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Li H, Guglielmetti C, Sei YJ, Zilberter M, Le Page LM, Shields L, Yang J, Nguyen K, Tiret B, Gao X, Bennett N, Lo I, Dayton TL, Kampmann M, Huang Y, Rathmell JC, Vander Heiden M, Chaumeil MM, Nakamura K. Neurons require glucose uptake and glycolysis in vivo. Cell Rep 2023; 42:112335. [PMID: 37027294 PMCID: PMC10556202 DOI: 10.1016/j.celrep.2023.112335] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/22/2023] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
Neurons require large amounts of energy, but whether they can perform glycolysis or require glycolysis to maintain energy remains unclear. Using metabolomics, we show that human neurons do metabolize glucose through glycolysis and can rely on glycolysis to supply tricarboxylic acid (TCA) cycle metabolites. To investigate the requirement for glycolysis, we generated mice with postnatal deletion of either the dominant neuronal glucose transporter (GLUT3cKO) or the neuronal-enriched pyruvate kinase isoform (PKM1cKO) in CA1 and other hippocampal neurons. GLUT3cKO and PKM1cKO mice show age-dependent learning and memory deficits. Hyperpolarized magnetic resonance spectroscopic (MRS) imaging shows that female PKM1cKO mice have increased pyruvate-to-lactate conversion, whereas female GLUT3cKO mice have decreased conversion, body weight, and brain volume. GLUT3KO neurons also have decreased cytosolic glucose and ATP at nerve terminals, with spatial genomics and metabolomics revealing compensatory changes in mitochondrial bioenergetics and galactose metabolism. Therefore, neurons metabolize glucose through glycolysis in vivo and require glycolysis for normal function.
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Affiliation(s)
- Huihui Li
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Caroline Guglielmetti
- Department of Physical Therapy and Rehabilitation Science, San Francisco, CA 94158, USA; Department of Radiology and Biomedical Imaging, San Francisco, CA 94158, USA
| | - Yoshitaka J Sei
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Misha Zilberter
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Lydia M Le Page
- Department of Physical Therapy and Rehabilitation Science, San Francisco, CA 94158, USA; Department of Radiology and Biomedical Imaging, San Francisco, CA 94158, USA
| | - Lauren Shields
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Graduate Program in Biomedical Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Joyce Yang
- Graduate Program in Neuroscience, University of California San Francisco, San Francisco, CA 94158, USA
| | - Kevin Nguyen
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Brice Tiret
- Department of Physical Therapy and Rehabilitation Science, San Francisco, CA 94158, USA; Department of Radiology and Biomedical Imaging, San Francisco, CA 94158, USA
| | - Xiao Gao
- Department of Physical Therapy and Rehabilitation Science, San Francisco, CA 94158, USA; Department of Radiology and Biomedical Imaging, San Francisco, CA 94158, USA; UCSF/UCB Graduate Program in Bioengineering, University of California San Francisco, San Francisco, CA 94158, USA
| | - Neal Bennett
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Iris Lo
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Talya L Dayton
- Koch Institute for Integrative Cancer Research and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Martin Kampmann
- Graduate Program in Biomedical Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Graduate Program in Neuroscience, University of California San Francisco, San Francisco, CA 94158, USA; UCSF/UCB Graduate Program in Bioengineering, University of California San Francisco, San Francisco, CA 94158, USA; Institute for Neurodegenerative Diseases, University of California San Francisco, San Francisco, CA, USA; Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Yadong Huang
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Graduate Program in Biomedical Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Graduate Program in Neuroscience, University of California San Francisco, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jeffrey C Rathmell
- Vanderbilt Center for Immunobiology, Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Matthew Vander Heiden
- Koch Institute for Integrative Cancer Research and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Dana-Farber Cancer Institute, Boston, MA 02115, USA
| | - Myriam M Chaumeil
- Department of Physical Therapy and Rehabilitation Science, San Francisco, CA 94158, USA; Department of Radiology and Biomedical Imaging, San Francisco, CA 94158, USA; Graduate Program in Biomedical Sciences, University of California San Francisco, San Francisco, CA 94143, USA; UCSF/UCB Graduate Program in Bioengineering, University of California San Francisco, San Francisco, CA 94158, USA.
| | - Ken Nakamura
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Graduate Program in Biomedical Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Graduate Program in Neuroscience, University of California San Francisco, San Francisco, CA 94158, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA.
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Cunningham-Myrie C, Theall KP, Younger-Coleman N, Wiggan J, McFarlane S, Francis D, Bennett N, Tulloch-Reid M, Ferguson TS, Davidson T, Govia I, Guthrie-Dixon N, Aiken W, Grant A, Webster-Kerr K, Wilks R. Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III). Prev Med Rep 2022; 30:101998. [PMID: 36189127 PMCID: PMC9519374 DOI: 10.1016/j.pmedr.2022.101998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Decreased physical activity (PA) has been associated with residents living in neighborhoods perceived as being disordered or having high crime levels. What is unknown are the characteristics of individuals who engage in moderate to vigorous levels of PA (MVPA) despite living in these vulnerable neighborhoods, or who may be referred to as positive deviants (PD). We examined the factors associated with PD for PA among Jamaicans. Between 2016 and 2017 the Jamaica Health and Lifestyle Survey, a cross-sectional nationally representative survey (n = 2807), was conducted on individuals aged 15 years and older. Regression analyses were performed to identify associations with PD, defined using engagement in MVPA among persons living in vulnerable neighborhoods (N = 1710). Being female (odds ratio [OR]a = 0.64 (0.48, 0.86); p = 0.003), obese while living in an urban area (ORa = 0.39; 95 % CI = 0.26, 0.59; p < 0.0001), unemployed (ORa = 0.53; 95 % CI = 0.39, 0.73; p < 0.0001), or a student (ORa = 0.62; 95 % CI = 0.39, 0.98); p = 0.041) was associated with a significantly lower likelihood of PD, while having a personal medical history of at least one chronic disease significantly increased likelihood (ORa = 1.43; 95 % CI = 1.08, 1.90; p = 0.014). Taking a PD approach may be one angle to consider in trying to determine what is working and for whom, so that this may be harnessed in policy, prevention and intervention programming to increase PA.
