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Holland C, Baker M, Bates A, Hughes C, Richmond PC, Carlson S, Moore HC. Parental awareness and attitudes towards prevention of respiratory syncytial virus in infants and young children in Australia. Acta Paediatr 2024; 113:786-794. [PMID: 38299226 DOI: 10.1111/apa.17127] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/07/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
AIM To assess parental awareness of respiratory syncytial virus (RSV) and the level of acceptance of future RSV prevention strategies. METHODS A cross-sectional online survey was implemented targeting "future" and "current" parents of children aged ≤5 years in Australia. RESULTS From 1992 eligible participants, two non-mutually exclusive subgroups were formed: "current" parents (N = 1931) and "pregnant/planning" parents (N = 464: 403 also "current" parents and 61 "future" parents). Participants were predominantly (86.6%) aged 25-39 years and 68.5% with university education. The majority (89.6% current; 78.7% future) had heard of RSV. Of those, 64.2% (current) and 50.0% (future) were aware that pneumonia is associated with RSV; 71.8% (current) and 52.1% (future) were aware that bronchiolitis is associated with RSV. In multivariable logistic regression analyses, Australian-born parents (aOR = 2.47 [95% CI: 1.48-4.12]), living in the eastern states (e.g., New South Wales: aOR = 6.15 [95% CI:2.10-18.04]), with a university-level education (aOR = 2.61 [95% CI:1.38-4.94]) and being a current parent (aOR = 12.26 [95% CI:2.82-53.28]) were associated with higher RSV awareness. There was a high level of acceptance for maternal vaccines (future: 79.3%) and infant immunisation (all: 81.7%). CONCLUSION While RSV awareness and immunisation acceptance were high, there was limited knowledge of severity of RSV, especially in future parents. Education campaigns need to be developed to increase RSV knowledge.
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Affiliation(s)
- Charlie Holland
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Megan Baker
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Amber Bates
- Tiny Sparks Western Australia, Perth, Western Australia, Australia
| | - Catherine Hughes
- The Immunisation Foundation of Australia, Sydney, New South Wales, Australia
| | - Peter C Richmond
- Discipline of Paediatrics, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Vaccine Trials Group, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia
- Department of Immunology, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Samantha Carlson
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Social Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Hannah C Moore
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
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Baker M, Eyre-Brook A, Gokaraju K, Jones V, Thyagarajan D, Ali A, Booker S. Non-operative management of terrible triad injuries of the elbow; not so terrible? Shoulder Elbow 2024; 16:200-205. [PMID: 38655413 PMCID: PMC11034474 DOI: 10.1177/17585732231190599] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 04/26/2024]
Abstract
Introduction Terrible triad injuries (TTIs) of the elbow have traditionally been reported to have poor outcomes, hence requiring surgical stabilisation. We identified and reviewed patients with TTIs treated non-operatively within our department. Methods We retrospectively reviewed patients with TTI treated non-operatively with standardised elbow-instability rehabilitation from 2010 to 2020. We used Mason and Morrey classifications for radial head and coronoid fractures, respectively. Non-operative indications included a congruent joint on CT, significant co-morbidities pre-disposing to high-risk surgery and/or patient preference. Outcomes included Oxford Elbow Score (OES), ROM and complications. Results Nineteen patients were included (mean age 49; 37% female). At an average of 6 years (range 2-11 years) post-treatment, mean OES was 46 ± 7. At last clinic review, mean 6 months (2-15), average ROM was 131 ± 11° flexion, 8 ± 10° extension, 85 ± 12° supination and 85 ± 13° pronation. One patient required arthrolysis and another had an incongruent ulnohumeral joint which developed clicking with a functional ROM. Conclusion Our report suggests non-operatively managed and appropriately rehabilitated TTI injuries can achieve good function and ROM. We recommend conservative management as a viable option in cases with joint congruency and no mechanical block in patients with significant co-morbidities or those refusing surgery but patients must be assessed on a case-by-case basis.
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Affiliation(s)
- Megan Baker
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - Alistair Eyre-Brook
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - Kishan Gokaraju
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - Valerie Jones
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - David Thyagarajan
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - Amjid Ali
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - Simon Booker
- Orthopaedic Department, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
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Yim H, Garrett PM, Baker M, Cha J, Sreekumar V, Dennis SJ. Examining dependencies among different time scales in episodic memory - an experience sampling study. Front Psychol 2024; 14:1277741. [PMID: 38274692 PMCID: PMC10808733 DOI: 10.3389/fpsyg.2023.1277741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
We re-examined whether different time scales such as week, day of week, and hour of day are independently used during memory retrieval as has been previously argued (i.e., independence of scales). To overcome the limitations of previous studies, we used experience sampling technology to obtain test stimuli that have higher ecological validity. We also used pointwise mutual information to directly calculate the degree of dependency between time scales in a formal way. Participants were provided with a smartphone and were asked to wear it around their neck for two weeks, which was equipped with an app that automatically collected time, images, GPS, audio and accelerometry. After a one-week retention interval, participants were presented with an image that was captured during their data collection phase, and were tested on their memory of when the event happened (i.e., week, day of week, and hour). We find that, in contrast to previous arguments, memories of different time scales were not retrieved independently. Moreover, through rendering recurrence plots of the images that the participants collected, we provide evidence the dependency may have originated from the repetitive events that the participants encountered in their daily life.
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Affiliation(s)
- Hyungwook Yim
- Department of Cognitive Sciences, Hanyang University, Seoul, Republic of Korea
| | - Paul M. Garrett
- School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Megan Baker
- School of Psychology, The University of Newcastle, Callaghan, NSW, Australia
| | - Jaehyuk Cha
- Department of Computer Science, Hanyang University, Seoul, Republic of Korea
| | - Vishnu Sreekumar
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India
| | - Simon J. Dennis
- School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Stevens Brentjens LBPM, Obukhova D, Delvoux B, den Hartog JE, Bui BN, Mol F, de Bruin JP, Besselink D, Teklenburg G, Morgan F, Baker M, Broekmans FJM, van Golde RJT, Zamani Esteki M, Romano A. Local production of 17β-oestradiol in the endometrium during the implantation window: a pilot study. Reprod Fertil 2023; 4:e230065. [PMID: 37962510 PMCID: PMC10762592 DOI: 10.1530/raf-23-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/14/2023] [Indexed: 11/15/2023] Open
Abstract
Graphical abstract Abstract Sex steroids are converted to bioactive metabolites and vice versa by endometrial steroid-metabolising enzymes. Studies indicate that alterations in this metabolism might affect endometrial receptivity. This pilot study determined whether the endometrial formation and inactivation of 17β-oestradiol differed between the supposedly embryo-receptive endometrium and non-receptive endometrium of women undergoing IVF/intracytoplasmic sperm injection (ICSI). Endometrial biopsies were obtained from IVF/ICSI patients 5-8 days after ovulation in a natural cycle, prior to their second IVF/ICSI cycle with fresh embryo transfer (ET). Endometrial biopsies from patients who achieved clinical pregnancy after fresh ET (n = 15) were compared with endometrial biopsies from patients that did not conceive after fresh ET (n = 15). Formation of 17β-oestradiol (oxidative 17β-hydroxysteroid dehydrogenases (HSDs)), oestrone (reductive HSD17Bs) and inhibition of HSD17B1 activity were determined by high-performance liquid chromatography. The endometrial transcriptome was profiled using RNA sequencing followed by principal component analysis and differentially expressed gene analysis. The false discovery rate-adjusted P < 0.05 and log fold change >0.5 were selected as the screening threshold. Formation and inactivation of 17β-oestradiol resulted similar between groups. Inhibition of HSD17B1 activity was significantly higher in the non-pregnant group when only primary infertile women (n = 12) were considered (27.1%, n = 5 vs 16.2%, n = 7, P = 0.04). Gene expression analysis confirmed the presence of HSD17B1 (encoding HSD17B1), HSD17B2 (encoding HSD17B2) and 33 of 46 analysed steroid metabolising enzymes in the endometrium. In the primary infertile subgroup (n = 10) 12 DEGs were found including LINC02349 which has been linked to implantation. However, the exact relationship between steroid-metabolising enzyme activity, expression and implantation outcome requires further investigation in larger, well-defined patient groups. Lay summary Sex hormones are produced and broken down by enzymes that can be found in the endometrium (the inner lining of the womb). This enzyme activity might influence the chances of becoming pregnant. We compared (i) enzyme activity in the endometrium of 15 women who did and 15 women who did not become pregnant in their second in vitro fertilisation attempt, (ii) how enzyme activity can be blocked by an inhibitor, and (iii) differences in gene expression (the process by which instructions in our DNA are converted into a product). Enzyme activity was similar between groups. We found that in women who have never been pregnant in the past, inhibition of enzyme activity was higher and found differences in a gene that has been linked to the implantation of the embryo, but future studies should be performed in larger, well-defined patient groups to confirm these findings.
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Affiliation(s)
- L B P M Stevens Brentjens
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
| | - D Obukhova
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - B Delvoux
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
| | - J E den Hartog
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
| | - B N Bui
- Department of Gynaecology & Reproductive Medicine, University Medical Centre Utrecht, Heidelberglaan, Utrecht, The Netherlands
| | - F Mol
- Centre for Reproductive Medicine, Reproduction and Development, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
| | - J P de Bruin
- Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, Henri Dunantstraat, Hertogenbosch, The Netherlands
| | - D Besselink
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Geert Grooteplein Zuid, Nijmegen, The Netherlands
| | - G Teklenburg
- Isala Fertility Clinic, Isala Hospital, Dokter van Heesweg, Zwolle, The Netherlands
| | - F Morgan
- Department of Complex Tissue Regeneration, MERLN Institute, Maastricht University, Maastricht, The Netherlands
| | - M Baker
- Department of Complex Tissue Regeneration, MERLN Institute, Maastricht University, Maastricht, The Netherlands
| | - F J M Broekmans
- Department of Gynaecology & Reproductive Medicine, University Medical Centre Utrecht, Heidelberglaan, Utrecht, The Netherlands
| | - R J T van Golde
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
| | - M Zamani Esteki
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention & Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - A Romano
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel, Maastricht, The Netherlands
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Shafi RMA, Pease ER, Romanowicz M, Baker M, Wakefield S, Morgan WS, Dell ML. The Importance of Sibling Relationships for Children in Foster Care. J Am Acad Psychiatry Law 2023:JAAPL.230029-23. [PMID: 37257906 DOI: 10.29158/jaapl.230029-23] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
There are approximately 500,000 children in the foster care system in the United States of America. With exposure to chronic and cumulative trauma, they constitute a population with an increased risk of developing mental health concerns and adverse outcomes in later life, including contact with the forensic system. Legislative frameworks that have been developed to facilitate improved outcomes are outlined, although these vary between states, and the focus is often on the parental relationship. Several studies have emphasized the importance of sibling relationships and that placing siblings in the same foster home is associated with higher rates of placement stability, reunification, adoption and guardianship, and fostering positive sibling relations. The multifaceted role of the clinician in promoting recovery from trauma, enhancing resiliency, and thoughtfully prescribing and advocating for familial relationships is discussed.
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Affiliation(s)
- R M A Shafi
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Eric R Pease
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Magdalena Romanowicz
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Megan Baker
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Sarah Wakefield
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Wynne S Morgan
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Mary Lynn Dell
- Dr. Shafi is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN, and Consultant Psychiatrist, Department of Psychiatry, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia. Dr. Pease is Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Romanowicz is Child and Adolescent Fellowship Director, and Assistant Professor of Psychiatry, Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN. Dr. Baker is Consultant Child and Adolescent Psychiatrist, Momentum for Health, San Jose, CA. Dr. Wakefield is Department Chair of Psychiatry, Director of Child and Adolescent Psychiatry Services, Texas Tech University Health Sciences Center, Lubbock, TX. Dr. Morgan is Assistant Professor of Psychiatry, UMass Chan Medical School, Department of Psychiatry, Worcester MA. Dr. Dell is Division Chief of Child and Adolescent Psychiatry, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA.
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Perez A, Linden H, Johnson N, Diab S, Jani C, Gawryletz CD, Fine R, Lawson L, Baker M, Poillucci V, Blumencranz LE, Audeh W. Abstract OT2-05-01: FLEX: 30K Full Transcriptome, Real-World Evidence Database for Early-Stage Breast Cancer, and Investigator-Initiated Protocols. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-ot2-05-01] [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: 03/06/2023]
Abstract
Abstract
FLEX: 30K Full Transcriptome, Real-World Evidence Database for Early-Stage Breast Cancer, and Investigator-Initiated Protocols BACKGROUND: Genomic signatures, such as the 70-gene MammaPrint, provide additional prognostic information for early-stage breast cancer (EBC), such as tumor metastatic potential, and expand the available information clinicians and patients require for shared treatment decision making beyond the standard clinicopathologic factors. EBC tumors are further stratified into clinically actionable subtypes by molecular assays such as the 80-gene molecular profiling assay BluePrint, improving pathological complete response rates (pCR) and outcomes as evidenced by a number of recent trials. The ongoing FLEX Study (NCT03053193) is designed to expand the genomic information available for EBC cases, and to increase the speed of data generation for rare and underserved research areas. To date, FLEX is the largest international multicenter real-world evidence (RWE) EBC registry, with more than 10,000 patients enrolled in fewer than five years since opening. FLEX pairs full genome data with more than 800 clinical data points collected over 10 years of follow up to provide the most comprehensive big data database available for early-stage breast cancer. The FLEX enrollment has a goal of a minimum of 30,000 patients within 10 years. METHODS: The FLEX study is a multicenter, prospective, observational trial for patients ≥18 years old with histologically proven stage I-III invasive breast cancer that is node negative or positive (up to three nodes) who receive MammaPrint, with or without BluePrint as standard of care management. Patients consent to the collection of clinically annotated full transcriptome data. Additionally, this study protocol allows physicians to investigate targeted populations or clinical trial investigator-initiated studies (IIS) upon approval by a peer-driven Scientific Review Committee. As patients enrolled in the FLEX study meet all eligibility criteria for inclusion no additional consent is required. The FLEX enrollment has already surpassed 1/3 of set target goal. As of April 2022, the trial has surpassed 10,000 patients enrolled at nearly 100 trial sites across the US and Europe, Middle East and Africa (EMEA). To date, there have been 36 publications in international scientific congresses with 39 FLEX IIS and in progress. With over 250 active and collaborating physicians leveraging the shared infrastructure, the IIS have enabled the ability to address disparities in treatment to underrepresented populations, rare subtypes, age, and patient centered specific topics. Current and future questions investigated via this platform will continue to strive to improve outcomes for early-stage breast cancer patients.
