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Dohrn MF, Beijer D, Lone MA, Bayraktar E, Oflazer P, Orbach R, Donkervoort S, Foley AR, Rose A, Lyons M, Louie RJ, Gable K, Dunn T, Chen S, Danzi MC, Synofzik M, Bönnemann CG, Nazlı Başak A, Hornemann T, Zuchner S. Recurrent de-novo gain-of-function mutation in SPTLC2 confirms dysregulated sphingolipid production to cause juvenile amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2024; 95:201-205. [PMID: 38041684 PMCID: PMC10922288 DOI: 10.1136/jnnp-2023-332130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/27/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) leads to paralysis and death by progressive degeneration of motor neurons. Recently, specific gain-of-function mutations in SPTLC1 were identified in patients with juvenile form of ALS. SPTLC2 encodes the second catalytic subunit of the serine-palmitoyltransferase (SPT) complex. METHODS We used the GENESIS platform to screen 700 ALS whole-genome and whole-exome data sets for variants in SPTLC2. The de-novo status was confirmed by Sanger sequencing. Sphingolipidomics was performed using liquid chromatography and high-resolution mass spectrometry. RESULTS Two unrelated patients presented with early-onset progressive proximal and distal muscle weakness, oral fasciculations, and pyramidal signs. Both patients carried the novel de-novo SPTLC2 mutation, c.203T>G, p.Met68Arg. This variant lies within a single short transmembrane domain of SPTLC2, suggesting that the mutation renders the SPT complex irresponsive to regulation through ORMDL3. Confirming this hypothesis, ceramide and complex sphingolipid levels were significantly increased in patient plasma. Accordingly, excessive sphingolipid production was shown in mutant-expressing human embryonic kindney (HEK) cells. CONCLUSIONS Specific gain-of-function mutations in both core subunits affect the homoeostatic control of SPT. SPTLC2 represents a new Mendelian ALS gene, highlighting a key role of dysregulated sphingolipid synthesis in the pathogenesis of juvenile ALS. Given the direct interaction of SPTLC1 and SPTLC2, this knowledge might open new therapeutic avenues for motor neuron diseases.
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Affiliation(s)
- Maike F Dohrn
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - Danique Beijer
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Museer A Lone
- Institute of Clinical Chemistry, University Hospital Zürich, Zürich, Switzerland
| | - Elif Bayraktar
- Koç University, School of Medicine, Translational Medicine Research Center- NDAL, Istanbul, Turkey
| | - Piraye Oflazer
- Koç University, School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Rotem Orbach
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institutes of Health, Bethesda, Maryland, USA
| | - Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institutes of Health, Bethesda, Maryland, USA
| | - A Reghan Foley
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institutes of Health, Bethesda, Maryland, USA
| | - Aubrey Rose
- Greenwood Genetic Center Foundation, Greenwood, South Carolina, USA
| | - Michael Lyons
- Greenwood Genetic Center Foundation, Greenwood, South Carolina, USA
| | - Raymond J Louie
- Greenwood Genetic Center Foundation, Greenwood, South Carolina, USA
| | - Kenneth Gable
- Department of Biochemistry and Molecular Biology, Uniformed Services University, Bethesda, Maryland, USA
| | - Teresa Dunn
- Department of Biochemistry and Molecular Biology, Uniformed Services University, Bethesda, Maryland, USA
| | - Sitong Chen
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Matt C Danzi
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Matthis Synofzik
- Translational Genomics of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institutes of Health, Bethesda, Maryland, USA
| | - A Nazlı Başak
- Koç University, School of Medicine, Translational Medicine Research Center- NDAL, Istanbul, Turkey
| | - Thorsten Hornemann
- Institute of Clinical Chemistry, University Hospital Zürich, Zürich, Switzerland
| | - Stephan Zuchner
- Dr. John T. Macdonald Foundation, Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA
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2
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Li D, Wang Q, Bayat A, Battig MR, Zhou Y, Bosch DG, van Haaften G, Granger L, Petersen AK, Pérez-Jurado LA, Aznar-Laín G, Aneja A, Hancarova M, Bendova S, Schwarz M, Kremlikova Pourova R, Sedlacek Z, Keena BA, March ME, Hou C, O’Connor N, Bhoj EJ, Harr MH, Lemire G, Boycott KM, Towne M, Li M, Tarnopolsky M, Brady L, Parker MJ, Faghfoury H, Parsley LK, Agolini E, Dentici ML, Novelli A, Wright M, Palmquist R, Lai K, Scala M, Striano P, Iacomino M, Zara F, Cooper A, Maarup TJ, Byler M, Lebel RR, Balci TB, Louie R, Lyons M, Douglas J, Nowak C, Afenjar A, Hoyer J, Keren B, Maas SM, Motazacker MM, Martinez-Agosto JA, Rabani AM, McCormick EM, Falk MJ, Ruggiero SM, Helbig I, Møller RS, Tessarollo L, Tomassoni Ardori F, Palko ME, Hsieh TC, Krawitz PM, Ganapathi M, Gelb BD, Jobanputra V, Wilson A, Greally J, Jacquemont S, Jizi K, Bruel AL, Quelin C, Misra VK, Chick E, Romano C, Greco D, Arena A, Morleo M, Nigro V, Seyama R, Uchiyama Y, Matsumoto N, Taira R, Tashiro K, Sakai Y, Yigit G, Wollnik B, Wagner M, Kutsche B, Hurst AC, Thompson ML, Schmidt R, Randolph L, Spillmann RC, Shashi V, Higginbotham EJ, Cordeiro D, Carnevale A, Costain G, Khan T, Funalot B, Tran Mau-Them F, Fernandez Garcia Moya L, García-Miñaúr S, Osmond M, Chad L, Quercia N, Carrasco D, Li C, Sanchez-Valle A, Kelley M, Nizon M, Jensson BO, Sulem P, Stefansson K, Gorokhova S, Busa T, Rio M, Hadj Habdallah H, Lesieur-Sebellin M, Amiel J, Pingault V, Mercier S, Vincent M, Philippe C, Fatus-Fauconnier C, Friend K, Halligan RK, Biswas S, Rosser J, Shoubridge C, Corbett M, Barnett C, Gecz J, Leppig K, Slavotinek A, Marcelis C, Pfundt R, de Vries BB, van Slegtenhorst MA, Brooks AS, Cogne B, Rambaud T, Tümer Z, Zackai EH, Akizu N, Song Y, Hakonarson H. Spliceosome malfunction causes neurodevelopmental disorders with overlapping features. J Clin Invest 2024; 134:e171235. [PMID: 37962958 PMCID: PMC10760965 DOI: 10.1172/jci171235] [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: 04/06/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023] Open
Abstract
Pre-mRNA splicing is a highly coordinated process. While its dysregulation has been linked to neurological deficits, our understanding of the underlying molecular and cellular mechanisms remains limited. We implicated pathogenic variants in U2AF2 and PRPF19, encoding spliceosome subunits in neurodevelopmental disorders (NDDs), by identifying 46 unrelated individuals with 23 de novo U2AF2 missense variants (including 7 recurrent variants in 30 individuals) and 6 individuals with de novo PRPF19 variants. Eight U2AF2 variants dysregulated splicing of a model substrate. Neuritogenesis was reduced in human neurons differentiated from human pluripotent stem cells carrying two U2AF2 hyper-recurrent variants. Neural loss of function (LoF) of the Drosophila orthologs U2af50 and Prp19 led to lethality, abnormal mushroom body (MB) patterning, and social deficits, which were differentially rescued by wild-type and mutant U2AF2 or PRPF19. Transcriptome profiling revealed splicing substrates or effectors (including Rbfox1, a third splicing factor), which rescued MB defects in U2af50-deficient flies. Upon reanalysis of negative clinical exomes followed by data sharing, we further identified 6 patients with NDD who carried RBFOX1 missense variants which, by in vitro testing, showed LoF. Our study implicates 3 splicing factors as NDD-causative genes and establishes a genetic network with hierarchy underlying human brain development and function.
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Affiliation(s)
- Dong Li
- Center for Applied Genomics, and
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Qin Wang
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Allan Bayat
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department for Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | | | - Yijing Zhou
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Daniëlle G.M. Bosch
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gijs van Haaften
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Leslie Granger
- Department of Genetics and Metabolism, Randall Children’s Hospital at Legacy Emanuel Medical Center, Portland, Oregon, USA
| | - Andrea K. Petersen
- Department of Genetics and Metabolism, Randall Children’s Hospital at Legacy Emanuel Medical Center, Portland, Oregon, USA
| | - Luis A. Pérez-Jurado
- Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
- Genetic Service, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Gemma Aznar-Laín
- Universitat Pompeu Fabra, Barcelona, Spain
- Pediatric Neurology, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Anushree Aneja
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Miroslava Hancarova
- Department of Biology and Medical Genetics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Sarka Bendova
- Department of Biology and Medical Genetics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Martin Schwarz
- Department of Biology and Medical Genetics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Radka Kremlikova Pourova
- Department of Biology and Medical Genetics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Zdenek Sedlacek
- Department of Biology and Medical Genetics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Beth A. Keena
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | - Elizabeth J. Bhoj
- Center for Applied Genomics, and
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Gabrielle Lemire
- Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Kym M. Boycott
- Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Megan Li
- Invitae, San Francisco, California, USA
| | - Mark Tarnopolsky
- Division of Neuromuscular and Neurometabolic Disorders, Department of Paediatrics, McMaster University Children’s Hospital, Hamilton, Ontario, Canada
| | - Lauren Brady
- Division of Neuromuscular and Neurometabolic Disorders, Department of Paediatrics, McMaster University Children’s Hospital, Hamilton, Ontario, Canada
| | - Michael J. Parker
- Department of Clinical Genetics, Sheffield Children’s Hospital, Sheffield, United Kingdom
| | | | - Lea Kristin Parsley
- University of Illinois College of Medicine, Mercy Health Systems, Rockford, Illinois, USA
| | - Emanuele Agolini
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Maria Lisa Dentici
- Medical Genetics Unit, Academic Department of Pediatrics, IRCCS, Ospedale Pediatrico Bambino Gesù, Rome, Italy
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Meredith Wright
- Rady Children’s Institute for Genomic Medicine, San Diego, California, USA
| | - Rachel Palmquist
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Khanh Lai
- Division of Pediatric Pulmonary and Sleep Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Marcello Scala
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Università Degli Studi di Genova, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, and
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Università Degli Studi di Genova, Genoa, Italy
- Pediatric Neurology and Muscular Diseases Unit, and
| | - Michele Iacomino
- Medical Genetics Unit, IRCCS, Istituto Giannina Gaslini, Genoa, Italy
| | - Federico Zara
- Medical Genetics Unit, IRCCS, Istituto Giannina Gaslini, Genoa, Italy
| | - Annina Cooper
- Department of Genetics, Southern California Permanente Medical Group, Kaiser Permanente, San Diego, California, USA
| | - Timothy J. Maarup
- Department of Genetics, Kaiser Permanente, Los Angeles, California, USA
| | - Melissa Byler
- Center for Development, Behavior and Genetics, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Robert Roger Lebel
- Center for Development, Behavior and Genetics, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Tugce B. Balci
- Division of Genetics, Department of Paediatrics, London Health Sciences Centre, London, Ontario, Canada
| | - Raymond Louie
- Greenwood Genetic Center, Greenwood, South Carolina, USA
| | - Michael Lyons
- Greenwood Genetic Center, Greenwood, South Carolina, USA
| | - Jessica Douglas
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Catherine Nowak
- Division of Genetics and Metabolism, Mass General Hospital for Children, Boston, Massachusetts, USA
| | - Alexandra Afenjar
- APHP. SU, Reference Center for Intellectual Disabilities Caused by Rare Causes, Department of Genetics and Medical Embryology, Hôpital Trousseau, Paris, France
| | - Juliane Hoyer
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Boris Keren
- Department of Genetics, Hospital Pitié-Salpêtrière, Paris, France
| | - Saskia M. Maas
- Department of Human Genetics, Academic Medical Center, and
| | - Mahdi M. Motazacker
