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Kemp P, van der Lans RJL, Otten JJ, Adriaensen GFJPM, Benoist LBL, Cornet ME, Hoven DR, Rinia B, Verkest V, Fokkens WJ, Reitsma S. Hypereosinophilia during dupilumab treatment in patients with chronic rhinosinusitis with nasal polyps. Rhinology 2024; 62:202-207. [PMID: 37999634 DOI: 10.4193/rhin23.357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Increased blood eosinophil count (BEC) is common in patients under dupilumab treatment for chronic rhinosinusitis with nasal polyps (CRSwNP). This study investigated the prevalence and consequences of hypereosinophilia and to help define patients at risk. METHODS Real-life, prospective observational cohort study of patients treated with dupilumab for severe CRSwNP. Eligible patients were adult and biological-naive (N=334). All BEC values at baseline and during treatment were reported. Patients with a follow-up of >= 1 year were included to define patients at risk for hypereosinophilia by comparing baseline BEC values (N=218). Furthermore, clinical characteristics and therapeutic consequences for patients with BEC >= 3.0 were noted. RESULTS Hypereosinophilia developed in a minority of patients, with a peak at week 12 (16.2% with BEC >= 1.5, and 1.7% >= 3.0) in cross-sectional analysis. BEC >= 1.5 developed in 28.9% and BEC >=3.0 in 4.6% of cases with a minimal 1-year follow-up. Baseline BEC was significantly higher for patients developing BEC >= 1.5 and BEC >=3.0, with an optimal cut-off point of 0.96 to predict developing BEC >= 3.0. CONCLUSIONS Blood eosinophil count (BEC) >= 1.5 is transient and usually abates with no therapeutic interventions and BEC >= 3.0 is rare. Hypereosinophilic syndrome did not occur and switching to a different biological was rarely employed. A baseline BEC of >=1.0 can be a reason for extra caution.
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Affiliation(s)
- P Kemp
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - R J L van der Lans
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - J J Otten
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - G F J P M Adriaensen
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L B L Benoist
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M E Cornet
- Department of Otorhinolaryngology, Alrijne Hospital, Leiden, The Netherlands
| | - D R Hoven
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - B Rinia
- Department of Otorhinolaryngology, Isala Hospital, Zwolle, The Netherlands
| | - V Verkest
- Department of Otorhinolaryngology, GZA Hospital Sint-Vincentius, Antwerp, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - S Reitsma
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Parasiewicz P, Belka K, Łapińska M, Ławniczak K, Prus P, Adamczyk M, Buras P, Szlakowski J, Kaczkowski Z, Krauze K, O'Keeffe J, Suska K, Ligięza J, Melcher A, O'Hanley J, Birnie-Gauvin K, Aarestrup K, Jones PE, Jones J, Garcia de Leaniz C, Tummers JS, Consuegra S, Kemp P, Schwedhelm H, Popek Z, Segura G, Vallesi S, Zalewski M, Wiśniewolski W. Over 200,000 kilometers of free-flowing river habitat in Europe is altered due to impoundments. Nat Commun 2023; 14:6289. [PMID: 37813852 PMCID: PMC10562483 DOI: 10.1038/s41467-023-40922-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/03/2023] [Indexed: 10/11/2023] Open
Abstract
European rivers are disconnected by more than one million man-made barriers that physically limit aquatic species migration and contribute to modification of freshwater habitats. Here, a Conceptual Habitat Alteration Model for Ponding is developed to aid in evaluating the effects of impoundments on fish habitats. Fish communities present in rivers with low human impact and their broad environmental settings enable classification of European rivers into 15 macrohabitat types. These classifications, together with the estimated fish sensitivity to alteration of their habitat are used for assessing the impacts of six main barrier types (dams, weirs, sluices, culverts, fords, and ramps). Our results indicate that over 200,000 km or 10% of previously free-flowing river habitat has been altered due to impoundments. Although they appear less frequently, dams, weirs and sluices cause much more habitat alteration than the other types. Their impact is regionally diverse, which is a function of barrier height, type and density, as well as biogeographical location. This work allows us to foresee what potential environmental gain or loss can be expected with planned barrier management actions in rivers, and to prioritize management actions.
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Affiliation(s)
| | - Kamila Belka
- National Inland Fisheries Research Institute, Olsztyn, Poland.
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland.
| | - Małgorzata Łapińska
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland
- University of Lodz, Łódź, Poland
| | - Karol Ławniczak
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland
- University of Lodz, Łódź, Poland
| | - Paweł Prus
- National Inland Fisheries Research Institute, Olsztyn, Poland
| | | | - Paweł Buras
- National Inland Fisheries Research Institute, Olsztyn, Poland
| | | | - Zbigniew Kaczkowski
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland
- University of Lodz, Łódź, Poland
| | - Kinga Krauze
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland
| | - Joanna O'Keeffe
- National Inland Fisheries Research Institute, Olsztyn, Poland
| | - Katarzyna Suska
- National Inland Fisheries Research Institute, Olsztyn, Poland
| | - Janusz Ligięza
- National Inland Fisheries Research Institute, Olsztyn, Poland
| | - Andreas Melcher
- University of Natural Resources and Life Sciences, Vienna, Austria
| | | | | | | | | | | | | | | | | | - Paul Kemp
- University of Southampton, Southampton, UK
| | | | | | | | | | - Maciej Zalewski
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland
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Shrestha A, Dani M, Kemp P, Fertleman M. Acute Sarcopenia after Elective and Emergency Surgery. Aging Dis 2022; 13:1759-1769. [PMID: 36465176 PMCID: PMC9662269 DOI: 10.14336/ad.2022.0404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/04/2022] [Indexed: 04/12/2024] Open
Abstract
Sarcopenia is an increasingly recognised condition of loss of muscle mass and function. The European Working Group on Sarcopenia in Older People 2 (EWSOP2) updated their definition in 2018, emphasising the importance of low muscle strength in diagnosis. Acute sarcopenia has been arbitrarily defined as sarcopenia lasting less than 6 months. This review highlights the pathophysiology involved in muscle wasting following surgery, focussing on hormonal factors, inflammation, microRNAs, and oxidative stress. Biomarkers such as GDF-15, IGF-1 and various microRNAs may predict post-surgical muscle loss. The impact of existing sarcopenia on various types of surgery and incident muscle wasting following surgery is also described. The gaps in research found include the need for longitudinal studies looking in changes in muscle strength and quantity following surgery. Further work is needed to examine if biomarkers are replicated in other surgery to consolidate existing theories on the pathophysiology of muscle wasting.
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Affiliation(s)
- Alvin Shrestha
- Cutrale Perioperative and Ageing group, Imperial College London, London SW7 2BX, United Kingdom
| | - Melanie Dani
- Cutrale Perioperative and Ageing group, Imperial College London, London SW7 2BX, United Kingdom
| | - Paul Kemp
- National Lung and Health Institute, Imperial College London, London SW7 2BX, United Kingdom
| | - Michael Fertleman
- Cutrale Perioperative and Ageing group, Imperial College London, London SW7 2BX, United Kingdom
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Limbu S, Farjo N, Farjo B, Kemp P, Higgins C. 746 Transcriptomic profiling of frontal and occipital dermal papilla reveals potential role of TRPS1 in androgenic alopecia. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Achison M, Adamson S, Akpan A, Aspray T, Avenell A, Band MM, Bashir T, Burton LA, Cvoro V, Donnan PT, Duncan GW, George J, Gordon AL, Gregson CL, Hapca A, Henderson E, Hume C, Jackson TA, Kemp P, Kerr S, Kilgour A, Lyell V, Masud T, McKenzie A, McKenzie E, Patel H, Pilvinyte K, Roberts HC, Rossios C, Sayer AA, Smith KT, Soiza RL, Steves CJ, Struthers AD, Sumukadas D, Tiwari D, Whitney J, Witham MD. Effect of perindopril or leucine on physical performance in older people with sarcopenia: the LACE randomized controlled trial. J Cachexia Sarcopenia Muscle 2022; 13:858-871. [PMID: 35174663 PMCID: PMC8977979 DOI: 10.1002/jcsm.12934] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 07/16/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This trial aimed to determine the efficacy of leucine and/or perindopril in improving physical function in older people with sarcopenia. METHODS Placebo-controlled, parallel group, double-blind, randomized two-by-two factorial trial. We recruited adults aged ≥ 70 years with sarcopenia, defined as low gait speed (<0.8 m/s on 4 m walk) and/or low handgrip strength (women < 20 kg, men < 30 kg) plus low muscle mass (using sex and body mass index category-specific thresholds derived from normative UK BioBank data) from 14 UK centres. Eligible participants were randomized to perindopril 4 mg or placebo, and to oral leucine powder 2.5 g or placebo thrice daily. The primary outcome was the between-group difference in the short physical performance battery (SPPB) score over 12-month follow-up by repeated-measures mixed models. Results were combined with existing systematic reviews using random-effects meta-analysis to derive summary estimates of treatment efficacy. RESULTS We screened 320 people and randomized 145 participants compared with an original target of 440 participants. For perindopril [n = 73, mean age 79 (SD 6), female sex 39 (53%), mean SPPB 7.1 (SD 2.3)] versus no perindopril [n = 72, mean age 79 (SD 6), female sex 39 (54%), mean SPPB 6.9 (SD 2.4)], median adherence to perindopril was lower (76% vs. 96%; P < 0.001). Perindopril did not improve the primary outcome [adjusted treatment effect -0.1 points (95%CI -1.2 to 1.0), P = 0.89]. No significant treatment benefit was seen for any secondary outcome including muscle mass [adjusted treatment effect -0.4 kg (95%CI -1.1 to 0.3), P = 0.27]. More adverse events occurred in the perindopril group (218 vs. 165), but falls rates were similar. For leucine [n = 72, mean age 78 (SD 6), female sex 38 (53%), mean SPPB 7.0 (SD 2.1)] versus no leucine [n = 72, mean age 79 (SD 6), female sex 40 (55%), mean SPPB 7.0 (SD 2.5)], median adherence was the same in both groups (76% vs. 76%; P = 0.99). Leucine did not improve the primary outcome [adjusted treatment effect 0.1 point (95%CI -1.0 to 1.1), P = 0.90]. No significant treatment benefit was seen for any secondary outcome including muscle mass [adjusted treatment effect -0.3 kg (95%CI -1.0 to 0.4), P = 0.47]. Meta-analysis of angiotensin converting enzyme inhibitor/angiotensin receptor blocker trials showed no clinically important treatment effect for the SPPB [between-group difference -0.1 points (95%CI -0.4 to 0.2)]. CONCLUSIONS Neither perindopril nor leucine improved physical performance or muscle mass in this trial; meta-analysis did not find evidence of efficacy of either ACE inhibitors or leucine as treatments to improve physical performance.