Citation Format: Alejandra Perez, Hannah Linden, Nathalie Johnson, Sami Diab, Chirag Jani, Chelsea D. Gawryletz, Richard Fine, Laura Lawson, Megan Baker, Victoria Poillucci, Lisa E. Blumencranz, William Audeh. FLEX: 30K Full Transcriptome, Real-World Evidence Database for Early-Stage Breast Cancer, and Investigator-Initiated Protocols [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-05-01.
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Affiliation(s)
| | - Hannah Linden
- 2University of Washington, Fred Hutchison Cancer Center, Seattle, Washington, USA
| | | | - Sami Diab
- 4Rocky Mountain Cancer Center, Littleton, Colorado
| | | | | | | | | | - Megan Baker
- 9Roper St. Francis Health, Mount Pleasant, South Carolina
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Madhavan M, Ritchie AJ, Aboagye J, Jenkin D, Provstgaad-Morys S, Tarbet I, Woods D, Davies S, Baker M, Platt A, Flaxman A, Smith H, Belij-Rammerstorfer S, Wilkins D, Kelly EJ, Villafana T, Green JA, Poulton I, Lambe T, Hill AVS, Ewer KJ, Douglas AD. Tolerability and immunogenicity of an intranasally-administered adenovirus-vectored COVID-19 vaccine: An open-label partially-randomised ascending dose phase I trial. EBioMedicine 2022; 85:104298. [PMID: 36229342 PMCID: PMC9550199 DOI: 10.1016/j.ebiom.2022.104298] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/08/2022] [Accepted: 09/16/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Intranasal vaccination may induce protective local and systemic immune responses against respiratory pathogens. A number of intranasal SARS-CoV-2 vaccine candidates have achieved protection in pre-clinical challenge models, including ChAdOx1 nCoV-19 (AZD1222, University of Oxford / AstraZeneca). METHODS We performed a single-centre open-label Phase I clinical trial of intranasal vaccination with ChAdOx1 nCoV-19 in healthy adults, using the existing formulation produced for intramuscular administration. Thirty SARS-CoV-2 vaccine-naïve participants were allocated to receive 5 × 109 viral particles (VP, n=6), 2 × 1010 VP (n=12), or 5 × 1010 VP (n=12). Fourteen received second intranasal doses 28 days later. A further 12 received non-study intramuscular mRNA SARS-CoV-2 vaccination between study days 22 and 46. To investigate intranasal ChAdOx1 nCoV-19 as a booster, six participants who had previously received two intramuscular doses of ChAdOx1 nCoV-19 and six who had received two intramuscular doses of BNT162b2 (Pfizer / BioNTech) were given a single intranasal dose of 5 × 1010 VP of ChAdOx1 nCoV-19. Objectives were to assess safety (primary) and mucosal antibody responses (secondary). FINDINGS Reactogenicity was mild or moderate. Antigen-specific mucosal antibody responses to intranasal vaccination were detectable in a minority of participants, rarely exceeding levels seen after SARS-CoV-2 infection. Systemic responses to intranasal vaccination were typically weaker than after intramuscular vaccination with ChAdOx1 nCoV-19. Antigen-specific mucosal antibody was detectable in participants who received an intramuscular mRNA vaccine after intranasal vaccination. Seven participants developed symptomatic SARS-CoV-2 infection. INTERPRETATION This formulation of intranasal ChAdOx1 nCoV-19 showed an acceptable tolerability profile but induced neither a consistent mucosal antibody response nor a strong systemic response. FUNDING AstraZeneca.
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Affiliation(s)
- Meera Madhavan
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK
| | - Adam J Ritchie
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Jeremy Aboagye
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Daniel Jenkin
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK
| | - Samuel Provstgaad-Morys
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Iona Tarbet
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Danielle Woods
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Sophie Davies
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Megan Baker
- Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK
| | - Abigail Platt
- Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK
| | - Amy Flaxman
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Holly Smith
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | | | - Deidre Wilkins
- Translational Medicine, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, 1 Medimmune Way, Gaithersburg, MD 20878, USA
| | - Elizabeth J Kelly
- Translational Medicine, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, 1 Medimmune Way, Gaithersburg, MD 20878, USA
| | - Tonya Villafana
- Clinical Development, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Justin A Green
- Clinical Development, Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Ian Poulton
- Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK
| | - Teresa Lambe
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK; Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK; China Academy of Medical Sciences Oxford Institute, University of Oxford, NDM Research Building, Old Road Campus, Headington, Oxford OX3 7FZ, UK
| | - Adrian V S Hill
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Katie J Ewer
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK
| | - Alexander D Douglas
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7BN, UK.
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Lemmon MT, Smith MD, Viudez‐Moreiras D, de la Torre‐Juarez M, Vicente‐Retortillo A, Munguira A, Sanchez‐Lavega A, Hueso R, Martinez G, Chide B, Sullivan R, Toledo D, Tamppari L, Bertrand T, Bell JF, Newman C, Baker M, Banfield D, Rodriguez‐Manfredi JA, Maki JN, Apestigue V. Dust, Sand, and Winds Within an Active Martian Storm in Jezero Crater. Geophys Res Lett 2022; 49:e2022GL100126. [PMID: 36245893 PMCID: PMC9540647 DOI: 10.1029/2022gl100126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
Rovers and landers on Mars have experienced local, regional, and planetary-scale dust storms. However, in situ documentation of active lifting within storms has remained elusive. Over 5-11 January 2022 (LS 153°-156°), a dust storm passed over the Perseverance rover site. Peak visible optical depth was ∼2, and visibility across the crater was briefly reduced. Pressure amplitudes and temperatures responded to the storm. Winds up to 20 m s-1 rotated around the site before the wind sensor was damaged. The rover imaged 21 dust-lifting events-gusts and dust devils-in one 25-min period, and at least three events mobilized sediment near the rover. Rover tracks and drill cuttings were extensively modified, and debris was moved onto the rover deck. Migration of small ripples was seen, but there was no large-scale change in undisturbed areas. This work presents an overview of observations and initial results from the study of the storm.
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Affiliation(s)
| | - M. D. Smith
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | | | | | | | - A. Munguira
- Física Aplicada, Escuela de Ingeniería de BilbaoUPV/EHUBilbaoSpain
| | | | - R. Hueso
- Física Aplicada, Escuela de Ingeniería de BilbaoUPV/EHUBilbaoSpain
| | | | - B. Chide
- Space and Planetary Exploration TeamLos Alamos National LaboratoryLos AlamosNMUSA
| | | | - D. Toledo
- Instituto Nacional de Técnica AerospacialMadridSpain
| | - L. Tamppari
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | | | | | | | - M. Baker
- Smithsonian National Air and Space MuseumWashingtonDCUSA
| | | | | | - J. N. Maki
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - V. Apestigue
- Instituto Nacional de Técnica AerospacialMadridSpain
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9
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Baker M. Accessing the electronic structure and magnetism of linearly coordinated transition metal dopants with X-ray dichroism and resonant inelastic scattering. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322095572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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10
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Salkeld J, Themistocleous Y, Barrett JR, Mitton CH, Rawlinson TA, Payne RO, Hou MM, Khozoee B, Edwards NJ, Nielsen CM, Sandoval DM, Bach FA, Nahrendorf W, Ramon RL, Baker M, Ramos-Lopez F, Folegatti PM, Quinkert D, Ellis KJ, Poulton ID, Lawrie AM, Cho JS, Nugent FL, Spence PJ, Silk SE, Draper SJ, Minassian AM. Repeat controlled human malaria infection of healthy UK adults with blood-stage Plasmodium falciparum: Safety and parasite growth dynamics. Front Immunol 2022; 13:984323. [PMID: 36072606 PMCID: PMC9444061 DOI: 10.3389/fimmu.2022.984323] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
In endemic settings it is known that natural malaria immunity is gradually acquired following repeated exposures. Here we sought to assess whether similar acquisition of blood-stage malaria immunity would occur following repeated parasite exposure by controlled human malaria infection (CHMI). We report the findings of repeat homologous blood-stage Plasmodium falciparum (3D7 clone) CHMI studies VAC063C (ClinicalTrials.gov NCT03906474) and VAC063 (ClinicalTrials.gov NCT02927145). In total, 24 healthy, unvaccinated, malaria-naïve UK adult participants underwent primary CHMI followed by drug treatment. Ten of these then underwent secondary CHMI in the same manner, and then six of these underwent a final tertiary CHMI. As with primary CHMI, malaria symptoms were common following secondary and tertiary infection, however, most resolved within a few days of treatment and there were no long term sequelae or serious adverse events related to CHMI. Despite detectable induction and boosting of anti-merozoite serum IgG antibody responses following each round of CHMI, there was no clear evidence of anti-parasite immunity (manifest as reduced parasite growth in vivo) conferred by repeated challenge with the homologous parasite in the majority of volunteers. However, three volunteers showed some variation in parasite growth dynamics in vivo following repeat CHMI that were either modest or short-lived. We also observed no major differences in clinical symptoms or laboratory markers of infection across the primary, secondary and tertiary challenges. However, there was a trend to more severe pyrexia after primary CHMI and the absence of a detectable transaminitis post-treatment following secondary and tertiary infection. We hypothesize that this could represent the initial induction of clinical immunity. Repeat homologous blood-stage CHMI is thus safe and provides a model with the potential to further the understanding of naturally acquired immunity to blood-stage infection in a highly controlled setting.
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Affiliation(s)
- Jo Salkeld
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Jordan R. Barrett
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Celia H. Mitton
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Ruth O. Payne
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Mimi M. Hou
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Baktash Khozoee
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Nick J. Edwards
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Carolyn M. Nielsen
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Diana Muñoz Sandoval
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Florian A. Bach
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Wiebke Nahrendorf
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Megan Baker
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | | | - Doris Quinkert
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Ian D. Poulton
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Alison M. Lawrie
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Jee-Sun Cho
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Fay L. Nugent
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Philip J. Spence
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah E. Silk
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Simon J. Draper
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Angela M. Minassian
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
- *Correspondence: Angela M. Minassian,
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11
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Peterfy C, Corominas H, De Agustin JJ, Perez-Garcia C, Lopez Lasanta M, Borrell Paños H, Reina-Sanz D, Sanmartí R, Narváez J, Narvaez JA, Sharma V, Alataris K, Genovese MC, Baker M, Marsal S. AB0398 AURICULAR TRANSCUTANEOUS HI-FREQUENCY E-MMUNOTHERAPY SEQUENCES (ATHENS) FOR THE TREATMENT OF RHEUMATOID ARTHRITIS: 1-YEAR CHANGES IN SYNOVITIS, OSTEITIS, AND BONE EROSION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1809] [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
BackgroundCurrent pharmacological treatments remain inadequate for a significant proportion of patients with rheumatoid arthritis (RA), and thus alternative treatment approaches are needed. Prior results from the first 12 weeks of a proof-of-concept (POC) study showed that ATHENS, a non-invasive high-frequency vagus nerve therapy, was well-tolerated with meaningful reductions in RA disease severity as measured by the American College of Rheumatology response criteria (ACR) and the Disease Activity Score using 28 joints (DAS28)[1].ObjectivesThe current analysis assessed long-term changes (52 weeks total follow-up) in disease activity as measured by ACR, DAS28, and the following MRI-assessed changes: synovitis, osteitis, bone erosion, and cartilage loss.MethodsFollowing the completion of the 12-week POC study, patients achieving a reduction in DAS28-CRP of ≥1.2 were given the option to enroll in the 9-month open-label extension (OLE) study. During the extension phase, patients were to use the wearable device for 15 minutes per day. Adjustment of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biologic disease-modifying antirheumatic drugs (bDMARDs) were allowed during the OLE. Changes from baseline were assessed at 12 weeks (end of initial POC) and 52 weeks (end of the OLE). Structural damage and disease progression were evaluated by standardized MRI of the wrist and hand, with and without intravenous gadolinium-based contrast. MRIs were evaluated by two independent, central readers, blinded to clinical information and visit-order of the images, and were scored for synovitis, osteitis and bone erosion using the OMERACT-RAMRIS method. Cartilage loss was also determined using the 9-point cartilage loss scale (CARLOS).ResultsTwenty-seven of 30 patients completed the initial 12-week study, of whom 19 consented and entered the OLE. Of those 19 patients, 4 (21%) discontinued due to lack of efficacy, while the remaining 15 completed the 9-month extension. Due to the COVID-19 pandemic, 7 patients were unable to complete a 52-week MRI scan; MRI evaluations at baseline, 12 weeks, and 52 weeks were available for 8 patients.DAS28-CRP mean (standard deviation [SD]) change from baseline was -1.78 (1.01) at 12 weeks (n=19; p<0.0001) and -2.30 (1.22) at 52 weeks (n=15; p<0.0001). ACR20, ACR50, and ACR70 response rates were 68%, 42%, and 21% at 52 weeks (n=19; discontinued participants were deemed non-responders). MRI analysis of synovitis, osteitis, bone erosion, and cartilage loss showed no evidence of disease progression through 52 weeks compared with baseline (Table 1).Table 1.Change in MRI OMERACT-RAMRIS from baseline to week 52ScoreBaseline (n=8)Week 12 (n=8)Week 52 (n=8)Change Week 12 vs BL (n=8)Change Week 52 vs BL (n=8)CARLOS, mean (SD)3.9 (5.6)3.9 (5.6)3.9 (5.6)0.0 (0.0)0.0 (0.0)Erosion, mean (SD)10.8 (10.3)10.5 (10.3)10.6 (10.3)-0.3 (0.4)-0.1 (0.8)Osteitis, mean (SD)2.8 (4.1)2.3 (3.7)1.0 (1.1)-0.5 (1.1)-1.8 (3.1)Synovitis, mean (SD)4.0 (4.2)4.1 (4.7)3.3 (4.0)0.1 (0.6)-0.7 (1.0)CARLOS = Cartilage loss score; OMERACT = Outcome Measures in Rheumatology; RAMRIS = Rheumatoid Arthritis Magnetic Resonance Imaging Scoring SystemDuring the 9-month extension study, two new adverse events were reported (cornea transplant and right hand dysesthesia) in 2 (11%) patients; neither was treatment-related and both resolved without intervention. No serious adverse events were reported.ConclusionIn patients with an initial treatment response to the Nēsos ATHENS therapy in the 12-week POC study, reductions in DAS28-CRP were sustained through 52 weeks. Although results should be interpreted cautiously given the small sample size and lack of control arm, MRI evaluation of synovitis, osteitis, bone erosion, and cartilage loss suggested no disease progression.References[1]Marsal, S., The Lancet Rheumatology, 2021. 3(4): p. e262-e269.Disclosure of InterestsCharles Peterfy Consultant of: Nesos Corp, Employee of: Spire Sciences, Héctor Corominas: None declared, Juan Jose de Agustin: None declared, Carolina Perez-Garcia: None declared, Maria Lopez Lasanta: None declared, Helena Borrell Paños: None declared, D Reina-Sanz: None declared, Raimón Sanmartí: None declared, J. Narváez: None declared, Jose Antonio Narvaez: None declared, Vivek Sharma Shareholder of: Nesos Corp., Employee of: Nesos Corp., Konstantinos Alataris Shareholder of: Nesos Corp., Employee of: Nesos Corp., Mark C. Genovese Shareholder of: Nesos Corp. and Gilead, Employee of: Gilead, Matthew Baker Shareholder of: Nesos Corp., Consultant of: Nesos Corp., Sara Marsal Consultant of: Nesos, Pfizer, Sandoz, Novartis, Gilead, Grant/research support from: Nesos, BMS, Celgene, Merck Sharp and Dohme, Pfizer, Sandoz, Novartis, Sanofi, Janssen, Union Chimique Belge Pharma
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12
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Baker M, Birkin E, Pochiraju R, Rochell D, Marshall C. An electronic naso-gastric tube pathway, incorporating a clinical decision support tool, improves patient safety and reporting. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Ballanamada Appaiah N, Probert S, Boyle K, Rogers D, Stewart J, Baker M. 143 Intestinal Failure: Epidemiology, Catheter Related Sepsis and Challenges. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.083] [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: 11/14/2022]
Abstract
Abstract
Background
The aforementioned service provides specialist intestinal failure care to patients in Leicestershire and surrounding counties.
