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Williams O, Gray BJ, Perrett SE. Identifying the public health needs of a UK probation cohort: a cross-sectional analysis. J Public Health (Oxf) 2024; 46:12-19. [PMID: 37738133 DOI: 10.1093/pubmed/fdad183] [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: 05/04/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The health needs of those under probation are likely high, but they have received very little public health attention. Limited evidence exists on the public health needs and interventions to support this cohort. METHODS Surveys were completed by 257 people on probation as part of a local health needs assessment. Results were compared with the general population responses from the National Survey for Wales (2021-22). RESULTS People on probation were 4.2 times more likely to self-report not-good general health (fair, bad or very bad) than the general population (adjusted Odds Ratio [aOR] 4.2, 95% Confidence Intervals [CI] 3.2-5.4). The odds of having a mental health condition were over eight times higher than the general population (aOR 8.8, 95% CI 6.8-11.4). Prevalence of smoking (52%), drug use (60%), attention-deficit hyperactivity disorder (21%), autism (4%) and dyslexia (15%) were all higher than the general population. General Practitioner usage and hospital stays were higher, but dentist or optician usage lower than the general population (P < 0.05). Emergency departments were accessed by 35%, with 9% frequenting them three or more times. CONCLUSIONS People on probation have poorer self-reported health, higher prevalence of unhealthy behaviours and higher accessing of reactive health services than the general population.
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Affiliation(s)
- O Williams
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, Wales
| | - B J Gray
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, Wales
| | - S E Perrett
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ, Wales
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Waziry R, Gu Y, Williams O, Hägg S. Connections between cross-tissue and intra-tissue biomarkers of aging biology in older adults. Epigenetics Commun 2023; 3:7. [PMID: 38037563 PMCID: PMC10688599 DOI: 10.1186/s43682-023-00022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 09/28/2023] [Indexed: 12/02/2023]
Abstract
Background Saliva measures are generally more accessible than blood, especially in vulnerable populations. However, connections between aging biology biomarkers in different body tissues remain unknown. Methods The present study included individuals (N = 2406) who consented for saliva and blood draw in the Health and Retirement Telomere length study in 2008 and the Venous blood study in 2016 who had complete data for both tissues. We assessed biological aging based on telomere length in saliva and DNA methylation and physiology measures in blood. DNA methylation clocks combine information from CpGs to produce the aging measures representative of epigenetic aging in humans. We analyzed DNA methylation clocks proposed by Horvath (353 CpG sites), Hannum (71 CpG sites), Levine or PhenoAge, (513 CpG sites), GrimAge, (epigenetic surrogate markers for select plasma proteins), Horvath skin and blood (391 CpG sites), Lin (99 CpG sites), Weidner (3 CpG sites), and VidalBralo (8 CpG sites). Physiology measures (referred to as phenotypic age) included albumin, creatinine, glucose, [log] C-reactive protein, lymphocyte percent, mean cell volume, red blood cell distribution width, alkaline phosphatase, and white blood cell count. The phenotypic age algorithm is based on parametrization of Gompertz proportional hazard models. Average telomere length was assayed using quantitative PCR (qPCR) by comparing the telomere sequence copy number in each patient's sample (T) to a single-copy gene copy number (S). The resulting T/S ratio was proportional to telomere length, mean. Within individual, relationships between aging biology measures in blood and saliva and variations according to sex were assessed. Results Saliva-based telomere length showed inverse associations with both physiology-based and DNA methylation-based aging biology biomarkers in blood. Longer saliva-based telomere length was associated with 1 to 4 years slower biological aging based on blood-based biomarkers with the highest magnitude being Weidner (β = - 3.97, P = 0.005), GrimAge (β = - 3.33, P < 0.001), and Lin (β = - 3.45, P = 0.008) biomarkers of DNA methylation. Conclusions There are strong connections between aging biology biomarkers in saliva and blood in older adults. Changes in telomere length vary with changes in DNA methylation and physiology biomarkers of aging biology. We observed variations in the relationship between each body system represented by physiology biomarkers and biological aging, particularly at the DNA methylation level. These observations provide novel opportunities for integration of both blood-based and saliva-based biomarkers in clinical care of vulnerable and clinically difficult to reach populations where either or both tissues would be accessible for clinical monitoring purposes.
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Affiliation(s)
- R. Waziry
- Department of Neurology, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Y. Gu
- Department of Neurology, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- The Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - O. Williams
- Department of Neurology, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - S. Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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Che N, Cantilena S, Looi-Somoye R, de Boer J, Williams O. Drug repositioning for MLL-rearranged B-cell acute lymphoblastic
leukaemia. KLINISCHE PADIATRIE 2022. [DOI: 10.1055/s-0042-1748689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- N Che
- UCL Great Ormond Street Institute of Child Health, London, United
Kingdom
| | - S Cantilena
- UCL Great Ormond Street Institute of Child Health, London, United
Kingdom
| | - R Looi-Somoye
- UCL Great Ormond Street Institute of Child Health, London, United
Kingdom
| | - J de Boer
- UCL Great Ormond Street Institute of Child Health, London, United
Kingdom
| | - O Williams
- UCL Great Ormond Street Institute of Child Health, London, United
Kingdom
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Virely C, Armenteros-Monterroso E, Gasparoli L, Martens JHA, Mansour MR, Williams O. Establishing the mechanism for RUVBL2 essentiality in acute myeloid
leukaemia. KLINISCHE PADIATRIE 2022. [DOI: 10.1055/s-0042-1748688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Virely
- Developmental Biology and Cancer Programme, Cancer Section, UCL Great
Ormond Street Institute of Child Health, London, United Kingdom
| | - E Armenteros-Monterroso
- Developmental Biology and Cancer Programme, Cancer Section, UCL Great
Ormond Street Institute of Child Health, London, United Kingdom
| | - L Gasparoli
- Developmental Biology and Cancer Programme, Cancer Section, UCL Great
Ormond Street Institute of Child Health, London, United Kingdom
| | - JHA Martens
- Department of Molecular Biology, Faculty of Science, Radboud, Institute
for Molecular Life Sciences, Radboud University, Nijmegen, The
Netherlands
| | - MR Mansour
- Department of Haematology, UCL Cancer Institute, London, United
Kingdom
| | - O Williams
- Developmental Biology and Cancer Programme, Cancer Section, UCL Great
Ormond Street Institute of Child Health, London, United Kingdom
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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6
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Williams O, Williams C, Turner D, Bull M, Watkins J, Hurt L. An epidemiological investigation of COVID-19 outbreaks in a group of care homes in Wales, UK: a retrospective cohort study. J Public Health (Oxf) 2021; 44:606-613. [PMID: 33993283 PMCID: PMC8194567 DOI: 10.1093/pubmed/fdab150] [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: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study describes the epidemiology of COVID-19 outbreaks in four care homes in terms of spread, severity, presentation and interventions. Methods Participants were 100 residents and 102 staff from four co-located care homes in Wales. Data were collected from the homes and Public Health Wales, including demographics, presentations, test status and results, hospital admissions and deaths. Genomic sequencing of confirmed case samples was completed, where possible. Epi-curves, crude attack rates, a Kaplan-Meier survival curve and adjusted hazard ratios were calculated using R. Results About 14 confirmed and 43 possible resident cases, 23 confirmed and 47 possible staff cases occurred. Crude attack rates of possible and confirmed cases were 57% (residents) and 69% (staff). Genomic sequencing for 10 confirmed case PCR samples identified at least 5 different UK lineages of COVID-19.42 (42%) residents died, 23 (55%) with COVID-19 or suspected COVID-19 recorded on the death certificate. The hazard ratio for death amongst resident possible and confirmed cases compared to null cases, adjusting for age and sex, was 13.26 (95% CI 5.61–31.34). Conclusions There were extensive outbreaks of COVID-19 in these homes with high crude attack rates and deaths. Universal testing and early isolation of residents are recommended.
