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Kowtha B, Byrd L, Nieto I, Chase M, Cunningham P, Rogers S. HRSA's Opioid and Oral Health Workforce Programs. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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2
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Badman SG, Willie B, Narokobi R, Gabuzzi J, Pekon S, Amos-Kuma A, Hakim AJ, Weikum D, Gare J, Silim S, Guy RJ, Donovan B, Cunningham P, Kaldor JM, Vallely AJ, Whiley D, Kelly-Hanku A. A diagnostic evaluation of a molecular assay used for testing and treating anorectal chlamydia and gonorrhoea infections at the point-of-care in Papua New Guinea. Clin Microbiol Infect 2019; 25:623-627. [PMID: 30107282 PMCID: PMC11005091 DOI: 10.1016/j.cmi.2018.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/04/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Papua New Guinea has among the highest prevalences of sexually transmissible infections (STIs) globally with no services able to accurately test for anorectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections. Here we prospectively evaluated the diagnostic performance of a molecular CT/NG assay used at the point-of-care (POC) with the aim of enhancing anorectal STI screening and same-day treatment. METHODS Men who have sex with men, transgender women and female sex workers taking part in Papua New Guinea's first large-scale biobehavioural study were enrolled and asked to provide a self-collected anorectal swab for POC GeneXpert CT/NG testing. Same-day treatment was offered if positive. A convenience sample of 396 unique and randomly selected samples were transported to Australia for comparison using the Cobas 4800 CT/NG test (Roche Molecular Diagnostics, Pleasanton, CA, USA). RESULTS A total of 326 samples provided valid results by Cobas whereas 70 samples provided invalid results suggesting inhibition. The positive, negative and overall percentage agreements of GeneXpert CT/NG for the detection of C. trachomatis were 96.7% (95% CI 92.3%-98.9%), 95.5% (95% CI 91.3%-98.0%) and 96.0% (95% CI 93.3%-97.8%), and for N. gonorrhoeae were 93.0% (95% CI 86.1%-97.1%), 100.0% (95% CI 98.3%-100.0%) and 97.8% (95% CI 95.6%-99.1%), respectively. CONCLUSIONS The overall rate of agreement between the GeneXpert and Cobas CT/NG assays was high with 96.0% for C. trachomatis and 97.8% for N. gonorrhoeae. Results from this study data suggest that the GeneXpert CT/NG assay is suitable for testing self-collected anorectal specimens at the POC and that same-day treatment was feasible.
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Affiliation(s)
- S G Badman
- Kirby Institute, UNSW Sydney, NSW, Australia.
| | - B Willie
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - R Narokobi
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - J Gabuzzi
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - S Pekon
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - A Amos-Kuma
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - A J Hakim
- The Division of Global HIV/TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D Weikum
- The Division of Global HIV/TB, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Gare
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - S Silim
- Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - R J Guy
- Kirby Institute, UNSW Sydney, NSW, Australia
| | - B Donovan
- Kirby Institute, UNSW Sydney, NSW, Australia; Sydney Sexual Health Centre, Sydney, NSW, Australia
| | - P Cunningham
- Kirby Institute, UNSW Sydney, NSW, Australia; St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, Darlinghurst, Sydney, NSW, Australia
| | - J M Kaldor
- Kirby Institute, UNSW Sydney, NSW, Australia
| | - A J Vallely
- Kirby Institute, UNSW Sydney, NSW, Australia; Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - D Whiley
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - A Kelly-Hanku
- Kirby Institute, UNSW Sydney, NSW, Australia; Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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Kitchen G, Hopwood T, Cunningham P, Poolman T, Begley N, Loudon A, Blaikley J, Ray D. Circadian regulation of macrophage phagocytosis is mediated by a REV-ERBα independent Bmal1/RhoA pathway. Br J Anaesth 2019. [DOI: 10.1016/j.bja.2018.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Iversen J, Grebely J, Catlett B, Cunningham P, Dore G, Maher L. O9 Progress towards elimination: rapid uptake of HCV treatment among people who inject drugs following broad access to DAA therapies. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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5
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Keen P, Conway DP, Cunningham P, McNulty A, Couldwell DL, Davies SC, Smith DE, Gray J, Holt M, O'Connor CC, Read P, Callander D, Prestage G, Guy R. Multi-centre field evaluation of the performance of the Trinity Biotech Uni-Gold HIV 1/2 rapid test as a first-line screening assay for gay and bisexual men compared with 4th generation laboratory immunoassays. J Clin Virol 2016; 86:46-51. [PMID: 27914286 DOI: 10.1016/j.jcv.2016.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/15/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Trinity Biotech Uni-Gold HIV test (Uni-Gold) is often used as a supplementary rapid test in testing algorithms. OBJECTIVE To evaluate the operational performance of the Uni-Gold as a first-line screening test among gay and bisexual men (GBM) in a setting where 4th generation HIV laboratory assays are routinely used. STUDY DESIGN We compared the performance of Uni-Gold with conventional HIV serology conducted in parallel among GBM attending 22 testing sites. Sensitivity was calculated separately for acute and established infection, defined using 4th generation screening Ag/Ab immunoassay (EIA) and Western blot results. Previous HIV testing history and results of supplementary 3rd generation HIV Ab EIA, and p24 antigen EIA were used to further characterise cases of acute infection. RESULTS Of 10,793 specimens tested with Uni-Gold and conventional serology, 94 (0.90%, 95%CI:0.70-1.07) were confirmed as HIV-positive by conventional serology, and 37 (39.4%) were classified as acute infection. Uni-Gold sensitivity was 81.9% overall (77/94, 95%CI:72.6-89.1); 56.8% for acute infection (21/37, 95%CI:39.5-72.9) and 98.2% for established infection (56/57, 95%CI:90.6-100.0). Of 17 false non-reactive Uni-Gold results, 16 were acute infections, and of these seven were p24 antigen reactive but antibody negative. Uni-Gold specificity was 99.9% (10,692/10,699, 95%CI:99.9-100.0), PPV was 91.7% (95%CI:83.6-96.6) and NPV was 99.8% (95%CI:99.7-99.9), respectively. CONCLUSIONS In this population, Uni-Gold had good specificity and sensitivity was high for established infections when compared to 4th generation laboratory assays, however sensitivity was lower in acute infections. Where rapid tests are used in populations with a high proportion of acute infections, additional testing strategies are needed to detect acute infections.
