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Harris R, Lowers V, Best A, Burnside G, Clarkson JE, Hulme C. Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: a feasibility randomised controlled trial. BMC Oral Health 2024; 24:195. [PMID: 38321444 PMCID: PMC10848507 DOI: 10.1186/s12903-024-03942-2] [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: 03/13/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Urgent dental care may be the only place where many people, especially vulnerable groups, access care. This presents an opportunity for delivery of a behavioural intervention promoting planned dental visiting, which may help address one of the factors contributing to a socio-economic gradient in oral health. Although we know that cueing events such as having a cancer diagnosis may create a 'teachable moment' stimulating positive changes in health behaviour, we do not know whether delivering an opportunistic intervention in urgent dental care is feasible and acceptable to patients. METHODS The feasibility study aimed to recruit 60 patients in a Dental Hospital and dental practices delivering urgent care within and outside working hours. Follow-up was by telephone, e mail and post over 4 months. RESULTS Although the recruitment window was shortened because of COVID-19, of 47 patients assessed for eligibility, 28 were enrolled (70.1% of screened patients provided consent). A relatively high proportion were from disadvantaged backgrounds (46.4%, 13/28 receiving State benefits). Retention was 82.1% (23/28), which was also the rate of completion of the Oral Health Impact Profile co-primary outcome. The other primary outcome involved linking participant details at recruitment, with centrally-held data on services provided, with 84.6% (22/26) records partly or fully successfully matched. All intervention participants received at least some of the intervention, although we identified aspects of dental nurse training which would improve intervention fidelity. CONCLUSIONS Despite recruitment being impacted by the pandemic, when the majority of clinical trials experienced reduced rates of recruitment, we found a high recruitment and consenting rate, even though patients were approached opportunistically to be enrolled in the trial and potentially receive an intervention. Retention rates were also high even though a relatively high proportion had a low socio-economic background. Therefore, even though patients may be in pain, and had not anticipated involvement before their urgent care visit, the study indicated that this was a feasible and acceptable setting in which to position an opportunistic intervention. This has the potential to harness the potential of the 'teachable moment' in people's lives, and provide support to help address health inequalities. TRIAL REGISTRATION ISRCTN 10,853,330 07/10/2019.
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Affiliation(s)
- Rebecca Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Whelan Building, Liverpool, L69 3GL, UK.
| | - V Lowers
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Whelan Building, Liverpool, L69 3GL, UK
| | - A Best
- Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
| | - G Burnside
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - J E Clarkson
- Division of Oral Health Sciences, School of Dentistry, University of Dundee, Dundee, UK
| | - C Hulme
- Health Economics Group, Department of Health & Community Science, University of Exeter Medical School, Exeter, UK
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Keitany GJ, Rubin BER, Garrett ME, Musa A, Tracy J, Liang Y, Ebert P, Moore AJ, Guan J, Eggers E, Lescano N, Brown R, Carbo A, Al-Asadi H, Ching T, Day A, Harris R, Linkem C, Popov D, Wilkins C, Li L, Wang J, Liu C, Chen L, Dines JN, Atyeo C, Alter G, Baldo L, Sherwood A, Howie B, Klinger M, Yusko E, Robins HS, Benzeno S, Gilbert AE. Multimodal, broadly neutralizing antibodies against SARS-CoV-2 identified by high-throughput native pairing of BCRs from bulk B cells. Cell Chem Biol 2023; 30:1377-1389.e8. [PMID: 37586370 PMCID: PMC10659930 DOI: 10.1016/j.chembiol.2023.07.011] [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: 09/20/2022] [Revised: 04/25/2023] [Accepted: 07/23/2023] [Indexed: 08/18/2023]
Abstract
TruAB Discovery is an approach that integrates cellular immunology, high-throughput immunosequencing, bioinformatics, and computational biology in order to discover naturally occurring human antibodies for prophylactic or therapeutic use. We adapted our previously described pairSEQ technology to pair B cell receptor heavy and light chains of SARS-CoV-2 spike protein-binding antibodies derived from enriched antigen-specific memory B cells and bulk antibody-secreting cells. We identified approximately 60,000 productive, in-frame, paired antibody sequences, from which 2,093 antibodies were selected for functional evaluation based on abundance, isotype and patterns of somatic hypermutation. The exceptionally diverse antibodies included RBD-binders with broad neutralizing activity against SARS-CoV-2 variants, and S2-binders with broad specificity against betacoronaviruses and the ability to block membrane fusion. A subset of these RBD- and S2-binding antibodies demonstrated robust protection against challenge in hamster and mouse models. This high-throughput approach can accelerate discovery of diverse, multifunctional antibodies against any target of interest.
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Affiliation(s)
| | | | | | - Andrea Musa
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | - Jeff Tracy
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | - Yu Liang
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | - Peter Ebert
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | | | - Erica Eggers
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | - Ryan Brown
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | - Adria Carbo
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | | | - Austin Day
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | | | | | | | - Lianqu Li
- GenScript ProBio Biotech, Nanjing, Jiangsu Province, China
| | - Jiao Wang
- GenScript ProBio Biotech, Nanjing, Jiangsu Province, China
| | - Chuanxin Liu
- GenScript ProBio Biotech, Nanjing, Jiangsu Province, China
| | - Li Chen
- GenScript ProBio Biotech, Nanjing, Jiangsu Province, China
| | | | - Caroline Atyeo
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
| | - Lance Baldo
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | - Bryan Howie
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | - Mark Klinger
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | - Erik Yusko
- Adaptive Biotechnologies, Seattle, WA 98109, USA
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Morrow A, Speechly C, Young AL, Tucker K, Harris R, Poplawski N, Andrews L, Nguyen Dumont T, Kirk J, Southey MC, Willis A. "Out of the blue": A qualitative study exploring the experiences of women and next of kin receiving unexpected results from BRA-STRAP research gene panel testing. J Genet Couns 2023. [PMID: 37864663 DOI: 10.1002/jgc4.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023]
Abstract
In the genomic era, the availability of gene panel and whole genome/exome sequencing is rapidly increasing. Opportunities for providing former patients with new genetic information are also increasing over time and recontacting former patients with new information is likely to become more common. Breast cancer Refined Analysis of Sequence Tests-Risk And Penetrance (BRA-STRAP) is an Australian study of individuals who had previously undertaken BRCA1 and BRCA2 genetic testing, with no pathogenic variants detected. Using a waiver of consent, stored DNA samples were retested using a breast/ovarian cancer gene panel and clinically significant results returned to the patient (or next of kin, if deceased). This qualitative study aimed to explore patient experiences, opinions, and expectations of recontacting in the Australian hereditary cancer setting. Participants were familial cancer clinic patients (or next of kin) who were notified of a new pathogenic variant identified via BRA-STRAP. In-depth, semi-structured interviews were conducted approximately 6 weeks post-result. Interviews were transcribed verbatim and analyzed using an inductive thematic approach. Thirty participants (all female; average age = 57; range 36-84) were interviewed. Twenty-five were probands, and five were next of kin. Most women reported initial shock upon being recontacted with unexpected news, after having obtained a sense of closure related to their initial genetic testing experiences and cancer diagnosis. For most, this initial distress was short-lived, followed by a process of readjustment, meaning-making and adaptation that was facilitated by perceived clinical and personal utility of the information. Women were overall satisfied with the waiver of consent approach and recontacting process. Results are in line with previous studies suggesting that patients have positive attitudes about recontacting. Women in this study valued new genetic information gained from retesting and were satisfied with the BRA-STRAP recontact model. Practice implications to facilitate readjustment and promote psychosocial adaptation were identified.
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Affiliation(s)
- April Morrow
- Implementation to Impact (i2i), School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Catherine Speechly
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Alison Luk Young
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kathy Tucker
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
- UNSW Prince of Wales Clinical School, Randwick, New South Wales, Australia
| | - Rebecca Harris
- Westmead Hospital Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead, New South Wales, Australia
| | - Nicola Poplawski
- Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Lesley Andrews
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tu Nguyen Dumont
- Department of Clinical Pathology, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Judy Kirk
- Westmead Hospital Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead, New South Wales, Australia
| | - Melissa C Southey
- Department of Clinical Pathology, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Amanda Willis
- Clinical Translation and Engagement Platform, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Rancilhac L, Enbody ED, Harris R, Saitoh T, Irestedt M, Liu Y, Lei F, Andersson L, Alström P. Introgression underlies phylogenetic uncertainty but not parallel plumage evolution in a recent songbird radiation. Syst Biol 2023:syad062. [PMID: 37801684 DOI: 10.1093/sysbio/syad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Indexed: 10/08/2023] Open
Abstract
Instances of parallel phenotypic evolution offer great opportunities to understand the evolutionary processes underlying phenotypic changes. However, confirming parallel phenotypic evolution and studying its causes requires a robust phylogenetic framework. One such example is the "black-and-white wagtails", a group of five species in the songbird genus Motacilla: one species, Motacilla alba, shows wide intra-specific plumage variation, while the four others form two pairs of very similar-looking species (M. aguimp + M. samveasnae and M. grandis + M. maderaspatensis, respectively). However, the two species in each of these pairs were not recovered as sisters in previous phylogenetic inferences. Their relationships varied depending on the markers used, suggesting that gene tree heterogeneity might have hampered accurate phylogenetic inference. Here, we use whole genome resequencing data to explore the phylogenetic relationships within this group, with a special emphasis on characterizing the extent of gene tree heterogeneity and its underlying causes. We first used multispecies coalescent methods to generate a "complete evidence" phylogenetic hypothesis based on genome-wide variants, while accounting for incomplete lineage sorting (ILS) and introgression. We then investigated the variation in phylogenetic signal across the genome, to quantify the extent of discordance across genomic regions, and test its underlying causes. We found that wagtail genomes are mosaics of regions supporting variable genealogies, because of ILS and inter-specific introgression. The most common topology across the genome, supporting M. alba and M. aguimp as sister species, appears to be influenced by ancient introgression. Additionally, we inferred another ancient introgression event, between M. alba and M. grandis. By combining results from multiple analyses, we propose a phylogenetic network for the black-and-white wagtails that confirms that similar phenotypes evolved in non-sister lineages, supporting parallel plumage evolution. Furthermore, the inferred reticulations do not connect species with similar plumage coloration, suggesting that introgression does not underlie parallel plumage evolution in this group. Our results demonstrate the importance of investigation of genome-wide patterns of gene tree heterogeneity to help understanding the mechanisms underlying phenotypic evolution.