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Affiliation(s)
- O Williams
- Public Health Wales, Cardiff CF10 4BZ, UK
| | - C Williams
- Public Health Wales, Cardiff CF10 4BZ, UK
| | - D Turner
- Public Health Wales, Cardiff CF10 4BZ, UK
| | - M Bull
- Public Health Wales, Cardiff CF10 4BZ, UK
| | - J Watkins
- Public Health Wales, Cardiff CF10 4BZ, UK
| | - L Hurt
- Cardiff University, Cardiff CF14 4YS, UK
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7
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Gadjev I, Sudar N, Babzien M, Duris J, Hoang P, Fedurin M, Kusche K, Malone R, Musumeci P, Palmer M, Pogorelsky I, Polyanskiy M, Sakai Y, Swinson C, Williams O, Rosenzweig JB. An inverse free electron laser acceleration-driven Compton scattering X-ray source. Sci Rep 2019; 9:532. [PMID: 30679471 PMCID: PMC6345986 DOI: 10.1038/s41598-018-36423-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/16/2018] [Indexed: 11/09/2022] Open
Abstract
The generation of X-rays and γ-rays based on synchrotron radiation from free electrons, emitted in magnet arrays such as undulators, forms the basis of much of modern X-ray science. This approach has the drawback of requiring very high energy, up to the multi-GeV-scale, electron beams, to obtain the required photon energy. Due to the limit in accelerating gradients in conventional particle accelerators, reaching high energy typically demands use of instruments exceeding 100’s of meters in length. Compact, less costly, monochromatic X-ray sources based on very high field acceleration and very short period undulators, however, may enable diverse, paradigm-changing X-ray applications ranging from novel X-ray therapy techniques to active interrogation of sensitive materials, by making them accessible in energy reach, cost and size. Such compactness and enhanced energy reach may be obtained by an all-optical approach, which employs a laser-driven high gradient accelerator based on inverse free electron laser (IFEL), followed by a collision point for inverse Compton scattering (ICS), a scheme where a laser is used to provide undulator fields. We present an experimental proof-of-principle of this approach, where a TW-class CO2 laser pulse is split in two, with half used to accelerate a high quality electron beam up to 84 MeV through the IFEL interaction, and the other half acts as an electromagnetic undulator to generate up to 13 keV X-rays via ICS. These results demonstrate the feasibility of this scheme, which can be joined with other techniques such as laser recirculation to yield very compact photon sources, with both high peak and average brilliance, and with energies extending from the keV to MeV scale. Further, use of the IFEL acceleration with the ICS interaction produces a train of high intensity X-ray pulses, thus enabling a unique tool synchronized with a laser pulse for ultra-fast strobe, pump-probe experimental scenarios.
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Affiliation(s)
- I Gadjev
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA.
| | - N Sudar
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - M Babzien
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - J Duris
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - P Hoang
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - M Fedurin
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - K Kusche
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - R Malone
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - P Musumeci
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - M Palmer
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - I Pogorelsky
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - M Polyanskiy
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - Y Sakai
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - C Swinson
- Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - O Williams
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - J B Rosenzweig
- UCLA Department of Physics and Astronomy, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
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8
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Hoang PD, Andonian G, Gadjev I, Naranjo B, Sakai Y, Sudar N, Williams O, Fedurin M, Kusche K, Swinson C, Zhang P, Rosenzweig JB. Experimental Characterization of Electron-Beam-Driven Wakefield Modes in a Dielectric-Woodpile Cartesian Symmetric Structure. Phys Rev Lett 2018; 120:164801. [PMID: 29756951 DOI: 10.1103/physrevlett.120.164801] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Indexed: 06/08/2023]
Abstract
Photonic structures operating in the terahertz (THz) spectral region enable the essential characteristics of confinement, modal control, and electric field shielding for very high gradient accelerators based on wakefields in dielectrics. We report here an experimental investigation of THz wakefield modes in a three-dimensional photonic woodpile structure. Selective control in exciting or suppressing of wakefield modes with a nonzero transverse wave vector is demonstrated by using drive beams of varying transverse ellipticity. Additionally, we show that the wakefield spectrum is insensitive to the offset position of strongly elliptical beams. These results are consistent with analytic theory and three-dimensional simulations and illustrate a key advantage of wakefield systems with Cartesian symmetry: the suppression of transverse wakes by elliptical beams.
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Affiliation(s)
- P D Hoang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - G Andonian
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - I Gadjev
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - B Naranjo
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - Y Sakai
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - N Sudar
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - O Williams
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
| | - M Fedurin
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Kusche
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - C Swinson
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - P Zhang
- School of Physical Electronics, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - J B Rosenzweig
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095-1547, USA
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9
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Abstract
Aims and methodA total of 384 incidents of violence against the person (six ‘serious' and 378 ‘mild’), by adult in-patients in general psychiatric units (GPUs) and learning disability units (LDUs) in 10 National Health Service trusts in the Anglia region, were evaluated by Interviews with staff and examination of records.ResultsThe findings, when compared with standards derived from previous recommendations, showed deficiencies in the documentation of incidents (there was no satisfactory written record of physical restraint for 97% of incidents in GPUs and 86% in LDUs), in the training of staff in ‘control and restraint’ procedures (If two or more staff were involved In physical restraint, for 3% of incidents in GPUs and 100% in LDUs, the staff had received no training within the previous 12 months) and in policies for victim support (there was no written policy that included procedures for victim support in relation to 84% of incidents in GPUs and 44% in LDUs).Clinical implicationsTrusts should consider reviewing their policies on the prevention and management of violence, particularly in relation to staff training.
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10
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Morris L, Smirnov A, Kvassay A, Leslie E, Kavanagh R, Alexander N, Davey G, Williams O, Gilks C, Najman J. P40 Initial outcomes of integrated community-based hepatitis C treatment for people who inject drugs: findings from the Queensland injectors’ health network. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30781-0] [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: 11/24/2022] Open
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11
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Cantilena S, Heidenreich O, Klussman JH, Williams O, de Boer J. Redeployed drug inducing MLL fusion degradation. Klin Padiatr 2016. [DOI: 10.1055/s-0036-1582491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Sundaresh A, Gasparoli L, Mangolini M, Edwards D, Hubank M, Brooks T, Bartram J, Goulden N, Ancliff P, de Boer J, Williams O. Aberrant transcriptional pathways in t(12;21) Acute Lymphoblastic Leukemia. Klin Padiatr 2016. [DOI: 10.1055/s-0036-1582489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Affiliation(s)
- J Witczak
- From the Aneurin Bevan Health Board, Department of Diabetes and Endocrinology, Royal Gwent Hospital, Cardiff Road, Newport, Gwent, NP20 2UB, UK
| | - O Williams
- From the Aneurin Bevan Health Board, Department of Diabetes and Endocrinology, Royal Gwent Hospital, Cardiff Road, Newport, Gwent, NP20 2UB, UK
| | - T Shekaraiah
- From the Aneurin Bevan Health Board, Department of Diabetes and Endocrinology, Royal Gwent Hospital, Cardiff Road, Newport, Gwent, NP20 2UB, UK
| | - K Obuobie
- From the Aneurin Bevan Health Board, Department of Diabetes and Endocrinology, Royal Gwent Hospital, Cardiff Road, Newport, Gwent, NP20 2UB, UK
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14
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Hornby ST, McDermott FD, Coleman M, Ahmed Z, Bunni J, Bunting D, Elshaer M, El-Shaer M, Evans V, Kimble A, Kostalas M, Page G, Singh J, Szczebiot L, Wienand-Barnett S, Wilkins A, Williams O, Newell P. Female gender and diabetes mellitus increase the risk of recurrence after laparoscopic incisional hernia repair. Ann R Coll Surg Engl 2015; 97:115-9. [PMID: 25723687 DOI: 10.1308/003588414x14055925058751] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Laparoscopic hernia repair is used widely for the repair of incisional hernias. Few case studies have focussed on purely 'incisional' hernias. This multicentre series represents a collaborative effort and employed statistical analyses to provide insight into the factors predisposing to recurrence of incisional hernia after laparoscopic repair. A specific hypothesis (ie, laterality of hernias as well as proximity to the xyphoid process and pubic symphysis predisposes to recurrence) was also tested. METHODS This was a retrospective study of all laparoscopic incisional hernias undertaken in six centres from 1 January 2004 to 31 December 2010. It comprised a comprehensive review of case notes and a follow-up using a structured telephone questionnaire. Patient demographics, previous medical/surgical history, surgical procedure, postoperative recovery, and perceived effect on quality of life were recorded. Repairs undertaken for primary ventral hernias were excluded. A logistic regression analysis was then fitted with recurrence as the primary outcome. RESULTS A total of 186 cases (91 females) were identified. Median follow-up was 42 months. Telephone interviews were answered by 115/186 (62%) of subjects. Logistic regression analyses suggested that only female sex (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.39-8.97) and diabetes mellitus (3.54; 1-12.56) significantly increased the risk of recurrence. Position of the defect had no statistical effect. CONCLUSIONS These data suggest an increased risk of recurrence after laparoscopic incisional hernia repair in females and subjects with diabetes mellitus. These data will help inform surgeons and patients when considering laparoscopic management of incisional hernias. We recommend a centrally hosted, prospectively maintained national/international database to carry out additional research.