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Affiliation(s)
- P Keen
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia.
| | - D P Conway
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia; Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW 2000, Australia
| | - P Cunningham
- NSW State Reference Laboratory for HIV, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia; St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW 2052, Australia
| | - A McNulty
- Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW 2000, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - D L Couldwell
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, NSW 2150, Australia; The Marie Bashir Institute for Infectious Diseases, University of Sydney, NSW 2145, Australia
| | - S C Davies
- Northern Sydney Sexual Health Service, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - D E Smith
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Albion Centre, Surry Hills, NSW 2010, Australia
| | - J Gray
- ACON, Surry Hills, Sydney, NSW 2010, Australia
| | - M Holt
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - C C O'Connor
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia; RPA Sexual Health, Community Health, Sydney LHD, Camperdown, Sydney, NSW 2050, Australia; Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
| | - P Read
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia; Kirketon Road Centre, PO Box 22, Kings Cross, NSW 1340, Australia
| | - D Callander
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - G Prestage
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC 3000, Australia
| | - R Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
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Turton AJ, Cunningham P, van Wijck F, Smartt HJM, Rogers CA, Sackley CM, Jowett S, Wolf SL, Wheatley K, van Vliet P. Home-based Reach-to-Grasp training for people after stroke is feasible: a pilot randomised controlled trial. Clin Rehabil 2016; 31:891-903. [DOI: 10.1177/0269215516661751] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To determine feasibility of a randomised controlled trial (RCT) of home-based Reach-to-Grasp training after stroke. Design: single-blind parallel group RCT. Participants: Residual arm deficit less than 12 months post-stroke. Interventions: Reach-to-Grasp training in 14 one-hour therapist’s visits over 6 weeks, plus one hour self-practice per day (total 56 hours). Control: Usual care. Main Measures: Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), pre-randomisation, 7, 12, 24 weeks post-randomisation. Results: Forty-seven participants (Reach-to-Grasp=24, usual care=23) were randomised over 17 months. Reach-to-Grasp participants received a median (IQR) 14 (13,14) visits, and performed 157 (96,211) repetitions per visit; plus 30 minutes (22,45) self-practice per day. Usual care participants received 10.5 (5,14) therapist visits, comprising 38.6 (30,45) minutes of arm therapy with 16 (6,24) repetitions of functional tasks per visit. Median ARAT scores in the reach-to-grasp group were 8.5 (3.0,24.0) at baseline and 14.5 (3.5,26.0) at 24 weeks compared to median of 4 at both time points (IQR: baseline (3.0,14.0), 24 weeks (3.0,30.0)) in the usual-care group. Median WMFT tasks completed at baseline and 24 weeks were 6 (3.0,11.5) and 8.5 (4.5,13.5) respectively in the reach-to-grasp group and 4 (3.0,10.0), 6 (3.0,14.0) in the usual care group. Incidence of arm pain was similar between groups. The study was stopped before 11 patients reached the 24 weeks assessment. Conclusions: An RCT of home-based Reach-to-Grasp training after stroke is feasible and safe. With ARAT being our preferred measure it is estimated that 240 participants will be needed for a future two armed trial.
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Affiliation(s)
- AJ Turton
- Department of Allied Health Professions, University of the West of England, UK
| | - P Cunningham
- Department of Allied Health Professions, University of the West of England, UK
| | - F van Wijck
- Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, UK
| | - HJM Smartt
- Clinical Trials and Evaluation Unit, School of Clinical Sciences, University of Bristol, UK
| | - CA Rogers
- Clinical Trials and Evaluation Unit, School of Clinical Sciences, University of Bristol, UK
| | - CM Sackley
- Institute of Health and Social Care Research, King’s College London, UK
| | - S Jowett
- School of Health and Population Sciences, University of Birmingham, UK
| | - SL Wolf
- Emory Rehabilitation Hospital, Emory University, Atlanta, USA
| | - K Wheatley
- Institute of Cancer and Genomic Sciences, University of Birmingham, UK
| | - P van Vliet
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia, and Hunter Medical Research Institute, UK
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van Vliet P, Cunningham P, Wijck F, Sackley C, Rogers C, Wolf S, Jowett S, Wheatley K, Turton A. Home-based reach-to-grasp training for people after stroke: a feasibility randomised controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Conway DP, Guy R, McNulty A, Couldwell DL, Davies SC, Smith DE, Keen P, Cunningham P, Holt M. Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney. HIV Med 2015; 16:280-7. [PMID: 25604470 DOI: 10.1111/hiv.12209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Rapid HIV testing (RHT) is well established in many countries, but it is new in Australia since a policy change in 2011. We assessed service provider acceptability of RHT before and after its implementation in four Sydney public sexual health clinics. METHODS Service providers were surveyed immediately after training in RHT and again 6-12 months later. Differences in mean scores between survey rounds were assessed via t-tests, with stratification by profession and the number of tests performed. RESULTS RHT was rated as highly acceptable among staff at baseline and acceptability scores improved between survey rounds. Belief in being sufficiently skilled and experienced to perform RHT (P = 0.004) and confidence in the delivery of nonreactive results increased (P = 0.007), while the belief that RHT was disruptive declined (P = 0.001). Acceptability was higher for staff who had performed a greater number of tests regarding comfort with their role in RHT (P = 0.004) and belief that patients were satisfied with RHT (P = 0.007). Compared with nurses, doctors had a stronger preference for a faster rapid test (P = 0.027) and were more likely to agree that RHT interfered with consultations (P = 0.014). CONCLUSIONS Differences in responses between professions may reflect differences in staff roles, the type of patients seen by staff and the model of testing used, all of which may affect the number of tests performed by staff. These findings may inform planning for how best to implement RHT in clinical services.
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Affiliation(s)
- D P Conway
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia; Short Street Sexual Health Centre, St George Hospital, Kogarah, NSW, Australia
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Jadoon A, Cunningham P, McDermott LC. Arachidonic acid metabolism in the human placenta: identification of a putative lipoxygenase. Placenta 2014; 35:422-4. [PMID: 24767823 DOI: 10.1016/j.placenta.2014.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/26/2014] [Accepted: 03/30/2014] [Indexed: 12/17/2022]
Abstract
Arachidonic acid (ARA) metabolites maintain pregnancy and control parturition. We generated a network of 77 proteins involved in placental ARA metabolism to identify novel proteins in this pathway. We identified a long pathway within this network which showed that secretory and cytosolic phospholipase A2 proteins act in concert. The functions of all network proteins expressed in the placental decidua were determined by database searches. Thus ARA metabolism was linked to carbohydrate metabolism. One protein, transmembrane protein 62 (TMEM62), expressed in decidua was previously uncharacterized, and was identified as a putative lipoxygenase. TMEM62 may play a role in pregnancy and/or parturition.