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Affiliation(s)
- Loïs Rancilhac
- Animal Ecology, Department of Ecology and Genetics, Evolutionary Biology Centre, Uppsala University, Norbyvägen 18 D, 752 36 Uppsala, Sweden
| | - Erik D Enbody
- Department of Medical Biochemistry and Microbiology, Uppsala University, 751 23 Uppsala, Sweden
- Biomolecular Engineering, University of California, Santa Cruz, California, USA
| | | | - Takema Saitoh
- Yamashina Institute for Ornithology, 115 Konoyama, Abiko, Chiba 270-1145, Japan
| | - Martin Irestedt
- Department of Bioinformatics and Genetics, Swedish Museum of Natural History, P.O. Box 50007, 104 05 Stockholm, Sweden
| | - Yang Liu
- State Key Laboratory of Biocontrol, School of Ecology, Sun Yat-sen University, Shenzhen 518107, China
| | - Fumin Lei
- Key Laboratory of Zoological Systematics and Evolution, Institute of Zoology, Chinese Academy of Sciences, 100101 Beijing, China
| | - Leif Andersson
- Department of Medical Biochemistry and Microbiology, Uppsala University, 751 23 Uppsala, Sweden
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX 77843, USA
| | - Per Alström
- Animal Ecology, Department of Ecology and Genetics, Evolutionary Biology Centre, Uppsala University, Norbyvägen 18 D, 752 36 Uppsala, Sweden
- Key Laboratory of Zoological Systematics and Evolution, Institute of Zoology, Chinese Academy of Sciences, 100101 Beijing, China
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Patel MB, Spikes H, Bailey RS, Connell T, Gill H, Gokel MR, Harris R, Meisel JW, Negin S, Yin SA, Gokel GW. Antimicrobial and Adjuvant Potencies of Di- n-alkyl Substituted Diazalariat Ethers. Antibiotics (Basel) 2023; 12:1513. [PMID: 37887214 PMCID: PMC10603992 DOI: 10.3390/antibiotics12101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
Lariat ethers are macrocyclic polyethers-crown ethers-to which sidearms are appended. 4,13-Diaza-18-crown-6 having twin alkyl chains at the nitrogens show biological activity. They exhibit antibiotic activity, but when co-administered at with an FDA-approved antibiotic, the latter's potency is often strongly enhanced. Potency enhancements and resistance reversals have been documented in vitro for a range of Gram-negative and Gram-positive bacteria with a variety of antimicrobials. Strains of E. coli and Staphylococcus aureus having resistance to a range of drugs have been studied and the potency enhancements (checkerboards) are reported here. Drugs included in the present study are ampicillin, cefepime, chlortetracycline, ciprofloxacin, doxycycline, kanamycin, minocycline, norfloxacin, oxycycline, penicillin G, and tetracycline. Enhancements of norfloxacin potency against S. aureus 1199B of up to 128-fold were observed. The properties of these lariat ethers have been studied to determine solubility, their membrane penetration, cytotoxicity and mammalian cell survival, and their effect on bacterial efflux pumps. It is shown that in some cases, the lariat ethers have complex antimicrobials with considerable selectivity. Based on these observations, including 1:1 complexation between lariat ethers and antimicrobials and the cytotoxicity of the MeI salts showing a separation index of 32-fold, they hold significant potential for further development.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - George W. Gokel
- Department of Chemistry and Biochemistry, University of Missouri-St. Louis, St. Louis, MO 63121, USA
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Tavabie OD, Abbott J, Abeysekera KWM, Balachandrakumar VK, Bennett K, Brennan P, Buchanan R, Dhaliwal A, Galanakis V, Hardy T, Harris R, Kronsten VT, Leighton J, Li W, Yin JL, Macken L, Marjot T, Maurice JB, McDowell H, Navaratnam J, Pohl K, Nayagam JS, Saunsbury E, Scott J, Sheth A, Sinharay R, Sheiybani G, Subhani M, Tavabie OD, Turner L, White H, Zakeri N, Balachandrakumar VK, Cook C, Hardy T, Harris R, Navaratnam J, Saunsbury E, Tavabie OD, Abbas N, Abbasi A, Abdul R, Abdulaziz M, Abduljabbar D, Abeysekera KWM, Adamson R, Adebayo D, Adhikarla AK, Adler M, Ahmad S, Ahmed S, Afifi M, Akram A, Al Radhi B, Al-Talib I, Alele J, Ali AM, Almusai S, Appleby V, Asmat H, Astbury S, Atkinson A, Badrulhisham F, Balachandrakumar VK, Ball A, Banfa M, Barn J, Begum S, Belfield K, Bendall O, Bhandari R, Bhatti P, Bradley M, Brennan P, Brown E, Bryce K, Burke L, Campbell R, Cargill T, Carroll G, Cartledge J, Chatterjee D, Chaundry R, Choudhry Z, Clare K, Cobbold J, Coburn R, Corvan F, Cox R, Craig D, Creamer J, Curran C, De Silva S, Dean L, Dillon J, Dunn R, Eckersley R, Eike G, Elagib A, Elkholi A, Elshaarawy O, Faloon S, Fan F, Fazili M, Fernandes D, Fox J, Foxton M, Gaba W, Gaikwad G, Gairola A, Galanakis V, Gallaher C, Gautam N, Germain L, Giles B, Gill C, Glover B, Glover J, Gomez D, Gomez M, Gordon V, Gormley S, Goulder J, Goyal S, Greenham O, Guthrie S, Hackett R, Haddadin Y, Hadjinicolaou A, Hall J, Haque T, Hardy T, Harris R, Hart C, Hasnain Nadir SM, Hassall J, Hasan S, Hawker-Bond G, Hawkyard J, Healey S, Hornby C, Hamza M, Humayun M, Hutchison J, Iftikhar Z, Ismail A, James J, Jopson L, Juthani D, Kaina P, Karim A, Karim SM, Kashyap V, Kassab M, Katarey D, Kenny L, Kerry G, Khan A, Khan A, Khan A, Khan MT, Khan T, Khatib A, Khattak MF, King JJ, Korani M, Kotha S, Kooner E, Lam WL, Lateef M, Leith D, Li W, Liaros A, Lourenco F, Lyles A, Mahenthiran M, Magee C, Maggs D, Mahalingam A, Mahmood R, Mandour MO, Manocha N, Mansour D, Marks D, Marjot T, Martin C, Martin H, Martin I, Martin K, Maruthan S, Masin R, Mason D, Matthews C, Mavrou A, Maxan E, Maxfield D, McAvoy E, McColl K, McCaughan H, McCorry R, McGoran J, McDonald S, McDowell H, McIlwane S, Meakin O, Mebarek L, Merrill H, Michail S, Modarres P, Mohamedali A, Mohammed Y, Mohammed Z, Mohan J, Monnier C, Moran E, Morrison G, Moroni F, Msaddi A, Mutar S, Navaratnam J, Neto-Pereira L, Nahed I, Ng J, Nwoguh C, O’Kane R, Omar S, Ososanya A, Parambil JV, Patel J, Pericleous M, Pervais Z, Phoolchund A, Pietrzycki J, Pillay L, Prabhu K, Putri YRF, Qazi U, Rafique KK, Raman K, Ranade V, Rastelli F, Ratcliffe E, Rattehalli D, Raza T, Razak A, Raghuraman A, Read G, Robins A, Rushbrook S, Salama M, St. Aimee L, Saravan R, Sarkar S, Saunsbury E, Serna S, Shahzad H, Shamsaldeen M, Sharip M, Shearer J, Sheikh A, Sheiybani G, Sheth A, Sherwin M, Shintre N, Singhal S, Sinha R, Sinharay R, Smith G, Smith R, Spicer J, Spoor J, Sreenivasan S, Srinivasa A, Srivastava A, Stagg G, Stanley J, Stevenson J, Stokes D, Stroud R, Subhani M, Suliman H, Sultana M, Summers N, Sutherland C, Swann R, Sykes L, Taha M, Tan KE, Tariq Z, Ming Tay JJ, Taylor A, Thakor A, Tsang J, Tyler Z, Unitt E, Volcek E, Wischhusen J, Watson I, Watters C, Wells G, Widlak M, Williams M, Woodland H, Wren L, Xyda S, Yeh J, Young A, Jie Yuan JS, Abbott J, Abeysekera KWM, Galanakis V, Li W, Sheth A, Sinharay R, Sheiybani G, Tavabie OD, Abbott J, Abeysekera KWM, Galanakis V, Li W, Sheth A, Sinharay R, Sheiybani G, Tavabie OD, Abeysekera KWM, Brennan P, Li W, Marjot T, Tavabie OD, Aithal G, Bernal W, Dillon J, Hogan B, McPherson S, Jones R, Rowe I, Snowdon V. Defining characteristics and outcomes for patients with non-alcoholic fatty liver disease admitted to hospital with decompensated cirrhosis. J Hepatol 2023; 79:e165-e167. [PMID: 37315808 DOI: 10.1016/j.jhep.2023.05.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/16/2023]
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Hilton C, Morris A, Burnside G, Harris R, Aggarwal VR, Procter S, Griffiths R, French P, Laverty L, Lobban F, Berry K, Shiers D, Golby R, Fazekas F, Valemis K, Perry A, Newens C, Kerry E, Mupinga P, Gkioni E, Lodge C, Dawber A, Elliott E, Lunat F, Palmier-Claus J. A two-arm, randomised feasibility trial using link workers to improve dental visiting in people with severe mental illness: a protocol paper. Pilot Feasibility Stud 2023; 9:157. [PMID: 37684682 PMCID: PMC10485965 DOI: 10.1186/s40814-023-01383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND People with severe mental illness (e.g. psychosis, bipolar disorder) experience poor oral health compared to the general population as shown by more decayed, missing and filled teeth and a higher prevalence of periodontal disease. Attending dental services allows treatment of oral health problems and support for prevention. However, people with severe mental illness face multiple barriers to attending routine dental appointments and often struggle to access care. Link work interventions use non-clinical support staff to afford vulnerable populations the capacity, opportunity, and motivation to navigate use of services. The authors have co-developed with service users a link work intervention for supporting people with severe mental illness to access routine dental appointments. The Mouth Matters in Mental Health Study aims to explore the feasibility and acceptability of this intervention within the context of a feasibility randomised controlled trial (RCT) measuring outcomes related to the recruitment of participants, completion of assessments, and adherence to the intervention. The trial will closely monitor the safety of the intervention and trial procedures. METHODS A feasibility RCT with 1:1 allocation to two arms: treatment as usual (control) or treatment as usual plus a link work intervention (treatment). The intervention consists of six sessions with a link worker over 9 months. Participants will be adults with severe mental illness receiving clinical input from secondary care mental health service and who have not attended a planned dental appointment in the past 3 years. Assessments will take place at baseline and after 9 months. The target recruitment total is 84 participants from across three NHS Trusts. A subset of participants and key stakeholders will complete qualitative interviews to explore the acceptability of the intervention and trial procedures. DISCUSSION The link work intervention aims to improve dental access and reduce oral health inequalities in people with severe mental illness. There is a dearth of research relating to interventions that attempt to improve oral health outcomes in people with mental illness and the collected feasibility data will offer insights into this important area. TRIAL REGISTRATION The trial was preregistered on ISRCTN (ISRCTN13650779) and ClinicalTrials.gov (NCT05545228).
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Affiliation(s)
- Claire Hilton
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Abigail Morris
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Girvan Burnside
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Rebecca Harris
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | | | - Sarah Procter
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Robert Griffiths
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Paul French
- Manchester Metropolitan University, Manchester, UK
- Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Louise Laverty
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK
| | - Fiona Lobban
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Katherine Berry
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - David Shiers
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Rebecca Golby
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Fanni Fazekas
- Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Kyriakos Valemis
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Antonia Perry
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Connie Newens
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Eirian Kerry
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Efstathia Gkioni
- Institute of Population Health, University of Liverpool, Liverpool, UK
- Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
| | - Christopher Lodge
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK
| | - Alison Dawber
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Emma Elliott
- School of Dentistry, University of Leeds, Leeds, UK
| | - Farah Lunat
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK
| | - Jasper Palmier-Claus
- The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
- Lancashire & South Cumbria NHS Foundation Trust, Lancashire, UK.
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Davis RA, Ganguly T, Harris R, Hausner SH, Kovacs L, Sutcliffe JL. Synthesis and Evaluation of a Monomethyl Auristatin E─Integrin α vβ 6 Binding Peptide-Drug Conjugate for Tumor Targeted Drug Delivery. J Med Chem 2023; 66:9842-9852. [PMID: 37417540 PMCID: PMC10388305 DOI: 10.1021/acs.jmedchem.3c00631] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Indexed: 07/08/2023]
Abstract
Many anticancer drugs exhibit high systemic off-target toxicities causing severe side effects. Peptide-drug conjugates (PDCs) that target tumor-specific receptors such as integrin αvβ6 are emerging as powerful tools to overcome these challenges. The development of an integrin αvβ6-selective PDC was achieved by combining the therapeutic efficacy of the cytotoxic drug monomethyl auristatin E with the selectivity of the αvβ6-binding peptide (αvβ6-BP) and with the ability of positron emission tomography (PET) imaging by copper-64. The [64Cu]PDC-1 was produced efficiently and in high purity. The PDC exhibited high human serum stability, integrin αvβ6-selective internalization, cell binding, and cytotoxicity. Integrin αvβ6-selective tumor accumulation of the [64Cu]PDC-1 was visualized with PET-imaging and corroborated by biodistribution, and [64Cu]PDC-1 showed promising in vivo pharmacokinetics. The [natCu]PDC-1 treatment resulted in prolonged survival of mice bearing αvβ6 (+) tumors (median survival: 77 days, vs αvβ6 (-) tumor group 49 days, and all other control groups 37 days).
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Affiliation(s)
- Ryan A. Davis
- Department
of Biomedical Engineering, University of
California, Davis, One
Shields Avenue, Davis, California 95616, United States
| | - Tanushree Ganguly
- Department
of Biomedical Engineering, University of
California, Davis, One
Shields Avenue, Davis, California 95616, United States
| | - Rebecca Harris
- Department
of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, 4150 V Street, Sacramento, California 95817, United States
| | - Sven H. Hausner
- Department
of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, 4150 V Street, Sacramento, California 95817, United States
| | - Luciana Kovacs
- Department
of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, 4150 V Street, Sacramento, California 95817, United States
| | - Julie L. Sutcliffe
- Department
of Biomedical Engineering, University of
California, Davis, One
Shields Avenue, Davis, California 95616, United States
- Department
of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, 4150 V Street, Sacramento, California 95817, United States
- Center
for Molecular and Genomic Imaging, University
of California, Davis, 451 Health Sciences Drive, Davis, California 95616, United States
- Radiochemistry
Research and Training Facility, University
of California, Davis, 2921 Stockton Blvd., Suite 1760, Sacramento, California 95817, United States
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O Connor R, Landes D, Harris R. Trends and inequalities in realised access to NHS primary care dental services in England before, during and throughout recovery from the COVID-19 pandemic. Br Dent J 2023:10.1038/s41415-023-6032-1. [PMID: 37438477 DOI: 10.1038/s41415-023-6032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/14/2023] [Accepted: 03/03/2023] [Indexed: 07/14/2023]
Abstract
Introduction The COVID-19 pandemic triggered unprecedented disruption to NHS dental services in England. This work describes changes in realised access to NHS primary care dental services between 2019 and 2022, with a particular focus on geographic and deprivation-based inequalities.Methods Data from the NHS Business Services Authority and Office for National Statistics were combined to calculate the proportion of resident populations utilising NHS primary care dental services. These data were compared over multiple six-monthly time periods between 2019 and 2022, across several levels of geography and by quintiles of area-level deprivation.Results The proportion of the England population utilising services fell substantially after the start of the COVID-19 pandemic, recovering to 75-80% of pre-pandemic levels in the first half of 2022. Substantial geographic variation was observed in the pre-pandemic time points and re-emerged as the recovery period progressed. Deprivation-based inequalities in service use were persistently present, although these were consistently greater in child than adult populations. While inequalities for children increased in the initial post-pandemic period, this pattern returned almost to pre-pandemic levels by 2022.Conclusions Socioeconomic inequalities and geographic variations in the use of NHS primary care dental services, seen before the COVID-19 pandemic, have re-emerged afterwards.