Aim
To study the epidemiology of IF cases referred to the service & review outcomes particularly the indications and delivery of parenteral nutrition (PN). To review catheter-related sepsis (CRS) rates and identify areas for improvement.
Method
Service data from January 2016 to November 2017 was analysed retrospectively. Descriptive and inferential statistical analysis was carried out. Chi-square/ Fisher Exact tests were used to identify significance on categorical data and non-parametric settling was used for qualitative data analysis.
Results
365 patients were referred to the service from January 2016 to November 2017. 58% patients had grade I intestinal failure. 34% and 24% referrals were made by the colorectal and hepato-pancreato-biliary (HPB) units respectively. Gut rest (27%) and bowel obstruction (25%) were the most common indications for nutritional support. Duration of PN requirements varied greatly, but most patients (39%) patients required it for up to 7 days. Single lumen PICC line (64%) and cephalic vein (54%) were the most commonly used catheter and site of vascular access respectively. Chronicity of IF and number of vascular catheters required to provide PN were significantly associated with rates of CRS.
Conclusions
CRS was found to be statistically significantly associated with chronic IF and number of vascular access catheters required to provide PN. Cost implication and morbidity of CRS could be analysed further to identify other ways to provide safer and cost-efficient parental nutrition for patients with intestinal failure.
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Affiliation(s)
| | - S. Probert
- Basildon & Thurrock Univeristy Hospital, Basildon, United Kingdom
| | - K. Boyle
- Leicester Royal Infirmary, Leicester, United Kingdom
| | - D. Rogers
- Leicester Royal Infirmary, Leicester, United Kingdom
| | - J. Stewart
- Leicester Royal Infirmary, Leicester, United Kingdom
| | - M. Baker
- Leicester Royal Infirmary, Leicester, United Kingdom
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14
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Hollings M, Mavros Y, Kay S, Anderberg K, Baker M, Wang Y, Zhao R, Meiklejohn J, Climstein M, O'Sullivan A, De Vos N, Baune B, Blair S, Simar D, Singh N, Fiatarone Singh M. Metformin Impairs the Cardiorespiratory Fitness Adaptation to High-Intensity Power Training in Older Adults With Type 2 Diabetes: Results From the GREAT2DO Randomised Controlled Trial. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.010] [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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15
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Hollings M, Mavros Y, Sharma P, Kay S, Anderberg K, Baker M, Wang Y, Zhao R, Meiklejohn J, Climstein M, O'Sullivan A, De Vos N, Baune B, Blair S, Singh N, Fiatarone Singh M. High Intensity Power Training Improves Ambulatory Blood Pressure for Hypertensive Older Adults With Type 2 Diabetes: Results From the GREAT2DO Randomised Controlled Trial. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Zhang - DUPLICATE S, Baker M. M244 POMEGRANATE SEED ALLERGY IN A TREE NUT-ALLERGIC CHILD. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Duggins M, Shah R, Baker M, Marget M, Oxford M, Hoyt A. P001 ALLERGISTS LEAD ANAPHYLAXIS PREPAREDNESS VIRTUAL WORKSHOPS FOR EARLY CHILDHOOD PROFESSIONALS AMIDST THE COVID-19 PANDEMIC. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.057] [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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18
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Lumley E, Perin G, Baker M, Hanton A, Mahendran A, Saha A. EP.TU.157Can Twitter Attention Predict Citation Metrics? A Machine Learning Aided Analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab311.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
Surgical journals have developed social media profiles to increase engagement though it remains unclear as to whether social media attention indices for publications act as a surrogate or predictor of traditional citation metrics. This study used machine learning to determine if there is a relationship between Twitter mentions and number of citations for surgical publications.
Methods
We identified all original research and review papers published in Annals of Surgery, BJS and JAMA Surgery in 2019. Citations data and Twitter mentions were retrieved and the Spearman rank coefficient was used to determine degree of correlation between the two variables. An unsupervised machine-learning hierarchical clustering algorithm was used to define clusters of outlying papers. Quantitative and qualitative analysis of the clusters was completed.
Results
413 papers were selected. Median number of citations was 7 (IQR 3-14), median number of Twitter mentions was 40 (IQR 15-79). No correlation between Twitter mentions and number of citations was observed (Spearman’s rho 0.076 p-value 0.124). Cluster analysis identified one large (cluster 2, 367/413 papers) and six small clusters. Analysis of cluster 2 revealed a weak but significant correlation between citations and Twitter mentions (Spearman’s rho 0.107 p-value 0.041). The remaining six clusters were characterised by an out of proportion number of Twitter mentions compared to citations or vice versa.
Conclusions
Twitter mentions should not be used as a surrogate or predictor of traditional citation metrics. In our database the relationship between social media attention and citations was skewed by a small number of outlying papers.
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Affiliation(s)
- Emma Lumley
- Calderdale and Huddersfield NHS Foundation Trust
| | | | - Megan Baker
- Calderdale and Huddersfield NHS Foundation Trust
| | - Alice Hanton
- Calderdale and Huddersfield NHS Foundation Trust
| | | | - Arin Saha
- Calderdale and Huddersfield NHS Foundation Trust
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Mahendran A, Perin G, Baker M, Hanton A, Lumley E, Saha A. SP2.2.3How to make the perfect tweet: exploring factors which affect retweetability of surgical research. Br J Surg 2021. [DOI: 10.1093/bjs/znab361.040] [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: 11/14/2022]
Abstract
Abstract
Aims
Twitter is a powerful platform for sharing information. Retweets allow users to reach a wider audience quickly. Our aim was to determine what tweet and twitter-account related factors affect the “retweetability” of surgical publications.
Methods
All papers published (in print) in Annals of Surgery, BJS and JAMASurgery in 2019 were selected. We identified each paper’s first appearance on Twitter and analysed characteristics of the posting twitter account and the tweet itself. The association between such characteristics and the number of retweets was investigated.
Results
413 papers were selected. Median number of retweets was 3 (range, 0-121). The first tweet created about a paper was usually from a reader (42%) with only a minority created by the journal (17%) or the authors (20%).
Use of visual abstracts (22/413, p<0.001), pictures (145/413, p<0.001), hashtags (149/413, p<0.001), mentions (183/413, p<0.001), number of followers (p < 0.001), age of twitter account (p = 0.003) and authors as creators of the first tweet (p < 0.001) were associated with higher retweets. When the journal created the first tweet, retweets were also increased (P < 0.001). Posting the title of the paper alone attracted fewer retweets (p < 0.001).
Multivariate analysis confirmed visual abstracts (p < 0.001), hashtags (p=p.008), pictures (p < 0.001) and authors as creators of the first tweet (p < 0.001) were predictive of increased retweetability.
Conclusions
Authors and journals should create the first presence on social media to improve engagement with their papers. Such tweets should use visual abstracts or pictures, relevant hashtags and avoid solely posting the paper title to make their research more widely shared.
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Affiliation(s)
| | | | - Megan Baker
- Calderdale & Huddersfield Hospitals Foundation Trust
| | - Alice Hanton
- Calderdale & Huddersfield Hospitals Foundation Trust
| | - Emma Lumley
- Calderdale & Huddersfield Hospitals Foundation Trust
| | - Arin Saha
- Calderdale & Huddersfield Hospitals Foundation Trust
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20
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Baker M, Hanton A, Perin G, Lumley E, Mahendran A, Saha A. EP.WE.372Has COVID-19 affected the attention surgical papers are receiving? Br J Surg 2021. [DOI: 10.1093/bjs/znab308.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Unsurprisingly, much of the medical profession has focussed on treating covid-19 over the past year often to the detriment of other pathologies. Engagement with academic literature may follow a similar trend; this paper used standard social media attention and citations metrices to assess whether the pandemic has affected engagement with surgical literature.
Method
Twitter Mentions and Mendeley Readers Data were retrieved for all papers published in Annals of Surgery, BJS and JAMASurgery between January 2019 and October 2020. The non-parametric Mann-Whitney U test was used to compare Twitter Mentions and Mendeley Readers for COVID surgical vs non-COVID surgical publications (in 2020) and all surgical papers published before and after the advent of COVID-19. A control database of all papers published in NEJM, BMJ and Lancet over the same period of time was also created.
Results
There was no difference in Twitter mentions between COVID-19 and non-COVID-19 papers (p-value 0.604); however there were significantly more Mendeley readers of COVID-19 papers than non-COVID-19 papers in 2020 (55 vs 5 median readers, p < 0.001). Surgical papers published in 2020 received significantly fewer Twitter mentions than those published in 2019 (15.5 vs 27, p < 0.001).
Analysis of the non-surgical control dataset revealed the opposite trend; papers published in 2020 received significantly more attention than those published in 2019 (39 vs 30 median Twitter citations, p < 0.001).
Conclusion
Surgical papers published during the COVID-19 pandemic received significantly fewer social media mentions. Such reduced visibility has the potential to affect future citation metrics and dissemination of surgical knowledge
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Affiliation(s)
- Megan Baker
- Calderdale & Huddersfield Hospitals Foundation Trust
| | - Alice Hanton
- Calderdale & Huddersfield Hospitals Foundation Trust
| | | | - Emma Lumley
- Calderdale & Huddersfield Hospitals Foundation Trust
| | | | - Arin Saha
- Calderdale & Huddersfield Hospitals Foundation Trust
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Minassian AM, Themistocleous Y, Silk SE, Barrett JR, Kemp A, Quinkert D, Nielsen CM, Edwards NJ, Rawlinson TA, Ramos Lopez F, Roobsoong W, Ellis KJ, Cho JS, Aunin E, Otto TD, Reid AJ, Bach FA, Labbé GM, Poulton ID, Marini A, Zaric M, Mulatier M, Lopez Ramon R, Baker M, Mitton CH, Sousa JC, Rachaphaew N, Kumpitak C, Maneechai N, Suansomjit C, Piteekan T, Hou MM, Khozoee B, McHugh K, Roberts DJ, Lawrie AM, Blagborough AM, Nugent FL, Taylor IJ, Johnson KJ, Spence PJ, Sattabongkot J, Biswas S, Rayner JC, Draper SJ. Controlled human malaria infection with a clone of Plasmodium vivax with high quality genome assembly. JCI Insight 2021; 6:152465. [PMID: 34609964 PMCID: PMC8675201 DOI: 10.1172/jci.insight.152465] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Controlled human malaria infection (CHMI) provides a highly informative means to investigate host-pathogen interactions and enable in vivo proof-of-concept efficacy testing of new drugs and vaccines. However, unlike Plasmodium falciparum, well-characterized P. vivax parasites that are safe and suitable for use in modern CHMI models are limited. Here, two healthy malaria-naïve UK adults with universal donor blood group were safely infected with a clone of P. vivax from Thailand by mosquito-bite CHMI. Parasitemia developed in both volunteers and, prior to treatment, each volunteer donated blood to produce a cryopreserved stabilate of infected red blood cells. Following stringent safety screening, the parasite stabilate from one of these donors ("PvW1") was thawed and used to inoculate six healthy malaria-naïve UK adults by blood-stage CHMI, at three different dilutions. Parasitemia developed in all volunteers, who were then successfully drug treated. PvW1 parasite DNA was isolated and sequenced to produce a high quality genome assembly by using a hybrid assembly method. We analysed leading vaccine candidate antigens and multigene families, including the Vivax interspersed repeat (VIR) genes of which we identified 1145 in the PvW1 genome. Our genomic analysis will guide future assessment of candidate vaccines and drugs, as well as experimental medicine studies.