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Affiliation(s)
- C Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - K P Theall
- Departments of Social, Behavioral, and Population Sciences and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - N Younger-Coleman
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - J Wiggan
- Ministry of Health & Wellness, Jamaica
| | - S McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - D Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
| | - N Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - M Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - T S Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - I Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - N Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - W Aiken
- Department of Surgery, Radiology, Anaesthesia & Intensive Care, University of the West Indies, Mona, Kingston, Jamaica
| | - A Grant
- Ministry of Health & Wellness, Jamaica
| | | | - R Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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Dauparas J, Anishchenko I, Bennett N, Bai H, Ragotte RJ, Milles LF, Wicky BIM, Courbet A, de Haas RJ, Bethel N, Leung PJY, Huddy TF, Pellock S, Tischer D, Chan F, Koepnick B, Nguyen H, Kang A, Sankaran B, Bera AK, King NP, Baker D. Robust deep learning-based protein sequence design using ProteinMPNN. Science 2022; 378:49-56. [PMID: 36108050 PMCID: PMC9997061 DOI: 10.1126/science.add2187] [Citation(s) in RCA: 214] [Impact Index Per Article: 107.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Although deep learning has revolutionized protein structure prediction, almost all experimentally characterized de novo protein designs have been generated using physically based approaches such as Rosetta. Here, we describe a deep learning-based protein sequence design method, ProteinMPNN, that has outstanding performance in both in silico and experimental tests. On native protein backbones, ProteinMPNN has a sequence recovery of 52.4% compared with 32.9% for Rosetta. The amino acid sequence at different positions can be coupled between single or multiple chains, enabling application to a wide range of current protein design challenges. We demonstrate the broad utility and high accuracy of ProteinMPNN using x-ray crystallography, cryo-electron microscopy, and functional studies by rescuing previously failed designs, which were made using Rosetta or AlphaFold, of protein monomers, cyclic homo-oligomers, tetrahedral nanoparticles, and target-binding proteins.
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Affiliation(s)
- J. Dauparas
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - I. Anishchenko
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - N. Bennett
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Molecular Engineering Graduate Program, University of Washington, Seattle, WA, USA
| | - H. Bai
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - R. J. Ragotte
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - L. F. Milles
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - B. I. M. Wicky
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - A. Courbet
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| | - R. J. de Haas
- Department of Physical Chemistry and Soft Matter, Wageningen University and Research, Wageningen, The Netherlands
| | - N. Bethel
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| | - P. J. Y. Leung
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Molecular Engineering Graduate Program, University of Washington, Seattle, WA, USA
| | - T. F. Huddy
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - S. Pellock
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - D. Tischer
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - F. Chan
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - B. Koepnick
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - H. Nguyen
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - A. Kang
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - B. Sankaran
- Berkeley Center for Structural Biology, Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley Laboratory, 1 Cyclotron Road, Berkeley, CA 94720, USA
| | - A. K. Bera
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - N. P. King
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
| | - D. Baker
- Department of Biochemistry, University of Washington, Seattle, WA, USA
- Institute for Protein Design, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
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Park F, Deeming S, Bennett N, Hyett J. Cost-effectiveness analysis of a model of first-trimester prediction and prevention of preterm pre-eclampsia compared with usual care. Ultrasound Obstet Gynecol 2021; 58:688-697. [PMID: 32851709 DOI: 10.1002/uog.22193] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Pre-eclampsia (PE) causes substantial maternal and neonatal mortality and morbidity. In addition to the personal impact on women, children and their families, PE has a significant economic impact on our society. Recent research suggests that a first-trimester multivariate model is highly predictive of preterm (< 37 weeks' gestation) PE and can be combined successfully with targeted prophylaxis (low-dose aspirin), resulting in an 80% reduction in prevalence of disease. The aim of this study was to examine the potential health outcomes and cost implications following introduction of first-trimester prediction and prevention of preterm PE within a public healthcare setting, compared with usual care, and to conduct a cost-effectiveness analysis to inform health-service decisions regarding implementation of such a program. METHODS A decision-analytic model was used to compare usual care with the proposed first-trimester screening intervention within the obstetric population (n = 6822) attending two public hospitals within a metropolitan district health service in New South Wales, Australia, between January 2015 and December 2016. The model, applied from early pregnancy, included exposure to a variety of healthcare professionals and addressed type of risk assessment (usual care or first-trimester screening) and use of (compliance with) low-dose aspirin prescribed prophylactically for prevention of PE. All pathways culminated in six possible health outcomes, ranging from no PE to maternal death. Results were presented as the number of cases of PE gained/avoided and the incremental increase/decrease in economic costs arising from the intervention compared with usual care. Significant assumptions were tested in sensitivity/uncertainty analyses. RESULTS The intervention produced, across all gestational ages, 31 fewer cases of PE and reduced aggregate economic health-service costs by 1 431 186 Australian dollars over the 2-year period. None of the tested iterations of uncertainty analyses reported additional cases of PE or higher economic costs. The new intervention based on first-trimester screening dominated usual care. CONCLUSION This cost-effectiveness analysis demonstrated a reduction in prevalence of preterm PE and substantial cost savings associated with a population-based program of first-trimester prediction and prevention of PE, and supports implementation of such a policy. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Park
- Department of Maternal Fetal Medicine, John Hunter Hospital, Newcastle, Australia
| | - S Deeming
- Health Research Economics, Hunter Medical Research Institute, Newcastle, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - N Bennett
- Department of Maternal Fetal Medicine, John Hunter Hospital, Newcastle, Australia
| | - J Hyett
- Sydney Institute for Women, Children and their Families, Royal Prince Alfred Hospital, Sydney, Australia
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine, University of Sydney, Sydney, Australia
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Lloyd M, Bennett N, Wilkinson A, Furlong N, Cardwell J, Michaels S. A mixed-methods evaluation of the impact of a pharmacist-led feedback pilot intervention on insulin prescribing in a hospital setting. Res Social Adm Pharm 2021; 17:2006-2014. [PMID: 33775557 DOI: 10.1016/j.sapharm.2021.03.007] [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: 01/12/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
AIMS To explore the impact of a prescribing feedback intervention on insulin prescribing. METHODS This was a mixed-methods study in a hospital setting. An insulin prescribing feedback intervention was delivered verbally and in writing to twelve doctors. Insulin prescribing error frequency was compared to ten doctors who had not received the feedback intervention. Insulin prescribing was audited over four weeks at the start and end of the intervention period. Semi-structured interviews were conducted with participating doctors who had received feedback, and qualitative data analysed thematically to explore the impact of the intervention on their prescribing practice. RESULTS Prescribing data were collected on 370 insulin prescriptions with 241 errors identified. A significant reduction (χ2 = 22.6, p=<0.05) in insulin prescribing error frequency was observed in the intervention group, with a non-significant increase reported in the control group. Feedback was received positively and considered valuable by doctors, supporting development of their knowledge and skills and encouraging reflection on their prescribing performance. Doctors described enhanced confidence in insulin prescribing and a desire to improve as a prescriber and avoid harm, with feedback raising awareness of their development needs. Prescribers also described enhanced team work, with greater information and feedback seeking behavior to inform future prescribing decisions. CONCLUSIONS Feedback has potential to improve insulin prescribing and is a valued and acceptable process intervention for doctors. The impact on insulin prescribing practice is varied and complex influencing the capability, opportunity and motivation of prescribers to adapt and evolve their behavior in response to ongoing feedback.