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15
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Andonian G, Williams O, Barber S, Bruhwiler D, Favier P, Fedurin M, Fitzmorris K, Fukasawa A, Hoang P, Kusche K, Naranjo B, O'Shea B, Stoltz P, Swinson C, Valloni A, Rosenzweig JB. Planar-dielectric-wakefield accelerator structure using Bragg-reflector boundaries. Phys Rev Lett 2014; 113:264801. [PMID: 25615344 DOI: 10.1103/physrevlett.113.264801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Indexed: 06/04/2023]
Abstract
We report experimental measurements of narrow-band, single-mode excitation, and drive beam energy modulation, in a dielectric wakefield accelerating structure with planar geometry and Bragg-reflector boundaries. A short, relativistic electron beam (∼1 ps) with moderate charge (∼100 pC) is used to drive the wakefields in the structure. The fundamental mode of the structure is reinforced by constructive interference in the alternating dielectric layers at the boundary, and is characterized by the spectral analysis of the emitted coherent Cherenkov radiation signal. Data analysis shows a narrow-band peak at 210 GHz corresponding to the fundamental mode of the structure. Simulations in both 2D and 3D provide insight into the propagating fields and reproduction of the electron beams dynamics observables and emitted radiation characteristics.
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Affiliation(s)
- G Andonian
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - O Williams
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - S Barber
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - D Bruhwiler
- University of Colorado at Boulder, Center for Integrated Plasma Studies, Boulder, Colorado 80309, USA and RadiaSoft LLC, Boulder, Colorado 80304, USA
| | - P Favier
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - M Fedurin
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Fitzmorris
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - A Fukasawa
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - P Hoang
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - K Kusche
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - B Naranjo
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - B O'Shea
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - P Stoltz
- Tech-X Corporation, Boulder, Colorado 80303, USA
| | - C Swinson
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - A Valloni
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
| | - J B Rosenzweig
- Department of Physics and Astronomy, University of California at Los Angeles (UCLA), Los Angeles, California 90095, USA
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16
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Duris J, Musumeci P, Babzien M, Fedurin M, Kusche K, Li RK, Moody J, Pogorelsky I, Polyanskiy M, Rosenzweig JB, Sakai Y, Swinson C, Threlkeld E, Williams O, Yakimenko V. High-quality electron beams from a helical inverse free-electron laser accelerator. Nat Commun 2014; 5:4928. [PMID: 25222026 DOI: 10.1038/ncomms5928] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/08/2014] [Indexed: 11/09/2022] Open
Abstract
Compact, table-top sized accelerators are key to improving access to high-quality beams for use in industry, medicine and academic research. Among laser-based accelerating schemes, the inverse free-electron laser (IFEL) enjoys unique advantages. By using an undulator magnetic field in combination with a laser, GeV m(-1) gradients may be sustained over metre-scale distances using laser intensities several orders of magnitude less than those used in laser wake-field accelerators. Here we show for the first time the capture and high-gradient acceleration of monoenergetic electron beams from a helical IFEL. Using a modest intensity (~10(13) W cm(-2)) laser pulse and strongly tapered 0.5 m long undulator, we demonstrate >100 MV m(-1) accelerating gradient, >50 MeV energy gain and excellent output beam quality. Our results pave the way towards compact, tunable GeV IFEL accelerators for applications such as driving soft X-ray free-electron lasers and producing γ-rays by inverse Compton scattering.
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Affiliation(s)
- J Duris
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - P Musumeci
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - M Babzien
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Fedurin
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - K Kusche
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - R K Li
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - J Moody
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - I Pogorelsky
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M Polyanskiy
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - J B Rosenzweig
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - Y Sakai
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - C Swinson
- Accelerator Test Facility, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - E Threlkeld
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - O Williams
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
| | - V Yakimenko
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
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17
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Rymer MM, Anderson CS, Harada M, Jarosz J, Ma N, Rowley HA, Summers D, Tastula K, Williams O, Bornstein NM. Stroke service: how can we improve and measure outcomes? Consensus summary from a global stroke forum. Acta Neurol Scand 2014; 130:73-80. [PMID: 24796345 DOI: 10.1111/ane.12256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2014] [Indexed: 11/27/2022]
Abstract
The success of acute stroke treatment is first and foremost time-dependent, and the need for improvement in acute stroke management is demonstrated by the fact that only a minority of patients gain access to treatment - in particular, intravenous recombinant tissue plasminogen activator (IV tPA) - within the necessary time window. Standards of acute stroke care vary widely both regionally and nationally; consequently, various healthcare organizations have undertaken initiatives to measure and improve quality of care. To date, most quality measures have been process-based, focusing primarily on metrics of patient care in the acute hospital-based setting (e.g., time to recombinant tPA administration). Therefore, there remains a need for metrics designed to assess how improvements in process translate into patient outcomes. A global forum was convened to share best practice and provide consensus recommendations on core metrics for measuring improvements in access to care and patient outcomes. Recommendations for core metrics of patient outcomes include hospital-based outcomes (e.g., neurological status at 24 h, ambulatory status at discharge) and post-discharge outcomes (e.g., modified Rankin Scale score at 30 and/or 90 days). Recommendations for best practice relating to aspects of people, process, and technology involved in the stroke treatment pathway that may help provide improvements in these core outcome measures are also outlined.
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Affiliation(s)
- M. M. Rymer
- The University of Kansas Hospital; Kansas City KS USA
| | - C. S. Anderson
- The George Institute for Global Health; Royal Prince Alfred Hospital; University of Sydney; Sydney NSW Australia
| | - M. Harada
- University of Tokushima; Tokushima Japan
| | | | - N. Ma
- Beijing Tiantan Hospital; Beijing China
| | - H. A. Rowley
- School of Medicine and Public Health; University of Wisconsin; Madison WI USA
| | - D. Summers
- St Luke's Neuroscience Institute; Kansas City MO USA
| | - K. Tastula
- Royal Prince Alfred Hospital; Sydney NSW Australia
| | | | - N. M. Bornstein
- Tel-Aviv Medical Center; Tel-Aviv University; Tel-Aviv Israel
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18
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Osaki H, Walf-Vorderwülbecke V, Mangolini M, Zhao L, Horton SJ, Morrone G, Schuringa JJ, de Boer J, Williams O. The AAA+ ATPase RUVBL2 is a critical mediator of MLL-AF9 oncogenesis. Leukemia 2013; 27:1461-8. [PMID: 23403462 DOI: 10.1038/leu.2013.42] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 01/18/2013] [Accepted: 02/11/2013] [Indexed: 12/27/2022]
Abstract
The most frequent chromosomal translocations in pediatric acute myeloid leukemia affect the 11q23 locus and give rise to mixed lineage leukemia (MLL) fusion genes, MLL-AF9 being the most prevalent. The MLL-AF9 fusion gene has been shown to induce leukemia in both mouse and human models. In this study, we demonstrate that leukemogenic activity of MLL-AF9 requires RUVBL2 (RuvB-like 2), an AAA+ ATPase family member that functions in a wide range of cellular processes, including chromatin remodeling and transcriptional regulation. Expression of RUVBL2 was dependent on MLL-AF9, as it increased upon immortalization of human cord blood-derived hematopoietic progenitor cells with the fusion gene and decreased following loss of fusion gene expression in conditionally immortalized mouse cells. Short hairpin RNA-mediated silencing experiments demonstrated that both the immortalized human cells and the MLL-AF9-expressing human leukemia cell line THP-1 required RUVBL2 expression for proliferation and survival. Furthermore, inhibition of RUVBL2 expression in THP-1 cells led to reduced telomerase activity and clonogenic potential. These data were confirmed with a dominant-negative Walker B-mutated RUVBL2 construct. Taken together, these data suggest the possibility of targeting RUVBL2 as a potential therapeutic strategy for MLL-AF9-associated leukemia.