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Affiliation(s)
- A Jadoon
- Diabetes and Nutritional Sciences Division, School of Medicine, Franklin Wilkins Building, Stamford Street, London SE1 9NH, UK
| | - P Cunningham
- Department of Biochemistry, School of Biomedical and Health Sciences, King's College London, Franklin Wilkins Building, Stamford Street, London SE1 9NH, UK
| | - L C McDermott
- Diabetes and Nutritional Sciences Division, School of Medicine, Franklin Wilkins Building, Stamford Street, London SE1 9NH, UK.
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O'Rourke J, Zimmermann JA, Shields W, McLaughlin D, Cunningham P, Magee C, Hickey DP. Organ donation following the circulatory determination of death (DCD): an audit of donation and outcomes following renal transplantation. Ir Med J 2014; 107:11-14. [PMID: 24592639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Organ Donation following the Circulatory determination of Death was introduced in Beaumont Hospital during 2011. The Intensive Care Society of Ireland formally endorsed a national DCD clinical practice guideline in 2012. This retrospective audit covers a 2-year period during which eleven patients were considered suitable for DCD and where consent was obtained. Nine patients died within the ninety-minute period following the withdrawal of life sustaining therapies and subsequently donated organs (82%). Eighteen kidneys were recovered and seventeen patients received renal transplants--one patient received a nephron-dosing dual renal transplant. Lungs were recovered on two occasions and one patient received a lung transplant. Heart valves were recovered on one occasion. To date sixteen of seventeen recipient patients have functioning renal transplants (94%). In conclusion, this model of deceased donation has proven acceptable to families, nursing and medical staff and the outcomes reported are consistent with international best practice.
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Affiliation(s)
- J O'Rourke
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9.
| | - J A Zimmermann
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9
| | - W Shields
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9
| | - D McLaughlin
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9
| | - P Cunningham
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9
| | - C Magee
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9
| | - D P Hickey
- Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Beaumont, Dublin 9
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Cunningham P, Burke J, McCulloch L, Varia R. P241 ‘CURE-CAP’: A Comprehensive Admission & Discharge Pneumonia Care Bundle. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Conway DP, Guy R, McNulty A, Couldwell DL, Davies SC, Smith DE, Keen P, Cunningham P, Holt M. P5.037 Experience of Rapid HIV Testing Increases Its Acceptability to Clinical Staff in Public Sexual Health Clinics in Sydney. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Conway DP, Holt M, McNulty A, Couldwell DL, Smith DE, Davies SC, Cunningham P, Keen P, Guy R. O15.4 Field Performance of the Alere Determine HIV Combo Assay in a Large Australian Multi-Centre Study in a Sexual Health Clinic Setting. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wade M, Tucker I, Cunningham P, Skinner R, Bell F, Lyons T, Patten K, Gonzalez L, Wess T. Investigating the origins of nanostructural variations in differential ethnic hair types using X-ray scattering techniques. Int J Cosmet Sci 2013; 35:430-41. [DOI: 10.1111/ics.12061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 04/27/2013] [Indexed: 11/27/2022]
Affiliation(s)
- M. Wade
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
| | - I. Tucker
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - P. Cunningham
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - R. Skinner
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - F. Bell
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - T. Lyons
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - K. Patten
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
| | - L. Gonzalez
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
| | - T. Wess
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
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Grange F, Hatzfeld D, Cunningham P, Molnar P, Roecker SW, Suárez G, Rodrígues A, Ocola L. Tectonic implications of the microearthquake seismicity and fault plane solutions in southern Peru. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/jb089ib07p06139] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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16
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Newman PR, Warren LF, Cunningham P, Chang TY, Cooper DE, Burdge GL, Polak-Dingels P, Lowe-Ma CK. Semiorganics: A New Class of Nlo Materials. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-173-557] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recent results indicate that certain organic molecules whose electronic structures are characterized by extended pi-molecular orbitals can exhibit significant second and third order nonlinear optical (NLO) effects [1]. Unfortunately, this same arrangement which leads to the NLO effects, can also result in essentially one-dimensional bonding coordination. This in turn means that crystals grown from these materials do not readily form good three-dimensional optical-quality crystals, but rather tend to form needles. In addition, pure organic crystals are usually bonded by weak van der Waals forces, often resulting in poor mechanical properties. Indeed, organic impurities are frequently incorporated into these systems during crystallization resulting in poor crystallinity, spurious absorptions, and low damage thresholds. This is particularly true in the case of polymeric NLO materials, where impurities result from the polymerization steps and/or starting materials.
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Hegarty M, O'Neill W, Colreavy F, Dwyer R, Cunningham P, Hanlon M. Potential organ donor audit in Ireland. Ir Med J 2010; 103:294-296. [PMID: 21560498] [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: 05/30/2023]
Abstract
As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1/9/07-31/8/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information/education campaigns.
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Affiliation(s)
- M Hegarty
- Department of Public Health, HSE Dublin Mid-Leinster, Tullamore, Co Offaly.
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Hogstrand C, Zheng D, Cunningham P, Kille P, Feeney G, Handy R. Dynamic transcriptomic profiles of zebrafish gills in response to zinc exposure. Comp Biochem Physiol A Mol Integr Physiol 2010. [DOI: 10.1016/j.cbpa.2010.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Haddad P, Chaudhry I, Husain N, McLaughlin S, Cunningham P, David A, Patel M. Psychiatrists’ attitudes to antipsychotic depot injections (i): Preferences and choice. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.937] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Patel M, Chaudhry I, Husain N, McLaughlin S, Cunningham P, David A, Haddad P. Psychiatrists’ attitudes to antipsychotic depot injections (II): Changes over 5 years. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.200] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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21
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Casey PB, Tracey JA, Cunningham P, Counihan A, Fleming J, Hickey D, Hegarty J. Renal and liver transplantation for toxin-induced organ failure. Clin Toxicol (Phila) 2007; 45:31-5. [PMID: 17357379 DOI: 10.1080/15563650600956220] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Determine the number and outcome of renal (January 1987-June 2001, inclusive) and liver transplants (January 1993-June 2001) performed in Ireland for drug or toxin-induced organ failure and identify the toxins involved. METHODS Retrospective review of national transplant coordinators' records and patient charts. RESULTS Fourteen patients received renal transplants for nephropathy secondary to drugs or toxins. In 12 of these cases, renal failure was attributed to chronic toxicity, principally cyclosporin A therapy (seven cases). One-year patient and graft survival were 100%. Twenty-nine liver transplants were for toxin-induced organ failure, and 20 of these were for chronic ethanol induced liver disease. One-year patient and graft survival rates were 77% and 73%, respectively. CONCLUSIONS Kidney and liver transplants were needed more often because of chronic toxicity than acute poisoning. Both groups had good outcomes at one year post-transplantation.