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Affiliation(s)
- Rhiannon O Connor
- Speciality Trainee in Dental Public Health, NHS England North East and Yorkshire, United Kingdom.
| | - David Landes
- Consultant in Dental Public Health, NHS England North East and Yorkshire, United Kingdom
| | - Rebecca Harris
- Professor of Dental Public Health, Institute of Population Health, University of Liverpool, United Kingdom
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Tavabie OD, Abeysekera KWM, Brennan PN, Marjot T, Kronsten VT, Li W, Nayagam JS, Dhaliwal A, Hardy T, Maurice JB, Zakeri N, Abbas N, Abbasi A, Abbott J, Abdul R, Abdulaziz M, Abduljabbar D, Adamson R, Adebayo D, Adhikarla AK, Adler M, Afifi M, Ahmad S, Ahmed S, Aithal G, Akram A, Al Radhi B, Al-Talib I, Alele J, Ali AM, Almusai S, Appleby V, Asmat H, Astbury S, Atkinson A, Badrulhisham F, Balachandrakumar VK, Ball A, Banfa M, Barn J, Begum S, Belfield K, Bendall O, Bennett K, Bernal W, Bhandari R, Bhatti P, Bradley M, Brown E, Bryce K, Buchanan R, Burke L, Campbell R, Cargill T, Carroll G, Cartledge J, Chatterjee D, Chaundry R, Choudhry Z, Clare K, Cobbold J, Coburn R, Cook C, Corvan F, Cox R, Craig D, Creamer J, Curran C, De Silva S, Dean L, Dillon J, Dillon J, Dunn R, Eckersley R, Eike G, Elagib A, Elkholi A, Elshaarawy O, Faloon S, Fan F, Fazili M, Fernandes D, Fox J, Foxton M, Gaba W, Gaikwad G, Gairola A, Galanakis V, Gallaher C, Gautam N, Germain L, Giles B, Gill C, Glover B, Glover J, Gomez D, Gomez M, Gordon V, Gormley S, Goulder J, Goyal S, Greenham O, Guthrie S, Hackett R, Haddadin Y, Hadjinicolaou A, Hall J, Hamza M, Haque T, Harris R, Hart C, Hasan S, Hasnain Nadir SM, Hassall J, Hawker-Bond G, Hawkyard J, Healey S, Hogan B, Hornby C, Humayun MD, Hutchison J, Iftikhar Z, Ismail A, James J, Jones R, Jopson L, Juthani D, Kaina P, Karim A, Karim SM, Kashyap V, Kassab M, Katarey D, Kenny L, Kerry G, Khan A, Khan A, Khan A, Khan MT, Khan T, Khatib A, Khattak MF, King JJ, Kooner E, Korani M, Kotha S, Lam WL, Lateef M, Leighton J, Leith D, Liaros A, Liu Yin J, Lourenco F, Lyles A, Macken L, Magee C, Maggs D, Mahalingam A, Mahenthiran M, Mahmood R, Mandour MO, Manocha N, Mansour D, Marks D, Martin C, Martin H, Martin I, Martin K, Maruthan S, Masin R, Mason D, Matthews C, Mavrou A, Maxan E, Maxfield D, McAvoy E, McCaughan H, McColl K, McCorry R, McDonald S, McDowell H, McGoran J, McIlwane S, McPherson S, Meakin O, Mebarek L, Merrill H, Michail S, Modarres P, Mohamedali A, Mohammed Y, Mohammed Z, Mohan J, Monnier C, Moran E, Moroni F, Morrison G, Msaddi A, Mutar S, Nahed I, Navaratnam J, Neto-Pereira L, Ng J, Nwoguh C, O'Kane R, Omar S, Ososanya A, Parambil JV, Patel J, Pericleous M, Pervais Z, Phoolchund A, Pietrzycki J, Pillay L, Pohl K, Prabhu K, Putri YRF, Qazi U, Rafique KK, Raghuraman A, Raman K, Ranade V, Rastelli F, Ratcliffe E, Rattehalli D, Raza T, Razak A, Read G, Robins A, Rowe I, Rushbrook S, Salama M, Saravan R, Sarkar S, Saunsbury E, Scott J, Serna S, Shahzad H, Shamsaldeen M, Sharip M, Shearer J, Sheikh A, Sheiybani G, Sherwin M, Sheth A, Shintre N, Singhal S, Sinha R, Sinharay R, Smith G, Smith R, Snowdon V, Spicer J, Spoor J, Sreenivasan S, Srinivasa A, Srivastava A, St. Aimee L, Stagg G, Stanley J, Stevenson J, Stokes D, Stroud R, Subhani M, Suliman H, Sultana M, Summers N, Sutherland C, Swann R, Sykes L, Taha M, Tan KE, Tariq Z, Tay JJM, Taylor A, Thakor A, Tsang J, Turner L, Tyler Z, Unitt E, Volcek E, Watson I, Watters C, Wells G, White H, Widlak M, Williams M, Wischhusen J, Woodland H, Wren L, Xyda S, Yeh J, Young A, Yuan JSJ. Regional variation in characteristics of patients with decompensated cirrhosis admitted to hospitals in the UK. Lancet Gastroenterol Hepatol 2023; 8:604-606. [PMID: 37148900 DOI: 10.1016/s2468-1253(23)00114-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/08/2023]
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Harris R, Karimi M. Dissecting the regulatory network of transcription factors in T cell phenotype/functioning during GVHD and GVT. Front Immunol 2023; 14:1194984. [PMID: 37441063 PMCID: PMC10333690 DOI: 10.3389/fimmu.2023.1194984] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
Transcription factors play a major role in regulation and orchestration of immune responses. The immunological context of the response can alter the regulatory networks required for proper functioning. While these networks have been well-studied in canonical immune contexts like infection, the transcription factor landscape during alloactivation remains unclear. This review addresses how transcription factors contribute to the functioning of mature alloactivated T cells. This review will also examine how these factors form a regulatory network to control alloresponses, with a focus specifically on those factors expressed by and controlling activity of T cells of the various subsets involved in graft-versus-host disease (GVHD) and graft-versus-tumor (GVT) responses.
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Affiliation(s)
- Rebecca Harris
- Department of Microbiology and Immunology, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
| | - Mobin Karimi
- Department of Microbiology and Immunology, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
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12
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Yang M, Lopez LN, Brewer M, Delgado R, Menshikh A, Clouthier K, Zhu Y, Vanichapol T, Yang H, Harris R, Gewin L, Brooks C, Davidson A, de Caestecker MP. Inhibition of Retinoic Acid Signaling in Proximal Tubular Epithelial cells Protects against Acute Kidney Injury by Enhancing Kim-1-dependent Efferocytosis. bioRxiv 2023:2023.06.15.545113. [PMID: 37398101 PMCID: PMC10312711 DOI: 10.1101/2023.06.15.545113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Retinoic acid receptor (RAR) signaling is essential for mammalian kidney development, but in the adult kidney is restricted to occasional collecting duct epithelial cells. We now show there is widespread reactivation of RAR signaling in proximal tubular epithelial cells (PTECs) in human sepsis-associated acute kidney injury (AKI), and in mouse models of AKI. Genetic inhibition of RAR signaling in PTECs protects against experimental AKI but is associated with increased expression of the PTEC injury marker, Kim-1. However, Kim-1 is also expressed by de-differentiated, proliferating PTECs, and protects against injury by increasing apoptotic cell clearance, or efferocytosis. We show that the protective effect of inhibiting PTEC RAR signaling is mediated by increased Kim-1 dependent efferocytosis, and that this is associated with de-differentiation, proliferation, and metabolic reprogramming of PTECs. These data demonstrate a novel functional role that reactivation of RAR signaling plays in regulating PTEC differentiation and function in human and experimental AKI. Graphical abstract
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Nielsen MJ, Dolman GE, Harris R, Frederiksen P, Chalmers J, Grove JI, Irving WL, Karsdal MA, Patel K, Leeming DJ, Guha IN. PRO-C3 is a predictor of clinical outcomes in distinct cohorts of patients with advanced liver disease. JHEP Rep 2023; 5:100743. [PMID: 37284140 PMCID: PMC10240276 DOI: 10.1016/j.jhepr.2023.100743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/24/2023] [Accepted: 03/15/2023] [Indexed: 06/08/2023] Open
Abstract
Background & Aims Fibroblast activity is a key feature of fibrosis progression and organ function loss, leading to liver-related complications and mortality. The fibrogenesis marker, PRO-C3, has been shown to have prognostic significance in relation to fibrosis progression and as a treatment efficacy marker. We investigated whether PRO-C3 was prognostic for clinical outcome and mortality in two distinct cohorts of compensated cirrhosis. Methods Cohort 1 was a rapid fibrosis progression cohort including 104 patients with HCV and biopsy-proven Ishak fibrosis stage ≥3 without prior clinical events. Cohort 2 was a prospective cohort including 172 patients with compensated cirrhosis of mixed aetiology. Patients were assessed for clinical outcomes. PRO-C3 was assessed in serum at baseline in cohorts 1 and 2, and compared with model for end-stage liver disease and albumin-bilirubin (ALBI) scores. Results In cohort 1, a 2-fold increase in PRO-C3 was associated with 2.7-fold increased hazard of liver-related events (95% CI 1.6-4.6), whereas a one unit increase in ALBI score was associated with a 6.5-fold increased hazard (95% CI 2.9-14.6). In cohort 2, a 2-fold increase in PRO-C3 was associated with a 2.7-fold increased hazard (95% CI 1.8-3.9), whereas a one unit increase in ALBI score was associated with a 6.3-fold increased hazard (95% CI 3.0-13.2). A multivariable Cox regression analysis identified PRO-C3 and ALBI as being independently associated with the hazard of liver-related outcomes. Conclusions PRO-C3 and ALBI were independent prognostic factors for predicting liver-related clinical outcomes. Understanding the dynamic range of PRO-C3 might enhance its use for both drug development and clinical practice. Impact and Implications We tested novel proteins of liver scarring (PRO-C3) in two groups of liver patients with advanced disease to see if they could predict clinical events. We found that this marker and an established test called ALBI were both independently associated with future liver-related clinical outcomes.
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Affiliation(s)
| | - Grace E. Dolman
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Rebecca Harris
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | | | - Jane Chalmers
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Jane I. Grove
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - William L. Irving
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | | | - Keyur Patel
- Division of Gastroenterology and Hepatology, University of Toronto Health Network, Toronto, ON, Canada
| | | | - Indra Neil Guha
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
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Alenezi YM, Harris R, Morling J, Card T. Prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) in Saudi Arabia: Systematic Review and Meta-analysis. Cureus 2023; 15:e40308. [PMID: 37448425 PMCID: PMC10337700 DOI: 10.7759/cureus.40308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Liver disease is fast emerging as a global health priority. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries, with an increasing prevalence associated with the rising prevalence of diabetes mellitus and obesity. The worldwide prevalence of NAFLD may be in the order of 25%, but in the Middle East, it may be even higher. This study aimed to estimate the prevalence of NAFLD in the Kingdom of Saudi Arabia (KSA). A systematic review and meta-analysis were undertaken. Electronic searches were carried out through Medline, EMBASE, CINAHL, Web of Science, and Google Scholar, for articles from inception to April 2020. Studies conducted on adult populations in any setting reporting NAFLD prevalence were included. Pooled proportions and associated 95% confidence intervals (CIs) were presented in forest plots using a random effect model. Eight studies, including 4045 participants, were included. The pooled prevalence of NAFLD among all adult populations in KSA was 16.8% (11.1%-22.5%). Amongst those with type 2 diabetes, the prevalence was 58.0% (45.0%-70.9%). There were no true general population studies of the prevalence of NAFLD in KSA available. This review suggests that NAFLD is common in the KSA, and that type 2 diabetes is a risk factor in KSA as identified elsewhere in the world.