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Affiliation(s)
- H Osaki
- Molecular Haematology and Cancer Biology Unit, UCL Institute of Child Health, London, UK
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19
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Hidding B, Rosenzweig JB, Xi Y, O'Shea B, Andonian G, Schiller D, Barber S, Williams O, Pretzler G, Königstein T, Kleeschulte F, Hogan MJ, Litos M, Corde S, White WW, Muggli P, Bruhwiler DL, Lotov K. Beyond injection: Trojan horse underdense photocathode plasma wakefield acceleration. ACTA ACUST UNITED AC 2013. [DOI: 10.1063/1.4773760] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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20
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Williams O, Michel B, Hutchings G, Debauche C, Hubinont C. Two-year neonatal outcome following PPROM prior to 25 weeks with a prolonged period of oligohydramnios. Early Hum Dev 2012; 88:657-61. [PMID: 22682720 DOI: 10.1016/j.earlhumdev.2012.01.012] [Citation(s) in RCA: 19] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 01/18/2012] [Accepted: 01/28/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Improved neonatal survival data have been reported following early preterm prelabour rupture of membranes (PPROM) prior to 25 weeks gestation with a prolonged latency to delivery and persistent oligohydramnios. However, data regarding long-term respiratory and neurological morbidity are lacking. AIMS To evaluate the respiratory and neurological outcome data at two years of age in a cohort of infants born following PPROM prior to 25 weeks with a prolonged latency (14 days) to delivery and compare the data to an aged matched group of infants. METHODS Retrospective case note analysis over a 43-month period at Saint Luc University Hospital, Brussels. RESULTS 15 surviving infants born following PPROM were matched to a group of 30 control infants. Although there was no significant difference in the incidence of BPD between the groups (33% vs 27%, p=0.24), the length of hospitalisation, duration of respiratory support and number of hospital readmissions for respiratory indications were all significantly higher for infants born following a prolonged period of oligohydramnios. There were no major anomalies on cranial ultrasound in the PPROM group and Baileys developmental assessment at 20-24 months corrected gestational age showed no difference between the two groups (Mental development index 93.9 vs 94.4 and Psychomotor development index 95.5 vs 95.8 respectively p = ns). CONCLUSION Neurodevelopmental outcome appears encouraging in this cohort although these infants are at high risk of prolonged initial hospitalisation and significant respiratory morbidity in the first two-years of life.
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Affiliation(s)
- O Williams
- Department of Neonatology, Cliniques Universitaires Saint Luc, Catholic University of Louvain, 10 Avenue Hippocrate, Brussels, Belgium.
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21
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Andonian G, Stratakis D, Babzien M, Barber S, Fedurin M, Hemsing E, Kusche K, Muggli P, O'Shea B, Wei X, Williams O, Yakimenko V, Rosenzweig JB. Dielectric wakefield acceleration of a relativistic electron beam in a slab-symmetric dielectric lined waveguide. Phys Rev Lett 2012; 108:244801. [PMID: 23004279 DOI: 10.1103/physrevlett.108.244801] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Indexed: 06/01/2023]
Abstract
We report first evidence of wakefield acceleration of a relativistic electron beam in a dielectric-lined slab-symmetric structure. The high energy tail of a ∼60 MeV electron beam was accelerated by ∼150 keV in a 2 cm-long, slab-symmetric SiO2 waveguide, with the acceleration or deceleration clearly visible due to the use of a beam with a bifurcated longitudinal distribution that serves to approximate a driver-witness beam pair. This split-bunch distribution is verified by longitudinal reconstruction analysis of the emitted coherent transition radiation. The dielectric waveguide structure is further characterized by spectral analysis of the emitted coherent Cherenkov radiation at THz frequencies, from a single electron bunch, and from a relativistic bunch train with spacing selectively tuned to the second longitudinal mode (TM02). Start-to-end simulation results reproduce aspects of the electron beam bifurcation dynamics, emitted THz radiation properties, and the observation of acceleration in the dielectric-lined, slab-symmetric waveguide.
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Affiliation(s)
- G Andonian
- Department of Physics and Astronomy, UCLA, Los Angeles, California 90095, USA
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22
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Spijkers-Hagelstein JAP, Schneider P, Hulleman E, de Boer J, Williams O, Pieters R, Stam RW. Elevated S100A8/S100A9 expression causes glucocorticoid resistance in MLL-rearranged infant acute lymphoblastic leukemia. Leukemia 2012; 26:1255-65. [PMID: 22282267 DOI: 10.1038/leu.2011.388] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
MLL-rearranged acute lymphoblastic leukemia (ALL) in infants is characterized by a poor clinical outcome and resistance to glucocorticoids (for example, prednisone and dexamethasone). As both the response to prednisolone in vitro and prednisone in vivo are predictive for clinical outcome, understanding and overcoming glucocorticoid resistance remains an essential step towards improving prognosis. Prednisolone-induced apoptosis depends on glucocorticoid-evoked Ca(2+) fluxes from the endoplasmic reticulum towards the mitochondria. Here, we demonstrate that in MLL-rearranged infant ALL, over-expression of S100A8 and S100A9 is associated with failure to induce free-cytosolic Ca(2+) and prednisolone resistance. Furthermore, we demonstrate that enforced expression of S100A8/S100A9 in prednisolone-sensitive MLL-rearranged ALL cells, rapidly leads to prednisolone resistance as a result of S100A8/S100A9 mediated suppression of prednisolone-induced free-cytosolic Ca(2+) levels. In addition, the Src kinase inhibitor PP2 markedly sensitized MLL-rearranged ALL cells otherwise resistant to prednisolone, via downregulation of S100A8 and S100A9, which allowed prednisolone-induced Ca(2+) fluxes to reach the mitochondria and trigger apoptosis. On the basis of this novel mechanism of prednisolone resistance, we propose that developing more specific S100A8/S100A9 inhibitors may well be beneficial for prednisolone-resistant MLL-rearranged infant ALL patients.
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Affiliation(s)
- J A P Spijkers-Hagelstein
- Department of Pediatric Oncology/Hematology, Erasmus Medical Center / Sophia Children's Hospital, Zuid-Holland, The Netherlands
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23
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Niraj G, Kelkar A, Jeyapalan I, Graff-Baker P, Williams O, Darbar A, Maheshwaran A, Powell R. Comparison of analgesic efficacy of subcostal transversus abdominis plane blocks with epidural analgesia following upper abdominal surgery. Anaesthesia 2011; 66:465-71. [PMID: 21457153 DOI: 10.1111/j.1365-2044.2011.06700.x] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Subcostal transversus abdominis plane (TAP) catheters have been reported to be an effective method of providing analgesia after upper abdominal surgery. We compared their analgesic efficacy with that of epidural analgesia after major upper abdominal surgery in a randomised controlled trial. Adult patients undergoing elective open hepatobiliary or renal surgery were randomly allocated to receive subcostal TAP catheters (n=29) or epidural analgesia (n=33), in addition to a standard postoperative analgesic regimen comprising of regular paracetamol and tramadol as required. The TAP group patients received bilateral subcostal TAP catheters and 1 mg.kg(-1) bupivacaine 0.375% bilaterally every 8 h. The epidural group patients received an infusion of bupivacaine 0.125% with fentanyl 2 μg.ml(-1) . The primary outcome measure was visual analogue pain scores during coughing at 8, 24, 48 and 72 h after surgery. We found no significant differences in median (IQR [range]) visual analogue scores during coughing at 8 h between the TAP group (4.0 (2.3-6.0 [0-7.5])) and epidural group (4.0 (2.5-5.3) [0-8.5])) and at 72 h (2.0 (0.8-4.0 [0-5]) and 2.5 (1.0-5.0 [0-6]), respectively). Tramadol consumption was significantly greater in the TAP group (p=0.002). Subcostal TAP catheter boluses may be an effective alternative to epidural infusions for providing postoperative analgesia after upper abdominal surgery.