- Laboratory of Genome Diagnostics, Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ahna M. Rabani
- Division of Medical Genetics, Department of Pediatrics, UCLA, Los Angeles, California, USA
| | - Elizabeth M. McCormick
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics
| | - Marni J. Falk
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics
| | - Sarah M. Ruggiero
- Division of Neurology, and
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ingo Helbig
- Division of Neurology, and
- The Epilepsy NeuroGenetics Initiative (ENGIN), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biomedical and Health Informatics (DBHi), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Rikke S. Møller
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark
| | - Lino Tessarollo
- Mouse Cancer Genetics Program, Center for Cancer Research, National Cancer Institute (NCI), Frederick, Maryland, USA
| | - Francesco Tomassoni Ardori
- Mouse Cancer Genetics Program, Center for Cancer Research, National Cancer Institute (NCI), Frederick, Maryland, USA
| | - Mary Ellen Palko
- Mouse Cancer Genetics Program, Center for Cancer Research, National Cancer Institute (NCI), Frederick, Maryland, USA
| | - Tzung-Chien Hsieh
- Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Peter M. Krawitz
- Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Mythily Ganapathi
- New York Genome Center, New York, New York, USA
- Department of Pathology, Columbia University Irving Medical Center, New York, New York, USA
| | - Bruce D. Gelb
- Mindich Child Health and Development Institute and the Departments of Pediatrics and Genetics and Genomic Sciences, Icahn School of Medicine, New York, New York, USA
| | - Vaidehi Jobanputra
- New York Genome Center, New York, New York, USA
- Department of Pathology, Columbia University Irving Medical Center, New York, New York, USA
| | | | - John Greally
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sébastien Jacquemont
- Division of Genetics and Genomics, CHU Ste-Justine Hospital and CHU Sainte-Justine Research Centre, University of Montreal, Montreal, Quebec, Canada
| | - Khadijé Jizi
- Division of Genetics and Genomics, CHU Ste-Justine Hospital and CHU Sainte-Justine Research Centre, University of Montreal, Montreal, Quebec, Canada
| | - Ange-Line Bruel
- INSERM UMR 1231, Genetics of Developmental Anomalies, Université de Bourgogne Franche-Comté, Dijon, France
- UF Innovation en Diagnostic Génomique des Maladies Rares, CHU Dijon Bourgogne, Dijon, France
- FHU-TRANSLAD, Fédération Hospitalo-Universitaire Translational Medicine in Developmental Anomalies, CHU Dijon Bourgogne, Dijon, France
| | - Chloé Quelin
- Medical Genetics Department, Centre de Référence Maladies Rares CLAD-Ouest, CHU Hôpital Sud, Rennes, France
| | - Vinod K. Misra
- Division of Genetic, Genomic, and Metabolic Disorders, Children’s Hospital of Michigan, Detroit, Michigan, USA
- Central Michigan University College of Medicine, Discipline of Pediatrics, Mount Pleasant, Michigan, USA
| | - Erika Chick
- Division of Genetic, Genomic, and Metabolic Disorders, Children’s Hospital of Michigan, Detroit, Michigan, USA
| | - Corrado Romano
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, Troina, Italy
- Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Manuela Morleo
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Naples, Italy
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Nigro
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Naples, Italy
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Rie Seyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
| | - Yuri Uchiyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryoji Taira
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsuya Tashiro
- Department of Pediatrics, Karatsu Red Cross Hospital, Saga, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Gökhan Yigit
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Bernd Wollnik
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
- Cluster of Excellence “Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells” (MBExC), University of Göttingen, Göttingen, Germany
| | - Michael Wagner
- Kinderzentrum Oldenburg, Sozialpädiatrisches Zentrum, Diakonisches Werk Oldenburg, Oldenburg, Germany
| | - Barbara Kutsche
- Kinderzentrum Oldenburg, Sozialpädiatrisches Zentrum, Diakonisches Werk Oldenburg, Oldenburg, Germany
| | - Anna C.E. Hurst
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Ryan Schmidt
- Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Linda Randolph
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
- Division of Medical Genetics, Children’s Hospital Los Angeles, California, USA
| | - Rebecca C. Spillmann
- Department of Pediatrics–Medical Genetics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Vandana Shashi
- Department of Pediatrics–Medical Genetics, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Dawn Cordeiro
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amanda Carnevale
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gregory Costain
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tayyaba Khan
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Benoît Funalot
- Department of Genetics, Hôpital Henri-Mondor APHP and CHI Creteil, University Paris Est Creteil, IMRB, Inserm U.955, Creteil, France
| | - Frederic Tran Mau-Them
- INSERM UMR 1231, Genetics of Developmental Anomalies, Université de Bourgogne Franche-Comté, Dijon, France
- UF Innovation en Diagnostic Génomique des Maladies Rares, CHU Dijon Bourgogne, Dijon, France
| | | | - Sixto García-Miñaúr
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, Madrid, Spain
| | - Matthew Osmond
- Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Lauren Chad
- Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Nada Quercia
- Department of Genetic Counselling, Division of Clinical and Metabolic Genetics, Hospital for Sick Children, Ottawa, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Diana Carrasco
- Department of Clinical Genetics, Cook Children’s Hospital, Fort Worth, Texas, USA
| | - Chumei Li
- Division of Genetics, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Amarilis Sanchez-Valle
- Division of Genetics and Metabolism, Department of Pediatrics, University of South Florida, Tampa, Florida, USA
| | - Meghan Kelley
- Division of Genetics and Metabolism, Department of Pediatrics, University of South Florida, Tampa, Florida, USA
| | - Mathilde Nizon
- Nantes Université, CHU Nantes, Medical Genetics Department, Nantes, France
- Nantes Université, CNRS, INSERM, l’Institut du Thorax, Nantes, France
| | | | | | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Svetlana Gorokhova
- Aix Marseille University, Inserm, U1251-MMG, Marseille Medical Genetics, Marseille, France
- Department of Medical Genetics, Timone Hospital, APHM, Marseille, France
| | - Tiffany Busa
- Department of Medical Genetics, Timone Hospital, APHM, Marseille, France
| | - Marlène Rio
- Department of Genomic Medicine of Rare Disorders, Necker Hospital, APHP Center, University Paris Cité, Paris, France
| | - Hamza Hadj Habdallah
- Department of Genomic Medicine of Rare Disorders, Necker Hospital, APHP Center, University Paris Cité, Paris, France
| | - Marion Lesieur-Sebellin
- Department of Genomic Medicine of Rare Disorders, Necker Hospital, APHP Center, University Paris Cité, Paris, France
| | - Jeanne Amiel
- Rare Disease Genetics Department, APHP, Hôpital Necker, Paris, France
- Université Paris Cité, Inserm, Institut Imagine, Embryology and Genetics of Malformations Laboratory, Paris, France
| | - Véronique Pingault
- Rare Disease Genetics Department, APHP, Hôpital Necker, Paris, France
- Université Paris Cité, Inserm, Institut Imagine, Embryology and Genetics of Malformations Laboratory, Paris, France
- Laboratoire de Biologie Médicale Multi-Sites SeqOIA (laboratoire-seqoia.fr), Paris, France
| | - Sandra Mercier
- Nantes Université, CHU Nantes, Medical Genetics Department, Nantes, France
- Nantes Université, CNRS, INSERM, l’Institut du Thorax, Nantes, France
| | - Marie Vincent
- Nantes Université, CHU Nantes, Medical Genetics Department, Nantes, France
- Nantes Université, CNRS, INSERM, l’Institut du Thorax, Nantes, France
| | - Christophe Philippe
- INSERM UMR 1231, Genetics of Developmental Anomalies, Université de Bourgogne Franche-Comté, Dijon, France
| | | | - Kathryn Friend
- Genetics and Molecular Pathology, SA Pathology, Adelaide, South Australia, Australia
| | | | | | - Jane Rosser
- Department of General Medicine, Women’s and Children’s Hospital, Adelaide, South Australia, Australia
| | - Cheryl Shoubridge
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, South Australia, Australia
| | - Mark Corbett
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, South Australia, Australia
| | - Christopher Barnett
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, South Australia, Australia
- Pediatric and Reproductive Genetics Unit, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia
| | - Jozef Gecz
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kathleen Leppig
- Genetic Services, Kaiser Permenante of Washington, Seattle, Washington, USA
| | - Anne Slavotinek
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Carlo Marcelis
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rolph Pfundt
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bert B.A. de Vries
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Alice S. Brooks
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Benjamin Cogne
- Nantes Université, CHU Nantes, Medical Genetics Department, Nantes, France
- Nantes Université, CNRS, INSERM, l’Institut du Thorax, Nantes, France
- Laboratoire de Biologie Médicale Multi-Sites SeqOIA (laboratoire-seqoia.fr), Paris, France
| | - Thomas Rambaud
- Laboratoire de Biologie Médicale Multi-Sites SeqOIA (laboratoire-seqoia.fr), Paris, France
| | - Zeynep Tümer
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elaine H. Zackai
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Naiara Akizu
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yuanquan Song
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hakon Hakonarson
- Center for Applied Genomics, and
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Justen M, Edelman EJ, Chawarski M, Coupet E, Cowan E, Lyons M, Owens P, Martel S, Richardson L, Rothman R, Whiteside L, O'Connor PG, Zahn E, D'Onofrio G, Fiellin DA, Hawk KF. Perspectives on and experiences of emergency department-initiated buprenorphine among clinical pharmacists: A multi-site qualitative study. J Subst Use Addict Treat 2023; 155:209058. [PMID: 37149149 DOI: 10.1016/j.josat.2023.209058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/05/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Clinical pharmacists are well positioned to enhance efforts to promote emergency department (ED)-initiated buprenorphine to treat opioid use disorder (OUD). Among clinical pharmacists in urban EDs, we sought to characterize barriers and facilitators for ED-initiated buprenorphine to inform future implementation efforts and enhance access to this highly effective OUD treatment. METHODS This study was conducted as a part of Project ED Health (CTN-0069, NCT03023930), a multisite effectiveness-implementation study aimed at promoting ED-initiated buprenorphine that was conducted between April 2017 and July 2020. Data collection and analysis were grounded in the Promoting Action on Research Implementation in Health Services (PARIHS) framework to assess perspectives on the relationship between 3 elements: evidence for buprenorphine, the ED context, and facilitation needs to promote ED-initiated buprenorphine. The study used an iterative coding process to identify overlapping themes within these 3 domains. RESULTS The study conducted eight focus groups/interviews across four geographically disparate EDs with 15 pharmacist participants. We identified six themes. Themes related to evidence included (1) varied levels of comfort and experience among pharmacists with ED-initiated buprenorphine that increased over time and (2) a perception that patients with OUD have unique challenges that require guidance to optimize ED care. With regards to context, clinical pharmacists identified: (3) their ability to clarify scope of ED care in the context of unique pharmacology, formulations, and regulations of buprenorphine to ED staff, and that (4) their presence promotes successful program implementation and quality improvement. Participants identified facilitation needs including: (5) training to promote practice change and (6) ways to leverage already existing pharmacy resources outside of the ED. CONCLUSION Clinical pharmacists play a unique and critical role in the efforts to promote ED-initiated buprenorphine. We identified 6 themes that can inform pharmacist-specific interventions that could aid in the successful implementation of this practice.