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Affiliation(s)
- M Lloyd
- Clinical Education Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK.
| | - N Bennett
- Clinical Education Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK
| | - A Wilkinson
- Pharmacy Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK
| | - N Furlong
- Diabetes Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK
| | - J Cardwell
- Diabetes Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK
| | - S Michaels
- Diabetes Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK
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Bennett N, Crouch S, Hoskins A, Malloy M, Walker K, Worth L. ‘Closing the gap’: Evaluating the success of non-mandatory strategies for influenza vaccination of Victorian healthcare workers. Vaccine 2020; 38:6363-6366. [DOI: 10.1016/j.vaccine.2020.08.013] [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: 02/17/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/15/2022]
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Ferguson BS, Bennett N, Zambataro C, Shimkunas R, Del Rio CL. P6341Impact of left-ventricular hemodynamics on treadmill exercise intolerance in conscious rats: pilot evaluation in animals with diastolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0938] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Exercise intolerance is a clinical hallmark of patients with hypertrophic cardiomyopathy and/or impaired diastolic function. Elevated LV filling pressures, particularly in response to acute exercise bouts, are thought to play a role limiting exercise capacity in ventricles with abnormal relaxation/compliance. However, it is experimentally difficult to obtain in vivo hemodynamic measures necessary for the evaluation of centrally mediated dysfunction. Leveraging radio-telemetry, we evaluated central hemodynamic parameters as mediators of exercise intolerance in obese ZSF1 rats with diabetes, hypertension, and diastolic dysfunction.
Methods
Both ZSF1 (637+12g, n=8) and age-matched (28 weeks) healthy control (CTRL, 543+14g, n=4, P<0.05) rats were instrumented for telemetric left-ventricular pressure (LVP) recordings. Following surgical recovery rats were familiarized to treadmill running and subsequently challenged with an exercise protocol aimed at increasing heart rate by 200 beats/min (5° incline, 15 m/min, increased by 3 m/min every 2-min) until volitional exhaustion. LV pressures were collected continuously during cage resting, treadmill resting, and post-exercise until heart rate returned to baseline. Additionally, resting echocardiographic and blood glucose measures were collected.
Results
At rest, ZSF1 rats had preserved ejection fraction (73+6 vs 79+9%), elevated (P<0.05) blood glucose (237+83 vs 94+23 mg/dL), end-systolic (147+18 vs 103+13 mmHg), and end-diastolic pressures (16+3 vs 9+3 mmHg), with preserved indexed end-diastolic volumes (670+95 vs 741+89 μL/kg), suggesting impaired diastolic compliance. ZSF1 rats terminated exercise prematurely (8:26+1:20 vs 10:27+1:18 min, P<0.05), indicating a limitation in exercise capacity. This early volitional exhaustion was noted while end-diastolic pressures were not further increased (17+7 mmHg), suggesting that other pathological derangement may play a role modulating exercise capacity. For instance, ZSF1 rats tended to have a blunted increase in the systolic index dP/dt40 (+2589+1450 vs +3938+749 mmHg/s, P<0.1) despite achieving comparable increases in HR (193+34 vs 196+38 bpm) with exercise.
Conclusion
This pilot study demonstrates the feasibility for evaluation of left-ventricular hemodynamics during exercise in rodents with diastolic dysfunction, establishing a platform to evaluate both the mechanisms of exercise intolerance as well as potential therapeutic approaches to rescue exercise capacity.
Acknowledgement/Funding
MyoKardia
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Affiliation(s)
- B S Ferguson
- MyoKardia, South San Francisco, United States of America
| | - N Bennett
- MyoKardia, South San Francisco, United States of America
| | - C Zambataro
- MyoKardia, South San Francisco, United States of America
| | - R Shimkunas
- MyoKardia, South San Francisco, United States of America
| | - C L Del Rio
- MyoKardia, South San Francisco, United States of America
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Bennett N, Pham M, Roston A, Wren J, Hudnall M, Cooley L, Brannigan R. 234 Testosterone-Replacement Therapy in Patients with Baseline Low-normal to Normal Testosterone Levels and Hypogonadal Symptoms. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Patel M, Hudnall M, Cooley L, Fitzgerald M, Pham M, Wren J, Desai A, Brannigan R, Bennett N. 159 Two Year Cost Analysis of Penile Rehabilitation Post-Prostatectomy for Various Regimens at a Single Institution. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Ladlow P, Bennett N, Phillip R, Dharm-Datta S, McMenemy L, Bennett AN. Passive-dynamic ankle-foot orthosis improves medium-term clinical outcomes after severe lower extremity trauma. J ROY ARMY MED CORPS 2018; 165:330-337. [PMID: 30415216 PMCID: PMC6839716 DOI: 10.1136/jramc-2018-001082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 11/30/2022]
Abstract
Introduction Individuals with delayed below-knee amputation have previously reported superior clinical outcomes compared with lower limb reconstruction. The UK military have since introduced a passive-dynamic ankle-foot orthosis (PDAFO) into its rehabilitation care pathway to improve limb salvage outcomes. The aims were to determine if wearing a PDAFO improves medium-term clinical outcomes and what influence does multidisciplinary team (MDT) rehabilitation have after PDAFO fitting? Also, what longitudinal changes in clinical outcomes occur with MDT rehabilitation and how do these results compare with patients with previous lower extremity trauma discharged prior to PDAFO availability? Methods We retrospectively evaluated levels of mobility, activities of daily living, anxiety, depression and pain in a heterogeneous group of 23 injured UK servicemen 34±11 months after PDAFO provision. We also retrospectively analysed 16 patients across four time points (pre-PDAFO provision, first, second and final inpatient admissions post-PDAFO provision) using identical outcome measures, plus the 6 min walk test. Results Outcomes were compared with previous below-knee limb salvage and amputees. Before PDAFO, 74% were able to walk and 4% were able to run independently. At follow-up, this increased to 91% and 57%, respectively. Mean depression and anxiety scores remained stable over time (p>0.05). After 3 weeks, all patients could walk independently (pre-PDAFO=31%). Mean 6 min walk distance significantly increased from 440±75 m (pre-PDAFO) to 533±68 m at last admission (p=0.003). The ability to run increased from 6% to 44% after one admission. Conclusions All functional and most psychosocial outcomes in PDAFO users were superior to previous limb salvage and comparable to previous below-knee amputees. The PDAFO facilitated favourable short-term and medium-term changes in all clinical outcome measurements.