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Affiliation(s)
| | - Marcus Achison
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Simon Adamson
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Asangaedem Akpan
- Clinical Research Network Northwest Coast, University of Liverpool, Liverpool University Hospitals NHS FT Trust, Liverpool, UK
| | - Terry Aspray
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Translational Clinical Research Institute, Newcastle University and Newcastle-upon-Tyne NHS Trust, Newcastle upon Tyne, UK
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Margaret M Band
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Tufail Bashir
- Cardiovascular and Respiratory Interface Section, National Heart and Lung Institute, Imperial College London, South Kensington Campus, London, UK
| | - Louise A Burton
- Medicine for the Elderly, NHS Tayside, Dundee, UK and Ageing and Health, University of Dundee, Dundee, UK
| | - Vera Cvoro
- Victoria Hospital, Kirkcaldy, UK.,Centre for Clinical Brain Sciences University of Edinburgh, Edinburgh, UK
| | - Peter T Donnan
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Gordon W Duncan
- Medicine for the Elderly, NHS Lothian, Edinburgh, UK and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Jacob George
- Department of Clinical Pharmacology, Division of Molecular & Clinical Medicine, University of Dundee Medical School, Ninewells Hospital, Dundee, UK
| | - Adam L Gordon
- Unit of Injury, Inflammation and Recovery, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Department of Medicine for the Elderly, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Celia L Gregson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.,Older Person's Unit, Royal United Hospital NHS Foundation Trust Bath, Bath, UK
| | - Adrian Hapca
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Emily Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Royal United Hospital Bath NHS Foundation Trust, Bath, UK
| | - Cheryl Hume
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Thomas A Jackson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Paul Kemp
- Cardiovascular and Respiratory Interface Section, National Heart and Lung Institute, Imperial College London, South Kensington Campus, London, UK
| | - Simon Kerr
- Department of Older People's Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alixe Kilgour
- Medicine for the Elderly, NHS Lothian, Edinburgh, UK
| | - Veronica Lyell
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Tahir Masud
- Clinical Gerontology Research Unit, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK
| | - Andrew McKenzie
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Emma McKenzie
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Harnish Patel
- NIHR Biomedical Research Centre, University of Southampton and University Hospital Southampton NHSFT, Southampton, UK
| | - Kristina Pilvinyte
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, University of Southampton, Mailpoint 807 Southampton General Hospital, Southampton, UK
| | - Christos Rossios
- Cardiovascular and Respiratory Interface Section, National Heart and Lung Institute, Imperial College London, South Kensington Campus, London, UK
| | - Avan A Sayer
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Translational Clinical Research Institute, Newcastle University and Newcastle-upon-Tyne NHS Trust, Newcastle upon Tyne, UK
| | - Karen T Smith
- Tayside Clinical Trials Unit (TCTU), Tayside Medical Science Centre (TASC), University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Roy L Soiza
- Ageing & Clinical Experimental Research (ACER) Group, University of Aberdeen, Aberdeen, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London & Department of Clinical Gerontology, King's College Hospital, London, UK
| | - Allan D Struthers
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital, Dundee, UK
| | - Deepa Sumukadas
- Department of Medicine for the Elderly, NHS Tayside, Dundee, UK
| | - Divya Tiwari
- Bournemouth University and Royal Bournemouth Hospital, Bournemouth, UK
| | - Julie Whitney
- School of Population Health & Environmental Sciences, King's College London and King's College Hospital, London, UK
| | - Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Translational Clinical Research Institute, Newcastle University and Newcastle-upon-Tyne NHS Trust, Newcastle upon Tyne, UK
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Witham MD, Adamson S, Avenell A, Band MM, Donnan PT, George J, Hapca A, Hume C, Kemp P, McKenzie E, Pilvinyte K, Smith K, Struthers AD, Sumukadas D. 667 EFFECT OF LEUCINE SUPPLEMENTATION ON PHYSICAL PERFORMANCE, MUSCLE MASS AND QUALITY OF LIFE IN OLDER PEOPLE WITH SARCOPENIA. Age Ageing 2022. [DOI: 10.1093/ageing/afac036.667] [Citation(s) in RCA: 1] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Leucine supplementation improves muscle protein synthesis in physiological studies and has been proposed as a treatment to improve muscle mass and physical performance. We tested the effects of leucine supplementation in a randomised controlled trial enrolling patients with sarcopenia.
Methods
We conducted a placebo-controlled, parallel group, double-blind, randomised two-by-two factorial trial. Participants aged 70 and over with low muscle mass by bioimpedance and either low grip strength or low walk speed, were recruited from 14 UK sites. Participants were randomised to receive one year of leucine powder 2.5 g three times a day or matching placebo, plus perindopril 4 mg once daily or matching placebo. The primary outcome was the between-group difference in the Short Physical Performance Battery, measured at baseline, 6 and 12 months, analysed using repeated-measures mixed models. Secondary outcomes included grip strength, quadriceps strength, six-minute walk distance, appendicular muscle mass measured by dual x-ray absorptiometry, quality of life measured using the EQ5D tool, falls rates and adverse events.
Results
We screened 320 people and randomised 145 participants, mean age 79 (SD 6) years; 78 (54%) were women and the mean SPPB was 7.0 (SD 2.4). 72 were randomised to leucine and 73 to placebo. Median adherence was the same in both groups (76% vs 76%; p < 0.001). Leucine had no significant effect on the primary outcome (adjusted treatment effect 0.1 points [95%CI -1.0 to 1.1]). No significant treatment effect was seen for any secondary outcome. There were similar numbers of adverse events in both groups (leucine 187, placebo 196) and falls rates were similar (leucine 1.9 [95%CI 0.9 to 2.9] per year; placebo 2.9 [95%CI 0.8 to 5.0] per year).
Conclusion
Leucine did not improve measures of physical performance, muscle mass or quality of life in older people with sarcopenia.
