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Zadeh H, Curran M, Del Castillo N, Morales C, Dukes K, Martinez D, Salinas JL, Bryant R, Bojang M, Carvour ML. Epidemiological approaches to multivariable models of health inequity: A study of race, rurality, and occupation during the COVID-19 pandemic. Ann Epidemiol 2024; 94:42-48. [PMID: 38642626 DOI: 10.1016/j.annepidem.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Methods for assessing the structural mechanisms of health inequity are not well established. This study applies a phased approach to modeling racial, occupational, and rural disparities on the county level. METHODS Rural counties with disparately high rates of COVID-19 incidence or mortality were randomly paired with in-state control counties with the same rural-urban continuum code. Analysis was restricted to the first six months of the pandemic to represent the baseline structural reserves for each county and reduce biases related to the disruption of these reserves over time. Conditional logistic regression was applied in two phases-first, to examine the demographic distribution of disparities and then, to examine the relationships between these disparities and county-level social and structural reserves. RESULTS In over 200 rural county pairs (205 for incidence, 209 for mortality), disparities were associated with structural variables representing economic factors, healthcare infrastructure, and local industry. Modeling results were sensitive to assumptions about the relationships between race and other social and structural variables measured at the county level, particularly in models intended to reflect effect modification or mediation. CONCLUSIONS Multivariable modeling of health disparities should reflect the social and structural mechanisms of inequity and anticipate interventions that can advance equity.
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Affiliation(s)
- Hannah Zadeh
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Sociology and Criminology, College of Liberal Arts and Sciences, University of Iowa, 401 North Hall, Iowa City, IA 52242, United States
| | - Michaela Curran
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States
| | - Nicole Del Castillo
- Department of Psychiatry, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States
| | - Carol Morales
- Department of Internal Medicine, University of New Mexico School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM 87131, United States
| | - Kimberly Dukes
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States
| | - Denise Martinez
- Department of Family Medicine, Carver College of Medicine, 200 Hawkins Drive, University of Iowa, Iowa City, IA 52242, United States
| | - Jorge L Salinas
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, United States
| | - Rachel Bryant
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States
| | - Matida Bojang
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
| | - Martha L Carvour
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United States; Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, United States.
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Mee JF, Murphy D, Curran M. Bovine congenital defects recorded by veterinary practitioners. Reprod Domest Anim 2024; 59:e14501. [PMID: 37975255 DOI: 10.1111/rda.14501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/06/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023]
Abstract
A mobile phone app was used by 59 veterinary practitioners to collect case histories and images of 191 cattle with congenital defects distributed nationally over a 3-year period. The majority of cases were recorded during the spring calving season (57.6%) in pluriparous dairy dams. The majority of calves were recorded at birth or within the first week (66.5%) in singletons born at full-term. On the majority of farms (75.9%), this was the only congenitally deformed bovine recorded up to that point in the year and on the majority of farms, there were no congenitally deformed cattle recorded in the previous 5 years. The majority of congenital defects (83.5%) were recorded in the musculoskeletal or digestive systems. The three most commonly recorded individual defects were intestinal atresia (24.1%), schistosomus reflexus (20.4%) and ankylosis (6.8%); multiple defects were recorded in 13.1% of cases. These findings highlight the relatively high prevalence of intestinal atresia and schistosomus reflexus in calves attended by veterinary practitioners, which warrants implementation of preventive measures. The project highlights the potential benefits of veterinary-practitioner apps to detect changing trends in endemic, or the emergence of novel, congenital or other conditions.
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Affiliation(s)
- J F Mee
- Teagasc, Animal and Bioscience Research Department, Moorepark Research Centre, Fermoy, Co. Cork, Ireland
| | - D Murphy
- XLVets Ireland & Sliabh Luachra Veterinary Centre, Rathmore, Co. Kerry, Ireland
| | - M Curran
- XLVets Ireland, Newport, Co. Tipperary, Ireland
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Herbach EL, Nash SH, Lizarraga IM, Carnahan RM, Wang K, Ogilvie AC, Curran M, Charlton ME. Patterns of Evidence-Based Care for the Diagnosis, Staging, and First-line Treatment of Breast Cancer by Race-Ethnicity: A SEER-Medicare Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1312-1322. [PMID: 37436422 PMCID: PMC10592343 DOI: 10.1158/1055-9965.epi-23-0218] [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: 03/10/2023] [Revised: 05/18/2023] [Accepted: 07/10/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in guideline-recommended breast cancer treatment are well documented, however studies including diagnostic and staging procedures necessary to determine treatment indications are lacking. The purpose of this study was to characterize patterns in delivery of evidence-based services for the diagnosis, clinical workup, and first-line treatment of breast cancer by race-ethnicity. METHODS SEER-Medicare data were used to identify women diagnosed with invasive breast cancer between 2000 and 2017 at age 66 or older (n = 2,15,605). Evidence-based services included diagnostic procedures (diagnostic mammography and breast biopsy), clinical workup (stage and grade determination, lymph node biopsy, and HR and HER2 status determination), and treatment initiation (surgery, radiation, chemotherapy, hormone therapy, and HER2-targeted therapy). Poisson regression was used to estimate rate ratios (RR) and 95% confidence intervals (CI) for each service. RESULTS Black and American Indian/Alaska Native (AIAN) women had significantly lower rates of evidence-based care across the continuum from diagnostics through first-line treatment compared to non-Hispanic White (NHW) women. AIAN women had the lowest rates of HER2-targeted therapy and hormone therapy initiation. While Black women also had lower initiation of HER2-targeted therapy than NHW, differences in hormone therapy were not observed. CONCLUSIONS Our findings suggest patterns along the continuum of care from diagnostic procedures to treatment initiation may differ across race-ethnicity groups. IMPACT Efforts to improve delivery of guideline-concordant treatment and mitigate racial-ethnic disparities in healthcare and survival should include procedures performed as part of the diagnosis, clinical workup, and staging processes.
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Affiliation(s)
- Emma L. Herbach
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Sarah H. Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Ingrid M. Lizarraga
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Ryan M. Carnahan
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Kai Wang
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA
| | - Amy C. Ogilvie
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Michaela Curran
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA
| | - Mary E. Charlton
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
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Brady D, Curran M, Carpiano RM. A test of the predictive validity of relative versus absolute income for self-reported health and well-being in the United States. Demogr Res 2023; 48:775-808. [PMID: 37588006 PMCID: PMC10430759 DOI: 10.4054/demres.2023.48.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND A classic debate concerns whether absolute or relative income is more salient. Absolute values resources as constant across time and place while relative contextualizes one's hierarchical location in the distribution of a time and place. OBJECTIVE This study investigates specifically whether absolute income or relative income matters more for health and well-being. METHODS We exploit within-person, within-age, and within-time variation with higher-quality income measures and multiple health and well-being outcomes in the United States. Using the Panel Study of Income Dynamics and the Cross-National Equivalent File, we estimate three-way fixed effects models of self-rated health, poor health, psychological distress, and life satisfaction. RESULTS For all four outcomes, relative income has much larger standardized coefficients than absolute income. Robustly, the confidence intervals for relative income do not overlap with zero. By contrast, absolute income mostly has confidence intervals that overlap with zero, and its coefficient is occasionally signed in the wrong direction. A variety of robustness checks support these results. CONCLUSIONS Relative income has far greater predictive validity than absolute income for self-reported health and well-being. CONTRIBUTION Compared to earlier studies, this study provides a more rigorous comparison and test of the predictive validity of absolute and relative income that is uniquely conducted with data on the United States. This informs debates on income measurement, the sources of health and well-being, and inequalities generally. Plausibly, these results can guide any analysis that includes income in models.