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Affiliation(s)
- Yusef M Alenezi
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- Family and Community Medicine, College of Medicine, Northern Borders University, Arar, SAU
| | - Rebecca Harris
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
| | - Joanne Morling
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
| | - Tim Card
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
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Mathur MR, Nagrath D, Mishra VK, Harris R, Saeed SS, Selvaraj S, Mehta A, Farooqui HH. Antibiotic prescriptions for oral diseases in India: evidence from national prescription data. BMC Oral Health 2023; 23:170. [PMID: 36966284 PMCID: PMC10039494 DOI: 10.1186/s12903-023-02889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 03/15/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION The key objective of this research was to describe the prescription rate of various antibiotics for dental problems in India and to study the relevance of the prescriptions by analysing antibiotic types associated with different dental diagnoses, using a large-scale nationally representative dataset. METHODS We used a 12-month period (May 2015 to April 2016) medical audit dataset from IQVIA (formerly IMS Health). We coded the dental diagnosis provided in the medical audit data to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) and the prescribed antibiotics for the diagnosis to the Anatomic Therapeutic Chemical (ATC) -2020 classification of the World Health Organization. The primary outcome measure was the medicine prescription rate per 1,000 persons per year (PRPY1000). RESULTS Our main findings were-403 prescriptions per 1,000 persons per year in the year 2015 -2016 for all dental ailments. Across all ATC level 1 classification, 'Diseases of hard tissues' made up the majority of the prescriptions. 'Beta-lactam', 'Penicillin,' and 'Cephalosporins' were the most commonly prescribed antibiotics for dental diagnoses followed by 'Macrolides' and 'Quinolones'. 'Dental caries', 'Discoloration of tooth', and 'Toothache' were the most common reasons for 'Beta-Lactams' and 'Penicillin' prescriptions. CONCLUSION To conclude our study reports first ever country (India) level estimates of antibiotic prescription by antibiotic classes, age groups, and ICD-11 classification for dental ailments.
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Affiliation(s)
- Manu Raj Mathur
- Queen Mary University of London, Mile End Rd, Bethnal Green, London, E1 4NS, England.
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India.
| | - Deepti Nagrath
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
| | - Vijay Kumar Mishra
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
| | | | | | - Sakthivel Selvaraj
- Health Economics, Financing and Policy, Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
| | - Aashna Mehta
- Public Health Foundation of India, Plot No. 47 Sector 44, Institutional Area, Gurgaon, 122002, Haryana, India
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Harris R, Mammadli M, Hiner S, Suo L, Yang Q, Sen JM, Karimi M. TCF-1 regulates NKG2D expression on CD8 T cells during anti-tumor responses. Cancer Immunol Immunother 2022; 72:1581-1601. [PMID: 36562825 DOI: 10.1007/s00262-022-03323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/01/2022] [Indexed: 12/24/2022]
Abstract
Cancer immunotherapy relies on improving T cell effector functions against malignancies, but despite the identification of several key transcription factors (TFs), the biological functions of these TFs are not entirely understood. We developed and utilized a novel, clinically relevant murine model to dissect the functional properties of crucial T cell transcription factors during anti-tumor responses. Our data showed that the loss of TCF-1 in CD8 T cells also leads to loss of key stimulatory molecules such as CD28. Our data showed that TCF-1 suppresses surface NKG2D expression on naïve and activated CD8 T cells via key transcriptional factors Eomes and T-bet. Using both in vitro and in vivo models, we uncovered how TCF-1 regulates critical molecules responsible for peripheral CD8 T cell effector functions. Finally, our unique genetic and molecular approaches suggested that TCF-1 also differentially regulates essential kinases. These kinases, including LCK, LAT, ITK, PLC-γ1, P65, ERKI/II, and JAK/STATs, are required for peripheral CD8 T cell persistent function during alloimmunity. Overall, our molecular and bioinformatics data demonstrate the mechanism by which TCF-1 modulated several critical aspects of T cell function during CD8 T cell response to cancer. Summary Figure: TCF-1 is required for persistent function of CD8 T cells but dispensable for anti-tumor response. Here, we have utilized a novel mouse model that lacks TCF-1 specifically on CD8 T cells for an allogeneic transplant model. We uncovered a molecular mechanism of how TCF-1 regulates key signaling pathways at both transcriptomic and protein levels. These key molecules included LCK, LAT, ITK, PLC-γ1, p65, ERK I/II, and JAK/STAT signaling. Next, we showed that the lack of TCF-1 impacted phenotype, proinflammatory cytokine production, chemokine expression, and T cell activation. We provided clinical evidence for how these changes impact GVHD target organs (skin, small intestine, and liver). Finally, we provided evidence that TCF-1 regulates NKG2D expression on mouse naïve and activated CD8 T cells. We have shown that CD8 T cells from TCF-1 cKO mice mediate cytolytic functions via NKG2D.
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Affiliation(s)
- Rebecca Harris
- Department of Microbiology and Immunology, SUNY Upstate Medical University, 766 Irving Ave Weiskotten Hall Suite 2281, Syracuse, NY, 13210, USA
| | - Mahinbanu Mammadli
- Department of Microbiology and Immunology, SUNY Upstate Medical University, 766 Irving Ave Weiskotten Hall Suite 2281, Syracuse, NY, 13210, USA
| | - Shannon Hiner
- Department of Microbiology and Immunology, SUNY Upstate Medical University, 766 Irving Ave Weiskotten Hall Suite 2281, Syracuse, NY, 13210, USA
| | - Liye Suo
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Qi Yang
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School Rutgers Child Health Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Jyoti Misra Sen
- National Institute On Aging-National Institutes of Health, BRC Building, 251 Bayview Boulevard, Suite 100, Baltimore, MD, 21224, USA.,Center On Aging and Immune Remodeling and Immunology Program, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA
| | - Mobin Karimi
- Department of Microbiology and Immunology, SUNY Upstate Medical University, 766 Irving Ave Weiskotten Hall Suite 2281, Syracuse, NY, 13210, USA.
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Yoon HW, Kitt E, Smith K, Comar CE, Harris R, Hopkins A, Jaimes J, Rustempasic SM, Gautam R, Esona MD, Handy L. 1218. Genotypic Investigation of a Rotavirus Cluster at a Pediatric Hospital in 2022. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1050] [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: 12/23/2022] Open
Abstract
Abstract
Background
Rotavirus group A (RVA) was the most common cause of infectious gastroenteritis among young children before introduction of rotavirus vaccine in the United States in 2006. Following widespread vaccination, U.S. hospital acquired (HA) rotavirus cases are rare. We describe a cluster of rotavirus infections in a pediatric hospital with a genotype uncommon among U.S. children.
Methods
Patient cases of HA gastrointestinal (GI) illness were detected through hospital-wide microbiology surveillance, performed by Infection Prevention and Control (IPC) practitioners per state requirements. Cluster procedures were implemented on a unit when 3 cases were identified by symptoms and/or laboratory tests within 48 hours. Due to the current rarity of rotavirus clusters, the hospital partnered with Centers for Disease Control and Prevention (CDC) laboratories to sequence strains in addition to instituting local control measures. RVA strains were genotyped by using the genotype specific qRT-PCR assays for VP7 and VP4 genes. Next Generation Sequencing (NGS) was performed for RVA strain characterization on Illumina MiSeq. Genotypes for all 10 RVA were determined by NCBI’s BLASTN program.
Results
Epidemiologic surveillance identified a rotavirus cluster of 10 patients aged 10 months to 10 years old, of whom 50% had received rotavirus vaccine. Symptoms included emesis and diarrhea. Cases could not be attributed to vaccine related shedding. All patients had epidemiologic links by contiguous bed spaces or shared care teams. Sequencing was conclusive for 9 of the 10 stool samples to be a G9P[4] genotype, which is rarely detected amongst U.S. children. Local control measures of increased education and cleaning, isolation of positive patients in single rooms, use of soap and water instead of alcohol-based hand sanitizer on room exit, and furlough of symptomatic healthcare workers halted transmission.
Conclusion
Routine surveillance of HA GI illness identified a cluster; RVA strain genotyping and characterization identified unusual rotavirus genotype G9P[4] as the cause. Partnership between IPC practitioners and laboratorians with CDC demonstrated the need to enhance infection prevention measures to halt transmission and identified a rare rotavirus strain as the likely cause of the cluster.
Disclosures
Courtney E. Comar, PhD, Pfizer: Stocks/Bonds|Viatris: Stocks/Bonds.
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Affiliation(s)
- Hee-won Yoon
- Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Eimear Kitt
- Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Kenneth Smith
- Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Courtney E Comar
- Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Rebecca Harris
- Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Amy Hopkins
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Jose Jaimes
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | | | - Rashi Gautam
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Mathew D Esona
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | - Lori Handy
- Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
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Mututanthri S, Thoradeniya T, Samaranayake A, Harris R. Free sugar intake and associated factors among Sri Lankan preschool children. BMC Nutr 2022; 8:137. [PMID: 36411465 PMCID: PMC9677688 DOI: 10.1186/s40795-022-00638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Excessive free sugar intake tends to be associated with unpleasant health consequences, such as dental caries and unhealthy weight gain in children, as well as a number of noncommunicable diseases in adults. The WHO suggests that the best method for addressing these issues is to reduce free sugar consumption throughout life, in order to be successful, these measures should be implemented as early as possible. This makes the early formative years of preschool an important point for possible intervention. To confirm this, baseline information on current sugar intake levels is needed, as well as identification of factors associated with high levels of consumption. METHODS This cross-sectional study was conducted in the district of Colombo, Sri Lanka. The probability proportionate to size technique combined with cluster sampling was used to select a representative sample of 813 children aged 4-5-years from 82 preschools. We developed, and validated a quantitative food frequency questionnaire (FFQ) to assess free sugar consumption. Data on correlated factors were collected from caregivers using a pre-tested self-administered questionnaire. RESULTS Based on the data, the daily median (IQR) free sugar intake of preschool children was 57.9 (33.2-95.8) grams/day (approximately to 14.5 (8.3-23.9) teaspoons/day) or 21.1% (12.5-34.9%) of their daily energy requirements. The WHO recommends limiting sugar intake to less than 5% of total energy intake; however, the current level is fourfold, and 96% of children consume higher percentage of energy from free sugar than recommended. In terms of total daily sugar consumption, bakery products accounted for 27%, followed by biscuits (15%), and table sugar (15%). Increasing maternal education level significantly reduced sugar intake (p = 0.04). Children of other ethnicities ate more sugar than the Sinhala children (p = 0.01). There was higher sugar intake among those who ate while returning from preschool (p < 0.001), while watching television (p < 0.001), and those who had school-going siblings (p = 0.02). CONCLUSION Among preschool children, free sugar consumption levels were very high and most of the children consumed more sugar than is recommended; which warranted urgent actions to curb sugar intake among them.
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Affiliation(s)
- Shanika Mututanthri
- grid.466905.8Ministry of Health, No. 385, Rev. Baddegama Wimalawansa Thero Mawatha, Colombo, 10 Sri Lanka
| | - Tharanga Thoradeniya
- grid.8065.b0000000121828067Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Anil Samaranayake
- grid.466905.8Ministry of Health, No. 385, Rev. Baddegama Wimalawansa Thero Mawatha, Colombo, 10 Sri Lanka
| | - Rebecca Harris
- grid.10025.360000 0004 1936 8470Department of Public Health, Policy and Systems, University of Liverpool, Whelan Building, Quadrangle, Liverpool, L69 3GB UK
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Hong KS, Pagan K, Whalen W, Harris R, Yang J, Stout-Delgado H, Cho SJ. The Role of Glutathione Reductase in Influenza Infection. Am J Respir Cell Mol Biol 2022; 67:438-445. [PMID: 35767671 PMCID: PMC9753556 DOI: 10.1165/rcmb.2021-0372oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 08/18/2021] [Accepted: 06/29/2022] [Indexed: 02/05/2023] Open
Abstract
Influenza infection induces lung epithelial cell injury via programmed cell death. Glutathione, a potent antioxidant, has been reported to be associated with influenza infection. We hypothesized that lung epithelial cell death during influenza infection is regulated by glutathione metabolism. Eight-week-old male and female BALB/c mice were infected with influenza (PR8: A/PR/8/34 [H1N1]) via intranasal instillation. Metabolomic analyses were performed on whole lung lysate after influenza infection. For in vitro analysis, Beas-2B cells were infected with influenza. RNA was extracted, and QuantiTect Primer Assay was used to assess gene expression. Glutathione concentrations were assessed by colorimetric assay. Influenza infection resulted in increased inflammation and epithelial cell injury in our murine model, leading to increased morbidity and mortality. In both our in vivo and in vitro models, influenza infection was found to induce apoptosis and necroptosis. Influenza infection led to decreased glutathione metabolism and reduced glutathione reductase activity in lung epithelial cells. Genetic inhibition of glutathione reductase suppressed apoptosis and necroptosis of lung epithelial cells. Pharmacologic inhibition of glutathione reductase reduced airway inflammation, lung injury, and cell death in our murine influenza model. Our results demonstrate that glutathione reductase activity is suppressed during influenza. Glutathione reductase inhibition prevents epithelial cell death and morbidity in our murine influenza model. Our results suggest that glutathione reductase-dependent glutathione metabolism may play an important role in the host response to viral infection by regulating lung epithelial cell death.
