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Campbell P, Rutten FH, Lee MM, Hawkins NM, Petrie MC. Heart failure with preserved ejection fraction: everything the clinician needs to know. Lancet 2024; 403:1083-1092. [PMID: 38367642 DOI: 10.1016/s0140-6736(23)02756-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 02/19/2024]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is increasingly recognised and diagnosed in clinical practice, a trend driven by an ageing population and a rise in contributing comorbidities, such as obesity and diabetes. Representing at least half of all heart failure cases, HFpEF is recognised as a complex clinical syndrome. Its diagnosis and management are challenging due to its diverse pathophysiology, varied epidemiological patterns, and evolving diagnostic and treatment approaches. This Seminar synthesises the latest insights on HFpEF, integrating findings from recent clinical trials, epidemiological research, and the latest guideline recommendations. We delve into the definition, pathogenesis, epidemiology, diagnostic criteria, and management strategies (non-pharmacological and pharmacological) for HFpEF. We highlight ongoing clinical trials and future developments in the field. Specifically, this Seminar offers practical guidance tailored for primary care practitioners, generalists, and cardiologists who do not specialise in heart failure, simplifying the complexities in the diagnosis and management of HFpEF. We provide practical, evidence-based recommendations, emphasising the importance of addressing comorbidities and integrating the latest pharmacological treatments, such as SGLT2 inhibitors.
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Affiliation(s)
- Patricia Campbell
- Department of Cardiology, Southern Trust, Craigavon Area Hospital, Portadown, UK.
| | - Frans H Rutten
- Department of General Practice and Nursing Science, Julius Centre, University Medical Centre, Utrecht University, Utrecht, Netherlands
| | - Matthew My Lee
- School of Cardiovascular and Metabolic Health, University of Glasgow, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow, UK
| | - Nathaniel M Hawkins
- Division of Cardiology, University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
| | - Mark C Petrie
- School of Cardiovascular and Metabolic Health, University of Glasgow, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow, UK
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2
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Yoo D, Divard G, Raynaud M, Cohen A, Mone TD, Rosenthal JT, Bentall AJ, Stegall MD, Naesens M, Zhang H, Wang C, Gueguen J, Kamar N, Bouquegneau A, Batal I, Coley SM, Gill JS, Oppenheimer F, De Sousa-Amorim E, Kuypers DRJ, Durrbach A, Seron D, Rabant M, Van Huyen JPD, Campbell P, Shojai S, Mengel M, Bestard O, Basic-Jukic N, Jurić I, Boor P, Cornell LD, Alexander MP, Toby Coates P, Legendre C, Reese PP, Lefaucheur C, Aubert O, Loupy A. A Machine Learning-Driven Virtual Biopsy System For Kidney Transplant Patients. Nat Commun 2024; 15:554. [PMID: 38228634 DOI: 10.1038/s41467-023-44595-z] [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] [Received: 06/26/2023] [Accepted: 12/21/2023] [Indexed: 01/18/2024] Open
Abstract
In kidney transplantation, day-zero biopsies are used to assess organ quality and discriminate between donor-inherited lesions and those acquired post-transplantation. However, many centers do not perform such biopsies since they are invasive, costly and may delay the transplant procedure. We aim to generate a non-invasive virtual biopsy system using routinely collected donor parameters. Using 14,032 day-zero kidney biopsies from 17 international centers, we develop a virtual biopsy system. 11 basic donor parameters are used to predict four Banff kidney lesions: arteriosclerosis, arteriolar hyalinosis, interstitial fibrosis and tubular atrophy, and the percentage of renal sclerotic glomeruli. Six machine learning models are aggregated into an ensemble model. The virtual biopsy system shows good performance in the internal and external validation sets. We confirm the generalizability of the system in various scenarios. This system could assist physicians in assessing organ quality, optimizing allograft allocation together with discriminating between donor derived and acquired lesions post-transplantation.
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Affiliation(s)
- Daniel Yoo
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
| | - Gillian Divard
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
- Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Marc Raynaud
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
| | | | | | | | - Andrew J Bentall
- Division of Nephrology and Hypertension, Mayo Clinic Transplant Center, Rochester, MN, USA
| | | | - Maarten Naesens
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Huanxi Zhang
- Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Changxi Wang
- Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Juliette Gueguen
- Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, Tours, France
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, Paul Sabatier University, INSERM, Toulouse, France
| | - Antoine Bouquegneau
- Department of Nephrology-Dialysis-Transplantation, Centre hospitalier universitaire de Liège, Liège, Belgium
| | - Ibrahim Batal
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Shana M Coley
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - John S Gill
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Federico Oppenheimer
- Kidney Transplant Department, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Erika De Sousa-Amorim
- Kidney Transplant Department, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Dirk R J Kuypers
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Antoine Durrbach
- Department of Nephrology, AP-HP Hôpital Henri Mondor, Créteil, Île de France, France
| | - Daniel Seron
- Nephrology Department, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Barcelona, Spain
| | - Marion Rabant
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Paul Duong Van Huyen
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Patricia Campbell
- Faculty of Medicine & Dentistry - Laboratory Medicine & Pathology Dept, University of Alberta, Edmonton, AB, Canada
| | - Soroush Shojai
- Faculty of Medicine & Dentistry - Laboratory Medicine & Pathology Dept, University of Alberta, Edmonton, AB, Canada
| | - Michael Mengel
- Faculty of Medicine & Dentistry - Laboratory Medicine & Pathology Dept, University of Alberta, Edmonton, AB, Canada
| | - Oriol Bestard
- Nephrology Department, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Barcelona, Spain
| | - Nikolina Basic-Jukic
- Department of nephrology, arterial hypertension, dialysis and transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivana Jurić
- Department of nephrology, arterial hypertension, dialysis and transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Peter Boor
- Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Lynn D Cornell
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mariam P Alexander
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - P Toby Coates
- Department of Renal and Transplantation, University of Adelaide, Royal Adelaide Hospital Campus, Adelaide, SA, Australia
| | - Christophe Legendre
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
- Department of Kidney Transplantation, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Peter P Reese
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadephia, PA, USA
| | - Carmen Lefaucheur
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
- Kidney Transplant Department, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Olivier Aubert
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France
- Department of Kidney Transplantation, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Alexandre Loupy
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, F-75015, Paris, France.
- Department of Kidney Transplantation, Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
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Halloran K, Hirji A, Weinkauf J, Nagendran J, Campbell P. Exploring a postoperative alternative to intraoperative therapeutic plasma exchange for sensitized lung transplant recipients. J Heart Lung Transplant 2024:S1053-2498(24)00002-0. [PMID: 38211837 DOI: 10.1016/j.healun.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024] Open
Affiliation(s)
- Kieran Halloran
- Department of Medicine, University of Alberta, Edmonton, Canada.
| | - Alim Hirji
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Justin Weinkauf
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Jayan Nagendran
- Department of Surgery, University of Alberta, Edmonton, Canada
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Forbes S, Halpin A, Lam A, Grynoch D, Parker R, Hidalgo L, Bigam D, Anderson B, Dajani K, Kin T, O'Gorman D, Senior PA, Campbell P, Shapiro AJ. Islet transplantation outcomes in type 1 diabetes and transplantation of HLA-DQ8/DR4: results of a single-centre retrospective cohort in Canada. EClinicalMedicine 2024; 67:102333. [PMID: 38169703 PMCID: PMC10758748 DOI: 10.1016/j.eclinm.2023.102333] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024] Open
Abstract
Background In solid organ transplantation, HLA matching between donor and recipient is associated with superior outcomes. In islet transplantation, an intervention for Type 1 diabetes, HLA matching between donor and recipient is not performed as part of allocation. Susceptibility to Type 1 diabetes is associated with the presence of certain HLA types. This study was conducted to determine the impact of these susceptibility antigens on islet allograft survival. Methods This is a single-centre retrospective cohort study. This cohort of transplant recipients (n = 268) received islets from 661 donor pancreases between March 11th, 1999 and August 29th, 2018 at the University of Alberta Hospital (Edmonton, AB, Canada). The frequency of the Type 1 diabetes susceptibility HLA antigens (HLA-A24, -B39, -DQ8, -DQ2 and-DQ2-DQA1∗05) in recipients and donors were determined. Recipient and donor HLA antigens were examined in relation to time to first C-peptide negative status/graft failure or last observation point. Taking into account multiple transplants per patient, we fitted a Gaussian frailty survival analysis model with baseline hazard function stratified by transplant number, adjusted for cumulative islet dose and other confounders. Findings Across all transplants recipients of donors positive for HLA-DQ8 had significantly better graft survival (adjusted HRs 0.33 95% CI 0.17-0.66; p = 0.002). At first transplant only, donors positive for HLA-DQ2-DQA1∗05 had inferior graft survival (adjusted HR 1.96 95% CI 1.10-3.46); p = 0.02), although this was not significant in the frailty analysis taking multiple transplants into account (adjusted HR 1.46 95% CI 0.77-2.78; p = 0.25). Other HLA antigens were not associated with graft survival after adjustment for confounders. Interpretation Our findings suggest islet transplantation from HLA-DQ8 donors is associated with superior graft outcomes. A donor positive for HLA-DQ2-DQA1∗05 at first transplant was associated with inferior graft survival but not when taking into account multiple transplants per recipient. The relevance of HLA-antigens on organ allocation needs further evaluation and inclusion in islet transplant registries and additional observational and interventional studies to evaluate the role of HLA-DQ8 in islet graft survival are required. Funding None.
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Affiliation(s)
- Shareen Forbes
- Clinical Islet Transplant Programme, University of Alberta, Edmonton, Canada
- Department of Surgery, University of Alberta, Edmonton, Canada
- Queen's Medical Research Institute, BHF Centre for Cardiovascular Science, University of Edinburgh, Scotland, UK
| | - Anne Halpin
- Alberta Precision Laboratories, University of Alberta, Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Anna Lam
- Clinical Islet Transplant Programme, University of Alberta, Edmonton, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Canada
| | - Don Grynoch
- Alberta Precision Laboratories, University of Alberta, Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Richard Parker
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Scotland, UK
| | - Luis Hidalgo
- Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - David Bigam
- Department of Surgery, University of Alberta, Edmonton, Canada
| | - Blaire Anderson
- Department of Surgery, University of Alberta, Edmonton, Canada
| | - Khaled Dajani
- Department of Surgery, University of Alberta, Edmonton, Canada
| | - Tatsuya Kin
- Clinical Islet Transplant Programme, University of Alberta, Edmonton, Canada
| | - Doug O'Gorman
- Clinical Islet Transplant Programme, University of Alberta, Edmonton, Canada
| | - Peter A. Senior
- Clinical Islet Transplant Programme, University of Alberta, Edmonton, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Canada
| | - Patricia Campbell
- Alberta Precision Laboratories, University of Alberta, Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - A.M. James Shapiro
- Clinical Islet Transplant Programme, University of Alberta, Edmonton, Canada
- Department of Surgery, University of Alberta, Edmonton, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Canada
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5
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Plattner P, Wood E, Al Ayoubi L, Beliuskina O, Bissell ML, Blaum K, Campbell P, Cheal B, de Groote RP, Devlin CS, Eronen T, Filippin L, Garcia Ruiz RF, Ge Z, Geldhof S, Gins W, Godefroid M, Heylen H, Hukkanen M, Imgram P, Jaries A, Jokinen A, Kanellakopoulos A, Kankainen A, Kaufmann S, König K, Koszorús Á, Kujanpää S, Lechner S, Malbrunot-Ettenauer S, Müller P, Mathieson R, Moore I, Nörtershäuser W, Nesterenko D, Neugart R, Neyens G, Ortiz-Cortes A, Penttilä H, Pohjalainen I, Raggio A, Reponen M, Rinta-Antila S, Rodríguez LV, Romero J, Sánchez R, Sommer F, Stryjczyk M, Virtanen V, Xie L, Xu ZY, Yang XF, Yordanov DT. Nuclear Charge Radius of ^{26m}Al and Its Implication for V_{ud} in the Quark Mixing Matrix. Phys Rev Lett 2023; 131:222502. [PMID: 38101341 DOI: 10.1103/physrevlett.131.222502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023]
Abstract
Collinear laser spectroscopy was performed on the isomer of the aluminium isotope ^{26m}Al. The measured isotope shift to ^{27}Al in the 3s^{2}3p ^{2}P_{3/2}^{○}→3s^{2}4s ^{2}S_{1/2} atomic transition enabled the first experimental determination of the nuclear charge radius of ^{26m}Al, resulting in R_{c}=3.130(15) fm. This differs by 4.5 standard deviations from the extrapolated value used to calculate the isospin-symmetry breaking corrections in the superallowed β decay of ^{26m}Al. Its corrected Ft value, important for the estimation of V_{ud} in the Cabibbo-Kobayashi-Maskawa matrix, is thus shifted by 1 standard deviation to 3071.4(1.0) s.