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Affiliation(s)
- David Brady
- University of California, Riverside, USA, and WZB Berlin Social Science Center, Germany
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Tierney A, Curran M, Collins L, Kennedy L, McDonnell C, Jurascheck A, Sheikhi A, Walsh C, Button B, Casserly B, Cahalan R. P231 Steps Ahead: optimising physical activity in adults with cystic fibrosis - a pilot randomised trial using wearable technology, goal setting and text message feedback. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00560-4] [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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Curran M, Tierney AC, Button B, Collins L, Kennedy L, McDonnell C, Casserly B, Cahalan R. The effectiveness of exercise interventions to increase physical activity in Cystic Fibrosis: A systematic review. J Cyst Fibros 2021; 21:272-281. [PMID: 34753671 DOI: 10.1016/j.jcf.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/10/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
Physical activity (PA) and exercise have numerous benefits in Cystic Fibrosis (CF) including improved lung function, exercise capacity and quality of life. Despite these benefits, the effectiveness of interventions to promote PA in this population are still largely unknown. The objective of this review was to synthesise existing research and determine whether exercise interventions are effective in promoting PA in people with CF. Using the PRISMA guidelines, a comprehensive search was conducted. Fifteen studies (463 participants) met the inclusion criteria. Eleven studies demonstrated improvements in PA in both short- and long-term interventions. However, the interventions were variable across the included studies, with a large inconsistency in PA assessment tools used. Aerobic training and activity counselling were the two elements identified in this review which most consistently improved PA. Future research should consider larger sample sizes and the use of accurate instruments to assess and track PA levels longitudinally.
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Affiliation(s)
- M Curran
- School of Allied Health, University of Limerick, Limerick, Ireland; University Hospital Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | - A C Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia; Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Limerick, Ireland
| | - B Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia; Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - L Collins
- University Hospital Limerick, Limerick, Ireland
| | - L Kennedy
- University Hospital Limerick, Limerick, Ireland
| | - C McDonnell
- University Hospital Limerick, Limerick, Ireland
| | - B Casserly
- University Hospital Limerick, Limerick, Ireland
| | - R Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Jurascheck A, Sheikhi A, Button B, Casserly B, Cahalan R. P198 Physical activity is associated with aerobic capacity and lung function in adults with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01223-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Button B, Casserly B, Cahalan R. P201 The effectiveness of exercise interventions to increase physical activity in cystic fibrosis: a systematic review. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01226-1] [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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Curran M, Campbell JP, Powell E, Chikhlia A, Narendran P. The mobilisation of early mature CD56dim-CD16bright NK cells is blunted following a single bout of vigorous intensity exercise in Type 1 Diabetes. Exerc Immunol Rev 2020; 26:116-131. [PMID: 32139354] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Type 1 diabetes (T1D) is a T cell mediated autoimmune disease that targets and destroys insulin-secreting pancreatic beta cells. Although T cell mediated, a number of other immune cells are also critically involved in coordinating the events leading to T1D. Specifically, innate subsets play an important role in the pathogenesis of T1D. NK cells are one of the first cell types to infiltrate the pancreas, causing damage and release of beta cell antigens. Previous work in our group has shown differential mobilisation of highly differentiated CD8+ T cells during vigorous intensity exercise in T1D compared to a control cohort. Here, we aimed to explore exercise-induced mobilisation of other cell types involved in T1D pathogenesis. In this study, we investigated the effects of a single bout of vigorous (80% predicted VO2max) intensity exercise on innate cell mobilisation in T1D and control participants. T1D (N=12, mean age 33.2yrs, predicted VO₂max 32.2 ml.kg.min⁻¹, BMI 25.3 kg.m⁻²) and control (N=12, mean age 29.4yrs, predicted VO2 max 38.5 ml.kg.min⁻¹, BMI 23.7 kg.m⁻² male participants completed a 30-minute bout of cycling at 80% predicted VO₂ max in a fasted state. Peripheral blood was collected at baseline, immediately post-exercise, and 1 hour post-exercise. NK cell subsets mobilised during vigorous intensity exercise in both control and T1D participants. However, mature NK cells, defined as the CD56dimCD16bright subset, displayed a lower percentage increase following vigorous intensity exercise in T1D participants (Control: 185.12%, T1D: 97.06%). This blunted mobilisation was specific to early mature NK cells (KIR+) but not later differentiated NK cells (KIR+CD57+). Myeloid lineage subsets mobilised to a similar extent in both control and T1D participants. In conclusion, vigorous exercise mobilises innate immune cells in people with T1D albeit to a different extent to those without T1D. This mobilisation of innate immune cells provides a mechanistic argument to support exercise in people with T1D where it has the potential to improve surveillance for infection and to modulate the autoimmune response to the beta cell.
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Affiliation(s)
- M Curran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Functional and Mechanistic Safety, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - J P Campbell
- Department for Health, University of Bath, Bath, UK
| | - E Powell
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - A Chikhlia
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - P Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Department of Diabetes, The Queen Elizabeth Hospital, Birmingham, UK
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Popp CJ, Butler M, Curran M, Illiano P, Sevick MA, St-Jules DE. Evaluating steady-state resting energy expenditure using indirect calorimetry in adults with overweight and obesity. Clin Nutr 2019; 39:2220-2226. [PMID: 31669004 DOI: 10.1016/j.clnu.2019.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/08/2019] [Accepted: 10/02/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Determining a period of steady state (SS) is recommended when estimating resting energy expenditure (REE) using a metabolic cart. However, this practice may be unnecessarily burdensome and time-consuming in the research setting. AIM The aim of the study was to evaluate the use of SS criteria, and compare it to alternative approaches in adults with overweight and obesity. METHODS In this cross-sectional, ancillary analysis, participants enrolled in a bariatric (study 1; n = 13) and lifestyle (study 2; n = 51) weight loss intervention were included. Indirect calorimetry was performed during baseline measurements using a metabolic cart for 25 min, including a 5-min stabilization period at the start. SS was defined as the first 5-min period with a coefficient of variation (CV) ≤10% for both VO2 and VCO2 (hereafter REE5-SS). Body composition was measured using bioelectrical impedance analysis in study 2 participants only. REE5-SS was compared against the lowest CV (REECV-lowest), 5-min time intervals (REE6-10, REE11-15, REE16-20, REE21-25), 4-min and 3-min SS intervals (REE4-SS and REE3-SS), and time intervals of 6-15, 6-20 and 6-25 min (REE6-15, REE6-20, and REE6-25) using repeated measures ANOVA and Bland-Altman analysis to test for bias, limits of agreement and accuracy (±6% measured REE). RESULTS Participants were 54 ± 13 years old, mostly women (75%) and had a BMI of 35 ± 5 kg/m2. Overall, 54/63 (84%) of participants reached REE5-SS, often (47/54, 87%) within the first 10-min (6-15 min). Alternative approaches to estimating REE had a relatively low bias (-16 to 13 kcals), narrow limits of agreement and high accuracy (83-98%) when compared to REE5-SS, in particular, outperforming standard prediction equations (e.g., Mifflin St. Joer). CONCLUSION Indirect calorimetry measurements that utilize the 5-min SS approach to estimate REE are considered the gold-standard. Under circumstances of non-SS, it appears 4-min and 3-min SS periods, or fixed time intervals of atleast 5 min are accurate and practical alternatives for estimating REE in adults with overweight and obesity. However, future trials should validate alternative methods in similar populations to confirm these findings.