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Affiliation(s)
- G Niraj
- Department of Anaesthesia and Pain Management, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
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24
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Rogstad K, Thomas A, Williams O, Forster G, Munday P, Robinson A, Rooney G, Sherrard J, Tenant-Flowers M, Wilkinson D, Lazaro N. UK National Guideline on the Management of Sexually Transmitted Infections and Related Conditions in Children and Young People (2009). Int J STD AIDS 2010; 21:229-41. [DOI: 10.1258/ijsa.2009.009353] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- K Rogstad
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF
| | - A Thomas
- Department of Community Paediatrics. St. James's University Hospital, Leeds LS9 7TF
| | - O Williams
- Department of Genitourinary Medicine, Wrexham Maelor Hospital, Croesnewydd Road. Wrexham LL13 7TD
| | - G Forster
- Ambrose King Centre, Royal London Hospital, Turner Street, London E1 1BB
| | - P Munday
- Watford Sexual Health Centre, Watford General Hospital, Vicarage Road, Watford WD18 OHB
| | - A Robinson
- The Mortimer Market Centre, Off Capper Street, London WC1E 6AU
| | - G Rooney
- Great Western Hospital, Swindon SN3 6BB
| | - J Sherrard
- The Churchill Hospital, Old Road Headington, Oxford OX3 7LJ
| | - M Tenant-Flowers
- Department of Sexual Health, The Caldecott Centre, King's College Hospital NHS Foundation Trust, London SE5 9RS
| | - D Wilkinson
- Jefferiss Wing Centre for Sexual Health, Imperial College Healthcare NHS Trust, London
| | - N Lazaro
- Royal Preston Hospital, Preston PR2 9HT, UK
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25
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Woodward MJ, de Boer J, Heidorn S, Hubank M, Kioussis D, Williams O, Brady HJM. Tnfaip8 is an essential gene for the regulation of glucocorticoid-mediated apoptosis of thymocytes. Cell Death Differ 2009; 17:316-23. [PMID: 19730441 DOI: 10.1038/cdd.2009.125] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Glucocorticoids have significant immunoregulatory actions on thymocytes and T cells and act by binding and activating cytosolic glucocorticoid receptors, which translocate to the nucleus and control gene expression through binding to specific response elements in target genes. Glucocorticoids promote cell death by activating an apoptotic program that requires transcriptional regulation. We set out to identify genes that are crucial to the process of glucocorticoid-mediated thymocyte apoptosis. Freshly isolated murine primary thymocytes were treated with dexamethasone, mRNA isolated and used to screen DNA microarrays. A set of candidate genes with upregulated expression was identified and selected members assayed in reconstituted fetal thymic organ culture (FTOC). Fetal liver-derived hematopoietic progenitor cells (HPCs) were infected with retroviruses expressing individual genes then used to repopulate depleted fetal thymic lobes. Reconstituted FTOCs expressing the gene Tnfaip8 were treated with dexamethasone and shown to be greatly sensitized to dexamethasone. Retrovirus-mediated RNA interference was applied to knock down Tnfaip8 expression in HPCs and these were used to reconstitute FTOCs. We observed that downregulating the expression of Tnfaip8 alone was sufficient to effectively protect thymocytes against glucocorticoid-induced apoptosis. We propose that Tnfaip8 is crucial in regulating glucocorticoid-mediated apoptosis of thymocytes.
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Affiliation(s)
- M J Woodward
- Molecular Haematology and Cancer Biology Unit, University College London Institute of Child Health, London, UK
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26
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Williams O, Hutchings G, Debieve F, Debauche C. Contemporary neonatal outcome following rupture of membranes prior to 25 weeks with prolonged oligohydramnios. Early Hum Dev 2009; 85:273-7. [PMID: 19108959 DOI: 10.1016/j.earlhumdev.2008.11.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 11/13/2008] [Accepted: 11/13/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prolonged oligohydramnios following early preterm prelabour rupture of membranes (PPROM) is traditionally associated with high neonatal mortality and significant risk of pulmonary hypoplasia. However, recent evidence points to an apparent improvement in outcome. AIMS To document current neonatal outcomes following rupture of membranes prior to 25 weeks with severe persistent oligohydramnios and a latency to delivery of at least 14 days. METHODS A retrospective case note analysis over a 28-month period at Saint Luc University Hospital, Brussels. RESULTS From 23 pregnancies that were complicated by PPROM prior to 25 weeks, 15 infants were born after 24 weeks with a latency of more than 14 days and persistent oligohydramnios. Nine infants (60%) had severe respiratory failure and clinical signs compatible with pulmonary hypoplasia. Seven of these infants (78%) responded to high frequency ventilation and inhaled nitric oxide therapy with good clinical outcome but two died from severe respiratory failure. Five infants showed no clinical signs of pulmonary hypoplasia and responded to conventional neonatal management. One of these infants died at 77 days of age of necrotising enterocolitis. One infant was not resuscitated and died within minutes of birth, following prior discussion with the perinatal team and the parents. Survivors in this high-risk group (73%) had low morbidity at the time of discharge. SUMMARY The favourable neonatal survival and morbidity figures are in keeping with recent published evidence. This study confirms improved outcome even amongst the highest risk infants with documented persistent oligohydramnios.
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Affiliation(s)
- O Williams
- Department of Neonatology, Cliniques Universitaires Saint Luc, Catholic University of Louvain, Brussels, Belgium.
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27
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May C, Williams O, Milner AD, Peacock J, Rafferty GF, Hannam S, Greenough A. Relation of exhaled nitric oxide levels to development of bronchopulmonary dysplasia. Arch Dis Child Fetal Neonatal Ed 2009; 94:F205-9. [PMID: 19383857 DOI: 10.1136/adc.2008.146589] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [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: 11/03/2022]
Abstract
OBJECTIVE To test the hypothesis that exhaled nitric oxide levels on day 28 and changes in exhaled nitric oxide levels in the neonatal period would differ according to whether infants developed bronchopulmonary dysplasia (BPD) and its severity. DESIGN Prospective observational study. SETTING Tertiary neonatal intensive care unit. PATIENTS 80 infants (median gestational age 28, range 24-32 weeks), 46 of whom developed BPD. INTERVENTIONS Exhaled nitric oxide measurements were attempted on days 3, 5, 7, 14, 21 and 28. MAIN OUTCOME MEASURES BPD (oxygen dependency at 28 days), mild BPD (oxygen dependent at 28 days, but not 36 weeks postmenstrual age (PMA)); moderate BPD (oxygen dependent at 36 weeks PMA) and severe BPD (respiratory support dependent at 36 weeks PMA). RESULTS On day 28, exhaled nitric oxide levels were higher in infants with BPD compared to those without BPD (p<0.001) and there was a linear trend in exhaled nitric oxide results as BPD severity increased (p = 0.006). No significances in the change in exhaled nitric oxide levels over the neonatal period were found between the four groups. CONCLUSION Exhaled nitric oxide levels are raised in infants with established BPD, particularly in those developing moderate or severe BPD, and may reflect ongoing inflammation.
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Affiliation(s)
- C May
- Division of Asthma, Allergy and Lung Biology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
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28
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Morrow M, Samanta A, Kioussis D, Brady HJM, Williams O. TEL-AML1 preleukemic activity requires the DNA binding domain of AML1 and the dimerization and corepressor binding domains of TEL. Oncogene 2007; 26:4404-14. [PMID: 17237815 DOI: 10.1038/sj.onc.1210227] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [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] [Received: 05/08/2006] [Revised: 11/01/2006] [Accepted: 11/22/2006] [Indexed: 12/30/2022]
Abstract
The t(12;21)(p13;q22) translocation generates the TEL-AML1 (TEL, translocation-Ets-leukemia; AML1, acute myeloid leukemia-1) (ETV6-RUNX1) fusion product and is the most common chromosomal abnormality in pediatric leukemia. Our previous studies using a murine fetal liver transplantation model demonstrated that TEL-AML1 promotes the self-renewal of B-cell precursors in vitro and enhances the expansion of hematopoietic stem cells (HSCs) in vivo. This is consistent with the hypothesis that TEL-AML1 induces expansion of a preleukemic clone. Several studies have described domains within TEL-AML1 involved in the transcriptional regulation of specific target genes. However, it is unclear which of these domains is important for the activity of TEL-AML1 in preleukemic hematopoiesis. In order to examine this, we have generated a panel of deletion mutants and expressed them in HSCs. These experiments demonstrate that TEL-AML1 requires multiple domains from both TEL and AML1 to alter hematopoiesis. Furthermore, mutation of a single amino-acid residue within the runt homology domain of AML1, required for DNA binding, was sufficient to abrogate TEL-AML1 activity. These data suggest that TEL-AML1 acts as an aberrant transcription factor to perturb multiple pathways during hematopoiesis.