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Affiliation(s)
- P Plattner
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Universität Innsbruck, Innrain 52, 6020 Innsbruck, Austria
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - E Wood
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - L Al Ayoubi
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - O Beliuskina
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - M L Bissell
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Department of Physics and Astronomy, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - K Blaum
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - P Campbell
- Department of Physics and Astronomy, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - B Cheal
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - R P de Groote
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - C S Devlin
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - T Eronen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - L Filippin
- Spectroscopy, Quantum Chemistry and Atmospheric Remote Sensing (SQUARES), Université libre de Bruxelles, 1050 Brussels, Belgium
| | - R F Garcia Ruiz
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, Massachusetts 02139, USA
| | - Z Ge
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Geldhof
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - W Gins
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - M Godefroid
- Spectroscopy, Quantum Chemistry and Atmospheric Remote Sensing (SQUARES), Université libre de Bruxelles, 1050 Brussels, Belgium
| | - H Heylen
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - M Hukkanen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - P Imgram
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - A Jaries
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - A Jokinen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - A Kanellakopoulos
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - A Kankainen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Kaufmann
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - K König
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - Á Koszorús
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - S Kujanpää
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Lechner
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
| | - S Malbrunot-Ettenauer
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - P Müller
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - R Mathieson
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - I Moore
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - W Nörtershäuser
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - D Nesterenko
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - R Neugart
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
- Institut für Kernchemie, Universität Mainz, Fritz-Straßmann-Weg 2, 55128 Mainz, Germany
| | - G Neyens
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - A Ortiz-Cortes
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - H Penttilä
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - I Pohjalainen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - A Raggio
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - M Reponen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Rinta-Antila
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - L V Rodríguez
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
- IJCLab, CNRS/IN2P3, Université Paris-Saclay, 91400 Orsay, France
| | - J Romero
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - R Sánchez
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - F Sommer
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - M Stryjczyk
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - V Virtanen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - L Xie
- Department of Physics and Astronomy, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Z Y Xu
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - X F Yang
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, 209 Chengfu Road, 100871 Beijing, China
| | - D T Yordanov
- IJCLab, CNRS/IN2P3, Université Paris-Saclay, 91400 Orsay, France
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Kelly B, Campbell P. Symptomatic Heart Failure With Preserved Ejection Fraction: Is It Too Late to Consider Additional Therapies? J Card Fail 2023; 29:1504-1506. [PMID: 37541611 DOI: 10.1016/j.cardfail.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023]
Affiliation(s)
- Bronagh Kelly
- Department of Cardiology, Craigavon Area Hospital, Southern Trust, Northern Ireland
| | - Patricia Campbell
- Department of Cardiology, Craigavon Area Hospital, Southern Trust, Northern Ireland
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7
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Kelsey E, Holmes A, Tissot S, Campbell P, McLeod K. Management of recurrent localised bladder amyloid, has methotrexate helped? Urol Case Rep 2023; 51:102577. [PMID: 37811541 PMCID: PMC10551828 DOI: 10.1016/j.eucr.2023.102577] [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: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023] Open
Abstract
Background Amyloidosis of the bladder is a benign condition which can present with a multitude of symptoms including bladder mass, irritative voiding symptoms and haematuria. Case presentation We report on the investigation and management of a patient with recurrent localised amyloidosis of the bladder, which appears to have been managed fortuitously by concurrent methotrexate prescribed for another indication. Conclusion We provide further assessment and management with a focus on the possible benefit of methotrexate for management of localised bladder amyloidosis.
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Affiliation(s)
- E. Kelsey
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
| | - A. Holmes
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
| | - S. Tissot
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
| | - P. Campbell
- Department of Haematology, University Hospital Geelong, Barwon Health, Australia
- Deakin University School of Medicine, Australia
| | - K. McLeod
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
- Deakin University School of Medicine, Australia
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8
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Townsend M, Pidborochynski T, Cantor RS, Khoury M, Campbell P, Halpin A, Urschel S, Kim D, Nahirniak S, West LJ, Buchholz H, Conway J. Prospective examination of HLA sensitization after VAD implantation in children and adults. Transpl Immunol 2023; 80:101892. [PMID: 37419373 DOI: 10.1016/j.trim.2023.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Ventricular assist devices (VADs) have improved survival to heart transplantation (HTx). However, VADs have been associated with development of antibodies against human leukocyte antigen (HLA-Ab) which may limit the donor pool and decrease survival post-HTx. Since HLA-Ab development after VAD insertion is poorly understood, the purpose of this prospective single-center study was to quantify the incidence of and evaluate risk factors for HLA-Ab development across the age spectrum following VAD implantation. METHODS Adult and pediatric patients undergoing VAD placement as bridge to transplant or transplant candidacy between 5/2016 and 7/2020 were enrolled. HLA-Ab were assessed pre-VAD and at 1-, 3-, and 12-months post-implant. Factors associated with HLA-Ab development post-VAD implant were explored using univariate and multivariate logistic regression. RESULTS 15/41 (37%) adults and 7/17 (41%) children developed new HLA-Ab post-VAD. The majority of patients (19/22) developed HLA-Ab within two months of implant. New class I HLA-Ab were more common (87% adult, 86% pediatric). Prior pregnancy was strongly associated with HLA-Ab development in adults post-VAD (HR 16.7, 95% CI 1.8-158, p = 0.01). Of the patients who developed new HLA-Ab post-VAD, in 45% (10/22) the HLA-Ab resolved while in 55% (12/22) the HLA-Ab persisted. CONCLUSION More than one-third of adult and pediatric VAD patients developed new HLA-Ab early after VAD implant with the majority having class I antibodies. Prior pregnancy was strongly associated with post-VAD HLA-Ab development. Further studies are needed to predict regression or persistence of HLA-Ab developed post-VAD, to understand modulation of individuals' immune responses to sensitizing events, and to determine whether transiently detected HLA-Ab post-VAD recur and have long-term clinical impact post-heart transplantation.
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Affiliation(s)
- Madeleine Townsend
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
| | - Tara Pidborochynski
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
| | - Ryan S Cantor
- Kirklin Solutions, Birmingham, AL, United States of America
| | - Michael Khoury
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Canada Donation And Transplantation Research Program, University of Alberta, Edmonton, AB, Canada
| | - Patricia Campbell
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Anne Halpin
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Simon Urschel
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Canada Donation And Transplantation Research Program, University of Alberta, Edmonton, AB, Canada; Department of Surgery, University of Alberta, Edmonton, AB, Canada; Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Daniel Kim
- Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Susan Nahirniak
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Lori J West
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Canada Donation And Transplantation Research Program, University of Alberta, Edmonton, AB, Canada; Department of Surgery, University of Alberta, Edmonton, AB, Canada; Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Holger Buchholz
- Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
| | - Jennifer Conway
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada
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Solis-Trapala I, Campbell P, Lacey R, Rowlands G, Dunn K, Protheroe J. Are childhood factors predictive of adult health literacy? A longitudinal birth cohort analysis. SSM Popul Health 2023; 23:101426. [PMID: 37252287 PMCID: PMC10220279 DOI: 10.1016/j.ssmph.2023.101426] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/31/2023] Open
Abstract
Health literacy (HL), defined as the ability of an individual to understand and appraise health information to make informed decisions on their health, helps maintain and improve one's health and thus reduce the use of healthcare services. There is a recognised global effort to address insufficient HL in early life and understand how HL develops. This study examined the association of a range of factors including educational, speech and language ability, health and healthcare engagement, sleep problems, mental health, demographic, environmental, and maternal factors at different childhood stages (from 5 years to 11 years) with later adult HL at age 25. HL was measured using a HL ordinal score (insufficient, limited, or sufficient) derived from the European Literacy Survey Questionnaire-short version (HLS-EU-Q16) within a large UK based birth cohort (Avon Longitudinal Study of Parents and Children: ALSPAC study). Univariate proportional odds logistic regression models for the probability of having higher levels of HL were developed. Results of analysis of 4248 participants showed that poorer speech and language ability (aged 9 years, OR 0.18 95% CI 0.04 to 0.78), internalising in child (age 11 years, OR 0.62 95% CI 0.5 to 0.78), child depression (age 9 years, OR 0.67 95% CI 0.52 to 0.86), and the presence of maternal depression (child age 5, OR 0.80 95% CI 0.66 to 0.96), reduced the odds of sufficient HL when adult. Our results suggest some useful markers to identify children at potential risk of low HL that could be targeted for research into future interventions within school settings, for example, child's speech and language capability. In addition, this study identified child and maternal mental health as factors associated with later development of limited HL and future research should consider what potential mechanisms might explain this link.
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Affiliation(s)
- I. Solis-Trapala
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - P. Campbell
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Midlands Partnership NHS Foundation Trust, St Georges' Hospital, Stafford, ST16 3AG, UK
| | - R.J. Lacey
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - G. Rowlands
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK
| | - K.M. Dunn
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - J. Protheroe
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
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Hogan J, Sankarayanaran R, Campbell P, O'Nwere Tan T. Detecting the undetected. Eur J Heart Fail 2023. [PMID: 37078375 DOI: 10.1002/ejhf.2855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/08/2023] [Indexed: 04/21/2023] Open
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11
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Brendefur Corwin LM, Campbell P, Jakobsen K, Müller F, Lai X, Unemo M, Leegaard TM, Vildershøj Bjørnholt J, Olsen AO. Improvement in Neisseria gonorrhoeae culture rates by bedside inoculation and incubation at a clinic for sexually transmitted infections. Ann Clin Microbiol Antimicrob 2023; 22:27. [PMID: 37072830 PMCID: PMC10114361 DOI: 10.1186/s12941-023-00576-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Culture of Neisseria gonorrhoeae is essential for surveillance of complete antimicrobial susceptibility profiles. In 2014, the culture success rate of N. gonorrhoeae from samples taken at the clinic for sexually transmitted infections (STI clinic), Oslo University Hospital, Norway, was only 20%. The present study aimed to improve gonococcal culture rates using bedside inoculation of patient samples on gonococcal agar plates and incubation at the STI clinic. METHODS This prospective quality improvement study was conducted by the STI clinic and the Department of Microbiology at Oslo University Hospital from May 2016 - October 2017. When culture of N. gonorrhoeae was clinically indicated, we introduced a parallel 'bedside culture' at the STI clinic and compared results with the standard culture at the microbiology department. Samples were taken from urethra, anorectum, pharynx and cervix. Culture rates were compared across symptomatic and asymptomatic anatomical sites. RESULTS From 596 gonococcal-positive PCR samples, bedside culture had a significantly higher success rate of 57% compared to 41% with standard culture (p < 0.05). Overall, culture rate from symptomatic sites was 91% v. 45% from asymptomatic sites. The culture rates from different anatomical sites were as follows: urethra 93%, anorectum 64%, pharynx 28% and cervix 70%. Bedside culture significantly (p < 0.05) improved the culture rates for symptomatic urethral and asymptomatic pharyngeal samples. CONCLUSIONS Where feasible, bedside inoculation on gonococcal agar plates and incubation of samples from patients with gonorrhoea is recommended. This will improve the culture diagnostics and provide additional gonococcal isolates for antimicrobial resistance surveillance.