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Affiliation(s)
- M D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle-upon-Tyne Hospitals Trust
- Molecular and Clinical Medicine, University of Dundee
| | - S Adamson
- Tayside Clinical Trials Unit, University of Dundee
| | - A Avenell
- Health Services Research Unit, University of Aberdeen
| | - M M Band
- Tayside Clinical Trials Unit, University of Dundee
| | - P T Donnan
- Tayside Clinical Trials Unit, University of Dundee
| | - J George
- Molecular and Clinical Medicine, University of Dundee
| | - A Hapca
- Tayside Clinical Trials Unit, University of Dundee
| | - C Hume
- Tayside Clinical Trials Unit, University of Dundee
| | - P Kemp
- Cardiovascular and Respiratory Interface Section, Imperial College London
| | - E McKenzie
- Tayside Clinical Trials Unit, University of Dundee
| | - K Pilvinyte
- Tayside Clinical Trials Unit, University of Dundee
| | - K Smith
- Tayside Clinical Trials Unit, University of Dundee
| | - A D Struthers
- Molecular and Clinical Medicine, University of Dundee
| | - D Sumukadas
- Department of Medicine for the Elderly, NHS Tayside, Dundee
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Witham MD, Adamson S, Avenell A, Band MM, Donnan PT, George J, Hapca A, Hume C, Kemp P, McKenzie E, Pilvinyte K, Smith K, Struthers AD, Sumukadas D. 666 EFFECT OF PERINDOPRIL ON PHYSICAL PERFORMANCE, MUSCLE MASS AND QUALITY OF LIFE IN OLDER PEOPLE WITH SARCOPENIA: RESULTS: FROM THE. Age Ageing 2022. [DOI: 10.1093/ageing/afac036.666] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Angiotensin-converting enzyme inhibitors such as perindopril have been proposed as treatments to improve muscle mass and physical performance but have not been tested in randomised controlled trials enrolling patients with sarcopenia.
Methods
We conducted a placebo-controlled, parallel group, double-blind, randomised two-by-two factorial trial. Participants aged 70 and over with low muscle mass by bioimpedance and either low grip strength or low walk speed, were recruited from 14 UK sites. Participants were randomised to receive one year of perindopril 4 mg once daily or matching placebo, and to receive leucine powder 2.5 g three times a day or matching placebo. The primary outcome was the between-group difference in the Short Physical Performance Battery, measured at baseline, 6 and 12 months, analysed using repeated-measures mixed models. Secondary outcomes included grip strength, quadriceps strength, six-minute walk distance, appendicular muscle mass measured by dual x-ray absorptiometry, quality of life measured using the EQ5D tool, falls rates and adverse events.
Results
We screened 320 people and randomised 145 participants, mean age 79 (SD 6) years; 78 (54%) were women and the mean SPPB was 7.0 (SD 2.4). 73 were randomised to perindopril and 72 to placebo. Median adherence was lower for perindopril (76% vs 96%; p < 0.001). Perindopril had no significant effect on the primary outcome (adjusted treatment effect −0.1 points [95%CI -1.2 to 1.0]). No significant treatment effect was seen for any secondary outcome except for worse EQ5D thermometer scores in the perindopril group (treatment effect −12 points [95%CI -21 to −3]). More adverse events were seen in the perindopril group (218 vs 165) but falls rates were similar (perindopril 2.0 [95%CI 1.1 to 3.0] per year; placebo 2.8 [95%CI 0.6 to 5.1] per year).
Conclusion
Perindopril did not improve measures of physical performance, muscle mass or quality of life in older people with sarcopenia.
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Affiliation(s)
- M D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle-upon-Tyne Hospitals Trust
- Molecular and Clinical Medicine, University of Dundee
| | - S Adamson
- Tayside Clinical Trials Unit, University of Dundee
| | - A Avenell
- Health Services Research Unit, University of Aberdeen
| | - M M Band
- Tayside Clinical Trials Unit, University of Dundee
| | - P T Donnan
- Tayside Clinical Trials Unit, University of Dundee
| | - J George
- Molecular and Clinical Medicine, University of Dundee
| | - A Hapca
- Tayside Clinical Trials Unit, University of Dundee
| | - C Hume
- Tayside Clinical Trials Unit, University of Dundee
| | - P Kemp
- Cardiovascular and Respiratory Interface Section, Imperial College London
| | - E McKenzie
- Tayside Clinical Trials Unit, University of Dundee
| | - K Pilvinyte
- Tayside Clinical Trials Unit, University of Dundee
| | - K Smith
- Tayside Clinical Trials Unit, University of Dundee
| | - A D Struthers
- Molecular and Clinical Medicine, University of Dundee
| | - D Sumukadas
- Department of Medicine for the Elderly, NHS Tayside, Dundee
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Banaderakhshan R, Kemp P, Breul L, Steinbichl P, Hartmann C, Fürhacker M. Bisphenol A and its alternatives in Austrian thermal paper receipts, and the migration from reusable plastic drinking bottles into water and artificial saliva using UHPLC-MS/MS. Chemosphere 2022; 286:131842. [PMID: 34388431 DOI: 10.1016/j.chemosphere.2021.131842] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
Bisphenol A (BPA) a synthetic, high production volume chemical identified as endocrine disruptor and toxic to reproduction is mainly used in the production of polycarbonate plastics, in epoxy resins, polyvinylchloride, thermal papers as color developer, and is present in a wide range of consumer goods such as food packaging materials, storage containers, and cash receipts. Due to its effects on health and legal restrictions, BPA is increasingly replaced by other bisphenols. In this study, BPA and 13 alternatives including BPS, Bisphenol F (BPF), Bisphenol B (BPB), Bisphenol C (BPC), Bisphenol Z (BPZ), Bisphenol M (BPM), Bisphenol P (BPP), Bisphenol AF (BPAF), Bisphenol FL (BPFL), Bisphenol C12 (BPC12), Tetramethylbisphenol A (tmBPA), 4,4-bisphenol (BP-4,4), and p,p-oxybisphenol were analyzed in thermal paper cash receipts (content) and migration studies were carried out in BPA-free labelled reusable plastic drinking bottles using a sensitive UHPLC-MS/MS method. The receipts contained almost only BPA and BPS, whereas BPS was found in all samples ranging at levels up to 38 μg/g. BPA was detected at low concentrations, only in one sample 11,000 μg/g were found, exceeding the EU limit of BPA in thermal paper of 0.02% per weight. In leaching solutions from the drinking bottles BPA, BPS and BPF were found at concentrations up to 0.047 μg/L BPA, 0.043 μg/L BPS, and <0.01 μg/L BPF. No other analogues were detected. However, these levels identified are far below the legal limits. In addition, a theoretical exposure assessment was conducted indicating that exposures were within the current regulatory guidelines.
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Affiliation(s)
- Rojin Banaderakhshan
- Institute of Sanitary Engineering and Water Pollution Control, Department WAU, University of Natural Resources and Life Sciences Vienna, Muthgasse 18, 1190, Vienna, Austria; Environment Agency Austria, Spittelauer Lände 5, 1090, Vienna, Austria
| | - Paul Kemp
- Institute of Sanitary Engineering and Water Pollution Control, Department WAU, University of Natural Resources and Life Sciences Vienna, Muthgasse 18, 1190, Vienna, Austria
| | - Lea Breul
- Environment Agency Austria, Spittelauer Lände 5, 1090, Vienna, Austria
| | | | | | - Maria Fürhacker
- Institute of Sanitary Engineering and Water Pollution Control, Department WAU, University of Natural Resources and Life Sciences Vienna, Muthgasse 18, 1190, Vienna, Austria.
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9
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van der Walt K, Kemp P, Sofkova-Bobcheva S, Burritt D, Nadarajan J. Evaluation of droplet-vitrification, vacuum infiltration vitrification and encapsulation-dehydration for cryopreservation of Syzygium maire zygotic embryos. Cryo Letters 2021; 42:202-209. [PMID: 35363839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Syzygium maire is a threatened tree species with limited information on long-term storage options for its recalcitrant seed. OBJECTIVE To evaluate the cryopreservation of S. maire zygotic embryo axes (EA) using dehydration, encapsulation-dehydration as well as PVS2 vitrification using droplet vitrification (DV) and the novel droplet vacuum infiltration vitrification (DVIV) methods. MATERIALS AND METHODS Excised naked and sodium alginate encapsulated EA were desiccated to various moisture contents (MC) using a laminar flow cabinet. Moisture content, embryo survival and plantlet formation, before and after cryopreservation, were assessed at 1 h intervals during the desiccation period (0-6 h). The influence of PVS2, using DV and DVIV, was assessed for various desiccation times and temperatures. RESULTS Encapsulated EA desiccated to 31% and 37% MC survived but no plantlets formed following cryopreservation. Exposure to PVS2 using the DV method had a negative impact on embryo survival and plantlet formation, while DVIV resulted in improved results for non-cryopreserved EA. However, neither PVS2 vitrification method resulted in embryo survival following cryopreservation. CONCLUSION S. maire embryos are sensitive to desiccation and likely require physical, chemical or a combination of protection methods to increase embryo survival and plantlet formation following cryopreservation.