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Affiliation(s)
- C J Popp
- Department of Population Health, New York University, USA.
| | - M Butler
- Department of Population Health, New York University, USA
| | - M Curran
- Department of Population Health, New York University, USA
| | - P Illiano
- Department of Population Health, New York University, USA
| | - M A Sevick
- Department of Population Health, New York University, USA; Department of Medicine, New York University, USA
| | - D E St-Jules
- Department of Population Health, New York University, USA
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Arkin L, Buhr K, Brandling‐Bennett H, Chiu Y, Chong B, Curran M, Hunt R, Paller A, Werth V, Klein‐Gitelman M, Scheven E, Ardalan K. Practice‐based differences in paediatric DLE. Br J Dermatol 2019. [DOI: 10.1111/bjd.18396] [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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Arkin L, Buhr K, Brandling‐Bennett H, Chiu Y, Chong B, Curran M, Hunt R, Paller A, Werth V, Klein‐Gitelman M, Scheven E, Ardalan K. 儿童 DLE 的基于实践的差异. Br J Dermatol 2019. [DOI: 10.1111/bjd.18407] [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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13
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Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Sheikhi A, Walsh C, Casserly B, Cahalan R. ePS3.10 Reliability and validity of the ActivPAL and Fitbit Charge 2 as a measure of step count in cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30268-1] [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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Harries IB, Curran M, Mitrousi K, Williams M, Berlot B, De Francesco V, Lawton C, Bucciarelli-Ducci C. 530Anthracycline-treated cancer survivors with normal LVEF have significant perturbations of longitudinal strain and myocardial tissue composition. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez115.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- I B Harries
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - M Curran
- University of Bristol, Medical School, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - K Mitrousi
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - M Williams
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - B Berlot
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - V De Francesco
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - C Lawton
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - C Bucciarelli-Ducci
- Bristol Heart Institute, Bristol, United Kingdom of Great Britain & Northern Ireland
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Arkin LM, Buhr K, Brandling-Bennett H, Chiu Y, Chong B, Curran M, Hunt R, Paller AS, Werth VP, Klein-Gitelman M, von Scheven E, Ardalan K. Practice-based differences in paediatric discoid lupus erythematosus. Br J Dermatol 2019; 181:805-810. [PMID: 30768778 DOI: 10.1111/bjd.17780] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE. OBJECTIVES The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE. METHODS An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement. RESULTS Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment. CONCLUSIONS We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease.
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Affiliation(s)
- L M Arkin
- Department of Dermatology and Pediatrics, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI, U.S.A
| | - K Buhr
- Department of Biostatistics, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI, U.S.A
| | - H Brandling-Bennett
- Department of Dermatology and Pediatrics, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI, U.S.A
| | - Y Chiu
- Department of Dermatology and Pediatrics, Medical College of Wisconsin, Milwaukee, WI, U.S.A
| | - B Chong
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, U.S.A
| | - M Curran
- Department of Pediatrics, University of Colorado, Denver, CO, U.S.A
| | - R Hunt
- Department of Pediatrics and Dermatology, Baylor College of Medicine, Houston, TX, U.S.A
| | - A S Paller
- Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A
| | - V P Werth
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, U.S.A.,Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, U.S.A
| | - M Klein-Gitelman
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A
| | - E von Scheven
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, U.S.A
| | - K Ardalan
- Department of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A
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Abstract
Cross-national empirical research about the link between income inequality and population health produces conflicting conclusions. We address these mixed findings by examining the degree to which the income inequality and health relationship varies with economic development. We estimate fixed-effects models with different measures of income inequality and population health. Results suggest that development moderates the association between inequality and two measures of population health. Our findings produce two generalizations. First, we observe a global gradient in the relationship between income inequality and population health. Second, our results are consistent with income inequality as a proximate or conditional cause of lower population health. Income inequality has a 139.7% to 374.3% more harmful effect on health in poorer than richer countries and a significantly harmful effect in 2.1% to 53.3% of countries in our sample and 6.6% to 67.6% of the world's population but no significantly harmful effect in richer countries.
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Leeming DJ, Willumsen N, Sand JMB, Holm Nielsen S, Dasgupta B, Brodmerkel C, Curran M, Bager CL, Karsdal MA. A serological marker of the N-terminal neoepitope generated during LOXL2 maturation is elevated in patients with cancer or idiopathic pulmonary fibrosis. Biochem Biophys Rep 2018; 17:38-43. [PMID: 30555938 PMCID: PMC6276730 DOI: 10.1016/j.bbrep.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/01/2018] [Accepted: 11/10/2018] [Indexed: 01/26/2023] Open
Abstract
Objectives Lysyl oxidase like 2 (LOXL2) is associated with poor prognosis in idiopathic pulmonary disease (IPF) and cancer. We developed an Enzyme-linked immunosorbent assay (ELISA) targeting the LOXL2 neo-epitope generated through the release of the signal peptide during LOXL2 maturation. Design and methods An ELISA targeting the N-terminal site of the human LOXL2 was developed including technical optimization and validation steps. Serum LOXL2 was measured in patients with breast, colorectal, lung, ovarian, pancreatic and prostate cancer, melanoma, IPF and in healthy controls (n = 16). Results A technically robust and specific assay was developed. LOXL2 was detectable in serum from healthy controls and showed reactivity towards recombinant LOXL2. Compared to controls, LOXL2 levels were significantly (p < 0.001–0.05) elevated in serum from patients with breast, colerectal, lung, ovarian and pancreatic cancer (mean range: 49–84 ng/mL), but not in prostate cancer (mean: 36 ng/mL) and malignant melanoma patients (41 ng/mL). Serum LOXL2 was elevated in IPF patients compared to healthy controls (mean: 76.5 vs 46.8 ng/mL; p > 0.001) Conclusions A specific ELISA towards the N-terminal neo-epitope site in LOXL2 was developed which detected significantly elevated serum levels from patients with above-mentioned cancer types or IPF compared to healthy controls.