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Affiliation(s)
- L M Brendefur Corwin
- Department of Microbiology, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - P Campbell
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- National Advisory Unit for Sexually Transmitted Infections, Oslo University Hospital, Oslo, Norway
| | - K Jakobsen
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Müller
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - X Lai
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, UK
| | - T M Leegaard
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - J Vildershøj Bjørnholt
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - A O Olsen
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Koszorús Á, Block M, Campbell P, Cheal B, de Groote RP, Gins W, Moore ID, Ortiz-Cortes A, Raggio A, Warbinek J. High-precision measurements of the hyperfine structure of cobalt ions in the deep ultraviolet range. Sci Rep 2023; 13:4783. [PMID: 36959230 PMCID: PMC10036477 DOI: 10.1038/s41598-023-31378-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
High-precision hyperfine structure measurements were performed on stable, singly-charged [Formula: see text]Co ions at the IGISOL facility in Jyväskylä, Finland using the collinear laser spectroscopy technique. A newly installed light collection setup enabled the study of transitions in the 230 nm wavelength range from low-lying states below 6000 cm[Formula: see text]. We report a 100-fold improvement on the precision of the hyperfine A parameters, and furthermore present newly measured hyperfine B paramaters.
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Affiliation(s)
- Á Koszorús
- Department of Physics, University of Liverpool, Liverpool, L69 7ZE, United Kingdom.
- Experimental Physics Department, CERN, CH1211, Geneva 23, Switzerland.
| | - M Block
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- Helmholtz Institute Mainz, 55099, Mainz, Germany
- Department of Chemistry - TRIGA site, University of Mainz, 55099, Mainz, Germany
| | - P Campbell
- Department of Physics and Astronomy, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - B Cheal
- Department of Physics, University of Liverpool, Liverpool, L69 7ZE, United Kingdom
| | - R P de Groote
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001, Leuven, Belgium
| | - W Gins
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
| | - I D Moore
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
| | - A Ortiz-Cortes
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Caen, France
| | - A Raggio
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
| | - J Warbinek
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
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Affiliation(s)
- Alicja Jasinska-Piadlo
- Cardiology Department, Southern Health and Social Care Trust, Portadown, UK
- School of Computing, Ulster University, Belfast, UK
| | - Patricia Campbell
- Cardiology Department, Southern Health and Social Care Trust, Portadown, UK
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14
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Corwin LMB, Ingebretsen A, Campbell P, Alfsnes K, Müller F, Mauder N, Koomey M, Bjørnholt JV. Fourier transform infrared spectroscopy; can it be used as a rapid typing method of Neisseria gonorrhoeae? J Microbiol Methods 2023; 205:106675. [PMID: 36681126 DOI: 10.1016/j.mimet.2023.106675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/16/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Typing of Neisseria gonorrhoeae is necessary for epidemiologic surveillance, while time consuming and resource intensive. Fourier transform infrared (FTIR) spectroscopy has shown promising results when typing several bacterial species. This study investigates whether FTIR spectroscopy can be used as a rapid method for typing clinical N. gonorrhoeae isolates, comparing FTIR spectroscopy to multi locus sequence typing (MLST), N. gonorrhoeae multi antigen sequence typing (NG-MAST) and whole genome sequencing (WGS). METHODS Sixty consecutive isolates from a venereology clinic and three isolates from an outbreak were included. Isolates were analysed with FTIR spectroscopy on the IR Biotyper system (Bruker Daltonik) with the IR Biotyper software (version 2.1) with default analysis settings (spectral range 1300-800 cm-1). Four technical replicates of each isolate were analysed in three different runs. The output was a hierarchical cluster analysis (HCA) presented as a dendrogram; a tree-like overview of how closely different isolates are related. FTIR spectroscopy was compared to MLST, NG-MAST and WGS to see if the FTIR spectroscopy-dendrogram grouped the isolates in the same clusters. RESULTS Fifty-one out of 60 isolates, and the three outbreak isolates, produced at least one spectrum in each run and were included. No agreement between FTIR spectroscopy and MLST or NG-MAST or WGS was shown. The FTIR spectroscopy-dendrogram failed to cluster the outbreak isolates. CONCLUSION FTIR spectroscopy (spectral range 1300-800 cm-1) is not yet suitable for epidemiologic typing of N. gonorrhoeae. Absence of a capsule as well as phase- and antigenic variation of carbohydrate surface structures of the gonococcal cell wall may contribute to our findings. Future studies should include analysis of a wider range of the spectrum recorded (4000-500 cm-1), and should also explore further mathematical analytic approaches of the similarity between spectra.
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Affiliation(s)
- Linn Merete Brendefur Corwin
- Microbiology Dept Rikshospitalet, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway; University of Oslo (UiO), Institute of Clinical Medicine, PO Box 1072 Blindern, 0316 Oslo, Norway.
| | - André Ingebretsen
- Microbiology Dept Rikshospitalet, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway.
| | - Patricia Campbell
- University of Oslo (UiO), Institute of Clinical Medicine, PO Box 1072 Blindern, 0316 Oslo, Norway; Microbiology Dept, Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway.
| | - Kristian Alfsnes
- Norwegian Institute of Public Health (NIPH), PO Box 222 Skøyen, 0213 Oslo, Norway.
| | - Fredrik Müller
- Microbiology Dept Rikshospitalet, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway; University of Oslo (UiO), Institute of Clinical Medicine, PO Box 1072 Blindern, 0316 Oslo, Norway.
| | - Norman Mauder
- Bruker Daltonics GmbH & Co. KG, Fahrenheitstrasse 4, 28359 Bremen, Germany.
| | - Michael Koomey
- University of Oslo (UiO), Department of Biosciences, PO Box 1072 Blindern, 0316 Oslo, Norway.
| | - Jørgen Vildershøj Bjørnholt
- Microbiology Dept Rikshospitalet, Oslo University Hospital, PO Box 4950 Nydalen, 0424 Oslo, Norway; University of Oslo (UiO), Institute of Clinical Medicine, PO Box 1072 Blindern, 0316 Oslo, Norway.
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15
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Boamah B, Barnsley S, Finch L, Briens J, Siciliano S, Hogan N, Hecker M, Hanson M, Campbell P, Peters R, Manek A, Al-Dissi AN, Weber L. Target Organ Toxicity in Rats After Subchronic Oral Exposure to Soil Extracts Containing a Complex Mixture of Contaminants. Arch Environ Contam Toxicol 2023; 84:85-100. [PMID: 36577861 DOI: 10.1007/s00244-022-00972-1] [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] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Complex mixtures of unknown contaminants present a challenge to identify toxicological risks without using large numbers of animals and labor-intensive screens of all organs. This study examined soil extracts from a legacy-contaminated pesticide packaging and blending site. HepG2 cytotoxicity was used as an initial screen of 18 soil samples; then, three extracts (A, B and C) from different locations at the study site were used for testing in animals. The first two extracts were identified as the most toxic in vitro, and the latter extract obtained from a location further from these two toxic sampling sites. Then, target organ toxicities were identified following biweekly oral gavage for one month of three soil extracts (0.1% in polyethylene glycol or PEG) compared to vehicle control in male Sprague-Dawley rats (n = 9-10/group). Exposure to extract A significantly increased neutrophils and lymphocytes compared to control. In contrast, all extracts increased plasma α-2 macroglobulin and caused mild-to-moderate lymphocytic proliferation within the spleen white pulp, all indicative of inflammation. Rats exposed to all soil extracts exhibited acute tubular necrosis. Cholinesterase activity was significantly reduced in plasma, but not brain, after exposure to extract A compared to control. Increased hepatic ethoxyresorufin-o-deethylase activity compared to control was observed following exposure to extracts A and B. Exposure to soil extract C in rats showed a prolonged QTc interval in electrocardiography as well as increased brain lipid peroxidation. Candidate contaminants are organochlorine, organophosphate/carbamate pesticides or metabolites. Overall, HepG2 cytotoxicity did not successfully predict the neurotoxicity and cardiotoxicity observed with extract C but was more successful with suspected hydrocarbon toxicities in extracts A and B. Caution should be taken when extrapolating the observation of no effects from in vitro cell culture to in vivo toxicity, and better cell culture lines or assays should be explored.
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Affiliation(s)
- B Boamah
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - S Barnsley
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - L Finch
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - J Briens
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - S Siciliano
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - N Hogan
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - M Hecker
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - M Hanson
- Environment and Geography, University of Manitoba, Winnipeg, MB, Canada
| | - P Campbell
- Wood Environment & Infrastructure Solutions, Winnipeg, MB, Canada
| | - R Peters
- Federated Co-Operatives Limited, Saskatoon, SK, Canada
| | - A Manek
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - A N Al-Dissi
- Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - L Weber
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada.
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Tambur AR, Bestard O, Campbell P, Chong AS, Barrio MC, Ford ML, Gebel HM, Heidt S, Hickey M, Jackson A, Kosmoliaptsis V, Lefaucheur C, Louis K, Mannon RB, Mengel M, Morris A, Pinelli DF, Reed EF, Schinstock C, Taupin JL, Valenzuela N, Wiebe C, Nickerson P. Sensitization in transplantation: Assessment of Risk 2022 Working Group Meeting Report. Am J Transplant 2023; 23:133-149. [PMID: 36695615 DOI: 10.1016/j.ajt.2022.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/20/2022] [Accepted: 11/02/2022] [Indexed: 01/13/2023]
Abstract
The Sensitization in Transplantation: Assessment of Risk workgroup is a collaborative effort of the American Society of Transplantation and the American Society of Histocompatibility and Immunogenetics that aims at providing recommendations for clinical testing, highlights gaps in current knowledge, and proposes areas for further research to enhance histocompatibility testing in support of solid organ transplantation. This report provides updates on topics discussed by the previous Sensitization in Transplantation: Assessment of Risk working groups and introduces 2 areas of exploration: non-human leukocyte antigen antibodies and utilization of human leukocyte antigen antibody testing measurement to evaluate the efficacy of antibody-removal therapies.
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Affiliation(s)
- Anat R Tambur
- Department of Surgery, Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA.
| | - Oriol Bestard
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Patricia Campbell
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
| | - Anita S Chong
- Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, Illinois, USA
| | - Martha Crespo Barrio
- Department of Nephrology, Hospital del Mar & Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Mandy L Ford
- Department of Surgery and Emory Transplant Center, Emory University, Atlanta, Georgia, USA
| | - Howard M Gebel
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sebastiaan Heidt
- Department of Immunology, Leiden University Medical Center, Netherlands
| | - Michelle Hickey
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Annette Jackson
- Department of Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Carmen Lefaucheur
- Paris Translational Research Center for Organ Transplantation, Institut national de la santé et de la recherche médicale UMR-S970, Université de Paris, Paris, France
| | - Kevin Louis
- Paris Translational Research Center for Organ Transplantation, Institut national de la santé et de la recherche médicale UMR-S970, Université de Paris, Paris, France
| | - Roslyn B Mannon
- Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Michael Mengel
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
| | - Anna Morris
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David F Pinelli
- Department of Surgery, Comprehensive Transplant Center, Northwestern University, Chicago, Illinois, USA
| | - Elaine F Reed
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | | | - Jean-Luc Taupin
- Department of Immunology, Saint Louis Hospital and University Paris-Cité, Paris, France
| | - Nicole Valenzuela
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Chris Wiebe
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Peter Nickerson
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Simas V, Orr R, Schram B, Canetti E, Campbell P, Pope R. Occupational factors associated with the development of spondylosis in physically demanding occupations: a rapid review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Campbell P, Canetti E, Simas V, Schram B, Pope R, Orr R. Risk factors for the development of glenohumeral dislocations in tactical populations: a systematic review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Canetti E, Schram B, Simas V, Campbell P, Orr R, Pope R. Risk factors for the development of femoroacetabular impingement in physically demanding occupations: a systematic review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schram B, Canetti E, Simas V, Campbell P, Pope R, Orr R. Occupational risk factors for the development of disc herniation in physically demanding occupations: a rapid review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Campbell P, Canetti E, Simas V, Schram B, Pope R, Orr R. Risk factors for the development of Superior Labrum Anterior to Posterior (SLAP) tears in physically demanding occupations: a systematic review and meta-analysis. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Jasinska-Piadlo A, Bond R, Biglarbeigi P, Brisk R, Campbell P, Browne F, McEneaneny D. Data-driven versus a domain-led approach to k-means clustering on an open heart failure dataset. Int J Data Sci Anal 2022. [DOI: 10.1007/s41060-022-00346-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
AbstractDomain-driven data mining of health care data poses unique challenges. The aim of this paper is to explore the advantages and the challenges of a ‘domain-led approach’ versus a data-driven approach to a k-means clustering experiment. For the purpose of this experiment, clinical experts in heart failure selected variables to be used during the k-means clustering, whilst during the ‘data-driven approach’ feature selection was performed by applying principal component analysis to the multidimensional dataset. Six out of seven features selected by physicians were amongst 26 features that contributed most to the significant principal components within the k-means algorithm. The data-driven approach showed advantage over the domain-led approach for feature selection by removing the risk of bias that can be introduced by domain experts. Whilst the ‘domain-led approach’ may potentially prohibit knowledge discovery that can be hidden behind variables not routinely taken into consideration as clinically important features, the domain knowledge played an important role at the interpretation stage of the clustering experiment providing insight into the context and preventing far fetched conclusions. The “data-driven approach” was accurate in identifying clusters with distinct features at the physiological level. To promote the domain-led data mining approach, as a result of this experiment we developed a practical checklist guiding how to enable the integration of the domain knowledge into the data mining project.