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Affiliation(s)
- P B Casey
- National Poisons Information Centre Beaumont Hospital, Dublin, Ireland.
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22
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Rashid T, Jayakumar KS, Binder A, Ellis S, Cunningham P, Ebringer A. Rheumatoid arthritis patients have elevated antibodies to cross-reactive and non cross-reactive antigens from Proteus microbes. Clin Exp Rheumatol 2007; 25:259-67. [PMID: 17543151] [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: 05/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Although a large number of independent studies have shown a paramount role for Proteus mirabilis in the aetiopathogenesis of rheumatoid arthritis (RA), this hypothesis is still controversial among rheumatologists. The main obstacle to its acceptance is the impression that increased Proteus antibodies in RA patients is a secondary phenomenon, occurring as the result of cross-reactivity between bacterial and self-antigens. To shed light on this problem, we examined the link between antibodies to various cross-reactive and non cross-reactive antigenic peptides from P. mirabilis and analysed the relationship between these antibodies and disease severity in patients with RA. METHODS Using the ELISA method, serum samples from 70 RA patients and 20 healthy controls were screened for total and class-specific antibodies against three human cross-reactive and non-crossreactive synthetic peptides from P. mirabilis haemolysin, urease C and urease F enzymes. An antibody index, which comprised the total concentration of antibodies against these peptides in each sample, was correlated with the biochemical parameters of disease activity and/or severity, such as the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factors (RF). Furthermore, anti-peptide antibody indices were evaluated among RA patients with different levels of disease activity as defined by ESR and CRP. RESULTS Significantly elevated levels of total and class-specific IgG antibodies against the 3 Proteus peptides were observed among RA patients compared to healthy controls (p < 0.001). Active RA patients had elevated IgM antibodies against all peptides compared to healthy subjects (p < 0.001). However, no such elevation was observed in IgA anti-peptide antibodies in RA patients. A positive correlation was observed between the antibody indices and ESR (p < 0.001) and CRP (p < 0.01) concentrations, but not the RF status or disease duration. Furthermore, more than 90% of active RA patients showed positive values for the Proteus anti-peptide indices. CONCLUSION The elevated levels of antibodies against Proteus antigenic epitopes (which are cross-reactive or non cross-reactive with human tissue antigens) observed indicates that this enhanced bacterial immune response in RA patients is specifically triggered by Proteus microbes. Furthermore, the correlation of anti-peptide antibody indices with the biochemical markers of disease activity indicates that these antibodies exert damaging cytotoxic effects on joint tissues during the course of the disease.
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Affiliation(s)
- T Rashid
- School of Biomedical and Health Sciences, Kings College London, London, UK
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Abstract
This study was undertaken to qualitatively and quantitatively compare fast MRI of hips with and without parallel imaging using SENSE (sensitivity encoding). 27 patients underwent MRI of the hips with coronal T1 turbo spin echo (TSE) (repetition time (TR) 500 ms, effective echo time (TEeff) 15 ms, Turbo Factor 4), coronal IR-TSE (TR 2000 ms, TEeff 30 ms, inversion time (TI) 160 ms, Turbo Factor 20) and axial T2 TSE (TR 3000 ms, TEeff 80 ms, Turbo Factor 20) weighted images acquired with and without SENSE with a reduction factor of 2. Conventional imaging was performed in 8 min and 36 s. Images acquired with SENSE were acquired in 5 min and 31 s without a discernible reduction in image quality or a significant quantitative reduction in image signal to noise ratio, contrast to noise ratio or edge enhancement.
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Affiliation(s)
- M Ryan
- Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
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Cantwell C, Ryan M, O'Connell M, Cunningham P, Brennan D, Costigan D, Lynch T, Eustace S. A comparison of inflammatory myopathies at whole-body turbo STIR MRI. Clin Radiol 2005; 60:261-7. [PMID: 15664582 DOI: 10.1016/j.crad.2004.06.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- C Cantwell
- Cappagh National Orthopaedic Hospital, Finglas, Dublin, Eire
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O'Kelly P, Giblin L, Spencer S, Donohoe J, Walshe JJ, Little DM, Hickey D, Cunningham P, Conlon PJ. Outcomes of adult cadaveric renal transplantation in Ireland 1986 to 2001. Ir J Med Sci 2005; 174:42-8. [PMID: 15868889 DOI: 10.1007/bf03168518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/29/2022]
Abstract
BACKGROUND Since the introduction of renal transplantation in the Republic of Ireland in 1964, the number of transplants performed annually has increased from single figures in the 1960s to the current rate of approximately 130 renal transplants per year. Improvements in graft and patient outcomes have been associated with the introduction of the immunosuppressive agent Cyclosporin (CSA) in the mid 1980s. AIMS The aim of this study was to examine trends in outcomes and factors that influence outcomes for adult kidney transplantation from 1986 to 2001. METHODS All adult cadaveric kidney transplantations carried out between 1986 and 2001 were included. We separated the transplanted grafts and patients into four time periods; 1986-1989, 1990-1993, 1994-1997, 1998-2001. Graft and patient survival outcomes were compared for the different periods. RESULTS The one-year kidney graft survival rate increased from 82% during 1986-1989 to 86% during 1998-2001. Patient survival over the four time periods studied has remained stable at approximately 95% at one year. CONCLUSION We report a significant improvement in kidney graft outcomes over the past 16 years. Patient survival has remained relatively stable during this period.
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Affiliation(s)
- P O'Kelly
- Departments of Nephrology' and Renal Transplantation, Beaumont Hospital, Dublin, Ireland
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26
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Awad IT, Dwyer R, Rohan D, Fanning R, Keane E, Counihan A, Cunningham P. Brain death and organ donation: an audit in the Irish National Transplantation and Neurosurgical Centre. Ir Med J 2004; 97:77-9. [PMID: 15164688] [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: 04/29/2023]
Abstract
We set out to identify the reasons why potential organ donors (PODs) fail to become actual donors and the causes of under-utilization of organs offered for donation. We audited 354 patients who died in the intensive Care Unit over 18 months. Of 155 PODs, 78 (50%) did not undergo brain stem testing (BST) because of (i) unavoidable death from non-CNS causes before BST (n = 50), (ii) treatment withdrawal without BST (n = 17) and (iii) preconditions for BST were not fulfilled (n = 11). Brain death was confirmed in 75 patients. Relatives refused consent for donation in 25 patients organ donation was not discussed with the family in 6, and medical contraindications to organ donation prevented donation in 5. Thirty seven (24% of all PODs) became organ donors who provided a total of 216 organ. All donated kidneys were utilized but unsuitability and logistic issues prevented utilization of 20% and 13% of all donated organs respectively. The commonest reason for failure to utilise potential organ donors was failure to perform BST. In most cases this was because BSTs were not possible but more aggressive management of and the routine performance of BST in all PODs could increase the number of donors. Not approaching relatives to ask consent for organ donation and a high rate of refusal by relatives also led to loss of organ donors.