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Affiliation(s)
- Peter Ladlow
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK
| | - N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK.,Blatchford, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK
| | - R Phillip
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK
| | - S Dharm-Datta
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK
| | - L McMenemy
- Centre for Blast Injury Studies (CBIS), Imperial College London, London, UK
| | - A N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Surrey, UK.,National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
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Farah CS, Kordbacheh F, John K, Bennett N, Fox SA. Molecular classification of autofluorescence excision margins in oral potentially malignant disorders. Oral Dis 2018; 24:732-740. [DOI: 10.1111/odi.12818] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/23/2022]
Affiliation(s)
- C S Farah
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - F Kordbacheh
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - K John
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - N Bennett
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - S A Fox
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
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12
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Wallen J, Kansas B, Kohler T, Karpman E, Christine B, Khera M, Jones L, Bennett N, Rhee E, Brant W, Bella A, Henry G. 334 Post Priapism PROPPER Data Shows Good Satisfaction and Functional Outcomes. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Brant W, Bella A, Karpman E, Kansas B, Christine B, Jones L, Khera M, Kohler T, Rhee E, Bennett N, Henry G. 141 Use and Satisfaction in Patients with Peyronies Disease who have Undergone Penile Prosthesis: 1 and 2 Year Followup from the PROPPER Registry. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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14
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Jones L, Henry G, Karpman E, Kansas B, Brant W, Bennett N, Khera M, Kohler T, Christine B, Rhee E, Bella A. 119 Measurement of Sexual Function in the Prostate Cancer Patient at One year following insertion of a Penile Prosthesis. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.078] [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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15
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Fasugba O, Koerner J, Bennett N, Burrell S, Laguitan R, Hoskins A, Beckingham W, Mitchell BG, Gardner A. Development and evaluation of a website for surveillance of healthcare-associated urinary tract infections in Australia. J Hosp Infect 2018; 99:98-102. [PMID: 29341882 DOI: 10.1016/j.jhin.2018.01.006] [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: 10/29/2017] [Accepted: 01/09/2018] [Indexed: 11/29/2022]
Abstract
Phase II of the Surveillance to Reduce Urinary Tract Infections project piloted a website for point prevalence surveys of healthcare-associated (HAUTI) and catheter-associated urinary tract infection in Australian hospitals and aged care homes. This report describes development and evaluation of the website for online data collection. Evaluation findings from 38 data collectors indicated that most respondents found website registration and web form use easy (N = 22; 58% and N = 16; 43%, respectively). The need for improved computer literacy skills and automated data systems were highlighted. This study demonstrated a novel approach for Australian HAUTI data collection; however, refinements are needed before national roll-out.
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Affiliation(s)
- O Fasugba
- Nursing Research Institute, Australian Catholic University and St Vincent's Health Australia (Sydney), Australian Capital Territory, Australia; Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia.
| | - J Koerner
- Faculty of Health Sciences, Australian Catholic University, Canberra, Australian Capital Territory, Australia
| | - N Bennett
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - S Burrell
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - R Laguitan
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - A Hoskins
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - W Beckingham
- Infection Prevention and Control, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia
| | - B G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Wahroonga, New South Wales, Australia
| | - A Gardner
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Canberra, Australian Capital Territory, Australia
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16
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Khera M, Bella A, Brant W, Christine B, Kansas B, Jones L, Kohler T, Bennett N, Rhee E, Henry G. PS-05-002 Penile prosthesis can safely be inserted in patients with Peyronie’s disease: Interim results of the PROPPER study. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.107] [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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17
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Jones L, Henry G, Karpman E, Kansas B, Brant W, Bennett N, Khera M, Kohler T, Christine B, Rhee E, Bella A. 181 Measurement of Sexual Function in the Prostate Cancer Patient at One year following insertion of a Penile Prosthesis. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.12.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Kuan WL, Bennett N, He X, Skepper JN, Martynyuk N, Wijeyekoon R, Moghe PV, Williams-Gray CH, Barker RA. α-Synuclein pre-formed fibrils impair tight junction protein expression without affecting cerebral endothelial cell function. Exp Neurol 2016; 285:72-81. [PMID: 27632900 DOI: 10.1016/j.expneurol.2016.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/01/2016] [Accepted: 09/11/2016] [Indexed: 12/17/2022]
Abstract
Recently it has been shown that there is impaired cerebral endothelial function in many chronic neurodegenerative disorders including Alzheimer's and Huntington's disease. Such problems have also been reported in Parkinson's disease, in which α-synuclein aggregation is the pathological hallmark. However, little is known about the relationship between misfolded α-synuclein and endothelial function. In the present study, we therefore examined whether α-synuclein preformed fibrils affect endothelial function in vitro. Using a well-established endothelial cell model, we found that the expression of tight junction proteins, in particular zona occludens-1 and occludin, was significantly perturbed in the presence of fibril-seeded neurotoxicity. Disrupted expression of these proteins was also found in the postmortem brains of patients dying with Parkinson's disease. There was though little evidence in vitro of functional impairments in endothelial cell function in terms of transendothelial electrical resistance and permeability. This study therefore shows for the first time that misfolded α-synuclein can interact and affect the cerebral endothelial system, although its relevance to the pathogenesis of Parkinson's disease remains to be elucidated.
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Affiliation(s)
- Wei-Li Kuan
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom.
| | - Neal Bennett
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom; Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, United States
| | - Xiaoling He
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
| | - Jeremy N Skepper
- Cambridge Advanced Imaging Centre, Department of Physiology, Development and Neuroscience, Anatomy Building, University of Cambridge, Downing Street, Cambridge CB2 3DY, United Kingdom
| | - Nataly Martynyuk
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
| | - Ruwani Wijeyekoon
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
| | - Prabhas V Moghe
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, United States; Department of Chemical & Biochemical Engineering, Rutgers University, Piscataway, NJ, United States
| | - Caroline H Williams-Gray
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
| | - Roger A Barker
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom; Department of Neurology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
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Khera M, Bella A, Karpman E, Brant W, Christine B, Kansas B, Jones L, Kohler T, Bennett N, Rhee E, Henry G. 114 Penile Prosthesis Can Safely and Easily Be Inserted in Patients with Peyronie's Disease: Results of the PROPPER Study. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.120] [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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20
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Henry G, Karpman E, Brant W, Christine B, Kansas B, Khera M, Jones L, Bennett N, Rhee E, Eisenhart E, Bella A. HP-05-001 Baseline Data of Real-World Penile Implant Patients in 2015 from the Prospective Registry of Outcomes with Penile Prosthesis for Erectile Restoration (PROPPER). J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Henry G, Karpman E, Brant W, Christine B, Kansas B, Khera M, Jones L, Kohler T, Bennett N, Rhee E, Eisenhart E, Bella A. 061 The who, how and what of Real-World Penile Implants Patients in 2015: The propper (Prospective Registry of Outcomes with Penile Prosthesis for Erectile Restoration) Registry Baseline Data. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Kohler T, Bella A, Karpman E, Brant W, Christine B, Jones L, Kansas B, Bennett N, Khera M, Rhee E, Henry G. PS-06-002 Penile implant device dissatisfaction & reasons for non-use from the PROPPER study. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Stuart RL, Marshall C, Orr E, Bennett N, Athan E, Friedman D, Reilly M. Survey of infection control and antimicrobial stewardship practices in Australian residential aged-care facilities. Intern Med J 2016; 45:576-80. [PMID: 25955463 DOI: 10.1111/imj.12740] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/29/2015] [Indexed: 11/27/2022]
Abstract
This study assessed infection prevention and antimicrobial stewardship (AMS) practices in Australian residential aged-care facilities (RACF). Two hundred and sixty-five surveys (15.6%) were completed with all states represented and the majority (177 (67.3%)) privately run. Only 30.6% RACF had infection control trained staff on site. Few facilities had AMS policies, only 14% had antimicrobial prescribing restrictions. Most facilities offered vaccination to residents (influenza vaccination rates >75% in 73% of facilities), but pneumococcal vaccination was poor.