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Barbetta A, Meeberg G, Rocque B, Barhouma S, Weaver C, Gilmour S, Faytrouni F, Guttman O, Zielsdorf S, Etesami K, Kwon Y, Yanni G, Campbell P, Shapiro J, Emamaullee J. Immunologic benefits of maternal living donor allografts in pediatric liver transplantation: fewer rejection episodes and no evidence of de novo allosensitization. Pediatr Transplant 2022; 26:e14197. [PMID: 34806273 PMCID: PMC9053650 DOI: 10.1111/petr.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/23/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pediatric liver transplant (LT) recipients of maternal living liver donor (LLD) grafts have been reported to experience fewer rejection episodes. However, it is unclear whether this benefit translates to reduction in developing donor-specific antibody (DSA) among maternal-LLD recipients. The aim of this study was to compare immunologic outcomes among maternal-LLD, non-maternal-LLD, and deceased donor liver transplant (DDLT) recipients. METHODS Children (≤18 years) who underwent LT between 1/1998 and 12/2019 at two high-volume LT centers in North America were evaluated. Patients were divided into three groups by type of graft received (maternal-LLD, non-maternal LLD, and DDLT). Clinical variables and outcomes were compared according to each graft type. RESULTS A total of 450 pediatric primary LT were analyzed: 275 (61.1%) DDLT, 73 (16.2%) maternal-LLD, and 102 (22.6%) non-maternal-LLD. Children receiving LLD grafts were less likely to develop rejection when compared to the DDLT group (DDLT 46.9% vs. maternal-LLD 31.5% vs. non-maternal-LLD 28.4%, p = 0.001). There was no difference in rejection rates between maternal and non-maternal-LLD recipients. A higher percentage of maternal-LLD recipients were on immunosuppression monotherapy compared to non-maternal-LLD and DDLT recipients (6.7% vs. 1.2 vs. 2.4%, respectively). A subgroup of 68 patients were tested for DSA post-LT. Maternal-LLD recipients were less likely to develop de novo DSA (maternal-LLD 11.8% vs. non-maternal-LLD 19.3% vs. DDLT 43%, p = 0.018). None of the maternal-LLD recipients developed antibody-mediated rejection. CONCLUSIONS These data support the concept of immunologic benefit of maternal-LLD in pediatric LT, with lower rates of rejection and allosensitization post-LT when compared to DDLT recipients.
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Affiliation(s)
- Arianna Barbetta
- Department of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, CA, USA
| | | | - Brittany Rocque
- Department of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, CA, USA
| | | | - Carly Weaver
- Division of Hepatobiliary and Abdominal Organ Transplantation Surgery, Children’s Hospital-Los Angeles, Los Angeles, CA USA
| | | | - Farah Faytrouni
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Orlee Guttman
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Shannon Zielsdorf
- Department of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, CA, USA,University of Southern California, Los Angeles, CA, USA,Division of Hepatobiliary and Abdominal Organ Transplantation Surgery, Children’s Hospital-Los Angeles, Los Angeles, CA USA
| | - Kambiz Etesami
- Department of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, CA, USA,University of Southern California, Los Angeles, CA, USA,Division of Hepatobiliary and Abdominal Organ Transplantation Surgery, Children’s Hospital-Los Angeles, Los Angeles, CA USA
| | - Yong Kwon
- Department of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, CA, USA,University of Southern California, Los Angeles, CA, USA,Division of Hepatobiliary and Abdominal Organ Transplantation Surgery, Children’s Hospital-Los Angeles, Los Angeles, CA USA
| | - George Yanni
- University of Southern California, Los Angeles, CA, USA,Department of Pediatrics, Children’s Hospital-Los Angeles, Los Angeles, CA USA
| | - Patricia Campbell
- Alberta Transplant Institute, Edmonton, AB, Canada,Departemtent of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | | | - Juliet Emamaullee
- Department of Surgery, Division of Abdominal Organ Transplant, University of Southern California, Los Angeles, CA, USA,University of Southern California, Los Angeles, CA, USA,Division of Hepatobiliary and Abdominal Organ Transplantation Surgery, Children’s Hospital-Los Angeles, Los Angeles, CA USA
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Geldhof S, Kortelainen M, Beliuskina O, Campbell P, Caceres L, Cañete L, Cheal B, Chrysalidis K, Devlin CS, de Groote RP, de Roubin A, Eronen T, Ge Z, Gins W, Koszorus A, Kujanpää S, Nesterenko D, Ortiz-Cortes A, Pohjalainen I, Moore ID, Raggio A, Reponen M, Romero J, Sommer F. Impact of Nuclear Deformation and Pairing on the Charge Radii of Palladium Isotopes. Phys Rev Lett 2022; 128:152501. [PMID: 35499902 DOI: 10.1103/physrevlett.128.152501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/01/2022] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
The impact of nuclear deformation can been seen in the systematics of nuclear charge radii, with radii generally expanding with increasing deformation. In this Letter, we present a detailed analysis of the precise relationship between nuclear quadrupole deformation and the nuclear size. Our approach combines the first measurements of the changes in the mean-square charge radii of well-deformed palladium isotopes between A=98 and A=118 with nuclear density functional calculations using Fayans functionals, specifically Fy(std) and Fy(Δr,HFB), and the UNEDF2 functional. The changes in mean-square charge radii are extracted from collinear laser spectroscopy measurements on the 4d^{9}5s ^{3}D_{3}→4d^{9}5p ^{3}P_{2} atomic transition. The analysis of the Fayans functional calculations reveals a clear link between a good reproduction of the charge radii for the neutron-rich Pd isotopes and the overestimated odd-even staggering: Both aspects can be attributed to the strength of the pairing correlations in the particular functional which we employ.
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Affiliation(s)
- S Geldhof
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- KU Leuven, Instituut voor Kern- en Stralingsfysica, 3001 Leuven, Belgium
| | - M Kortelainen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - O Beliuskina
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - P Campbell
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Caceres
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, 14000 Caen, France
| | - L Cañete
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - B Cheal
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | | | - C S Devlin
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - R P de Groote
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A de Roubin
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - T Eronen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Z Ge
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - W Gins
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A Koszorus
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - S Kujanpää
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - D Nesterenko
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A Ortiz-Cortes
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, 14000 Caen, France
| | - I Pohjalainen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - I D Moore
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A Raggio
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - M Reponen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - J Romero
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - F Sommer
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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Campbell P, Park S, Ebramzadeh E. Semi-quantitative histology confirms that the macrophage is the predominant cell type in metal-on-metal hip tissues. J Orthop Res 2022; 40:387-395. [PMID: 33749015 PMCID: PMC9292819 DOI: 10.1002/jor.25040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/11/2021] [Accepted: 03/10/2021] [Indexed: 02/04/2023]
Abstract
Numerous studies have examined the histology of metal-on-metal hip tissues for evidence of a dose response to metal wear but have often reported inconclusive or contradictory findings. The aim of the present study was to address these discrepancies using multiple histological scoring methods to characterize the tissue features of one large group of revised metal-on-metal total hips. Periprosthetic tissues from 165 metal-on-metal hip revisions were examined for features of aseptic lymphocytic vasculitis associated lesions (ALVAL) as rated using two scoring systems as well as rankings for macrophage and lymphocyte numbers, intracellular wear debris and necrosis. Correlations between histological features and clinical variables including gender and time to revision and implant variables including articular surface wear volume or visual taper corrosion scores were examined. Both ALVAL scores reflected the macrophage dominated histology with average scores of 5.9/10 and 1.5/3. There was a statistically significant correlation between the original ALVAL score and wear rate per year (correlation coefficient = 0.17, p = .05) and a moderate correlation between the number of macrophages and wear particles and wear volume. There was no statistically significant correlation between wear and any other feature including lymphocytic inflammation or necrosis. Strong correlations between combined cup and ball wear volume and histological characteristics were not observed, although the number of macrophages was more closely correlated with wear than lymphocytes or necrosis.
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Affiliation(s)
- Patricia Campbell
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Department of Orthopaedic SurgeryOrthopaedic Institute for Children, UCLALos AngelesCaliforniaUSA
| | - Sang‐Hyun Park
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Department of Orthopaedic SurgeryOrthopaedic Institute for Children, UCLALos AngelesCaliforniaUSA
| | - Edward Ebramzadeh
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Department of Orthopaedic SurgeryOrthopaedic Institute for Children, UCLALos AngelesCaliforniaUSA
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Jasinska-Piadlo A, Bond R, Biglarbeigi P, Brisk R, Campbell P, McEneaneny D. What can machines learn about heart failure? A systematic literature review. Int J Data Sci Anal 2021. [DOI: 10.1007/s41060-021-00300-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractThis paper presents a systematic literature review with respect to application of data science and machine learning (ML) to heart failure (HF) datasets with the intention of generating both a synthesis of relevant findings and a critical evaluation of approaches, applicability and accuracy in order to inform future work within this field. This paper has a particular intention to consider ways in which the low uptake of ML techniques within clinical practice could be resolved. Literature searches were performed on Scopus (2014-2021), ProQuest and Ovid MEDLINE databases (2014-2021). Search terms included ‘heart failure’ or ‘cardiomyopathy’ and ‘machine learning’, ‘data analytics’, ‘data mining’ or ‘data science’. 81 out of 1688 articles were included in the review. The majority of studies were retrospective cohort studies. The median size of the patient cohort across all studies was 1944 (min 46, max 93260). The largest patient samples were used in readmission prediction models with the median sample size of 5676 (min. 380, max. 93260). Machine learning methods focused on common HF problems: detection of HF from available dataset, prediction of hospital readmission following index hospitalization, mortality prediction, classification and clustering of HF cohorts into subgroups with distinctive features and response to HF treatment. The most common ML methods used were logistic regression, decision trees, random forest and support vector machines. Information on validation of models was scarce. Based on the authors’ affiliations, there was a median 3:1 ratio between IT specialists and clinicians. Over half of studies were co-authored by a collaboration of medical and IT specialists. Approximately 25% of papers were authored solely by IT specialists who did not seek clinical input in data interpretation. The application of ML to datasets, in particular clustering methods, enabled the development of classification models assisting in testing the outcomes of patients with HF. There is, however, a tendency to over-claim the potential usefulness of ML models for clinical practice. The next body of work that is required for this research discipline is the design of randomised controlled trials (RCTs) with the use of ML in an intervention arm in order to prospectively validate these algorithms for real-world clinical utility.
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Jayasundara D, Sheridan S, Randall D, Campbell P, Edmond K, Liu B, McIntyre PB, Gidding HF, Wood JG. 472Long-term effectiveness of 3-dose primary course and 4-year booster dose of pertussis vaccine in Australia. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Australia’s National Immunisation Program recommended a 3-dose primary Diphtheria-Tetanus-Pertussis (DTP) vaccination course at 2, 4 and 6 months and a booster dose at 4 years during 2003-2015. We examined vaccine effectiveness by time since doses 3 and 4, as studies to date have shown conflicting results.