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Affiliation(s)
- I T Awad
- Beaumont Hospital, Beaumont Road, Dublin 9, Republic of Ireland
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27
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Cunningham P. Introduction to Bioinformatics, S. A. Krawetz and D. D. Womble, Humana Press, 746 pp, ISBN 1-58829-241-X(2003). Cell Biochem Funct 2004. [DOI: 10.1002/cbf.1086] [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: 11/06/2022]
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Wilson C, Hughes L, Rashid T, Cunningham P, Bansal S, Ebringer A, Ettelaie C. Antibodies to prion and Acinetobacter peptide sequences in bovine spongiform encephalopathy. Vet Immunol Immunopathol 2004; 98:1-7. [PMID: 15127836 DOI: 10.1016/j.vetimm.2003.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An amino acid sequence homology has been identified between the bovine prion sequence (RPVDQ) and the Acinetobacter calcoaceticus enzyme, uridine-diphosphate-N-acetyl glucosamine-1-carboxy-vinyl-transferase which also contains (RPVDQ). Class-specific IgA, IgG and IgM antibodies against synthetic peptides containing the structurally related sequences present in bovine prion and A. calcoaceticus were measured in 189 bovine spongiform encephalopathy (BSE) positive cattle, 127 BSE negative cattle and 87 healthy control animals using an ELISA technique. Class-specific IgA, IgG and IgM antibodies against the structurally related synthetic peptides were significantly elevated in BSE positive cattle when compared to BSE negative cattle (P < 0.001) and healthy control animals (P < 0.001). These autoantibodies may have a role in the pathogenesis of BSE.
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Affiliation(s)
- C Wilson
- Division of Health and Life Sciences, Infection and Immunity Group, King's College, London, 150 Stamford Street, London SE1 9NN, UK
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29
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Liao JH, Marking GM, Hsu KF, Matsushita Y, Ewbank MD, Borwick R, Cunningham P, Rosker MJ, Kanatzidis MG. alpha- and beta-A2Hg3M2S8 (A = K, Rb; M = Ge, Sn): polar quaternary chalcogenides with strong nonlinear optical response. J Am Chem Soc 2003; 125:9484-93. [PMID: 12889979 DOI: 10.1021/ja034121l] [Citation(s) in RCA: 190] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The closely related phases alpha- and beta-A(2)Hg(3)M(2)S(8) (A = K, Rb; M = Ge, Sn) have been discovered using the alkali polychalcogenide flux method and are described in detail. They present new structure types with a polar noncentrosymmetric crystallographic motif and strong nonlinear second-harmonic generation (SHG) properties. The alpha-allotropic form crystallizes in the orthorhombic space group Aba2 with a = 19.082(2) A, b = 9.551(1) A, c = 8.2871(8) A for the K(2)Hg(3)Ge(2)S(8) analogue, and a = 19.563(2) A, b = 9.853(1) A, c = 8.467(1) A for the K(2)Hg(3)Sn(2)S(8) analogue. The beta-form crystallizes in the monoclinic space group C2 with a = 9.5948(7) A, b = 8.3608(6) A, c = 9.6638(7) A, beta = 94.637 degrees for the K(2)Hg(3)Ge(2)S(8) analogue. The thermal stability and optical and spectroscopic properties of these compounds are reported along with detailed solubility and crystal growth studies of the alpha-Kappa(2)Hg(3)Ge(2)S(8) in K(2)S(8) flux. These materials are wide gap semiconductors with band gaps at approximately 2.40 and approximately 2.64 eV for the Sn and Ge analogues, respectively. Below the band gap the materials exhibit a very wide transmission range to electromagnetic radiation up to approximately 14 microm. alpha-K(2)Hg(3)Ge(2)S(8) shows anisotropic thermal expansion coefficients. SHG measurements, performed with a direct phase-matched method, showed very high nonlinear coefficient d(eff) for beta-K(2)Hg(3)Ge(2)S(8) approaching 20 pm/V. Crystals of K(2)Hg(3)Ge(2)S(8) are robust to air exposure and have a high laser-damage threshold.
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Affiliation(s)
- J-H Liao
- Department of Chemistry and Center for Fundamental Materials Research, Michigan State University, East Lansing, Michigan 48824-1322, USA
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30
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Cunningham P, Pickreign J. Uninsurance rates vary widely across communities and regions. Data Bull (Cent Stud Health Syst Change) 2003:1-2. [PMID: 12583347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- P Cunningham
- Center for Studying Health System Change, Washington, DC, USA
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31
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Tu H, Cunningham P. Strong opinions held about the tradeoff between choice of providers and cost of care. Data Bull (Cent Stud Health Syst Change) 2003:1-2. [PMID: 12577947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- H Tu
- Center for Studying Health System Change, Washington, DC, USA
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32
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Lesser C, Cunningham P. Access to care: is it improving or declining? Data Bull (Cent Stud Health Syst Change) 2003:1-2. [PMID: 12577941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- C Lesser
- Center for Studying Health System Change, Washington, DC, USA
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Abstract
This paper describes a bias problem encountered in a machine learning approach to outcome prediction in anticoagulant drug therapy. The outcome to be predicted is a measure of the clotting time for the patient; this measure is continuous and so the prediction task is a regression problem. Artificial neural networks (ANNs) are a powerful mechanism for learning to predict such outcomes from training data. However, experiments have shown that an ANN is biased towards values more commonly occurring in the training data and is thus, less likely to be correct in predicting extreme values. This issue of bias in training data in regression problems is similar to the associated problem with minority classes in classification. However, this bias issue in classification is well documented and is an on-going area of research. In this paper, we consider stratified sampling and boosting as solutions to this bias problem and evaluate them on this outcome prediction problem and on two other datasets. Both approaches produce some improvements with boosting showing the most promise.