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Affiliation(s)
- R L Stuart
- Department of Infectious Diseases, Monash Health, Melbourne, Australia.,Department Medicine, Monash University, Melbourne, Australia
| | - C Marshall
- Department of Infectious Diseases, Royal Melbourne Hospital, Melbourne, Australia.,Department Medicine, University of Melbourne, Melbourne, Australia
| | - E Orr
- Department of Infectious Diseases, Monash Health, Melbourne, Australia
| | - N Bennett
- VICNISS Coordinating Centre, Melbourne, Australia
| | - E Athan
- Department Infectious Disease, Barwon Health, Geelong, Victoria, Australia.,Department of Medicine, Deakin University, Geelong, Victoria, Australia
| | - D Friedman
- Department Infectious Disease, Barwon Health, Geelong, Victoria, Australia.,Department of Medicine, Deakin University, Geelong, Victoria, Australia
| | - M Reilly
- Hands-On Infection Control, Perth, Western Australia, Australia
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24
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Osborne MA, Jarvis HL, Bennett N, Phillip RD. A modern-day solution to a 100-yearold problem: the use of a bespoke offloading brace in the rehabilitation of ‘Deck-Slap’ and other high-energy lower limb injuries. ACTA ACUST UNITED AC 2014. [DOI: 10.1136/jrnms-100-337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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
Abstract‘Deck-Slap’ is an injury pattern first described at the Battle of Jutland; it is still relevant today, with anti-vehicle mines a significant threat to Coalition troops. The effect of a device exploding beneath a vehicle produces a wave of high energy that is rapidly transmitted through the steel floor; this causes significant axial loading of lower limbs often resulting in severe fractures (notably of the calcaneum). Recent advancements in orthopaedic surgery have allowed for limbs that were destined for immediate amputation following significant trauma to be salvaged. However, despite intense rehabilitation, many of these salvaged limbs have subsequently gone on to delayed amputation, as functional outcomes are often poor. Technologically advanced prosthetic devices are available that afford good quality of life and allow for increased activity levels; these devices are, however, expensive to procure and maintain. This report describes a United Kingdom (UK) Armed Forces soldier who suffered a typical ‘deck-slap’ injury in Afghanistan with subsequent limb salvage. The use of the Bespoke Off-loading Brace (BOB) is discussed. The results presented here indicate that the biomechanical function of a patient with this type of injury improves when wearing the BOB. Further studies are needed to assess long-term clinical outcomes and the functional benefit of the device as a viable and cost-effective alternative to delayed limb amputation.
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25
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Ferguson T, Younger-Coleman N, Tulloch-Reid M, Knight-Madden J, Bennett N, Samms-Vaughan M, Ashley D, McCaw-Binns A, Molaodi O, Cruickshank J, Harding S, Wilks R. P10.4 EARLY LIFE PREDICTORS OF BLOOD PRESSURE IN AFRO-CARIBBEAN YOUNG ADULTS: THE JAMAICA 1986 BIRTH COHORT STUDY. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.207] [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: 11/29/2022] Open
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26
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Osborne MA, Jarvis HL, Bennett N, Phillip RD. A modern-day solution to a 100-year-old problem: the use of a Bespoke Off-loading Brace in the rehabilitation of 'Deck-Slap' and other high-energy lower limb injuries. J R Nav Med Serv 2014; 100:337-343. [PMID: 25895417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
'Deck-Slap' is an injury pattern first described at the Battle of Jutland; it is still relevant today, with anti-vehicle mines a significant threat to Coalition troops. The effect of a device exploding beneath a vehicle produces a wave of high energy that is rapidly transmitted through the steel floor; this causes significant axial loading of lower limbs often resulting in severe fractures (notably of the calcaneum). Recent advancements in orthopaedic surgery have allowed for limbs that were destined for immediate amputation following significant trauma to be salvaged. However, despite intense rehabilitation, many of these salvaged limbs have subsequently gone on to delayed amputation, as functional outcomes are often poor. Technologically advanced prosthetic devices are available that afford good quality of life and allow for increased activity levels; these devices are, however, expensive to procure and maintain. This report describes a United Kingdom (UK) Armed Forces soldier who suffered a typical 'deck-slap' injury in Afghanistan with subsequent limb salvage. The use of the Bespoke Off-loading Brace (BOB) is discussed. The results presented here indicate that the biomechanical function of a patient with this type of injury improves when wearing the BOB. Further studies are needed to assess long-term clinical outcomes and the functional benefit of the device as a viable and cost-effective alternative to delayed limb amputation.
