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Barry M, Trivedi A, Miyazawa B, Vivona L, Shimmin D, Pathipati P, Keane C, Cuschieri J, Pati S. Regulation of Vascular Endothelial Integrity by Mesenchymal Stem Cell Extracellular Vesicles after Hemorrhagic Shock and Trauma. Res Sq 2024:rs.3.rs-4284907. [PMID: 38746312 PMCID: PMC11092837 DOI: 10.21203/rs.3.rs-4284907/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
BACKGROUND Patients with hemorrhagic shock and trauma (HS/T) are vulnerable to the endotheliopathy of trauma (EOT), characterized by vascular barrier dysfunction, inflammation, and coagulopathy. Cellular therapies such as mesenchymal stem cells (MSCs) and MSC extracellular vesicles (EVs) have been proposed as potential therapies targeting the EOT. In this study we investigated the effects of MSCs and MSC EVs on endothelial and epithelial barrier integrity in vitro and in vivo in a mouse model of HS/T. This study addresses systemic effects of HS/T on multiorgan EOT in HS/T model. METHODS In vitro , pulmonary endothelial cell (PEC) and Caco-2 intestinal epithelial cell monolayers were treated with control media, MSC conditioned media (CM), or MSC EVs in varying doses and subjected to a thrombin or hydrogen peroxide (H 2 O 2 ) challenge, respectively. Monolayer permeability was evaluated with a cell impedance assay, and intercellular junction integrity was evaluated with immunofluorescent staining. In vivo , a mouse model of HS/T was used to evaluate the effects of lactated Ringer's (LR), MSCs, and MSC EVs on endothelial and epithelial intercellular junctions in the lung and small intestine as well as on plasma inflammatory biomarkers. RESULTS MSC EVs and MSC CM attenuated permeability and preserved intercellular junctions of the PEC monolayer in vitro, whereas only MSC CM was protective of the Caco-2 epithelial monolayer. In vivo , both MSC EVs and MSCs mitigated the loss of endothelial adherens junctions in the lung and small intestine, though only MSCs had a protective effect on epithelial tight junctions in the lung. Several plasma biomarkers including MMP8 and VEGF were elevated in LR- and EV-treated but not MSC-treated mice. CONCLUSIONS In conclusion, MSC EVs could be a potential cell-free therapy targeting endotheliopathy after HS/T via preservation of the vascular endothelial barrier in multiple organs early after injury. Further research is needed to better understand the immunomodulatory effects of these products following HS/T and to move toward translating these therapies into clinical studies.
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Al Azzawi M, Kelly O, Welaratne I, McGuire A, Sartini-Bhreathnach A, Stanley E, Kell M, Stokes M, Barry M, Walsh S, Heeney A. Localisation using multiple magnetic seeds in unilateral breast surgery. Ir Med J 2024; 117:924. [PMID: 38526068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
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Barry M, Gozali A, Vu L. Impact of Social Vulnerability on Long-Term Growth Outcomes in Sutureless Versus Sutured Repair of Gastroschisis. Eur J Pediatr Surg 2023; 33:477-484. [PMID: 36720245 DOI: 10.1055/s-0043-1761921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of this study is to describe the long-term growth and nutrition outcomes of sutureless versus sutured gastroschisis repair. We hypothesized that weight z-score at 1 year would be affected by social determinants of health measured by the U.S. Centers for Disease Control Social Vulnerability Index (SVI). MATERIALS AND METHODS We conducted a single-center retrospective review of patients who underwent gastroschisis repair (n = 97) from 2007 to 2018. Growth z-scores collected through 5 years of age and long-term clinical outcomes were compared based on the closure method and the type of gastroschisis (simple vs. complicated). Multiple regression analysis was performed to identify the impact of SVI themes and other covariates on weight for age z-score at 1 year. RESULTS In total, 46 patients underwent sutureless repair and 51 underwent sutured repair with median follow-up duration of 2.5 and 1.9 years, respectively. Weight and length z-scores decreased after birth but normalized within the first year of life. Growth and long-term clinical outcomes were similar regardless of the closure method, while patients with complicated gastroschisis had higher rates of hospitalizations, small bowel obstructions, and additional abdominal surgeries. Using multiple regression, both low discharge weight and high SVI in the "minority status and language" theme were associated with lower weight for age z-scores at 1 year (p = 0.003 and p = 0.03). CONCLUSION Sutureless and sutured gastroschisis repairs result in similar growth and long-term outcomes. Patients living in areas with greater social vulnerability may be at increased risk of poor weight gain. Patients should be followed at least through their first year to ensure appropriate growth.
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Affiliation(s)
- Mark Barry
- Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Aileen Gozali
- School of Medicine, University of California San Francisco, San Francisco, California, United States
| | - Lan Vu
- Division of Pediatric Surgery, University of California San Francisco, San Francisco, California, United States
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Smolyaninov II, Balzano Q, Barry M, Young D. Superlensing enables radio communication and imaging underwater. Sci Rep 2023; 13:18333. [PMID: 37884588 PMCID: PMC10603028 DOI: 10.1038/s41598-023-45663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/22/2023] [Indexed: 10/28/2023] Open
Abstract
Wireless radio communications provide a backbone to our technological civilization. However, radio communications are widely believed to be impossible in many situations where radios are surrounded by conductive media, such as underwater or underground, thus making ocean exploration difficult and creating well-known mine safety problems. In addition, since most imaging techniques rely on electromagnetic waves, the difficulty of electromagnetic wave propagation through biological tissues, which are mostly made of water, also severely limits bioimaging. Here we show that contrary to common beliefs, radio signals may be efficiently propagated through water over useful distances. Both radio communication and radio imaging through water may be enabled by superlensing of surface electromagnetic waves propagating along the water surface. We have demonstrated underwater radio communication over distances of several hundred skin depth in the MHz frequency range, which would require sensitivity below 10-100 W in a conventional radio communication channel. We also demonstrated subwavelength super-resolution radio imaging in the GHz range by using water surface as a superlens. Our results indicate new ways to perform bioimaging, as well as marine life safe techniques of wireless radio communication and imaging underwater, which are essential for ocean and seafloor exploration. We also anticipate that the developed techniques will provide invaluable means of studying the extraterrestrial water worlds, such as potentially inhabitable Jovian moons.
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Affiliation(s)
| | - Quirino Balzano
- Saltenna LLC, 1751 Pinnacle Drive #600, McLean, VA, 22102, USA
| | - Mark Barry
- Saltenna LLC, 1751 Pinnacle Drive #600, McLean, VA, 22102, USA
| | - Dendy Young
- Saltenna LLC, 1751 Pinnacle Drive #600, McLean, VA, 22102, USA
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Nguyen R, Barry M, Azevedo Loiola R, Ferret PJ, Andres E. PhotoSENSIL-18 assay development: Enhancing the safety testing of cosmetic raw materials and finished products to support the in vitro photosensitization assessment? Toxicology 2023; 495:153613. [PMID: 37558156 DOI: 10.1016/j.tox.2023.153613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/07/2023] [Accepted: 08/06/2023] [Indexed: 08/11/2023]
Abstract
Although photosensitization remains a major toxicological endpoint for the safety assessment of cosmetic products and their raw materials, there is no validated in vitro method available for the evaluation of this adverse effect so far. Given that previous studies have proposed that the Interleukine-18 (IL-18) plays a key role in keratinocyte-driven pro-inflammatory responses specific of the skin sensitization process, we hypothesize that IL-18 might be used as a specific biomarker for in vitro photosensitization assessment. The aim of the present study was the set-up of a new in vitro assay using IL-18 as a biomarker for the identification of photosensitizers in a reconstructed human epidermis (RHE) model. EpiCS™ RHE were incubated with a set of 16 known sensitising / phototoxic / photosensitizing substances and exposed to ultra-violet (UV) irradiation. Then, the cell viability was analysed by MTT assay, while the IL-18 secretion was quantified by ELISA. Preliminary assays have shown that 1 h of incubation followed by a recovery period of 23 h induced the highest IL-18 production in response to UV exposure. This protocol was used to test 16 substances and a ratio of IL-18 production (UV+/UV- ratio) was then generated. Our data shows that the cut-off of 1.5 (UV+/UV- ratio) is the most predictive model among the tested conditions, being capable of identifying true positive photosensitizers (8 of 9) with a good prediction in comparison with in vivo data. In a nutshell, our data suggests that the PhotoSENSIL-18 is a promising in vitro method for identification of photosensitizing substances. Although further studies are necessary to optimize the model, we foresee that the PhotoSENSIL-18 assay can be used in the context of an Integrative Approach to Testing and Assessment (IATA) of chemicals.
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Affiliation(s)
- R Nguyen
- Laboratoires Pierre Fabre, 3 avenue Hubert Curien, BP 13562, 31035 Toulouse Cedex, France
| | - M Barry
- Oroxcell SAS, 102 avenue Gaston Roussel, 93230 Romainville, France
| | - R Azevedo Loiola
- Oroxcell SAS, 102 avenue Gaston Roussel, 93230 Romainville, France
| | - P-J Ferret
- Laboratoires Pierre Fabre, 3 avenue Hubert Curien, BP 13562, 31035 Toulouse Cedex, France
| | - E Andres
- Oroxcell SAS, 102 avenue Gaston Roussel, 93230 Romainville, France.
