres for the low-dose test (LDT) are unknown. This study aimed to survey centres and test the accuracy of ten different synacthen preparation strategies used for the LDT. METHODS Members of 6 international endocrine societies were surveyed regarding diagnostic tests used for adrenal insufficiency, and in particular the SST. Synacthen was diluted for the LDT and concentrations measured using a synacthen ELISA. RESULTS Survey responses were received from 766 individuals across 60 countries (52% adult, 45% paediatric endocrinologists). The SST is used by 98% of centres: 92% using high-dose (250 μg), 43% low-dose and 37% both. Ten low-dose dilution methods were assessed and variation in synacthen concentration was demonstrated with intramethod coefficients of variation (CV) ranging from 2.1% to 109%. The method using 5% dextrose as a diluent was the least variable (CV of 2.1%). The variation in dilution methods means that the dose of synacthen administered in a LDT may vary between 0.16 and 0.81 μg. CONCLUSIONS The high-dose SST is the most popular diagnostic test of adrenal insufficiency, but up to 72% of paediatric endocrinologists use a LDT. There is considerable variation observed both within and between low-dose synacthen dilution methods creating considerable risk of inaccurate dosing and thereby invalid results.
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Affiliation(s)
- Alexandra S Cross
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - E Helen Kemp
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Anne White
- School of Medical Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Leanne Walker
- School of Medical Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Suzanne Meredith
- School of Medical Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Pooja Sachdev
- Department of Endocrinology, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Nils P Krone
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department of Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Richard J Ross
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Neil P Wright
- Department of Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Charlotte J Elder
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
- Department of Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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Kumari D, Walker L, Bochnakova T, Mitchell S, Buethe J. 3:09 PM Abstract No. 400 Women in interventional radiology: factors that influence women to pursue IR. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.444] [Citation(s) in RCA: 2] [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: 11/27/2022] Open
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Burns T, Gargan L, Walker L, Heatherington S, Topping-Morris B, Vellonoweth C, Deahl M, James D, McDougall N, Richards J. Not Just Bricks and Mortar. Psychiatr bull 2018. [DOI: 10.1192/pb.22.8.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- L. Walker
- School of Health Sciences Massey University Wellington New Zealand
- Graduate School of Nursing and Midwifery Victoria University of Wellington Wellington New Zealand
| | - J. Clendon
- Office of the Chief Nursing Officer, Ministry of Health Wellington New Zealand
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Singh SP, Tuomainen H, Girolamo GD, Maras A, Santosh P, McNicholas F, Schulze U, Purper-Ouakil D, Tremmery S, Franić T, Madan J, Paul M, Verhulst FC, Dieleman GC, Warwick J, Wolke D, Street C, Daffern C, Tah P, Griffin J, Canaway A, Signorini G, Gerritsen S, Adams L, O'Hara L, Aslan S, Russet F, Davidović N, Tuffrey A, Wilson A, Gatherer C, Walker L. Protocol for a cohort study of adolescent mental health service users with a nested cluster randomised controlled trial to assess the clinical and cost-effectiveness of managed transition in improving transitions from child to adult mental health services (the MILESTONE study). BMJ Open 2017; 7:e016055. [PMID: 29042376 PMCID: PMC5652531 DOI: 10.1136/bmjopen-2017-016055] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 08/18/2017] [Accepted: 08/25/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Disruption of care during transition from child and adolescent mental health services (CAMHS) to adult mental health services may adversely affect the health and well-being of service users. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Healthcare) study evaluates the longitudinal course and outcomes of adolescents approaching the transition boundary (TB) of their CAMHS and determines the effectiveness of the model of managed transition in improving outcomes, compared with usual care. METHODS AND ANALYSIS This is a cohort study with a nested cluster randomised controlled trial. Recruited CAMHS have been randomised to provide either (1) managed transition using the Transition Readiness and Appropriateness Measure score summary as a decision aid, or (2) usual care for young people reaching the TB. Participants are young people within 1 year of reaching the TB of their CAMHS in eight European countries; one parent/carer and a CAMHS clinician for each recruited young person; and adult mental health clinician or other community-based care provider, if young person transitions. The primary outcome is Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) measuring health and social functioning at 15 months postintervention. The secondary outcomes include mental health, quality of life, transition experience and healthcare usage assessed at 9, 15 and 24 months postintervention. With a mean cluster size of 21, a total of 840 participants randomised in a 1:2 intervention to control are required, providing 89% power to detect a difference in HoNOSCA score of 0.30 SD. The addition of 210 recruits for the cohort study ensures sufficient power for studying predictors, resulting in 1050 participants and an approximate 1:3 randomisation. ETHICS AND DISSEMINATION The study protocol was approved by the UK National Research Ethics Service (15/WM/0052) and equivalent ethics boards in participating countries. Results will be reported at conferences, in peer-reviewed publications and to all relevant stakeholder groups. TRIAL REGISTRATION NUMBER ISRCTN83240263; NCT03013595 (pre-results).