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Affiliation(s)
- Kyung Sook Hong
- Division of Critical Care Medicine, Department of Surgery, Ewha Womans University College of Medicine, Seoul, South Korea; and
| | - Kassandra Pagan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - William Whalen
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Rebecca Harris
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Jianjun Yang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Heather Stout-Delgado
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Soo Jung Cho
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
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20
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Derella C, Crandall R, Looney J, Thomas J, McKie K, Forseen C, Harris R. 267 Skeletal muscle oxygenation extraction is lower in women than men with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00957-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Harris R, Foskett-Tharby R. From dental contract to system reform: why an incremental approach is needed. Br Dent J 2022; 233:377-381. [DOI: 10.1038/s41415-022-4919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/09/2022]
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22
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Al-yaseen W, Jones R, McGregor S, Wade W, Gallagher J, Harris R, Johnson I, KC S, Robertson M, Innes N. Aerosol and splatter generation with rotary handpieces used in restorative and orthodontic dentistry: a systematic review. BDJ Open 2022; 8:26. [PMID: 36068221 PMCID: PMC9447949 DOI: 10.1038/s41405-022-00118-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities. This systematic review assesses the literature for changes in aerosol-contamination levels when rotary instruments are used, (1) as distance increases from patient’s mouth; (2) as time passes after the procedure; and (3) when using different types of handpieces. Methods The review methods and reporting are in line with PRISMA statements. A structured search was conducted over five platforms (September 2021). Studies were assessed independently by two reviewers. To be eligible studies had to assess changes in levels of aerosol contamination over different distances, and time points, with rotary hand instruments. Studies’ methodologies and the sensitivity of the contamination-measurement approaches were evaluated. Results are presented descriptively. Results From 422 papers identified, 23 studies were eligible. All investigated restorative procedures using rotary instruments and one study additionally looked at orthodontic bracket adhesive material removal. The results suggest contamination is significantly reduced over time and distance. However, for almost all studies that investigated these two factors, the sizes of the contaminated particles were not considered, and there were inconclusive findings regarding whether electric-driven handpieces generate lower levels of contaminated particles. Conclusion Aerosol contamination levels reduce as distances, and post-procedure times increase. However, there was sparce and inconsistent evidence on the clearing time and no conclusions could be drawn. High-speed handpieces produce significantly higher levels of contamination than slow-speed ones, and to a lesser extent, micro-motor handpieces. However, when micro-motor handpieces were used with water, the contamination levels rose and were similar to high-speed handpiece contamination levels.
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23
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Marra A, Gazzo A, Gupta A, Selenica P, Da Silva E, Pareja F, Pei X, Zhu Y, Razavi P, Safonov A, Ferraro E, Harris R, Riaz N, Reis-Filho J, Chandarlapaty S. 210O Mutational signature analysis reveals patterns of genomic instability linked to resistance to endocrine therapy (ET) +/- CDK 4/6 inhibition (CDK4/6i) in estrogen receptor-positive/HER2-negative (ER+/HER2-) metastatic breast cancer (MBC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.249] [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] Open
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24
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Bockhold S, McNulty J, Abdurakman E, Bezzina P, Drey N, England A, Flinton D, Khine R, McEntee M, Mekiš N, Precht H, Rainford L, Sá Dos Reis C, Santos A, Syrgiamiotis V, Willis S, Woodley J, Beardmore C, Harris R, O'Regan T, Malamateniou C. Research ethics systems, processes, and awareness across Europe: Radiography research ethics standards for Europe (RRESFE). Radiography (Lond) 2022; 28:1032-1041. [PMID: 35964488 DOI: 10.1016/j.radi.2022.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/23/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The Radiography Research Ethics Standards for Europe (RRESFE) project aims to provide a cross-sectional snapshot of current research ethics systems, processes, and awareness of such, across Europe together with identifying the associated challenges, education, and training needs. METHODS A cross-sectional online survey targeting radiography researchers in Europe was conducted. Data collection took place between April 26 and July 12, 2021, using a snowball sampling approach. Descriptive and analytical statistics were used to identify trends in research ethics frameworks across Europe. RESULTS 285 responses were received across 33 European and 23 non-European countries. Most (n = 221; 95%) European respondents stated ethics approval is required before commencing research in their country. Requirements around research ethics approval and awareness of such requirements varied by European region (X2 (2, n = 129) = 7.234, p = 0.013) and were found to differ depending on the type of research participant and study design. Additionally, European respondents reported ethics approval is a national requirement more often than their non-European counterparts (X2 (1, n = 282) = 4.316, p = 0.049). Requirements for ethics approval were also associated with the undergraduate programme duration (2-year vs. 3-year vs. 3.5 year vs. 4-year vs. multiple programme durations; X2 (4, n = 231) = 10.075, p = 0.016) and availability of postgraduate training (postgraduate training available vs. postgraduate training not available; X2 (1, n = 231) = 15.448, p = <0.001) within respondents' country. CONCLUSION Respondents from countries with longer programme durations/availability of multiple programme lengths, availability of postgraduate training, and establishment of European Qualifications Framework Level 6 were generally associated with less uncertainty and more comprehensive research ethics requirements. IMPLICATIONS FOR PRACTICE Results are informative of the current status of research ethics within evidence-based radiography.
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Affiliation(s)
- S Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - J McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - E Abdurakman
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - P Bezzina
- Radiography, Faculty of Health Sciences, L-Università ta' Malta, Malta
| | - N Drey
- Division of Nursing, School of Health Sciences, City University of London, United Kingdom
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - D Flinton
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - R Khine
- School of Health Care and Social Work, Buckinghamshire New University, United Kingdom
| | - M McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Mekiš
- Medical Imaging and Radiotherapy, Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - H Precht
- Diagnostic and Treatment and Radiography Education, Health Sciences Research Centre, UCL University College, Denmark
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - C Sá Dos Reis
- Radiological Medical Imaging Technology, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Santos
- Medical Imaging and Radiotherapy, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - V Syrgiamiotis
- CT-MRI Department, General Children's Hospital of Athens Agia Sophia, and University of West Attica, Greece
| | - S Willis
- Health Education England, National Health Service, London, United Kingdom
| | - J Woodley
- School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Beardmore
- Society and College of Radiographers, London, United Kingdom
| | - R Harris
- Society and College of Radiographers, London, United Kingdom
| | - T O'Regan
- Society and College of Radiographers, London, United Kingdom
| | - C Malamateniou
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom.
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25
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Bockhold S, McNulty J, Abdurakman E, Bezzina P, Drey N, England A, Flinton D, Khine R, McEntee M, Mekiš N, Precht H, Rainford L, Sá Dos Reis C, Santos A, Syrgiamiotis V, Willis S, Woodley J, Beardmore C, Harris R, O'Regan T, Malamateniou C. Research ethics training, challenges, and suggested improvements across Europe: Radiography research ethics standards for Europe (RRESFE). Radiography (Lond) 2022; 28:1016-1024. [PMID: 35939960 DOI: 10.1016/j.radi.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 07/07/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION The Radiography Research Ethics Standards for Europe (RRESFE) project aimed to provide a cross-sectional view of the current state of radiography research ethics across Europe. This included investigating education and training in research ethics, and identifying the key challenges and potential improvements associated with using existing research ethics frameworks. METHODS This cross-sectional online survey targeting radiography researchers in Europe was conducted between April 26 and July 12, 2021. Descriptive and analytical statistics were used to identify research ethics education and training trends. Content analysis of qualitative responses was employed to identify significant challenges and proposed improvements in research ethics frameworks of practice. RESULTS There were 232 responses received across 33 European countries. Most (n = 132; 57%) respondents had received some research ethics training; however, fewer participants had received training on safeguarding vulnerable patients (n = 72; 38%), diversity and inclusivity (n = 62; 33%), or research with healthy volunteers (n = 60; 32%). Training was associated with a greater perceived importance of the need for research ethics review (p = 0.031) and with the establishment of EQF Level 6 training (p = 0.038). The proportion of formally trained researchers also varied by region (p = <0.001). Time-to-ethics-approval was noted as the biggest challenge for professionals making research ethics applications. CONCLUSION Early and universal integration of research-oriented teaching within the radiography education framework which emphasises research ethics is recommended. Additionally, study findings suggest research ethics committee application and approval processes could be further simplified and streamlined. IMPLICATIONS FOR PRACTICE The survey contributes to a growing body of knowledge surrounding the importance of education and training in research ethics for assuring a high standard of research outputs in Radiography and has identified hurdles to obtaining research ethics approval for further investigation and address.
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Affiliation(s)
- S Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - J McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - E Abdurakman
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - P Bezzina
- Radiography, Faculty of Health Sciences, L-Università ta' Malta, Malta
| | - N Drey
- Division of Nursing, School of Health Sciences, City University of London, United Kingdom
| | - A England
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - D Flinton
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
| | - R Khine
- School of Health Care and Social Work, Buckinghamshire New University, United Kingdom
| | - M McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland
| | - N Mekiš
- Medical Imaging and Radiotherapy, Faculty of Health Sciences, University of Ljubljana, Slovenia
| | - H Precht
- Diagnostic and Treatment and Radiography Education, Health Sciences Research Centre, University College Lillebælt, Vejle, Denmark
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - C Sá Dos Reis
- Radiological Medical Imaging Technology, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Santos
- Medical Imaging and Radiotherapy, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - V Syrgiamiotis
- CT-MRI Department, General Children's Hospital of Athens Agia Sophia, and University of West Attica, Greece
| | - S Willis
- Health Education England, National Health Service, London, United Kingdom
| | - J Woodley
- School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - C Beardmore
- Society and College of Radiographers, London, United Kingdom
| | - R Harris
- Society and College of Radiographers, London, United Kingdom
| | - T O'Regan
- Society and College of Radiographers, London, United Kingdom
| | - C Malamateniou
- Division of Midwifery and Radiography, School of Health Sciences, City University of London, United Kingdom
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26
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McCollum R, Zaizay Z, Dean L, Watson V, Frith L, Alhassan Y, Kollie K, Piotrowski H, Bates I, Anderson de Cuevas R, Harris R, Chowdhury S, Berrian H, Smith JS, Tate WS, El Hajj T, Ozano K, Hastie O, Parker C, Kollie J, Zawolo G, Ding Y, Dacombe R, Taegtmeyer M, Theobald S. Qualitative study exploring lessons from Liberia and the UK for building a people-centred resilient health systems response to COVID-19. BMJ Open 2022; 12:e058626. [PMID: 35914910 PMCID: PMC9344595 DOI: 10.1136/bmjopen-2021-058626] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION COVID-19 has tested the resilience of health systems globally and exposed existing strengths and weaknesses. We sought to understand health systems COVID-19 adaptations and decision making in Liberia and Merseyside, UK. METHODS We used a people-centred approach to carry out qualitative interviews with 24 health decision-makers at national and county level in Liberia and 42 actors at county and hospital level in the UK (Merseyside). We explored health systems' decision-making processes and capacity to adapt and continue essential service delivery in response to COVID-19 in both contexts. RESULTS Study respondents in Liberia and Merseyside had similar experiences in responding to COVID-19, despite significant differences in health systems context, and there is an opportunity for multidirectional learning between the global south and north. The need for early preparedness; strong community engagement; clear communication within the health system and health service delivery adaptations for essential health services emerged strongly in both settings. We found the Foreign, Commonwealth and Development Office (FCDO) principles to have value as a framework for reviewing health systems changes, across settings, in response to a shock such as a pandemic. In addition to the eight original principles, we expanded to include two additional principles: (1) the need for functional structures and mechanisms for preparation and (2) adaptable governance and leadership structures to facilitate timely decision making and response coordination. We find the use of a people-centred approach also has value to prompt policy-makers to consider the acceptance of service adaptations by patients and health workers, and to continue the provision of 'routine services' for individuals during health systems shocks. CONCLUSION Our study highlights the importance of a people-centred approach, placing the person at the centre of the health system, and value in applying and adapting the FCDO principles across diverse settings.