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Mahlow J, Sanchez A, Barry M, Sirohi D. Composite Pheochromocytoma/
Paraganglioma‐Ganglioneuroma
with a Germline
SDHC
Mutation: A First of Its Kind Case Report. Histopathology 2022; 81:682-685. [DOI: 10.1111/his.14776] [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] [Received: 07/12/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- J Mahlow
- Department of Pathology, University of Utah Huntsman Cancer Institute and University of Utah Salt Lake City UT USA
| | - A Sanchez
- Division of Urology, Department of Surgery University of Utah Salt Lake City UT USA
| | - M Barry
- Department of Pathology, University of Utah Huntsman Cancer Institute and University of Utah Salt Lake City UT USA
| | - D Sirohi
- Department of Pathology, University of Utah Huntsman Cancer Institute and University of Utah Salt Lake City UT USA
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Barry M, Wu F, Pati S, Chipman A, Geng H, Kozar R. Lyophilized plasma resuscitation downregulates inflammatory gene expression in a mouse model of sepsis. J Trauma Acute Care Surg 2022; 93:S119-S127. [PMID: 35881828 DOI: 10.1097/ta.0000000000003658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Plasma resuscitation may improve outcomes by targeting endotheliopathy induced by severe sepsis or septic shock. Given the logistical constraints of using fresh frozen plasma in military settings or areas with prolonged prehospital care, dried products such as lyophilized plasma (LP) have been developed. We hypothesized that resuscitation with LP would decrease lung injury, inflammation, and mortality in a mouse sepsis model. METHODS Adult male C57BL/6J mice received an intraperitoneal injection of cecal slurry. Twenty-two hours later, the mice were anesthetized, the femoral artery was cannulated, and the mice were randomized to receive resuscitation with LP (10 mL/kg) or lactated Ringer's (LR; 30 mL/kg) for 1 hour. At 48-hours post-cecal slurry injection, bronchoalveolar lavage fluid was collected, the lungs were harvested, and plasma was obtained. Mortality and bronchoalveolar lavage total protein concentration (as an indicator of permeability) were compared between groups. The lungs were analyzed for histopathology and inflammatory gene expression using NanoString, and the plasma was analyzed for biomarkers of inflammation and endothelial function. RESULTS There was no significant difference in short-term mortality between LR and LP mice, 38% versus 47%, respectively ( p = 0.62). Bronchoalveolar lavage protein levels were similar among mice resuscitated with LR or LP, and there was a lack of significant histopathologic lung injury in all groups. However, LP resuscitation resulted in downregulation of pulmonary inflammatory genes, including signaling pathways such as Janus kinase-signal transducer and activator of transcription and nuclear factor κB, and a circulating inflammatory biomarker profile similar to sham animals. CONCLUSION Resuscitation with LP did not improve mortality or reduce permeability or injury in this model compared with LR. However, LP downregulated pulmonary inflammatory gene signaling and may also reduce circulating biomarkers of inflammation. Future studies should evaluate LP resuscitation in combination with antibiotics and other therapeutics to determine whether the anti-inflammatory effects of LP may improve outcomes in sepsis.
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Affiliation(s)
- Mark Barry
- From the Department of Surgery (M.B., S.P.), University of California, San Francisco, San Francisco, California; Shock Trauma Center (F.W., A.C., R.K.), University of Maryland School of Medicine, Baltimore, Maryland; and Department of Laboratory Medicine (S.P., H.G.), University of California, San Francisco, San Francisco, California
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Rehman A, Tariq S, Kumar J, Martin L, Bannon C, Duffy T, Murphy E, Stack J, Barry M, Murphy CL. POS0661 MAJOR COST SAVINGS ASSOCIATED WITH BIOLOGIC DOSE REDUCTION IN PATIENTS WITH INFLAMMATORY ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAnti-TNF drugs have dramatically improved the management of inflammatory arthritis (IA).Although the introduction of biosimilars have reduced the cost, chronic use of biologic agentshas a high impact on healthcare expenditure. This study evaluated the cost effectiveness of adose reduction strategy for the most commonly used anti- TNF drugs over a period of 10 yearsin patients with IA in remission.ObjectivesThe purpose of this study was to explore whether patients with Inflammatory Arthritis (IA) (Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS) would remain in remission after 10 year period, following a reduction in biologic dosing frequency and to calculate the cost savings associated with dose reduction.MethodsThis prospective, non-blinded, non-randomised study was commenced in 2010. Patientswith IA, Rheumatoid arthritis (RA),ankylosing spondylitis (AS) and Psoriatic arthritis (PsA)who were in remission as defined by disease activity indices (DAS28<2.6, BASDAI<4), andwere offered Anti TNF dose reduction. Patients on etanercept were reduced from 50mgweekly to fortnightly, adalimumab 40mg once monthly instead of fortnightly. Patients wereassessed for disease activity at 1, 4 and 10 years following reduction in dosingfrequency.Cost saving was calculated by deducting the total annual cost of the biologicagent used over 10 years compared with the cost if the dosing interval had not changed.ResultsSeventy nine patients with inflammatory arthritis in remission were recruited. 57% had rheumatoid arthritis (n=45), 13% psoriatic arthritis (n=10) and 30% ankylosing spondylitis (n=24). 57% (n=45) were taking etanercept and 43% (n=34) adalimumab. The percentage of patients who maintained dose reduction at 10 years was 9% (n=7). Of the total 48 patients who were successfully dose reduced at year 1 (n=42), (69%, n=29) were able to maintain the dose reduction up to 4 years and 9% (n=7) maintained this dose reduction up to year 10. The estimated cost saving was €4,928 per patient per year. Estimated cost savings for 7 patients on reduced dose was €344,952.88 over 10 years.ConclusionAnti TNF dose reduction strategy in patients with IA results in substantial cost savings. Implementation of a dose reduction strategy while monitoring of disease activity reduces the financial impact of the use of biologic therapies. Further studies should be done to identify which patients are more likely to remain in remission while on dose reduction.References[1]Bonafede MM, Gandra SR, Watson C, Princic N, Fox KM. Cost per treated patient for etanercept, adalimumab, and infliximab across adult indications: a claims analysis. Adv Ther. 2012 Mar;29(3):234-48. doi: 10.1007/s12325-012-0007-y. Epub 2012 Mar 9. PMID: 22411424.[2]Joaquín Borrás-Blasco, Antonio Gracia-Pérez, J Dolores Rosique-Robles, MD Elvira Casterá & F Javier Abad (2014) Clinical and economic impact of the use of etanercept 25 mg once weekly in rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis patients, Expert Opinion on Biological Therapy, 14:2, 145-150, DOI: 10.1517/14712598.2014.868433[3]Carter CT, Changolkar AK, Scott McKenzie R. Adalimumab, etanercept, and infliximab utilization patterns and drug costs among rheumatoid arthritis patients. J Med Econ. 2012;15(2):332-9. doi: 10.3111/13696998.2011.649325. Epub 2012 Jan 6. PMID: 22168788.Disclosure of InterestsNone declared
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Barnhart EP, Ruppert LF, Hiebert R, Smith HJ, Schweitzer HD, Clark AC, Weeks EP, Orem WH, Varonka MS, Platt G, Shelton JL, Davis KJ, Hyatt RJ, McIntosh JC, Ashley K, Ono S, Martini AM, Hackley KC, Gerlach R, Spangler L, Phillips AJ, Barry M, Cunningham AB, Fields MW. In Situ Enhancement and Isotopic Labeling of Biogenic Coalbed Methane. Environ Sci Technol 2022; 56:3225-3233. [PMID: 35142487 DOI: 10.1021/acs.est.1c05979] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Subsurface microbial (biogenic) methane production is an important part of the global carbon cycle that has resulted in natural gas accumulations in many coal beds worldwide. Laboratory studies suggest that complex carbon-containing nutrients (e.g., yeast or algae extract) can stimulate methane production, yet the effectiveness of these nutrients within coal beds is unknown. Here, we use downhole monitoring methods in combination with deuterated water (D2O) and a 200-liter injection of 0.1% yeast extract (YE) to stimulate and isotopically label newly generated methane. A total dissolved gas pressure sensor enabled real-time gas measurements (641 days preinjection and for 478 days postinjection). Downhole samples, collected with subsurface environmental samplers, indicate that methane increased 132% above preinjection levels based on isotopic labeling from D2O, 108% based on pressure readings, and 183% based on methane measurements 266 days postinjection. Demonstrating that YE enhances biogenic coalbed methane production in situ using multiple novel measurement methods has immediate implications for other field-scale biogenic methane investigations, including in situ methods to detect and track microbial activities related to the methanogenic turnover of recalcitrant carbon in the subsurface.