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Affiliation(s)
- D J Leeming
- Nordic Bioscience A/S, Biomarkers and Research, Herlev, Denmark
| | - N Willumsen
- Nordic Bioscience A/S, Biomarkers and Research, Herlev, Denmark
| | - J M B Sand
- Nordic Bioscience A/S, Biomarkers and Research, Herlev, Denmark
| | - S Holm Nielsen
- Nordic Bioscience A/S, Biomarkers and Research, Herlev, Denmark
| | - B Dasgupta
- Janssen Research and Development, LLC, Spring House, PA, USA
| | - C Brodmerkel
- Janssen Research and Development, LLC, Spring House, PA, USA
| | - M Curran
- Janssen Research and Development, LLC, Spring House, PA, USA
| | | | - M A Karsdal
- Nordic Bioscience A/S, Biomarkers and Research, Herlev, Denmark
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Narendran P, Jackson N, Daley A, Thompson D, Stokes K, Greenfield S, Charlton M, Curran M, Solomon TPJ, Nouwen A, Lee SI, Cooper AR, Mostazir M, Taylor RS, Kennedy A, Andrews RC. Exercise to preserve β-cell function in recent-onset Type 1 diabetes mellitus (EXTOD) - a randomized controlled pilot trial. Diabet Med 2017; 34:1521-1531. [PMID: 28905421 DOI: 10.1111/dme.13439] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 01/07/2023]
Abstract
AIM Residual β-cell function is present at the time of diagnosis with Type 1 diabetes. Preserving this β-cell function reduces complications. We hypothesized that exercise preserves β-cell function in Type 1 diabetes and undertook a pilot trial to address the key uncertainties in designing a definitive trial to test this hypothesis. METHODS A randomized controlled pilot trial in adults aged 16-60 years diagnosed with Type 1 diabetes within the previous 3 months was undertaken. Participants were assigned to control (usual care) or intervention (exercise consultation every month), in a 1 : 1 ratio for 12 months. The primary outcomes were recruitment rate, drop out, exercise adherence [weeks with ≥ 150 min of self-reported moderate to vigorous physical activity (MVPA)], and exercise uptake in the control group. The secondary outcomes were differences in insulin sensitivity and rate of loss of β-cell function between intervention and control at 6 and 12 months. RESULTS Of 507 individuals who were approached, 58 (28 control, 30 intervention) entered the study and 41 completed it. Participants were largely white European males, BMI 24.8 ± 3.8 kg/m2 , HbA1c 75 ± 25 mmol/mol (9 ± 2%). Mean level of objectively measured MVPA increased in the intervention group (mean 243 to 273 min/week) and 61% of intervention participants reached the target of ≥ 150 min/week of self-reported MVPA on at least 42 weeks of the year. Physical activity levels fell slightly in the control group (mean 277 to 235 min of MVPA/week). There was exploratory evidence that intervention group became more insulin sensitive and required less insulin. However, the rate of loss of β-cell function appeared similar between the groups, although the change in insulin sensitivity may have affected this. CONCLUSION We show that it is possible to recruit and randomize people with newly diagnosed Type 1 diabetes to a trial of an exercise intervention, and increase and maintain their exercise levels for 12 months. Future trials need to incorporate measures of greater adherence to exercise training targets, and include more appropriate measures of β-cell function. (Clinical Trials Registry No; ISRCTN91388505).
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Affiliation(s)
- P Narendran
- The Institute of Metabolism and Systems Research, Centre for Endocrinology, Diabetes and Metabolism, The Medical School, University of Birmingham, Birmingham, UK
- Department of Diabetes, The Queen Elizabeth Hospital, Birmingham, UK
| | - N Jackson
- Division of Medicine, University of Bristol, Bristol, UK
| | - A Daley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - D Thompson
- School for Health, University of Bath, Bath, UK
| | - K Stokes
- School for Health, University of Bath, Bath, UK
| | - S Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - M Charlton
- Department of Diabetes, The Queen Elizabeth Hospital, Birmingham, UK
| | - M Curran
- The Institute of Metabolism and Systems Research, Centre for Endocrinology, Diabetes and Metabolism, The Medical School, University of Birmingham, Birmingham, UK
| | - T P J Solomon
- The Institute of Metabolism and Systems Research, Centre for Endocrinology, Diabetes and Metabolism, The Medical School, University of Birmingham, Birmingham, UK
| | - A Nouwen
- Department of Psychology, School of Science and Technology, Middlesex University, London, UK
| | - S I Lee
- The Institute of Metabolism and Systems Research, Centre for Endocrinology, Diabetes and Metabolism, The Medical School, University of Birmingham, Birmingham, UK
| | - A R Cooper
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education and Research Centre, Bristol, UK
| | - M Mostazir
- College of Life and Environmental Sciences (CLES), University of Exeter, Exeter, UK
| | - R S Taylor
- Institute of Health Research, University of Exeter, Exeter, UK
| | - A Kennedy
- The Institute of Metabolism and Systems Research, Centre for Endocrinology, Diabetes and Metabolism, The Medical School, University of Birmingham, Birmingham, UK
- Department of Diabetes, The Queen Elizabeth Hospital, Birmingham, UK
| | - R C Andrews
- University of Exeter, Medical School, University of Exeter, Exeter, UK
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Glisson B, Massarelli E, William W, Johnson F, Kies M, Ferrarotto R, Guo M, Peng S, Lee J, Tran H, Kim Y, Haymaker C, Bernatchez C, Curran M, Sanchez Espiridion B, Rodriguez Canales J, Wistuba I, van der Burg S, Wang J, Melief C. Nivolumab and ISA 101 HPV vaccine in incurable HPV-16+ cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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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20
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Kehlet SN, Bager CL, Willumsen N, Dasgupta B, Brodmerkel C, Curran M, Brix S, Leeming DJ, Karsdal MA. Cathepsin-S degraded decorin are elevated in fibrotic lung disorders - development and biological validation of a new serum biomarker. BMC Pulm Med 2017; 17:110. [PMID: 28793886 PMCID: PMC5550991 DOI: 10.1186/s12890-017-0455-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023] Open
Abstract
Background Decorin is one of the most abundant proteoglycans of the extracellular matrix and is mainly secreted and deposited in the interstitial matrix by fibroblasts where it plays an important role in collagen turnover and tissue homeostasis. Degradation of decorin might disturb normal tissue homeostasis contributing to extracellular matrix remodeling diseases. Here, we present the development and validation of a competitive enzyme-linked immunosorbent assay (ELISA) quantifying a specific fragment of degraded decorin, which has potential as a novel non-invasive serum biomarker for fibrotic lung disorders. Methods A fragment of decorin cleaved in vitro using human articular cartilage was identified by mass-spectrometry (MS/MS). Monoclonal antibodies were raised against the neo-epitope of the cleaved decorin fragment and a competitive ELISA assay (DCN-CS) was developed. The assay was evaluated by determining the inter- and intra-assay precision, dilution recovery, accuracy, analyte stability and interference. Serum levels were assessed in lung cancer patients, patients with idiopathic pulmonary fibrosis (IPF), patients with chronic obstructive pulmonary disease (COPD) and healthy controls. Results The DCN-CS ELISA was technically robust and was specific for decorin cleaved by cathepsin-S. DCN-CS was elevated in lung cancer patients (p < 0.0001) and IPF patients (p < 0.001) when compared to healthy controls. The diagnostic power for differentiating lung cancer patients and IPF patients from healthy controls was 0.96 and 0.77, respectively. Conclusion Cathepsin-S degraded decorin could be quantified in serum using the DCN-CS competitive ELISA. The clinical data indicated that degradation of decorin by cathepsin-S is an important part of the pathology of lung cancer and IPF.