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Affiliation(s)
- Rosalind McCollum
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Victoria Watson
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lucy Frith
- Centre for Social Ethics & Policy, School of Law, The University of Manchester, Manchester, UK
| | - Yussif Alhassan
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Karsor Kollie
- Neglected Tropical Disease Programme, Ministry of Health, Monrovia, Liberia
| | - Helen Piotrowski
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Imelda Bates
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rebecca Harris
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Shahreen Chowdhury
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Hannah Berrian
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - John Solunta Smith
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Wede Seekey Tate
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Taghreed El Hajj
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kim Ozano
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Olivia Hastie
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Colleen Parker
- Department of Planning, Policy and M&E, Ministry of Health, Monrovia, Liberia
| | - Jerry Kollie
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Georgina Zawolo
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Yan Ding
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Russell Dacombe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical Infectious Diseases Institute, Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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27
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Abeysekera KWM, Macpherson I, Glyn-Owen K, McPherson S, Parker R, Harris R, Yeoman A, Rowe IA, Dillon JF. Community pathways for the early detection and risk stratification of chronic liver disease: a narrative systematic review. Lancet Gastroenterol Hepatol 2022; 7:770-780. [PMID: 35525248 DOI: 10.1016/s2468-1253(22)00020-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/07/2023]
Abstract
Patients with chronic liver disease are often diagnosed during an index presentation to hospital with decompensated cirrhosis or liver-related events, and these presentations are associated with high mortality. However, there is often a long asymptomatic phase, in which there is an opportunity for earlier diagnosis and interventions to prevent progression to advanced disease. Therefore, strategies for early diagnosis and interventions (including behavioural changes and pharmacological treatments) that prevent patients progressing to cirrhosis and its associated complications probably have substantial benefits for patients and health-care services. Many community pathways have been generated. Some pathways focus on abnormal liver function tests as a starting point to diagnose liver disease. Other pathways target groups at greater risk of chronic liver disease-particularly people with harmful alcohol consumption, type 2 diabetes, and obesity. This systematic review summarises the existing strategies available for the early detection or risk stratification of liver disease, focusing primarily on alcohol-related liver disease and non-alcoholic fatty liver disease. Conducting randomised clinical trials that compare different strategies will be essential to elucidate which pathways are acceptable to patients, feasible, provide high diagnostic accuracy for the detection of liver disease, improve liver-related outcomes, and are most cost-effective at the population level.
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Affiliation(s)
| | - Iain Macpherson
- Division of Clinical and Molecular Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Kate Glyn-Owen
- School of Primary Care, Population Science and Medical Education (PPM), Faculty of Medicine, University of Southampton, University Hospital Southampton, UK
| | - Stuart McPherson
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Richard Parker
- Leeds Liver Unit, St James's University Hospital, Leeds, UK
| | - Rebecca Harris
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
| | - Andrew Yeoman
- Aneurin Bevan University Health Board, Hepatology, Newport, UK
| | - Ian A Rowe
- Leeds Liver Unit, St James's University Hospital, Leeds, UK; Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - John F Dillon
- Division of Clinical and Molecular Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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28
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Sudjaritruk T, Kaewpoowat Q, Prasarakee C, Sarachai S, Taurel AF, Sricharoen N, Assawawongprom P, Saheng J, Harris R, Nealon J, Yoksan S. Seroepidemiological study of Japanese encephalitis virus in Chiang Mai: Immunity and susceptibility 28 years after introduction of a vaccination programme. PLoS Negl Trop Dis 2022; 16:e0010674. [PMID: 35913983 PMCID: PMC9371339 DOI: 10.1371/journal.pntd.0010674] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/11/2022] [Accepted: 07/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Thailand has introduced a nationwide vaccination against Japanese encephalitis virus (JEV) into National Immunization Programme since the 1990’s. To improve the understanding of immunity and susceptibility of the population after 28 years of a vaccination programme, we conducted a JEV seroepidemiological study in a JEV-endemic area of Thailand.
Methods
An age-stratified, population-based, seroepidemiological study was conducted in Chiang Mai, Thailand–a northern Thai province where is an endemic area of Japanese encephalitis. Nine districts were chosen based on administrative definition: rural (n = 3); urban (n = 3); and peri-urban (n = 3). Within each district, eligible participants were randomly selected from 3 age groups: adolescents (10–20 years); adults (21–50 years); and older adults/elderly (≥51 years) by computer randomization. Plaque reduction neutralization tests (PRNT50 and PRNT90) were performed to measure neutralizing antibodies to JEV. To account for the cross-reactivity of JEV and other flaviviruses, JEV seroprotection was defined according to age, previous history of JEV vaccination, and PRNT50/PRNT90 levels of study participants.
Results
Overall, 279 adolescents, 297 adults, and 297 older adults/elderly were enrolled from nine districts. Age-stratified, protocol-defined, cluster-adjusted JEV seroprotection rates were 61% (95% CI: 48–73%), 43% (95% CI: 31–57%), and 52% (95% CI: 37–67%) for adolescents, adults, and older adults/elderly, respectively. Living in peri-urban districts, having a history of prior dengue virus infection, and previously receiving mouse brain-derived JEV vaccine were significantly associated with seroprotection to JEV in adolescents. Older age and male sex were associated with seroprotection for adults; and only male sex was the associated factor for older adults/elderly (P <0.05).
Conclusions
Approximately half of population living in a JEV-endemic area demonstrated seroprotection to JEV. Ongoing nationwide surveillance on JEV seropepidemiology is an important strategy to understand the evolving population-level immunity to JEV, and to help formulating the appropriate recommendations on JE immunization.
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Affiliation(s)
- Tavitiya Sudjaritruk
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- * E-mail:
| | - Quanhathai Kaewpoowat
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chanidapa Prasarakee
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Saowalak Sarachai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Natthanidnan Sricharoen
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jutamad Saheng
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Rebecca Harris
- Vaccine Epidemiology and Modeling Department, Sanofi, Singapore
| | - Joshua Nealon
- Vaccine Epidemiology and Modeling Department, Sanofi, Singapore
| | - Sutee Yoksan
- Center for Vaccine Development, Institute of Molecular Biosciences, Mahidol University, Bangkok, Thailand
- Chulabhorn Research Institute, Bangkok, Thailand
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Harris R, Yang M, Schmidt C, Royet C, Singh S, Natarajan A, Morris M, Frezza C, Laman H. Fbxo7 promotes Cdk6 activity to inhibit PFKP and glycolysis in T cells. J Cell Biol 2022; 221:e202203095. [PMID: 35670764 PMCID: PMC9178409 DOI: 10.1083/jcb.202203095] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
Fbxo7 is associated with cancer and Parkinson's disease. Although Fbxo7 recruits substrates for SCF-type ubiquitin ligases, it also promotes Cdk6 activation in a ligase-independent fashion. We discovered PFKP, the gatekeeper of glycolysis, in a screen for Fbxo7 substrates. PFKP is an essential Cdk6 substrate in some T-ALL cells. We investigated the molecular relationship between Fbxo7, Cdk6, and PFKP, and the effect of Fbxo7 on T cell metabolism, viability, and activation. Fbxo7 promotes Cdk6-independent ubiquitination and Cdk6-dependent phosphorylation of PFKP. Importantly, Fbxo7-deficient cells have reduced Cdk6 activity, and hematopoietic and lymphocytic cells show high expression and significant dependency on Fbxo7. CD4+ T cells with reduced Fbxo7 show increased glycolysis, despite lower cell viability and activation levels. Metabolomic studies of activated CD4+ T cells confirm increased glycolytic flux in Fbxo7-deficient cells, alongside altered nucleotide biosynthesis and arginine metabolism. We show Fbxo7 expression is glucose-responsive at the mRNA and protein level and propose Fbxo7 inhibits PFKP and glycolysis via its activation of Cdk6.
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Affiliation(s)
- Rebecca Harris
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Ming Yang
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Christina Schmidt
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Chloe Royet
- Pôle Chimie Balard Recherche, Institut des Biomolécules Max Mousseron-UMR5247, Montpellier, France
| | - Sarbjit Singh
- Eppley Institute for Cancer Research, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE
| | - Amarnath Natarajan
- Eppley Institute for Cancer Research, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE
| | - May Morris
- Pôle Chimie Balard Recherche, Institut des Biomolécules Max Mousseron-UMR5247, Montpellier, France
| | - Christian Frezza
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Heike Laman
- Department of Pathology, University of Cambridge, Cambridge, UK
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Maben J, Conolly A, Abrams R, Rowland E, Harris R, Kelly D, Kent B, Couper K. 'You can't walk through water without getting wet' UK nurses' distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study. Int J Nurs Stud 2022; 131:104242. [PMID: 35525086 PMCID: PMC8976696 DOI: 10.1016/j.ijnurstu.2022.104242] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Pre-COVID-19 research highlighted the nursing profession worldwide as being at high risk from symptoms of burnout, post-traumatic stress disorder (PTSD) and suicide. The World Health Organization declared a pandemic on 11th March 2020 due to the sustained risk of further global spread of COVID-19. The high healthcare burden associated with COVID-19 has increased nurses' trauma and workload, thereby exacerbating pressure on an already strained workforce and causing additional psychological distress for staff. OBJECTIVES The Impact of COVID-19 on Nurses (ICON) interview study examined the impacts of the pandemic on frontline nursing staff's psychosocial and emotional wellbeing. DESIGN Longitudinal qualitative interview study. SETTINGS Nurses who had completed time 1 and 2 of the ICON survey were sampled to include a range of UK work settings including acute, primary and community care and care homes. Interviewees were purposively sampled for maximum variation to cover a broad range of personal and professional factors, and experiences during the COVID-19 pandemic, including redeployment. METHODS Nurses participated in qualitative in-depth narrative interviews after the first wave of COVID-19 in July 2020 (n = 27) and again at the beginning of the second wave in December 2020 (n = 25) via video and audio platform software. Rigorous qualitative narrative analysis was undertaken both cross-sectionally (within wave) and longitudinally (cross wave) to explore issues of consistency and change. RESULTS The terms moral distress, compassion fatigue, burnout and PTSD describe the emotional states reported by the majority of interviewees leading many to consider leaving the profession. Causes of this identified included care delivery challenges; insufficient staff and training; PPE challenges and frustrations. Four themes were identified: (1) 'Deathscapes' and impoverished care (2) Systemic challenges and self-preservation (3) Emotional exhaustion and (4) (Un)helpful support. CONCLUSIONS Nurses have been deeply affected by what they have experienced and report being forever altered with the impacts of COVID-19 persisting and deeply felt. There is an urgent need to tackle stigma to create a psychologically safe working environment and for a national COVID-19 nursing workforce recovery strategy to help restore nurse's well-being and demonstrate a valuing of the nursing workforce and therefore support retention.
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Affiliation(s)
- J. Maben
- University of Surrey, United Kingdom,Corresponding author
| | | | - R. Abrams
- University of Surrey, United Kingdom
| | | | - R. Harris
- King's College London, United Kingdom
| | - D. Kelly
- Cardiff University, United Kingdom
| | - B. Kent
- University of Plymouth, United Kingdom
| | - K. Couper
- University of Warwick and University Hospitals Birmingham NHS Foundation Trust, United Kingdom
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Harris R, Lowers V, Hulme C, Burnside G, Best A, Clarkson JE, Cooke R, Van Der Zande M, Maitland R. Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial. Trials 2022; 23:475. [PMID: 35672830 PMCID: PMC9172193 DOI: 10.1186/s13063-022-06418-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with disadvantaged backgrounds are less likely to visit the dentist for planned care, even though they have disproportionately poorer oral health. They are correspondingly more likely to experience dental problems and use urgent dental care, general practices and Accident and Emergency departments, which not only makes meeting their needs expensive, but, since these services often rely on prescriptions rather than addressing the clinical cause, can contribute to antimicrobial resistance. METHODS The RETURN intervention has been developed with substantial community co-production, to be delivered opportunistically in urgent dental care settings. This brief intervention is delivered by dental nurses and involves material relevant to the 'in-group' targeted. The material includes booklets relating to barriers to planned dental visiting with corresponding short video clips featuring local people and including a modelling element. Dental nurses are trained to have supportive and non-judgemental conversations, assisting patients to set personal goals and action plans, which are reinforced in a follow-up text within a few weeks. A randomised controlled trial will be undertaken in 3 types of sites: dental practices delivering urgent care (a) within working hours, (b) out of hours, and (c) in a Dental Hospital. The trial will recruit 1180 adult urgent dental care users over 12 months, who have not visited a dentist for a planned care appointment for 2 years or more and do not have a dentist who they visit for routine care. It aims to investigate the effectiveness and cost-effectiveness of the intervention and to explore whether the intervention has different effects across the socio-economic gradient. Participants will be followed up at 6, 12 and 18 months after randomisation. Co-primary outcomes are attendance at a dental practice for planned care within 12 months and self-reported oral health-related quality of life at 12 months. DISCUSSION This is a pragmatic trial, evaluating the effectiveness of the intervention under the usual condition in which it might be applied. Since dental practices work as independent contractors to the NHS, this brings implementation and fidelity challenges which will be explored and described in embedded qualitative work. TRIAL REGISTRATION ISRCTN registry identifier ISRCTN84666712. Registered 12/04/2021.