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Affiliation(s)
- M Morrow
- Molecular Haematology and Cancer Biology Unit, Institute of Child Health, University College, London, UK
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29
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Affiliation(s)
- A C Flint
- University of California San Francisco, Department of Neurology, Neurovascular Service and Neurocritical Care, 505 Parnassus Avenue, Room M-830, San Francisco, CA 94143-0114, USA.
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30
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Abstract
Exhaled nitric oxide (eNO) levels were measured in eight ventilated infants, mean gestational age 25.8 (SD 1.7) weeks and postnatal age 55 (SD 39) days, before and after three days of dexamethasone treatment. The eNO levels fell from a mean of 6.5 (SD 3.4) to 4.2 (SD 2.6) parts per billion (p = 0.031) and the mean supplementary oxygen levels from 62% to 45% (p = 0.0078).
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Affiliation(s)
- O Williams
- Children Nationwide Regional Neonatal Intensive Care Centre, 4th floor Ruskin Wing, King's College Hospital, London SE5 9RS, UK
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31
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Abstract
A 26 week gestation infant had an increasingly elevated right hemidiaphragm following drainage of bilateral pleural effusions and failed extubation on numerous occasions. Electric stimulation of the phrenic nerves revealed absent activity on the right, indicating phrenic nerve injury from chest tube drain insertion. Diaphragmatic plication was performed and the infant successfully extubated four days later.
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Affiliation(s)
- O Williams
- Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK
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Williams O, Forster G, Robinson A. Screening for sexually transmitted infections in children and adolescents in the United Kingdom: British Co-operative Clinical Group. Int J STD AIDS 2001; 12:487-92. [PMID: 11487387 DOI: 10.1258/0956462011923561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Our objectives were (1) to assess the number of young people aged under 16 years attending genitourinary medicine (GUM) departments in the UK in 1998; (2) to identify clinical activity and policy; (3) to determine the knowledge and training needs of healthcare professionals within GUM providing care for this client group. In July 1999 a questionnaire was circulated via the 18 regional British Co-operative Clinical Group (BCCG) representatives to the consultants in charge of all 197 main GUM departments in the UK. One hundred and sixty out of 197 (81%) completed questionnaires were returned and analysed. The reported number of under-16-year-olds attending in 1998 varied considerably between clinics; for females ranging from 0 to 256 and for males between 0 and 50, with a male to female ratio of 1:4.4. The majority of responding clinics, 139/160 (87%) had been involved in the screening of abused children/adolescents for sexually transmitted infections (STIs). Most clinics were prepared to screen for STI (86%), HIV test (79%) and assess contraceptive needs (50%) in this age group. Staff involved in care included health advisers (74), nurses (59), and doctors (138) in the responding clinics. Only 31/160 clinics (19%) had a written policy for the management of children/adolescents attending their clinic. The majority of respondents were aware of their child protection policy [122/154 (79%)] and designated child sexual abuse doctor, [125/157 (80%)] in their district. When questioned on previous and current training needs, 134/160 (84%) respondents identified their need for further training in the area of adolescent sexual health and 124/160 (78%) in child sex abuse. The publication Physical Signs of Sexual Abuse in Children, was known to 112/160 (70%) respondents, of whom 58/112 (52%) who answered this question had read the publication. Genitourinary physicians in the UK are aware of the increasing number of children and adolescents accessing their services, and recognize the need to identify those in abusive situations. Written policies dealing with children and adolescents in GUM clinics in the UK are lacking. This needs to be rectified urgently. This survey identifies that further training in the field of child sexual abuse and adolescent sexual health would be welcomed by the respondents.
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Affiliation(s)
- O Williams
- Department of Genitourinary Medicine, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, UK
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Robinson AJ, Williams O. 'Say no to sex; great idea but...'. Int J STD AIDS 2001; 12:485-6. [PMID: 11487386 DOI: 10.1258/0956462011923516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
T cell development is characterized by the induction of apoptosis in most immature thymocytes and the rescue from apoptosis of a small proportion of cells by the process of positive selection.Up-regulation of the anti-apoptotic molecule Bcl-2 is associated with thymocytes undergoing positive selection and a bcl-2 transgene promotes the generation of mature T cells. In contrast,mice transgenic for the pro-apoptotic molecule Bax show impaired T cell maturation. We have used fetal thymic organ culture to determine the action of Bcl-2 and Bax on positive selection of thymocytes. Our data show that Bcl-2 and Bax do not alter the number of thymocytes positively selected by a defined peptide ligand. This implies that Bcl-2 and Bax alter the production of mature T cells in vivo by influencing thymocyte viability rather than by direct action on positive selection. It also presents a solution to the 'chicken-and-egg' scenario relating to Bcl-2 up-regulation and positive selection. The data suggest that the up-regulation of Bcl-2 associated with T cell maturation is a consequence of positive selection rather than a cause of it.
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Affiliation(s)
- O Williams
- Division of Molecular Immunology, Medical Research Council, National Institute for Medical Research, London, GB
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Morris RW, Fitzpatrick R, Hajat S, Reeves BC, Murray DW, Hannen D, Rigge M, Williams O, Gregg PJ. Primary total hip replacement: variations in patient management in Oxford & Anglia, Trent, Yorkshire & Northern 'regions'. Ann R Coll Surg Engl 2001; 83:190-6. [PMID: 11432139 PMCID: PMC2503572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVES To examine national practice, and variations in practice, concerning total hip replacement; in particular the choice of prosthesis and the involvement of consultants in NHS operations. DESIGN Pre-operative survey of patients undergoing total hip replacement. SETTING Five English regions serving combined population of 16.8 million people. SUBJECTS 13,343 total hip replacement operations in one year commencing September 1996, either in NHS or private sector. MAIN OUTCOME MEASURES Prosthesis used for surgery, status of surgeons involved in operation, use of laminar flow operating theatre. RESULTS Prostheses without well documented 5-year survival were used in 5504 (58%) of 9417 operations for which information was available. The consultant was the operator in 4810 (64%) of 7499 NHS operations. In 1352 trainee-led operations, the consultant was present for only 637 (47%); this figure was 54% for trainees in years 1-4 of their training. Substantial variation between NHS consultant firms occurred both for use of prostheses with well documented survival data, and supervision of trainees by the consultant. CONCLUSIONS This large study is the first attempt to describe national practice for primary total hip replacement. Substantial variation among consultant firms was observed for all indices of practice reported.
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Affiliation(s)
- R W Morris
- Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK.
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Simon AK, Williams O, Mongkolsapaya J, Jin B, Xu XN, Walczak H, Screaton GR. Tumor necrosis factor-related apoptosis-inducing ligand in T cell development: sensitivity of human thymocytes. Proc Natl Acad Sci U S A 2001; 98:5158-63. [PMID: 11309507 PMCID: PMC33180 DOI: 10.1073/pnas.091100398] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [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: 01/25/2023] Open
Abstract
TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) is a recently identified member of the tumor necrosis factor cytokine superfamily. TRAIL has been shown to induce apoptosis in various tumor cell lines, whereas most primary cells seem to be resistant. These observations have raised considerable interest in the use of TRAIL in tumor therapy. Yet little is known about the physiological function of TRAIL. This is particularly the case in the immune system, where TRAIL has been suggested by some to be involved in target cell killing and lymphocyte death. We have developed a panel of mAbs and soluble proteins to address the role of TRAIL in lymphocyte development. These studies demonstrate activation-induced sensitization of thymocytes to TRAIL-mediated apoptosis and expression of the apoptosis-inducing TRAIL receptors. However, with the use of several model systems, our subsequent experiments rule out the possibility that TRAIL plays a major role in antigen-induced deletion of thymocytes. In contrast to thymocytes, there is no up-regulation of TRAIL receptors in peripheral T cells on activation, which remain resistant to TRAIL. Thus, susceptibility to TRAIL-induced apoptosis is controlled differently by central and peripheral T cells.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 2
- ATP-Binding Cassette Transporters/genetics
- Animals
- Antibodies, Monoclonal
- Apoptosis/drug effects
- Apoptosis Regulatory Proteins
- CD4 Antigens/analysis
- CD8 Antigens/analysis
- Cells, Cultured
- Child, Preschool
- Clonal Deletion/drug effects
- Cytotoxicity, Immunologic
- Flow Cytometry
- Genes, RAG-1/genetics
- Humans
- Infant
- Jurkat Cells
- Lymphocyte Activation
- Membrane Glycoproteins/metabolism
- Membrane Glycoproteins/pharmacology
- Mice
- Mice, Knockout
- Organ Culture Techniques
- Receptors, TNF-Related Apoptosis-Inducing Ligand
- Receptors, Tumor Necrosis Factor/metabolism
- T-Lymphocytes/cytology
- T-Lymphocytes/drug effects
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- TNF-Related Apoptosis-Inducing Ligand
- Thymus Gland/cytology
- Thymus Gland/drug effects
- Thymus Gland/immunology
- Thymus Gland/metabolism
- Tumor Necrosis Factor-alpha/metabolism
- Tumor Necrosis Factor-alpha/pharmacology
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Affiliation(s)
- A K Simon
- Medical Research Council Human Immunology Unit, Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, United Kingdom.