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Affiliation(s)
- Elliott P Barnhart
- U.S. Geological Survey, Helena, Montana 59601, United States
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
| | | | - Randy Hiebert
- Biosqueeze Inc., Butte, Montana 59701, United States
| | - Heidi J Smith
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana 59717, United States
| | - Hannah D Schweitzer
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana 59717, United States
| | - Arthur C Clark
- U.S. Geological Survey, Reston, Virginia 20192, United States
| | - Edwin P Weeks
- U.S. Geological Survey, Reston, Virginia 20192, United States
| | - William H Orem
- U.S. Geological Survey, Reston, Virginia 20192, United States
| | | | - George Platt
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana 59717, United States
| | - Jenna L Shelton
- U.S. Geological Survey, Reston, Virginia 20192, United States
| | - Katherine J Davis
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana 59717, United States
| | | | - Jennifer C McIntosh
- Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, Arizona 85721, United States
| | - Kilian Ashley
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Shuhei Ono
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Anna M Martini
- Geology Department, Amherst College, Amherst, Massachusetts 01002, United States
| | - Keith C Hackley
- Isotech/Stratum Reservoir, Champaign, Illinois 61821, United States
| | - Robin Gerlach
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana 59717, United States
- Isotech/Stratum Reservoir, Champaign, Illinois 61821, United States
| | - Lee Spangler
- Energy Research Institute, Montana State University, Bozeman, Montana 59717, United States
| | - Adrienne J Phillips
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana 59717, United States
- Isotech/Stratum Reservoir, Champaign, Illinois 61821, United States
| | - Mark Barry
- Pro-Oceanus Systems Inc., Bridgewater, Nova Scotia B4V 1N1, Canada
| | - Alfred B Cunningham
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
| | - Matthew W Fields
- Center for Biofilm Engineering, Montana State University, Bozeman, Montana 59717, United States
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana 59717, United States
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Barry M, Trivedi A, Pathipati P, Miyazawa BY, Vivona LR, Togarrati PP, Khakoo M, Tanner H, Norris P, Pati S. Mesenchymal stem cell extracellular vesicles mitigate vascular permeability and injury in the small intestine and lung in a mouse model of hemorrhagic shock and trauma. J Trauma Acute Care Surg 2022; 92:489-498. [PMID: 34882596 PMCID: PMC8866219 DOI: 10.1097/ta.0000000000003487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hemorrhagic shock and trauma (HS/T)-induced gut injury may play a critical role in the development of multi-organ failure. Novel therapies that target gut injury and vascular permeability early after HS/T could have substantial impacts on trauma patients. In this study, we investigate the therapeutic potential of human mesenchymal stem cells (MSCs) and MSC-derived extracellular vesicles (MSC EVs) in vivo in HS/T in mice and in vitro in Caco-2 human intestinal epithelial cells. METHODS In vivo, using a mouse model of HS/T, vascular permeability to a 10-kDa dextran dye and histopathologic injury in the small intestine and lungs were measured among mice. Groups were (1) sham, (2) HS/T + lactated Ringer's (LR), (3) HS/T + MSCs, and (4) HS/T + MSC EVs. In vitro, Caco-2 cell monolayer integrity was evaluated by an epithelial cell impedance assay. Caco-2 cells were pretreated with control media, MSC conditioned media (CM), or MSC EVs, then challenged with hydrogen peroxide (H2O2). RESULTS In vivo, both MSCs and MSC EVs significantly reduced vascular permeability in the small intestine (fluorescence units: sham, 456 ± 88; LR, 1067 ± 295; MSC, 765 ± 258; MSC EV, 715 ± 200) and lung (sham, 297 ± 155; LR, 791 ± 331; MSC, 331 ± 172; MSC EV, 303 ± 88). Histopathologic injury in the small intestine and lung was also attenuated by MSCs and MSC EVs. In vitro, MSC CM but not MSC EVs attenuated the increased permeability among Caco-2 cell monolayers challenged with H2O2. CONCLUSION Mesenchymal stem cell EVs recapitulate the effects of MSCs in reducing vascular permeability and injury in the small intestine and lungs in vivo, suggesting MSC EVs may be a potential cell-free therapy targeting multi-organ dysfunction in HS/T. This is the first study to demonstrate that MSC EVs improve both gut and lung injury in an animal model of HS/T.
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Affiliation(s)
- Mark Barry
- University of California, San Francisco. Department of Surgery. 513 Parnassus Ave. San Francisco, CA 94143
| | - Alpa Trivedi
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Praneeti Pathipati
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Byron Y. Miyazawa
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Lindsay R. Vivona
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | | | - Manisha Khakoo
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Heather Tanner
- Vitalant Research Institute. 270 Masonic Ave. San Francisco, CA 94118
| | - Philip Norris
- Vitalant Research Institute. 270 Masonic Ave. San Francisco, CA 94118
| | - Shibani Pati
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
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Barry M, Pati S. Targeting repair of the vascular endothelium and glycocalyx after traumatic injury with plasma and platelet resuscitation. Matrix Biol Plus 2022; 14:100107. [PMID: 35392184 PMCID: PMC8981767 DOI: 10.1016/j.mbplus.2022.100107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/03/2021] [Revised: 02/10/2022] [Accepted: 03/10/2022] [Indexed: 02/06/2023] Open
Abstract
Endothelial glycocalyx shedding is a key instigator of the endotheliopathy of trauma. Plasma and platelet transfusions preserve vascular integrity in pre-clinical models. However, platelets may be less effective than plasma in preserving the glycocalyx.
Severely injured patients with hemorrhagic shock can develop endothelial dysfunction, systemic inflammation, and coagulation disturbances collectively known as the endotheliopathy of trauma (EOT). Shedding of the endothelial glycocalyx occurs early after injury, contributes to breakdown of the vascular barrier, and plays a critical role in the pathogenesis of multiple organ dysfunction, leading to poor outcomes in trauma patients. In this review we discuss (i) the pathophysiology of endothelial glycocalyx and vascular barrier breakdown following hemorrhagic shock and trauma, and (ii) the role of plasma and platelet transfusion in maintaining the glycocalyx and vascular endothelial integrity.
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Affiliation(s)
- Mark Barry
- University of California, San Francisco, Department of Surgery. 513 Parnassus Ave., San Francisco, CA 94143, United States
- Corresponding author.
| | - Shibani Pati
- University of California, San Francisco, Department of Surgery. 513 Parnassus Ave., San Francisco, CA 94143, United States
- University of California, San Francisco, Department of Laboratory Medicine. 513 Parnassus Ave., San Francisco, CA 94143, United States
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Gainey M, Qu K, Garbern S, Barry M, Lee J, Nasrin S, Nelson E, Rosen R, Alam N, Schmid C, Levine A. 288 Assessing the Performance of Clinical Diagnostic Models for Dehydration among Patients With Cholera and Undernutrition in Bangladesh. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.301] [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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Hussein M, Angerud A, Saez J, Bogaert E, Barry M, Silvestre Patallo I, Shipley D, Clark C, Hernandez V. PD-0900 Improving the modelling of Elekta Agility MLC in RayStation. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07179-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pati S, Fennern E, Holcomb JB, Barry M, Trivedi A, Cap AP, Martin MJ, Wade C, Kozar R, Cardenas JC, Rappold JF, Spiegel R, Schreiber MA. Treating the endotheliopathy of SARS-CoV-2 infection with plasma: Lessons learned from optimized trauma resuscitation with blood products. Transfusion 2021; 61 Suppl 1:S336-S347. [PMID: 34269437 PMCID: PMC8446992 DOI: 10.1111/trf.16452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Shibani Pati
- Department of Lab MedicineUniversity of California San Francisco School of MedicineSan FranciscoCaliforniaUSA
| | - Erin Fennern
- Department of SurgeryMount Sinai Icahn School of MedicineNew YorkNew YorkUSA
| | | | - Mark Barry
- Department of SurgeryUniversity of California San Francisco School of MedicineSan FranciscoCaliforniaUSA
| | - Alpa Trivedi
- Department of Lab MedicineUniversity of California San Francisco School of MedicineSan FranciscoCaliforniaUSA
| | - Andrew P. Cap
- U.S. Army Institute of Surgical ResearchJBSA‐FT Sam HoustonSan AntonioTexasUSA
| | | | - Charles Wade
- Department of Surgery McGovern School of MedicineUniversity of Texas Health Science CenterHoustonTexasUSA
| | - Rosemary Kozar
- Department of SurgeryUniversity of MarylandBaltimoreMarylandUSA
| | - Jessica C. Cardenas
- Department of Surgery McGovern School of MedicineUniversity of Texas Health Science CenterHoustonTexasUSA
| | - Joseph F. Rappold
- Department of Surgery Maine Medical CenterTufts University School of MedicinePortlandMaineUSA
| | - Renee Spiegel
- Department of SurgeryElmhurst Hospital CenterElmhurstNew YorkUSA
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Barry M, Trivedi A, Miyazawa BY, Vivona LR, Khakoo M, Zhang H, Pathipati P, Bagri A, Gatmaitan MG, Kozar R, Stein D, Pati S. Cryoprecipitate attenuates the endotheliopathy of trauma in mice subjected to hemorrhagic shock and trauma. J Trauma Acute Care Surg 2021; 90:1022-1031. [PMID: 33797484 PMCID: PMC8141010 DOI: 10.1097/ta.0000000000003164] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Plasma has been shown to mitigate the endotheliopathy of trauma. Protection of the endothelium may be due in part to fibrinogen and other plasma-derived proteins found in cryoprecipitate; however, the exact mechanisms remain unknown. Clinical trials are underway investigating early cryoprecipitate administration in trauma. In this study, we hypothesize that cryoprecipitate will inhibit endothelial cell (EC) permeability in vitro and will replicate the ability of plasma to attenuate pulmonary vascular permeability and inflammation induced by hemorrhagic shock and trauma (HS/T) in mice. METHODS In vitro, barrier permeability of ECs subjected to thrombin challenge was measured by transendothelial electrical resistance. In vivo, using an established mouse model of HS/T, we compared pulmonary vascular permeability among mice resuscitated with (1) lactated Ringer's solution (LR), (2) fresh frozen plasma (FFP), or (3) cryoprecipitate. Lung tissue from the mice in all groups was analyzed for markers of vascular integrity, inflammation, and inflammatory gene expression via NanoString messenger RNA quantification. RESULTS Cryoprecipitate attenuates EC permeability and EC junctional compromise induced by thrombin in vitro in a dose-dependent fashion. In vivo, resuscitation of HS/T mice with either FFP or cryoprecipitate attenuates pulmonary vascular permeability (sham, 297 ± 155; LR, 848 ± 331; FFP, 379 ± 275; cryoprecipitate, 405 ± 207; p < 0.01, sham vs. LR; p < 0.01, LR vs. FFP; and p < 0.05, LR vs. cryoprecipitate). Lungs from cryoprecipitate- and FFP-treated mice demonstrate decreased lung injury, decreased infiltration of neutrophils and activation of macrophages, and preserved pericyte-endothelial interaction compared with LR-treated mice. Gene analysis of lung tissue from cryoprecipitate- and FFP-treated mice demonstrates decreased inflammatory gene expression, in particular, IL-1β and NLRP3, compared with LR-treated mice. CONCLUSION Our data suggest that cryoprecipitate attenuates the endotheliopathy of trauma in HS/T similar to FFP. Further investigation is warranted on active components and their mechanisms of action.