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Affiliation(s)
- Marissa Justen
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States of America.
| | - E Jennifer Edelman
- Yale School of Medicine, Department of Internal Medicine, Edward S. Harkness, Building A, 4th floor 367 Cedar Street, New Haven, CT 06510, United States of America
| | - Marek Chawarski
- Yale School of Medicine, Department of Psychiatry, 300 George St #901, New Haven, CT 06511, United States of America
| | - Edouard Coupet
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Ave, Suite 260, New Haven, CT 06519, United States of America
| | - Ethan Cowan
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, United States of America
| | - Michael Lyons
- University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, United States of America
| | - Patricia Owens
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Ave, Suite 260, New Haven, CT 06519, United States of America
| | - Shara Martel
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Ave, Suite 260, New Haven, CT 06519, United States of America
| | - Lynne Richardson
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, United States of America
| | - Richard Rothman
- John Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States of America
| | - Lauren Whiteside
- University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, United States of America
| | - Patrick G O'Connor
- Yale School of Medicine, Department of Internal Medicine, Edward S. Harkness, Building A, 4th floor 367 Cedar Street, New Haven, CT 06510, United States of America
| | - Evan Zahn
- Yale New Haven Hospital, 20 York Street, New Haven, CT 06510, United States of America
| | - Gail D'Onofrio
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Ave, Suite 260, New Haven, CT 06519, United States of America
| | - David A Fiellin
- Yale School of Medicine, Department of Internal Medicine, Edward S. Harkness, Building A, 4th floor 367 Cedar Street, New Haven, CT 06510, United States of America; Yale School of Medicine, Department of Emergency Medicine, 464 Congress Ave, Suite 260, New Haven, CT 06519, United States of America
| | - Kathryn F Hawk
- Yale School of Medicine, Department of Emergency Medicine, 464 Congress Ave, Suite 260, New Haven, CT 06519, United States of America
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Delanne J, Lecat M, Blackburn P, Klee E, Stumpel C, Stegmann S, Stevens S, Nava C, Heron D, Keren B, Mahida S, Naidu S, Babovic-Vuksanovic D, Herkert J, Torring P, Kibæk M, De Bie I, Pfundt R, Hendriks Y, Ousager L, Bend R, Warren H, Skinner S, Lyons M, Poe C, Chevarin M, Jouan T, Garde A, Thomas Q, Kuentz P, Tisserant E, Duffourd Y, Philippe C, Faivre L, Thauvin-Robinet C. Further clinical and molecular characterization of an XLID syndrome associated with BRWD3 variants, a gene implicate in leukemia-related JAK-STAT pathway. Eur J Med Genet 2022; 66:104670. [DOI: 10.1016/j.ejmg.2022.104670] [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: 07/07/2022] [Revised: 10/13/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022]
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5
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Matt A, Kemp J, Semciw A, Mosler A, Gooden B, O’Sullivan M, Lyons M, Salmon L. Failure to meet expectations of sport or recreation following total hip arthroplasty is associated with younger age, high BMI, and poor general health. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.100] [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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6
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Kennedy E, Mulvihill M, Cronin L, Scannell M, Coakley E, Lyons M, Barrett L, Cloney T, Pillay I. 326 USE OF A PHARMACY PRIORITISATION TOOLKIT IN FRAIL OLDER ADULTS PRESENTING TO THE EMERGENCY DEPARTMENT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.285] [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
A Pharmacy Prioritisation Toolkit (PPT) was adapted for use by a front door frailty multidisciplinary team to direct pharmacist review.
Methods
Over a 4-week period pharmacist referrals based on a toolkit used by the team were reviewed. Data was recorded in Excel including age, reason for referral and outcome of Medicines Optimisation Review (MOR). Pharmacy-identified patients were also analysed.
Results
Forty-Five patients were referred by the team using the PPT and 25 were pharmacist-identified for review. Reason for referral were use of high-risk medication (20/45), suspected medication related admission (9/45), chronic kidney disease or acute kidney injury (7/45), specific pharmaceutical concerns (5/45) >10 regular medications (4/45). Of those reviewed, 29 MORs were made. Of patients who were pharmacist identified, 10 MORs were made (53% of patients). The toolkit was retrospectively applied to these patients and would have selected all but 3.
Conclusion
The PPT was successfully used by the team to generate 45 referrals for pharmacist review over a 4-week period. As a result of analysis of these recommendations, antimicrobial prophylaxis for urinary tract infections will be added to the high-risk medicines list on the PPT. Development of the toolkit is ongoing using a plan, do, study, act model with input from all members of the team to further improve both its efficacy and utility.
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Affiliation(s)
- E Kennedy
- Cork University Hospital , Cork, Ireland
| | | | - L Cronin
- Cork University Hospital , Cork, Ireland
| | - M Scannell
- Cork University Hospital , Cork, Ireland
| | - E Coakley
- Cork University Hospital , Cork, Ireland
| | - M Lyons
- Cork University Hospital , Cork, Ireland
| | - L Barrett
- Cork University Hospital , Cork, Ireland
| | - T Cloney
- Cork University Hospital , Cork, Ireland
| | - I Pillay
- Cork University Hospital , Cork, Ireland
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Maruya KA, Lao W, Vandervort DR, Fadness R, Lyons M, Mehinto AC. Bioanalytical and chemical-specific screening of contaminants of concern in three California (USA) watersheds. Heliyon 2022; 8:e09534. [PMID: 35663765 PMCID: PMC9160045 DOI: 10.1016/j.heliyon.2022.e09534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/04/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022] Open
Abstract
To broaden the scope of contaminants monitored in human-impacted riverine systems, water, sediment, and treated wastewater effluent were analyzed using receptor-based cell assays that provide an integrated response to chemicals based on their mode of biological activity. Samples were collected from three California (USA) watersheds with varying degrees of urbanization and discharge from municipal wastewater treatment plants (WWTPs). To complement cell assay results, samples were also analyzed for a suite of contaminants of emerging concern (CECs) using gas and liquid chromatography-mass spectrometry (GC- and LC-MS/MS). For most water and sediment samples, bioassay equivalent concentrations for estrogen and glucocorticoid receptor assays (ER- and GR-BEQs, respectively) were near or below reporting limits. Measured CEC concentrations compared to monitoring trigger values established by a science advisory panel indicated minimal to moderate concern in water but suggested that select pesticides (pyrethroids and fipronil) had accumulated to levels of greater concern in river sediments. Integrating robust, standardized bioanalytical tools such as the ER and GR assays utilized in this study into existing chemical-specific monitoring and assessment efforts will enhance future CEC monitoring efforts in impacted riverine systems and coastal watersheds.
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Affiliation(s)
- Keith A Maruya
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, 92626, USA
| | - Wenjian Lao
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, 92626, USA
| | - Darcy R Vandervort
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, 92626, USA
| | - Richard Fadness
- California Regional Water Quality Control Board, North Coast Region, Santa Rosa, CA, 95403, USA
| | - Michael Lyons
- California Regional Water Quality Control Board, Los Angeles Region, Los Angeles, CA, 90013, USA
| | - Alvine C Mehinto
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, 92626, USA
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Fee T, Lyons M, Hilton B, DuPont B. 18. Trisomy 18p detected in DNA from saliva but absent in DNA from blood. Cancer Genet 2022. [DOI: 10.1016/j.cancergen.2022.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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9
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Volkmann E, Tashkin D, Wilhalme H, Lyons M, Kim G, Goldin J, Roth M, Assassi S. POS0859 C-REACTIVE PROTEIN AND INTERLEUKIN-6: POTENTIAL BIOMARKERS OF DISEASE ACTIVITY AND TREATMENT RESPONSE IN SYSTEMIC SCLEROSIS-INTERSTITIAL LUNG DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1374] [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
BackgroundClinically feasible and valid biomarkers of systemic sclerosis-interstitial lung disease (SSc-ILD) are needed. While promising candidate biomarkers are under investigation (e.g., KL-6, CCL-8), clinical assays for these proteins are not currently available. C-reactive protein (CRP) measurements are feasible, cost-effective, and have been shown to predict mortality in SSc.1 Measuring interleukin (IL)-6, a proinflammatory cytokine implicated in SSc-ILD pathogenesis, is also feasible in most clinical settings.Objectives(1) To investigate whether CRP and IL-6 levels change in response to treatment with immunosuppression in SSc-ILD; (2) To explore whether the change in CRP and IL-6 predict the future course of forced vital capacity (FVC).MethodsCRP and IL-6 levels were measured in serum at baseline and after 12 months in participants of Scleroderma Lung Study (SLS) II (patients with active SSc-ILD receiving 24 months of mycophenolate or 12 months cyclophosphamide followed by 12 months of placebo2). Measured values were log-transformed to remove skewness. The FVC%-predicted was measured every 3 months over the course of 24 months. Spearman’s correlations evaluated the relationship between baseline CRP or IL-6 measurements and other patient parameters. Paired t-tests were used to compare the change in individual CRP and IL-6 measurements from baseline to 12 months. Linear mixed effects models were used to examine the relationship between the change in CRP and IL-6 (baseline to 12 months) and the subsequent course of the FVC (12 to 24 months). All analysis were performed for the entire cohort and separately by treatment arm.ResultsOf the 142 participants of SLS II, 101 had CRP and IL-6 measurements at baseline and 12 months. Baseline CRP and IL-6 levels correlated significantly with higher modified Rodnan skin score (CRP: r=0.3, P=0.005; IL-6: r=0.2, P=0.01) and shorter disease duration (CRP: r=-0.3, P=0.005; IL-6: r=-0.2, P=0.01) and were higher in patients with diffuse SSc (CRP: P=0.007; IL-6: P=0.01). Relationships to baseline FVC and DLCO were not observed. CRP decreased significantly from baseline to 12 months in the whole group (P=0.01), but the decrease was slightly greater in patients randomized to mycophenolate versus cyclophosphamide (-0.47 vs. -0.33 ug/mL). IL-6 also decreased from baseline to 12 months in the whole group with a trend towards significance (P=0.10) (Figure 1). The mean decrease in IL-6 was again slightly greater in patients randomized to mycophenolate versus cyclophosphamide (-0.31 vs. -0.10 pg/mL). After controlling for baseline FVC and treatment arm in the mixed effects model, there was a relationship between the decrease in CRP from baseline to 12 months and an improved course of FVC 12 to 24 months (Estimate -0.64), but this did not reach significance (P=0.14). However, after controlling for baseline FVC and treatment arm, a greater decrease in IL-6 from baseline to 12 months was significantly associated with a greater improvement in FVC from 12 to 24 months (Estimate -1.28; P=0.01).Figure 1.Change in CRP (A) and IL-6 (B) from baseline to 12 months by treatment arm in SLS II. CYC=cyclophosphamide (Blue), MMF=mycophenolate (red)ConclusionPatients with active SSc-ILD receiving one year of immunosuppressive therapy in the SLS II study experienced reductions in their CRP and IL-6 levels over this interval. The magnitude of the decrease in CRP and IL-6 over the first year also correlated with the course of FVC over the ensuing 12 months. These findings suggest a dynamic relationship between CRP and IL-6 measurements and the course of SSc-ILD in patients on immunosuppressive therapy. Further investigation of these findings is warranted.References[1]Liu et al. Arthritis Care Res 2013.[2]Tashkin et al. Lancet Resp Med 2016.Disclosure of InterestsElizabeth Volkmann Speakers bureau: Boehringer Ingelheim, Consultant of: Boehringer Ingelheim, Grant/research support from: Forbius, Kadmon, Horizon, Boehringer Ingelheim, Donald Tashkin: None declared, Holly Wilhalme: None declared, Marka Lyons: None declared, Grace Kim: None declared, Jonathan Goldin: None declared, Michael Roth Grant/research support from: Genentech, Shervin Assassi Consultant of: Boehringer Ingelheim
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10
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Slayday R, Bell T, Lyons M, Kremen W, Franz C. Erectile Function, Sexual Satisfaction, and Cognitive Decline in Men from Midlife to Old Age. Innov Aging 2021. [PMCID: PMC8682512 DOI: 10.1093/geroni/igab046.3595] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated how changes in erectile function and sexual satisfaction relate to cognitive decline in men from midlife into early old age. This is a major transitional period for increased incidence of erectile function and for cognitive decline. We examined 833 men from the Vietnam Era Twin Study of Aging whose mean ages were 56, 61, and 68 at the time of assessment. Erectile function and sexual satisfaction were measured using scores from the International Index of Erectile Function. Individuals with erectile dysfunction at baseline were excluded. Cognitive performance was measured using factor scores for separate domains of episodic memory, executive function, and processing speed. We tested linear mixed models hierarchically adjusted for demographics, sexual activity, as well as physical and mental health confounders to examine how changes in erectile function and sexual satisfaction related to changes in cognitive function. Declines in erectile function were associated with declines in episodic memory (p=.004, d=.25), while declines in sexual satisfaction were associated with declines in processing speed (p=.006, d=.19). Decreasing erectile function and sexual satisfaction may be indicative of individuals also likely to be facing cognitive decline. Possible mechanisms accounting for these changes may include white matter microvascular disease and/or various lifestyle influences. Discussing and tracking sexual health with middle aged men may be a crucial step in identifying those likely to face cognitive decline.
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Affiliation(s)
- Riki Slayday
- The Pennsylvania State University, State College, Pennsylvania, United States
| | - Tyler Bell
- University of California San Diego, La Jolla, California, United States
| | - Michael Lyons
- Boston University, Boston, Massachusetts, United States
| | - William Kremen
- University of California San Diego, La Jolla, California, United States
| | - Carol Franz
- University of California San Diego, La Jolla, California, United States
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11
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Spiekermann L, Lyons M, Deutsch N. A mixed-methods approach to understanding trajectories of mentoring relationship growth. J Community Psychol 2021; 49:2250-2263. [PMID: 34235738 DOI: 10.1002/jcop.22648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
The proposed study integrates quantitative and qualitative approaches to examine mentors with different relationship trajectories reflect on their relationships. Using quantitative and qualitative methods, mentor reports of relationship quality are plotted over time and different growth patterns identified: (1) progressive, (2) stable-high, (3) dip and recovery, (4) stable-low, and (5) regressive. Qualitative coding was used to identify patterns in mentors' descriptions of their relationship experiences-including both what mentors wrote about and how they wrote about it.