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Affiliation(s)
- R Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Whelan Building, Liverpool, L69 3GL, UK.
| | - V Lowers
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - C Hulme
- Health Economics Group, Institute of Health Research University of Exeter Medical School, Exeter, UK
| | - G Burnside
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - A Best
- Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
| | - J E Clarkson
- Division of Oral Health Sciences, Dental Hospital & School, Park Place, Dundee, UK
| | - R Cooke
- School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent, ST4 2DE, UK
| | - M Van Der Zande
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - R Maitland
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.,Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
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Humphreys J, Morgan E, Clayton S, Jarad F, Harris R, Albadri S. Molar-incisor hypomineralisation combat: exploratory qualitative interviews with general dental practitioners in England regarding the management of children with molar-incisor hypomineralisation. Br Dent J 2022:10.1038/s41415-022-4254-2. [PMID: 35618918 PMCID: PMC9135101 DOI: 10.1038/s41415-022-4254-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/10/2021] [Indexed: 11/09/2022]
Abstract
Introduction Molar-incisor hypomineralisation (MIH) presents as a spectrum, with severe cases becoming increasingly complex to manage. This study aimed to investigate the perceptions and experience of general dental practitioners (GDPs) in England when managing children with MIH.Method Semi-structured telephone interviews with GDPs who regularly treat children took place in May 2020. A sample of four male and six female GDPs with 1-15 years of experience was achieved through purposively sampling interested parties following advertisement via professional groups. Thematic analysis using a realist and inductive approach was used in analysis.Results The overarching theme was of managing uncertainty, with four subthemes: setting the scene; fighting the tooth; working within the system; and self and interpersonal insight. Despite being knowledgeable, participants expressed varying levels of confidence in many aspects while managing children with MIH. There was a great deal of uncertainty surrounding 'doing the right thing' across the themes. Systemic barriers to managing children with MIH within the general dental service were identified.Conclusion The challenges of managing children with MIH was experienced as 'uncertainty'. Barriers within the general dental service made managing children with MIH difficult and participants relied on colleagues in secondary care to manage severe cases.
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Affiliation(s)
- Judith Humphreys
- Department of Paediatric Dentistry, University of Liverpool, UK.
| | - Emma Morgan
- Department of Paediatric Dentistry, University of Liverpool, UK
| | - Stephen Clayton
- Department of Public Health, Policy and Systems, University of Liverpool, UK
| | - Fadi Jarad
- Department of Restorative Dentistry, University of Liverpool, UK
| | - Rebecca Harris
- Department of Public Health, Policy and Systems, University of Liverpool, UK
| | - Sondos Albadri
- Department of Paediatric Dentistry, University of Liverpool, UK
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McIlveen P, Alchin C, Hoare PN, Bowman S, Harris R, Gotting G, Gilmour J, Perera HN, Beccaria L, Kossen C, Cavaye J, Creed A, McDonald N. Place identity and careers in regional Australia. Australian Journal of Career Development 2022. [DOI: 10.1177/10384162221085807] [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: 11/16/2022]
Abstract
Emerging public discourse about making a “tree change”, “green change”, or “sea change” emphasizes the putative benefits of working and residing in regional Australia. Yet, attracting and retaining workers in the regions is a challenge for policymakers, governments, and industries. The present research involved two separate surveys of people residing in regional Australian communities to discern demographic and psychological predictors of their intent to stay in their region: income, years in the region, family, life satisfaction, job satisfaction, and place identity. Multiple regression analyses found incremental evidence of place identity as a predictor of intent to stay. The findings regarding place identity have implications for career development practice, human resources recruitment strategies, and public policy focused on regional Australia.
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Affiliation(s)
- Peter McIlveen
- School of Education, University of Southern Queensland, Australia
| | - Carolyn Alchin
- School of Education, University of Southern Queensland, Australia
| | - P. Nancey Hoare
- School of Psychology & Counselling, University of Southern Queensland, Australia
| | - Sarah Bowman
- School of Psychology & Counselling, University of Southern Queensland, Australia
| | - Rebecca Harris
- School of Psychology & Counselling, University of Southern Queensland, Australia
| | - Geraldine Gotting
- School of Psychology & Counselling, University of Southern Queensland, Australia
| | - John Gilmour
- School of Psychology & Counselling, University of Southern Queensland, Australia
| | | | - Lisa Beccaria
- School of Nursing & Midwifery, University of Southern Queensland, Australia
| | - Chris Kossen
- School of Arts and Communication, University of Southern Queensland, Australia
| | - Jim Cavaye
- Institute for Resilient Regions, University of Southern Queensland, Australia
| | | | - Nicole McDonald
- School of Health, Medical and Applied Sciences, CQUniversity, Australia
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Paruk F, Pillay U, Rech D, Maimela G, Matsebula T, Harris R. Telehealth opportunities for South Africa have been brought into focus by the COVID-19 pandemic. S Afr Med J 2022; 112:13548. [PMID: 35587802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023] Open
Affiliation(s)
- F Paruk
- Africa Telehealth Collaboration, South Africa.
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Bennett H, Harris R. To feed or not to feed – review of post-operative feeding strategies after gastric cancer surgery and impact on outcomes. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Harris R, Hayes E, Nandi D, Gajarski R, McConnell P, Wright L. VAD as Bridge to Transplant Decision in Nine-Year-Old Child with Duchenne Muscular Dystrophy. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Davis RA, Hausner SH, Harris R, Sutcliffe JL. A Comparison of Evans Blue and 4-( p-Iodophenyl)butyryl Albumin Binding Moieties on an Integrin α vβ 6 Binding Peptide. Pharmaceutics 2022; 14:pharmaceutics14040745. [PMID: 35456579 PMCID: PMC9025560 DOI: 10.3390/pharmaceutics14040745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 01/26/2023] Open
Abstract
Serum albumin binding moieties (ABMs) such as the Evans blue (EB) dye fragment and the 4-(p-iodophenyl)butyryl (IP) have been used to improve the pharmacokinetic profile of many radiopharmaceuticals. The goal of this work was to directly compare these two ABMs when conjugated to an integrin αvβ6 binding peptide (αvβ6-BP); a peptide that is currently being used for positron emission tomography (PET) imaging in patients with metastatic cancer. The ABM-modified αvβ6-BP peptides were synthesized with a 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetracetic acid (DOTA) chelator for radiolabeling with copper-64 to yield [64Cu]Cu DOTA-EB-αvβ6-BP ([64Cu]1) and [64Cu]Cu DOTA-IP-αvβ6-BP ([64Cu]2). Both peptides were evaluated in vitro for serum albumin binding, serum stability, and cell binding and internalization in the paired engineered melanoma cells DX3puroβ6 (αvβ6 +) and DX3puro (αvβ6 −), and pancreatic BxPC-3 (αvβ6 +) cells and in vivo in a BxPC-3 xenograft mouse model. Serum albumin binding for [64Cu]1 and [64Cu]2 was 53−63% and 42−44%, respectively, with good human serum stability (24 h: [64Cu]1 76%, [64Cu]2 90%). Selective αvβ6 cell binding was observed for both [64Cu]1 and [64Cu]2 (αvβ6 (+) cells: 30.3−55.8% and 48.5−60.2%, respectively, vs. αvβ6 (−) cells <3.1% for both). In vivo BxPC-3 tumor uptake for both peptides at 4 h was 5.29 ± 0.59 and 7.60 ± 0.43% ID/g ([64Cu]1 and [64Cu]2, respectively), and remained at 3.32 ± 0.46 and 4.91 ± 1.19% ID/g, respectively, at 72 h, representing a >3-fold improvement over the non-ABM parent peptide and thereby providing improved PET images. Comparing [64Cu]1 and [64Cu]2, the IP-ABM-αvβ6-BP [64Cu]2 displayed higher serum stability, higher tumor accumulation, and lower kidney and liver accumulation, resulting in better tumor-to-organ ratios for high contrast visualization of the αvβ6 (+) tumor by PET imaging.
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Affiliation(s)
- Ryan A. Davis
- Department of Biomedical Engineering, University of California, Davis, CA 95616, USA;
| | - Sven H. Hausner
- Department of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, CA 95817, USA; (S.H.H.); (R.H.)
| | - Rebecca Harris
- Department of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, CA 95817, USA; (S.H.H.); (R.H.)
| | - Julie L. Sutcliffe
- Department of Biomedical Engineering, University of California, Davis, CA 95616, USA;
- Department of Internal Medicine, Division of Hematology/Oncology, University of California, Davis, CA 95817, USA; (S.H.H.); (R.H.)
- Center for Molecular and Genomic Imaging, University of California, Davis, CA 95616, USA
- Correspondence: ; Tel.: +1-916-734-5536
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Shen JZ, Qiu Z, Wu Q, Zhang G, Harris R, Sun D, Rantala J, Barshop WD, Zhao L, Lv D, Won KA, Wohlschlegel J, Sangfelt O, Laman H, Rich JN, Spruck C. A FBXO7/EYA2-SCF FBXW7 axis promotes AXL-mediated maintenance of mesenchymal and immune evasion phenotypes of cancer cells. Mol Cell 2022; 82:1123-1139.e8. [PMID: 35182481 PMCID: PMC8934274 DOI: 10.1016/j.molcel.2022.01.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/25/2021] [Accepted: 01/25/2022] [Indexed: 12/14/2022]
Abstract
A mesenchymal tumor phenotype associates with immunotherapy resistance, although the mechanism is unclear. Here, we identified FBXO7 as a maintenance regulator of mesenchymal and immune evasion phenotypes of cancer cells. FBXO7 bound and stabilized SIX1 co-transcriptional regulator EYA2, stimulating mesenchymal gene expression and suppressing IFNα/β, chemokines CXCL9/10, and antigen presentation machinery, driven by AXL extracellular ligand GAS6. Ubiquitin ligase SCFFBXW7 antagonized this pathway by promoting EYA2 degradation. Targeting EYA2 Tyr phosphatase activity decreased mesenchymal phenotypes and enhanced cancer cell immunogenicity, resulting in attenuated tumor growth and metastasis, increased infiltration of cytotoxic T and NK cells, and enhanced anti-PD-1 therapy response in mouse tumor models. FBXO7 expression correlated with mesenchymal and immune-suppressive signatures in patients with cancer. An FBXO7-immune gene signature predicted immunotherapy responses. Collectively, the FBXO7/EYA2-SCFFBXW7 axis maintains mesenchymal and immune evasion phenotypes of cancer cells, providing rationale to evaluate FBXO7/EYA2 inhibitors in combination with immune-based therapies to enhance onco-immunotherapy responses.
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Affiliation(s)
- Jia Z Shen
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Zhixin Qiu
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | - Qiulian Wu
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | - Guoxin Zhang
- Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, CA 92037, USA
| | - Rebecca Harris
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK
| | - Dahui Sun
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | | | - William D Barshop
- Department of Biological Chemistry, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Linjie Zhao
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | - Deguan Lv
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | | | - James Wohlschlegel
- Department of Biological Chemistry, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Olle Sangfelt
- Department of Cell and Molecular Biology, Karolinska Institute, Stockholm 171 77, Sweden
| | - Heike Laman
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK
| | - Jeremy N Rich
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA 15213, USA; Division of Regenerative Medicine, Department of Medicine, University of California, San Diego, CA 92037, USA; Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
| | - Charles Spruck
- Tumor Initiation and Maintenance Program, NCI-Designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA.
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Sethi S, Kumar A, Clough J, Ravindran S, Harris R, Harvey P, Raju S, Brookes MJ, Rutter CS, Steed H. Women in gastroenterology: the UK trainee experience. Frontline Gastroenterol 2022; 13:484-489. [PMID: 36250176 PMCID: PMC9555141 DOI: 10.1136/flgastro-2022-102101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/11/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Compared with other medical specialties, there are lower numbers of female trainees and lower rates of flexible working in gastroenterology. This study aims to examine the experience of male and female trainees to understand specialty demographics and the experience of training. Methods Gastroenterology training data were obtained from the British Society of Gastroenterology (BSG) trainee surveys from 2014, 2018 and 2020, and from the Royal College of Physicians Medical Workforce unit between 2011 and 2019. Data on endoscopy measures from 2011 to 2021 were obtained from the Joint Advisory Group (JAG) on gastrointestinal endoscopy, including the JAG Endoscopy training system and the National Endoscopy Database. Data were segregated and compared by gender. Results The percentage of female gastroenterology trainees remains at around 40%, largely unchanged over the previous decade. From the BSG trainee survey, 29.5% of women have flexible working patterns compared with 2.6% of men (p<0.001), which is lower than other medical specialties. Less than half of female trainees felt confident about their job prospects once they qualify. A greater proportion of male than female trainees achieved provisional colonoscopy certification during training (55% vs 45%, p=0.005) and female trainees took longer to certify than male trainees (63 months vs 56 months, p=0.004). The total length of training time from primary medical qualification to consultancy was the same for men and women. Conclusion Changes must be addressed from a national and institutional level to address equitable access to national training programmes and equality of outcome for male and female trainees.