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Affiliation(s)
- Mark Barry
- University of California, San Francisco. Department of Surgery. 513 Parnassus Ave. San Francisco, CA 94143
| | - Alpa Trivedi
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Byron Y. Miyazawa
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Lindsay R. Vivona
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Manisha Khakoo
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Haoqian Zhang
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Praneeti Pathipati
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
| | - Anil Bagri
- Cerus Corporation. 1220 Concord Ave. Concord, CA
| | | | - Rosemary Kozar
- Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD
| | - Deborah Stein
- University of California, San Francisco. Department of Surgery. 513 Parnassus Ave. San Francisco, CA 94143
| | - Shibani Pati
- University of California, San Francisco. Department of Laboratory Medicine. 513 Parnassus Ave. San Francisco, CA 94143
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Baskin CR, Barry M, Cohen RE, Condren C, Crosley S, Dickhans CD, Donaldson K, Gardner S, Griffin KJA, Place A, Doucette ED, Schmidt S. All Hands on Deck: Local Public Health Agencies Leveraging the Incident Command System During Crises. Health Secur 2021; 19:364-369. [PMID: 33794098 DOI: 10.1089/hs.2020.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The COVID-19 pandemic has stretched limited public health resources beyond measures, particularly at the local level. What started as an interesting report of pneumonia of unknown etiology in late December 2019 in Wuhan, China, bloomed into an international crisis by mid-January 2020. However, it was not until late January, when the first case was reported in the United States, that a new reality took shape for US public health agencies. After all, severe acute respiratory syndrome never made it to this country, and the only 2 cases of Middle East respiratory syndrome here were imported and never spread. Local public health agencies are notoriously short-staffed and underfunded. Therefore, when a crisis looms, personnel from a multitude of areas within the agencies are called upon to help out. Under its innovative and forward-thinking leadership, the St. Louis County Department of Health internally implemented the Incident Command System, a component of the National Incident Management System. While reassignment of individuals to new responsibilities under a new and temporary reporting structure did not always go perfectly, Incident Command System kept its promise to be adaptable to a fast-evolving situation, to clearly outline needed areas of responsibility, and to provide scaffolding that kept the Department of Health functional in chaotic times. It was able to be implemented quickly within hours of the first confirmed COVID-19 case in St. Louis County and enhanced the quality and timeliness of the public health response. This experience is being shared to provide a model of how organizations with limited personnel can use the Incident Command System to reorganize and meet unexpected challenges with increased success.
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Affiliation(s)
- Carole R Baskin
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Mark Barry
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Rachel E Cohen
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Colleen Condren
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Sarah Crosley
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Carrie D Dickhans
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Kate Donaldson
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Sharon Gardner
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Ken J A Griffin
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Arletta Place
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Emily D Doucette
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
| | - Spring Schmidt
- Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL
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Duggan B, Smith A, Barry M. Uptake of biosimilars for TNF-α inhibitors adalimumab and etanercept following the best-value biological medicine initiative in Ireland. Int J Clin Pharm 2021; 43:1251-1256. [PMID: 33560486 DOI: 10.1007/s11096-021-01243-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/26/2022]
Abstract
Background There is over 10 years of clinical experience and evidence to show that biosimilar medicines can be used as safely and effectively in approved therapeutic indications as their originator biological medicines. In Ireland, biosimilar medicine uptake has been very slow, and savings to the health service will only be realised through fostering a competitive biological medicine market. Objective The objective of this study was to investigate the utilisation of biosimilars following a 'best-value biological' medicine initiative for adalimumab and etanercept in the Irish healthcare setting. Methods Data was extracted from the National High Tech claims database and High Tech ordering and management hub for the following drugs; adalimumab (Humira®, Amgevita®, Hulio®, Idacio®, and Imraldi®) and etanercept (Enbrel® and Benepali®). Main outcome measure: uptake of the best-value biological medicines. Results In June 2019, just over 90 patients had been initiated on, or switched to a best-value biological for adalimumab or etanercept. Over the next 12 months this increased to over 8500 patients. With the best-value biologicals accounting for approximately 50 % of market share in June 2020, the combined estimated savings and avoided costs are €22.7 million to date. The gain-share prescribing incentive has raised over €3.6 million for the specialties to invest back into patient care. Conclusion Against the background of a finite healthcare budget, this study shows that increasing use of biosimilars can create the financial savings and space to invest in new innovative therapies for the benefit of many patients.
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Affiliation(s)
- B Duggan
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
- Health Services Executive (HSE) Medicines Management Programme, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
| | - Amelia Smith
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland.
| | - M Barry
- Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
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Reynolds C, Dominguez Castro P, Bardon L, Kennelly S, Clyne B, Bury G, Bradley C, Finnigan K, McCullagh L, Barry M, Murrin C, Perrotta C, Gibney E, Corish C. It Takes A Village: Patient Perspectives On The Management Of Malnutrition In The Community. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.178] [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]
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Castro PD, Reynolds C, Kennelly S, Clyne B, Bury G, Bradley C, Finnigan K, McCullagh L, Barry M, Murrin C, Perrotta C, Gibney E, Corish C. “Don’t Go Near The Word Malnutrition”; A qualitative study of community healthcare professionals and patients views on the term malnutrition. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.557] [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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20
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Dominguez Castro P, Reynolds C, Bizzaro G, Kennelly S, Clyne B, Bury G, Bradley C, Finnigan K, McCullagh L, Barry M, Murrin C, Perrotta C, Gibney E, Corish C. Large number of prescribed central nervous system drugs and younger age predict the use of more oral nutritional supplements units. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Reynolds C, Dominguez Castro P, Kennelly S, Clyne B, Bury G, Bradley C, Finnigan K, McCullagh L, Barry M, Murrin C, Perrotta C, Gibney E. Healthcare professionals’ preferences for the delivery, content and structure of a malnutrition education programme: An exploratory qualitative Study. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.179] [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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Abstract
Abstract
The goal of ensuring that all human beings can have healthy lives and can maximise their health potential calls for concerted action on health promotion as an integral component of modern health systems and public policy. In addressing current health and global challenges, there is an urgent need to move beyond the rhetoric of health promotion towards concrete action and strengthening the capacity of countries to implement health promotion at a political, policy and service delivery level. This presentation reviews progress to date and critically considers the enabling mechanisms and system requirements for transformative health promotion actions that can improve the capacity of health and social systems to improve population health and wellbeing, reduce health inequities, and realise the ambitions of the SDGs and the right to health for all. Drawing on a recent report prepared for the European Commission, this presentation discusses what actions are needed to strengthen health promoting policies, research and practices that support a whole-of-government and whole-of-society approach. This presentation makes the case for investing in transformative actions for improved health and wellbeing. Health promotion needs to be placed at the centre of the health policy and sustainable development agenda in order to enhance the resilience of health systems, improve health equity, and make health promotion practices and actions integral to the global health and wellbeing agenda.
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Affiliation(s)
- M Barry
- IUHPE, Montréal, Canada
- WHO Collaborating Centre for Health Promotion Research, National University of Ireland Galway, Galway, Ireland
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Al Majid F, Aldrees A, Barry M, Binkhamis K, Allam A, Almohaya A. Streptococcus anginosus group infections: Management and outcome at a tertiary care hospital. J Infect Public Health 2020; 13:1749-1754. [PMID: 32917555 DOI: 10.1016/j.jiph.2020.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/07/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Data on patients with invasive Streptococcus anginosus group (SAG) infections is limited, as it's been considered commensal bacteria in the human microbiota. We conducted an analysis of SAG infections to assist clinicians in understanding their burden and clinical outcomes. METHODS A retrospective study of medical records, identifying invasive SAG bacteria of sterile-site isolates that were managed from May 2015 to April 2017, at a tertiary care hospital in Riyadh, Saudi Arabia. Demographic data, clinical presentation, site of infection, antibiotic use, and outcome were recorded and analyzed to identify factors associated with poor outcome and/or polymicrobial growth. RESULTS We identified 105 cases of SAG infections in adults, with 52% of the patients being male and the mean age of 52.4 years with comorbidities occurring in more than half of the cases such as diabetes (38%) and malignancy (15%). Overall mortality was 6%, and it was statistically associated with age older than 65 years, polymicrobial growth and a history of malignancy. The infection frequencies were skin and soft tissue infections (SSTI; 55%), intra-abdominal infections (24%), bacteremia (14%), genitourinary infections (8.5%), and pleuropulmonary infections (5%). Abscesses accounted for 68% of cases. Polymicrobial infection (46%) with Enterobacteriaceae and Gram-negative anaerobes coincided with SAG infection. Polymicrobial growth was significantly associated with abscess formation, intra-abdominal source of infections, and poor outcome. In addition, death in patients with SAG was statistically associated with patients older than 65 years of age and those with history of cancer or transplant. CONCLUSION SSTIs and intra-abdominal infections are the most common clinical presentations in our cohort. Bacteremia was uncommon; however, the prognosis is less favorable. Overall susceptibility to penicillin was 91%, therefore β-lactam antibiotics are the drug of choice and additional coverage for anaerobic and gram-negative bacteria should be considered for intra-abdominal collection and solid or organ abscesses.
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Affiliation(s)
- F Al Majid
- Infectious Diseases Division, Department of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - A Aldrees
- Infectious Diseases Division, Department of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - M Barry
- Infectious Diseases Division, Department of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - K Binkhamis
- Microbiology Unit, Department of Pathology, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
| | - A Allam
- Department of Internal Medicine & Critical Care, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - A Almohaya
- Infectious Diseases Division, Department of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia.