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Affiliation(s)
- Lara Spiekermann
- Curry School of Education, University of Virginia, Charlottesville, Virginia, USA
| | - Michael Lyons
- Curry School of Education, University of Virginia, Charlottesville, Virginia, USA
| | - Nancy Deutsch
- Curry School of Education, University of Virginia, Charlottesville, Virginia, USA
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Brewer G, Centifanti L, Caicedo JC, Huxley G, Peddie C, Stratton K, Lyons M. Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder. Illness, Crisis & Loss 2021; 30:795-811. [PMID: 36199441 PMCID: PMC9403522 DOI: 10.1177/10541373211023951] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The psychological impact of the COVID-19 pandemic on coronavirus patients, health
care workers, and the general population is clear. Relatively few studies have,
however, considered the impact of the pandemic on those with pre-existing mental
health conditions. Therefore, the present study investigates the personal
experiences of those with anxiety, depression, and obsessive-compulsive disorder
during COVID-19. We conducted a qualitative study utilising Reddit discussion
forum posts. We conducted three separate thematic analyses from 130 posts in
subreddit forums aimed for people identifying with anxiety, depression, and
obsessive-compulsive disorder. We identified a number of similar discussion
forum themes (e.g., COVID-19 intensifying symptoms and a lack of social
support), as well as themes that were unique to each forum type (e.g.,
hyperawareness and positive experiences during the pandemic). Findings should
guide future practice and the support provided to those living with mental
distress.
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Affiliation(s)
- G. Brewer
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - L. Centifanti
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - J. Castro Caicedo
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - G. Huxley
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - C. Peddie
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - K. Stratton
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - M. Lyons
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
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13
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Gass JM, Louie RJ, Merrihew A, Hilton BA, DuPont BR, Lyons M. 19. De novo homozygous variant due to uniparental isodisomy results in a recessive disorder. Cancer Genet 2021. [DOI: 10.1016/j.cancergen.2021.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Santa Maria D, Markham C, Misra SM, Coleman DC, Lyons M, Desormeaux C, Cron S, Guilamo-Ramos V. Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake. BMC Public Health 2021; 21:585. [PMID: 33761920 PMCID: PMC7992324 DOI: 10.1186/s12889-021-10534-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement. METHODS Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11-14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level. RESULTS Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period. CONCLUSION A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02600884 . Prospectively registered September 1, 2015.
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Affiliation(s)
- D Santa Maria
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA.
| | - C Markham
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, USA
| | - S M Misra
- Baylor College of Medicine, Texas Children's Hospital, 8080 North Stadium Drive, Suite 250, Houston, TX, USA
| | - D C Coleman
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA
| | - M Lyons
- University of Texas Health Science Center at Houston, Cizik School of Nursing, 6901 Bertner Ave, Houston, TX, USA
| | - C Desormeaux
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - S Cron
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - V Guilamo-Ramos
- Center for Latino Adolescent and Family Health, New York University, New York, NY, USA
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Hannon E, Leonard A, Martin L, Lyons M, Deasy C, Gallagher PF, Brosnan S, Ahern E, James K. Letter to the Editor: An Unknown Unknown: Early Identification of Dysphagia in Frail Patients in the Emergency Department. J Nutr Health Aging 2021; 25:1030-1031. [PMID: 34545925 DOI: 10.1007/s12603-021-1653-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- E Hannon
- Evelyn Hannon, Specialist Registrar in Geriatric Medicine, Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland, Phone: 00353 861943693, /, Twitter handle: @EvelynHannon
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16
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Jenkinson PW, Plevris N, Siakavellas S, Lyons M, Arnott ID, Wilson D, Watson AJM, Jones GR, Lees CW. Temporal Trends in Surgical Resection Rates and Biologic Prescribing in Crohn's Disease: A Population-based Cohort Study. J Crohns Colitis 2020; 14:1241-1247. [PMID: 32840295 DOI: 10.1093/ecco-jcc/jjaa044] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 12/24/2022]
Abstract
BACKGROUND The use of biologic therapy for Crohn's disease [CD] continues to evolve, however, the effect of this on the requirement for surgery remains unclear. We assessed changes in biologic prescription and surgery over time in a population-based cohort. METHODS We performed a retrospective cohort study of all 1753 patients diagnosed with CD in Lothian, Scotland, between January 1, 2000 and December 31, 2017, reviewing the electronic health record of each patient to identify all CD-related surgery and biologic prescription. Cumulative probability and hazard ratios for surgery and biologic prescription from diagnosis were calculated and compared using the log-rank test and Cox regression analysis stratified by year of diagnosis into cohorts. RESULTS The 5-year cumulative risk of surgery was 20.4% in cohort 1 [2000-2004],18.3% in cohort 2 [2005-2008], 14.7% in cohort 3 [2009-2013], and 13.0% in cohort 4 [2014-2017] p <0.001. The 5-year cumulative risk of biologic prescription was 5.7% in cohort 1, 12.2% in cohort 2, 22.0% in cohort 3, and 44.9% in cohort 4 p <0.001. CONCLUSIONS The increased and earlier use of biologic therapy in CD patients corresponded with a decreasing requirement for surgery over time within our cohort. This could mean that adopting a top-down or accelerated step-up treatment strategy may be effective at reducing the requirement for surgery in newly diagnosed CD.
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Affiliation(s)
- P W Jenkinson
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.,Department of Surgery, Raigmore Hospital, Inverness, UK
| | - N Plevris
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - S Siakavellas
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - M Lyons
- School of Medicine, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - I D Arnott
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - D Wilson
- Department of Paediatric Gastroenterology, Royal Hospital for Sick Children, Edinburgh, UK
| | - A J M Watson
- Department of Surgery, Raigmore Hospital, Inverness, UK
| | - G-R Jones
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - C W Lees
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
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17
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Anderson B, Lyons M, Henao-Tamayo MI, Juarrero MG, Robertson G. Improving the computational reproducibility of immunological research. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.222.25] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Many excellent and free training resources exist to improve the computational reproducibility of biomedical research. However, most of these materials target researchers at the stage of data analysis, and they typically provide much less guidance on principles and techniques to improve the reproducibility of the earlier steps of experimental data recording and experimental data pre-processing that are critical for ensuring the reproducibility of immunological research. Many common existing practices---including the use of spreadsheets with embedded formulas that concurrently record and analyze experimental data, problematic management of project files, and reliance on proprietary, vendor-supplied point-and-click software for data pre-processing---interfere with the transparency, reproducibility, and efficiency of laboratory-based immunological research projects. Under an NIH grant, we are creating new training modules as a resource for laboratory-based biomedical researchers to learn how simple computational principles can improve reproducibility at the stages of data recording and pre-processing in immunological research. In this poster, we will highlight several simple approaches that we have identified through this project to improve the reproducibility of immunological research, including strategies for re-designing data collection spreadsheet templates to more easily integrate into a reproducible data analysis workflow and the use of reproducible reporting tools within a laboratory setting.
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18
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Asay BC, Edwards BB, Andrews J, Ramey ME, Richard JD, Podell BK, Gutiérrez JFM, Frank CB, Magunda F, Robertson GT, Lyons M, Ben-Hur A, Lenaerts AJ. Digital Image Analysis of Heterogeneous Tuberculosis Pulmonary Pathology in Non-Clinical Animal Models using Deep Convolutional Neural Networks. Sci Rep 2020; 10:6047. [PMID: 32269234 PMCID: PMC7142129 DOI: 10.1038/s41598-020-62960-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/18/2020] [Indexed: 01/28/2023] Open
Abstract
Efforts to develop effective and safe drugs for treatment of tuberculosis require preclinical evaluation in animal models. Alongside efficacy testing of novel therapies, effects on pulmonary pathology and disease progression are monitored by using histopathology images from these infected animals. To compare the severity of disease across treatment cohorts, pathologists have historically assigned a semi-quantitative histopathology score that may be subjective in terms of their training, experience, and personal bias. Manual histopathology therefore has limitations regarding reproducibility between studies and pathologists, potentially masking successful treatments. This report describes a pathologist-assistive software tool that reduces these user limitations, while providing a rapid, quantitative scoring system for digital histopathology image analysis. The software, called 'Lesion Image Recognition and Analysis' (LIRA), employs convolutional neural networks to classify seven different pathology features, including three different lesion types from pulmonary tissues of the C3HeB/FeJ tuberculosis mouse model. LIRA was developed to improve the efficiency of histopathology analysis for mouse tuberculosis infection models, this approach has also broader applications to other disease models and tissues. The full source code and documentation is available from https://Github.com/TB-imaging/LIRA.
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Affiliation(s)
- Bryce C Asay
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Blake Blue Edwards
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
- Department of Computer Science, Colorado State University, Fort Collins, Colorado, United States of America
| | - Jenna Andrews
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Michelle E Ramey
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Jameson D Richard
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Brendan K Podell
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Juan F Muñoz Gutiérrez
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Chad B Frank
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Forgivemore Magunda
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Gregory T Robertson
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Michael Lyons
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Asa Ben-Hur
- Department of Computer Science, Colorado State University, Fort Collins, Colorado, United States of America
| | - Anne J Lenaerts
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, United States of America.
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19
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Plevris N, Chuah CS, Allen RM, Arnott ID, Brennan PN, Chaudhary S, Churchhouse AMD, Din S, Donoghue E, Gaya DR, Groome M, Jafferbhoy HM, Jenkinson PW, Lam WL, Lyons M, Macdonald JC, MacMaster M, Mowat C, Naismith GD, Potts LF, Saffouri E, Seenan JP, Sengupta A, Shasi P, Sutherland DI, Todd JA, Veryan J, Watson AJM, Watts DA, Jones GR, Lees CW. Real-world Effectiveness and Safety of Vedolizumab for the Treatment of Inflammatory Bowel Disease: The Scottish Vedolizumab Cohort. J Crohns Colitis 2019; 13:1111-1120. [PMID: 30768123 DOI: 10.1093/ecco-jcc/jjz042] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 02/08/2023]
Abstract
BACKGROUND & AIMS Vedolizumab is an anti-a4b7 monoclonal antibody that is licensed for the treatment of moderate to severe Crohn's disease and ulcerative colitis. The aims of this study were to establish the real-world effectiveness and safety of vedolizumab for the treatment of inflammatory bowel disease. METHODS This was a retrospective study involving seven NHS health boards in Scotland between June 2015 and November 2017. Inclusion criteria included: a diagnosis of ulcerative colitis or Crohn's disease with objective evidence of active inflammation at baseline (Harvey-Bradshaw Index[HBI] ≥5/Partial Mayo ≥2 plus C-reactive protein [CRP] >5 mg/L or faecal calprotectin ≥250 µg/g or inflammation on endoscopy/magnetic resonance imaging [MRI]); completion of induction; and at least one clinical follow-up by 12 months. Kaplan-Meier survival analysis was used to establish 12-month cumulative rates of clinical remission, mucosal healing, and deep remission [clinical remission plus mucosal healing]. Rates of serious adverse events were described quantitatively. RESULTS Our cohort consisted of 180 patients with ulcerative colitis and 260 with Crohn's disease. Combined median follow-up was 52 weeks (interquartile range [IQR] 26-52 weeks). In ulcerative colitis, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 57.4%, 47.3%, and 38.5%, respectively. In Crohn's disease, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 58.4%, 38.9%, and 28.3% respectively. The serious adverse event rate was 15.6 per 100 patient-years of follow-up. CONCLUSIONS Vedolizumab is a safe and effective treatment for achieving both clinical remission and mucosal healing in ulcerative colitis and Crohn's disease.