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Affiliation(s)
- B Mac Namee
- Department of Computer Science, Trinity College, 2, Dublin, Ireland
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Hughes LE, Bonell S, Natt RS, Wilson C, Tiwana H, Ebringer A, Cunningham P, Chamoun V, Thompson EJ, Croker J, Vowles J. Antibody responses to Acinetobacter spp. and Pseudomonas aeruginosa in multiple sclerosis: prospects for diagnosis using the myelin-acinetobacter-neurofilament antibody index. Clin Diagn Lab Immunol 2001; 8:1181-8. [PMID: 11687461 PMCID: PMC96247 DOI: 10.1128/cdli.8.6.1181-1188.2001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antibody responses to Acinetobacter (five strains), Pseudomonas aeruginosa, Escherichia coli, myelin basic protein (MBP), and neurofilaments were measured in sera from 26 multiple sclerosis (MS) patients, 20 patients with cerebrovascular accidents (CVA), 10 patients with viral encephalitis, and 25 healthy blood donors. In MS patients, elevated levels of antibodies against all strains of Acinetobacter tested were present, as well as antibodies against P. aeruginosa, MBP, and neurofilaments, but not antibodies to E. coli, compared to the CVA group and controls. The myelin-Acinetobacter-neurofilament antibody index appears to distinguish MS patients from patients with CVAs or healthy controls. The relevance of such antibodies to the neuropathology of MS requires further evaluation.
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Affiliation(s)
- L E Hughes
- Infection and Immunity Group, Division of Life Sciences, King's College London, London, United Kingdom
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35
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Suzuki K, Kaufmann GR, Mukaide M, Cunningham P, Harris C, Leas L, Kondo M, Imai M, Pett SL, Finlayson R, Zaunders J, Kelleher A, Cooper DA. Novel deletion of HIV type 1 reverse transcriptase residue 69 conferring selective high-level resistance to nevirapine. AIDS Res Hum Retroviruses 2001; 17:1293-6. [PMID: 11559430 DOI: 10.1089/088922201750461366] [Citation(s) in RCA: 8] [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: 11/13/2022] Open
Abstract
A novel deletion of residue 69 of the HIV-1 reverse transcriptase (RT) gene was detected in combination with mutations V75I/V and F77L/F in a patient with partial virological response to several antiretroviral drug regimens, including stavudine (D4T), didanosine (DDI), lamivudine (3TC), saquinavir (SQV), and nevirapine (NVP). Longitudinal analysis of samples revealed that this deletion emerged upon reinitiation DDI/D4T therapy following a toxicity-induced short discontinuation of all antiretrovirals. Analysis of the resistance phenotype showed a greater than 62-fold increase of the IC50 of NVP, but no significant change in sensitivity to other single nonnucleoside reverse transcriptase inhibitors (NNRTIs). The mutated virus showed only a moderately reduced sensitivity to DDI (6.7-fold) and D4T (4.8 fold). In a subsequent sample 3 months later additional RT mutations were found, including A62V, Y188L, and Q151M, conferring high-level cross-resistance to multiple nucleoside analogs. Our findings provide evidence that the deletion of RT residue 69 selectively confers high-level NVP resistance.
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Affiliation(s)
- K Suzuki
- Centre for Immunology, St. Vincent's Hospital, Sydney, NSW 2010, Australia.
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Troy CS, MacHugh DE, Bailey JF, Magee DA, Loftus RT, Cunningham P, Chamberlain AT, Sykes BC, Bradley DG. Genetic evidence for Near-Eastern origins of European cattle. Nature 2001; 410:1088-91. [PMID: 11323670 DOI: 10.1038/35074088] [Citation(s) in RCA: 300] [Impact Index Per Article: 13.0] [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: 11/09/2022]
Abstract
The limited ranges of the wild progenitors of many of the primary European domestic species point to their origins further east in Anatolia or the fertile crescent. The wild ox (Bos primigenius), however, ranged widely and it is unknown whether it was domesticated within Europe as one feature of a local contribution to the farming economy. Here we examine mitochondrial DNA control-region sequence variation from 392 extant animals sampled from Europe, Africa and the Near East, and compare this with data from four extinct British wild oxen. The ancient sequences cluster tightly in a phylogenetic analysis and are clearly distinct from modern cattle. Network analysis of modern Bos taurus identifies four star-like clusters of haplotypes, with intra-cluster diversities that approximate to that expected from the time depth of domestic history. Notably, one of these clusters predominates in Europe and is one of three encountered at substantial frequency in the Near East. In contrast, African diversity is almost exclusively composed of a separate haplogroup, which is encountered only rarely elsewhere. These data provide strong support for a derived Near-Eastern origin for European cattle.
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Affiliation(s)
- C S Troy
- Department of Genetics, Smurfit Institute, Trinity College, Dublin 2, Ireland
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Kaufmann GR, Suzuki K, Cunningham P, Mukaide M, Kondo M, Imai M, Zaunders J, Cooper DA. Impact of HIV type 1 protease, reverse transcriptase, cleavage site, and p6 mutations on the virological response to quadruple therapy with saquinavir, ritonavir, and two nucleoside analogs. AIDS Res Hum Retroviruses 2001; 17:487-97. [PMID: 11350662 DOI: 10.1089/08892220151126526] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Genotype alterations of HIV-1 protease, reverse transcriptase, cleavage sites p7/p1 and p1/p6, as well as p6(gag) and transframe protein p6* were studied in an observational cohort of 42 individuals who received antiretroviral therapy consisting of saquinavir, ritonavir, and two nucleoside analogs. In a multivariate logistic regression analysis, the prior protease inhibitor experience (odds ratio, 6.20; 95% CI, 1.22-31.38) and the presence of primary protease mutations (odds ratio, 9.99; 95% CI, 1.05-94.72) were independently associated with virological failure. Moreover, a trend was observed in that individuals with N-terminal amino acid insertions in the proline-rich motif of the p6(gag) protein were less likely to experience virological failure (OR, 0.17; 95% CI, 0.02-1.35; p = 0.09). In contrast, the presence of secondary protease, reverse transcriptase, or cleavage site mutations was not independently associated with treatment failure. However, mutations at cleavage site p7/p1 (p = 0.01) and C-terminal p6* mutations (p = 0.02) were both associated with primary protease mutations. In conclusion, the presence of primary protease mutations was the most important predictor of the subsequent virological response. Moreover, there is some evidence that insertions in the proline-rich area of the p6(gag) protein may affect the virological response. The relationship between mutations of cleavage sites or C-terminal p6* residues and protease mutations suggests that these alterations may serve a compensatory role, increasing viral fitness.
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Affiliation(s)
- G R Kaufmann
- National Centre in HIV Epidemiology and Clinical Research, Sydney NSW 2010, Australia
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Jones RT, Frary R, Cunningham P, Weddle JD, Kaiser L. The psychological effects of Hurricane Andrew on ethnic minority and Caucasian children and adolescents: a case study. Cultur Divers Ethnic Minor Psychol 2001; 7:103-8. [PMID: 11244900 DOI: 10.1037/1099-9809.7.1.103] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The impact of Hurricane Andrew on 212 African American, Caucasian, and Hispanic elementary and middle school children was examined at 6 months postdisaster. Using self-report instruments, this case study examined the predictive utility of several hypothesized mediators of children's reactions to disaster. Results showed higher levels of intrusive symptomatology for girls and for elementary school children as compared with their middle school counterparts. No differences were found with reference to race. The lack of findings concerning race is addressed, as well as implications for future studies.