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Nguyen A, Siman N, Barry M, Cleland C, Pham‐Singer H, Ogedegbe O, Berry C, Shelley D. Patient‐Physician Race/Ethnicity Concordance Improves Adherence to Cardiovascular Disease Guidelines. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13398] [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: 11/30/2022] Open
Affiliation(s)
- A.M. Nguyen
- NYU Langone Health New York NY United States
| | - N. Siman
- NYU Langone Health New York NY United States
| | - M. Barry
- NYU Langone Health New York NY United States
| | - C.M. Cleland
- New York University School of Medicine New York NY United States
| | - H. Pham‐Singer
- New York City Department of Health and Mental Hygiene Long Island City NY United States
| | - O. Ogedegbe
- New York University School of Medicine New York NY United States
| | - C. Berry
- Department of Population Health NYU Langone Health New York NY United States
| | - D. Shelley
- NYU College of Global Public Health New York NY United States
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Pers YM, Dubois A, Barry TA, Sall MD, March L, Sow MS, Keita AK, Taverne B, Etard JF, Toure A, Barry M, Delaporte E. FRI0447 FIRST COMPREHENSIVE LONG-TERM ASSESSMENT OF MUSCULOSKELETAL CONSEQUENCES AMONG EBOLA SURVIVORS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The tremendous size of the 2013-2016 West African outbreak of Ebola virus disease (EVD) resulted in a sizeable population of survivors, many reporting short-term sequelae such as arthralgia and myalgia.Objectives:We aimed to report a detailed and long-term description of patients’ musculoskeletal (MS) symptoms.Methods:We performed a cross-sectional study following systematic rheumatological screening of patients included in the Postebogui cohort (Conakry district). We used regression models to establish the magnitude of EVD as a risk factor for developing chronic MS pain by comparison with a control cohort and to establish risk factors for developing MS pain among survivors.Results:The study included 313 patients (55.6% female), with a median age of 28.2 years (IQR 21-37), and a median time from ETC discharge to rheumatological visit of 26.2 months (IQR 23-30). Chronic MS pain was reported in 216 (69%) patients, and was predominantly mechanical (48%). Enthesis and painful peripheral joints were largely involved (91%) with symmetrical distribution. Previous Ebola infection was a major risk factor for chronic MS pain (aOR, 6.662 [95% CI, 4.522–9.921]). Among survivors, increasing age (OR 1.14, 95% CI 1.08-1.22) and female gender (OR 3.58, 95% CI 1.22-11.80) were both associated with persistent MS pain, while myalgia experienced during the acute phase of EVD appeared protective (OR 0.14, 95% CI 0.04-0.42).Conclusion:Our study provides the most accurate long-term description of MS disorders among Ebola survivors. Joint and muscle pain sequelae are frequent and require specialized care.Disclosure of Interests:None declared
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Smith A, Barry M. Oral Anticoagulants - Utilisation and Expenditure under the Community Drugs Schemes. Ir Med J 2020; 113:71. [PMID: 32603567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aims This study determined the impact of the direct oral anticoagulants (DOACs) on the utilisation and expenditure on oral anticoagulants (OACs) in the Irish Community healthcare setting. We also investigated aspects of DOAC prescribing. Methods Using anonymised prescription data from the HSE pharmacy claims database we investigated anticoagulant prescribing over the study period (1/1/2014 - 31/12/2018). Results Some 74,748 patients were being treated with OACs by the year end 2018 an increase of 30,319 over 5 years. Warfarin prescribing fell from 32,751 patients in 2014 to 16,166 by the year end 2018. Apixaban is the most frequently prescribed OAC and annual expenditure on DOACs now exceeds € 51 million. Patients treated with DOACs are older than participants in the pivotal clinical trials and are frequently co-administered interacting drugs. Conclusion The introduction of DOACs has resulted in an overall increase in anticoagulant prescribing, a significant reduction in warfarin usage and a large increase in expenditure.
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Affiliation(s)
- A Smith
- Department of Pharmacology & Therapeutics, Trinity College Dublin
- Health Services Executive (HSE) Medicines Management Programme
| | - M Barry
- Department of Pharmacology & Therapeutics, Trinity College Dublin
- Health Services Executive (HSE) Medicines Management Programme
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Zehra S, Doyle F, Barry M, Walsh S, Kell MR. Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis. Breast Cancer 2020; 27:534-566. [PMID: 32162181 DOI: 10.1007/s12282-020-01076-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 08/18/2019] [Accepted: 02/27/2020] [Indexed: 12/21/2022]
Abstract
The present review evaluated health-related quality of life (HR-QoL) outcomes in surgical breast cancer survivors who received breast reconstruction (BR), breast-conservation surgery (BCS) or mastectomy (M), and whether HR-QoL domains across generic and disease/surgery-specific questionnaires are compatible. Six electronic databases were searched for appropriate observational studies. Standardized scores for different HR-QoL domains in the BR, BCS, and M treatment groups were extracted from each study for the purpose of a meta-analysis. Using Stata version 14.0, a random-effects meta-analysis model was adopted for each outcome variable to estimate the effect size, 95% CI-confidence intervals, and statistical significance. Sixteen of the 18 eligible studies with BR (n = 1474) and BCS (n = 2612) or M (n = 1458) groups were included in the meta-analysis. The BR group exhibited a better physical health (k = 12; 0.1, 95% CI 0.04, 0.24) and body image (k = 12; 0.50, 95% CI 0.10, 0.89) than the M group. However, the two groups exhibited comparable social health (k = 13; 0.1, 95% CI -0.07, 0.37), emotional health (k = 13; -0.08, 95% CI - 0.41, 0.25), global health (k = 7; 0.1, 95% CI - 0.01, 0.27), and sexual health (k =11; 0.2, 95% CI - 0.02,0.57). There was no clear evidence of the superiority of BR to BCS for all the six domains. These results suggest that HR-QoL outcomes in BR and BCS groups are better than the M group. Therefore, women opting for BR or BCS are likely to report fairly better HR-QoL outcomes than M. However, due to the significant heterogeneity observed in most BR versus BCS outcomes, developing a unified questionnaire incorporating both breast/surgery-specific and generic HR-QoL domains is warranted.
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Affiliation(s)
- Sadaf Zehra
- Department of General Surgery, St George's University Hospital, London, UK.
| | - F Doyle
- Royal College of Surgeon Ireland, Dublin, Ireland
| | - M Barry
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Walsh
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - M R Kell
- Mater Misericordiae University Hospital, Dublin, Ireland
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Pearse JE, Cadwgan JE, Wisher V, Jesmont C, Mason-Burton P, Barry M, Jona James J, Kelly S, Basu AP. Feasibility Trial of Thumb Taping by Parents in Infants with Cerebral Palsy: Brief Report. Dev Neurorehabil 2020; 23:50-58. [PMID: 30668211 DOI: 10.1080/17518423.2019.1566280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: To determine the feasibility and acceptability of parent-delivered elastic taping to the thumb and wrist in infants with cerebral palsy (CP).Design: Randomized cross-over feasibility trial.Participants: 20 infants (11 male; mean age 22 months) with CP.Intervention: Groups A and B received taping for 4 and 2 weeks, respectively.Outcomes: Primary: Recruitment and retention rates; adherence to protocol; Parent Satisfaction Questionnaire. Secondary: House Thumb score; Zancolli classification; Assisting Hand Assessment (AHA)/mini AHA. Exploratory: Duration of hand regard, thumb in palm, and open hand contact with toys during AHA/mini AHA.Results: Recruitment was feasible (95.2% uptake). Completion rates were 80% and 60% in Groups A and B. Questionnaire feedback was generally positive. Some parents reported increased awareness of the taped hand. Objective improvements were rare though one participant showed consistent improvement in thumb position.Conclusion: Taping proved feasible and acceptable; individual case benefit suggests further research is required.Trial registration: ISRCTN41918400.
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Affiliation(s)
- J E Pearse
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Newcastle University, Newcastle upon Tyne, UK
| | - J E Cadwgan
- Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, Kings Health Partners, London, UK.,Newcastle University, Newcastle upon Tyne, UK
| | - V Wisher
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - C Jesmont
- Newcastle University, Newcastle upon Tyne, UK
| | | | - M Barry
- Newcastle University, Newcastle upon Tyne, UK
| | | | - S Kelly
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - A P Basu
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Newcastle University, Newcastle upon Tyne, UK
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Cisse FA, Damien C, Haba M, Touré ML, Barry M, Djibo ABA, Bah AK, Soumah FM, Naeije G. Stroke burden in Guinea: Results from the Conakry Ignace Deen Hospital stroke registry. Int J Stroke 2019; 15:666-667. [DOI: 10.1177/1747493019884521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sub-Saharan Africa has extremely high stroke prevalence and case fatality. Most Sub-Saharan African regions are uncharted in terms of stroke characteristics, epidemiology, and burden. We report here the results from the first stroke registry in Guinea.