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Affiliation(s)
- N Plevris
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - C S Chuah
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - R M Allen
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - I D Arnott
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - P N Brennan
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - S Chaudhary
- Department of Gastroenterology, University Hospital Hairmyres, East Kilbride, UK
| | | | - S Din
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - E Donoghue
- Department of Gastroenterology, Forth Valley Royal Hospital, Larbert, UK
| | - D R Gaya
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - M Groome
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - H M Jafferbhoy
- Department of Gastroenterology, Victoria Hospital, Kirkcaldy, UK
| | - P W Jenkinson
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK.,Department of Colorectal Surgery, Raigmore Hospital, Inverness, UK
| | - W L Lam
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - M Lyons
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - J C Macdonald
- Department of Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK
| | - M MacMaster
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - C Mowat
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - G D Naismith
- Department of Gastroenterology, Royal Alexandra Hospital, Paisley, UK
| | - L F Potts
- Department of Gastroenterology, Raigmore Hospital, Inverness, UK
| | - E Saffouri
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - J P Seenan
- Department of Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK
| | - A Sengupta
- Department of Gastroenterology, Victoria Hospital, Kirkcaldy, UK
| | - P Shasi
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - D I Sutherland
- Department of Gastroenterology, University Hospital Hairmyres, East Kilbride, UK
| | - J A Todd
- Department of Gastroenterology, Ninewells Hospital, Dundee, UK
| | - J Veryan
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - A J M Watson
- Department of Colorectal Surgery, Raigmore Hospital, Inverness, UK
| | - D A Watts
- Department of Gastroenterology, Forth Valley Royal Hospital, Larbert, UK
| | - G R Jones
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - C W Lees
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
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20
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Jones GR, Fascì-Spurio F, Kennedy NA, Plevris N, Jenkinson P, Lyons M, Wong L, MacLean P, Glancy S, Lees CW. Faecal Calprotectin and Magnetic Resonance Enterography in Ileal Crohn's Disease: Correlations Between Disease Activity and Long-Term Follow-Up. J Crohns Colitis 2019; 13:442-450. [PMID: 30452618 DOI: 10.1093/ecco-jcc/jjy187] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 02/08/2023]
Abstract
BACKGROUND AND AIMS Magnetic resonance enterography [MRE] is the gold standard for assessing ileal inflammation in Crohn's disease [CD]. The aim of the present study was to correlate faecal calprotectin [FC] to MRE via a simple score in an exclusive ileal cohort with long-term follow-up for association with time to surgery or biologic therapy. METHODS In total, 150 MRE studies with matched FC [±30 days] were identified from the Edinburgh FC Register [2008-12; n = 18138]. Scans were re-read blinded to clinical data, independently, by two expert gastrointestinal radiologists, to generate a simple MRE score [range 0-10] from assessment of the worst intestinal segment plus total disease extent. RESULTS In total, 119 MRE scans were evaluated from 104 patients with ileal CD [L1 or L3 with panproctocolectomy]. Receiver operating characteristic analysis showed an area under the curve of 0.77 [0.67-0.87, p < 0.0001] for FC and MRE score >1, with an optimal cut-off of 145 μg/g for severe inflammation on MRE with 69.3% [57.6-79.5] sensitivity and 71.4% [53.7-85.4] specificity. Long-term follow-up over a median [interquartile range] of 2086 days [1786-2353] revealed FC ≥ 145 μg/g was associated with reduced biologic-free survival until 3 years following MRE, whereas MRE score [severe vs absent] was associated with reduced surgery- and biologic-free survival throughout follow-up. Backwards stepwise logistic regression revealed that length of ileal disease (odds ratio [OR] 3.8, 1.1-13.2, p = 0.034) and increased bowel wall thickness at MRE [OR 4.2, 1.6-10.7, p < 0.0001] or female sex [OR 5.2, 1.5-18.7, p = 0.011] increased the risk of biologic use or surgery, respectively. CONCLUSIONS FC correlates well with MRE assessment of ileal CD with MRE parameters associated with long-term biologic- and surgery-free remission.
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Affiliation(s)
- G R Jones
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK.,University of Edinburgh, Gastrointestinal Unit, Centre for Genomic and Experimental Medicine, Edinburgh, UK
| | - F Fascì-Spurio
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK.,Sapienza University, Gastroenterology Unit, Rome, Italy
| | - N A Kennedy
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK.,University of Edinburgh, Gastrointestinal Unit, Centre for Genomic and Experimental Medicine, Edinburgh, UK
| | - N Plevris
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK
| | - P Jenkinson
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK
| | - M Lyons
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK
| | - L Wong
- Western General Hospital, Department of Radiology, Edinburgh, UK
| | - P MacLean
- Western General Hospital, Department of Radiology, Edinburgh, UK
| | - S Glancy
- Western General Hospital, Department of Radiology, Edinburgh, UK
| | - C W Lees
- Western General Hospital, Gastrointestinal Unit, Edinburgh, UK.,University of Edinburgh, Gastrointestinal Unit, Centre for Genomic and Experimental Medicine, Edinburgh, UK
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21
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Carson P, Lyons M. Severe Rhinitis Medicamentosa Successfully Treated with Rhinolight® Endonasal UV Phototherapy. Ir Med J 2019; 112:874. [PMID: 30875167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aim Report successful application of UV endonasal phototherapy as a treatment for severe rhinitis medicamentosa and allergic rhinitis. Methods Allergic rhinitis confirmed by history and skin prick testing; rhinitis medicamentosa based on history. Both confirmed at nasendoscopy. Symptom score before & after treatment. Introduction of Rhinolight endonasal u/v phototherapy for allergic rhinitis. Single patient report. Results Successful remission of Rhinitis Medicamentosa confirmed with patient after eight sessions Rhinolight endonasal phototherapy. Use of nasal decongestant dropped from 2 bottles/daily x 4 years to zero. Symptoms reduced from 25 pre-treatment to 6 post-treatment. Rhinitis medicamentosa is clinically characterized by nasal congestion without rhinorrhea, postnasal drip, or sneezing that begins after using a nasal decongestant for more than 3 days. Treatment involves discontinuation of the offending drug. Discussion Rhinolight endonasal phototherapy is a new treatment for allergic rhinitis and offered as last resort for a patient with untreated allergic rhinitis and overuse of topical decongestants. Patient reports a significant improvement in symptoms with cessation of topical decongestant. Report a successful application of UV endonasal phototherapy as a treatment for severe rhinitis medicamentosa against a background of long standing allergic rhinitis.
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Affiliation(s)
- P Carson
- Slievemore Clinic, Dublin, Ireland
| | - M Lyons
- Edinburgh Medical School, Scotland
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22
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Harrison NR, Youssef FF, Lyons M. Brief Exposure to Pictures Depicting Poor Environments Leads to Increased Consumption of Beer in Adult Social Drinkers. Subst Use Misuse 2019; 54:681-691. [PMID: 30465469 DOI: 10.1080/10826084.2018.1536151] [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] [Indexed: 10/27/2022]
Abstract
Previous studies have suggested a trait-like association between neighborhood deprivation and alcohol consumption. However, it is not known whether temporarily manipulating poverty and affluence states by exposure to stimuli signifying resource-scarcity or resource-wealth would influence alcohol-seeking behavior. Here, we aimed to investigate whether implicit exposure to affluence and poverty-related pictures would influence beer consumption. Participants in a "poverty" group viewed pictures depicting impoverished environments, and participants in an "affluence" group viewed images of wealthy environments. After priming, participants were provided with nonalcoholic beer (which they were told was alcohol-containing beer) and orange juice under the guise of a bogus taste test, to measure their alcohol-seeking behavior. Results showed that priming participants with a resource-scarce environment led to an increase in beer consumption (as a percentage of total fluid consumed), compared to priming with a resource-rich environment. The same pattern of results was obtained in both a Western European sample (Experiment 1) and a West Indian sample (Experiment 2). In Experiment 2, we also tested whether risk-taking behavior, measured by the Balloon Analogue Risk Task, was influenced by the environmental priming; no differences between groups were observed. These results provide the first experimental evidence that manipulation of poverty-affluence state, by brief exposure to pictures of impoverished or wealthy neighborhoods, can influence alcohol-seeking behavior in adult social drinkers.
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Affiliation(s)
- N R Harrison
- a Department of Psychology , Liverpool Hope University , Liverpool , UK
| | - F F Youssef
- b Department of Preclinical Sciences, Faculty of Medical Sciences , The University of the West Indies , St. Augustine , Trinidad and Tobago
| | - M Lyons
- c School of Psychology , The University of Liverpool , Liverpool , Liverpool , UK
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Abstract
The tetracycline antibiotics incorporate into bone similar to bisphosphonates. Tetracycline stains bone a fluorescent yellow and minocycline, more commonly used for chronic acne, stains bone dark green. Owing to its frequent use, the occurrence of green bone discoloration due to antibiotics in the tetracycline class is well understood. Its pigmentation can be seen through delicate, thin tissue as a dark blue-gray. Histologic inspection of this bone will confirm a benign condition without evidence of bone disease. Although yellow and green discoloration has been documented frequently in association with oral surgery, it has been reported less commonly in the lower extremity. Green discoloration of bone has rarely been reported in the foot and ankle. Unlike other forms of hyperpigmentation of the skin and bone, this entity is benign when resulting from tetracycline therapy. It is always prudent to have a clinical correlate for an unusual discoloration or hyperpigmentation of any tissue when it exists. In the absence of a definitive clinical correlation, a biopsy is warranted. The following case studies provide a pictoral of green bone as it was encountered in the foot and ankle of 2 young adult females undergoing surgery.
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Affiliation(s)
- Molly S Judge
- Director, Research and Publications, Mercy Foot & Ankle Residency Program, Cleveland, OH.
| | - J Michael Miller
- Director of Fellowship Training, Department of surgery, American Health Network, Indianapolis, IN
| | - Michael Lyons
- PGY-IV, Fellow, Department of Surgery, American Health Network, Indianapolis, IN
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Kremen W, Beck A, Gustavson D, Reynolds C, Tu X, Sanderson-Cimino M, Lyons M, Franz C. DOES EDUCATION ENHANCE INTELLECTUAL ABILITY AND COGNITIVE RESERVE? EVIDENCE FOR A SENSITIVE PERIOD. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W Kremen
- University of California San Diego, La Jolla, CA, USA
| | - A Beck
- San Diego State University
| | | | | | - X Tu
- University of California, San Diego
| | | | | | - C Franz
- University of California San Diego
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25
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Slayday R, Franz C, Fang B, Tu X, Gustavson D, Lyons M, Kremen W. INTERACTIVE EFFECTS OF ALCOHOL CONSUMPTION AND APOE-E4 STATUS ON GENERAL COGNITIVE ABILITY IN MIDDLE-AGED MEN. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - C Franz
- University of California San Diego
| | - B Fang
- University of California San Diego
| | - X Tu
- University of California, San Diego
| | | | | | - W Kremen
- University of California San Diego, La Jolla, CA, USA
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26
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Toomey R, Coyne A, Franz C, McKenzie R, Panizzon M, Kremen W, Lyons M. DEPRESSION, INFLAMMATION AND CARDIOVASCULAR BURDEN IN MIDDLE AGE TWINS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A Coyne
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - C Franz
- University of California San Diego
| | - R McKenzie
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - M Panizzon
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - W Kremen
- University of California San Diego, La Jolla, CA, USA
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27
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Winders WT, Ariizumi R, Hart K, Elder N, Lyons M, Lindsell C, Adeoye O. Hypertensive ED patients: Missed opportunities for addressing hypertension and facilitating outpatient follow-up. Am J Emerg Med 2018; 36:2268-2275. [PMID: 30297318 DOI: 10.1016/j.ajem.2018.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/23/2018] [Accepted: 09/17/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Hypertension is a leading cause of morbidity and mortality. The emergency department (ED) frequently serves populations with unmet health needs and could have a greater and more systematic role in secondary prevention for hypertension. This study sought to determine, among hypertensive patients discharged from the ED, the frequency that patients 1) received hypertension-specific education, and 2) followed-up with a primary care provider. We secondarily assessed participant beliefs about hypertension. METHODS This non-experimental, observational study enrolled a convenience sample of consenting patients with asymptomatic, markedly elevated blood pressure (systolic ≥160 mmHg or diastolic ≥100 mmHg) with medium to low triage acuity discharged from an urban, academic ED. Discharge instructions were assessed through chart review. Patients followed up per their normal routine without intervention. Participants were interviewed by phone two to four weeks after ED discharge to ascertain outpatient follow-up and describe beliefs about hypertension. RESULTS From April through June 2014, 200 patients were approached, of whom 90 were enrolled. Of these, 77% of patients reported a previous diagnosis of hypertension, and 60% reported current treatment with antihypertensive medications. Five patients (5.5%) received written instructions at discharge addressing hypertension, although 59 (65.6%) reported that they were informed about their elevated blood pressure during the ED visit. Follow-up with a primary care provider within 2-4 weeks of discharge was completed in 57% of cases. None of the patients who received hypertension-specific discharge instructions completed follow-up. CONCLUSIONS Over half of markedly hypertensive patients discharged from the ED followed up with primary care within four weeks. Nonetheless, missed opportunities for improved secondary prevention among ED patients with hypertension are common. There is an urgent need for evidence-based interventions to assist emergency departments in addressing this health threat.