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Affiliation(s)
- K van der Walt
- Otari Native Botanic Garden and Wilton's Bush Reserve, Wellington City Council, 160 Wilton Road, Wellington; Massey University of New Zealand, Private Bag 11222, Palmerston North, New Zealand.
| | - P Kemp
- Massey University of New Zealand, Private Bag 11222, Palmerston North, New Zealand
| | - S Sofkova-Bobcheva
- Massey University of New Zealand, Private Bag 11222, Palmerston North, New Zealand
| | - D Burritt
- University of Otago, Department of Botany, P.O. Box 56, Dunedin, New Zealand
| | - J Nadarajan
- Massey University of New Zealand, Private Bag 11222, Palmerston North; the New Zealand Institute for Plant and Food Research Limited, Private Bag 11600, Palmerston North, New Zealand
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10
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Limbu S, Farjo N, Farjo B, Kemp P, Higgins C. 584 Transcriptomic analysis to identify protective dermal papilla signature in occipital scalp. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Howard A, Agathos JA, Phelps A, Cowlishaw S, Terhaag S, Arjmand HA, Armstrong R, Berle D, Steel Z, Brewer D, Human B, Herwig A, Wigg C, Kemp P, Wellauer R, O'Donnell ML. Prevalence and treatment implications of ICD-11 complex PTSD in Australian treatment-seeking current and ex-serving military members. Eur J Psychotraumatol 2021; 12:1844441. [PMID: 34025910 PMCID: PMC8128128 DOI: 10.1080/20008198.2020.1844441] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Despite growing support for the distinction between posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as separate diagnoses within the ICD-11 psychiatric taxonomy, the prevalence and treatment implications of CPTSD among current and ex-serving military members have not been established. Objective: The study aims were to a) establish the prevalence of provisional ICD-11 CPTSD diagnosis relative to PTSD in an Australian sample of treatment-seeking current and ex-serving military members, and b) examine the implications of CPTSD diagnosis for intake profile and treatment response. Methods: The study analysed data collected routinely from Australian-accredited treatment programmes for military-related PTSD. Participants were 480 current and ex-serving military members in this programmes who received a provisional ICD-11 diagnosis of PTSD or CPTSD at intake using proxy measures. Measures of PTSD symptoms, disturbances in self-organisation, psychological distress, mental health and social relationships were considered at treatment intake, discharge, and 3-month follow-up. Results: Among participants with a provisional ICD-11 diagnosis, 78.2% were classified as having CPTSD, while 21.8% were classified as having PTSD. When compared to ICD-11 PTSD, participants with CPTSD reported greater symptom severity and psychological distress at intake, and lower scores on relationship and mental health dimensions of the quality of life measure. These relative differences persisted at each post-treatment assessment. Decreases in PTSD symptoms between intake and discharge were similar across PTSD (d RM = -0.81) and CPTSD (d RM = -0.76) groups, and there were no significant post-treatment differences between groups when controlling for initial scores. Conclusions: CPTSD is common among treatment-seeking current and ex-serving military members, and is associated with initially higher levels of psychiatric severity, which persist over time. Participants with CPTSD were equally responsive to PTSD treatment; however, the tendency for those with CPTSD to remain highly symptomatic post-treatment suggests additional treatment components should be considered.
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Affiliation(s)
- Alexandra Howard
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - James A Agathos
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Andrea Phelps
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Sean Cowlishaw
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sonia Terhaag
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Hussein-Abdullah Arjmand
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Renee Armstrong
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - David Berle
- Discipline of Clinical Psychology, University of Technology Sydney, Sydney, Australia
| | - Zachary Steel
- Discipline of Clinical Psychology, University of Technology Sydney, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia.,St John of God Mental Health Services, Richmond Hospital, Sydney, Australia
| | | | | | | | - Christopher Wigg
- Veteran Mental Health Rehabilitation Unit, The Jamie Larcombe Centre, Adelaide, Australia
| | - Paul Kemp
- Veteran Mental Health Rehabilitation Unit, The Jamie Larcombe Centre, Adelaide, Australia
| | | | - Meaghan L O'Donnell
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
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12
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Chock RY, Clucas B, Peterson EK, Blackwell BF, Blumstein DT, Church K, Fernández‐Juricic E, Francescoli G, Greggor AL, Kemp P, Pinho GM, Sanzenbacher PM, Schulte BA, Toni P. Evaluating potential effects of solar power facilities on wildlife from an animal behavior perspective. Conservat Sci and Prac 2020. [DOI: 10.1111/csp2.319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Rachel Y. Chock
- Recovery Ecology San Diego Zoo Institute for Conservation Research Escondido California USA
| | - Barbara Clucas
- Department of Wildlife Humboldt State University Arcata California USA
| | - Elizabeth K. Peterson
- Communities to Build Active STEM Engagement Colorado State University‐Pueblo Pueblo Colorado USA
- Department of Biology Colorado State University‐Pueblo Pueblo Colorado USA
| | - Bradley F. Blackwell
- U.S. Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services National Wildlife Research Center Sandusky Ohio USA
| | - Daniel T. Blumstein
- Department of Ecology and Evolutionary Biology University of California Los Angeles Los Angeles California USA
| | - Kathleen Church
- Great Lakes Institute for Environmental Research University of Windsor Windsor Ontario Canada
| | | | - Gabriel Francescoli
- Sección Etología, Facultad de Ciencias Universidad de la República Montevideo Uruguay
| | - Alison L. Greggor
- Recovery Ecology San Diego Zoo Institute for Conservation Research Escondido California USA
| | - Paul Kemp
- International Centre for Ecohydraulics Research, Faculty of Engineering and Physical Sciences, Department of Civil, Maritime and Environmental Engineering University of Southampton Southampton UK
| | - Gabriela M. Pinho
- Department of Ecology and Evolutionary Biology University of California Los Angeles Los Angeles California USA
| | | | - Bruce A. Schulte
- Department of Biology Western Kentucky University Bowling Green Kentucky USA
| | - Pauline Toni
- Department of Biology Université de Sherbrooke Québec Canada
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13
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Laborde A, Habit E, Link O, Kemp P. Strategic methodology to set priorities for sustainable hydropower development in a biodiversity hotspot. Sci Total Environ 2020; 714:136735. [PMID: 32018960 DOI: 10.1016/j.scitotenv.2020.136735] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/20/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
Massive exploitation of freshwater systems for hydropower generation in developing countries is challenging sustainability due to cumulative environmental impacts in regions with high endemism. Habitat fragmentation is recognized as a major impact on river ecosystems. The nature and magnitude of connectivity loss depend on characteristics of the hydropower projects, and of the threatened fish communities. In areas where appropriate mitigation technology is lacking, there is a need to identify the fish species that are most at risk to better concentrate efforts. This paper aimed to set conservation priorities for sustainable hydropower development by analyzing native fish species and project characteristics. The Chilean ichthyogeographic province, an ecoregion with high endemism and massive hydropower projects development, has been considered as a case study. By using overlapping information on the characteristics of 1124 hydropower projects and distribution of native fish species, we identified three project categories of projects based on their need for mitigation. These were projects where mitigation was considered: a) not required (15%), b) required and feasible (35%), and c) required but challenging (50%). Projects where mitigation was not required were located at sites where native fish were absent and/or where water intakes allowed fish to pass. Interestingly, projects where mitigation was feasible were inhabited by a species assemblage that comprised the genus Trichomycterus, Diplomystes and Percilia, and the species Ch. pisciculus and B. maldonadoi. This finding emphasizes the need to develop a multispecific fishway that can accommodate this group. Projects where mitigation would be difficult to achieve were located at sites with a variety of different assemblages, thus making a standard fish pass solution challenging and site-specific. This study advances understanding for the need to develop mitigation strategies and technologies in ecoregions of high endemism threatened by hydropower and to prioritize the construction of planned projects.