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Affiliation(s)
| | | | - Sarah E Silk
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Jordan R Barrett
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Alison Kemp
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Doris Quinkert
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Nick J Edwards
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | - Jee-Sun Cho
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Eerik Aunin
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, United Kingdom
| | - Thomas D Otto
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, United Kingdom
| | - Adam J Reid
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, United Kingdom
| | - Florian A Bach
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Ian D Poulton
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Arianna Marini
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Marija Zaric
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Margaux Mulatier
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Megan Baker
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Celia H Mitton
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Jason C Sousa
- Experimental Therapeutics Branch, Walter Reed Army Institute of Research, Maryland, United States of America
| | | | | | | | | | - Tianrat Piteekan
- Mahidol Vivax Research Unit, Mahidol University, Bangkok, Thailand
| | - Mimi M Hou
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Baktash Khozoee
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Kirsty McHugh
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - David J Roberts
- Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, United Kingdom
| | - Alison M Lawrie
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Fay L Nugent
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Iona J Taylor
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Philip J Spence
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Sumi Biswas
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Julian C Rayner
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Simon J Draper
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
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22
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de Graaf H, Payne RO, Taylor I, Miura K, Long CA, Elias SC, Zaric M, Minassian AM, Silk SE, Li L, Poulton ID, Baker M, Draper SJ, Gbesemete D, Brendish NJ, Martins F, Marini A, Mekhaiel D, Edwards NJ, Roberts R, Vekemans J, Moyle S, Faust SN, Berrie E, Lawrie AM, Hill F, Hill AVS, Biswas S. Safety and Immunogenicity of ChAd63/MVA Pfs25-IMX313 in a Phase I First-in-Human Trial. Front Immunol 2021; 12:694759. [PMID: 34335606 PMCID: PMC8318801 DOI: 10.3389/fimmu.2021.694759] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Transmission blocking vaccines targeting the sexual-stages of the malaria parasite could play a major role to achieve elimination and eradication of malaria. The Plasmodium falciparum Pfs25 protein (Pfs25) is the most clinically advanced candidate sexual-stage antigen. IMX313, a complement inhibitor C4b-binding protein that forms heptamers with the antigen fused to it, improve antibody responses. This is the first time that viral vectors have been used to induce antibodies in humans against an antigen that is expressed only in the mosquito vector. Methods Clinical trial looking at safety and immunogenicity of two recombinant viral vectored vaccines encoding Pfs25-IMX313 in healthy malaria-naive adults. Replication-deficient chimpanzee adenovirus serotype 63 (ChAd63) and the attenuated orthopoxvirus modified vaccinia virus Ankara (MVA), encoding Pfs25-IMX313, were delivered by the intramuscular route in a heterologous prime-boost regimen using an 8-week interval. Safety data and samples for immunogenicity assays were taken at various time-points. Results The reactogenicity of the vaccines was similar to that seen in previous trials using the same viral vectors encoding other antigens. The vaccines were immunogenic and induced both antibody and T cell responses against Pfs25, but significant transmission reducing activity (TRA) was not observed in most volunteers by standard membrane feeding assay. Conclusion Both vaccines were well tolerated and demonstrated a favorable safety profile in malaria-naive adults. However, the transmission reducing activity of the antibodies generated were weak, suggesting the need for an alternative vaccine formulation. Trial Registration Clinicaltrials.gov NCT02532049.
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Affiliation(s)
- Hans de Graaf
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ruth O Payne
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Iona Taylor
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Kazutoyo Miura
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Carol A Long
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Sean C Elias
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Marija Zaric
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Sarah E Silk
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Lee Li
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Ian D Poulton
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Megan Baker
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Simon J Draper
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Diane Gbesemete
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nathan J Brendish
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Filipa Martins
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Arianna Marini
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - David Mekhaiel
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Nick J Edwards
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Rachel Roberts
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Sarah Moyle
- Clinical Biomanufacturing Facility, University of Oxford, Oxford, United Kingdom
| | - Saul N Faust
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust and Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Eleanor Berrie
- Clinical Biomanufacturing Facility, University of Oxford, Oxford, United Kingdom
| | - Alison M Lawrie
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Adrian V S Hill
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Sumi Biswas
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
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23
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Minassian AM, Silk SE, Barrett JR, Nielsen CM, Miura K, Diouf A, Loos C, Fallon JK, Michell AR, White MT, Edwards NJ, Poulton ID, Mitton CH, Payne RO, Marks M, Maxwell-Scott H, Querol-Rubiera A, Bisnauthsing K, Batra R, Ogrina T, Brendish NJ, Themistocleous Y, Rawlinson TA, Ellis KJ, Quinkert D, Baker M, Lopez Ramon R, Ramos Lopez F, Barfod L, Folegatti PM, Silman D, Datoo M, Taylor IJ, Jin J, Pulido D, Douglas AD, de Jongh WA, Smith R, Berrie E, Noe AR, Diggs CL, Soisson LA, Ashfield R, Faust SN, Goodman AL, Lawrie AM, Nugent FL, Alter G, Long CA, Draper SJ. Reduced blood-stage malaria growth and immune correlates in humans following RH5 vaccination. Med 2021; 2:701-719.e19. [PMID: 34223402 PMCID: PMC8240500 DOI: 10.1016/j.medj.2021.03.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/19/2021] [Accepted: 03/25/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Development of an effective vaccine against the pathogenic blood-stage infection of human malaria has proved challenging, and no candidate vaccine has affected blood-stage parasitemia following controlled human malaria infection (CHMI) with blood-stage Plasmodium falciparum. METHODS We undertook a phase I/IIa clinical trial in healthy adults in the United Kingdom of the RH5.1 recombinant protein vaccine, targeting the P. falciparum reticulocyte-binding protein homolog 5 (RH5), formulated in AS01B adjuvant. We assessed safety, immunogenicity, and efficacy against blood-stage CHMI. Trial registered at ClinicalTrials.gov, NCT02927145. FINDINGS The RH5.1/AS01B formulation was administered using a range of RH5.1 protein vaccine doses (2, 10, and 50 μg) and was found to be safe and well tolerated. A regimen using a delayed and fractional third dose, in contrast to three doses given at monthly intervals, led to significantly improved antibody response longevity over ∼2 years of follow-up. Following primary and secondary CHMI of vaccinees with blood-stage P. falciparum, a significant reduction in parasite growth rate was observed, defining a milestone for the blood-stage malaria vaccine field. We show that growth inhibition activity measured in vitro using purified immunoglobulin G (IgG) antibody strongly correlates with in vivo reduction of the parasite growth rate and also identify other antibody feature sets by systems serology, including the plasma anti-RH5 IgA1 response, that are associated with challenge outcome. CONCLUSIONS Our data provide a new framework to guide rational design and delivery of next-generation vaccines to protect against malaria disease. FUNDING This study was supported by USAID, UK MRC, Wellcome Trust, NIAID, and the NIHR Oxford-BRC.
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Affiliation(s)
| | - Sarah E. Silk
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | | | - Kazutoyo Miura
- Laboratory of Malaria and Vector Research, NIAID/NIH, Rockville, MD 20852, USA
| | - Ababacar Diouf
- Laboratory of Malaria and Vector Research, NIAID/NIH, Rockville, MD 20852, USA
| | - Carolin Loos
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | | | - Ashlin R. Michell
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Michael T. White
- Department of Parasites and Insect Vectors, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Nick J. Edwards
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Ian D. Poulton
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Celia H. Mitton
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Ruth O. Payne
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Michael Marks
- Centre for Clinical Infection and Diagnostics Research, King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Hector Maxwell-Scott
- Centre for Clinical Infection and Diagnostics Research, King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Antonio Querol-Rubiera
- Centre for Clinical Infection and Diagnostics Research, King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Karen Bisnauthsing
- Centre for Clinical Infection and Diagnostics Research, King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Rahul Batra
- Centre for Clinical Infection and Diagnostics Research, King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Tatiana Ogrina
- NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Nathan J. Brendish
- NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | | | | | | | - Doris Quinkert
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Megan Baker
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | | | - Lea Barfod
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Daniel Silman
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Mehreen Datoo
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Iona J. Taylor
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Jing Jin
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - David Pulido
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | | | - Willem A. de Jongh
- ExpreSion Biotechnologies, SCION-DTU Science Park, Agern Allé 1, Hørsholm 2970, Denmark
| | - Robert Smith
- Clinical BioManufacturing Facility, University of Oxford, Oxford OX3 7JT, UK
| | - Eleanor Berrie
- Clinical BioManufacturing Facility, University of Oxford, Oxford OX3 7JT, UK
| | | | | | | | | | - Saul N. Faust
- NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Anna L. Goodman
- Centre for Clinical Infection and Diagnostics Research, King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | | | - Fay L. Nugent
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - Galit Alter
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Carole A. Long
- Laboratory of Malaria and Vector Research, NIAID/NIH, Rockville, MD 20852, USA
| | - Simon J. Draper
- The Jenner Institute, University of Oxford, Oxford OX3 7DQ, UK
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Long L, Baker M, Carruthers M, Meysami A, Spiera R, Reddy M, Kavanagh M, Francesco M, Langrish C, Neale A, Arora P, Stone JH. AB0756 IMMUNE-MEDIATED BASIS FOR A PHASE 2A CLINICAL STUDY COMPARING RILZABRUTINIB VS GLUCOCORTICOIDS IN RITUXIMAB-REFRACTORY PATIENTS WITH IGG4-RELATED DISEASE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.407] [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
Background:IgG4-related disease (IgG4-RD) is an immune-mediated disorder causing fibro-inflammatory lesions. Although the cause remains unknown, it may be driven by interactions between B lymphocytes and CD4+ cytotoxic and regulatory T cells and is characterized by an increase in short-lived plasmablasts, circulating antibodies, and macrophages. Standard therapy mainly includes glucocorticoids (GC), limited by toxicity with long-term use (> 6 mo), and to a lesser extent, immunosuppressives (eg, rituximab). Bruton tyrosine kinase (BTK) plays an important role in the activation of multiple immune effector cells such as B cells, mast cells, eosinophils, basophils, monocytes/macrophages, and neutrophils. Dysregulation of the activation of these immune cells results in autoimmune inflammation, tissue damage, and development of fibrosis. Rilzabrutinib is a highly selective oral BTK inhibitor that targets multiple pathways of innate and adaptive immunity (with direct effects on B-cell and FcR pathways) and has the potential to inhibit antigen presentation to autoreactive T cells.Objectives:To provide the biological rationale for rilzabrutinib in IgG4-RD.Methods:Rilzabrutinib has been evaluated in biochemical, in vitro studies, and in vivo models of inflammatory diseases. Additional support is provided by the phase 2 trial for oral rilzabrutinib in patients with pemphigus vulgaris and the phase 2 trial for oral rilzabrutinib in patients with immune thrombocytopenia (ITP).Results:Rilzabrutinib inhibited the activity of BTK and B-cell receptor in B cells (IC50 5-123 nM) and Fc gamma receptor in IgG/Fc gamma receptor-stimulated monocytes (IC50 56 nM) and blocked IgG- and IgM-mediated antibody production in enriched B cells when stimulated in T-cell dependent (anti-CD40+IL-21) and T-cell independent (TLR-9/CpG and TNP-LPS) pathways. The impact of rilzabrutinib on innate cell pathways was further confirmed by significant dose-dependent inhibition of macrophage and neutrophil-driven passive rat Arthus reaction (P < 0.01 vs vehicle) and antibody-induced murine ITP (P < 0.05 vs vehicle). In a 12-week phase 2 pemphigus vulgaris trial, 54% of patients achieved the primary endpoint, control of disease activity (CDA) on low-dose corticosteroids by week 4, and 73% achieved it by week 12. In the phase 2 trial of ITP patients (median 6 prior therapies), rilzabrutinib 400 mg bid showed rapid and sustained improvement in platelet counts and only grade 1/2-related adverse events1. In responders, platelet counts increased as early as day 8, potentially due to innate immune mechanisms. Collectively, results in both B and innate immune cells provide an initial basis for evaluating rilzabrutinib in IgG4-RD. The ongoing phase 2a study (NCT04520451) is investigating rilzabrutinib 400 mg bid (+tapered GC) vs GC control (3:1) for 12 weeks in IgG4-RD patients refractory to rituximab. The primary objective is to evaluate the safety and ability of rilzabrutinib to induce GC-free remission at week 12. Coupled with known preclinical/clinical findings, mechanistic analyses in this ongoing IgG4-RD study will profile B and other immune cell effects pre-/post-rilzabrutinib dosing to enhance the clinical understanding of rilzabrutinib in IgG4-RD.Conclusion:Studies of rilzabrutinib that show beneficial effects on both B-cell and innate cell pathways provide support for its therapeutic role in immune-mediated diseases and for targeting the underlying pathophysiological effects of IgG4-RD. Effective and safe therapies that rapidly induce and maintain clinical responses, while minimizing the need for continuous GC treatment, remain an unmet need for patients with IgG4-RD.References:[1]Kuter et al. Res Pract Thromb Haemost. 2020;4(suppl 1): PB1318.Disclosure of Interests:Li Long Employee of: Principia Biopharma, a Sanofi Company, Matthew Baker: None declared, Mollie Carruthers: None declared, Alireza Meysami: None declared, Robert Spiera Consultant of: research funding and personal fees for consulting from Chemocentryx, Formation Biologics, Roche-Genentech, and Sanofi, Grant/research support from: research funding fees from BMS, Boehringer Ingelheim, Corbus, GSK, and Inflarx; personal fees from AbbVie, CSL Behring, GSK, and Janssen, Mamatha Reddy Employee of: Principia Biopharma, a Sanofi Company, Marianne Kavanagh Employee of: Principia Biopharma, a Sanofi Company, Michelle Francesco Employee of: Principia Biopharma, a Sanofi Company, Claire Langrish Employee of: Principia Biopharma, a Sanofi Company, Ann Neale Employee of: Principia Biopharma, a Sanofi Company, Puneet Arora Employee of: Principia Biopharma, a Sanofi Company, John H. Stone Consultant of: research funding and personal fees for consulting from Principia and Sanofi