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Affiliation(s)
- F Abass Cisse
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - C Damien
- Department of Neurology, Université Libre de Bruxelles, Bruxelles Belgium
| | - M Haba
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - ML Touré
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - M Barry
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - ABA Djibo
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - AK Bah
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - FM Soumah
- Department of Neurology, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - G Naeije
- Department of Neurology, Université Libre de Bruxelles, Bruxelles Belgium
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Cisse FA, Damien C, Bah AK, Touré ML, Barry M, Djibo Hamani AB, Haba M, Soumah FM, Naeije G. Minimal Setting Stroke Unit in a Sub-Saharan African Public Hospital. Front Neurol 2019; 10:856. [PMID: 31447769 PMCID: PMC6692431 DOI: 10.3389/fneur.2019.00856] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/24/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction: Sub-Saharan Africa (SSA) has the highest stroke prevalence along with a case fatality that amounts to 40%. We aimed to assess the effect of a minimal setting stroke unit in SSA Public hospital on stroke mortality and main medical complications. Materials and Methods: The study was set in Conakry, Guinea, Ignace Deen public referral hospital. Clinical characteristics, hospital mortality and main medical stroke complications rates (pneumonia, urinary tract infections, sores and venous thromboembolism) of admitted stroke patients after the installation of a minimal stroke unit equipped with heart rate, blood pressure and blood oxygen saturation monitoring and portable oxygen concentrator (POST) were compared to a similar number of stroke patients admitted before the stroke unit creation (PRE). Results: PRE (n = 318) and POST (n = 361) stroke, patients were comparable in term of age (61 ± 14 vs. 60 ± 14.8 years, p = 0.24), sex (56 vs. 50% males, p = 0.09), High blood pressure rate (76.7 vs. 79%, p = 0.44), stroke subtype (ischemic in 72 vs. 78% of cases, p = 0.05) and NIHSS (11 ± 4 vs. 11 ± 4, p = 0.85). Diabetes was more frequent in the PRE group (19 vs. 9%, p < 0.001). Mortality was significantly lower in the POST group (7.2 vs. 22.3%, p < 0.0001) as well as medical complications (4.1 vs. 27.7%, p < 0.001) and lower pneumonia rate (3.3 vs. 14.5%, p < 0.001). Conclusions: Minimally equipped stroke units significantly reduce stroke mortality and main medical complications in SSA.
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Affiliation(s)
- Fode A Cisse
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - Charlotte Damien
- Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Aissatou K Bah
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - M L Touré
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - M Barry
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - A B Djibo Hamani
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - Michel Haba
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - Fode M Soumah
- Department of Neurology, CHU Ignace Deen, Université Gamal Abdel Nasser Conakry (UGANC), Conakry, Guinea
| | - Gilles Naeije
- Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
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O’Shea MP, Harkin K, Sulaiman HM, Hennessy M, Barry M, Kennedy C. More Teaching – Not More Exams: Interns’ Views in Improving Prescribing Safety. Ir Med J 2019; 112:943. [PMID: 31411396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- M P O’Shea
- TCD Department of Clinical Pharmacology, Dublin
| | - K Harkin
- Inchicore Family Doctors, Dublin
| | | | - M Hennessy
- TCD Department of Clinical Pharmacology, Dublin
| | - M Barry
- TCD Department of Clinical Pharmacology, Dublin
| | - C Kennedy
- TCD Department of Clinical Pharmacology, Dublin
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32
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Berggren K, Hixon M, Restrepo Cruz S, Cowan A, Ozbun M, Keysar S, Jimeno A, Barry M, Craig S, James J, McCance D, Beswick E, Gan G. MK2 Pathway Mediates Radiation-Induced Tumor Inflammation and Is a Poor Prognostic Factor in Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Andres E, Barry M, Hundt A, Dini C, Ferret PJ. Human tissue based sensitization assessment: set-up of an accurate prediction model for distinguishing skin sensitizers using a new assay adapted to hydrophobic substances and mixtures. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.678] [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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34
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Warren K, Myers S, Barry M, Jasper M. Clinical embryo sample tracking using the mitochondrial genome. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1176] [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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Cardwell K, Clyne B, Moriarty F, Wallace E, Fahey T, Boland F, McCullagh L, Clarke S, Finnigan K, Daly M, Barry M, Smith SM. Supporting prescribing in Irish primary care: protocol for a non-randomised pilot study of a general practice pharmacist (GPP) intervention to optimise prescribing in primary care. Pilot Feasibility Stud 2018; 4:122. [PMID: 30002869 PMCID: PMC6034254 DOI: 10.1186/s40814-018-0311-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 06/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Prescribing for patients taking multiple medicines (i.e. polypharmacy) is challenging for general practitioners (GPs). Limited evidence suggests that the integration of pharmacists into the general practice team could improve the management of these patients. The aim of this study is to develop and test an intervention involving pharmacists, working within GP practices, to optimise prescribing in Ireland, which has a mixed public and private primary healthcare system. Methods This non-randomised pilot study will use a mixed-methods approach. Four general practices will be purposively sampled and recruited. A pharmacist will join the practice team for 6 months. They will participate in the management of repeat prescribing and undertake medication reviews (which will address high-risk prescribing and potentially inappropriate prescribing, deprescribing and cost-effective and generic prescribing) with adult patients. Pharmacists will also provide prescribing advice regarding the use of preferred drugs, undertake clinical audits, join practice team meetings and facilitate practice-based education. Throughout the 6-month intervention period, anonymised practice-level medication (e.g. medication changes) and cost data will be collected. A nested Patient Reported Outcome Measure (PROM) study will be undertaken during months 4 and 5 of the 6-month intervention period to explore the impact of the intervention in older adults (aged ≥ 65 years). For this, a sub-set of 50 patients aged ≥ 65 years with significant polypharmacy (≥ 10 repeat medicines) will be recruited from each practice and invited to a medication review with the pharmacist. PROMs and healthcare utilisation data will be collected using patient questionnaires, and a 6-week follow-up review conducted. Acceptability of the intervention will be explored using pre- and post-intervention semi-structured interviews with key stakeholders. Quantitative and qualitative data analysis will be undertaken and an economic evaluation conducted. Discussion This non-randomised pilot study will provide evidence regarding the feasibility and potential effectiveness of general practice-based pharmacists in Ireland and provide data on whether a randomised controlled trial of this intervention is indicated. It will also provide a deeper understanding as to how a pharmacist working as part of the general practice team will affect organisational processes and professional relationships in a mixed public and private primary healthcare system.
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Affiliation(s)
- Karen Cardwell
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - B Clyne
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - F Moriarty
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - E Wallace
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - T Fahey
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - F Boland
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - L McCullagh
- 2Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - S Clarke
- 3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - K Finnigan
- 3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - M Daly
- 3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - M Barry
- 2Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland.,3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - S M Smith
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
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Barry M, Nader J, Hun Y, Havet E, Barry F, Laude M, Bonnaire B, Caus T. [Aberrant birth of a radial artery in the upper third of the forearm: A case report]. Morphologie 2018; 102:101-105. [PMID: 29615313 DOI: 10.1016/j.morpho.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 10/17/2022]
Abstract
We report the case of a 68-year-old patient, operated on in our department of a quadruple coronary bypass grafting. The grafting strategy consisted initially on harvesting the left internal thoracic artery and the left radial artery. The harvest of this latter failed because of a rare anatomical variation of the radial artery, which rose from the confluence of two branches: a superficial and a deep radial artery at the proximal third of the forearm approximately 10cm below the elbow.
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Affiliation(s)
- M Barry
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France; Laboratoire d'anatomie, faculté de médecine d'Amiens, université de Picardie Jules-Vernes, 80000Amiens, France.
| | - J Nader
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
| | - Y Hun
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
| | - E Havet
- Laboratoire d'anatomie, faculté de médecine d'Amiens, université de Picardie Jules-Vernes, 80000Amiens, France
| | - F Barry
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
| | - M Laude
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France; Laboratoire d'anatomie, faculté de médecine d'Amiens, université de Picardie Jules-Vernes, 80000Amiens, France; Service d'imagerie et radiologie médicale, CHU Amiens-Picardie, 80080 Amiens, France
| | - B Bonnaire
- Service d'imagerie et radiologie médicale, CHU Amiens-Picardie, 80080 Amiens, France
| | - T Caus
- Service de chirurgie cardiaque, CHU Amiens-Picardie, 80080 Amiens France
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Qian P, Barry M, Lu J, Al-Raisi S, Mina A, Ryan J, Bandodkar S, Alvarez S, James V, Ronquillo J, Varikatt W, Clayton Z, Chong J, Kovoor P, Pouliopoulos J, McEwan A, Thiagalingam A, Thomas S. Development and Validation of a Novel Microwave Transcatheter Renal Denervation System and an Intraprocedural Physiological End Point for Renal Sympathetic Denervation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.006] [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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Somily AM, Alahaideb A, Ridha A, Syyed S, Shakoor Z, Fatani A, Al-Subaie S, Barry M, Torchyan AA, BinSaeed AA, Alrabiaah A, Kambal AM, Senok A. Clinical and therapeutic features of brucellosis: An 11-year study at a tertiary care hospital in Riyadh, Saudi Arabia. Trop Biomed 2017; 34:977-982. [PMID: 33592968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To study the varying presentations, risk factors, and treatment outcomes among patients with physician-diagnosed brucellosis. This retrospective analysis evaluated all cases of brucellosis reported at King Khalid University Hospital during 2003-2013. Data were retrieved from patient records and a laboratory information system. Descriptive statistics were generated to summarize the study variables. Fisher's exact test or Pearson's chi-square test was used to compare categorical variables. Out of 163 patients identified with brucellosis, 76.7% of patients were culture positive. Fever was the most frequent symptom (85.9%), followed by arthralgia (46.6%). The most common clinical signs was splenomegaly (12.9%), followed by hepatomegaly (11.0%). Laboratory investigations revealed lymphocytosis and anemia in 66.3% and 55.2% of the patients, respectively. Approximately half of the patients (47.8%) had high erythrocyte sedimentation rates, and 56.4% had neutrophilia. Raw milk consumption and direct contact with animals were reported by 45.4% and 16.0% of patients, respectively. Treatment failure and relapse were observed in 8 (5.7%) cases. All treatment failures and relapses occurred among children <= 10 years of age or adults > 45 years old (11.0% vs. 0%; p = 0.006). Our findings demonstrate that raw milk consumption can be a substantial factor in brucellosis prevention in Saudi Arabia. Laboratory findings, along with the observed pattern in clinical signs and symptoms, can potentially mean underdiagnosis of mild cases. Age was the only factor associated with unfavorable treatment outcomes.