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Affiliation(s)
- S N Kehlet
- Nordic Bioscience A/S, Herlev, Denmark. .,Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark.
| | | | | | - B Dasgupta
- Janssen Pharmaceutical Companies of J & J, LLC, Springhouse, PA, USA
| | - C Brodmerkel
- Janssen Pharmaceutical Companies of J & J, LLC, Springhouse, PA, USA
| | - M Curran
- Janssen Pharmaceutical Companies of J & J, LLC, Springhouse, PA, USA
| | - S Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
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Owen JE, Curran M, Bantum EO, Hanneman R. Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention. Cyberpsychol Behav Soc Netw 2017; 19:388-96. [PMID: 27327066 DOI: 10.1089/cyber.2015.0359] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Web and mobile (mHealth) interventions have promise for improving health outcomes, but engagement and attrition may be reducing effect sizes. Because social networks can improve engagement, which is a key mechanism of action, understanding the structure and potential impact of social networks could be key to improving mHealth effects. This study (a) evaluates social network characteristics of four distinct communication channels (discussion board, chat, e-mail, and blog) in a large social networking intervention, (b) predicts membership in online communities, and (c) evaluates whether community membership impacts engagement. Participants were 299 cancer survivors with significant distress using the 12-week health-space.net intervention. Social networking attributes (e.g., density and clustering) were identified separately for each type of network communication (i.e., discussion board, blog, web mail, and chat). Each channel demonstrated high levels of clustering, and being a community member in one communication channel was associated with being in the same community in each of the other channels (φ = 0.56-0.89, ps < 0.05). Predictors of community membership differed across communication channels, suggesting that each channel reached distinct types of users. Finally, membership in a discussion board, chat, or blog community was strongly associated with time spent engaging with coping skills exercises (Ds = 1.08-1.84, ps < 0.001) and total time of intervention (Ds = 1.13-1.80, ps < 0.001). mHealth interventions that offer multiple channels for communication allow participants to expand the number of individuals with whom they are communicating, create opportunities for communicating with different individuals in distinct channels, and likely enhance overall engagement.
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Affiliation(s)
- Jason E Owen
- 1 Veterans Affairs Palo Alto Health Care System, Dissemination & Training Division, National Center for Posttraumatic Stress Disorder , Menlo Park, California
| | - Michaela Curran
- 2 Department of Sociology, University of California , Riverside, California
| | | | - Robert Hanneman
- 2 Department of Sociology, University of California , Riverside, California
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Arienzo MM, McConnell JR, Chellman N, Criscitiello AS, Curran M, Fritzsche D, Kipfstuhl S, Mulvaney R, Nolan M, Opel T, Sigl M, Steffensen JP. A Method for Continuous (239)Pu Determinations in Arctic and Antarctic Ice Cores. Environ Sci Technol 2016; 50:7066-7073. [PMID: 27244483 DOI: 10.1021/acs.est.6b01108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Atmospheric nuclear weapons testing (NWT) resulted in the injection of plutonium (Pu) into the atmosphere and subsequent global deposition. We present a new method for continuous semiquantitative measurement of (239)Pu in ice cores, which was used to develop annual records of fallout from NWT in ten ice cores from Greenland and Antarctica. The (239)Pu was measured directly using an inductively coupled plasma-sector field mass spectrometer, thereby reducing analysis time and increasing depth-resolution with respect to previous methods. To validate this method, we compared our one year averaged results to published (239)Pu records and other records of NWT. The (239)Pu profiles from the Arctic ice cores reflected global trends in NWT and were in agreement with discrete Pu profiles from lower latitude ice cores. The (239)Pu measurements in the Antarctic ice cores tracked low latitude NWT, consistent with previously published discrete records from Antarctica. Advantages of the continuous (239)Pu measurement method are (1) reduced sample preparation and analysis time; (2) no requirement for additional ice samples for NWT fallout determinations; (3) measurements are exactly coregistered with all other chemical, elemental, isotopic, and gas measurements from the continuous analytical system; and (4) the long half-life means the (239)Pu record is stable through time.
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Affiliation(s)
- M M Arienzo
- Desert Research Institute , 2215 Raggio Parkway, Reno, Nevada 89512, United States
| | - J R McConnell
- Desert Research Institute , 2215 Raggio Parkway, Reno, Nevada 89512, United States
| | - N Chellman
- Desert Research Institute , 2215 Raggio Parkway, Reno, Nevada 89512, United States
| | - A S Criscitiello
- University of Calgary , 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada
| | - M Curran
- Australian Antarctic Division, 203 Channel Highway, Kingston Tasmania 7050, Australia
- Antarctic Climate and Ecosystems Cooperative Research Centre, University of Tasmania , Hobart 7001, Australia
| | - D Fritzsche
- Alfred-Wegener-Institut, Potsdam/Bremerhaven, Germany
| | - S Kipfstuhl
- Alfred-Wegener-Institut, Potsdam/Bremerhaven, Germany
| | - R Mulvaney
- British Antarctic Survey, High Cross, Madingley Road, Cambridge CB3 0ET, United Kingdom
| | - M Nolan
- University of Alaska Fairbanks , 505 N Chandalar Dr, Fairbanks, Alaska 99775, United States
| | - T Opel
- Alfred-Wegener-Institut, Potsdam/Bremerhaven, Germany
| | - M Sigl
- Paul Scherrer Institute , 5232 Villigen, Switzerland
| | - J P Steffensen
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen , Copenhagen, Denmark
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Dasgupta B, Cherkas Y, Lamberth S, Hayden K, Brodmerkel C, Marotta A, Curran M. FRI0009 Serum 14-3-3 ETA Is An RA Specific Mechanistic Marker. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4292] [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: 11/03/2022]
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Gourley I, Calderon C, Beyer M, Hamade L, Margolies R, Gilmer K, Messina T, Fields O, Tisdale D, Curran M, Rowe A. SAT0063 Remote Assessment of Daily Fluctuations of Patient-Reported Disease Symptoms and Activity in Rheumatoid Arthritis: Feasibility, Compliance and Acceptability. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stevens B, Torok K, Li S, Hershey N, Curran M, Higgins G, Moore K, Rabinovich E, Stevens A. SAT0256 Juvenile Systemic Sclerosis Cohort within The Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry: Baseline and Follow Up Characteristics. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4299] [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: 11/03/2022]
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Silkoff PE, Strambu I, Laviolette M, Singh D, FitzGerald JM, Lam S, Kelsen S, Eich A, Ludwig-Sengpiel A, Hupp GC, Backer V, Porsbjerg C, Girodet PO, Berger P, Leigh R, Kline JN, Dransfield M, Calhoun W, Hussaini A, Khatri S, Chanez P, Susulic VS, Barnathan ES, Curran M, Das AM, Brodmerkel C, Baribaud F, Loza MJ. Asthma characteristics and biomarkers from the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) longitudinal profiling study. Respir Res 2015; 16:142. [PMID: 26576744 PMCID: PMC4650115 DOI: 10.1186/s12931-015-0299-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/31/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Asthma is a heterogeneous disease and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. The purpose of the ADEPT study was to correlate clinical features and biomarkers with molecular characteristics, by profiling asthma (NCT01274507). This report presents for the first time the study design, and characteristics of the recruited subjects. METHODS Patients with a range of asthma severity and healthy non-atopic controls were enrolled. The asthmatic subjects were followed for 12 months. Assessments included history, patient questionnaires, spirometry, airway hyper-responsiveness to methacholine, fractional exhaled nitric oxide (FENO), and biomarkers measured in induced sputum, blood, and bronchoscopy samples. All subjects underwent sputum induction and 30 subjects/cohort had bronchoscopy. RESULTS Mild (n = 52), moderate (n = 55), severe (n = 51) asthma cohorts and 30 healthy controls were enrolled from North America and Western Europe. Airflow obstruction, bronchodilator response and airways hyperresponsiveness increased with asthma severity, and severe asthma subjects had reduced forced vital capacity. Asthma control questionnaire-7 (ACQ7) scores worsened with asthma severity. In the asthmatics, mean values for all clinical and biomarker characteristics were stable over 12 months although individual variability was evident. FENO and blood eosinophils did not differ by asthma severity. Induced sputum eosinophils but not neutrophils were lower in mild compared to the moderate and severe asthma cohorts. CONCLUSIONS The ADEPT study successfully enrolled asthmatics across a spectrum of severity and non-atopic controls. Clinical characteristics were related to asthma severity and in general asthma characteristics e.g. lung function, were stable over 12 months. Use of the ADEPT data should prove useful in defining biological phenotypes to facilitate personalized therapeutic approaches.