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Marsal S, Corominas H, De Agustin JJ, Perez-Garcia C, Lopez Lasanta M, Borrell Paños H, Reina-Sanz D, Sanmartí R, Narváez J, Franco-Jarava C, Peterfy C, Narvaez JA, Sharma V, Alataris K, Genovese MC, Baker M. AB0264 1-YEAR RESULTS OF A NON-INVASIVE AURICULAR VAGUS NERVE STIMULATION DEVICE IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background:Despite the clinical benefits of current pharmacological treatments for rheumatoid arthritis (RA), there remains an unmet need for alternative treatment approaches. Initial results of a 12-week proof-of-concept study of non-invasive, vagus nerve stimulation (VNS) of the auricular branch of the vagus nerve from a wearable device to treat RA showed the device to be well-tolerated with significant reductions in the DAS28-CRP and RA disease severity1.Objectives:This analysis presents data from the 9-month extension of the original proof-of-concept study.Methods:Following the completion of the 12-week proof-of-concept study, responding patients (defined as achieving a reduction in DAS28-CRP of ≥1.2 from baseline and/or achievement of ACR20) were given the option to enroll in a 9-month extension study. Use of the wearable device continued daily for up to 30 minutes as in the first 12 weeks of the study. Alteration of baseline medication and addition of conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and biologic DMARDs were allowed during the extension phase.Results:20/27 patients who completed the initial 12-week study met the enrollment criteria for the extension phase; 19 of those patients consented to participate. 4/19 patients (21%) discontinued the extension study due to lack of efficacy (1 patient after 1 month, 2 patients after 3 months, and 1 patient after 6 months in the extension); 15 patients completed the extension phase. 2/15 patients (13%) added biologic therapy to their treatment regimen. Mean DAS28-CRP reduction from baseline to the end of the extension (12 months total) in all patients completing the extension was 2.23 (95% CI: -1.60, -2.86). For patients who did and did not add biologic therapy, mean DAS28-CRP reduction was 2.98 and 2.11, respectively. Individual DAS28-CRP reductions are shown in the figure 1. Mean HAQ-DI reduction from baseline to the end of the extension in all patients was 0.70. 2 non-device related adverse events were reported in the study extension: one related to cornea transplant and one related to dysesthesia. No serious adverse events were reported during the study extension phase.Conclusion:Benefits from the use of the wearable device were maintained over longer periods of time from the initial 12-week proof-of-concept study, with few safety concerns as no additional side effects were observed.References:[1]Marsal S et al. Non-invasive Vagus Nerve Stimulation Improves Signs and Symptoms of Rheumatoid Arthritis: Results of a Pilot Study [in press]. The Lancet Rheumatol, 2021Disclosure of Interests:Sara Marsal Speakers bureau: BMS, Pfizer, UCB, Celgene, Roche, Sanofi, Consultant of: Pfizer, Abbvie, Roche, Celgene, Galapagos, MSD, UCB, BMS, Sanofi, Grant/research support from: Pfizer, Abbvie, Roche, Celgene, MSD, UCB, BMS, Novartis, Janssen, Sanofi, Héctor Corominas: None declared, Juan Jose de Agustin: None declared, Carolina Perez-Garcia: None declared, Maria Lopez Lasanta: None declared, Helena Borrell Paños: None declared, D Reina-Sanz: None declared, Raimón Sanmartí: None declared, J. Narváez: None declared, Clara Franco-Jarava: None declared, Charles Peterfy Speakers bureau: Novartis, Bristol Myers Squibb, Amgen, Consultant of: Multiple companies on behalf of Spire Sciences Inc., Jose Antonio Narvaez: None declared, Vivek Sharma Shareholder of: Nēsos Corp, Employee of: Nēsos Corp, Konstantinos Alataris Shareholder of: Nēsos Corp, Employee of: Nēsos Corp, Mark C. Genovese Shareholder of: Gilead Sciences, Nēsos Corp, Employee of: Gilead Sciences, Matthew Baker Shareholder of: Nēsos Corp, Consultant of: Nēsos Corp
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Williams K, Selwyn C, Elkins C, Young S, Pancione K, Baker M, Getch Y. An integrated addictions nursing subspecialty to expand the opioid use disorder and substance use disorder workforce. Eur Psychiatry 2021. [PMCID: PMC9480147 DOI: 10.1192/j.eurpsy.2021.1521] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction In the U.S. approximately11.4 million misused prescription pain relievers; 2.1 million had an OUD in 2017. The Addictions Nursing Subspecialty was created to address this epidemic by expanding a workforce trained in OUD/SUD screening, treatment, and prevention. A curriculum was developed that included integrated/telehealth health care settings in medical and mental health provider shortage areas during their last nine months of training. Courses were developed and taught by aninterprofessional team of university faculty and informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery. Courses were also offered as electives for nursing, clinical-counseling, social work, and other health science disciplines emphasizing an interdisciplinary approach to healthcare. Objectives Expand the OUD/SUD trained workforce in areas with high OUD/SUD mortality rates and high mental health provider shortages emphasizing team-based integrated care and telehealth settings. Methods Program curriculum was informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery using integrated care. Competencies included: Core Competencies for Integrated Behavioral Health and Primary Care that have been set forth by the Center for Integrated Health Solutions, telehealth competencies outlined in the recommended competencies by the National Organization of Nurse Practitioner Faculties (NONPF), and Core Competencies for Addictions Medicine by the American Board of Addictions Medicine. Results Approximately 11 students enrolled in courses received additions integrated/telehealth health care settings. Students responded positively to evaluations regarding timely feedback, unique approach (i.e. intrative content, short videos and discussions). Conclusions The Addictions Nursing subspecialty will continue to be offered allowing enrollment for nurses twice a year.
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Baker M, Huefner JC, Bellonci C, Hilt R, Carlson GA. Polypharmacy in the Management of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Review and Update. J Child Adolesc Psychopharmacol 2021; 31:148-163. [PMID: 33600217 DOI: 10.1089/cap.2020.0162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objective: Prescription of multiple medications concurrently for children and adolescents has increased in recent years. Examination of this practice has been undervalued relative to its incidence. This article reviews studies investigating effectiveness of medication combinations for youth with attention-deficit/hyperactivity disorder (ADHD). Methods: A literature search identified studies that combined two or more prescribed medications for the treatment of ADHD. Included studies focused on youth; had study design of randomized controlled trial (RCT), nonrandomized trial, or case review (n > 10); and included an outcome measure of treatment effectiveness. Results: Thirty-nine pertinent studies were identified. All studies combined two medications, with the vast majority including a stimulant (n = 37). The largest group (n = 16) combined stimulant and alpha-agonist, finding greater efficacy than alpha-agonist alone but not stimulant alone in all cases. A few RCTs found benefit from the addition of risperidone or divalproex to stimulant for comorbid aggression. Four studies adding atomoxetine found mixed reports of benefit, including the only small RCT showing no benefit. RCTs with selective serotonin reuptake inhibitors found minimal evidence of benefit for mood or anxiety comorbidities. Conclusion: The best studied combination is stimulant and alpha-agonist; addition of alpha-agonist to stimulant seems effective for residual symptoms of ADHD. Stimulant plus risperidone has the most evidence of efficacy for comorbid aggression or disruptive behavior. Limited support exists for the effectiveness of other medication combinations, including no trials studying three or more medications concurrently. Combinations frequently yielded more side effects, leaving monotherapy preferable if a sufficient treatment response can be achieved.
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Affiliation(s)
- Megan Baker
- Momentum for Health, San Jose, California, USA
| | - Jonathan C Huefner
- Boys Town Child and Family Translational Research Center, Boys Town, Nebraska, USA
| | - Christopher Bellonci
- Judge Baker Children's Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert Hilt
- Seattle Children's Hospital, Seattle, Washington, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Gabrielle A Carlson
- Division of Child and Adolescent Psychiatry, Renaissance School of Medicine at Stony Brook, Stony Brook, New York, USA
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Peravali M, Gomes-Lima C, Tefera E, Baker M, Sherchan M, Farid S, Burman K, Constantinescu F, Veytsman I. P09.25 Role of Immune Checkpoint Inhibitors (ICPi) in KRAS-Mutated Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lohr WD, Wanta JW, Baker M, Grudnikoff E, Morgan W, Chhabra D, Lee T. Intentional Discontinuation of Psychostimulants Used to Treat ADHD in Youth: A Review and Analysis. Front Psychiatry 2021; 12:642798. [PMID: 33959050 PMCID: PMC8093505 DOI: 10.3389/fpsyt.2021.642798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/09/2021] [Indexed: 12/22/2022] Open
Abstract
Objectives: This paper reviews the literature on intentional discontinuation of psychostimulants in ADHD to summarize what is known about clinical course of controlled discontinuation and guide practitioners who are considering stopping these medications for youth with ADHD. Methods: A systematic search was executed in Cochrane CENTRAL, EMBASE, Psychinfo, and MEDLINE databases to identify all articles that addressed the topic of deprescribing of psychotropic medications in children and adolescents. Keywords and search strings were developed using "PICO" framework, involving Population of interest (<18 y.o.), Intervention ("discontinuation," "deprescribing," and synonyms), Comparator (continuation of specific medications), and Outcomes. Ten reviewers conducted the initial screen via a single reviewer system. Articles that met a set of three inclusionary criteria were selected for full text review and identification as specific to discontinuation of stimulants in ADHD. Results: The literature review identified 35 articles specifically addressing intentional deprescribing, discontinuation, tapering, or withdrawal of stimulants for children and adolescents with ADHD. In addition to providing broad support for the efficacy of stimulants to treat ADHD and reduce negative outcomes, there is a distinct population of children and adolescents with ADHD who do not relapse or deteriorate when taken off medications for ADHD. The majority of articles addressed either the re-emergence of ADHD symptoms or side effects, both desired and adverse, following discontinuation of stimulants. While confirming the ability of stimulants to treat ADHD in youth, our results support periodic consideration of trials of stopping medications to determine continued need. Conclusions: This systematic review summarizes the literature on deprescribing stimulants for ADHD in children and adolescents. Further research is needed to determine the optimal duration of treatment, identify patients that may benefit from medication discontinuation, and inform evidence-based guidelines for discontinuation when appropriate. More research is needed to understand and define the subgroup of youth who may succeed with stimulant discontinuation.
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Affiliation(s)
- W David Lohr
- Division of Child and Adolescent Psychiatry, Department of Pediatrics, University of Louisville, Louisville, KY, United States
| | - Jonathon W Wanta
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Megan Baker
- Momentum for Mental Health, Palo Alto, CA, United States
| | - Eugene Grudnikoff
- School of Medicine, Hofstra University, Hempstead, NY, United States
| | - Wynne Morgan
- Division of Child and Adolescent Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - Divya Chhabra
- Department of Psychiatry, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, Weill Cornell Medical College, New York, NY, United States
| | - Terry Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Acharya A, Agarwal R, Baker M, Baudry J, Bhowmik D, Boehm S, Byler KG, Chen S, Coates L, Cooper C, Demerdash O, Daidone I, Eblen J, Ellingson S, Forli S, Glaser J, Gumbart JC, Gunnels J, Hernandez O, Irle S, Kneller D, Kovalevsky A, Larkin J, Lawrence T, LeGrand S, Liu SH, Mitchell J, Park G, Parks J, Pavlova A, Petridis L, Poole D, Pouchard L, Ramanathan A, Rogers D, Santos-Martins D, Scheinberg A, Sedova A, Shen Y, Smith J, Smith M, Soto C, Tsaris A, Thavappiragasam M, Tillack A, Vermaas J, Vuong V, Yin J, Yoo S, Zahran M, Zanetti-Polzi L. Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19. J Chem Inf Model 2020; 60:5832-5852. [PMID: 33326239 PMCID: PMC7754786 DOI: 10.1021/acs.jcim.0c01010] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Indexed: 01/18/2023]
Abstract
We present a supercomputer-driven pipeline for in silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. Ensemble docking makes use of MD results by docking compound databases into representative protein binding-site conformations, thus taking into account the dynamic properties of the binding sites. We also describe preliminary results obtained for 24 systems involving eight proteins of the proteome of SARS-CoV-2. The MD involves temperature replica exchange enhanced sampling, making use of massively parallel supercomputing to quickly sample the configurational space of protein drug targets. Using the Summit supercomputer at the Oak Ridge National Laboratory, more than 1 ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to 10 configurations of each of the 24 SARS-CoV-2 systems using AutoDock Vina. Comparison to experiment demonstrates remarkably high hit rates for the top scoring tranches of compounds identified by our ensemble approach. We also demonstrate that, using Autodock-GPU on Summit, it is possible to perform exhaustive docking of one billion compounds in under 24 h. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and artificial intelligence (AI) methods to cluster MD trajectories and rescore docking poses.
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Affiliation(s)
- A. Acharya
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - R. Agarwal
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - M. Baker
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - J. Baudry
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899, USA
| | - D. Bhowmik
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - S. Boehm
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - K. G. Byler
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899, USA
| | - S.Y. Chen
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - L. Coates
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - C.J. Cooper
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - O. Demerdash
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - I. Daidone
- Department of Physical and Chemical Sciences, University of L’Aquila, I-67010 L’Aquila, Italy
| | - J.D. Eblen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - S. Ellingson
- University of Kentucky, Division of Biomedical Informatics, College of Medicine, UK Medical Center MN 150, Lexington KY, 40536, USA
| | - S. Forli
- Scripps Research, La Jolla, CA, 92037, USA
| | - J. Glaser
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - J. C. Gumbart
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - J. Gunnels
- HPC Engineering, Amazon Web Services, Seattle, WA 98121, USA
| | - O. Hernandez
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - S. Irle
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996, USA
| | - D.W. Kneller
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - A. Kovalevsky
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - J. Larkin
- NVIDIA Corporation, Santa Clara, CA 95051, USA
| | - T.J. Lawrence
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - S. LeGrand
- NVIDIA Corporation, Santa Clara, CA 95051, USA
| | - S.-H. Liu
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - J.C. Mitchell
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - G. Park
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - J.M. Parks
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - A. Pavlova
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - L. Petridis
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - D. Poole
- NVIDIA Corporation, Santa Clara, CA 95051, USA
| | - L. Pouchard
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - A. Ramanathan
- Data Science and Learning Division, Argonne National Lab, Lemont, IL 60439, USA
| | - D. Rogers
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | | | | | - A. Sedova
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830, USA
| | - Y. Shen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996, USA
| | - J.C. Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - M.D. Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830, USA
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996, USA
| | - C. Soto
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - A. Tsaris
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | | | | | - J.V. Vermaas
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - V.Q. Vuong
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996, USA
| | - J. Yin
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA
| | - S. Yoo
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973, USA
| | - M. Zahran
- Department of Biological Sciences, New York City College of Technology, The City University of New York (CUNY), Brooklyn, NY 11201, USA
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Came H, Kidd J, McCreanor T, Baker M, Rodgers B. Re-imagining anti-racism in the health sector in Aotearoa New Zealand. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.861] [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: 11/14/2022] Open
Abstract
Abstract
Background
Racism and dishonouring of te Tiriti o Waitangi are significant contributors to ethnic health inequities in Aotearoa. It is unclear how health professionals can contribute to the disruption of racism.