Methods
Perinatal, immunisation, pertussis notification and death data were linked for 1,086,319 infants born in two Australian states in 2003-2012. Administration of DTP doses 3 and 4 from 5.5-7 months and 47-53 months respectively, was considered age-appropriate. Adjusted Cox proportional hazards models with time-varying vaccination status were used to estimate vaccine effectiveness (VE = 1–hazard ratio) against notified pertussis post age-appropriate doses 3 and 4 compared to unvaccinated children, with additional benefit of dose 4 compared to receipt of primary course alone.
Results
Dose 3 VE declined from 79% (CI 75%-83%) from 0-6 months to 64% (CI 60%-67%) at 6-36 months and 45% (CI 31%-56%) at 36-42 months post-vaccination. Compared to unvaccinated children, VE after dose 4 declined from 83% (CI 80%-86%) at 0-12 months to 67% (CI 60%-72%) and 55% (CI 46%-63%) in the following two 12-month periods post-vaccination. When compared to dose 3, the relative VE for dose 4 was 58% (CI 51%-64%) in 0-18 months post-vaccination.
Conclusion and Key messages
Our study adds to previous Australian evidence for substantial waning of vaccine induced immunity against pertussis over a 3-year period following dose 3. VE was significantly higher in the 18 months following dose 4 compared to receipt of primary course alone.
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Affiliation(s)
- Duleepa Jayasundara
- Centre for Epidemiology and Evidence, NSW Ministry of Health, St Leonards, Australia
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, Australia
- The University of Sydney Northern Clinical School, St Leonards, Australia
| | - Sarah Sheridan
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, Australia
- The University of Sydney Northern Clinical School, St Leonards, Australia
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
- School of Public Health and Community Medicine, UNSW Medicine, University of NSW,, Sydney, Australia
| | - Deborah Randall
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, Australia
- The University of Sydney Northern Clinical School, St Leonards, Australia
| | - Patricia Campbell
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Karen Edmond
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Bette Liu
- School of Public Health and Community Medicine, UNSW Medicine, University of NSW,, Sydney, Australia
| | - Peter B McIntyre
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
| | - Heather F Gidding
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, Australia
- The University of Sydney Northern Clinical School, St Leonards, Australia
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
- School of Public Health and Community Medicine, UNSW Medicine, University of NSW,, Sydney, Australia
| | - James G Wood
- School of Public Health and Community Medicine, UNSW Medicine, University of NSW,, Sydney, Australia
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Khoury M, Pidborochynski T, Halpin A, Campbell P, Urschel S, Kim D, West L, Buchholz H, Conway J. Human Leukocyte Antigen Antibody Sampling in Ventricular Assist Device Recipients: Are We Talking? Transplant Proc 2021; 53:2377-2381. [PMID: 34412914 DOI: 10.1016/j.transproceed.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ventricular assist devices (VADs) are commonly used as a bridge to transplantation but may yield HLA sensitization. We evaluated the prevalence of HLA antibody (Ab) sampling pre- and post-VAD placement in pediatric and adult patients and notification of VAD status to the HLA laboratory. METHODS All pediatric and adult patients who received a first-time VAD between 2005 and 2013 were included in this single-center retrospective review. Data were collected from the University of Alberta Hospital histocompatibility laboratory's information system and a local VAD database. RESULTS In total, 106 patients were included (40 pediatric, median 3.0 years [interquartile range, 0.3-10.7]; 66 adult, 55.0 years [46.8-61.2]). HLA Ab sampling within 1-month pre-VAD occurred in 70% of pediatric and 79% of adult recipients (P = .215). Testing within 1 month of VAD placement occurred in 89% of pediatric and 67% of adult recipients (P = .012). For those with HLA Ab sampling within 30 days postimplant, notification to the HLA laboratory of VAD status occurred in 19 of 27 (70%) pediatric and 24 of 33 (73%) adult patients (P = .533). Of patients transplanted post VAD with HLA Ab samples collected, 12 of 28 (43%) and 13 of 38 (34%) adult recipients did not have notification of VAD status to the HLA laboratory (P = .322). CONCLUSIONS There were inconsistencies in HLA Ab sampling and communication to the HLA laboratory surrounding VAD placement. Standardization of both HLA Ab assessment frequency after VAD implantation and communication regarding changes in clinical status and the occurrence of key sensitizing events such as VAD placement are imperative as patients await transplantation.
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Affiliation(s)
- Michael Khoury
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada.
| | - Tara Pidborochynski
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
| | - Anne Halpin
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada; Alberta Public Laboratories (APL), Edmonton, AB, Canada
| | - Patricia Campbell
- Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada; Alberta Public Laboratories (APL), Edmonton, AB, Canada
| | - Simon Urschel
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada
| | - Daniel Kim
- Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada
| | - Lori West
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada
| | - Holger Buchholz
- Department of Medicine, University of Alberta, Edmonton, AB, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Conway
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada
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30
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Schinstock CA, Askar M, Bagnasco SM, Batal I, Bow L, Budde K, Campbell P, Carroll R, Clahsen-van Groningen MC, Cooper M, Cornell LD, Cozzi E, Dadhania D, Diekmann F, Hesselink DA, Jackson AM, Kikic Z, Lower F, Naesens M, Roelofs JJ, Sapir-Pichhadze R, Kraus ES. A 2020 Banff Antibody-mediatedInjury Working Group examination of international practices for diagnosing antibody-mediated rejection in kidney transplantation - a cohort study. Transpl Int 2021; 34:488-498. [PMID: 33423340 DOI: 10.1111/tri.13813] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/24/2020] [Accepted: 01/02/2021] [Indexed: 12/24/2022]
Abstract
The Banff antibody-mediated rejection (ABMR) classification is vulnerable to misinterpretation, but the reasons are unclear. To better understand this vulnerability, we evaluated how ABMR is diagnosed in practice. To do this, the Banff Antibody-Mediated Injury Workgroup electronically surveyed an international cohort of nephrologists/surgeons (n = 133) and renal pathologists (n = 99). Most providers (97%) responded that they use the Banff ABMR classification at least sometimes, but DSA information is often not readily available. Only 41.1% (55/133) of nephrologists/surgeons and 19.2% (19/99) of pathologists reported that they always have DSA results when the biopsy is available. Additionally, only 19.6% (26/133) of nephrologists/surgeons responded that non-HLA antibody or molecular transcripts are obtained when ABMR histologic features are present but DSA is undetected. Several respondents agreed that histologic features concerning for ABMR in the absence of DSA and/or C4d are not well accounted for in the current classification [31.3% (31/99) pathologists and 37.6% (50/133) nephrologist/surgeons]. The Banff ABMR classification appears widely accepted, but efforts to improve the accessibility of DSA information for the multidisciplinary care team are needed. Further clarity is also needed in Banff ABMR nomenclature to account for the spectrum of ABMR and for histologic features suspicious for ABMR when DSA is absent.
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Affiliation(s)
- Carrie A Schinstock
- William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA
| | - Medhat Askar
- Baylor University Medical Center, Dallas, TX, USA.,Texas A&M Health Science Center Collect of Medicine, Bryan, TX, USA
| | - Serena M Bagnasco
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ibrahim Batal
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Laurine Bow
- Department of Transplantation Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Klemens Budde
- Medizinische Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Patricia Campbell
- Department of Medicine and Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada
| | - Robert Carroll
- Transplantation Immunogenetics Service, Australian Red Cross Blood Service Melbourne, Melbourne, Vic., Australia.,University of South Australia, Adelaide, SA, Australia
| | | | - Matthew Cooper
- Medstar Georgetown Transplant Institute, Washington, DC, USA
| | - Lynn D Cornell
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Emanuele Cozzi
- Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Darshana Dadhania
- Department of Medicine, Weill Cornell Medicine - New York Presbyterian Hospital, New York, NY, USA
| | - Fritz Diekmann
- Kidney Transplant Unit, Institut d'Incestigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
| | - Dennis A Hesselink
- Department of Nephrology and Transplantation, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Zeljko Kikic
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Vienna, Austria
| | - Fritz Lower
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY, USA
| | - Maarten Naesens
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.,Department of Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Joris J Roelofs
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Ruth Sapir-Pichhadze
- Centre for Outcomes Research & Evaluation Research Institute, McGill University Health Center, Montreal, QC, Canada
| | - Edward S Kraus
- Division of Nephrology/Transplant Nephrology, Johns Hopkins University, Baltimore, MD, USA
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31
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Batlevi CL, Salles G, Tilly H, Chaidos A, McKay P, Phillips T, Assouline S, Campbell P, Ribrag V, Damaj GL, Dickinson M, Jurczak W, Kaźmierczak M, Opat S, Radford JR, Schmitt A, Rajarethinam A, Shang G, Morschhauser F. CHARACTERISTICS OF PATIENTS ACHIEVING COMPLETE OR PARTIAL RESPONSE (CR/PR) WITH TAZEMETOSTAT (TAZ) IN WILD‐TYPE RELAPSED/REFRACTORY (R/R) FOLLICULAR LYMPHOMA (FL). Hematol Oncol 2021. [DOI: 10.1002/hon.21_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C. L. Batlevi
- Memorial Sloan Kettering Cancer Center Lymphoma Service Department of Medicine New York USA
| | - G. Salles
- Lyon‐Sud Hospital University of Lyon Hematology Pierre‐Bénite France
| | - H. Tilly
- Centre Henri Becquerel and Rouen University Department of Haematology and INSERM U1245 Rouen France
| | - A. Chaidos
- Imperial College Healthcare NHS Trust Hammersmith Hospital Department of Medicine London UK
| | - P. McKay
- Beatson West of Scotland Cancer Centre Department of Hematology Glasgow UK
| | - T. Phillips
- University of Michigan Hematology and Oncology Ann Arbor USA
| | - S. Assouline
- Division of Hematology Sir Mortimer B. Davis‐Jewish General Hospital Oncology Montreal Canada
| | - P. Campbell
- Barwon Health University Hospital Geelong Department of Clinical Haematology Geelong Australia
| | - V. Ribrag
- Gustave Roussy Hematology Villejuif France
| | - G. Laurent Damaj
- Hematology Institute University Hospital School of Medicine Hematology Caen France
| | - M. Dickinson
- Peter MacCallum Cancer Centre Royal Melbourne Hospital Department of Clinical Haematology Melbourne Australia
| | - W. Jurczak
- Maria Sklodowska‐Curie National Research Institute of Oncology Department of Hematology Kraków Poland
| | - M. Kaźmierczak
- Poznań University of Medical Sciences Department of Hematology and Bone Marrow Transplantation Poznań Poland
| | - S. Opat
- Monash University Department of Haematology Victoria Australia
| | - J. R. Radford
- University of Manchester NIHR Manchester Clinical Research Facility Manchester Academic Health Science Centre The Christie NHS Foundation Trust Department of Medical Oncology Manchester UK
| | - A. Schmitt
- Institut Bergonié Department of Hematology Bordeaux France
| | | | - G. Shang
- Epizyme, Inc. Medical Affairs Cambridge USA
| | - F. Morschhauser
- Groupe de Recherche sur les formes Injectables et les Technologies Associées CHU de Lille Université de Lille Oncology Lille France
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Campbell P, McKeveney P, Donegan K, Ataliotis C, Patton C, Mullan R. Practical guidance for the use of potassium binders in the management of hyperkalaemia in patients with heart failure and/or chronic kidney disease. Br J Hosp Med (Lond) 2021; 82:1-11. [PMID: 33914625 DOI: 10.12968/hmed.2021.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Given the critical physiological role of potassium, it is understandable that the development of severe hyperkalaemia requires effective management to reduce its effects, which include muscle weakness, paralysis and cardiac arrhythmias. Hyperkalaemia most often results from the failure of renal adaptation to potassium imbalance. Patients who are most susceptible to the development of hyperkalaemia include those with chronic kidney disease and those with heart failure. These patients are often treated with renin-angiotensin-aldosterone system (RAAS) inhibitors, such as angiotensin-converting enzyme inhibitors and angiotensin II-receptor blockers, but the development of hyperkalaemia can require down-titration or cessation of RAAS inhibitors. This presents a significant challenge to nephrologists, cardiologists and healthcare professionals treating these patients as this can prevent them from receiving maximum guideline-directed RAAS inhibitor therapy. Panellists in this roundtable discussion shared their clinical experiences of using potassium binders to manage hyperkalaemia in patients with chronic kidney disease and patients with heart failure (illustrated with case studies) in Northern Ireland and considered recommendations for the implementation and maintenance of chronic potassium-lowering treatment.