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Smyth LA, Reynolds L, Tyrrell R, Williams O, Norton T, Schumacher T, Tybulewicz V, Ley SC, Kioussis D. Signaling in primary thymocytes after presentation of altered peptide ligands by antigen-presenting cells or MHC-peptide tetramers. Cold Spring Harb Symp Quant Biol 2001; 64:275-81. [PMID: 11232297 DOI: 10.1101/sqb.1999.64.275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- L A Smyth
- Divisions of Molecular Immunology, National Institute for Medical Research, The Ridgeway, Mill Hill, London NW7 1AA
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Rooney K, Bertram J, Austen C, Connelley G, Rose M, Williams O, Carter C. The effective use of automated apheresis of autologous red cells in elective orthopaedic and major urological surgery – a rural hospital experience. Transfus Apher Sci 2001. [DOI: 10.1016/s1473-0502(01)00013-1] [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: 10/18/2022]
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Abstract
The T-cell repertoire is generated as a result of selection processes that happen in the thymus. The molecular basis of these processes is beginning to be elucidated and many of the molecules identified have a role in regulating cell death. These molecules range from orphan nuclear receptors and transcription factors to cyclin-dependent kinase 2 and Bcl2 family members.
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Affiliation(s)
- O Williams
- Division of Molecular Immunology, National Institute for Medical Research, The Ridgeway, Mill Hill, NW7 1AA, London, UK
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Fitzpatrick R, Morris R, Hajat S, Reeves B, Murray DW, Hannen D, Rigge M, Williams O, Gregg P. The value of short and simple measures to assess outcomes for patients of total hip replacement surgery. Qual Health Care 2000; 9:146-50. [PMID: 10980074 PMCID: PMC1743526 DOI: 10.1136/qhc.9.3.146] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [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: 11/04/2022]
Abstract
OBJECTIVES To evaluate the performance of a patient assessed outcome measure, the Oxford Hip Score, in a national study of primary hip replacement surgery. DESIGN A survey of patients' health status before undergoing primary hip replacement surgery and three months and one year after surgery. SETTING 143 hospitals in three NHS English regions. PATIENTS 7151 patients admitted for primary total hip replacement surgery over a period of 13 months from September 1996. MAIN MEASURES For patients, Oxford Hip Score and satisfaction with hip replacement and, for surgeons, American Anesthesiologists' Society (ASA) classification of physical status. RESULTS The response rates to the postal questionnaire at three and 12 months follow up were 85.2% and 80.7%, respectively. Including all three administrations of the questionnaire, all except two items of the Oxford Hip Score were completed by 97% or more respondents and only one item at one administration appeared marginally to reduce the reliability of the score. The effect sizes for changes in the score from baseline to three months was 2.50 and to 12 months was 3.05. Patients rated by surgeons as being healthy preoperatively by the ASA classification were somewhat more likely to return a completed questionnaire at three months (79.4% versus 75.3%) and 12 months (72.4% versus 70.3%) than those rated as having poorer health. CONCLUSIONS Overall there was little evidence of difficulties for patients in completing the Oxford Hip Score or of unreliable data, except in relation to one questionnaire item. The instrument was very responsive to change over time and score changes for the Oxford Hip Score related well to patients' satisfaction with their surgery. The instrument is an appropriate measure in terms of validity, responsiveness, and feasibility for evaluating total hip replacement from the
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Affiliation(s)
- R Fitzpatrick
- Institute of Health Sciences, University of Oxford, Headington, UK.
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Williams O, Demirer T, Lilleby K, Buckner CD, Bensinger WI. Tempo of hematologic recovery correlates with peripheral blood CD34+ cell level in patients undergoing stem cell mobilization. J Clin Apher 2000; 13:1-6. [PMID: 9590490 DOI: 10.1002/(sici)1098-1101(1998)13:1<1::aid-jca1>3.0.co;2-d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/08/2022]
Abstract
This study was undertaken to evaluate the relationship between the time to recovery of peripheral blood counts and CD34+ cells in the peripheral blood (PB) and apheresis collections of patients undergoing intensive chemotherapy followed by rhG-CSF. Twenty-three patients with a median age of 42 years (range 17-64) with malignancies underwent peripheral blood stem cell (PBSC) collection after cyclophosphamide (CY) 4 g/m2 and etoposide (600 mg/m2) followed by rhG-CSF (10 microg/kg/day). The WBC, platelet counts, CD34+ cell counts per ml of PB, and CD34+ cells in apheresis products were followed in all patients. The relationship of the time to recovery of WBC > 1,000/microl, >3,000/microl, >10,000/microl and platelets >20,000/microl and 50,000/microl was compared to the average daily CD34+ cells/ml in each patient using the Spearman Correlation test. The tempo of recovery of WBC and platelets were highly correlated with the average CD34+ cell count in blood. In order to derive some useful guidelines for the timing of apheresis, the patients were divided into two groups, early recover (ER) and late recover (LR) based on the median time (day 10) to reach WBC count greater than 1,000/microl. ER patients had an average daily PB CD34+ cell count of 9.04 x 10(4)/ml (range 0.44-17.5) and a median yield of CD34+ cells of 10.43 x 10(6)/kg (range 0.60-25.95) compared to LR patients, who had 1.87 x 10(4)/ml (range 0.32-5.44) in the PB (P = .001) and a yield 3.20 x 10(6)/kg CD34+ cells (range 0.037-9.39) (P = .001). Patients recovering their WBC to 1,000/ml within 10 days of completing this regimen may undergo PBSC collection and achieve minimum-target cell doses of >2.5 x 10(6) CD34+ cells/kg--100% of the time.
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Affiliation(s)
- O Williams
- Fred Hutchinson Cancer Research Center and the University of Washington, Seattle 98104, USA
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Abstract
Apoptosis plays a critical role in T cell development and thymic selection. Thymocytes which undergo antigen-induced negative selection have been demonstrated to die by apoptosis. Despite this, relatively little is known about the specific apoptotic pathway involved in negative selection. We have examined the role of cyclin-dependent kinase 2 (Cdk2), a key regulator of thymocyte apoptosis, in this process. Stimulation of thymocytes with cognate antigen leads to a large increase in Cdk2 kinase activity. We also show that pharmacological inhibitors of Cdk2 block thymocyte apoptosis in response to antigen. Our data show that Cdk2 activity is essential for the apoptotic pathway used in negative selection.
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Affiliation(s)
- O Williams
- Division of Molecular Immunology, MRC National Institute for Medical Research, London, GB
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Chang M, Marquardt AP, Wood BL, Williams O, Cotler SJ, Taylor SL, Carithers RL, Gretch DR. In situ distribution of hepatitis C virus replicative-intermediate RNA in hepatic tissue and its correlation with liver disease. J Virol 2000; 74:944-55. [PMID: 10623757 PMCID: PMC111615 DOI: 10.1128/jvi.74.2.944-955.2000] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [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: 12/19/2022] Open
Abstract
Liver failure from chronic hepatitis C is the leading indication for liver transplantation in the United States. However, the pathogenesis of liver injury resulting from chronic hepatitis C virus (HCV) infection is not well understood. To examine the relationship between HCV replication in liver tissue and hepatocellular injury, a strand-specific in situ hybridization procedure was developed. The sensitivity and specificity of digoxigenin-labeled riboprobes were optimized by analyzing Northern blots and cell lines expressing HCV RNAs. For the current study, both genomic (sense) and replicative-intermediate (antisense) HCV RNAs were detected and quantified in 8 of 8 liver tissue specimens from infected patients versus 0 of 11 liver tissue specimens from noninfected controls. The distribution pattern for HCV replicative-intermediate RNA in liver was different from that for HCV genomic RNA. HCV genomic RNA was variably distributed throughout infected livers and was located primarily in the cytoplasm of hepatocytes, with some signal in fibroblasts and/or macrophages in the surrounding fibroconnective tissue. However, HCV replicative-intermediate RNA showed a more focal pattern of distribution and was exclusively localized in the cytoplasm of hepatocytes. There was no significant relationship between the distribution pattern for HCV genomic RNA and any indices of hepatocellular injury. However, a highly significant correlation was observed between the percentage of cells staining positive for replicative-intermediate RNA and the degree of hepatic inflammatory activity (P, < 0.0001). Furthermore, the ratio of cells staining positive for HCV replicative-intermediate versus genomic RNA correlated with the histological severity of liver injury (P, 0. 0065), supporting the hypothesis that active replication of HCV in liver tissue may be a significant determinant of hepatocellular injury.