Methods
This multi-disciplinary study draws on systems change tools, evidence from the health kaupapa Waitangi Tribunal claim (WAI 2575), a review of professional competencies documents, and focus groups with Māori and non-Māori health practitioners to identify how to strengthen anti-racism praxis in health services. The preliminary data collected in 2019 has undergone a thematic analysis and is being synthesised collaboratively with stakeholders to generate a complex continuum of anti-racism praxis. This will be applied via two site-specific action research projects.
Results
The pilot study has been completed but data collection is still underway on the main study. The initial cut of a continuum of practice grouped behaviours into i) problematic, ii) variable to iii) proactive. Problematic behaviors included examples of cultural and institutional racism, Variable behavior included engagement with Te Reo me ona tikanga (Māori language and protocols), and professional development and compliance. The proactive grouping included Māori leadership and workforce, responding to Māori realities, reflective practice and critical consciousness.
Conclusions
Initial findings suggest anti-racism continuum of practice may be useful to strengthen competency documents, curricula, policy and discipline-specific professional development planning.
Key messages
With the persistence of institutional racism in colonial settings like Aotearoa we need to imagine new ways to pursue anti-racism. Mapping anti-racism praxis is a useful way to identify variations in practice with a view to strengthening curriculum, competencies and ultimately practice.
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Affiliation(s)
- H Came
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - J Kidd
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - T McCreanor
- Te Rōpū Whāriki, Massey University, Auckland, New Zealand
| | - M Baker
- Te Rau Ora, Wellington, New Zealand
| | - B Rodgers
- University of Auckland, Auckland, New Zealand
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Baker M, Hyka J. Response to Ahlander et al., 2020 (Anxiety during MRI of the spine in relation to scanner design and size). Radiography (Lond) 2020; 26:269. [DOI: 10.1016/j.radi.2020.03.004] [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] [Received: 03/01/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
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Baker M, Alberti P, Tsao T, Fluegge K, Howland R, Haberman M. Does Accounting for Community‐Level SDOH Matter for Readmission Policy? Insights from New York City. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13404] [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: 11/29/2022] Open
Affiliation(s)
- M. Baker
- AAMC Washington DC United States
| | | | - T.‐Y. Tsao
- New York City Department of Health and Mental Hygiene New York NY United States
| | - K. Fluegge
- New York City Department of Health and Mental Hygiene New York NY United States
| | - R. Howland
- New York City Department of Health and Mental Hygiene New York NY United States
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Acharya A, Agarwal R, Baker M, Baudry J, Bhowmik D, Boehm S, Byler KG, Coates L, Chen SY, Cooper CJ, Demerdash O, Daidone I, Eblen JD, Ellingson S, Forli S, Glaser J, Gumbart JC, Gunnels J, Hernandez O, Irle S, Larkin J, Lawrence TJ, LeGrand S, Liu SH, Mitchell JC, Park G, Parks JM, Pavlova A, Petridis L, Poole D, Pouchard L, Ramanathan A, Rogers D, Santos-Martins D, Scheinberg A, Sedova A, Shen S, Smith JC, Smith MD, Soto C, Tsaris A, Thavappiragasam M, Tillack AF, Vermaas JV, Vuong VQ, Yin J, Yoo S, Zahran M, Zanetti-Polzi L. Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19. ChemRxiv 2020:12725465. [PMID: 33200117 PMCID: PMC7668744 DOI: 10.26434/chemrxiv.12725465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 07/29/2020] [Indexed: 01/18/2023]
Abstract
We present a supercomputer-driven pipeline for in-silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. We also describe preliminary results obtained for 23 systems involving eight protein targets of the proteome of SARS CoV-2. THe MD performed is temperature replica-exchange enhanced sampling, making use of the massively parallel supercomputing on the SUMMIT supercomputer at Oak Ridge National Laboratory, with which more than 1ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to ten configurations of each of the 23 SARS CoV-2 systems using AutoDock Vina. We also demonstrate that using Autodock-GPU on SUMMIT, it is possible to perform exhaustive docking of one billion compounds in under 24 hours. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and AI methods to cluster MD trajectories and rescore docking poses.
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Affiliation(s)
- A Acharya
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332
| | - R Agarwal
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - M Baker
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - J Baudry
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899
| | - D Bhowmik
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
| | - S Boehm
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - K G Byler
- The University of Alabama in Huntsville, Department of Biological Sciences. 301 Sparkman Drive, Huntsville, AL 35899
| | - L Coates
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
| | - S Y Chen
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - C J Cooper
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - O Demerdash
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - I Daidone
- Department of Physical and Chemical Sciences, University of L'Aquila, I-67010 L'Aquila, Italy
| | - J D Eblen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - S Ellingson
- University of Kentucky, Division of Biomedical Informatics, College of Medicine, UK Medical Center MN 150, Lexington KY, 40536
| | - S Forli
- Scripps Research, La Jolla, CA, 92037
| | - J Glaser
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | - J C Gumbart
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332
| | - J Gunnels
- HPC Engineering, Amazon Web Services, Seattle, WA 98121
| | - O Hernandez
- Computer Science and Mathematics Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - S Irle
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996
| | - J Larkin
- NVIDIA Corporation, Santa Clara, CA 95051
| | - T J Lawrence
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - S LeGrand
- NVIDIA Corporation, Santa Clara, CA 95051
| | - S-H Liu
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - J C Mitchell
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - G Park
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - J M Parks
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - A Pavlova
- School of Physics, Georgia Institute of Technology, Atlanta, GA 30332
| | - L Petridis
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - D Poole
- NVIDIA Corporation, Santa Clara, CA 95051
| | - L Pouchard
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - A Ramanathan
- Data Science and Learning Division, Argonne National Lab, Lemont, IL 60439
| | - D Rogers
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | | | | | - A Sedova
- Biosciences Division, Oak Ridge National Lab, Oak Ridge, TN 37830
| | - S Shen
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
- Graduate School of Genome Science and Technology, University of Tennessee, Knoxville, TN, 37996
| | - J C Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - M D Smith
- UT/ORNL Center for Molecular Biophysics, Oak Ridge National Laboratory, TN, 37830
- The University of Tennessee, Knoxville. Department of Biochemistry & Cellular and Molecular Biology, 309 Ken and Blaire Mossman Bldg. 1311 Cumberland Avenue Knoxville, TN, 37996
| | - C Soto
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - A Tsaris
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | | | | | - J V Vermaas
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | - V Q Vuong
- Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831
- Bredesen Center for Interdisciplinary Research and Graduate Education, University of Tennessee, Knoxville, TN 37996
| | - J Yin
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37830
| | - S Yoo
- Computational Science Initiative, Brookhaven National Laboratory, Upton, NY 11973
| | - M Zahran
- Department of Biological Sciences, New York City College of Technology, The City University of New York (CUNY), Brooklyn, NY 11201
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Creagh AP, Simillion C, Scotland A, Lipsmeier F, Bernasconi C, Belachew S, van Beek J, Baker M, Gossens C, Lindemann M, De Vos M. Smartphone-based remote assessment of upper extremity function for multiple sclerosis using the Draw a Shape Test. Physiol Meas 2020; 41:054002. [DOI: 10.1088/1361-6579/ab8771] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Marsal S, Corominas H, Lopez Lasanta M, Reina-Sanz D, Perez-Garcia C, Borrell Paños H, Sanmartí R, Narváez J, Franco-Jarava C, Narvaez JA, De Agustin JJ, Sharma V, Alataris K, Genovese MC, Baker M. SAT0133 PILOT CLINICAL STUDY OF A NON-INVASIVE AURICULAR VAGUS NERVE STIMULATION DEVICE IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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:Despite the clinical benefit of current pharmacological treatments for rheumatoid arthritis (RA), there remains an unmet need for alternative treatment approaches. Vagus nerve stimulation (VNS) via an implanted device has been shown to attenuate RA disease severity in patients resistant to therapy,1as evidenced by a reduction in the DAS28-CRP score following a month of daily stimulation.Objectives:This pilot study investigated the safety and efficacy of a wearable (non-invasive) device that attaches to the outer ear to treat RA via electrical stimulation of the auricular branch of the vagus nerve.Methods:Patients with active RA (≥4 tender/swollen joints based on a 28-joint count, Disease Activity Score-28 with C-reactive protein (DAS28-CRP) >3.8, active synovitis detected on ultrasound and MRI) and inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), or csDMARD and biologic DMARDs (bDMARDs), were enrolled in this open-label study. Patients used the device for up to 30 minutes daily over the course of the 12-week study. The primary endpoint was the change in DAS28-CRP score at Week 12. Secondary endpoints included a safety analysis, proportion of patients achieving ACR20/50/70, the mean change in HAQ-DI and the proportion of patients achieving a HAQ-DI MCID of at least 0.22 over 12 weeks. Additionally, sleep scores were assessed using a visual analogue scale (0-100) at baseline and 12 weeks.Results:Thirty patients with active RA were enrolled, of which 27 patients completed the 12-week protocol. Three patients dropped out of the study: two patients decided to seek other treatment and one patient moved out of the country. Data for three additional patients was not included in this dataset as it was still being collected. Of the 24 patients with complete 12-week datasets, 88% were female, the average age was 54.9 years, mean disease duration was 7.3 years, and four patients had an inadequate response to one or two bDMARDs.The mean change in DAS28-CRP from baseline to Week 12 was -1.43 (p<0.05; Figure 1) and ACR20/50/70 response rates were 58.3%, 37.5%, and 16.7%, respectively (Figure 2). HAQ-DI change from baseline was -0.50 (p<0.05) at 12 weeks, and 15 out of 24 patients achieved an overall HAQ-DI reduction of 0.22 (62.5%). VAS sleep scores were significantly improved over the 12-week study. Scores for trouble falling asleep, awakened by pain at night, and awakened by pain in morning decreased by 64%, 70%, and 60%, respectively (p<0.05, n = 23). Three study adverse events (AEs) were reported: two device related AEs due skin irritation at the earpiece insertion site and one AE due to mucous accumulation in the throat.Figure 1Figure 2Average DAS28-CRP is shown for each study visit. Error bars indicate standard error of mean. Percentage of subjects meeting ACR20/50/70 at 12 weeks.Conclusion:In this pilot study, auricular stimulation was well tolerated and daily use over 12 weeks attenuated RA disease severity. Further evaluation in larger controlled studies are needed to confirm whether a non-invasive wearable device might offer an alternative approach for the treatment of RA.References:[1]Koopman FA, et al. (2016) Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. Proc Nat Acad Sci 2016; 113: 8284–9.Disclosure of Interests:Sara Marsal: None declared, Héctor Corominas Speakers bureau: Abbvie, Lilly, Pfizer, Roche, Maria Lopez Lasanta: None declared, D Reina-Sanz: None declared, Carolina Perez-Garcia: None declared, Helena Borrell Paños Speakers bureau: Lilly, Novartis, MSD and Janssen, Raimón Sanmartí Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer, J. Narváez: None declared, Clara Franco-Jarava: None declared, Jose Antonio Narvaez: None declared, Juan Jose de Agustin: None declared, Vivek Sharma Shareholder of: Vorso Corp., Konstantinos Alataris Shareholder of: Vorso Corp., Mark C. Genovese Grant/research support from: Abbvie, Eli Lilly and Company, EMD Merck Serono, Galapagos, Genentech/Roche, Gilead Sciences, Inc., GSK, Novartis, Pfizer Inc., RPharm, Sanofi Genzyme, Consultant of: Abbvie, Eli Lilly and Company, EMD Merck Serono, Genentech/Roche, Gilead Sciences, Inc., GSK, Novartis, RPharm, Sanofi Genzyme, Matthew Baker Consultant of: Gilead, Vorso, Paid instructor for: Gilead
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Cappuccini F, Bryant R, Pollock E, Carter L, Verrill C, Hollidge J, Poulton I, Baker M, Mitton C, Baines A, Meier A, Schmidt G, Harrop R, Protheroe A, MacPherson R, Kennish S, Morgan S, Vigano S, Romero PJ, Evans T, Catto J, Hamdy F, Hill AVS, Redchenko I. Safety and immunogenicity of novel 5T4 viral vectored vaccination regimens in early stage prostate cancer: a phase I clinical trial. J Immunother Cancer 2020; 8:e000928. [PMID: 32591433 PMCID: PMC7319775 DOI: 10.1136/jitc-2020-000928] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) has been under investigation as a target for antigen-specific immunotherapies in metastatic disease settings for the last two decades leading to a licensure of the first therapeutic cancer vaccine, Sipuleucel-T, in 2010. However, neither Sipuleucel-T nor other experimental PCa vaccines that emerged later induce strong T-cell immunity. METHODS In this first-in-man study, VANCE, we evaluated a novel vaccination platform based on two replication-deficient viruses, chimpanzee adenovirus (ChAd) and MVA (Modified Vaccinia Ankara), targeting the oncofetal self-antigen 5T4 in early stage PCa. Forty patients, either newly diagnosed with early-stage PCa and scheduled for radical prostatectomy or patients with stable disease on an active surveillance protocol, were recruited to the study to assess the vaccine safety and T-cell immunogenicity. Secondary and exploratory endpoints included immune infiltration into the prostate, prostate-specific antigen (PSA) change, and assessment of phenotype and functionality of antigen-specific T cells. RESULTS The vaccine had an excellent safety profile. Vaccination-induced 5T4-specific T-cell responses were measured in blood by ex vivo IFN-γ ELISpot and were detected in the majority of patients with a mean level in responders of 198 spot-forming cells per million peripheral blood mononuclear cells. Flow cytometry analysis demonstrated the presence of both CD8+ and CD4+ polyfunctional 5T4-specific T cells in the circulation. 5T4-reactive tumor-infiltrating lymphocytes were isolated from post-treatment prostate tissue. Some of the patients had a transient PSA rise 2-8 weeks following vaccination, possibly indicating an inflammatory response in the target organ. CONCLUSIONS An excellent safety profile and T-cell responses elicited in the circulation and also detected in the prostate gland support the evaluation of the ChAdOx1-MVA 5T4 vaccine in efficacy trials. It remains to be seen if this vaccination strategy generates immune responses of sufficient magnitude to mediate clinical efficacy and whether it can be effective in late-stage PCa settings, as a monotherapy in advanced disease or as part of multi-modality PCa therapy. To address these questions, the phase I/II trial, ADVANCE, is currently recruiting patients with intermediate-risk PCa, and patients with advanced metastatic castration-resistant PCa, to receive this vaccine in combination with nivolumab. TRIAL REGISTRATION The trial was registered with the U.S. National Institutes of Health (NIH) Clinical Trials Registry (ClinicalTrials.gov identifier NCT02390063).