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Affiliation(s)
- Swaran P Singh
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - Helena Tuomainen
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
| | - Athanasios Maras
- Yulius Academy, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, MaudsleyHospital, London, UK
- HealthTracker Ltd, Gillingham, UK
| | - Fiona McNicholas
- Department of Child and Adolescent Psychiatry, University College Dublin School of Medicine and Medical Science, Dublin, Republic of Ireland
- Geary Institute, University College Dublin, Dublin, Republic of Ireland
- Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin, Republic of Ireland
- Lucena Clinic, SJOG, Dublin, Republic of Ireland
| | - Ulrike Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | | | - Sabine Tremmery
- Departmentof Neurosciences, Child & Adolescent Psychiatry, University of Leuven, Leuven, Belgium
- Department of Child & Adolescent Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - Tomislav Franić
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - Jason Madan
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - Moli Paul
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, UK
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gwen C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jane Warwick
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - Dieter Wolke
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
- Departmentof Psychology, Universityof Warwick, Coventry, UK
| | - Cathy Street
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - Claire Daffern
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - Priya Tah
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - James Griffin
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - Alastair Canaway
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - Giulia Signorini
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
| | - Suzanne Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Laura Adams
- School of Psychology, Plymouth University, UK
| | - Lesley O'Hara
- SJOG Research Foundation, Dublin, Republic of Ireland
| | - Sonja Aslan
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Frédérick Russet
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Nikolina Davidović
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - Amanda Tuffrey
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - Anna Wilson
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - Charlotte Gatherer
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
| | - Leanne Walker
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, Universityof Warwick, Coventry, UK
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Bryant JL, Gieling RG, Meredith SL, Allen TJ, Walker L, Telfer BA, Supuran CT, Williams KJ, White A. Novel carbonic anhydrase IX-targeted therapy enhances the anti-tumour effects of cisplatin in small cell lung cancer. Int J Cancer 2017; 142:191-201. [DOI: 10.1002/ijc.31042] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 08/28/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Jennifer L Bryant
- Division of Diabetes, Endocrinology & Gastroenterology; University of Manchester; Manchester United Kingdom
- Division of Pharmacy & Optometry, School of Biology, Medicine and Health; University of Manchester; Manchester United Kingdom
| | - Roben G Gieling
- Division of Pharmacy & Optometry, School of Biology, Medicine and Health; University of Manchester; Manchester United Kingdom
| | - Suzanne L Meredith
- Division of Diabetes, Endocrinology & Gastroenterology; University of Manchester; Manchester United Kingdom
| | - Tiffany-Jayne Allen
- Division of Diabetes, Endocrinology & Gastroenterology; University of Manchester; Manchester United Kingdom
| | - Leanne Walker
- Division of Diabetes, Endocrinology & Gastroenterology; University of Manchester; Manchester United Kingdom
| | - Brian A Telfer
- Division of Pharmacy & Optometry, School of Biology, Medicine and Health; University of Manchester; Manchester United Kingdom
| | | | - Kaye J Williams
- Division of Pharmacy & Optometry, School of Biology, Medicine and Health; University of Manchester; Manchester United Kingdom
| | - Anne White
- Division of Diabetes, Endocrinology & Gastroenterology; University of Manchester; Manchester United Kingdom
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Zhang M, Matyunina L, Walker L, Chen W, Xiao H, Benigno B, Wu R, McDonald J. Evidence for the Importance of Post-transcriptional Regulatorychanges in ovarian cancer metastasis and the contribution of miRNAs. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martin D, Macary C, Jones C, Walker L, O'Connor M, Thompson E, Gallitano K, Leffler M, McSherry C, Kosinski M, White M. Development of novel observer-reported outcome assessments in clinical trials of patients with Duchenne muscular dystrophy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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