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Affiliation(s)
- R T Jones
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061-0436, USA
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Cunningham P. Computerised data acquisition and analysis for the life sciences. A hands-on guide. Simon S. Young, Cambridge University Press, 232 pp. (2000). Cell Biochem Funct 2001. [DOI: 10.1002/cbf.945] [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: 11/11/2022]
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Kaufmann GR, Zaunders JJ, Cunningham P, Kelleher AD, Grey P, Smith D, Carr A, Cooper DA. Rapid restoration of CD4 T cell subsets in subjects receiving antiretroviral therapy during primary HIV-1 infection. AIDS 2000; 14:2643-51. [PMID: 11125882 DOI: 10.1097/00002030-200012010-00003] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [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: 11/26/2022]
Abstract
OBJECTIVE To compare the effect of highly active antiretroviral therapy on immune reconstitution in subjects with acute and chronic HIV-1 infection. DESIGN Prospective study including 58 treatment-naive subjects who commenced indinavir or nelfinavir and two nucleosides during primary (PHI; n = 28) or chronic HIV-1 infection (CHI; n = 30). METHODS Naive (CD45RA+ 62L+), memory (CD45RA-) and activated (CD38+ HLA-DR+) T cell subsets were quantified at 1-2 monthly time intervals using 4-colour flow cytometry. RESULTS At 1 year, HIV-1 RNA declined in both cohorts to undetectable levels (< 50 copies/ml), while median CD4 lymphocyte count increased from 470 to 758 x 10(6) cells/l in PHI and from 204 to 310 x 10(6) cells/l in CHI, reaching > 500 x 10(6) cells/l in 93% of PHI, but only in 37% of CHI subjects (P < 0.001). Naive CD4 lymphocytes increased from 106 to 176 x 10(6) cells/l in PHI and from 41 to 44 x 10(6) cells/l in CHI (PHI versus CHI at 12 months: P = 0.003), while memory cells rose from 368 to 573 x 10(6) cells/l in PHI and from 148 to 223 x 10(6) cells/l in CHI (P < 0.001). Early increases (< 3 months) of CD4 lymphocytes were larger in subjects with PHI, consisting of naive CD45RA+ CD62L+ as well as memory CD45RA- CD62L+ cells (P = 0.001). CD4 activation declined from 5 to 2% in PHI and from 13 to 6% in CHI (P = 0.001), while CD8 cell activation was reduced from 33 to 15% in PHI and from 42 to 19% in CHI (P = 0.02). CONCLUSION Immune reconstitution was more complete, occurred earlier and comprised both naive and memory CD4 T lymphocytes in subjects who commenced antiretroviral therapy during primary HIV-1 infection.
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Affiliation(s)
- G R Kaufmann
- National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW, Australia
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Abstract
Artificial neural networks (ANNs) are very popular as classification or regression mechanisms in medical decision support systems despite the fact that they are unstable predictors. This instability means that small changes in the training data used to build the model (i.e. train the ANN) may result in very different models. A central implication of this is that different sets of training data may produce models with very different generalisation accuracies. In this paper, we show in detail how this can happen in a prediction system for use in in-vitro fertilisation. We argue that claims for the generalisation performance of ANNs used in such a scenario should only be based on k-fold cross-validation tests. We also show how the accuracy of such a predictor can be improved by aggregating the output of several predictors.
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Affiliation(s)
- P Cunningham
- Department of Computer Science, Trinity College, Dublin, Ireland.
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Abstract
Emergency Departments (EDs) operate at the interface between the inpatient and ambulatory sectors of health care. Because of shared funding between the Commonwealth and States for ambulatory care, there has been intense focus on the ED patient population, and the potential to shift the locus of care for non-inpatients. One of the frequently cited models for the provision of after-hours GP services is the Balmain General Practice Casualty (GPC). This paper analyses the GPC model, looking in detail at casemix, clinical quality, waiting times and cost-effectiveness. It is argued that the services provided and the casemix of the patient population of GPC and EDs are distinctly different. Cost-effectiveness for GPC has not been objectively established. Health service planning should recognise the distinct but complementary roles of general practice and emergency medicine. Evaluation of alternative models of service provision should critically examine the available evidence, and comparisons should be based on a precise analysis of equivalent services.
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Affiliation(s)
- S Ieraci
- Liverpool Hospital, Australasian College for Emergency Medicine
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Abstract
In this paper, we investigate how the level of diversity amongst individual neural networks in a bagged ensemble can significantly influence overall ensemble generalization performance. We propose a new technique that tunes this diversity so that ensemble generalization performance is optimized and evaluate its performance on benchmark regression data-sets.
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Affiliation(s)
- J G Carney
- Department of Computer Science, University of Dublin, Trinity College, Ireland.
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Pohl H, Llados F, Ingerman L, Cunningham P, Raymer J, Wall C, Gasiewicz T, de C. Atsdr Evaluation of Health Effects of Chemicals. Vii: Chlorinated Dibenzo-P-Dioxins. Toxicol Ind Health 2000. [DOI: 10.1191/074823300678827690] [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: 11/05/2022]
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Kaufmann GR, Cunningham P, Zaunders J, Law M, Vizzard J, Carr A, Cooper DA. Impact of early HIV-1 RNA and T-lymphocyte dynamics during primary HIV-1 infection on the subsequent course of HIV-1 RNA levels and CD4+ T-lymphocyte counts in the first year of HIV-1 infection. Sydney Primary HIV Infection Study Group. J Acquir Immune Defic Syndr 1999; 22:437-44. [PMID: 10961604 DOI: 10.1097/00126334-199912150-00003] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/26/2022]
Abstract
Plasma HIV-1 RNA and CD4+ T-cell counts after HIV-1 seroconversion are important independent markers that predict the clinical course of HIV-1 infection. The prognostic significance of these parameters during primary HIV-1 infection, however, remains largely unknown. In a cohort of 53 male study subjects (age, 33 +/- 7 years), who consecutively presented with primary HIV-1 infection, we analyzed the relationship between early plasma HIV-1 RNA, CD4+ and CD8+ T-cell counts, beta2-microglobulin, and p24-antigen levels determined in the first 3 months and subsequent plasma HIV-1 RNA levels and CD4+ T-cell counts 6 to 12 months after onset of primary symptoms. Peak, nadir, and median HIV-1 RNA levels in the first 30 days were already significantly associated with HIV-1 RNA levels at 6 to 12 months (p = .02, p < .0001, and p = .01, respectively). Similarly, early nadir and median CD4+ T-lymphocyte counts in the first 30 days showed a significant relationship with CD4+ T-cell counts at 6 to 12 months (p = .009 and p = .0008, respectively). Study subjects with an early decline of CD4+ counts to <500 cells/microl had an eightfold higher risk that CD4+ counts were <500 cells/microl at 1 year. Of all evaluated virologic parameters, only nadir HIV-1 RNA at 76 days predicted CD4+ counts at 6 to 12 months (p = .006). Early HIV-1 RNA levels and CD4+ counts are already associated with the time course of those parameters 6 to 12 months after onset of symptoms. Nadir viral load was the strongest predictor of HIV-1 RNA levels as well as of CD4+ counts at 6 to 12 months. An early decline of CD4+ T lymphocytes may be a useful clinical prognostic marker for rapid disease progression.