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27
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Greenbaum A, Chaves SS, Perez A, Aragon D, Bandyopadhyay A, Bennett N, Fowler B, Hancock E, Lynfield R, McDonald-Hamm C, Reingold A, Ryan P, Schaffner W, Sharangpani R, Spencer M, Thomas A, Yousey-Hindes K, Zansky S, Finelli L. Heavy alcohol use as a risk factor for severe outcomes among adults hospitalized with laboratory-confirmed influenza, 2005–2012. Infection 2013; 42:165-70. [DOI: 10.1007/s15010-013-0534-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/10/2013] [Indexed: 11/25/2022]
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28
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Dhakal H, Zhang Z, Guthrie R, MacMullen J, Bennett N. Development of flax/carbon fibre hybrid composites for enhanced properties. Carbohydr Polym 2013; 96:1-8. [DOI: 10.1016/j.carbpol.2013.03.074] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/15/2013] [Accepted: 03/23/2013] [Indexed: 10/27/2022]
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29
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Santema P, Teitel Z, Manser M, Bennett N, Clutton-Brock T. Effects of cortisol administration on cooperative behavior in meerkat helpers. Behav Ecol 2013. [DOI: 10.1093/beheco/art039] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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CliniMurphy M, Bennett N, Eaton K, Kottke M. An educational commercial sexual exploitation of children prevention Web site: development and pilot testing in an urban family planning teen. Contraception 2012. [DOI: 10.1016/j.contraception.2011.11.054] [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: 10/14/2022]
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31
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MacNeil JR, Cohn AC, Farley M, Mair R, Baumbach J, Bennett N, Gershman K, Harrison LH, Lynfield R, Petit S, Reingold A, Schaffner W, Thomas A, Coronado F, Zell ER, Mayer LW, Clark TA, Messonnier NE. Current Epidemiology and Trends in Invasive Haemophilus influenzae Disease--United States, 1989-2008. Clin Infect Dis 2011; 53:1230-6. [DOI: 10.1093/cid/cir735] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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32
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Jamnadas-Khoda B, Brown M, El-Khani U, Bennett N. The use of Tebbetts scalpel handle for bone rasping. J Plast Reconstr Aesthet Surg 2011; 64:1729-30. [PMID: 21798836 DOI: 10.1016/j.bjps.2011.06.045] [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: 06/06/2011] [Revised: 06/24/2011] [Accepted: 06/28/2011] [Indexed: 11/25/2022]
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33
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Powell SE, Hariri S, Steinau M, Bauer H, Bennett N, Bloch K, Schafer S, Niccolai L, Unger ER, Markowitz L. O1-S02.06 Detection of cervical cancer precursors and associated HPV types in the USA: HPV-IMPACT preliminary results. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050109.12] [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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34
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McCabe K, Shobeiri N, Beseau D, Adams M, Holden R, Shobeiri N, Adams M, Holden R, Maio T, McCabe K, Laverty K, Beseau D, Pang J, Jozefacki A, Shobeiri N, Holden R, Adams M, Salem S, Jankowski V, Passlick-Deetjen J, Peter M, Zidek W, Jankowski J, Riser B, Barreto F, Valaitis P, Cook C, White J, Drueke T, Holmes C, Massy Z, Mizobuchi M, Ogata H, Kumata C, Nakazawa A, Koiwa F, Kinugasa E, Akizawa T, Lopez I, Aguilera-Tejero E, Guerrero F, Pineda C, Raya AI, Peralta A, Rodriguez M, Ciceri P, Volpi E, Brenna I, Brancaccio D, Cozzolino M, Bozic M, deRoij J, Parisi E, Ruiz-Ortega M, Fernandez E, Valdivielso JM, Lee CT, Ng HY, Tsai YC, Yang YK, Niwa T, Adijiang A, Shimizu H, Nishijima F, Okamoto T, Kamata K, Naito S, Aoyama T, Tazaki H, Yamanaka N, Koenigshausen E, Ohlsson S, Woznowski M, Quack I, Potthoff SA, Rump LC, Sellin L, Maquigussa E, Pereira L, Arnoni C, Boim M, Lee KW, Jeong JY, Jang WI, Chung S, Choi DE, Na KR, Shin YT, Slabiak-Blaz N, Adamczak M, Ritz E, Wiecek A, Uz E, Uz B, Sahin Balcik O, Kaya A, Akdeniz D, Bavbek Ruzgaresen N, Uz E, Turgut FH, Bayrak R, Carlioglu A, Akcay A, Galichon P, Vittoz N, Cornaire E, Baugey E, Vandermeersch S, Verpont MC, Mesnard L, Xu-Dubois YC, Hertig A, Rondeau E, Kokeny G, Fekeshazy O, Fang L, Rosivall L, Mozes MM, Duggan K, Hodge G, Ha H, Chen J, Lee L, Tay C, Macdonald G, Wang PHM, Tamouza H, Chemouny J, Monsinjon E, Tiwari M, Vende F, Vrtovsnik F, Camara NO, Benhamou M, Monteiro RC, Moura IC, Rigothier C, Saleem M, Ripoche J, Mathieson P, Combe C, Welsh G, Duwel A, Munoz-Felix JM, Lopez-Novoa JM, Martinez-Salgado C, Koutroutsos K, Kassimatis T, Nomikos A, Giannopoulou I, Papadakis J, Nakopoulou L, Nakamichi T, Mori T, Sato T, Sato H, Ito S, Neudecker S, Heilmann M, Kramer P, Wolf I, Sticht C, Schock-Kusch D, Gubhaju L, Kriz W, Bertram JF, Schad LR, Gretz N, Munoz-Felix JM, Fuentes-Calvo I, Lopez-Novoa JM, Martinez-Salgado C, Kimura T, Takabatake Y, Takahashi A, Kaimori JY, Matsui I, Namba T, Kitamura H, Niimura F, Matsusaka T, Soga T, Rakugi H, Isaka Y, Shin SJ, Kim KS, Kim WK, Rampanelli E, Teske G, Leemans J, Florquin S, Small D, Bennett N, Roy S, Gobe G, Blazquez-Medela AM, Garcia-Sanchez O, Lopez-Hernandez FJ, Lopez-Novoa JM, Martinez-Salgado C, Deibel A, Cheng J, Warner G, Knudsen B, Gray C, Lien K, Juskewitch J, Grande J, Wang N, Wang X, Zeng M, Sun B, Xing C, Zhao X, Xiong M, Yang J, Cao K, Priante G, Musacchio E, Sartori L, Valvason C, Baggio B, Pitlovanciv EDON, Reis LA, Pessoa EA, Teixeira L, Borges FT, Simoes MJ, Schor N, Munoz-Felix JM, Duwel A, Lopez-Novoa JM, Martinez-Salgado C, Doustar Y, Mohajeri D, Smirnov AV, Kucher AG, Ivanova GT, Berseneva ON, Parastaeva MM, Zarajsky MI, Saburova IJ, Kaukov IG, Koppe L, Fouque D, Dugenet Y, Soulage C, Wan J, Yang X, Cui J, Zou Z. Experimental pathology. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.52] [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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35
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Zhang Z, Dhakal H, Surip S, Popov I, Bennett N. Characterisation of roof tile coating degradation using nano-indentation test and surface profilometry. Polym Degrad Stab 2011. [DOI: 10.1016/j.polymdegradstab.2011.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Scantlebury M, Krackow S, Pillay N, Bennett N, Schradin C. Basking is affected by season and influences oxygen consumption in desert-living striped mice. J Zool (1987) 2010. [DOI: 10.1111/j.1469-7998.2010.00687.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Herst P, Diggelmann K, Bennett N, Tuaine J, Kelly L. MEPILEX LITE DRESSINGS IN THE MANAGEMENT OF RADIATION-INDUCED SKIN REACTIONS. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72871-2] [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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Collier SR, Kanaley JA, Carhart R, Frechette V, Tobin MM, Bennett N, Luckenbaugh AN, Fernhall B. Cardiac autonomic function and baroreflex changes following 4 weeks of resistance versus aerobic training in individuals with pre-hypertension. Acta Physiol (Oxf) 2009; 195:339-48. [PMID: 18774947 DOI: 10.1111/j.1748-1716.2008.01897.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM Cardiac autonomic modulation and baroreflex sensitivity (BRS) are altered in individuals with hypertension. Aerobic exercise (AE) training has been shown to improve both measures, yet little is known about the effects of resistance exercise (RE). The purpose of this study was to examine the heart rate variability (HRV) and BRS following 4 weeks of resistance or aerobic training in a population with borderline high blood pressure (BP). METHODS Twenty-nine mild hypertensives were recruited and randomly assigned to 4 weeks of RE or AE training. Before and after training, resting measures of HRV frequencies and BRS were obtained. RESULTS There was a significant decrease in resting systolic BP for both exercise training modes (RE 136 +/- 3.0 pre- to 132 +/- 3.4 post-training vs. AE 142 +/- 4.0 pre- to 137 +/- 3.6 mmHg post-training, P = 0.019). Diastolic BP decreased significantly following both exercise training modes (RE 78 +/- 1.31 pre to 74 +/- 1.1 post vs. AE 80 +/- 1.7 pre to 77 +/- 1.6 mmHg post, P = 0.002). A significant time by training mode interaction for low frequency : high frequency (HF) ratio (P = 0.017) with AE decreasing the ratio (275.21 +/- 67.28 to 161.26 +/- 61.49) and RE increasing this ratio (143.73 +/- 65.00 to 227.83 +/- 59.41). Natural log-transformed (ln) HRV values showed a time-by-training mode interaction for ln HF (P = 0.05) as ln HF increased (4.7 +/- 0.38 to 5.4 +/- 0.35 ms(2)) following AE and decreased (5.98 +/- 0.37 to 5.76 +/- 0.42 ms(2)) following RE. BRS increased following aerobic training and decreased after resistance training (6.74 +/- 1.2 to 7.94 +/- 1.3 and 10.44 +/- 1.2 to 9.1 +/- 1.2 ms mmHg(-1) respectively, P = 0.021). CONCLUSIONS Aerobic exercise improved the autonomic nervous system (increasing vagal tone, reducing sympathovagal balance while increasing BRS) while RE showed no improvements in cardiac autonomic tone and decreased BRS.