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Affiliation(s)
- M Chang
- Departments of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington 98195, USA
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Wack A, Corbella P, Harker N, Roderick K, Norton T, Williams K, Williams O, Kioussis D. Th cells and Th2 responses can develop in the absence of MHC class II-CD4 interactions. J Immunol 1999; 163:1162-9. [PMID: 10415010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
In this paper, we address the question whether CD4 and MHC class II expression are necessary for the development of the T helper lineage during thymocyte maturation and for activation-induced Th2 responses. To bypass the CD4-MHC class II interaction requirements for positive selection and activation, we used mice that are doubly transgenic for CD8 and for the MHC class I-restricted TCR F5. This transgene combination leads to MHC class I-dependent maturation of CD4 lineage cells. Upon activation, these CD4 lineage T cells secrete IL-4 and give help to B cells but show no cytotoxic activity. Remarkably, neither MHC class II nor CD4 expression are necessary for the generation and helper functions of these cells. This suggests that under normal conditions, coreceptor-MHC interactions are necessary to ensure the canonical combinations of coreceptor and function in developing thymocytes, but that they do not determine functional commitment. Our results also imply that expression of the CD4 gene does not influence, but is merely associated with the decision to establish the T helper program. In addition, we show that activation through TCR-MHC class I interactions can induce Th2 responses independently of CD4 and MHC class II expression.
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Affiliation(s)
- A Wack
- Division of Molecular Immunology, National Institute for Medical Research, London, United Kingdom
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45
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Abstract
The vaccinia virus WR A5L open reading frame (corresponding to open reading frame A4L in vaccinia virus Copenhagen) encodes an immunodominant late protein found in the core of the vaccinia virion. To investigate the role of this protein in vaccinia virus replication, we have constructed a recombinant virus, vA5Li, in which the endogenous gene has been deleted and an inducible copy of the A5 gene dependent on isopropyl-beta-D-thiogalactopyranoside (IPTG) for expression has been inserted into the genome. In the absence of inducer, the yield of infectious virus was dramatically reduced. However, DNA synthesis and processing, viral protein expression (except for A5), and early stages in virion formation were indistinguishable from the analogous steps in a normal infection. Electron microscopy revealed that the major vaccinia virus structural form present in cells infected with vA5Li in the absence of inducer was immature virions. Viral particles were purified from vA5Li-infected cells in the presence and absence of inducer. Both particles contained viral DNA and the full complement of viral proteins, except for A5, which was missing from particles prepared in the absence of inducer. The particles prepared in the presence of IPTG were more infectious than those prepared in its absence. The A5 protein appears to be required for the immature virion to form the brick-shaped intracellular mature virion.
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Affiliation(s)
- O Williams
- Laboratory of Viral Diseases, Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, Maryland 20852, USA
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Abstract
In a double-blind, randomized, controlled study, 61 patients who received a standardized anaesthetic for day case arthroscopic knee surgery were studied. Group T (n = 31) received tramadol 1.5 mg kg-1, and group F (n = 30) received fentanyl 1.5 micrograms kg-1 at the induction of anaesthesia. All patients also received 20 mL of intra-articular bupivacaine 0.5% at the end of surgery. Assessments were made of pain at rest and on movement, analgesic requirements and side-effects at hourly intervals up to 6 h and by means of a postal questionnaire at 24 h and 48 h post-operatively. Group F had higher pain scores than group T at 4 h only [VAS 3.3 (1.6-5.5) vs. 2.4 (1-4), P = 0.039, respectively; median (interquartile range)]. There were no other significant differences between the groups in terms of pain scores, supplemental analgesic requirements or incidence of side-effects. We conclude that tramadol offers little benefit clinically compared with fentanyl when used at induction of anaesthesia for day case arthroscopic knee surgery. Further studies are indicated in patients with more severe pain to determine the role of tramadol in post-operative analgesia.
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Affiliation(s)
- B Cagney
- University Department of Anaesthesia, Leicester General Hospital, UK
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Mok CL, Gil-Gómez G, Williams O, Coles M, Taga S, Tolaini M, Norton T, Kioussis D, Brady HJ. Bad can act as a key regulator of T cell apoptosis and T cell development. J Exp Med 1999; 189:575-86. [PMID: 9927519 PMCID: PMC2192908 DOI: 10.1084/jem.189.3.575] [Citation(s) in RCA: 83] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bad is a distant relative of Bcl-2 and acts to promote cell death. Here, we show that Bad expression levels are greatly increased in thymocytes during apoptosis. We generated bad transgenic mice to study the action of upregulated Bad expression on T cell apoptosis. The T cells from these mice are highly sensitive to apoptotic stimuli, including anti-CD95. The numbers of T cells are greatly depleted and the processes of T cell development and selection are perturbed. We show that the proapoptotic function of Bad in primary T cells is regulated by Akt kinase and that Bad overexpression enhances both cell cycle progression and interleukin 2 production after T cell activation. These data suggest that Bad can act as a key regulator of T cell apoptosis and that this is a consequence of its upregulation after exposure to death stimuli.
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Affiliation(s)
- C L Mok
- Division of Molecular Immunology, MRC National Institute for Medical Research, London NW7 1AA, United Kingdom
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48
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Affiliation(s)
- N Meisler
- Medical University of South Carolina, Charleston 29425, USA.
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49
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Abstract
Between 1993 and 1997, clinicians from 9 departments of genitourinary medicine (GUM) and one department of sexual health in East Anglia met to audit the process of contact tracing in chlamydial infection. After defining the target group, standards were set for discussion of the diagnosis with the index patient, appropriate treatment of the condition and documented notification of partners. Data were collected for all patients with confirmed chlamydial infection during the periods January to March 1995 and 1996. Considering the combined data for both years, overall 97% of patients were informed of the diagnosis and 100% received appropriate treatment. Notification of partners was addressed at the initial consultation in 99% of cases and again at follow-up in 87%. Where contacts were traceable, there was confirmation that assessment had occurred in 65%, and the index cases reported that 66% had undergone assessment. The achievements and also the problems associated with this audit are discussed.
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Affiliation(s)
- C Sonnex
- Department of Genitourinary Medicine, Addenbrooke's NHS Trust Hospital, Cambridge, UK
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50
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Abstract
T cell development and selection in the thymus are shaped by the induction of apoptosis. However, a direct role in T cell development and selection for any of the molecules known to regulate apoptosis has remained controversial. We have studied the effect of bax and bcl-2 transgenes in recombination activation gene 1-deficient (RAG-1(-/-)) mice transgenic for the major histocompatibility complex class I-restricted F5 T cell receptor. Overexpression of a bax transgene in the thymus seriously impairs the production of mature T cells, whereas bcl-2 overexpression greatly promotes it. The effect of bax and bcl-2 overexpression on antigen-induced negative selection was studied using fetal thymic organ cultures. This analysis showed that Bcl-2 strongly inhibits negative selection, whereas Bax does not affect it. Our data directly show that Bcl-2 family members have specific roles in T cell selection and also lend support to the hypothesis that Bax and Bcl-2 can antagonize each other's action in a certain apoptosis pathway while in another they can be functionally nonreciprocal.
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Affiliation(s)
- O Williams
- Division of Molecular Immunology, Medical Research Council, National Institute for Medical Research, London, United Kingdom
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