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Affiliation(s)
- G R Kaufmann
- Centre for Immunology, St. Vincent's Hospital, Sydney, New South Wales, Australia.
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48
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Koo GC, Blake JT, Shah K, Staruch MJ, Dumont F, Wunderler D, Sanchez M, McManus OB, Sirotina-Meisher A, Fischer P, Boltz RC, Goetz MA, Baker R, Bao J, Kayser F, Rupprecht KM, Parsons WH, Tong XC, Ita IE, Pivnichny J, Vincent S, Cunningham P, Hora D, Feeney W, Kaczorowski G. Correolide and derivatives are novel immunosuppressants blocking the lymphocyte Kv1.3 potassium channels. Cell Immunol 1999; 197:99-107. [PMID: 10607427 DOI: 10.1006/cimm.1999.1569] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [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: 11/22/2022]
Abstract
The voltage-gated potassium channel, Kv1.3, is specifically expressed on human lymphocytes, where it controls membrane potential and calcium influx. Blockade of Kv1.3 channels by margatoxin was previously shown to prevent T cell activation and attenuate immune responses in vivo. In the present study, a triterpene natural product, correolide, was found to block Kv1.3 channels in human and miniswine T cells by electrophysiological characterization. T cell activation events, such as anti-CD3-induced calcium elevation, IL-2 production, and proliferation were inhibited by correolide in a dose-dependent manner. More potent analogs were evaluated for pharmacokinetic profiles and subsequently tested in a delayed-type hypersensitivity (DTH) response to tuberculin in the miniswine. Two compounds were dosed orally, iv, or im, and both compounds suppressed DTH responses, demonstrating that small molecule blockers of Kv1.3 channels can act as immunosuppressive agents in vivo. These studies establish correolide and its derivatives as novel immunosuppressants.
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Affiliation(s)
- G C Koo
- Merck Research Laboratories, Rahway, New Jersey, 07065, USA
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Drisko JE, Faidley TD, Zhang D, McDonald TJ, Nicolich S, Hora DF, Cunningham P, Li C, Rickes E, McNamara L, Chang C, Smith RG, Hickey GJ. Administration of a nonpeptidyl growth hormone secretagogue, L-163, 255, changes somatostatin pattern, but has no effect on patterns of growth hormone-releasing factor in the hypophyseal-portal circulation of the conscious pig. Proc Soc Exp Biol Med 1999; 222:70-7. [PMID: 10510248 DOI: 10.1111/j.1525-1373.1999.09997.x] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The activity of the growth hormone secretagog, L-163,255, on growth hormone (GH), growth hormone-releasing factor (GRF), and somatostatin (SRIF) levels was evaluated in a porcine model of hypophyseal portal blood (HPB) collection. Young, castrated pigs had HPB and jugular blood collected for approximately 300 min. The blood collection was divided into discrete periods: baseline (BL) approximately 180 min; GH response period (RSP) approximately 90 min; and positive control period following a GRF bolus, 30 min. RSP was divided into a dominant response period (DOM) and a tail (TL). The spontaneous relationship between HPB GRF and SRIF and peripheral GH during BL has been reported (Proc Soc Exp Biol Med 217:188-196, 1998). The apex of the GH pulse resulting from L-163,255 administration was nonrandomly associated (P < 0.05) with descending periods of SRIF troughs. Frequency and amplitude of GRF and SRIF pulses, and frequency and depth of SRIF troughs were not different between BL and the beginning of DOM (the 20-30 min of GH increase). GH AUC was significantly greater (P < 0.05) for DOM compared to BL and TL, and for TL compared to BL. GRF AUC tended to be greater (P < 0.1) for RSP compared to BL, but the majority of the increase was in the TL period. There were no significant differences in the SRIF AUCs between the sampling periods. Furthermore, in a separate experiment, fos activity (a marker of neuronal activation) in the hypothalamus of pigs was examined after either L-163,255 (1x or 4x), isotonic saline (control), or hypertonic saline (positive control) administration. There were no differences in fos activity in the GRF, SRIF, or CRH immunopositive neurons between L-163,255 treatment and control. The pituitaries of the L-163,255-treated pigs showed marked fos activation compared to the controls. In conclusion, L-163,255 in pigs has its primary effect at the level of the anterior pituitary.
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Affiliation(s)
- J E Drisko
- Department of Basic Animal Science Research, Merck Research Laboratories, Rahway, New Jersey 07065, USA.
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Abstract
PURPOSE We analyze the effect of intraoperative heparin in cadaveric renal transplantation. MATERIALS AND METHODS We examined the records of 100 consecutive cadaveric transplant recipients who received 5,000 units of heparin at the time of vascular clamping (group 1), and compared the incidence of graft thrombosis and postoperative hemorrhagic complications to 100 consecutive cadaveric transplant recipients who did not receive heparin (group 2). The groups were similar in terms of donor age, sex, number of transplant recipients, sensitization, multiple vessels, delayed graft function and human leukocyte antigen mismatch. All patients received cyclosporine based triple therapy immunosuppression. All explanted grafts were examined histologically to rule out hyperacute rejection. RESULTS There was no statistical difference between the 2 groups. The overall incidence of graft thrombosis was 5% (6% in group 1 and 4% in group 2). There was a greater need for blood transfusion in group 1, with 25 patients requiring transfusion postoperatively versus 14 in group 2. CONCLUSIONS Intraoperative heparin did not reduce the incidence of graft thrombosis in this retrospective study. It did increase the postoperative blood transfusion requirements. As a result of this analysis, we have abandoned its use.
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Affiliation(s)
- P Mohan
- Department of Transplantation, Beaumont Hospital, Dublin, Ireland
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