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Affiliation(s)
- P E Silkoff
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA.
| | - I Strambu
- Arensia Exploratory Medicine, Sos. Viilor 90, Bucharest, 050159, Romania.
| | - M Laviolette
- Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ), 2725, Chemin Ste-Foy, Québec, G1V 4G5, Canada.
| | - D Singh
- Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, University of Manchester, Southmoor Road, Manchester, M23 9QZ, UK.
| | - J M FitzGerald
- Institute for Heart and Lung Health, The Lung Centre, 7th Floor, Gordon, Canada. .,Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
| | - S Lam
- Institute for Heart and Lung Health, The Lung Centre, 7th Floor, Gordon, Canada.,Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - S Kelsen
- Department of Thoracic Medicine and Surgery, Temple University School of Medicine, 3401 N. Broad St., Philadelphia, PA, 19140, USA.
| | - A Eich
- IKF Pneumologie Frankfurt, Institut für klinische Forschung Pneumologie, Clinical Research Centre Respiratory Diseases, Schaumainkai 101-103, Stresemannallee, 360596, Frankfurt, Germany.
| | - A Ludwig-Sengpiel
- KLB Gesundheitsforschung Lübeck GmbH, Sandstr. 18, 23552, Lübeck, Germany.
| | - G C Hupp
- Yale Center for Asthma and Airway Disease, Division of Pulmonary and Critical Care and Sleep Medicine, Yale School of Medicine, TAC 441, 300 Cedar Street, New Haven, CT, 06520, USA.
| | - V Backer
- Department of Respiratory Medicine, Respiratory Research Unit, Bispebjerg University Hospital, Bispebjerg bakke 23, DK-2400, Copenhagen, NV, Denmark.
| | - C Porsbjerg
- Department of Respiratory Medicine, Respiratory Research Unit, Bispebjerg University Hospital, Bispebjerg bakke 23, DK-2400, Copenhagen, NV, Denmark.
| | - P O Girodet
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, F-33000, Bordeaux, France
| | - P Berger
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, CIC 1401, F-33000, Bordeaux, France.
| | - R Leigh
- Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - J N Kline
- Division of Pulmonary, C ritical Care, and Occupational Medicine, University of Iowa, W219B GH UIHC, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
| | - M Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham & Birmingham VA Medical Center, 422 THT, 1900 University Blvd, Birmingham, AL, 35294, USA.
| | - W Calhoun
- 4.116 John Sealy Annex, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0568, USA.
| | - A Hussaini
- Parexel International, Shelton Simmons (MD), 3001 S Hanover St #7, Brooklyn, MD, 21225, USA.
| | - S Khatri
- Department of Pulmonary and Critical Care, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
| | - P Chanez
- Department of Respiratory Diseases and CIC Nord AP-HM, UMR INSERM U1067 CNRS 7733, Aix-Marseille Université, Marseille, France.
| | - V S Susulic
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - E S Barnathan
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - M Curran
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - A M Das
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - C Brodmerkel
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - F Baribaud
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
| | - M J Loza
- Janssen Research & Development LLC, 1400 McKean Rd, Springhouse, PA, 19477, USA
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Ranellou K, Crump C, Misra R, Wooldridge D, Rose G, Gharbia S, Parmar S, Curran M, Verlander N, Zhang H, Jalal H. Genomic diversity of BK polyomavirus in East of England – Preliminary data. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.189] [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: 10/23/2022]
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Kristensen JH, Larsen L, Dasgupta B, Brodmerkel C, Curran M, Karsdal MA, Sand JMB, Willumsen N, Knox AJ, Bolton CE, Johnson SR, Hägglund P, Svensson B, Leeming DJ. Levels of circulating MMP-7 degraded elastin are elevated in pulmonary disorders. Clin Biochem 2015; 48:1083-8. [PMID: 26164539 DOI: 10.1016/j.clinbiochem.2015.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 07/03/2015] [Accepted: 07/04/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Elastin is a signature protein of the lungs. Matrix metalloproteinase-7 (MMP-7) is important in lung defence mechanisms and degrades elastin. However, MMP-7 activity in regard to elastin degradation has never been quantified serologically in patients with lung diseases. An assay for the quantification of MMP-7 generated elastin fragments (ELM7) was therefore developed to investigate MMP-7 derived elastin degradation in pulmonary disorders such as idiopathic pulmonary fibrosis (IPF) and lung cancer. DESIGN AND METHODS Monoclonal antibodies (mABs) were raised against eight carefully selected MMP-7 cleavage sites on elastin. After characterisation and validation of the mABs, one mAB targeting the ELM7 fragment was chosen. ELM7 fragment levels were assessed in serum samples from patients diagnosed with IPF (n=123, baseline samples, CTgov reg. NCT00786201), and lung cancer (n=40) and compared with age- and sex-matched controls. RESULTS The ELM7 assay was specific towards in vitro MMP-7 degraded elastin and the ELM7 neoepitope but not towards other MMP-7 derived elastin fragments. Serum ELM7 levels were significantly increased in IPF (113%, p<0.0001) and lung cancer (96%, p<0.0001) compared to matched controls. CONCLUSIONS MMP-7-generated elastin fragments can be quantified in serum and may reflect pathological lung tissue turnover in several important lung diseases.