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Affiliation(s)
- A M Somily
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Alahaideb
- Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Ridha
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - S Syyed
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Z Shakoor
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Fatani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - S Al-Subaie
- Pediatrics Infectious Diseases Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - M Barry
- Adult Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A A Torchyan
- Prince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A A BinSaeed
- Prince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Alrabiaah
- Pediatrics Infectious Diseases Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A M Kambal
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Senok
- Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Carroll P, Barry M, Harold L, O'Grady M, Barry-Murphy B, O'Neill A, Brennan L. An investigation of the impact of ‘Facilitation Skills for Health and Well-Being’ training. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.368] [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: 11/13/2022] Open
Affiliation(s)
- P Carroll
- Centre for Health Behaviour Research, Waterford, Ireland
| | - M Barry
- Centre for Health Behaviour Research, Waterford, Ireland
| | - L Harold
- Centre for Health Behaviour Research, Waterford, Ireland
| | - M O'Grady
- Centre for Health Behaviour Research, Waterford, Ireland
| | | | - A O'Neill
- National Youth Council of Ireland, Dublin, Ireland
| | - L Brennan
- Men's Development Network, Waterford, Ireland
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Corcoran A, Hickey N, Barry M, Usher C, McCullagh LM. Ivacaftor for cystic fibrosis: An evaluation of real world utilisation and expenditure in the Irish Healthcare Setting. Ir Med J 2017; 110:619. [PMID: 29169001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In Ireland, Ivacaftor is reimbursed, on the High-Tech Drug Scheme, for the treatment of cystic fibrosis in patients age 6 years and older who have the G551D mutation. The aim of this study was to analyse the utilisation and expenditure of Ivacaftor on this scheme in the 12 month period post-reimbursement. All patients who had received Ivacaftor (regardless of General Medical Services Scheme eligibility/ineligibility) were included. A total of 140 individuals (male=74; 53%) received Ivacaftor over the defined 12 month study period (from January 2015 to December 2015 inclusive). The cohort ranged in age from 6 years to 61 years. The mean age was 22 years; a positive skew in age distribution indicated that a greater number of the cohort were in the younger age groups. No statistically significant difference was detected in the mean ages of the male and female subgroups. Drug acquisition expenditure by the Health Services Executive on Ivacaftor over the 12 month study period was €29.81 million.
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Affiliation(s)
| | - N Hickey
- Trinity College Dublin, Dublin, Ireland
| | - M Barry
- Trinity College Dublin, Dublin, Ireland
- National Centre For Pharmacoeconomics, St. James' Hospital, Dublin
| | - C Usher
- Trinity College Dublin, Dublin, Ireland
- National Centre For Pharmacoeconomics, St. James' Hospital, Dublin
| | - L M McCullagh
- Trinity College Dublin, Dublin, Ireland
- National Centre For Pharmacoeconomics, St. James' Hospital, Dublin
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Harker TD, Harker NF, Harker FR, Peace J, Barry M, Ludbrook MR, Ji W. Analysis of footprints provides additional insights during monitoring of Duvaucel’s geckos (Hoplodactylus duvaucelii). New Zealand Journal of Zoology 2017. [DOI: 10.1080/03014223.2017.1348365] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T. D. Harker
- School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, New Zealand
- Motuora Restoration Society Inc., PO Box 100-132, North Shore, Auckland 0745, New Zealand
| | - N. F. Harker
- School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, New Zealand
- Motuora Restoration Society Inc., PO Box 100-132, North Shore, Auckland 0745, New Zealand
| | - F. R. Harker
- Motuora Restoration Society Inc., PO Box 100-132, North Shore, Auckland 0745, New Zealand
| | - J. Peace
- School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, New Zealand
| | - M. Barry
- Institute of Natural and Mathematical Sciences, Massey University, Private Bag 102-904, Albany, Auckland, New Zealand
| | - M. R. Ludbrook
- Institute of Natural and Mathematical Sciences, Massey University, Private Bag 102-904, Albany, Auckland, New Zealand
| | - W. Ji
- Institute of Natural and Mathematical Sciences, Massey University, Private Bag 102-904, Albany, Auckland, New Zealand
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Garchitorena A, Sokolow SH, Roche B, Ngonghala CN, Jocque M, Lund A, Barry M, Mordecai EA, Daily GC, Jones JH, Andrews JR, Bendavid E, Luby SP, LaBeaud AD, Seetah K, Guégan JF, Bonds MH, De Leo GA. Disease ecology, health and the environment: a framework to account for ecological and socio-economic drivers in the control of neglected tropical diseases. Philos Trans R Soc Lond B Biol Sci 2017; 372:20160128. [PMID: 28438917 PMCID: PMC5413876 DOI: 10.1098/rstb.2016.0128] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [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] [Accepted: 01/03/2017] [Indexed: 01/27/2023] Open
Abstract
Reducing the burden of neglected tropical diseases (NTDs) is one of the key strategic targets advanced by the Sustainable Development Goals. Despite the unprecedented effort deployed for NTD elimination in the past decade, their control, mainly through drug administration, remains particularly challenging: persistent poverty and repeated exposure to pathogens embedded in the environment limit the efficacy of strategies focused exclusively on human treatment or medical care. Here, we present a simple modelling framework to illustrate the relative role of ecological and socio-economic drivers of environmentally transmitted parasites and pathogens. Through the analysis of system dynamics, we show that periodic drug treatments that lead to the elimination of directly transmitted diseases may fail to do so in the case of human pathogens with an environmental reservoir. Control of environmentally transmitted diseases can be more effective when human treatment is complemented with interventions targeting the environmental reservoir of the pathogen. We present mechanisms through which the environment can influence the dynamics of poverty via disease feedbacks. For illustration, we present the case studies of Buruli ulcer and schistosomiasis, two devastating waterborne NTDs for which control is particularly challenging.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'.
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Affiliation(s)
- A Garchitorena
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
- PIVOT, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - S H Sokolow
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - B Roche
- UMI UMMISCO 209 IRD/UPMC - Bondy, France
- UMR MIVEGEC 5290 CNRS - IRD - Université de Montpellier, Montpellier, France
| | - C N Ngonghala
- Department of Mathematics, University of Florida, Gainesville, FL 32611, USA
| | - M Jocque
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - A Lund
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA 94305, USA
| | - M Barry
- Center for Innovation in Global Health, Stanford University, Stanford, CA 94305, USA
| | - E A Mordecai
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - G C Daily
- Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - J H Jones
- Department of Earth System Science, Stanford University, Stanford, CA 94305, USA
- Department of Life Sciences, Imperial College, London, UK
| | - J R Andrews
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - E Bendavid
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - S P Luby
- Center for Innovation in Global Health, Stanford University, Stanford, CA 94305, USA
| | - A D LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University, Stanford, CA 94305, USA
| | - K Seetah
- Department of Anthropology, Stanford University, Stanford, CA 94305, USA
| | - J F Guégan
- UMR MIVEGEC 5290 CNRS - IRD - Université de Montpellier, Montpellier, France
- Future Earth international programme, OneHealth core research programme, Montréal, Canada
| | - M H Bonds
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
- PIVOT, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA 02115, USA
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - G A De Leo
- Department of Biology, Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
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Keita A, Toure A, Sow M, Raoul H, Magassouba N, Delaporte E, Etard JF, Abel L, Ayouba A, Baize S, Bangoura K, Barry A, Barry M, Cissé M, Delaporte E, Delmas C, Desclaux A, Diallo S, Diallo M, Diallo M, Étard JF, Etienne C, Faye O, Fofana I, Granouillac B, Hébert E, Izard S, Kassé D, Keita A, Koivugui L, Kpamou C, Lacarabaratz C, Leroy S, Marchal C, Levy Y, Magassouba N, March L, Msellati P, Niane H, Peeters M, Pers YM, Raoul H, Sacko S, Savané I, Sow M, Taverne B, Touré A, Traoré F. Extraordinary long-term and fluctuating persistence of Ebola virus RNA in semen of survivors in Guinea: implications for public health. Clin Microbiol Infect 2017; 23:412-413. [DOI: 10.1016/j.cmi.2016.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 09/01/2016] [Accepted: 11/02/2016] [Indexed: 11/16/2022]
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Hill D, Royce M, Lomo L, Barry M, Kang H, Wiggins C, Prossnitz E. Abstract P5-10-08: Estrogen receptor quantitative measures and differences in breast cancer survival. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-10-08] [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
Introduction: In New Mexico, Hispanic women have a 1.7-fold increased risk of breast cancer-specific death compared to non-Hispanic white women. In previous studies, race/ethnic minority women have had larger survival disparities in estrogen receptor positive (ER+) than ER- disease, suggesting some aspect of ER may mediate survival outcomes. We thus conducted an extensive assessment of ER quantitative measures.
Objective: To determine whether ER percent positive and intensity differs by ethnicity, and to evaluate whether that potential difference might account for a proportion of survival disparities.
Methods: We conducted a population-based case-cohort study of first invasive breast cancer diagnosed in white females from 1997-2009 in six NM counties, identified through Surveillance Epidemiology End Results (SEER). We selected 15% of breast cancer cases and all breast cancer deaths through 2012. After IRB approval, pathology reports and tissue microarrays served as sources of ER, PR, and Her2 information. Tumors were classified according to modified intrinsic subtypes based on immunohistochemistry. Data were analyzed using Cox proportional hazards models adapted for case-cohort with weighted estimates (cohort weighted by 6.67x), and estimated hazard ratios (HR) and 95% confidence intervals (CI) using the robust variance and alpha=.05. The proportional hazards assumption was verified by Schoenfeld residuals. All analyses were adjusted for age. Interaction was assessed by inclusion of main effects and a product term (subtype* exposure).