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Affiliation(s)
- Federica Cappuccini
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Richard Bryant
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
- Department of Urology, Churchill Hospital, Oxford, UK
| | - Emily Pollock
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Lucy Carter
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Clare Verrill
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford University, Oxford, UK
| | - Julianne Hollidge
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
| | - Ian Poulton
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Megan Baker
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Celia Mitton
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Andrea Baines
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | | | | | | | - Andrew Protheroe
- Department of Oncology, Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, UK
| | | | - Steven Kennish
- Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Susan Morgan
- Department of Pathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Selena Vigano
- Oncology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Pedro J Romero
- Oncology, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - James Catto
- Academic Urology Unit, The University of Sheffield, Sheffield, UK
| | - Freddie Hamdy
- Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK
- Department of Urology, Churchill Hospital, Oxford, UK
| | - Adrian V S Hill
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
| | - Irina Redchenko
- Nuffield Department of Medicine, The Jenner Institute, Oxford University, Oxford, UK
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Abstract
The management of pain in patients with chronic kidney disease (CKD) is challenging for many reasons. These patients have increased susceptibility to adverse drug effects due to altered drug metabolism and excretion, and there are limited safety data for use in this population despite a high pain burden. Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been regarded as dangerous for use in patients with CKD because of their risk for nephrotoxicity and thus alternative classes of analgesics, including opioids, have become more commonly used for pain control in this population. Given the well-established risks that opioids and other analgesics pose, further characterization of the risk posed by NSAIDs in patients with CKD is warranted. NSAID use has been associated with acute kidney injury, progressive loss of glomerular filtration rate in CKD, electrolyte derangements, and hypervolemia with worsening of heart failure and hypertension. The risk for these nephrotoxicity syndromes is modified by many comorbid conditions, risk factors, and characteristics of use, and in patients with CKD, the risk differs between levels of glomerular filtration rate. In this review, we offer recommendations for the cautious use of NSAIDs in the CKD population after careful consideration of these risk factors on an individualized basis.
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Affiliation(s)
- Megan Baker
- Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - Mark A Perazella
- Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT; Department of Medicine, Veterans Affairs Medical Center, West Haven, CT.
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Feldsine PT, Falbo-Nelson MT, Hustead DL, Aaronson J, Arling V, Baker M, Bozzuffi J, Bremer N, Chlebowski E, Clarke J, Crane A, Daniell E, Daugherty N, David J, Davis T, Diaz R, Donnelly S, Elwood M, Forgey R, Freshley J, Glowka L, Gottshall R, Graham R, Gray M, Griffith M, Hansen M, Harmon T, Herman R, Hofstrand P, Huether K, Irbys S, Jackey B, Jackson J, Jones T, Khasmakhi A, Lifur L, Linger T, MaCeda J, Mackin M, Marone C, McClure A, McDonagh S, Milligan L, Nelson J, Pandit K, Poole S, Rizzo M, Robinson J, Sparano R, Schriver J, Seibert M, Stone J, Summers D, Sweger L, Tebay D, Vera G, Weaver A, Wempe J, Wilkinson C, Willett J, Willoughby S, Zook T. Substrate Supporting Disc Method for Confirmed Detection of Total Coliforms and E. coli in all Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.5.988] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
The Coli Complete® substrate supporting disc (SSD) method for simultaneous confirmed total coliform count and Escherichia coli determination in all foods was compared with AOAC most probable number (MPN) methods, 966.23 and 966.24. Twenty-nine laboratories participated in this collaborative study in which 6 food types were analyzed. Four food types, raw ground beef, pork sausage, raw liquid milk, and nut meats, were naturally contaminated with coliform bacteria. Two foods, dry egg and fresh frozen vegetables, were seeded with coliforms. Three food types, ground beef, raw liquid milk, and pork sausage, were naturally contaminated with E. coli. Although pork sausage was naturally contaminated, the level was very low (<10/50 g); therefore, additional E. coli were inoculated into 1 lot of this food type. Three food types, nut meats, dry egg, and fresh frozen vegetables, were inoculated with E. coli. For naturally contaminated samples, duplicate determinations were made on 3 separate lots for each food type. For inoculated samples, low, medium, and high contamination levels plus uninoculated control samples were examined in duplicate. Data were analyzed separately for total coliform bacteria and for E. coli. Mean log MPN counts were determined by the SSD method and the appropriate AOAC MPN method. Results were then analyzed for repeatability, reproducibility, and mean log MPN statistical equivalence. Results were statistically equivalent for all total coliform levels in all food types except frozen vegetable and raw nut meat uninoculated control samples and 1 lot of pork sausage where the SSD method produced statistically significant greater numbers. For the E. coli determinations, results were statistically equivalent across all samples and all levels for each food type. The SSD method has been adopted first action by AOAC International for confirmed detection of total coliforms and E. coli in all foods.
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Affiliation(s)
- Philip T Feldsine
- BioControl Systems, Inc., 19805 North Creek Parkway, Bothell, WA 98011
| | | | - David L Hustead
- BioControl Systems, Inc., 19805 North Creek Parkway, Bothell, WA 98011
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Baker M, Nowak-Wegrzyn A. A303 REVIEW OF 122 CONSECUTIVE ORAL FOOD CHALLENGES TO WALNUT. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Brescia AA, Ward ST, Watt TMF, Rosenbloom LM, Baker M, Khan S, Ziese E, Romano MA, Bolling SF. Outcomes of Guideline-Directed Concomitant Annuloplasty for Functional Tricuspid Regurgitation. Ann Thorac Surg 2019; 109:1227-1232. [PMID: 31479635 DOI: 10.1016/j.athoracsur.2019.07.035] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/29/2019] [Accepted: 07/08/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite guideline recommendations, rates of concomitant tricuspid valve repair are suboptimal, possibly due to fear of complications. We reviewed morbidity, mortality, recurrent tricuspid regurgitation, and right ventricular remodeling after guideline-directed concomitant tricuspid valve repair. METHODS We performed guideline-directed concomitant tricuspid valve repair on 171 consecutive patients who underwent left-sided valve surgery (degenerative mitral surgery or aortic valve replacement) between May 2012 and March 2016. Exclusion criteria included functional mitral regurgitation, rheumatic disease, active endocarditis, and concomitant coronary artery bypass grafting or complex aortic surgery. RESULTS Mean age was 68 ± 12 years, and 47% (81 of 171) were women. Preoperative atrial fibrillation was present in 57% (98 of 171), and preoperative tricuspid regurgitation was moderate or higher in 64% (108 of 171). The rate of de novo pacemaker placement was 4.1% (7 of 171), and the 30-day mortality rate was 0.6% (1 of 171). Estimated survival was 95% ± 4% at 1 year and 92% ± 5% at 5 years. Freedom from moderate or worse residual/recurrent tricuspid regurgitation was 93% ± 6% at 6 months and 89% ± 8% at 3 years. Quantitative echocardiography found no significant increase in right ventricular dimensions or area at 1 year in subgroup analysis. Mean echocardiographic follow-up was 14.1 months, and mean clinical follow-up was 33.9 months. CONCLUSIONS Guideline-directed concomitant tricuspid valve repair resulted in excellent safety end points and survival. At 14 months, freedom from moderate or worse tricuspid regurgitation was high, right ventricular performance did not worsen, and the pacemaker rate was comparable to rates after isolated mitral repair. Given these findings, adherence to current guidelines regarding functional tricuspid regurgitation should be encouraged.
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Affiliation(s)
| | - Sarah T Ward
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Tessa M F Watt
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Liza M Rosenbloom
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Megan Baker
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Shazli Khan
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Emilie Ziese
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Matthew A Romano
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Steven F Bolling
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
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- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
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Haroon K, Arafeh A, Martin P, Rodgers T, Mendoza Ć, Baker M. Use of inline near-infrared spectroscopy to predict the viscosity of shampoo using multivariate analysis. Int J Cosmet Sci 2019; 41:346-356. [PMID: 31045248 PMCID: PMC6852037 DOI: 10.1111/ics.12536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/24/2019] [Indexed: 11/30/2022]
Abstract
Objective In the personal care industry, viscosity is a critical quality attribute that influences product quality and process economics. Like many industrial liquids, personal care liquids are complex non‐Newtonian liquids made up of aqueous surfactant systems whose viscosity depends on the build‐up of micellar networks. Measuring the viscosity of complex liquids offline is easily done using benchtop rheometers and viscometers. The challenge lies in measuring the viscosity of personal care liquids online during manufacturing. Being able to track the viscosity of such products through their manufacturing cycle will not only allow for better process control but also more enhanced quality control. Therefore, the aim of this work was to investigate how proxy measurements using inline near‐infrared (NIR) spectroscopy in transmission mode can be used to predict the viscosity of shampoo. NIR spectroscopy has not, to the best our knowledge, been used to predict the viscosity of complex surfactant systems like shampoo and could significantly affect the way quality is monitored in a manufacturing environment. Method This work focuses on viscosity changes because of differences in chloride content as salt is often used to adjust viscosity. The relationship between salt content and the viscosity of shampoo is well known following the salt curve. From an industrial perspective the region of interest for the formulation studied in this work only covers a small section of this curve. Therefore, two predictive models were developed: one covering the full range of the salt curve and another focusing on the industrially applicable region. Result Models were produced using partial least squares (PLS) where both datasets showed some predictive ability with the concentrated region of interest showing enhanced performance [root mean square error of prediction (RMSEP) – 2.32 Pa s] compared with the larger range (RMSEP – 4.44 Pa s). Conclusion This work provides a good starting point for developing robust predictive models for in situ viscosity measurements for shampoo manufacturing, where further work into different sources of variation and the extent of the modelling capability with regards to different formulations should be studied.