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Affiliation(s)
- J H Kristensen
- Nordic Bioscience A/S, Herlev, Denmark; The Technical University of Denmark, Department of Systems Biology, Kgs. Lyngby, Denmark.
| | - L Larsen
- Nordic Bioscience A/S, Herlev, Denmark
| | - B Dasgupta
- Janssen Research and Development, LLC, Spring House, PA, USA
| | - C Brodmerkel
- Janssen Research and Development, LLC, Spring House, PA, USA
| | - M Curran
- Janssen Research and Development, LLC, Spring House, PA, USA
| | | | | | | | - A J Knox
- Division of Respiratory Medicine and Respiratory Research Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - C E Bolton
- Division of Respiratory Medicine and Respiratory Research Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - S R Johnson
- Division of Respiratory Medicine and Respiratory Research Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - P Hägglund
- The Technical University of Denmark, Department of Systems Biology, Kgs. Lyngby, Denmark
| | - B Svensson
- The Technical University of Denmark, Department of Systems Biology, Kgs. Lyngby, Denmark
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Hsu B, Wang D, Sun Y, Salvadore G, Singh J, Curran M, Caers I, Drevets W, Wittenberg G, Chen G. SAT0182 Improvement in Measures of Depressed Mood and Anhedonia, and Fatigue, In a Randomized, Placebo-Controlled, Phase 2 Study of Sirukumab, A Human Anti-Interleukin-6 Antibody, In Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Foeldvari I, Györgyi Z, Baildam E, Batu E, Blakley M, Cakan M, Curran M, Fligelstone K, Mouthon L, Nemcova D, Pilkington C, Ruperto N, Tsinti M, Tsitsami E, Urbanvica K, Constantin T. AB0984 Development of a Juvenile Systemic Sclerosis Response Index (JSSRI): Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Walsh A, Whitaker J, Huang C, Cherkas Y, Lamberth S, Brodmerkel C, Curran M, Dobrin R. OP0027 Identification of Molecular Disease Drivers Using eQTLS Derived from a Cohort of Rheumatoid Arthritis Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Foweraker J, Jalili S, Athithan V, Grogono D, Curran M, Floto R. P198 New Approaches To The Culture Of Mycobacterium Abscessus Complex From Patients With Cystic Fibrosis. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.327] [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: 11/03/2022]
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Curran M, Oswald M, Lee A, Cherkas Y, Brodmerkel C, Lamberth S, Gregersen P. FRI0271 Modular Analysis of Peripheral Blood Gene Expression in Rheumatoid Arthritis Captures Reproducible Gene Expression Changes in TNF Responders. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cherkas Y, Brodmerkel C, Curran M, Lamberth S. FRI0038 Pharmacodynamic Effect of Intravenous Golimumab by Messenger RNA Expression Profiling. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Toedter G, Sague S, Wu X, Curran M, Hsu B. THU0105 Effect of sirukumab on hepcidin levels and markers of anemia: Results of a phase 2B trial in patients with active rheumatoid arthritis despite methotrexate therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lamberth S, Cherkas Y, Brodmerkel C, Curran M. SAT0009 Utility of VECTRA-DA™ on Assessment Of Rheumatoid Arthritis Disease Activity and Golimumab Response: Results of a Pilot Study from a Phase 3 Trial in Patients with Active Rheumatoid Arthritis Despite Methotrexate Therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1735] [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: 11/03/2022]
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Curran M, Terry P. Effects of synchronous music use in ultra distance events. J Sci Med Sport 2011. [DOI: 10.1016/j.jsams.2011.11.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cockayne S, Curran M, Denby G, Hashmi F, Hewitt C, Hicks K, Jayakody S, Kang’ombe A, McIntosh C, McLarnon N, Stamuli E, Thomas K, Turner G, Torgerson D, Watt I. EVerT: cryotherapy versus salicylic acid for the treatment of verrucae – a randomised controlled trial. Health Technol Assess 2011; 15:1-170. [PMID: 21899812 DOI: 10.3310/hta15320] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- S Cockayne
- Department of Health Sciences, York Trials Unit, University of York, York, UK
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Tunney MM, Ramage G, Patrick S, Curran M, Nixon JR, Gorman SP. Use of 16S ribosomal (rRNA) genes and immunofluorescence microscopy to detect prosthetic hip infection. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1998.tb02237.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M M Tunney
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast
- School of Pharmacy, The Queen’s University of Belfast
| | - G Ramage
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast
| | - S Patrick
- Department of Microbiology and Immunobiology, School of Clinical Medicine, The Queen’s University of Belfast
| | - M Curran
- Regional Histocompatability and Immunogenetic Laboratory, Belfast City Hospital
| | - J R Nixon
- Musgrave Park Hospital, Belfast BT9 7BL
| | - S P Gorman
- School of Pharmacy, The Queen’s University of Belfast
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Killingley B, Greatorex J, Cauchemez S, Enstone JE, Curran M, Read RC, Lim WS, Hayward A, Nicholson KG, Nguyen-Van-Tam JS. Virus shedding and environmental deposition of novel A (H1N1) pandemic influenza virus: interim findings. Health Technol Assess 2011; 14:237-354. [PMID: 20923613 DOI: 10.3310/hta14460-04] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The relative importance of different routes of influenza transmission, including the role of bioaerosols, and ability of masks and/or hand hygiene to prevent transmission, remains poorly understood. Current evidence suggests that infectious virus is not typically released from adults after 5 days of illness, however, little is known about the extent to which virus is deposited by infected individuals into the environment and whether deposited virus has the ability to infect new hosts. Further information about the deposition of viable influenza virus in the immediate vicinity of patients with pandemic influenza is fundamental to our understanding of the routes and mechanisms of transmission. OBJECTIVES To collect data on patients infected with pandemic H1N1 2009 (swine flu). Primary objectives were to correlate the amount of virus detected in a patient's nose with that recovered from his/her immediate environment, and with symptom duration and severity. Secondary objectives were to describe virus shedding and duration according to major patient characteristics: adults versus children, and those with mild illness (community patients) versus those with more severe disease (hospitalised patients). METHODS Adults and children, both in hospital and from the community, who had symptoms of pandemic H1N1 infection, were enrolled and visited every day during follow-up for a maximum of 12 days. Symptom data was collected and samples were taken, including nose swabs and swabs from surfaces and objects around patients. Samples of air were obtained using validated sampling equipment. The samples were tested for the presence of pandemic H1N1 virus, using polymerase chain reaction (PCR) to detect virus genome and an immunofluorescence technique to detect viable virus. RESULTS Forty-three subjects were followed up, and 19 of them were subsequently proven to be infected with pandemic H1N1 virus. The median duration of virus shedding from the 19 infected cases was 6 days when detection was performed by PCR, and 3 days when detection was performed by a culture technique. Over 30% of cases remained potentially infectious for at least 5 days. Only 0.5% of all community and none of the hospital swabs taken revealed virus on surfaces. Five subjects had samples of the air around them collected and virus was detected by PCR from four; some of the air particles in which virus was detected were small enough to be inhaled and deposited deep in the lungs. LIMITATION Small number of subjects recruited. CONCLUSIONS The finding that over 30% of infected individuals have infectious virus in their noses for 5 days or more has infection control implications. The data suggest that contact transmission of pandemic influenza via fomites may be less important than previously thought, but transmission via bioaerosols at short range may be possible, meaning that high-level personal protective equipment may be needed by health-care workers when attending patients with pandemic influenza. Further work is being undertaken to consolidate these findings, as they have important potential implications for the protection of health-care workers and the formulation of advice to households, nationally and internationally.