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Affiliation(s)
- A Laborde
- Department of Aquatic System, Faculty of Environmental Sciences, and EULA Centre, Universidad de Concepción, Concepción, Chile.
| | - E Habit
- Department of Aquatic System, Faculty of Environmental Sciences, and EULA Centre, Universidad de Concepción, Concepción, Chile
| | - O Link
- Civil Engineering Department, Universidad de Concepción, Concepción, Chile
| | - P Kemp
- International Centre for Ecohydraulic Research, Faculty of Engineering Physical Sciences, University of Southampton, UK
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14
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Troensegaard Nielsen K, Huss Eriksson A, Funch Carlsen M, Engell K, Jansson J, Petersson K, Røpke M, Kemp P. 387 Ex Vivo Visualization and Extended Drug Release from a Dissolvable Microarray. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Jones J, Börger L, Tummers J, Jones P, Lucas M, Kerr J, Kemp P, Bizzi S, Consuegra S, Marcello L, Vowles A, Belletti B, Verspoor E, Van de Bund W, Gough P, Garcia de Leaniz C. A comprehensive assessment of stream fragmentation in Great Britain. Sci Total Environ 2019; 673:756-762. [PMID: 31003103 DOI: 10.1016/j.scitotenv.2019.04.125] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/01/2019] [Accepted: 04/09/2019] [Indexed: 05/25/2023]
Abstract
Artificial barriers are one of the main threats to river ecosystems, resulting in habitat fragmentation and loss of connectivity. Yet, the abundance and distribution of most artificial barriers, excluding high-head dams, is poorly documented. We provide a comprehensive assessment of the distribution and typology of artificial barriers in Great Britain, and estimate for the first time the extent of river fragmentation. To this end, barrier data were compiled from existing databases and were ground-truthed by field surveys in England, Scotland and Wales to derive a correction factor for barrier density across Great Britain. Field surveys indicate that existing barrier databases underestimate barrier density by 68%, particularly in the case of low-head structures (<1 m) which are often missing from current records. Field-corrected barrier density estimates ranged from 0.48 barriers/km in Scotland to 0.63 barriers/km in Wales, and 0.75 barriers/km in England. Corresponding estimates of stream fragmentation by weirs and dams only, measured as mean barrier-free length, were 12.30 km in Scotland, 6.68 km in Wales and 5.29 km in England, suggesting the extent of river modification differs between regions. Our study indicates that 97% of the river network in Great Britain is fragmented and <1% of the catchments are free of artificial barriers.
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Affiliation(s)
- Joshua Jones
- Department of Biosciences, College of Science, Swansea University, Swansea SA2 8PP, UK.
| | - Luca Börger
- Department of Biosciences, College of Science, Swansea University, Swansea SA2 8PP, UK
| | - Jeroen Tummers
- Department of Biosciences, Durham University, Durham DH1 3LE, UK
| | - Peter Jones
- Department of Biosciences, College of Science, Swansea University, Swansea SA2 8PP, UK
| | - Martyn Lucas
- Department of Biosciences, Durham University, Durham DH1 3LE, UK
| | - Jim Kerr
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Paul Kemp
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Simone Bizzi
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Sofia Consuegra
- Department of Biosciences, College of Science, Swansea University, Swansea SA2 8PP, UK
| | - Lucio Marcello
- Rivers and Lochs Institute, University of Highlands and Islands, Inverness, UK
| | - Andrew Vowles
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Barbara Belletti
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Eric Verspoor
- Rivers and Lochs Institute, University of Highlands and Islands, Inverness, UK
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16
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Bloomer J, Sear D, Kemp P. Does variation in egg structure among five populations of Atlantic salmon ( Salmo salar) influence their survival in low oxygen conditions? R Soc Open Sci 2019; 6:181020. [PMID: 30800355 PMCID: PMC6366189 DOI: 10.1098/rsos.181020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/30/2018] [Indexed: 06/09/2023]
Abstract
Oxygen supply to the salmonid egg surface can be limited by external factors such as sedimentation and groundwater upwelling, while the egg membrane itself can impede diffusion from the egg surface to the embryo. Therefore, the structure of egg membranes could affect the rate at which embryos obtain oxygen from their surroundings. Published field data indicate that oxygen stress experienced by salmonid eggs can vary widely among populations. Therefore, if membrane architecture influences diffusion rate to the embryo, selection for more permeable membranes could occur in oxygen-stressed environments. Using electron microscopy, the membrane structure of eggs obtained from five UK Atlantic salmon (Salmo salar) populations is described. Membrane thickness, porosity and permeability to dissolved oxygen varied among populations. Furthermore, comparison of membranes of eggs that survived laboratory controlled low-oxygen conditions compared to those that died suggested that ova with less permeable membranes were more susceptible to hypoxia-induced mortality. In addition, membrane porosity was lower than previously reported indicating that oxygen requirements during incubation have been underestimated, so models such as the mass transfer theory that predict incubation success could currently overestimate ova survival. Variation in egg membrane structure influences low oxygen tolerance of Atlantic salmon embryos and could represent adaptation to low oxygen stress. Consequently, stock enhancement techniques such as supportive breeding that relieve incubation stress could erode structural adaptations.
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Affiliation(s)
- Jack Bloomer
- Department of Geography and the Environment, University of Southampton, Building 44, University Road, Southampton SO17 1BJ, UK
| | - David Sear
- Department of Geography and the Environment, University of Southampton, Building 44, University Road, Southampton SO17 1BJ, UK
| | - Paul Kemp
- International Centre for Ecohydraulics Research, Faculty of Engineering and the Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK
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17
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Leoni G, Lyness A, Ginty P, Schutte R, Pillai G, Sharma G, Kemp P, Mount N, Sharpe M. Preclinical development of an automated injection device for intradermal delivery of a cell-based therapy. Drug Deliv Transl Res 2018; 7:695-708. [PMID: 28812281 PMCID: PMC5574955 DOI: 10.1007/s13346-017-0418-z] [Citation(s) in RCA: 3] [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] [Indexed: 12/15/2022]
Abstract
Current methods for intradermal delivery of therapeutic products in clinical use include manual injection via the Mantoux technique and the use of injection devices, primarily developed for the delivery of vaccines and small molecules. A novel automated injection device is presented specifically designed for accurate delivery of multiple doses of product through a number of adjustable injection parameters, including injection depth, dose volume and needle insertion speed. The device was originally conceived for the delivery of a cell-based therapy to patients with skin wounds caused by epidermolysis bullosa. A series of preclinical studies was conducted (i) to evaluate the performance of the pre-production model (PreCTCDV01) and optimise the final design, (ii) to confirm that a cell therapy product can be effectively delivered through the injection system and (iii) to test whether the device can be safely and effectively operated by potential end-users. Results from these studies confirmed that the device is able to consistently deliver repeated doses of a liquid to the intradermal layer in an ex vivo skin model. In addition, the device can support delivery of a cell therapy product through a customised microbore tubing without compromising cell viability. Finally, the device was shown to be safe and easy to use as evidenced by usability testing. The clinical device has since been granted European market access and plans for clinical use are currently underway. The device is expected to find use in the emerging area of cell therapies and a broad spectrum of traditional parenteral drug delivery applications.
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Affiliation(s)
- Giulia Leoni
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Alex Lyness
- Centre for Biological Engineering, Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Patrick Ginty
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Rindi Schutte
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Gopalan Pillai
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Gayatri Sharma
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Paul Kemp
- Intercytex Ltd, 5 Vale Road, Stockport, SK6 3LE, UK
| | - Natalie Mount
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Michaela Sharpe
- Cell and Gene Therapy Catapult, 12th Floor Tower Wing, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK.
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18
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Stacey GN, Connon CJ, Coopman K, Dickson AJ, Fuller B, Hunt CJ, Kemp P, Kerby J, Man J, Matejtschuk P, Moore H, Morris J, Oreffo ROC, Slater N, Ward S, Wiggins C, Zimmermann H. Preservation and stability of cell therapy products: recommendations from an expert workshop. Regen Med 2017; 12:553-564. [DOI: 10.2217/rme-2017-0073] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
If the field of regenerative medicine is to deliver therapies, rapid expansion and delivery over considerable distances to large numbers of patients is needed. This will demand efficient stabilization and shipment of cell products. However, cryopreservation science is poorly understood by life-scientists in general and in recent decades only limited progress has been made in the technology of preservation and storage of cells. Rapid translation of new developments to a broader range of cell types will be vital, as will assuring a deeper knowledge of the fundamental cell biology relating to successful preservation and recovery of cell cultures. This report presents expert consensus on these and other issues which need to be addressed for more efficient delivery of cell therapies.