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Affiliation(s)
- K Haroon
- School of Chemical Engineering & Analytical Science, University of Manchester, James Chadwick Building, 2018 Booth St E, Manchester, M13 9SS, U.K
| | - A Arafeh
- School of Chemical Engineering & Analytical Science, University of Manchester, James Chadwick Building, 2018 Booth St E, Manchester, M13 9SS, U.K
| | - P Martin
- School of Chemical Engineering & Analytical Science, University of Manchester, James Chadwick Building, 2018 Booth St E, Manchester, M13 9SS, U.K
| | - T Rodgers
- School of Chemical Engineering & Analytical Science, University of Manchester, James Chadwick Building, 2018 Booth St E, Manchester, M13 9SS, U.K
| | - Ć Mendoza
- Unilver Research Port Sunlight, Quarry Rd East, Bebington, C63 3JW, U.K
| | - M Baker
- Unilver Research Port Sunlight, Quarry Rd East, Bebington, C63 3JW, U.K
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De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Ž, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Z, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, Kotseva K, De Backer G, Abreu A, Aguiar C, Badariene J, Bruthans J, Castro Conde A, Cifkova R, Crowley J, Davletov K, Bacquer DD, De Smedt D, De Sutter J, Deckers J, Dilic M, Dolzhenko M, Druais H, Dzerve V, Erglis A, Fras Z, Gaita D, Gotcheva N, Grobbee D, Gyberg V, Hasan Ali H, Heuschmann P, Hoes A, Jankowski P, Lalic N, Lehto S, Lovic D, Maggioni A, Mancas S, Marques-Vidal P, Mellbin L, Miličić D, Mirrakhimov E, Oganov R, Pogosova N, Reiner Ž, Rydén L, Stagmo M, Störk S, Sundvall J, Tokgözoğlu L, Tsioufis K, Vulic D, Wood D, Wood D, Kotseva K, Jennings C, Adamska A, Adamska S, Rydén L, Mellbin L, Tuomilehto J, Schnell O, Druais H, Fiorucci E, Glemot M, Larras F, Missiamenou V, Maggioni A, Taylor C, Ferreira T, Lemaitre K, Bacquer DD, De Backer G, Raman L, Sundvall J, DeSmedt D, De Sutter J, Willems A, De Pauw M, Vervaet P, Bollen J, Dekimpe E, Mommen N, Van Genechten G, Dendale P, Bouvier C, Chenu P, Huyberechts D, Persu A, Dilic M, Begic A, Durak Nalbantic A, Dzubur A, Hadzibegic N, Iglica A, Kapidjic S, Osmanagic Bico A, Resic N, Sabanovic Bajramovic N, Zvizdic F, Vulic D, Kovacevic-Preradovic T, Popovic-Pejicic S, Djekic D, Gnjatic T, Knezevic T, Kovacevic-Preradovic T, Kos L, Popovic-Pejicic S, Stanetic B, Topic G, Gotcheva N, Georgiev B, Terziev A, Vladimirov G, Angelov A, Kanazirev B, Nikolaeva S, Tonkova D, Vetkova M, Milicic D, Reiner Ž, Bosnic A, Dubravcic M, Glavina M, Mance M, Pavasovic S, Samardzic J, Batinic T, Crljenko K, Delic-Brkljacic D, Dula K, Golubic K, Klobucar I, Kordic K, Kos N, Nedic M, Olujic D, Sedinic V, Blazevic T, Pasalic A, Percic M, Sikic J, Bruthans J, Cífková R, Hašplová K, Šulc P, Wohlfahrt P, Mayer O, Cvíčela M, Filipovský J, Gelžinský J, Hronová M, Hasan-Ali H, Bakery S, Mosad E, Hamed H, Ibrahim A, Elsharef M, Kholef E, Shehata A, Youssef M, Elhefny E, Farid H, Moustafa T, Sobieh M, Kabil H, Abdelmordy A, Lehto S, Kiljander E, Kiljander P, Koukkunen H, Mustonen J, Cremer C, Frantz S, Haupt A, Hofmann U, Ludwig K, Melnyk H, Noutsias M, Karmann W, Prondzinsky R, Herdeg C, Hövelborn T, Daaboul A, Geisler T, Keller T, Sauerbrunn D, Walz-Ayed M, Ertl G, Leyh R, Störk S, Heuschmann P, Ehlert T, Klocke B, Krapp J, Ludwig T, Käs J, Starke C, Ungethüm K, Wagner M, Wiedmann S, Tsioufis K, Tolis P, Vogiatzi G, Sanidas E, Tsakalis K, Kanakakis J, Koutsoukis A, Vasileiadis K, Zarifis J, Karvounis C, Crowley J, Gibson I, Houlihan A, Kelly C, O'Donnell M, Bennati M, Cosmi F, Mariottoni B, Morganti M, Cherubini A, Di Lenarda A, Radini D, Ramani F, Francese M, Gulizia M, Pericone D, Davletov K, Aigerim K, Zholdin B, Amirov B, Assembekov B, Chernokurova E, Ibragimova F, Kodasbayev A, Markova A, Mirrakhimov E, Asanbaev A, Toktomamatov U, Tursunbaev M, Zakirov U, Abilova S, Arapova R, Bektasheva E, Esenbekova J, Neronova K, Asanbaev A, Baigaziev K, Toktomamatov U, Zakirov U, Baitova G, Zheenbekov T, Erglis A, Andrejeva T, Bajare I, Kucika G, Labuce A, Putane L, Stabulniece M, Dzerve V, Klavins E, Sime I, Badariene J, Gedvilaite L, Pečiuraite D, Sileikienė V, Skiauteryte E, Solovjova S, Sidabraite R, Briedis K, Ceponiene I, Jurenas M, Kersulis J, Martinkute G, Vaitiekiene A, Vasiljevaite K, Veisaite R, Plisienė J, Šiurkaitė V, Vaičiulis Ž, Jankowski P, Czarnecka D, Kozieł P, Podolec P, Nessler J, Gomuła P, Mirek-Bryniarska E, Bogacki P, Wiśniewski A, Pająk A, Wolfshaut-Wolak R, Bućko J, Kamiński K, Łapińska M, Paniczko M, Raczkowski A, Sawicka E, Stachurska Z, Szpakowicz M, Musiał W, Dobrzycki S, Bychowski J, Kosior D, Krzykwa A, Setny M, Kosior D, Rak A, Gąsior Z, Haberka M, Gąsior Z, Haberka M, Szostak-Janiak K, Finik M, Liszka J, Botelho A, Cachulo M, Sousa J, Pais A, Aguiar C, Durazzo A, Matos D, Gouveia R, Rodrigues G, Strong C, Guerreiro R, Aguiar J, Abreu A, Cruz M, Daniel P, Morais L, Moreira R, Rosa S, Rodrigues I, Selas M, Gaita D, Mancas S, Apostu A, Cosor O, Gaita L, Giurgiu L, Hudrea C, Maximov D, Moldovan B, Mosteoru S, Pleava R, Ionescu M, Parepa I, Pogosova N, Arutyunov A, Ausheva A, Isakova S, Karpova A, Salbieva A, Sokolova O, Vasilevsky A, Pozdnyakov Y, Antropova O, Borisova L, Osipova I, Lovic D, Aleksic M, Crnokrak B, Djokic J, Hinic S, Vukasin T, Zdravkovic M, Lalic N, Jotic A, Lalic K, Lukic L, Milicic T, Macesic M, Stanarcic Gajovic J, Stoiljkovic M, Djordjevic D, Kostic S, Tasic I, Vukovic A, Fras Z, Jug B, Juhant A, Krt A, Kugonjič U, Chipayo Gonzales D, Gómez Barrado J, Kounka Z, Marcos Gómez G, Mogollón Jiménez M, Ortiz Cortés C, Perez Espejo P, Porras Ramos Y, Colman R, Delgado J, Otero E, Pérez A, Fernández-Olmo M, Torres-LLergo J, Vasco C, Barreñada E, Botas J, Campuzano R, González Y, Rodrigo M, de Pablo C, Velasco E, Hernández S, Lozano C, González P, Castro A, Dalmau R, Hernández D, Irazusta F, Vélez A, Vindel C, Gómez-Doblas J, García Ruíz V, Gómez L, Gómez García M, Jiménez-Navarro M, Molina Ramos A, Marzal D, Martínez G, Lavado R, Vidal A, Rydén L, Boström-Nilsson V, Kjellström B, Shahim B, Smetana S, Hansen O, Stensgaard-Nake E, Deckers J, Klijn A, Mangus T, Peters R, Scholte op Reimer W, Snaterse M, Aydoğdu S, Ç Erol, Otürk S, Tulunay Kaya C, Ahmetoğlu Y, Ergene O, Akdeniz B, Çırgamış D, Akkoyun H Kültürsay S, Kayıkçıoğlu M, Çatakoğlu A, Çengel A, Koçak A, Ağırbaşlı M, Açıksarı G, Çekin M, Tokgözoğlu L, Kaya E, Koçyiğit D, Öngen Z, Özmen E, Sansoy V, Kaya A, Oktay V, Temizhan A, Ünal S, İ Yakut, Kalkan A, Bozkurt E, Kasapkara H, Dolzhenko M, Faradzh C, Hrubyak L, Konoplianyk L, Kozhuharyova N, Lobach L, Nesukai V, Nudchenko O, Simagina T, Yakovenko L, Azarenko V, Potabashny V, Bazylevych A, Bazylevych M, Kaminska K, Panchenko L, Shershnyova O, Ovrakh T, Serik S, Kolesnik T, Kosova H, Wood D, Adamska A, Adamska S, Jennings C, Kotseva K, Hoye P Atkin A, Fellowes D, Lindsay S, Atkinson C, Kranilla C, Vinod M, Beerachee Y, Bennett C, Broome M, Bwalya A, Caygill L, Dinning L, Gillespie A, Goodfellow R, Guy J, Idress T, Mills C, Morgan C, Oustance N, Singh N, Yare M, Jagoda J, Bowyer H, Christenssen V, Groves A, Jan A, Riaz A, Gill M, Sewell T, Gorog D, Baker M, De Sousa P, Mazenenga T, Porter J, Haines F, Peachey T, Taaffe J, Wells K, Ripley D, Forward H, McKie H, Pick S, Thomas H, Batin P, Exley D, Rank T, Wright J, Kardos A, Sutherland SB, Wren L, Leeson P, Barker D, Moreby B, Sawyer J, Stirrup J, Brunton M, Brodison A, Craig J, Peters S, Kaprielian R, Bucaj A, Mahay K, Oblak M, Gale C, Pye M, McGill Y, Redfearn H, Fearnley M. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis 2019; 285:135-146. [DOI: 10.1016/j.atherosclerosis.2019.03.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/22/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
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Nelson M, Kirshenbaum E, Bajic P, Farooq A, Baker M. 087 Characterizing the Priapism Superuser: A Longitudinal, Population-based Study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Folegatti PM, Bellamy D, Flaxman A, Mair C, Ellis C, Ramon RL, Ramos Lopez F, Mitton C, Baker M, Poulton I, Lawrie A, Roberts R, Minassian A, Ewer KJ, Evans TG, Hill AVS, Gilbert SC. Safety and Immunogenicity of the Heterosubtypic Influenza A Vaccine MVA-NP+M1 Manufactured on the AGE1.CR.pIX Avian Cell Line. Vaccines (Basel) 2019; 7:vaccines7010033. [PMID: 30909516 PMCID: PMC6466103 DOI: 10.3390/vaccines7010033] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/27/2019] [Accepted: 03/05/2019] [Indexed: 12/16/2022] Open
Abstract
Seasonal influenza infections have a significant global impact leading to increased health and economic burden. The efficacy of currently available seasonal influenza vaccines targeting polymorphic surface antigens has historically been suboptimal. Cellular immune responses against highly conserved Influenza A virus antigens, such as nucleoprotein (NP) and matrix protein-1 (M1), have previously been shown to be associated with protection from disease, whilst viral-vectored vaccines are an effective strategy to boost cell-mediated immunity. We have previously demonstrated that MVA encoding NP and M1 can induce potent and persistent T cell responses against influenza. In this Phase I study, we evaluated the safety and immunogenicity of MVA-NP+M1, which was newly manufactured on an immortalized cell line, in six healthy adult participants. The vaccine was well-tolerated with only mild to moderate adverse events that resolved spontaneously and were comparable to previous studies with the same vaccine manufactured in chick embryo fibroblasts. A significant increase in vaccine-specific T cell responses was detected seven days after immunization and was directed against both antigens in the vector insert. This small Phase I study supports progression of this vaccine to a Phase IIb study to assess immunogenicity and additional protective efficacy in older adults receiving licensed seasonal influenza vaccines.
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Affiliation(s)
- Pedro M Folegatti
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Duncan Bellamy
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Amy Flaxman
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Catherine Mair
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Chris Ellis
- Vaccitech Ltd, The Schrodinger Building, 2nd Floor, Oxford Science Park, Heatley Road, Oxford, OX4 4GE, UK.
| | - Raquel L Ramon
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Fernando Ramos Lopez
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Celia Mitton
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Megan Baker
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Ian Poulton
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Alison Lawrie
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Rachel Roberts
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Angela Minassian
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Katie J Ewer
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Thomas G Evans
- Vaccitech Ltd, The Schrodinger Building, 2nd Floor, Oxford Science Park, Heatley Road, Oxford, OX4 4GE, UK.
| | - Adrian V S Hill
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
| | - Sarah C Gilbert
- The Jenner Institute, University of Oxford, ORCRB, Roosevelt Drive, Oxford, OX3 7DQ, UK.
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Baker M, Muggridge R, Stacey A, Gribble K. Does standardised multichamber parenteral nutrition meet the needs of adult intestinal failure patients? Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Baker M, Flom J, Nowak-Wegrzyn A. CASE SERIES OF INFANTS WITH CHRONIC FPIES. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Baker M, Carlson GA. What do we really know about PRN use in agitated children with mental health conditions: a clinical review. Evid Based Ment Health 2018; 21:166-170. [PMID: 30361330 PMCID: PMC10270407 DOI: 10.1136/ebmental-2018-300039] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/16/2018] [Accepted: 09/20/2018] [Indexed: 11/03/2022]
Abstract
What is the evidence that 'pro re nata' (PRN) medication is effective for ending agitated outbursts in children and adolescents in psychiatric emergency rooms or inpatient units? Literature search was performed for studies of PRN medication use in children and adolescents that included an outcome measure. One randomised controlled trial, three prospective studies and six retrospective studies that included some outcome measure were identified. Outcome measures were heterogeneous, and frequently did not use standardised metrics assessing agitation level to measure effectiveness. The single small Randomized Controlled Trial (RTC) does not find a difference between placebo and medication, and outcomes of other studies do not control for potential placebo effect of the intervention itself as opposed to the medication. There is insufficient evidence to support the common practice of PRN medications for the management of acute agitation, and no data with which to inform clinical practice, such as which medicines and doses are helpful for specific populations or situations. Psychiatrists have no evidence-based medication interventions for acutely managing agitated outbursts in children and adolescents.
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Affiliation(s)
- Megan Baker
- Department of Child and Adolescent Psychiatry, NYU School of Medicine, New York City, New York, USA
| | - Gabriellle A Carlson
- Department of Psychiatry and Pediatrics, Stony Brook University School of Medicine, Stonybrook, New York, USA
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Gola A, Silman D, Walters AA, Sridhar S, Uderhardt S, Salman AM, Halbroth BR, Bellamy D, Bowyer G, Powlson J, Baker M, Venkatraman N, Poulton I, Berrie E, Roberts R, Lawrie AM, Angus B, Khan SM, Janse CJ, Ewer KJ, Germain RN, Spencer AJ, Hill AVS. Prime and target immunization protects against liver-stage malaria in mice. Sci Transl Med 2018; 10:10/460/eaap9128. [DOI: 10.1126/scitranslmed.aap9128] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 03/08/2018] [Accepted: 08/20/2018] [Indexed: 12/24/2022]
Abstract
Despite recent advances in treatment and vector control, malaria is still a leading cause of death, emphasizing the need for an effective vaccine. The malaria life cycle can be subdivided into three stages: the invasion and growth within liver hepatocytes (pre-erythrocytic stage), the blood stage (erythrocytic stage), and, finally, the sexual stage (occurring within the mosquito vector). Antigen (Ag)-specific CD8+ T cells are effectively induced by heterologous prime-boost viral vector immunization and known to correlate with liver-stage protection. However, liver-stage malaria vaccines have struggled to generate and maintain the high numbers of Plasmodium-specific circulating T cells necessary to confer sterile protection. We describe an alternative “prime and target” vaccination strategy aimed specifically at inducing high numbers of tissue-resident memory T cells present in the liver at the time of hepatic infection. This approach bypasses the need for very high numbers of circulating T cells and markedly increases the efficacy of subunit immunization against liver-stage malaria with clinically relevant Ags and clinically tested viral vectors in murine challenge models. Translation to clinical use has begun, with encouraging results from a pilot safety and feasibility trial of intravenous chimpanzee adenovirus vaccination in humans. This work highlights the value of a prime-target approach for immunization against malaria and suggests that this strategy may represent a more general approach for prophylaxis or immunotherapy of other liver infections and diseases.
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Mondal B, Choudhury S, Chatterjee K, Banerjee R, Shubham S, Baker M, Kumar H. Therapeutic effect of non-invasive vagus nerve stimulation in gait disturbance and freezing in Parkinson’s disease patients. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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