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Affiliation(s)
- B Killingley
- Division of Public Health and Epidemiology, University of Nottingham, Nottingham, UK
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Curran M. James Noel Curran. West J Med 2010. [DOI: 10.1136/bmj.c7031] [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: 11/03/2022]
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Enoch D, Brown F, Sismey A, Mlangeni D, Cone D, Curran M. P24.14 ESBL study in Peterborough; clinical & molecular epidemiology. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60239-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sen Gupta B, Curran M, Hasan S, Ghosh TK. Adsorption characteristics of Cu and Ni on Irish peat moss. J Environ Manage 2009; 90:954-960. [PMID: 18430507 DOI: 10.1016/j.jenvman.2008.02.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Revised: 12/21/2007] [Accepted: 02/29/2008] [Indexed: 05/26/2023]
Abstract
Peat has been widely used as a low cost adsorbent to remove a variety of materials including organic compounds and heavy metals from water. Various functional groups in lignin allow such compounds to bind on active sites of peat. The adsorption of Cu(2+) and Ni(2+) from aqueous solutions on Irish peat moss was studied both as a pure ion and from their binary mixtures under both equilibrium and dynamic conditions in the concentration range of 5-100mg/L. The pH of the solutions containing either Cu(2+) or Ni(2+) was varied over a range of 2-8. The adsorption of Cu(2+) and Ni(+2) on peat was found to be pH dependent. The adsorption data could be fitted to a two-site Langmuir adsorption isotherm and the maximum adsorption capacity of peat was determined to be 17.6 mg/g for Cu(2+) and 14.5mg/g for Ni(2+) at 298 K when the initial concentration for both Cu(2+) and Ni(2+) was 100mg/L, and the pH of the solution was 4.0 and 4.5, respectively. Column studies were conducted to generate breakthrough data for both pure component and binary mixtures of copper and nickel. Desorption experiments showed that 2mM EDTA solution could be used to remove all of the adsorbed copper and nickel from the bed.
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Affiliation(s)
- B Sen Gupta
- School of Chemical Engineering, Queen's University Belfast, UK.
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Zhang H, Ouyang X, Curran M, Parmar S, Sheppard M. Taqman probe real-time PCR for detection of enterovirus in archival heart tissue. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80828-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Macluskey M, Slevin M, Curran M, Nesbitt R. Indications for and anticipated difficulty of third molar surgery: A comparison between a dental hospital and a specialist high street practice. Br Dent J 2005; 199:671-5. [PMID: 16311571 DOI: 10.1038/sj.bdj.4812931] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2005] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the indications for and anticipated difficulty of third molar surgery between two different referral settings. DESIGN A prospective study involving completion of a proforma pre- and post-operatively. SETTING A dental teaching hospital and a specialist surgical dentistry practice in 2003. SUBJECTS AND METHODS Patients referred for the assessment of their third molars were recruited. Details of the clinical and radiographical assessment for each patient were recorded pre-operatively and the extent of surgery required post-operatively. RESULTS The main indication for referral for third molar extraction was pericoronitis in both centres. A larger number of patients were assessed and treated in a shorter period of time at the surgical dentist compared with the dental hospital. The surgical dentist was accurate in his assessment of the difficulty of surgery 96% of the time compared with 66% for the dental hospital staff. CONCLUSIONS This study highlights the benefits for patients in being treated by a surgical dentist. As dental students require exposure to surgical dentistry in order to attain a level of competence, a reduction in the number of patients being referred to dental hospitals may impact upon students' ability to both assess and perform surgical procedures. This may mean that undergraduates will be less able to fulfil the recommendations of the General Dental Council. An outreach programme for final year dental students to surgical dentistry practices would benefit all concerned.
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Affiliation(s)
- M Macluskey
- University of Dundee Dental Hospital and School, Park Place, Dundee.
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Abstract
Valganciclovir is a prodrug of ganciclovir which has been developed for the treatment of cytomegalovirus (CMV) retinitis in patients with AIDS. Oral valganciclovir is rapidly absorbed and hydrolysed to ganciclovir. The oral bioavailability of ganciclovir after oral valganciclovir administration is high. Oral valganciclovir 900 mg provides a daily exposure of ganciclovir comparable to that of intravenous ganciclovir 5 mg/kg. A single, randomised, nonblind study indicated that oral valganciclovir (900mg twice daily for 3 weeks then 900 mg once daily) and intravenous ganciclovir (5 mg/kg twice daily for 3 weeks then 5 mg/kg once daily) were equally effective in the treatment of newly diagnosed CMV retinitis in 160 patients with AIDS. Valganciclovir appears to have a similar tolerability profile to intravenous ganciclovir during induction therapy in patients with AIDS and newly diagnosed CMV retinitis. During maintenance therapy with valganciclovir, the most commonly reported adverse events included neutropenia, anaemia, thrombocytopenia, gastrointestinal (including diarrhoea, nausea, vomiting and abdominal pain), fever, headache, insomnia, peripheral neuropathy, paraesthesia and retinal detachment.
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Affiliation(s)
- M Curran
- Adis International Limited, Mairangi Bay, Auckland, New Zealand.
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Abstract
Fulvestrant is a 7alpha-alkylsulphinyl analogue of estradiol that competes with endogenous estrogen for binding to the estrogen receptor. Once bound to the receptor, fulvestrant attenuates receptor dimerisation, effecting a rapid degradation of the estrogen receptor protein and inhibition of transcription. Fulvestrant is a potent inhibitor of the growth of human breast cancer cells in vitro and in vivo. It has demonstrated pure anti-estrogenic activity in animal systems. Intramuscular fulvestrant 250 mg once a month was as effective as the oral aromatase inhibitor anastrozole 1 mg/day in 2 phase III trials in postmenopausal women with advanced breast cancer who had received prior endocrine therapy. Median time to disease progression (the primary end-point) with fulvestrant and anastrozole was 5.4 and 3.4 months (North American trial) and 5.5 and 5.1 months (European trial). The median duration of response was 19.3 and 10.5 months (North American trial) and 14.3 and 14.0 months (European trial). The most common adverse events with fulvestrant are gastrointestinal disturbances and hot flushes. Fulvestrant showed similar tolerability to anastrozole in 2 phase III trials.
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Affiliation(s)
- M Curran
- Adis International Limited, Mairangi Bay, Auckland, New Zealand.
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Prendergast DP, Halliday MI, McFerran NV, Curran M, McIhatton B, Middleton D, Fox MT, Wallace A. A novel approach to analysis of phage clones by reference strand mediated conformation analysis. Dis Markers 2001; 16:29-31. [PMID: 11360825 PMCID: PMC3851102 DOI: 10.1155/2000/703651] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- D P Prendergast
- Centre for Peptide and Protein Engineering, Queen's University of Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, BT9 7BL, N. Ireland.
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