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Affiliation(s)
- Glyn N Stacey
- UK Stem Cell Bank, Division of Advanced Therapies, NIBSC, South Mimms, Hertfordshire, UK
| | - Che J Connon
- Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Karen Coopman
- Chemical Engineering, Loughborough University, Loughborough, UK
| | - Alan J Dickson
- Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Barry Fuller
- Department of Surgery, University College London, London, UK
| | - Charles J Hunt
- UK Stem Cell Bank, Division of Advanced Therapies, NIBSC, South Mimms, Hertfordshire, UK
| | - Paul Kemp
- Intercytex Ltd & HairClone, Manchester, UK
| | - Julie Kerby
- Cell Therapy Manufacturing Development, Pfizer, Cambridge, UK
| | - Jennifer Man
- UK Stem Cell Bank, Division of Advanced Therapies, NIBSC, South Mimms, Hertfordshire, UK
| | - Paul Matejtschuk
- Standardisation Science, National Institute for Biological Standards and Control (NIBSC) a centre of the MHRA, South Mimms, Hertfordshire, UK
| | - Harry Moore
- Department of Biomedical Sciences, University of Sheffield, Sheffield, UK
| | | | - Richard OC Oreffo
- Centre for Human Development, Stem Cells & Regeneration, University of Southampton, Southampton, UK
| | - Nigel Slater
- The Bioscience Engineering Group, University of Cambridge, Cambridge, UK
| | | | - Claire Wiggins
- National Health Service – Blood & Transplant, Watford, UK
| | - Heiko Zimmermann
- Fraunhofer-Institute for Biomedical Engineering, Sulzbach, Germany
- Department of Molecular & Cellular Biotechnology/Nanotechnology, Saarland University, Saarbrücken, Germany
- Department of Marine Sciences, Universidad Católica del Norte, Antafogasta/Coquimbo, Chile
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19
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Garfield BE, Shao D, Parfitt L, Harries C, Price L, Dimopoulos K, Polkey MI, Kemp P, Wort SJ. S108 Low skeletal muscle strength and physical activity are associated with poor outcomes in pulmonary arterial hypertension. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Abstract
The last decade has seen considerable changes in the Regenerative Medicine industry, but unfortunately the hope for numerous treatments that ‘replace or regenerate human cells, tissues or organs to restore or establish normal function’ has not yet emerged. In contrast to this, there have been major advances in the field of cellular immunotherapy though some do not consider these to be Regenerative Medicines. Regulatory changes have in some cases improved the route to a marketing license but they have not been matched by clarification of the complex, national reimbursement processes for cell-based treatments and this has adversely affected a number of leading Regenerative Medicine Companies. The review considers the direction that the industry may go in the future in relation to scientific, manufacturing and clinical strategies which may improve the rate of success of new therapies..
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Affiliation(s)
- Paul Kemp
- HairClone, 70 Quay St, Manchester, M3 3EJ, UK
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21
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McGiven J, Hendry L, Brown D, Gillard K, Katiyar A, Stack J, Perrett L, Rollins M, Hughes S, Ready R, Kemp P, Morris P, Mawhinney I. The Development of an Efficient Test Automation and Sample Tracking System in a High-Throughput Veterinary Laboratory to Improve the Emergency Response to Outbreaks of Highly Infectious Disease in Great Britain. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jala.2006.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Serological surveillance testing for bovine brucellosis, Enzootic Bovine Leukosis, and Warble fly reaches approximately 1.7 million tests every year in the UK. An automated system was developed to improve the quality of data handling for all three surveys. The objectives were to make improvements in efficiency, sample tracking, and test reporting and to develop an epidemiological database. The developed system of bar-coded samples and test plates processed on automated equipment capable of scanning barcodes and transferring information across a computer network met the data objectives. Consolidating and automating the highly repetitive liquid-handling steps met the cost objectives. To reduce the impact of temporary bottlenecks in the system, a philosophy of ‘islands of automation’ was adopted to maximize the throughput. The creation of this system was driven largely by the need to have in place an effective emergency response capability to handle the serological needs of an outbreak of an acute and highly infectious veterinary disease such as Foot and Mouth Disease (FMD) in the UK.
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Affiliation(s)
- J. McGiven
- Veterinary Laboratories Agency, Surrey, UK
| | - L. Hendry
- Veterinary Laboratories Agency, Surrey, UK
| | - D. Brown
- Veterinary Laboratories Agency, Surrey, UK
| | - K. Gillard
- Veterinary Laboratories Agency, Surrey, UK
| | - A. Katiyar
- Veterinary Laboratories Agency, Surrey, UK
| | - J. Stack
- Veterinary Laboratories Agency, Surrey, UK
| | - L. Perrett
- Veterinary Laboratories Agency, Surrey, UK
| | - M. Rollins
- Hamilton Robotics, Hamilton Great Britain Ltd., UK
| | - S. Hughes
- Hamilton Robotics, Hamilton Great Britain Ltd., UK
| | - R. Ready
- Veterinary Laboratories Agency, Surrey, UK
| | - P. Kemp
- Veterinary Laboratories Agency, Surrey, UK
| | - P. Morris
- Veterinary Laboratories Agency, Surrey, UK
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22
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Kemp P. The best of the best: a review of select pediatric ophthalmology and strabismus case reports published in 2015. Digit J Ophthalmol 2016; 22:72-74. [DOI: 10.5693/djo.01.2016.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Garfield B, Shao D, Crosby A, Yang P, Morrell N, Polkey M, Kemp P, Wort SJ. P268 The role of growth and differentiation factor 15 in smooth muscle cell proliferation in pulmonary hypertension. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Garfield B, Parfitt L, Harries C, Dimopoulos K, Gatzoulis M, Kemp P, Polkey M, Wort S. S144 Quality Of Life In Idiopathic Pulmonary Arterial Hypertension Is Associated With Quadriceps Function And Size. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bloch S, Lee J, Syburrah T, Rosendahl U, Kemp P, Griffiths M, Polkey M. S140 Gdf-15 Down-regulation Of Muscle Microrna Drives Increased Sensitivity To Tgf- Signalling; A Novel Mechanism In Intensive Care Unit Acquired Weakness. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.146] [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: 11/03/2022]
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Bloch S, Syburrah T, Rosendahl U, Kemp P, Griffiths M, Polkey M. S139 A Paradoxical Rise In Rectus Femoris Myostatin (gdf-8) And Gdf-15 In Response To Neuromuscular Electrical Stimulation In Critical Care. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Outram SV, Gordon AR, Hager-Theodorides AL, Metcalfe J, Crompton T, Kemp P. KLF13 influences multiple stages of both B and T cell development. Cell Cycle 2014; 7:2047-55. [DOI: 10.4161/cc.7.13.6234] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Schnell C, Iarova P, Brooks S, Kidd E, Ford W, Ricardi D, Kemp P, Busse M. C10 Description Of The Breathing Phenotype In Two Mouse Models For Huntington's Disease. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sanders P, Straccia M, Joy S, Comella Bolla A, Bombau G, Svendsen C, Kemp P, Allen N, Canals J. B39 The Effect Of Huntingtin Gene Cag Repeat Expansion On Human Induced Pluripotent Stem Cell Neuronal Differentiation. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bayon Y, Vertès AA, Ronfard V, Egloff M, Snykers S, Salinas GF, Thomas R, Girling A, Lilford R, Clermont G, Kemp P. Translating cell-based regenerative medicines from research to successful products: challenges and solutions. Tissue Eng Part B Rev 2014; 20:246-56. [PMID: 24754565 DOI: 10.1089/ten.teb.2013.0727] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Tissue Engineering & Regenerative Medicine International Society-Europe (TERMIS-EU) Industry Committee as well as its TERMIS-Americas (AM) counterpart intend to address the specific challenges and needs facing the industry in translating academic research into commercial products. Over the last 3 years, the TERMIS-EU Industry Committee has worked with commercial bodies to deliver programs that encourage academics to liaise with industry in proactive collaborations. The TERMIS-EU 2013 Industry Symposium aimed to build on this commercial agenda by focusing on two topics: Operations Management (How to move a process into the good manufacturing practice [GMP] environment) and Clinical Translation (Moving a GMP process into robust trials). These topics were introduced by providing the synergistic business perspective of partnering between the multiple regenerative medicine stakeholders, throughout the life cycle of product development. Seven industry leaders were invited to share their experience, expertise, and strategies. Due to the complex nature of regenerative medicine products, partnering for their successful commercial development seems inevitable to overcome all obstacles by sharing experiences and expertise of all stakeholders. When ideally implemented, the "innovation quotient" of a virtual team resulting from the combination of internal and external project teams can be maximized through maximizing the three main dimensions: core competences, technology portfolio, and alliance management.
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Affiliation(s)
- Yves Bayon
- 1 Covidien-Sofradim Production , Trévoux, France
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Schnorbusch K, Brouns I, Lembrechts R, Pintelon I, Kemp P, Timmermans J, Adriaensen D. Neuroepithelial bodies as airway hypoxia sensors: re‐evaluation of the concept in different mouse live cell imaging models (869.6). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.869.6] [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)
| | | | | | | | - Paul Kemp
- Cardiff University CardiffUnited Kingdom
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Abstract
Those working in the regenerative medicine field currently face numerous regulatory and related challenges. This Perspective captures some of the key ideas of a UK-based working group drawn from academic, clinical and industrial communities and also identifies some key steps that should be taken in the UK and elsewhere to address these challenges.