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Affiliation(s)
| | | | | | | | - Carol Patton
- Craigavon Hospital, Southern HSC Trust, Portadown, Craigavon
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33
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Ho NC, Park SH, Campbell P, Van Citters DW, Ebramzadeh E, Sangiorgio S. Damage patterns in polyethylene fixed bearings of retrieved total ankle replacements. Foot Ankle Surg 2021; 27:316-320. [PMID: 32651082 DOI: 10.1016/j.fas.2020.06.012] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/03/2020] [Accepted: 06/25/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Poor long-term outcomes continue to hinder the universal adoption of total ankle replacements (TAR) for end stage arthritis. In the present study, polyethylene inserts of TARs retrieved at revision surgery were analyzed for burnishing, scratching, mechanical damage, pitting, and embedded particles. METHODS Fourteen retrieved polyethylene inserts from a fixed bearing total ankle replacement design currently in clinical use were analyzed. Duration of time in vivo was between 11.5 months and 120.1 months. Three investigators independently graded each articular surface in quadrants for five features of damage: burnishing, scratching, mechanical damage, pitting, and embedded particles. RESULTS No correlation was found for burnishing between the anterior and posterior aspects (p = 0.47); however, scratching and pitting were significantly higher on the posterior aspect compared to the anterior aspect (p < 0.03). There was a high correlation between burnishing and in vivo duration of the implant (anterior: R = 0.67, p = 0.01, posterior: R = 0.68, p = 0.01). CONCLUSION The higher concentration of posterior damage on these polyethylene inserts suggested that prosthesis-related (design) or surgeon-related (technique) factors might restrict the articulation of the implant. The resulting higher stresses in the posterior articular surfaces may have contributed to the failure of retrieved implants Keywords: Retrieval, Polyethylene Damage, Total Ankle Replacement.
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Affiliation(s)
- Nathan C Ho
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, 403 W. Adams Blvd., Los Angeles, CA 90007, United States.
| | - Sang-Hyun Park
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, 403 W. Adams Blvd., Los Angeles, CA 90007, United States.
| | - Patricia Campbell
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, 403 W. Adams Blvd., Los Angeles, CA 90007, United States.
| | - Douglas W Van Citters
- Thayer School of Engineering at Dartmouth, 14 Engineering Drive, Hanover, NH 03755, United States.
| | - Edward Ebramzadeh
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, 403 W. Adams Blvd., Los Angeles, CA 90007, United States.
| | - Sophia Sangiorgio
- The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, 403 W. Adams Blvd., Los Angeles, CA 90007, United States.
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Matheson LM, Pitson G, Yap CH, Singh M, Collins I, Campbell P, Patrick A, Rogers MJ. Measuring the quality of cancer care in the Barwon South Western region, Victoria, Australia. Int J Qual Health Care 2021; 33:5983668. [PMID: 33196785 DOI: 10.1093/intqhc/mzaa145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The implementation of clinical quality indicators for monitoring cancer care in regional, rural and remote areas. DESIGN Retrospective data from a population-based Clinical Quality Registry for lung, colorectal and breast cancers. SETTING All major health services in the Barwon South Western region, Victoria, Australia. PARTICIPANTS All patients who were diagnosed with cancer and who presented to a health service. INTERVENTION(S) Clinical subgroups to review variations. MAIN OUTCOME MEASURES(S) Clinical quality indicators for lung, colorectal and breast cancers. RESULTS Clinical indicators included the following: discussion at multidisciplinary meetings, the timeliness of care provided and the type of care for different stages of the disease and survival outcomes. Many of the derived clinical indicator targets were reached. However, variations led to an improvement in the tumour stage being recorded in the medical record; an improved awareness of the need for adjuvant chemotherapy for colorectal cancer; a reduction in time to treatment for lung cancer and a reduced time to surgery for breast cancer, and the 30-day mortality post-treatment for all of the tumour streams was highlighted. CONCLUSIONS Clinical quality indicators allow for valuable insights into patterns of care. These indicators are easily reproduced and may be of use to other cancer centres and health services.
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Affiliation(s)
- L M Matheson
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - G Pitson
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - C H Yap
- Cardiothoracic Surgery, University Hospital Geelong, Geelong, VIC 3220, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - M Singh
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - I Collins
- Dept of Oncology, South West Healthcare, Warrnambool, VIC 3280, Australia and.,School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - P Campbell
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia.,School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - A Patrick
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - M J Rogers
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
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35
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McCambridge J, Keane C, Walshe M, Campbell P, Heyes J, Kalra PR, Cowie MR, Riley JP, O'Hanlon R, Ledwidge M, Gallagher J, McDonald K. The prehospital patient pathway and experience of care with acute heart failure: a comparison of two health care systems. ESC Heart Fail 2020; 8:1076-1084. [PMID: 33369196 PMCID: PMC8006706 DOI: 10.1002/ehf2.13089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 01/12/2023] Open
Abstract
Aims This study aimed to analyse community management of patients during the symptomatic period prior to admission with acute decompensated heart failure (ADHF). Methods and results We conducted a prospective, two‐centre, two‐country observational study evaluating care pathways and patient experience in patients admitted to hospital with ADHF. Quantitative and qualitative data were gathered from patients, carers, and general practitioners (GPs). From the Irish centre, 114 patients enrolled, and from the English centre, 50 patients. Symptom duration longer than 72 h prior to hospitalization was noted among 70.4% (76) Irish and 80% (40) English patients, with no significant difference between those with a new diagnosis of HF [de novo HF (dnHF)] and those with known HF [established HF (eHF)] in either cohort. For the majority, dyspnoea was the dominant symptom; however, 63.3% (31) of these Irish patients and 47.2% (17) of these English patients did not recognize this as an HF symptom, with no significant difference between dnHF and eHF patients. Of the 46.5% (53) of Irish and 38% (19) of English patients reviewed exclusively by GPs before hospitalization, numbers prescribed diuretics were low (11.3%, six; and 15.8%, three, respectively); eHF patients were no more likely to receive diuretics than dnHF patients. Barriers to care highlighted by GPs included inadequate access to basic diagnostics, specialist support and up‐to‐date patient information, and lack of GP comfort in managing HF. Conclusion The aforementioned findings, consistent across both health care jurisdictions, show a clear potential to intervene earlier and more effectively in ADHF or to prevent the need for hospitalization.
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Affiliation(s)
- Joseph McCambridge
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Ciara Keane
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Myra Walshe
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Patricia Campbell
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - James Heyes
- Portsmouth Hospital NHS Trust, Portsmouth, UK
| | | | - Martin R Cowie
- Imperial College London (Royal Brompton Hospital), London, UK
| | - Jillian P Riley
- Imperial College London (Royal Brompton Hospital), London, UK
| | - Rory O'Hanlon
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Mark Ledwidge
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Joseph Gallagher
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.,Irish College of General Practitioners, Lincoln Place, Dublin 2, Ireland
| | - Kenneth McDonald
- Cardiology Department, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Abstract
Gathering health information is among the major motivations for getting online among older adults who want to be better prepared with knowledge to manage their health and personal care. Prior research also showed significant gender differences in health-related use of the Internet. This research examined the effect of Internet use for health information on (a) mistrust of physician, (b) empowerment, (c) self-care, and (d) worry and/or anxiety. The sample (N=710; Mean= 48.82, SD=16.43) was randomly drawn from a national probability-based online panel. We performed gender-stratified sub-sample analyses of older respondents (age ≥60, N= 194). Hierarchical linear regression analyses showed that there is a negative association between older age and feeling empowered because of using the internet for health information (β = -.23, p < .05) and a positive association between older age and mistrust of diagnosis and/or treatment of physician (β = .19, p < .05). Study respondents did not report better self-care as a result of obtaining information from the Internet (β = -.15, p > .05). Lastly, older adults reported less worry and/or anxiety because of information stumbled upon the Internet that may not be accurate (β = -.25, p < .05). Sub-sample analyses showed that there are gender differences. Particularly, older men reported greater mistrust (β = .32, p < .05), and less worry (β = -.44, p ≤ .01) while these associations were not significant among older women. Results call for examination of the synergy of age and gender in perceived benefits of health-related Internet use.
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Affiliation(s)
- Gul Seckin
- University of North Texas, Hickory Creek, Texas, United States
| | | | - Megan Lawson
- University of North Texas, Denton, United States
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Reardon DA, Brem S, Desai AS, Bagley SJ, Kurz SC, De La Fuente MI, Nagpal S, Welch MR, Hormigo A, Forsyth P, Mandell J, Khagi S, Aiken R, Walbert T, Lieberman F, Portnow J, Batiste J, Carroll N, Sylvester A, Campbell P, Lowy I, Dolgoter A, Boyer J, Kraynyak K, Morrow MP, McMullan T, Weiner DB, Skolnik J. LTBK-01. INO-5401 AND INO-9012 DELIVERED INTRAMUSCULARLY (IM) WITH ELECTROPORATION (EP) IN COMBINATION WITH CEMIPLIMAB (REGN2810) IN NEWLY DIAGNOSED GLIOBLASTOMA. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Novel T cell-enabling therapies, in combination with checkpoint inhibition, may improve OS in GBM. INO-5401 (synthetic DNA plasmids encoding hTERT, WT-1, PSMA) plus INO-9012 (synthetic DNA plasmid encoding IL-12), and the PD-1 immune checkpoint inhibitor cemiplimab, is given to patients with newly diagnosed GBM to evaluate tolerability, efficacy and immunogenicity.
METHODS
Phase I/II, single arm, 2 cohort study (A: MGMT unmethylated, B: MGMT methylated). Primary endpoint is safety; efficacy and immunogenicity are secondary. Nine mg INO-5401 plus 1 mg INO-9012 (every 3 weeks x 4 doses, then Q9W) is given IM with EP by CELLECTRA® 2000 with cemiplimab (350 mg IV Q3W). RT is given as 40 Gy over 3 weeks. TMZ is given with radiation (all patients), and adjuvantly (Cohort B only).
RESULTS
Fifty-two subjects enrolled: 32 in Cohort A; 20 in Cohort B. 35% women; median age 60 years (19–78 years). The adverse event profile is consistent with single-agent (INO-5401, INO-9012, EP and cemiplimab) reported events. OS at 12 months was 84.4% (Cohort A) and 85% (Cohort B). OS at 18 months in Cohort A is 50% (95% CI 31.9 - 68.1); median OS is 17.9 months (14.5 - NR); Cohort B OS18 and median OS will be presented. Tumor gene transcripts at diagnosis confirmed expression of INO-5401 antigens. Peripheral immune responses following INO-5401 revealed antigen-specific T cell responses by Interferon gamma ELISpot and flow cytometry, including cytokine production and expansion of antigen specific CD8+T cells with lytic potential.
CONCLUSIONS
INO-5401 + INO-9012, a novel DNA plasmid immunotherapy, demonstrates acceptable risk/benefit and generates robust systemic immune responses to encoded tumor antigens when administered with cemiplimab and RT/TMZ in newly diagnosed GBM patients. Overall survival is encouraging. Clinical trial information: NCT03491683.