Results: ER and intrinsic subtype information was available for 76% of the cohort (867/1143) and 70% of breast cancer deaths (689/991). Median follow up was 7.8 years. In analyses stratified by intrinsic subtype, Hispanic women experienced elevated mortality relative to non-Hispanic whites for luminal A (HR 1.9;95% CI 1.4-2.6), Luminal B (HR 2.9;95% CI 1.5-5.7), and TN tumors (HR 1.9;95% CI 1.0-3.6) but not Her2+ER- disease (HR 1.1;95% 0.3-3.4).
Overall ER Quantitative measures: Among ER+ women, breast cancer mortality decreased with increasing ER+ staining, measured by percent (p-trend=.004) or quartile (p-trend=.002). After adjustment for ER percent(ER%+), women with increased ER intensity (score>2) had reduced mortality, relative to score=1 (HR 0.6;95% CI 0.4-.1.0). Results did not differ by Luminal A or B subtype (p interaction> .05).
Ethnicity-specific ER quantitative measures: ER%+ distribution did not differ by Hispanic ethnicity. However, among Hispanic women, interaction terms for ER%+ (p=.04) or quartile (p=.08) by subtype in relation to breast cancer survival suggest that Hispanic women with increasing ER staining have a reduced risk of mortality in Luminal A but not Luminal B tumors. Such differences were not evident among non-Hispanic white women. In multivariate models, inclusion of ER%+ and staining intensity did not alter Hispanic survival disparity overall, but mediated 8.6% in Luminal B.
Conclusion: After inclusion of ER%+, ER staining intensity is an independent risk factor for breast cancer survival. Differences in ER quantitative measures appear to account for only a small proportion of survival disparities. Survival gaps in ER+ breast cancer may be attributable to host or other tumor factors.Introduction: In New Mexico, Hispanic women have a 1.7-fold increased risk of breast cancer-specific death compared to non-Hispanic white women. In previous studies, race/ethnic minority women have had larger survival disparities in estrogen receptor positive (ER+) than ER- disease, suggesting some aspect of ER may mediate survival outcomes. We thus conducted an extensive assessment of ER quantitative measures.
Objective: To determine whether ER percent positive and intensity differs by ethnicity, and to evaluate whether that potential difference might account for a proportion of survival disparities.
Methods: We conducted a population-based case-cohort study of first invasive breast cancer diagnosed in white females from 1997-2009 in six NM counties, identified through Surveillance Epidemiology End Results (SEER). We selected 15% of breast cancer cases and all breast cancer deaths through 2012. After IRB approval, pathology reports and tissue microarrays served as sources of ER, PR, and Her2 information. Tumors were classified according to modified intrinsic subtypes based on immunohistochemistry. Data were analyzed using Cox proportional hazards models adapted for case-cohort with weighted estimates (cohort weighted by 6.67x), and estimated hazard ratios (HR) and 95% confidence intervals (CI) using the robust variance and alpha=.05. The proportional hazards assumption was verified by Schoenfeld residuals. All analyses were adjusted for age. Interaction was assessed by inclusion of main effects and a product term (subtype* exposure).
Results: ER and intrinsic subtype information was available for 76% of the cohort (867/1143) and 70% of breast cancer deaths (689/991). Median follow up was 7.8 years. In analyses stratified by intrinsic subtype, Hispanic women experienced elevated mortality relative to non-Hispanic whites for luminal A (HR 1.9;95% CI 1.4-2.6), Luminal B (HR 2.9;95% CI 1.5-5.7), and TN tumors (HR 1.9;95% CI 1.0-3.6) but not Her2+ER- disease (HR 1.1;95% 0.3-3.4).
Overall ER Quantitative measures: Among ER+ women, breast cancer mortality decreased with increasing ER+ staining, measured by percent (p-trend=.004) or quartile (p-trend=.002). After adjustment for ER percent(ER%+), women with increased ER intensity (score>2) had reduced mortality, relative to score=1 (HR 0.6;95% CI 0.4-.1.0). Results did not differ by Luminal A or B subtype (p interaction> .05).
Ethnicity-specific ER quantitative measures: ER%+ distribution did not differ by Hispanic ethnicity. However, among Hispanic women, interaction terms for ER%+ (p=.04) or quartile (p=.08) by subtype in relation to breast cancer survival suggest that Hispanic women with increasing ER staining have a reduced risk of mortality in Luminal A but not Luminal B tumors. Such differences were not evident among non-Hispanic white women. In multivariate models, inclusion of ER%+ and staining intensity did not alter Hispanic survival disparity overall, but mediated 8.6% in Luminal B.
Conclusion: After inclusion of ER%+, ER staining intensity is an independent risk factor for breast cancer survival. Differences in ER quantitative measures appear to account for only a small proportion of survival disparities. Survival gaps in ER+ breast cancer may be attributable to host or other tumor factors.
Citation Format: Hill D, Royce M, Lomo L, Barry M, Kang H, Wiggins C, Prossnitz E. Estrogen receptor quantitative measures and differences in breast cancer survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-10-08.
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Affiliation(s)
- D Hill
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
| | - M Royce
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
| | - L Lomo
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
| | - M Barry
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
| | - H Kang
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
| | - C Wiggins
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
| | - E Prossnitz
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
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Qian P, Barry M, Chik W, Thiagalingam A, Thomas S, Pouliopoulos J. Identification of Regional Subendocardial and Subepicardial Conduction in Ischaemic Scar: Insight from Transmural Plunge Needle Mapping. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Andres E, Barry M, Hundt A, Dini C, Corsini E, Gibbs S, Roggen EL, Ferret PJ. Preliminary performance data of the RHE/IL-18 assay performed on SkinEthic ™ RHE for the identification of contact sensitizers. Int J Cosmet Sci 2016; 39:121-132. [PMID: 27455141 DOI: 10.1111/ics.12355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/21/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the performances of the RHE/IL-18 assay using the SkinEthic™ RHE model for the identification of contact sensitizers. METHODS A set of 18 substances and mixtures was tested on this epidermal model, following the RHE/IL-18 protocol. The final results of the assay were obtained following 5 interpretation schemes, to determine the optimal prediction model for this assay with this specific test system. The data were analysed with a special focus on the basal level of IL-18 release and on the performance obtained with respect to three different gold standards: LLNA, HRIPT and an integrated reference, constructed from all available results. RESULTS No important differences were found in the performance levels depending on the three gold standards. The performances obtained with the SkinEthic™ RHE model support that this model may be considered as an alternative to different reconstructed epidermis models (EpiDERM™ , EpiCS™ and VUMC-EE) for the performance of RHE/IL-18 assays. CONCLUSION The prediction model to be used was refined, and more substances have to be tested in order to gather enough data for this evaluation and to determine the right criteria applicable for this assay using the SkinEthic™ RHE test system.
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Affiliation(s)
- E Andres
- Oroxcell, 102 Avenue Gaston Roussel, Romainville, 93230, France
| | - M Barry
- Oroxcell, 102 Avenue Gaston Roussel, Romainville, 93230, France
| | - A Hundt
- Oroxcell, 102 Avenue Gaston Roussel, Romainville, 93230, France
| | - C Dini
- Oroxcell, 102 Avenue Gaston Roussel, Romainville, 93230, France
| | - E Corsini
- Laboratory of Toxicology, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via G. Balzaretti, 9, 20133, Milan, Italy
| | - S Gibbs
- Department of Dermatology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.,Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam, t.a.v. dienst Afspraken & Informatie, University of Amsterdam and VU University, Postbus 7822, 1081 HV, Amsterdam, the Netherlands
| | - E L Roggen
- 3Rs Management & Consulting ApS, Asavaenget 14, 2800 Kongens, Lyngby, Denmark
| | - P-J Ferret
- Institut De Recherche Pierre Fabre, Recherche et Développement Pierre Fabre Dermo Cosmetique, 3 Avenue Hubert Curien, BP 13562, 31035, Toulouse, France
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Abstract
The treatment of any open fracture should follow a logical sequence extending from injury to final rehabilitation. In the past, open fractures were usually sustained in armed conflicts and treated by military surgeons. Currently, the majority of open fractures are sustained as the result of motor vehicle accidents, but the management principles developed in the past are the same. The initial treatment should start in the resuscitation room using trauma resuscitation protocols. Once the patient is stable and any immediately life-threatening injuries treated, the wound should be debrided as early as possible and the skeleton stabilized. The wound is re-inspected 48 h later, and at that stage plans for definitive soft tissue cover can be made. Once soft tissue cover has been obtained, rehabilitation of the whole patient can start. Delayed union or bone loss should be aggressively treated to limit functional deficit and subsequent morbidity.
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Affiliation(s)
- M Barry
- The Royal London Hospital, London E1 1BB, UK
| | - SPF Hughes
- Imperial College School of Medicine, Charing Cross Hospital, London W6, UK
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Hereth-Hébert E, Toure A, Sow M, Barry M, Etard J, Delaporte É. COL 8–04 - Complications ophtalmologiques de l’infection à virus Ebola. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30294-3] [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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Touré A, Sow M, Etard J, Keita A, Leroy S, Taverne B, Savane I, Barry M, Delaporte E. COL 8-05 - Séquelles liées au virus Ebola : résultats de la cohorte Postebogui. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30295-5] [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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Alshamsi A, Barry M, Murphy E, Corry C, Duffy T. AB0932 Frequency of Vertebral Fracture on Lateral Vertebral Assessment in Patients with Osteopenia Undergoing DXA Scanning. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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