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Affiliation(s)
- Walter Tyler Winders
- Department of Emergency Medicine, Medical University of South Carolina, United States of America.
| | - Ren Ariizumi
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, United States of America.
| | - Kimberly Hart
- Department of Emergency Medicine, Vanderbilt University, Nashville, TN, United States of America.
| | - Nancy Elder
- Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH, United States of America.
| | - Michael Lyons
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, United States of America.
| | - Christopher Lindsell
- Department of Emergency Medicine, Vanderbilt University, Nashville, TN, United States of America
| | - Opeolu Adeoye
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, United States of America.
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Freiermuth C, Harger N, Ancona R, Ryan S, Ruffner A, Lyons M. 331 Implementation of a Standing Order Take-Home Naloxone Initiative in the Emergency Department. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.336] [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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Addicott E, Laurance S, Lyons M, Butler D, Neldner J. When rare species are not important: linking plot-based vegetation classifications and landscape-scale mapping in Australian savanna vegetation. COMMUNITY ECOL 2018. [DOI: 10.1556/168.2018.19.1.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- E. Addicott
- Queensland Herbarium, Mt. Coot-tha Road, Toowong, Department of Environment and Science, Queensland Government, QLD 4066, Australia
- Australian Tropical Herbarium, James Cook University, Cairns, QLD 4870, Australia
- Centre for Tropical Environmental & Sustainability Science (TESS) and College of Science and Engineering, James Cook University, P.O. Box 6811, Cairns, QLD 4870, Australia
| | - S. Laurance
- Centre for Tropical Environmental & Sustainability Science (TESS) and College of Science and Engineering, James Cook University, P.O. Box 6811, Cairns, QLD 4870, Australia
| | - M. Lyons
- Centre for Ecosystem Science, School of Biological, Earth and Environmental Sciences, UNSW Australia, NSW 2052, Australia
- New South Wales Office of Environment and Heritage, NSW 1232, Australia
| | - D. Butler
- Queensland Herbarium, Mt. Coot-tha Road, Toowong, Department of Environment and Science, Queensland Government, QLD 4066, Australia
| | - J. Neldner
- Queensland Herbarium, Mt. Coot-tha Road, Toowong, Department of Environment and Science, Queensland Government, QLD 4066, Australia
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Fisher R, Lyons M, Walls L. Do I Look Like a Surgeon? A Cross-Sectional Study of Career Aspirations of Students at a UK Medical School. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Haas SM, Perazzo JD, Ruffner AH, Ancona RM, Lyons M. The Know∗Now Project: Facilitated Serosorting in HIV-Status Sexual Partner Communication. AIDS Educ Prev 2017; 29:432-442. [PMID: 29068717 DOI: 10.1521/aeap.2017.29.5.432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An intervention was conducted providing access to clinic-verified HIV test results via a secure, web-based informatics platform to facilitate sexual partner HIV-status communication. Participants (N = 28) were men who have sex with men (MSM; HIV- n = 8, HIV+ n = 8) and heterosexuals (Non-MSM, n = 12). Focus groups with same-group members explored interest in using the intervention and baseline attitudes and practices relevant to serosorting. HIV-negative participants overwhelmingly expressed interest, regardless of MSM status. Interest among HIV-positive MSM was mixed. Six month follow-up interviews (n = 16) indicated 94% of all groups accessed the website, 69% had shown documented results to a sexual partner to initiate HIV-status discussion, and 88% reported future interest in using the 24/7 web-based tool with prospective sexual partners. Implications for future interventions facilitating HIV serosorting and sexual partner communication are discussed.
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Affiliation(s)
- Stephen M Haas
- Associate Professor, Department of Communication, University of Cincinnati, Cincinnati, Ohio
| | - Joseph D Perazzo
- Assistant Professor, College of Nursing, University of Cincinnati
| | | | | | - Michael Lyons
- Department of Emergency Medicine, University of Cincinnati
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Tan JH, Yeo JL, Oliver R, Lyons M, Robinson T, Staniforth A, Ahsan A, Walsh J, Jamil-Copley S, Ng Kam Chuen MJ. 122Reducing the burden of unnecessary LINQ implantable loop recorder remote downloads by implementing an in-hospital multidisciplinary strategy to individualise management of patients with high volume downloads. Europace 2017. [DOI: 10.1093/europace/eux283.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Haukoos J, Lyons M, White D, Hopkins E, Mucossi M, Pfeil S, Ruffner A, Signer D, Todorovic T, Al-Tayyib A, Rowan S, Hsieh YH, Sabel A, Rothman R. A Multi-Center Pragmatic Randomized Comparison of HIV Screening Strategy Effectiveness in the Emergency Department: The HIV TESTED Trial. Ann Epidemiol 2017. [DOI: 10.1016/j.annepidem.2017.07.039] [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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Lyons M, Gill E, Hogan B, Hayes E, Feather K, Bain J, Paterson R. The balance of accuracy and reliability in estimating tidal volume from height. J Intensive Care Soc 2017; 18:257. [PMID: 29118843 DOI: 10.1177/1751143716681327] [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: 11/16/2022] Open
Affiliation(s)
- M Lyons
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - E Gill
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - B Hogan
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - E Hayes
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - K Feather
- School of Medicine, University of Edinburgh, Edinburgh, UK
| | - J Bain
- Department of Critical Care, Western General Hospital, Edinburgh, UK
| | - R Paterson
- School of Medicine, University of Edinburgh, Edinburgh, UK.,Department of Critical Care, Western General Hospital, Edinburgh, UK
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Elman JA, Panizzon M, Jak AJ, Franz CE, Lyons M, Kremen WS. [P2–453]: UNDERDIAGNOSIS OF MCI IN LONGITUDINAL STUDIES: THE PROBLEM OF NOT ACCOUNTING FOR PRACTICE EFFECTS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Amy J. Jak
- University of California, San DiegoSan DiegoCAUSA
- VA San Diego Healthcare SystemSan DiegoCAUSA
| | | | | | - William S. Kremen
- University of California, San DiegoLa JollaCAUSA
- VA San Diego Healthcare SystemSan DiegoCAUSA
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Kremen WS, Logue MW, Panizzon M, Elman JA, Gillespie N, Hatton S, Gustavson D, Andreassen O, Dale AM, Lyons M, Neale M, Reynolds C, Franz CE. [P3–114]: ALZHEIMER'S DISEASE POLYGENIC RISK SCORE PREDICTS MILD COGNITIVE IMPAIRMENT (MCI) IN MIDDLE AGE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1325] [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: 10/18/2022]
Affiliation(s)
| | | | | | | | | | - Sean Hatton
- University of California, San DiegoSan DiegoCAUSA
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Lyons M, Lentz A, Coward R, Sukhu T. 175 Lisdexamfetamine Dimesylate (Vyvanse) for the Treatment of Neurogenic Anejaculation. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.12.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The emphasis on community-based services for people with psychiatric disorders requires a concerted response from occupational therapists, if we are to assist people to live meaningful lives in their own communities. This article draws on the fieldwork experiences of 16 Australian and American occupational therapy students, to reflect on fieldwork education and how it may be preparing students to meet the demands of proactive practice in psychiatry. Attention is drawn to the Importance of fieldwork education in community contexts for occupational therapy students, if these future therapists are to be adequately prepared for the demands of community mental health practice.
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Abstract
This article reports on a single case study of an occupational therapist working in a plastic surgery unit at an Australian public hospital. A phenomenological approach was used to explore the therapist's clinical reasoning in depth. Data were gathered over a 3–week period through semi-structured interviews with the informant and through participant observation of therapy sessions with patients and associated activities engaged in by the informant. The resulting narrative data were analysed inductively. The focus of this discussion is on the aspects of personal interactions that influence clinical reasoning. The article examines how such constructs as power, responsibility, caring and competence combine to influence clinical reasoning.
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Philippsen T, Orini M, Martin C, Volkova E, Ormerod J, Sohaib S, Elamin N, Blake S, Sawhney V, Ahmad S, Waring O, Bowers R, Raiman L, Hazelwood T, Mills R, Corrado C, Honarbakhsh S, Von Maydell A, Norrish G, Chubb H, Chubb H, Chubb H, Toledano M, Ruiz A, van Zalen J, Foley P, Pearman C, Rehal O, Foley P, Wong L, Foley P, Pearman C, Brahmbhatt D, Khan H, Wardley J, Akbar S, Christensen L, Hansen M, Brandes A, Tinker A, Munroe P, Lambiase P, Honarbakhsh S, McLean A, Lambiase P, Schilling R, Lane J, Chow A, Earley M, Hunter R, Khan F, Lambiase P, Schilling R, Sporton S, Dhinoja M, Camm C, Xavier R, de Sousa M, Betts T, Shun-Shin M, Wright I, Lim E, Lim P, Koawing M, Lefroy D, Linton N, Davies D, Peters N, Kanagaratnam P, Francis D, Whinnett Z, Khan M, Bowes R, Sahu J, Sheridan P, Rogers D, Kyriacou A, Kelland N, Lewis N, Lee J, Segall E, Diab I, Breitenstein A, Ullah W, Sporton S, Earley M, Finlay M, Dhinoja M, Schilling R, Hunter R, Ahmed M, Petkar S, Davidson N, Stout M, Pearce KP, Leo M, Ginks M, Rajappan K, Bashir Y, Balasubramaniam R, Sopher S, Betts T, Paisey J, Cheong J, Roy D, Adhya S, Williams S, O'Neill M, Niederer S, Providencia R, Srinivasan N, Ahsan S, Lowe M, Segal O, Hunter R, Finlay M, Earley M, Schilling R, Lambiase P, Stella S, Cantwell C, Chowdhury R, Kim S, Linton N, Whinnett Z, Koa-Wing M, Lefroy D, Davies DW, Kanagaratnam P, Lim PB, Qureshi N, Peters N, Cantarutti N, Limongelli G, Elliott P, Kaski J, Williams S, Lal K, Harrison J, Whitaker J, Kiedrowicz R, Wright M, O'Neill M, Harrison J, Whitaker J, Williams S, Wright M, Schaeffter T, Razavi R, O'Neill M, Karim R, Williams S, Harrison J, Whitaker J, Wright M, Schaeffter T, Razavi R, O'Neill M, Montanes M, Ella Field E, Walsh H, Callaghan N, Till J, Mangat J, Lowe M, Kaski J, Ruiz Duthil A, Li A, Saba M, Patel N, Beale L, Brickley G, Lloyd G, French A, Khavandi A, McCrea W, Barnes E, Chandrasekaran B, Parry J, Garth L, Chapman J, Todd D, Hobbs J, Modi S, Waktare J, Hall M, Gupta D, Snowdon R, Papageorgiou N, Providência R, Falconer D, Sewart E, Ahsan S, Segal O, Ezzat V, Rowland E, Lowe M, Lambiase P, Chow A, Swift M, Charlton P, James J, Colling A, Barnes E, Starling L, Kontogeorgis A, Roses-Noguer F, Wong T, Jarman J, Clague J, Till J, Colling A, James J, Hawkins M, Burnell S, Chandrasekaran B, Coulson J, Smith L, Choudhury M, Oguguo E, Boyett M, Morris G, Flinn W, Chari A, Belham M, Pugh P, Somarakis K, Parasa R, Allata A, Hashim H, Mathew T, Kayasundar S, Venables P, Quinn J, Ivanova J, Brown S, Oliver R, Lyons M, Chuen M, Walsh J, Robinson T, Staniforth A, Ahsan A, Jamil-Copley S. POSTERS (2)96CONTINUOUS VERSUS INTERMITTENT MONITORING FOR DETECTION OF SUBCLINICAL ATRIAL FIBRILLATION IN HIGH-RISK PATIENTS97HIGH DAY-TO-DAY INTRA-INDIVIDUAL REPRODUCIBILITY OF THE HEART RATE RESPONSE TO EXERCISE IN THE UK BIOBANK DATA98USE OF NOVEL GLOBAL ULTRASOUND IMAGING AND CONTINUEOUS DIPOLE DENSITY MAPPING TO GUIDE ABLATION IN MACRO-REENTRANT TACHYCARDIAS99ANTICOAGULATION AND THE RISK OF COMPLICATIONS IN PATIENTS UNDERGOING VT AND PVC ABLATION100NON-SUSTAINED VENTRICULAR TACHYCARDIA FREQUENTLY PRECEDES CARDIAC ARREST IN PATIENTS WITH BRUGADA SYNDROME101USING HIGH PRECISION HAEMODYNAMIC MEASUREMENTS TO ASSESS DIFFERENCES IN AV OPTIMUM BETWEEN DIFFERENT LEFT VENTRICULAR LEAD POSITIONS IN BIVENTRICULAR PACING102CAN WE PREDICT MEDIUM TERM MORTALITY FROM TRANSVENOUS LEAD EXTRACTION PRE-OPERATIVELY?103PREVENTION OF UNECESSARY ADMISSIONS IN ATRIAL FIBRILLATION104EPICARDIAL CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA ON UNINTERRUPTED WARFARIN: A SAFE APPROACH?105HOW WELL DOES THE NATIONAL INSTITUTE OF CLINICAL EXCELLENCE (NICE) GUIDENCE ON TRANSIENT LOSS OF CONSCIOUSNESS (T-LoC) WORK IN A REAL WORLD? AN AUDIT OF THE SECOND STAGE SPECIALIST CARDIOVASCULAT ASSESSMENT AND DIAGNOSIS106DETECTION OF ATRIAL FIBRILLATION IN COMMUNITY LOCATIONS USING NOVEL TECHNOLOGY'S AS A METHOD OF STROKE PREVENTION IN THE OVER 65'S ASYMPTOMATIC POPULATION - SHOULD IT BECOME STANDARD PRACTISE?107HIGH-DOSE ISOPRENALINE INFUSION AS A METHOD OF INDUCTION OF ATRIAL FIBRILLATION: A MULTI-CENTRE, PLACEBO CONTROLLED CLINICAL TRIAL IN PATIENTS WITH VARYING ARRHYTHMIC RISK108PACEMAKER COMPLICATIONS IN A DISTRICT GENERAL HOSPITAL109CARDIAC RESYNCHRONISATION THERAPY: A TRADE-OFF BETWEEN LEFT VENTRICULAR VOLTAGE OUTPUT AND EJECTION FRACTION?110RAPID DETERIORATION IN LEFT VENTRICULAR FUNCTION AND ACUTE HEART FAILURE AFTER DUAL CHAMBER PACEMAKER INSERTION WITH RESOLUTION FOLLOWING BIVENTRICULAR PACING111LOCALLY PERSONALISED ATRIAL ELECTROPHYSIOLOGY MODELS FROM PENTARAY CATHETER MEASUREMENTS112EVALUATION OF SUBCUTANEOUS ICD VERSUS TRANSVENOUS ICD- A PROPENSITY MATCHED COST-EFFICACY ANALYSIS OF COMPLICATIONS & OUTCOMES113LOCALISING DRIVERS USING ORGANISATIONAL INDEX IN CONTACT MAPPING OF HUMAN PERSISTENT ATRIAL FIBRILLATION114RISK FACTORS FOR SUDDEN CARDIAC DEATH IN PAEDIATRIC HYPERTROPHIC CARDIOMYOPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS115EFFECT OF CATHETER STABILITY AND CONTACT FORCE ON VISITAG DENSITY DURING PULMONARY VEIN ISOLATION116HEPATIC CAPSULE ENHANCEMENT IS COMMONLY SEEN DURING MR-GUIDED ABLATION OF ATRIAL FLUTTER: A MECHANISTIC INSIGHT INTO PROCEDURAL PAIN117DOES HIGHER CONTACT FORCE IMPAIR LESION FORMATION AT THE CAVOTRICUSPID ISTHMUS? INSIGHTS FROM MR-GUIDED ABLATION OF ATRIAL FLUTTER118CLINICAL CHARACTERISATION OF A MALIGNANT SCN5A MUTATION IN CHILDHOOD119RADIOFREQUENCY ASSOCIATED VENTRICULAR FIBRILLATION120CONTRACTILE RESERVE EXPRESSED AS SYSTOLIC VELOCITY DOES NOT PREDICT RESPONSE TO CRT121DAY-CASE DEVICES - A RETROSPECTIVE STUDY USING PATIENT CODING DATA122PATIENTS UNDERGOING SVT ABLATION HAVE A HIGH INCIDENCE OF SECONDARY ARRHYTHMIA ON FOLLOW UP: IMPLICATIONS FOR PRE-PROCEDURE COUNSELLING123PROGNOSTIC ROLE OF HAEMOGLOBINN AND RED BLOOD CELL DITRIBUTION WIDTH IN PATIENTS WITH HEART FAILURE UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY124REMOTE MONITORING AND FOLLOW UP DEVICES125A 20-YEAR, SINGLE-CENTRE EXPERIENCE OF IMPLANTABLE CARDIOVERTER DEFIBRILLATORS (ICD) IN CHILDREN: TIME TO CONSIDER THE SUBCUTANEOUS ICD?126EXPERIENCE OF MAGNETIC REASONANCE IMAGING (MEI) IN PATIENTS WITH MRI CONDITIONAL DEVICES127THE SINUS BRADYCARDIA SEEN IN ATHLETES IS NOT CAUSED BY ENHANCED VAGAL TONE BUT INSTEAD REFLECTS INTRINSIC CHANGES IN THE SINUS NODE REVEALED BY
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(F) BLOCKADE128SUCCESSFUL DAY-CASE PACEMAKER IMPLANTATION - AN EIGHT YEAR SINGLE-CENTRE EXPERIENCE129LEFT VENTRICULAR INDEX MASS ASSOCIATED WITH ESC HYPERTROPHIC CARDIOMYOPATHY RISK SCORE IN PATIENTS WITH ICDs: A TERTIARY CENTRE HCM REGISTRY130A DGH EXPERIENCE OF DAY-CASE CARDIAC PACEMAKER IMPLANTATION131IS PRE-PROCEDURAL FASTING A NECESSITY FOR SAFE PACEMAKER IMPLANTATION? Europace 2016. [DOI: 10.1093/europace/euw274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sparks S, Sidari M, Lyons M, Kritikos A. Pictures of you: Dot stimuli cause motor contagion in presence of a still human form. Conscious Cogn 2016; 45:135-145. [PMID: 27577527 DOI: 10.1016/j.concog.2016.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/29/2016] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
Abstract
In this study, we investigate which visual cues induce participants to encode a non-human motion stimulus in their motor system. Participants performed reach-to-grasp actions to a target after observing a dot moving in a direct or higher-arcing path across a screen. Dot motion occurred in the presence of a meaningless (scrambled human model) stimulus, a still human model, or a human model performing a direct or exaggeratedly curved reach to a target. Our results show that observing the dot displacement causes motor contagion (changes in the height of the observer's hand trajectory) when a human form was visually present in the background (either moving or still). No contagion was evident, however, when this human context was absent (i.e., human image scrambled and not identifiable). This indicates that visual cues suggestive of human agency can determine whether or not moving stimuli are encoded in the motor system.
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Affiliation(s)
- S Sparks
- School of Psychology, University of Queensland, St Lucia 4072, Australia.
| | - M Sidari
- School of Psychology, University of Queensland, St Lucia 4072, Australia
| | - M Lyons
- School of Psychology, University of Queensland, St Lucia 4072, Australia
| | - A Kritikos
- School of Psychology, University of Queensland, St Lucia 4072, Australia
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Bronicki L, Redin C, Drunat S, Piton A, Lyons M, Passemard S, Baumann C, Faivre L, Thevenon J, Rivière JB, Isidor B, Gan G, Francannet C, Gunel M, Jones J, Gleeson J, Willems M, Mandel JL, Stevenson RE, Friez M, Aylsworth AS. MG-112 Ten new cases further delineate the syndromic intellectual disability phenotype caused by mutations in DYRK1A. J Med Genet 2015. [DOI: 10.1136/jmedgenet-2015-103577.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bronicki LM, Redin C, Drunat S, Piton A, Lyons M, Passemard S, Baumann C, Faivre L, Thevenon J, Rivière JB, Isidor B, Gan G, Francannet C, Willems M, Gunel M, Jones JR, Gleeson JG, Mandel JL, Stevenson RE, Friez MJ, Aylsworth AS. Ten new cases further delineate the syndromic intellectual disability phenotype caused by mutations in DYRK1A. Eur J Hum Genet 2015; 23:1482-7. [PMID: 25920557 PMCID: PMC4613470 DOI: 10.1038/ejhg.2015.29] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/18/2014] [Accepted: 01/28/2015] [Indexed: 01/12/2023] Open
Abstract
The dual-specificity tyrosine-phosphorylation-regulated kinase 1A (DYRK1A) gene, located on chromosome 21q22.13 within the Down syndrome critical region, has been implicated in syndromic intellectual disability associated with Down syndrome and autism. DYRK1A has a critical role in brain growth and development primarily by regulating cell proliferation, neurogenesis, neuronal plasticity and survival. Several patients have been reported with chromosome 21 aberrations such as partial monosomy, involving multiple genes including DYRK1A. In addition, seven other individuals have been described with chromosomal rearrangements, intragenic deletions or truncating mutations that disrupt specifically DYRK1A. Most of these patients have microcephaly and all have significant intellectual disability. In the present study, we report 10 unrelated individuals with DYRK1A-associated intellectual disability (ID) who display a recurrent pattern of clinical manifestations including primary or acquired microcephaly, ID ranging from mild to severe, speech delay or absence, seizures, autism, motor delay, deep-set eyes, poor feeding and poor weight gain. We identified unique truncating and non-synonymous mutations (three nonsense, four frameshift and two missense) in DYRK1A in nine patients and a large chromosomal deletion that encompassed DYRK1A in one patient. On the basis of increasing identification of mutations in DYRK1A, we suggest that this gene be considered potentially causative in patients presenting with ID, primary or acquired microcephaly, feeding problems and absent or delayed speech with or without seizures.
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Affiliation(s)
| | - Claire Redin
- Department of Translational Medicine and Neurogenetics, IGBMC, CNRS UMR 7104, INSERM U964, Strasbourg University, Strasbourg, France
| | - Severine Drunat
- Department of Genetics and INSERM U1141, Robert Debré Hospital, Paris, France
| | - Amélie Piton
- Department of Translational Medicine and Neurogenetics, IGBMC, CNRS UMR 7104, INSERM U964, Strasbourg University, Strasbourg, France
- Laboratoire de diagnostic génétique, Faculty of Medicine and CHU Strasbourg, Strasbourg, France
| | | | - Sandrine Passemard
- Department of Genetics and INSERM U1141, Robert Debré Hospital, Paris, France
| | | | - Laurence Faivre
- Fédération Hospitalo- Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), Centre Hospitalier Universitaire Dijon, Dijon, France
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - Julien Thevenon
- Fédération Hospitalo- Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), Centre Hospitalier Universitaire Dijon, Dijon, France
- Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Interrégion Est, Centre Hospitalier Universitaire Dijon, Dijon, France
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - Jean-Baptiste Rivière
- Fédération Hospitalo- Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), Centre Hospitalier Universitaire Dijon, Dijon, France
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
- Laboratoire de Génétique Moléculaire, Plateau Technique de Biologie, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - Bertrand Isidor
- Medical Genetics- Clinical Genetics Unit, CHU de Nantes, Nantes-Cedex, France
| | - Grace Gan
- Department of Translational Medicine and Neurogenetics, IGBMC, CNRS UMR 7104, INSERM U964, Strasbourg University, Strasbourg, France
| | - Christine Francannet
- Service de génétique médicale, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Marjolaine Willems
- Department of Medical Genetics, Reference Center for Rare Diseases, Developmental Disorders and Multiple Congenital Anomalies, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Murat Gunel
- Department of Genetics and Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | | | - Joseph G Gleeson
- Department of Neurosciences, Howard Hughes Medical Institute, Rady Children's Hospital, University of California, San Diego, La Jolla, CA, USA
| | - Jean-Louis Mandel
- Department of Translational Medicine and Neurogenetics, IGBMC, CNRS UMR 7104, INSERM U964, Strasbourg University, Strasbourg, France
- Laboratoire de diagnostic génétique, Faculty of Medicine and CHU Strasbourg, Strasbourg, France
| | | | | | - Arthur S Aylsworth
- Departments of Pediatrics and Genetics, Division of Genetics and Metabolism, University of North Carolina, Chapel Hill, NC, USA
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Langley KG, Brown J, Gerber RJ, Fox J, Friez MJ, Lyons M, Schrier Vergano SA. Beyond Ohdo syndrome: A familial missense mutation broadens the MED12 spectrum. Am J Med Genet A 2015; 167A:3180-5. [PMID: 26338144 DOI: 10.1002/ajmg.a.37354] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/10/2015] [Indexed: 11/06/2022]
Abstract
Intellectual disability (ID) is estimated to affect 1-3% of the general population and is a common reason for referrals to pediatric and adult geneticists, as well as neurologists. There are many genetic and non-genetic causes of ID; X-linked forms are identifiable through their characteristic inheritance pattern. Current testing methods have been able to identify over 100 genes on the X chromosome responsible for X-linked intellectual disability (XLID) syndromes. MED12 [MIM *300188] (mediator complex subunit 12) mutations have been linked to numerous XLID syndromes, including Lujan, FG, and Ohdo, and MED12 is included in many XLID panels. MED12 is located at Xq13.1 and its product has roles in transcriptional activation and repression. We describe two affected male siblings and their unaffected mother with a novel missense mutation in MED12, c.4147G>A (p.Ala1383Thr). The siblings share some features of Ohdo syndrome, including feeding difficulties, microcephaly, and speech delay. However, additional attributes such as hypertonia, eosinophilic esophagitis, penile chordee, and particular facial dysmorphisms depart sufficiently from individuals previously described such that they appear to represent a new and expanded phenotype. This case lends credence to the evolving theory that the subtypes of Ohdo, and perhaps other MED12 disorders, reflect a spectrum of characteristics, rather than distinct syndromes. As XLID panel testing and whole exome sequencing (WES) becomes a standard of care for affected males, further MED12 mutations will broaden the phenotype of these intriguing disorders and challenge clinicians to rethink the current diagnostic boundaries.