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Affiliation(s)
- David A Reardon
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Steven Brem
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | - Adilia Hormigo
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Simon Khagi
- University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | | | - James Batiste
- Sarah Cannon Research Institute, Chattanooga, TN, USA
| | | | | | | | - Israel Lowy
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | | | - Jean Boyer
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | | | - David B Weiner
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
- The Wistar Institute, Philadelphia, PA, USA
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38
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Chih S, McDonald M, Dipchand A, Kim D, Ducharme A, Kaan A, Abbey S, Toma M, Anderson K, Davey R, Mielniczuk L, Campbell P, Zieroth S, Bourgault C, Badiwala M, Clarke B, Belanger E, Carrier M, Conway J, Doucette K, Giannetti N, Isaac D, MacArthur R, Senechal M. Canadian Cardiovascular Society/Canadian Cardiac Transplant Network Position Statement on Heart Transplantation: Patient Eligibility, Selection, and Post-Transplantation Care. Can J Cardiol 2020; 36:335-356. [PMID: 32145863 DOI: 10.1016/j.cjca.2019.12.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/17/2022] Open
Abstract
Significant practice-changing developments have occurred in the care of heart transplantation candidates and recipients over the past decade. This Canadian Cardiovascular Society/Canadian Cardiac Transplant Network Position Statement provides evidence-based, expert panel recommendations with values and preferences, and practical tips on: (1) patient selection criteria; (2) selected patient populations; and (3) post transplantation surveillance. The recommendations were developed through systematic review of the literature and using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The evolving areas of importance addressed include transplant recipient age, frailty assessment, pulmonary hypertension evaluation, cannabis use, combined heart and other solid organ transplantation, adult congenital heart disease, cardiac amyloidosis, high sensitization, and post-transplantation management of antibodies to human leukocyte antigen, rejection, cardiac allograft vasculopathy, and long-term noncardiac care. Attention is also given to Canadian-specific management strategies including the prioritization of highly sensitized transplant candidates (status 4S) and heart organ allocation algorithms. The focus topics in this position statement highlight the increased complexity of patients who undergo evaluation for heart transplantation as well as improved patient selection, and advances in post-transplantation management and surveillance that have led to better long-term outcomes for heart transplant recipients.
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Affiliation(s)
- Sharon Chih
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Michael McDonald
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Anne Dipchand
- Labatt Family Heart Centre, Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Kim
- University of Alberta, Edmonton, Alberta, Canada
| | - Anique Ducharme
- Institut de Cardiologie de Montréal, Université de Montréal, Montréal, Québec, Canada
| | | | - Susan Abbey
- Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mustafa Toma
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Kim Anderson
- Halifax Infirmary, Department of Medicine-Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan Davey
- University of Western Ontario, London, Ontario, Canada
| | - Lisa Mielniczuk
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | | | - Christine Bourgault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Québec
| | - Mitesh Badiwala
- Peter Munk Cardiac Centre, University Health Network and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Michel Carrier
- Department of Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Jennifer Conway
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Debra Isaac
- University of Calgary, Calgary, Alberta, Canada
| | | | - Mario Senechal
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Université Laval, Laval, Québec, Canada
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Jeong R, Quinn RR, Lentine KL, Ravani P, Ye F, Campbell P, Wen K, Broscheit C, Gourishankar S, Lam NN. Incidence, Risk Factors, and Outcomes of Kidney Transplant Recipients Treated With Both Basiliximab and Antithymocyte Globulin. Can J Kidney Health Dis 2020; 7:2054358120964061. [PMID: 33117549 PMCID: PMC7573718 DOI: 10.1177/2054358120964061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/23/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Kidney transplant recipients are given induction therapy to rapidly reduce the immune response and prevent rejection. Guidelines recommend that an interleukin-2 receptor antibody (basiliximab) be the first-line agent and that a lymphocyte-depleting agent (antithymocyte globulin [ATG]) be reserved for those at high immunologic risk. Objective: To determine the incidence, risk factors, and outcomes for patients who receive both basiliximab and ATG for induction compared to either agent alone. Design: Retrospective cohort study. Setting: We used the transplant electronic medical record at the University of Alberta Hospital in Edmonton, Canada. Patients/samples/participants: We included incident adult kidney transplant recipients from 2013 to 2018. Measurements: We measured baseline characteristics, type, and dose of induction therapy used, estimated glomerular filtration rate (eGFR) at 1-year posttransplant, and outcomes of all-cause graft failure, death-censored graft failure, all-cause mortality, and death with a functioning graft. Methods: Differences between induction groups were compared using chi-square test for categorical variables and Kruskal-Wallis tests for continuous variables. We performed multivariable logistic regression modeling with type of induction therapy as the dependent variable and the case-level factors as the predictors (adjusted odds ratio). We estimated the Kaplan-Meier failure functions and used log-rank tests to assess statistical significance of differences in unadjusted incidence across induction therapy types. We compared cumulative incidence functions using a Fine and Gray competing risk regression model. Results: In all, 430 kidney transplant recipients were followed for a mean of 3.9 years (standard deviation 1.5). Of these, 71% (n = 305) received basiliximab alone, 22% (n = 93) received ATG alone, and 7% (n = 32) received both basiliximab and ATG. After adjusting for age and sex, compared to the basiliximab alone group, patients were more likely to receive dual-induction therapy if they were sensitized (calculated panel reactive antibody ≥80%), had diabetes mellitus or peripheral vascular disease, or experienced delayed graft function. Compared to the ATG alone group, the dual-induction therapy group had worse graft function at 1 year (mean eGFR 42 vs. 59 mL/min/1.73 m2, P = .0008) and an increased risk of all-cause graft failure (31% vs. 13%, P = .02) and death-censored graft failure (16% vs. 4%, P = .03). Limitations: There is a risk of confounding by indication, as patients who received dual-induction therapy likely had worse outcomes due to the indication for dual-induction therapy (such as delayed graft function). Conclusions: In our study, 1 out of 10 recipients who were treated with basiliximab also received ATG for induction therapy. These patients experienced worse outcomes than those treated with ATG alone. Trial registration: Not applicable (cohort study).
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Affiliation(s)
- Rachel Jeong
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada
| | - Robert R Quinn
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Krista L Lentine
- Center for Abdominal Transplantation, Saint Louis University, MO, USA
| | - Pietro Ravani
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Feng Ye
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Patricia Campbell
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Kevin Wen
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Chris Broscheit
- Department of Pharmacy, University of Alberta Hospital, Edmonton, Canada
| | - Sita Gourishankar
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Ngan N Lam
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
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Tambur AR, Campbell P, Chong AS, Feng S, Ford ML, Gebel H, Gill RG, Kelsoe G, Kosmoliaptsis V, Mannon RB, Mengel M, Reed EF, Valenzuela NM, Wiebe C, Dijke IE, Sullivan HC, Nickerson P. Sensitization in transplantation: Assessment of risk (STAR) 2019 Working Group Meeting Report. Am J Transplant 2020; 20:2652-2668. [PMID: 32342639 PMCID: PMC7586936 DOI: 10.1111/ajt.15937] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/01/2020] [Accepted: 04/20/2020] [Indexed: 01/25/2023]
Abstract
The purpose of the STAR 2019 Working Group was to build on findings from the initial STAR report to further clarify the expectations, limitations, perceptions, and utility of alloimmune assays that are currently in use or in development for risk assessment in the setting of organ transplantation. The goal was to determine the precision and clinical feasibility/utility of such assays in evaluating both memory and primary alloimmune risks. The process included a critical review of biologically driven, state-of-the-art, clinical diagnostics literature by experts in the field and an open public forum in a face-to-face meeting to promote broader engagement of the American Society of Transplantation and American Society of Histocompatibility and Immunogenetics membership. This report summarizes the literature review and the workshop discussions. Specifically, it highlights (1) available assays to evaluate the attributes of HLA antibodies and their utility both as clinical diagnostics and as research tools to evaluate the effector mechanisms driving rejection; (2) potential assays to assess the presence of alloimmune T and B cell memory; and (3) progress in the development of HLA molecular mismatch computational scores as a potential prognostic biomarker for primary alloimmunity and its application in research trial design.
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Affiliation(s)
- Anat R. Tambur
- Department of SurgeryComprehensive Transplant CenterNorthwestern UniversityChicagoIllinoisUSA
| | - Patricia Campbell
- Department of Laboratory Medicine & PathologyUniversity of AlbertaEdmontonCanada
| | - Anita S. Chong
- Section of TransplantationDepartment of SurgeryThe University of ChicagoChicagoIllinoisUSA
| | - Sandy Feng
- Department of SurgeryUCSF Medical CenterSan FranciscoCaliforniaUSA
| | - Mandy L. Ford
- Department of Surgery and Emory Transplant CenterEmory UniversityAtlantaGeorgiaUSA
| | - Howard Gebel
- Department of PathologyEmory University School of MedicineAtlantaGeorgiaUSA
| | - Ronald G. Gill
- Department of ImmunologyUniversity of ColoradoDenverColoradoUSA
| | - Garnett Kelsoe
- Department of ImmunologyDuke University School of MedicineDurhamNorth CarolinaUSA
| | | | - Roslyn B. Mannon
- Department of MedicineDivision of NephrologyUniversity of Alabama School of MedicineBirminghamAlabamaUSA
| | - Michael Mengel
- Department of Laboratory Medicine & PathologyUniversity of AlbertaEdmontonCanada
| | - Elaine F. Reed
- Department of Pathology and Laboratory MedicineDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Nicole M. Valenzuela
- Department of Pathology and Laboratory MedicineDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Chris Wiebe
- Department of MedicineUniversity of ManitobaWinnipegManitobaCanada
| | - I. Esme Dijke
- Department of Laboratory Medicine & PathologyUniversity of AlbertaEdmontonCanada
| | - Harold C. Sullivan
- Department of PathologyEmory University School of MedicineAtlantaGeorgiaUSA
| | - Peter Nickerson
- Department of MedicineUniversity of ManitobaWinnipegManitobaCanada
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Reardon DA, Brem S, Desai AS, Bagley SJ, Kurz SC, De La Fuente MI, Nagpal S, Welch MR, Hormigo A, Carroll N, Bartra SK, Campbell P, Bhatt K, Lowy I, Boyer J, Kraynyak K, Morrow MP, McMullan T, Weiner DB, Skolnik J. INO-5401 and INO-9012 delivered intramuscularly (IM) with electroporation (EP) in combination with cemiplimab (REGN2810) in newly diagnosed glioblastoma (GBM): Interim results. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.2514] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2514 Background: Novel T cell-enabling therapies, in combination with checkpoint inhibition, may improve OS in GBM. INO-5401 (synthetic DNA plasmids encoding for hTERT, WT-1 and PSMA), plus INO-9012 (synthetic DNA plasmid encoding IL-12), with the PD-1 checkpoint inhibitor cemiplimab, is given to patients with newly-diagnosed GBM to evaluate tolerability, efficacy and immunogenicity of the combination. Methods: Phase I/II, single arm, 2 cohort study (A: MGMT unmethylated, B: MGMT methylated). The primary endpoint is safety; efficacy and immunogenicity are secondary. Nine mg INO-5401 plus 1 mg INO-9012 (every 3 weeks for 4 doses, then Q9W) is given with EP by CELLECTRA 2000 with cemiplimab (350 mg IV Q3W). RT is given as 40 Gy over 3 weeks. TMZ is given with radiation (all patients), followed by maintenance (Cohort B only). Results: Fifty two subjects were enrolled: 32 in Cohort A; 20 in Cohort B. 35% women and 90% white. Median age 60 years (range 19-78 years). Common Grade ≥3 AEs reported were: platelet count decreased (11.5%), tumor inflammation (7.7%), seizure (7.7%), ALT increased (7.7%), lymphocyte count decreased (7.7.%). One Grade 5 unrelated event of urosepsis was reported. Of 69 SAEs reported there was only 1 related to the combination therapy, Grade 1 pyrexia. 48% of subjects reported irAEs, most frequently ALT increased (9.6%), AST increased (7.7%), diarrhea (7.7%), pyrexia (7.7%) and tumor inflammation (7.7%). 71% of the reported SAEs and irAEs occurred within the first 12 weeks of treatment. OS at 12 months was 84.4% (95% CI 67.2, 94.7) in Cohort A; Cohort B will be presented at ASCO. ELISpot assessments demonstrated T cell responses to INO-5401. Flow cytometry demonstrated evidence of activated INO-5401-specific CD8+T cells with lytic potential (CD38+Prf+GrzA+) when compared with baseline, post-treatment in the majority of patients assayed. Conclusions: INO-5401 + INO-9012 in combination with cemiplimab and RT/TMZ has an acceptable safety profile, is immunogenic and may show a survival advantage in patients with newly-diagnosed GBM. OS18 data will be presented later this year. Clinical trial information: NCT03491683 .