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Affiliation(s)
- Robin R Ali
- UCL Institute of Ophthalmology, Bath St, London EC1V 9EL, UK
| | - Anthony P Hollander
- University of Bristol, School of Cellular & Molecular Medicine, Medical Sciences Building, University of Bristol, University Walk, Clifton, Bristol BS8 1TD, UK
| | - Paul Kemp
- Intercytex, Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, UK
| | | | - Martin R Wilkins
- Experimental Medicine, Imperial College London, Du Cane Road, London W12 0NN, UK
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Haji G, Wiegman C, Patel M, Kemp P, Adcock I, Chung F, Polkey M. P189 Mitochondrial dysfunction in muscle and airway compartments in COPD: preliminary findings:. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mohan D, Lewis A, Patel MS, Curtis K, Tanner R, Kemp P, Polkey MI. S53 Studying fibre specific gene expression in COPD using laser capture micro-dissection in human skeletal muscle. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Petrof G, Martinez-Queipo M, Mellerio J, Kemp P, McGrath J. Fibroblast cell therapy enhances initial healing in recessive dystrophic epidermolysis bullosa wounds: results of a randomized, vehicle-controlled trial. Br J Dermatol 2013; 169:1025-33. [DOI: 10.1111/bjd.12599] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2013] [Indexed: 01/22/2023]
Affiliation(s)
- G. Petrof
- St John's Institute of Dermatology; King's College London (Guy's Campus); London SE1 9RT U.K
| | - M. Martinez-Queipo
- St John's Institute of Dermatology; King's College London (Guy's Campus); London SE1 9RT U.K
| | - J.E. Mellerio
- St John's Institute of Dermatology; King's College London (Guy's Campus); London SE1 9RT U.K
| | - P. Kemp
- Intercytex Ltd; Core Technology Facility; 46 Grafton Street Manchester M13 9NT U.K
| | - J.A. McGrath
- St John's Institute of Dermatology; King's College London (Guy's Campus); London SE1 9RT U.K
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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, Stanley K, Morrissey D, Parsons S, Kuttikat A, Shenker N, Garrood T, Medley S, Ferguson AM, Keeling D, Duffort P, Irving K, Goulston L, Culliford D, Coakley P, Taylor P, Hart D, Spector T, Hakim A, Arden N, Mian A, Garrood T, Magan T, Chaudhary M, Lazic S, Sofat N, Thomas MJ, Moore A, Roddy E, Peat G, Rees F, Lanyon P, Jordan N, Chaib A, Sangle S, Tungekar F, Sabharwal T, Abbs I, Khamashta M, D'Cruz D, Dzifa Dey I, Isenberg DA, Chin CW, Cheung C, Ng M, Gao F, Qiong Huang F, Thao Le T, Yong Fong K, San Tan R, Yin Wong T, Julian T, Parker B, Al-Husain A, Yvonne Alexander M, Bruce I, Jordan N, Abbs I, D'cruz D, McDonald G, Miguel L, Hall C, Isenberg DA, Magee A, Butters T, Jury E, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Lazarus MN, Isenberg DA, Ehrenstein M, Carter LM, Isenberg DA, Ehrenstein MR, Chanchlani N, Gayed M, Yee CS, Gordon C, Ball E, Rooney M, Bell A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Sutton EJ, Watson KD, Isenberg D, Rahman A, Gordon C, Yee CS, Lanyon P, Jayne D, Akil M, D'Cruz D, Khamashta M, Lutalo P, Erb N, Prabu A, Edwards CJ, Youssef H, McHugh N, Vital E, Amft N, Griffiths B, Teh LS, Zoma A, Bruce I, Durrani M, Jordan N, Sangle S, D'Cruz D, Pericleous C, Ruiz-Limon P, Romay-Penabad Z, Carrera-Marin A, Garza-Garcia A, Murfitt L, Driscoll PC, Giles IP, Ioannou Y, Rahman A, Pierangeli SS, Ripoll VM, Lambrianides A, Heywood WE, Ioannou J, Giles IP, Rahman A, Stevens C, Dures E, Morris M, Knowles S, Hewlett S, Marshall R, Reddy V, Croca S, Gerona D, De La Torre Ortega I, Isenberg DA, Leandro M, Cambridge G, Reddy V, Cambridge G, Isenberg DA, Glennie M, Cragg M, Leandro M, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Artim Esen B, Pericleous C, MacKie I, Ioannou Y, Rahman A, Isenberg DA, Giles I, Skeoch S, Haque S, Pemberton P, Bruce I. BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nobili F, Naseri M, De Carli F, Asenbaum S, Booij J, Darcourt J, Ell P, Kapucu Ö, Kemp P, Svarer C, Morbelli S, Pagani M, Sabri O, Tatsch K, Tossici-Bolt L, Sera T, Borght TV, Van Laere K, Varrone A. Erratum to: Automatic semi-quantification of [123I]FP-CIT SPECT scans in healthy volunteers using BasGan version 2: results from the ENC-DAT database. Eur J Nucl Med Mol Imaging 2013. [DOI: 10.1007/s00259-013-2337-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Söderlund TA, Dickson JC, Prvulovich E, Ben-Haim S, Kemp P, Booij J, Nobili F, Thomsen G, Sabri O, Koulibaly PM, Akdemir OU, Pagani M, van Laere K, Asenbaum-Nan S, George J, Sera T, Tatsch K, Bomanji J. Value of Semiquantitative Analysis for Clinical Reporting of 123I-2-β-Carbomethoxy-3β-(4-Iodophenyl)-N-(3-Fluoropropyl)Nortropane SPECT Studies. J Nucl Med 2013; 54:714-22. [DOI: 10.2967/jnumed.112.110106] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Fleming JS, Tossici-Bolt L, Guy M, Kemp P. Comment on Mertens et al.: standardized added metabolic activity (SAM): a partial volume independent marker of total lesion glycolysis in liver metastases. Eur J Nucl Med Mol Imaging 2013; 40:788-9. [DOI: 10.1007/s00259-013-2364-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 02/03/2013] [Indexed: 01/17/2023]
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Shore A, Emes RD, Wessely F, Kemp P, Cillo C, D'Armiento M, Hoggard N, Lomax MA. A comparative approach to understanding tissue-specific expression of uncoupling protein 1 expression in adipose tissue. Front Genet 2013; 3:304. [PMID: 23293654 PMCID: PMC3535714 DOI: 10.3389/fgene.2012.00304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 12/10/2012] [Indexed: 01/04/2023] Open
Abstract
The thermoregulatory function of brown adipose tissue (BAT) is due to the tissue-specific expression of uncoupling protein 1 (UCP1) which is thought to have evolved in early mammals. We report that a CpG island close to the UCP1 transcription start site is highly conserved in all 29 vertebrates examined apart from the mouse and xenopus. Using methylation sensitive restriction digest and bisulfite mapping we show that the CpG island in both the bovine and human is largely un-methylated and is not related to differences in UCP1 expression between white and BAT. Tissue-specific expression of UCP1 has been proposed to be regulated by a conserved 5′ distal enhancer which has been reported to be absent in marsupials. We demonstrate that the enhancer, is also absent in five eutherians as well as marsupials, monotremes, amphibians, and fish, is present in pigs despite UCP1 having become a pseudogene, and that absence of the enhancer element does not relate to BAT-specific UCP1 expression. We identify an additional putative 5′ regulatory unit which is conserved in 14 eutherian species but absent in other eutherians and vertebrates, but again unrelated to UCP1 expression. We conclude that despite clear evidence of conservation of regulatory elements in the UCP1 5′ untranslated region, this does not appear to be related to species or tissues-specific expression of UCP1.
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Affiliation(s)
- Andrew Shore
- School of Biosciences, Cardiff University Cardiff, UK
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Kouimtsidis C, John-Smith S, Kemp P, Ikkos G. Evidence based mental healthcare and service innovation: review of concepts and challenges. Psychiatriki 2013; 24:45-54. [PMID: 23603268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Health provision systems in the developed western nations are currently facing major financial challenges. In order to meet these challenges, a number of new approaches used to assist the provision of health have been introduced, including the practice of health professionals. These approaches utilize specific methods of data capture and summarization such as: evidence based medicine (EBM) and practice guidelines. Evidence is generated from systematic clinical research as well as reported clinical experience and individually case based empirical evidence. All types of research though (quantitative or qualitative) have limitations. Similarly all types of evidence have advantages and disadvantages and can be complimentary to each other. Evidencebased individual decision (EBID) making is the commonest evidence-based medicine as practiced by the individual clinician in making decisions about the care of the individual patient. It involves integrating individual clinical expertise with the best available external clinical evidence from systematic research. However this sort of evidence-based medicine, focuses excessively on the individual (potentially at the expense of others) in a system with limited budgets. Evidence-based guidelines (EBG) also support the practice of evidence-based medicine but at the organizational or institutional level. The main aim is to identify which interventions, over a range of patients, work best and which is cost-effective in order to guide service development and provision at a strategic level. Doing this effectively is a scientific and statistical skill in itself and the quality of guidelines is based primarily on the quality research evidence. It is important to note that lack of systematic evidence to support an intervention does not automatically mean that an intervention must instantly be abandoned. It is also important that guidelines are understood for what they are, i.e. not rules, or complete statements of knowledge. EBM will never have enough suitable evidence for all and every aspects of health provision in every locality. Innovation signifies a substantial positive change compared to gradual or incremental changes. Innovation using inductive reasoning has to play a major role within health care system and it is applicable to all three level of service provision: clinical practice, policy and organisation structure. The aim of this paper is to examine critically the above concepts and their complimentary role in supporting provision of health care systems which are suitable for the requirements of the population, affordable, deliverable, flexible and adaptable to social changes.