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Affiliation(s)
- Katherine G Langley
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.,Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, Virginia
| | | | - Richard J Gerber
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.,Division of Neurodevelopmental Pediatrics, Naval Medical Center Portsmouth, Virginia
| | - Janelle Fox
- Division of Pediatric Urology, Naval Medical Center Portsmouth, Virginia
| | | | | | - Samantha A Schrier Vergano
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.,Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, Virginia
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Lyons M, Mohan H, Winter DC, Simms CK. Biomechanical abdominal wall model applied to hernia repair. Br J Surg 2015; 102:e133-9. [PMID: 25627126 DOI: 10.1002/bjs.9687] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/08/2014] [Accepted: 09/29/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND Most surgical innovations require extensive preclinical testing before employment in the operative environment. There is currently no way to develop and test innovations for abdominal wall surgery that is cheap, repeatable and easy to use. In hernia repair, the required mesh overlap relative to defect size is not established. The aims of this study were to develop a biomechanical model of the abdominal wall based on in vivo pressure measurements, and to apply this to study mesh overlap in hernia repair. METHODS An observational study of intra-abdominal pressure (IAP) levels throughout abdominal surgery was conducted to identify the peak perioperative IAP in vivo. This was then applied in the development of a surrogate abdominal wall model. An in vitro study of mesh overlap for various defect sizes was then conducted using this clinically relevant surrogate abdomen model. RESULTS The mean peak perioperative IAP recorded in the clinical study was 1740 Pa, and occurred during awakening from anaesthesia. This was reproduced in the surrogate abdomen model, which was also able to replicate incisional hernia formation. Using this model, the mesh overlap necessary to prevent hernia formation up to 20 kPa was found, independent of anatomical variations, to be 2 × (defect diameter) + 25 mm. CONCLUSION This study demonstrated that a surgically relevant surrogate abdominal wall model is a useful translational tool in the study of hernia repair. Surgical relevance This study examined the mesh overlap requirements for hernia repair, evaluated in a biomechanical model of the abdomen. Currently, mesh size is selected based on empirical evidence and may underpredict the requirement for large meshes. The study proposes a relationship between the defect size and mesh size to select the appropriate mesh size. Following further trials and investigations, this could be used in clinical practice to reduce the incidence of hernia recurrence.
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Affiliation(s)
- M Lyons
- Trinity Centre for Bioengineering, Department of Mechanical and Manufacturing Engineering, Parsons Building, Trinity College, Dublin, Ireland
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Martin NK, Foster GR, Vilar J, Ryder S, E Cramp M, Gordon F, Dillon JF, Craine N, Busse H, Clements A, Hutchinson SJ, Ustianowski A, Ramsay M, Goldberg DJ, Irving W, Hope V, De Angelis D, Lyons M, Vickerman P, Hickman M. HCV treatment rates and sustained viral response among people who inject drugs in seven UK sites: real world results and modelling of treatment impact. J Viral Hepat 2015; 22:399-408. [PMID: 25288193 PMCID: PMC4409099 DOI: 10.1111/jvh.12338] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hepatitis C virus (HCV) antiviral treatment for people who inject drugs (PWID) could prevent onwards transmission and reduce chronic prevalence. We assessed current PWID treatment rates in seven UK settings and projected the potential impact of current and scaled-up treatment on HCV chronic prevalence. Data on number of PWID treated and sustained viral response rates (SVR) were collected from seven UK settings: Bristol (37-48% HCV chronic prevalence among PWID), East London (37-48%), Manchester (48-56%), Nottingham (37-44%), Plymouth (30-37%), Dundee (20-27%) and North Wales (27-33%). A model of HCV transmission among PWID projected the 10-year impact of (i) current treatment rates and SVR (ii) scale-up with interferon-free direct acting antivirals (IFN-free DAAs) with 90% SVR. Treatment rates varied from <5 to over 25 per 1000 PWID. Pooled intention-to-treat SVR for PWID were 45% genotypes 1/4 [95%CI 33-57%] and 61% genotypes 2/3 [95%CI 47-76%]. Projections of chronic HCV prevalence among PWID after 10 years of current levels of treatment overlapped substantially with current HCV prevalence estimates. Scaling-up treatment to 26/1000 PWID annually (achieved already in two sites) with IFN-free DAAs could achieve an observable absolute reduction in HCV chronic prevalence of at least 15% among PWID in all sites and greater than a halving in chronic HCV in Plymouth, Dundee and North Wales within a decade. Current treatment rates among PWID are unlikely to achieve observable reductions in HCV chronic prevalence over the next 10 years. Achievable scale-up, however, could lead to substantial reductions in HCV chronic prevalence.
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Affiliation(s)
- N K Martin
- School of Social & Community Medicine, University of BristolBristol, UK,Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical MedicineLondon, UK,
Correspondence: Natasha K. Martin, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. E-mail:
| | - G R Foster
- Blizard Institute, Queen Mary's University of LondonLondon, UK
| | - J Vilar
- Pennine Acute Hospitals NHS TrustGreater Manchester, UK
| | - S Ryder
- Nottingham University Hospitals NHS TrustNottingham, UK
| | - M E Cramp
- Plymouth Hospital NHS TrustPlymouth, UK
| | - F Gordon
- University of Bristol Health TrustBristol, UK
| | | | - N Craine
- Health Protection WalesBangor, Wales, UK
| | - H Busse
- School of Social & Community Medicine, University of BristolBristol, UK
| | | | - S J Hutchinson
- Glasgow Caledonian UniversityGlasgow, UK,Health Protection ScotlandGlasgow, UK
| | - A Ustianowski
- Pennine Acute Hospitals NHS TrustGreater Manchester, UK
| | | | | | - W Irving
- University of NottinghamNottingham, UK
| | - V Hope
- Public Health EnglandLondon, UK
| | | | - M Lyons
- Health Protection WalesBangor, Wales, UK
| | - P Vickerman
- School of Social & Community Medicine, University of BristolBristol, UK,Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical MedicineLondon, UK
| | - M Hickman
- School of Social & Community Medicine, University of BristolBristol, UK
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Williams JG, Bachman MW, Jones AW, Myers JB, Kronhaus AK, Miller DL, Currie B, Lyons M, Zalkin J, Register-Mihalik JK, Tibbo-Valeriote H, De Maio VJ. Retrospective Validation of a Protocol to Limit Unnecessary Transport of Assisted-living Residents Who Fall. PREHOSP EMERG CARE 2014; 19:68-78. [DOI: 10.3109/10903127.2014.936631] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Craine N, Midgley C, Zou L, Evans H, Whitaker R, Lyons M. Elevated teenage conception risk amongst looked after children; a national audit. Public Health 2014; 128:668-70. [DOI: 10.1016/j.puhe.2014.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
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Whitaker R, Hendry M, Booth A, Carter B, Charles J, Craine N, Edwards RT, Lyons M, Noyes J, Pasterfield D, Rycroft-Malone J, Williams N. Intervention Now To Eliminate Repeat Unintended Pregnancy in Teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, qualitative and realist synthesis of implementation factors and user engagement. BMJ Open 2014; 4:e004733. [PMID: 24722200 PMCID: PMC3987728 DOI: 10.1136/bmjopen-2013-004733] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The UK has the highest rate of teenage pregnancies in Western Europe, a fifth are repeat pregnancies. Unintended conceptions can result in emotional, psychological and educational harm to teenage girls, often with enduring implications for their life chances. Babies of teenage mothers have increased mortality in their first year and increased risk of poverty, educational underachievement and unemployment later in life, with associated societal costs. METHODS AND ANALYSIS We will conduct a streamed, mixed-methods systematic review to find and evaluate interventions designed to reduce repeat unintended teen pregnancies. OUR AIMS ARE TO IDENTIFY Who is at greater risk of repeat unintended pregnancies? Which interventions are effective, cost-effective, how they work, in what setting and for whom? What are the barriers and facilitators to intervention uptake? Traditional electronic database searches will be augmented by targeted searches for evidence 'clusters' and guided by an advisory group of experts and stakeholders. To address the topic's inherent complexities, we will use a highly structured, innovative and iterative approach combining methodological techniques tailored to each stream of evidence. Quantitative data will be synthesised with reference to Cochrane guidelines for public health interventions. Qualitative evidence addressing facilitators and barriers to the uptake of interventions, experience and acceptability of interventions will be synthesised thematically. We will apply the principles of realist synthesis to uncover theories and mechanisms underpinning interventions. We will conduct an integration and overarching narrative of findings authenticated by client group feedback. ETHICS AND DISSEMINATION We will publish the complete review in 'Health Technology Assessment' and sections in specialist peer-reviewed journals. We will present at national and international conferences in the fields of public health, reproductive medicine and review methodology. Findings will be fed back to service users and practitioners via workshops run by the partner collaborators. TRAIL REGISTRATION NUMBER PROSPERO CRD42012003168. COCHRANE REGISTRATION NUMBER i=fertility/0068.
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Affiliation(s)
- Rh Whitaker
- North Wales Organisation for Randomised Trials in Health, Y Wern, Normal Site, Holyhead Road, Bangor University, Bangor, Gwynedd, UK
| | - M Hendry
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - A Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - B Carter
- Institute of Primary Care and Public Health, Cardiff University School of Medicine, Cardiff, UK
| | - J Charles
- Centre for Health Economics & Medicines Evaluation, Institute of Medical and Social Care Research, Bangor University, Bangor, UK
| | - N Craine
- Micobiology Department/Adran Microbioleg, Public Health Wales/Iechyd Cyhoeddus Cymru, Ysbyty Gwynedd, Bangor, Gwynedd, UK
| | - R T Edwards
- Centre for Health Economics & Medicines Evaluation, Institute of Medical and Social Care Research, Bangor University, Bangor, UK
| | - M Lyons
- Health Protection Division, Temple of Peace, Cathays Park, Cardiff, UK
| | - J Noyes
- Centre for Health Related Research, School of Healthcare Sciences, Fron Heulog, Bangor University, Bangor, UK
| | - D Pasterfield
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - J Rycroft-Malone
- Centre for Health Related Research, School of Healthcare Sciences, Fron Heulog, Bangor University, Bangor, UK
| | - N Williams
- North Wales Organisation for Randomised Trials in Health, Y Wern, Normal Site, Holyhead Road, Bangor University, Bangor, Gwynedd, UK
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Blanchard A, Lyons M, Nelson E. What is past is prologue: Pre-natal testosterone and parental bonding predicts adult attachment styles. Personality and Individual Differences 2014. [DOI: 10.1016/j.paid.2013.07.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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