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Affiliation(s)
- David A. Reardon
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Steven Brem
- University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | | | | | | | | | | | | | | | - Israel Lowy
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY
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Saunders B, Hill J, Foster N, Cooper V, Protheroe J, Chudyk A, Graham CC, Campbell P, Bartlam B. Patients’ and general practitioners’ views of stratified care for musculoskeletal pain: qualitative findings from the STarT MSK pilot trial. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lam NN, Boyne DJ, Quinn RR, Austin PC, Hemmelgarn BR, Campbell P, Knoll GA, Tibbles LA, Yilmaz S, Quan H, Ravani P. Mortality and Morbidity in Kidney Transplant Recipients With a Failing Graft: A Matched Cohort Study. Can J Kidney Health Dis 2020; 7:2054358120908677. [PMID: 32313663 PMCID: PMC7158256 DOI: 10.1177/2054358120908677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Due to their history of renal disease and exposure to immunosuppression, kidney transplant recipients with a failing graft may be at higher risk of adverse outcomes compared to nontransplant controls. Understanding the burden of disease in transplant recipients may inform treatment decisions of people whose native kidneys are failing and may be eligible for a transplant. Objective: To compare mortality and morbidity in kidney transplant recipients with a failing graft to matched nontransplant controls. Design: Retrospective cohort study. Setting: Alberta, Canada. Patients: Kidney transplant recipients with a failing graft were identified as having at least 2 estimated glomerular filtration rate (eGFR) measurements between 15-30 mL/min/1.73 m2 (90-365 days apart). We also identified nontransplant controls with a similar degree of kidney dysfunction. Measurements: Mortality and hospitalization. Methods: We propensity-score matched 520 kidney transplant recipients with a failing graft to 520 nontransplant controls. Results: The median age of the matched cohort was 57 years and 40% were women. Compared to matched nontransplant controls, recipients with a failing graft had a higher hazard of death (hazard ratio, 1.54; 95% confidence interval [CI], 1.28-1.85; p < .001) and a higher rate of all-cause hospitalization (rate ratio, 1.67; 95% CI, 1.42-1.97; p < .001). Kidney transplant recipients also had a higher rate of several cause-specific hospitalizations including genitourinary, cardiovascular, and infectious causes. Limitations: Observational design with the risk of residual confounding. Conclusions: A failing kidney transplant is associated with an increased burden of mortality and morbidity beyond chronic kidney disease. This information may assist the discussion of prognosis in kidney transplant recipients with a failing graft and the design of strategies to minimize risks.
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Affiliation(s)
- Ngan N Lam
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Devon J Boyne
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada
| | - Robert R Quinn
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | | | - Brenda R Hemmelgarn
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Patricia Campbell
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Gregory A Knoll
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
| | - Lee Anne Tibbles
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada
| | - Serdar Yilmaz
- Department of Surgery, Division of Transplantation, University of Calgary, AB, Canada
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Pietro Ravani
- Cumming School of Medicine, Division of Nephrology, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
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Ruswa N, Mavhunga F, Roscoe JC, Beukes A, Shipiki E, van Gorkom J, Sawadogo S, Agolory S, Menzies H, Tiruneh D, Makumbi B, Bayer B, Zezai A, Campbell P, Alexander H, Kalisvaart N, Forster N. Second nationwide anti-tuberculosis drug resistance survey in Namibia. Int J Tuberc Lung Dis 2020; 23:858-864. [PMID: 31439119 DOI: 10.5588/ijtld.18.0526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Namibia ranks among the 30 high TB burden countries worldwide. Here, we report results of the second nationwide anti-TB drug resistance survey.OBJECTIVE: To assess the prevalence and trends of multidrug-resistant TB (MDR-TB) in Namibia.METHODS: From 2014 to 2015, patients with presumptive TB in all regions of Namibia had sputum subjected to mycobacterial culture and phenotypic drug susceptibility testing (DST) for rifampicin, isoniazid, ethambutol and streptomycin if positive on smear microscopy and/or Xpert MTB/RIF.RESULTS: Of the 4124 eligible for culture, 3279 (79.5%) had Mycobacterium tuberculosis isolated. 3126 (95%) had a first-line DST completed (2392 new patients, 699 previously treated patients, 35 with unknown treatment history). MDR-TB was detected in 4.5% (95%CI 3.7-5.4) of new patients, and 7.9% (95%CI 6.0-10.1) of individuals treated previously. MDR-TB was significantly associated with previous treatment (OR 1.8, 95%CI 1.3-2.5) but not with HIV infection, sex, age or other demographic factors. Prior treatment failure demonstrated the strongest association with MDR-TB (OR 17.6, 95%CI 5.3-58.7).CONCLUSION: The prevalence of MDR-TB among new TB patients in Namibia is high and, compared with the first drug resistance survey, has decreased significantly among those treated previously. Namibia should implement routine screening of drug resistance among all TB patients.
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Affiliation(s)
- N Ruswa
- Ministry of Health and Social Services, Windhoek, Namibia, KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - F Mavhunga
- Ministry of Health and Social Services, Windhoek, Namibia
| | - J C Roscoe
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Beukes
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - E Shipiki
- Namibia Institute of Pathology, Windhoek, Namibia
| | - J van Gorkom
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - S Sawadogo
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Agolory
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H Menzies
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D Tiruneh
- World Health Organization, Geneva, Switzerland
| | - B Makumbi
- Namibia Institute of Pathology, Windhoek, Namibia
| | - B Bayer
- Ministry of Health and Social Services, Windhoek, Namibia
| | - A Zezai
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - P Campbell
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H Alexander
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - N Kalisvaart
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - N Forster
- Ministry of Health and Social Services, Windhoek, Namibia, International Training & Education Center for Health, Department of Global Health, University of Washington, Seattle, WA, USA
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Bastuba M, Cohen M, Bastuba A, Campbell P. MICROFLUIDIC SPERM SEPARATION DEVICE DRAMATICALLY LOWERS DFI. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.02.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Macintyre AK, Torrens C, Campbell P, Maxwell M, Pollock A, Biggs H, Woodhouse A, Williams JM, McLean J. Socioeconomic inequalities and the equity impact of population-level interventions for adolescent health: an overview of systematic reviews. Public Health 2020; 180:154-162. [PMID: 31923881 DOI: 10.1016/j.puhe.2019.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Despite robust evidence on health inequalities in adulthood, less attention has been paid to inequalities in adolescence. The aim of this overview was to examine systematic review (SR) evidence on the equity impact of population-level interventions intended to improve health, happiness and wellbeing for adolescents. STUDY DESIGN An overview (review of systematic reviews). METHODS Eleven electronic databases were systematically searched to identify SRs of population-level interventions for adolescent health. A secondary data analysis of socioeconomic inequality was conducted to identify whether SRs reported on primary studies in terms of disadvantage, by measures of socioeconomic status (SES) and by differential effects. RESULTS 35,310 review titles were screened; 566 full texts were retrieved and 140 SRs met the predefined selection criteria. Differential intervention effects were considered in 42/140 (30%) SRs, 18/140 (13%) reported primary studies using an SES measure and 16/140 (11%) explicitly reported differential effects. 15/140 SRs (11%) explicitly focused on socioeconomic inequalities; of these 4/15 reported differential intervention effects in more detail, 7/15 concluded there was insufficient primary evidence to identify the impact of interventions on socioeconomic inequalities and 4/15 planned to examine differential effects by SES, but this was not reported further. CONCLUSIONS Our overview identifies that there is limited SR evidence on the equity impact of population-level interventions for adolescent health. Strengthening the evidence on whether interventions narrow or widen inequalities for adolescents must be a priority for public health research.
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Affiliation(s)
- A K Macintyre
- Centre for Health Policy, University of Strathclyde, Lord Hope Building, 141 St. James Road, Glasgow, G4 0LT, UK.
| | - C Torrens
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - P Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - M Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, University of Stirling Innovation Park, Stirling, FK9 4NF, UK
| | - A Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - H Biggs
- Mental Health Foundation, Merchants House, 30 George Square, Glasgow, G2 1EG, UK
| | - A Woodhouse
- Children in Scotland, Level 1, Rosebery House, 9 Haymarket Terrace, Edinburgh, EH12 5EZ, UK
| | - J M Williams
- University of Edinburgh, Room 2.4, Doorway 6, Medical Quad, Teviot Place, Edinburgh, EH8 9AG, UK
| | - J McLean
- Mental Health Foundation, Merchants House, 30 George Square, Glasgow, G2 1EG, UK
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Jahr SH, Myro AZ, Vegge K, Campbell P. A man in his forties with acute onset of speech impairment and unilateral paresis. Tidsskr Nor Laegeforen 2019; 139:19-0129. [PMID: 31823567 DOI: 10.4045/tidsskr.19.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Stroke has several causes and the diagnostic investigation can be challenging. Neurosyphilis occurs when Treponema pallidum infects the central nervous system, and is a rare cause of stroke. CASE PRESENTATION A man in in his late forties with diabetes mellitus and overweight presented with headache, speech impairment and right-sided stroke symptoms. He also had cognitive impairment and psychiatric symptoms. He underwent intravenous thrombolysis, and standardised stroke investigation was without clear findings. Cerebral MRI demonstrated non-specific subtle changes in the primary motor cortex in the left frontal lobe. However, lumbar puncture revealed elevated white blood cell count, and syphilis tests were positive. INTERPRETATION Diagnosis of syphilis is often difficult and requires specific suspicion. Due to increasing incidence of the disease and its therapeutic consequences, alertness around the condition is important. Neurosyphilis should be suspected in young patients with stroke symptoms in the absence of risk factors and/or with cryptogenic strokes, especially in the presence of risk factors for syphilis infection and in patients from endemic areas.
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Paterson K, Metcalf B, Campbell P, Wrigley T, Kasza J, Bennell K, Hinman R. Associations between static foot posture, in-shoe plantar forces and knee pain in people with medial knee osteoarthritis. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kamper SJ, Michaleff ZA, Campbell P, Dunn KM, Yamato TP, Hodder RK, Wiggers J, Williams CM. Back pain, mental health and substance use are associated in adolescents. J Public Health (Oxf) 2019; 41:487-493. [PMID: 30204888 DOI: 10.1093/pubmed/fdy129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/09/2018] [Accepted: 06/27/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During adolescence, prevalence of pain and health risk factors such as smoking, alcohol use and poor mental health all rise sharply. The aim of this study was to describe the relationship between back pain and health risk factors in adolescents. METHODS Cross-sectional data from the Healthy Schools Healthy Futures study, and the Australian Child Wellbeing Project was used, mean age: 14-15 years. Children were stratified according to back pain frequency. Within each strata, the proportion of children that reported drinking alcohol or smoking or that experienced feelings of anxiety or depression was reported. Test-for-trend analyses assessed whether increasing frequency of pain was associated with health risk factors. RESULTS Data was collected from ~2500 and 3900 children. Larger proportions of children smoked or drank alcohol within each strata of increasing pain frequency. The trend with anxiety and depression was less clear, although there was a marked difference between the children that reported no pain, and pain more frequently. CONCLUSION Two large, independent samples show adolescents that experience back pain more frequently are also more likely to smoke, drink alcohol and report feelings of anxiety and depression. Pain appears to be part of the picture of general health risk in adolescents.
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Affiliation(s)
- S J Kamper
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - Z A Michaleff
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - P Campbell
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.,South Staffordshire and Shropshire NHS Foundation Trust, St George's Hospital, Stafford, Staffordshire, UK
| | - K M Dunn
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - T P Yamato
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - R K Hodder
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Australia
| | - J Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Australia
| | - C M Williams
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Australia
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