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Nobili F, Naseri M, De Carli F, Asenbaum S, Booij J, Darcourt J, Ell P, Kapucu Ö, Kemp P, Varer C, Morbelli S, Pagani M, Sabri O, Tatsch K, Tossici-Bolt L, Sera T, Borght TV, Van Laere K, Varrone A. Automatic semi-quantification of [123I]FP-CIT SPECT scans in healthy volunteers using BasGan version 2: results from the ENC-DAT database. Eur J Nucl Med Mol Imaging 2012; 40:565-73. [DOI: 10.1007/s00259-012-2304-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 11/09/2012] [Indexed: 11/27/2022]
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Morgan S, Kemp P, Booij J, Costa DC, Padayachee S, Lee L, Barber C, Carter J, Walker Z. Differentiation of frontotemporal dementia from dementia with Lewy bodies using FP-CIT SPECT. J Neurol Neurosurg Psychiatry 2012; 83:1063-70. [PMID: 22869921 DOI: 10.1136/jnnp-2012-302577] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There is increasing evidence that imaging with [123I]FP-CIT SPECT is helpful in differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) but it is not known how well the scan performs in differentiating DLB from frontotemporal dementia (FTD). METHOD We compared the striatal dopamine transporter (DAT) binding in FTD (n=12), DLB (n=10) and AD (n=9) by visually rating the caudate and putamen on [123I]FP-CIT SPECT scans. RESULTS The majority (9/10) of DLB cases had an abnormal scan and a significant reduction of uptake of DAT binding in the putamen and the caudate. A third (4/12) of the FTD cases also had an abnormal scan and a significant reduction in uptake in the putamen and the caudate. In contrast, only one out of nine AD cases had an abnormal scan. Significant differences were found when comparisons were made between the groups for visual analysis of the entire scan (p=0.001) and the four regions of interest (p=0.001 - 0.013). In contrast to the AD group (specificity of scan 89%), the specificity of [123I]FP-CIT SPECT scans was reduced in the FTD group to 67%. Three quarters of the study population had at least one extrapyramidal motor sign (EPMS), with bradykinesia being the most common EPMS in both FTD (83%) and DLB (70%). CONCLUSIONS This study highlights to clinicians that a positive (abnormal) [123I]FP-CIT SPECT scan, even in a patient with an EPMS, does not exclude the diagnosis of FTD and emphasises the importance of a comprehensive clinical evaluation and a detailed cognitive assessment.
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Affiliation(s)
- Shirlony Morgan
- Older People and Healthy Aging Directorate, Central and North West London NHS Foundation Trust, Bently House, 15-21 Headstone Drive, Middlesex, London, HA3 5QX, UK.
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Jackson AS, Shrikrishna D, Kelly JL, Hart N, Moxham J, Polkey MI, Kemp P, Hopkinson NS. Vitamin D and skeletal muscle strength and endurance in COPD. Eur Respir J 2012; 41:309-16. [DOI: 10.1183/09031936.00043112] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Riddoch-Contreras J, George T, Natanek SA, Marsh GS, Hopkinson NS, Tal-Singer R, Kemp P, Polkey MI. p38 Mitogen-activated Protein Kinase is Not Activated in the Quadriceps of Patients with Stable Chronic Obstructive Pulmonary Disease. COPD 2012; 9:142-50. [DOI: 10.3109/15412555.2011.644359] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Donaldson AVJ, Lewis A, Natanek A, Man WD, Kemp P, Polkey MI. S49 Increased skeletal muscle-specific microRNA-1 in the blood of COPD patients. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cummings JL, Henchcliffe C, Schaier S, Simuni T, Waxman A, Kemp P. The role of dopaminergic imaging in patients with symptoms of dopaminergic system neurodegeneration. Brain 2011; 134:3146-66. [PMID: 21810889 DOI: 10.1093/brain/awr177] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diagnosis of neurological and psychiatric conditions associated with disturbances of dopaminergic functioning can be challenging, especially in the early stages, and may be assisted with biomarkers such as dopamine system imaging. Distinguishing between Alzheimer's disease and dementia with Lewy bodies is a major diagnostic challenge. Clinical diagnosis of Parkinson's disease is straightforward with classic presentation, but accurate distinction among Parkinsonian variants may be difficult; non-Parkinson's disease conditions are commonly misdiagnosed as Parkinson's disease, and ~20% of patients with Parkinson's disease are not clinically diagnosed despite coming to medical attention. Early and accurate diagnosis is desirable to improve management. Imaging of the dopamine transporter using single-photon emission computed tomography may be of particular utility in this regard. Abnormal imaging indicates underlying nigrostriatal neurodegeneration, supportive of a diagnosis of Parkinson's disease, atypical parkinsonism or dementia with Lewy bodies, and identifies patient groups in whom dopaminergic therapy may be beneficial. Normal imaging supports diagnosis of a condition not involving nigrostriatal neurodegeneration such as Alzheimer's disease, essential tremor or drug-induced parkinsonism and hence a different therapeutic approach. In patients in whom there was diagnostic uncertainty between degenerative parkinsonism and non-degenerative tremor disorders, baseline imaging with the dopamine transporter ligand [(123)I]ioflupane (DaTscan™) has shown 78% sensitivity and 97% specificity with reference to clinical diagnosis at 3 years, versus 93% and 46%, respectively, for baseline clinical diagnosis. In a Phase III trial of [(123)I]ioflupane in patients with initial clinical diagnosis of probable or possible dementia with Lewy bodies or non-Lewy body dementia, mean specificity for excluding non-Lewy body dementia (predominantly Alzheimer's disease) was 90.4%. Using clinical diagnosis as a reference against which to assess sensitivity and specificity of dopamine transporter imaging is a limitation, but definitive diagnosis via pathological confirmation is generally not feasible. In a series of patients with post-mortem brain examination, imaging using [(123)I]ioflupane has demonstrated higher sensitivity (88%) and specificity (100%) for differentiating dementia with Lewy bodies from non-Lewy body dementia than clinical diagnosis (75% and 42%, respectively). Dopaminergic system imaging may be particularly valuable in patients with clinically inconclusive parkinsonism or a clinical diagnosis of possible dementia with Lewy bodies; it is not helpful in differentiating between Parkinson's disease and atypical parkinsonism, although postsynaptic dopaminergic imaging may be of utility. Other potential uses of dopamine transporter imaging include identification of patients with premotor Parkinson's disease, monitoring disease progression in testing novel therapeutics, and as an inclusion criterion for entry into clinical trials.
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Abstract
Pacific lampreys are capable of climbing vertical wetted surfaces through a two-phase (bending and stretching) locomotion mode using the oral disc for adherence. We investigate the physical mechanism and performance of this process by using a continuous beam model. Two mechanisms, one akin to the jumping process and the other related to the fast stretching of the body, have been identified. This locomotion mode may inspire biomimetic designs of anguilliform swimming devices capable of overcoming steep obstacles. By using a genetic algorithm simulation we identify the combination of kinematic parameters corresponding to optimal efficiency (defined as the gravitational potential energy gained in each climbing step divided by the energy spent to activate the motion). These parameters are similar to laboratory observations of lamprey motion, suggesting that this type of locomotion has been optimized for maximum efficiency through evolution.
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Affiliation(s)
- Q Zhu
- Department of Structural Engineering, University of California, San Diego, La Jolla, USA.
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Abstract
The periwinkle Littorina littorea exhibits morphological variation among southern New England populations that appear to be genetically continuous. In dense populations, individuals have relatively elongate shells in comparison to individuals in sparse populations, which have rounder, globose shells. We experimentally demonstrate that this shell variation is a function of snail growth rate. Rapidly growing snails develop thin, globose shells that accommodate more body mass than thicker, more elongate shells. The implications of these results are discussed in relation to interpreting morphological variation in extant gastropods and in the molluscan fossil record.
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Affiliation(s)
- P Kemp
- Section of Population Biology and Genetics, Brown University, Providence, RI 02912
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