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Affiliation(s)
- S R Collier
- Department of Exercise Science, Syracuse University, 820 Comstock Avenue, Syracuse, NY 13244, USA.
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Abstract
Two 12.5-year-old castrated male Persian cats from the same household, whose dams were littermates, presented simultaneously with gastric adenocarcinoma associated with proliferative and fibrosing gastritis. Intralesional adult Ollulanus tricuspis nematodes and rare surface-associated spiral-shaped bacteria were identified in one cat. No etiologic agents were identified in tissues from the second cat; however, gastric mucosa was examined following anthelmintic treatment. Clinical signs in each cat had commenced 2 months apart and included vomiting, hematemesis, intermittent melena, and weight loss. This is the first report of gastric adenocarcinoma occurring in housemate cats or cats of common descent. Carcinogenesis may have been influenced by shared undetermined genetic and environmental factors, possibly including Ollulanus tricuspis, spiral-shaped bacteria, or other etiologies for chronic gastritis that remain unidentified.
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Affiliation(s)
- M M Dennis
- Colorado State University, Fort Collins, CO 80523, USA.
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Grijalva C, Weinberg G, Bennett N, Staat M, Craig A, Iwane WDM, Postema A, Schaffner W, Edwards K, Griffin M. The Undetected Burden of Influenza Hospitalizations in Children. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s202-d] [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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Bennett N, Boardman C, Bull A, Richards M, Russo P, Clin Epid M. Educating Smaller Rural Hospital Infection Control (IC) Nurses, Victoria, Australia. Am J Infect Control 2006. [DOI: 10.1016/j.ajic.2006.05.123] [Citation(s) in RCA: 2] [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: 11/27/2022]
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Bennett N, Boardman C, Bull A, Richards M, Russo P. Piloting a Novel State-Wide Smaller Hospital Nosocomial Infection Surveillance Program. Am J Infect Control 2006. [DOI: 10.1016/j.ajic.2006.05.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bennett N, Berry K, Boardman C, Bull A, Burrell S, Richards M, Russo P. P17.59 The VICNISS Smaller Hospital Infection Control Surveillance Program: an Update Report. J Hosp Infect 2006. [DOI: 10.1016/s0195-6701(06)60330-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Russo P, Bull A, Bennett N, Boardman C, Burrell S, Richards M. The establishment of a statewide surveillance program for hospital-acquired infections in large acute care public hospitals in Victoria, Australia. Am J Infect Control 2005. [DOI: 10.1016/j.ajic.2005.04.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Friedman D, Bull A, Russo P, Bennett N, Richards M. Performance of the National Nosocomial Infections Surveillance System (NNIS) risk index in predicting surgical site infections in an Australian setting. Am J Infect Control 2005. [DOI: 10.1016/j.ajic.2005.04.232] [Citation(s) in RCA: 2] [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: 10/25/2022]
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Ross GL, Dunn R, Kirkpatrick J, Koshy CE, Alkureishi LW, Bennett N, Soutar DS, Camilleri IG. To thin or not to thin: the use of the anterolateral thigh flap in the reconstruction of intraoral defects. Br J Plast Surg 2003; 56:409-13. [PMID: 12873471 DOI: 10.1016/s0007-1226(03)00126-7] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The anterolateral thigh (ALT) flap has achieved popularity recently for free-flap reconstruction of intraoral defects following excision of squamous cell carcinoma. We have assessed the feasibility of the ALT flap as a free flap for oral lining and the potential use of the thinned ALT flap in a one-stage reconstruction. We used the ALT flap to reconstruct the oral cavity in 18 consecutive patients between December 2000 and December 2001 following intraoral resection of squamous cell carcinoma. Twelve patients underwent reconstruction using a standard ALT flap, four patients received a thinned ALT flap in a one-stage procedure, one patient received a standard ALT flap in combination with a fibula flap and one patient received a combination of a standard ALT flap and vascularised iliac bone. There were no complications in any of the 14 cases in which a standard ALT flap was used. Two of these flaps were thinned subsequently as secondary procedures. Of the four thinned ALT flaps, one flap failed completely and two flaps experienced partial necrosis. In all but one case the donor site was closed directly with minimal donor-site morbidity. The ALT flap is a versatile flap that can be used in combination with other flaps for more complex defects with minimal donor-site morbidity and is a useful alternative in the armamentarium of the head and neck surgeon. Thinning of the flap is best performed as a secondary procedure, should it be required.
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Affiliation(s)
- G L Ross
- Plastic Surgery Unit, Canniesburn Hospital, Switchback Road, Bearsden, Glasgow, Scotland G61 1QL, UK.
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Mallouk N, Ildefonse M, Pagès F, Ragno M, Bennett N. Basis for intracellular retention of a human mutant of the retinal rod channel alpha subunit. J Membr Biol 2002; 185:129-36. [PMID: 11891571 DOI: 10.1007/s00232-001-0119-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 05/22/2001] [Indexed: 11/30/2022]
Abstract
A mutant of the a subunit of the retinal rod cyclic GMP-gated channel, [Arg654(1-bp del)], corresponding to a truncated alphaR654Dstop subunit, was previously described in patients with retinitis pigmentosa: when expressed in HEK-293 cells, this mutated a subunit was retained inside the cell, but had normal channel activity in one case where it reached the plasma membrane, indicating that the mechanism of targeting is altered by the mutation, but not the function of the channel. The corresponding mutants of the bovine rod channel (alphaR656D stop), and of the closely related olfactory neuron channel (alphaR632Dstop) alpha subunits were expressed in Xenopus oocytes and their activity was analyzed by patch-clamp. Like their human homologue, these two channels have no activity, and we show that their GFP fusion proteins are accumulated into intracellular compartments. The truncation alone or the R/D mutation alone do not prevent or modify channel activity, indicating that neither the R656 residue nor the C-terminal domain downstream of R656 is necessary for homomeric channel targeting and function. Several mutations of R656 and of the preceding residues in the R656Dstop mutant disclose that the motif responsible for the absence of channel activity is an endoplasmic reticulum retention signal (KXKXXstop) in which the nature of the residues in positions -1 and -4 is determinant.
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Affiliation(s)
- N Mallouk
- Département de Biologie Moléculaire et Structurale, Laboratoire de Biophysique Moléculaire at Cellulaire (URA CNRS 520), C.E.A.-Grenoble, Grenoble, France
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Abstract
We have recently identified PP7, a novel group of plant protein Ser/Thr phosphatases, and hypothesized that PP7 may possess a calmodulin-binding site. To test this hypothesis, we assessed the effect of calmodulin on the activity of recombinant Arabidopsis thaliana PP7 and directly tested interaction between PP7 and calmodulin using surface plasmon resonance. Calmodulin exerted a moderate inhibitory effect on the phosphatase activity of PP7 with submicromolar affinity. PP7 specifically interacted with immobilized calmodulin (but not with recoverin, another EF hand Ca(2+)-binding protein) in a strictly Ca(2+)-dependent manner with nanomolar affinity. Deletion of an insert in the catalytic domain of PP7, predicted to function as a calmodulin-binding site, greatly decreased PP7 binding to calmodulin. These findings provide the first evidence for a plant protein phosphatase directly interacting with calmodulin and indicate that PP7 might be regulated by Ca(2+) levels in vivo.
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Affiliation(s)
- M A Kutuzov
- Laboratoire de Biophysique Moléculaire et Cellulaire, URA CNRS N520, Département de Biologie Moléculaire et Structurale, CEA-Grenoble, 17, rue des Martyrs, 38054 Grenoble Cedex 9, France.
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Abstract
OBJECTIVES To evaluate the impact of an intervention to reduce fall hazards in the homes of older people. DESIGN The intervention was administered to the 570 subjects in the experimental arm of a randomized controlled trial, with follow-up of subjects for 1 year. SETTING Community-based seniors living in Perth, Australia. PARTICIPANTS People age 70 and older. INTERVENTION Registered nurses delivered the intervention. It consisted of a home hazard assessment, an educational strategy on general fall hazard reduction and ways to reduce identified home hazards, and the free installation of safety devices: grab rails, nonslip stripping on steps, and double-sided tape for floor rugs and mats. All intervention subjects received the home hazard assessment, and 96% received the educational strategy. Grab rails were installed in 77% of homes, rugs were stabilized in 8%, and nonslip step stripping was installed in 36%. MEASUREMENTS Hazard prevalence was assessed at baseline in all homes and 11 months later in a random sample of 51 homes. Action taken in response to the intervention was assessed by a self-completed postal questionnaire completed 11 months after the intervention. RESULTS All homes had at least one fall hazard. The most prevalent were floor rugs and mats (mean of 14 per home), stepovers (Stepovers are structural changes to the height of the floor that were designed to be stepped over rather than stepped upon, for example, the lip of a shower or a bath side.) (mean of seven per home), steps (mean of four per home), and trailing cords (mean of two per home). The intervention was associated with a small but significant reduction in four of the five most prevalent hazards. The mean number of unsafe rugs and mats was reduced by 1.57 per house (95% confidence interval (CI) = 0.91-2.24); the mean number of unsafe steps was reduced by 0.61 per house (95% CI = 0.28-0.94); the mean number of rooms with trailing cords was reduced by 0.43 per house (95% CI = 0.10-0.76); and the mean number of unsafe chairs was reduced by 0.10 per house (95% CI = 0.02-0.18). Safety devices were installed in 81.9% of homes. Advice on modifying specific hazards identified on the home hazard assessment resulted in over 50% of subjects removing hazards of floor rugs and mats, trailing cords, and obstacles. The general education message prompted less activity to reduce these hazards than did the advice on identified hazards. CONCLUSIONS Fall hazards are ubiquitous in the homes of older people. The intervention resulted in a small reduction in the mean number of hazards per house, with many study subjects taking action but removing only a few hazards. The impact of the intervention in achieving self-reported action to reduce hazards was high.
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Affiliation(s)
- M Stevens
- Department of Public Health, The University of Western Australia, Nedlands, Australia
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Abstract
OBJECTIVES To evaluate the outcome of an intervention to reduce hazards in the home on the rate of falls in seniors. DESIGN Randomized controlled trial, with follow-up of subjects for 1 year. SETTING Community-based study in Perth, Western Australia. PARTICIPANTS People age 70 and older. INTERVENTION One thousand eight hundred seventy-nine subjects were recruited and randomly allocated by household to the intervention and control groups in the ratio 1:2. Because of early withdrawals, 1,737 subjects commenced the study. All members of both groups received a single home visit from a research nurse. Intervention subjects (n = 570) were offered a home hazard assessment, information on hazard reduction, and the installation of safety devices, whereas control subjects (n = 1,167) received no safety devices or information on home hazard reduction. MEASUREMENTS Both groups recorded falls on a daily calendar. Reported falls were confirmed by a semistructured telephone interview and were assigned to one of three overlapping categories: all falls, falls inside the home, and falls involving environmental hazards in the home. Analysis was by multivariate modelling of rate ratios and odds ratios for falls, corrected for household clustering, using Poisson regression and logistic regression with robust variance estimation. RESULTS Overall, 86% of study subjects completed the 1 year of follow-up. The intervention was not associated with any significant reduction in falls or fall-related injuries. There was no significant reduction in the intervention group in the incidence rate of falls involving environmental hazards inside the home (adjusted rate ratio, 1.11; 95% CI = 0.82-1.50), or the proportion of the intervention group who fell because of hazards inside the home (adjusted odds ratio, 0.97; 95% CI = 0.74-1.28). No reduction was seen in the rate of all falls (adjusted rate ratio, 1.02; 95% CI = 0.83-1.27) or the rate of falls inside the home (adjusted rate ratio, 1.17; 95% CI = 0.85-1.60). There was no significant reduction in the rate of injurious falls in intervention subjects (adjusted rate ratio, 0.92; 95% CI = 0.73-1.14). CONCLUSIONS The intervention failed to achieve a reduction in the occurrence of falls. This was most likely because the intervention strategies had a limited effect on the number of hazards in the homes of intervention subjects. The study provides evidence that a one-time intervention program of education, hazard assessment, and home modification to reduce fall hazards in the homes of healthy older people is not an effective strategy for the prevention of falls in seniors.
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Affiliation(s)
- M Stevens
- Department of Public Health, The University of Western Australia, Nedlands, Australia
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