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Affiliation(s)
- Sonika Sethi
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Aditi Kumar
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | | | | | - Rebecca Harris
- NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Philip Harvey
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Suneil Raju
- Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK
| | - Matthew James Brookes
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK,School of Medicine and Clinical Practice, Faculty of Sciences and Engineering, University of Wolverhampton, Wolverhampton, UK
| | - Charlotte S Rutter
- Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Helen Steed
- Department of Gastroenterology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK,School of Medicine and Clinical Practice, Faculty of Sciences and Engineering, University of Wolverhampton, Wolverhampton, UK
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40
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Macpherson I, Abeysekera KWM, Harris R, Mansour D, McPherson S, Rowe I, Rosenberg W, Dillon JF, Yeoman A. Identification of liver disease: why and how. Frontline Gastroenterol 2022; 13:367-373. [PMID: 36051960 PMCID: PMC9380769 DOI: 10.1136/flgastro-2021-101833] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
Mortality from chronic liver disease (CLD) in the UK has increased by over 400% since 1970, driven by alcohol, non-alcoholic fatty liver disease and hepatitis C virus, the natural histories of which can all be improved by early intervention. Patients often present with advanced disease, which would be preventable if diagnosed earlier and lifestyle change opportunities offered. Liver function tests (LFTs) are very commonly measured. Approximately 20% are abnormal, yet the majority are not investigated according to guidelines. However, investigating all abnormal LFTs to identify early liver disease would overwhelm services. Recently, several diagnostic pathways have been implemented across the country; some focus on abnormal LFTs and some on stratifying at-risk populations. This review will collate the evidence on the size of the problem and the challenges it poses. We will discuss the limitations and restrictions within systems that limit the responses available, review the current pathways being evaluated and piloted in the UK, and explore the arguments for and against LFT-based approaches and 'case-finding strategies' in the community diagnosis of liver disease. Furthermore, the role of fibrosis assessment methods (including scoring systems such as Fibrosis-4 (FIB-4) index, the enhanced liver fibrosis test and elastography) within these pathways will also be discussed. In conclusion, this review aims to establish some principles which, if adopted, are likely to improve the diagnosis of advanced liver disease, and identify the areas of contention for further research, in order to establish the most effective community detection models of liver disease.
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Affiliation(s)
- Iain Macpherson
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK,Department of Gastroenterology and Hepatology, Ninewells Hospital and Medical School, Dundee, UK
| | - Kushala W M Abeysekera
- Department of Liver Medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rebecca Harris
- NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Dina Mansour
- Department of Gastroenterology and Hepatology, Gateshead Health NHS Foundation Trust, Gateshead, UK,Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Stuart McPherson
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK,Liver Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Ian Rowe
- Leeds Institute for Medical Research, University of Leeds, Leeds, UK,Leeds Liver Unit, St James's University Hospital, Leeds, UK
| | - William Rosenberg
- Institute for Liver and Digestive Health, University College London Division of Medicine, London, UK,Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, London, UK
| | - John F Dillon
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK,Department of Gastroenterology and Hepatology, Ninewells Hospital and Medical School, Dundee, UK
| | - Andrew Yeoman
- Gwent Liver Unit, Aneurin Bevan University Health Board, Newport, UK
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Edgar RD, Perrone F, Foster AR, Payne F, Lewis S, Nayak KM, Kraiczy J, Cenier A, Torrente F, Salvestrini C, Heuschkel R, Hensel KO, Harris R, Jones DL, Zerbino DR, Zilbauer M. Culture-Associated DNA Methylation Changes Impact on Cellular Function of Human Intestinal Organoids. Cell Mol Gastroenterol Hepatol 2022; 14:1295-1310. [PMID: 36038072 PMCID: PMC9703134 DOI: 10.1016/j.jcmgh.2022.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND & AIMS Human intestinal epithelial organoids (IEOs) are a powerful tool to model major aspects of intestinal development, health, and diseases because patient-derived cultures retain many features found in vivo. A necessary aspect of the organoid model is the requirement to expand cultures in vitro through several rounds of passaging. This is of concern because the passaging of cells has been shown to affect cell morphology, ploidy, and function. METHODS Here, we analyzed 173 human IEO lines derived from the small and large bowel and examined the effect of culture duration on DNA methylation (DNAm). Furthermore, we tested the potential impact of DNAm changes on gene expression and cellular function. RESULTS Our analyses show a reproducible effect of culture duration on DNAm in a large discovery cohort as well as 2 publicly available validation cohorts generated in different laboratories. Although methylation changes were seen in only approximately 8% of tested cytosine-phosphate-guanine dinucleotides (CpGs) and global cellular function remained stable, a subset of methylation changes correlated with altered gene expression at baseline as well as in response to inflammatory cytokine exposure and withdrawal of Wnt agonists. Importantly, epigenetic changes were found to be enriched in genomic regions associated with colonic cancer and distant to the site of replication, indicating similarities to malignant transformation. CONCLUSIONS Our study shows distinct culture-associated epigenetic changes in mucosa-derived human IEOs, some of which appear to impact gene transcriptomic and cellular function. These findings highlight the need for future studies in this area and the importance of considering passage number as a potentially confounding factor.
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Affiliation(s)
- Rachel D Edgar
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Francesca Perrone
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - April R Foster
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; Centre for Pathway Analysis, Milner Therapeutics Institute, University of Cambridge, Cambridge, United Kingdom
| | - Felicity Payne
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Sophia Lewis
- Department of Molecular, Cell and Developmental Biology, University of California Los Angeles, Los Angeles, California; Eli and Edythe Broad Stem Cell Research Center, University of California Los Angeles, Los Angeles, California
| | - Komal M Nayak
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Judith Kraiczy
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Aurélie Cenier
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Franco Torrente
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Camilla Salvestrini
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Robert Heuschkel
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Kai O Hensel
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom; Witten/Herdecke University, Department of Paediatrics, Helios Medical Centre Wuppertal, Children's Hospital, Wuppertal, Germany
| | - Rebecca Harris
- Centre for Pathway Analysis, Milner Therapeutics Institute, University of Cambridge, Cambridge, United Kingdom
| | - D Leanne Jones
- Department of Molecular, Cell and Developmental Biology, University of California Los Angeles, Los Angeles, California; Eli and Edythe Broad Stem Cell Research Center, University of California Los Angeles, Los Angeles, California; Department of Anatomy and Medicine, Division of Geriatrics, University of California, San Francisco, San Francisco, California; Eli and Edythe Broad Center for Regeneration Medicine, University of California, San Francisco, San Francisco, California
| | - Daniel R Zerbino
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Matthias Zilbauer
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom; Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom.
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Thwala MM, Afantitis A, Papadiamantis AG, Tsoumanis A, Melagraki G, Dlamini LN, Ouma CNM, Ramasami P, Harris R, Puzyn T, Sanabria N, Lynch I, Gulumian M. Using the Isalos platform to develop a (Q)SAR model that predicts metal oxide toxicity utilizing facet-based electronic, image analysis-based, and periodic table derived properties as descriptors. Struct Chem 2021. [DOI: 10.1007/s11224-021-01869-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractEngineered nanoparticles (NPs) are being studied for their potential to harm humans and the environment. Biological activity, toxicity, physicochemical properties, fate, and transport of NPs must all be evaluated and/or predicted. In this work, we explored the influence of metal oxide nanoparticle facets on their toxicity towards bronchial epithelial (BEAS-2B), Murine myeloid (RAW 264.7), and E. coli cell lines. To estimate the toxicity of metal oxide nanoparticles grown to a low facet index, a quantitative structure–activity relationship ((Q)SAR) approach was used. The novel model employs theoretical (density functional theory calculations) and experimental studies (transmission electron microscopy images from which several particle descriptors are extracted and toxicity data extracted from the literature) to investigate the properties of faceted metal oxides, which are then utilized to construct a toxicity model. The classification mode of the k-nearest neighbour algorithm (EnaloskNN, Enalos Chem/Nanoinformatics) was used to create the presented model for metal oxide cytotoxicity. Four descriptors were identified as significant: core size, chemical potential, enthalpy of formation, and electronegativity count of metal oxides. The relationship between these descriptors and metal oxide facets is discussed to provide insights into the relative toxicities of the nanoparticle. The model and the underpinning dataset are freely available on the NanoSolveIT project cloud platform and the NanoPharos database, respectively.
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Raju SA, Harris R, Cook C, Harvey P, Ratcliffe E. UK-wide study of the opinions of gastroenterology trainees: COVID-19, Shape of Training and the future workforce. Frontline Gastroenterol 2021; 13:386-391. [PMID: 36042778 PMCID: PMC8694934 DOI: 10.1136/flgastro-2021-101965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/21/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has disrupted training. Gastroenterology higher specialty training is soon to be reduced from 5 years to 4. The British Society of Gastroenterology Trainees Section biennial survey aims to delineate the impact of COVID-19 on training and the opinions on changes to training. METHODS An electronic survey allowing for anonymised responses at the point of completion was distributed to all gastroenterology trainees from September to November 2020. RESULTS During the first wave of the COVID-19 pandemic, 71.0% of the respondents stated that more than 50% of their clinical time was mostly within general internal medicine. Trainees reported a significant impact on all aspects of their gastroenterology training due to lost training opportunities and increasing service commitments. During the first wave, 88.5% of the respondents reported no access to endoscopy training lists. Since this time, 66.2% of the respondents stated that their endoscopy training lists had restarted. This has resulted in fewer respondents achieving endoscopy accreditation. The COVID-19 pandemic has caused 42.2% of the respondents to consider extending their training to obtain the skills required to complete training. Furthermore, 10.0% of the respondents reported concerns of a delay to completion of training. The majority of respondents (84.2%) reported that they would not feel ready to be a consultant after 4 years of training. CONCLUSIONS Reductions in all aspects of gastroenterology training were reported. This is mirrored in anticipated concerns about completion of training in a shorter training programme as proposed in the new curriculum. Work is now required to ensure training is restored following the pandemic.
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Affiliation(s)
- Suneil A Raju
- Gastroenterology and Liver Unit, The University of Sheffield, Sheffield, UK
| | - Rebecca Harris
- Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Charlotte Cook
- Department of Hepatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Philip Harvey
- Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Chiotos K, Lee G, Sydney G, Wolfe H, Blumenthal J, Stinson H, McGowan N, Harab J, Traynor D, Dudhia A, Piccione J, Burke J, Doll A, Keim G, Woods-Hill C, Jennings M, Harris R, Gerber J. 1139. Reducing Collection of Tracheal Aspirate Bacterial Cultures: A Diagnostic Test Stewardship Intervention. Open Forum Infect Dis 2021. [PMCID: PMC8644428 DOI: 10.1093/ofid/ofab466.1332] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Tracheal aspirate (TA) bacterial cultures are often collected in mechanically ventilated children to evaluate for ventilator-associated infections (VAI), including tracheitis and pneumonia. However, frequent bacterial colonization of tracheal tubes results in poor specificity of positive TA cultures for distinguishing bacterial infection from colonization, which contributes to antibiotic overuse for VAI. We performed a quality improvement project to reduce collection of TA cultures through implementation of a consensus guideline to standardize culture ordering, and measured its impact on antibiotic use in a tertiary PICU.
Methods
A multidisciplinary team including PICU, pulmonary, and ID clinicians developed the consensus guideline in November 2019-February 2020. The first Plan-Do-Study-Act (PDSA) cycle occurred in August 2020 and included provider education, providing a link to the guideline in the TA culture order, and signs and screensavers highlighting key guideline recommendations. The second PDSA cycle occurred in October-December 2020 and included weekly emails to on service PICU clinicians. Statistical process control charts were used to measure the number of TA cultures collected/100 ventilator days and broad-spectrum antibiotic DOT/100 ventilator days. The number of patients treated for VAI/100 ventilator days and guideline compliance were also measured.
Results
The baseline rate of TA culture collection was 4.58/100 ventilator days. A centerline shift to 3.33 cultures/100 ventilator days occurred in March 2020. Following PDSA 1 and 2 in October 2020, a second downward centerline shift to 2.22 cultures/100 ventilator days occurred (Figure 1). Broad-spectrum antibiotic days of therapy/100 ventilator days decreased in November 2019 coincident with the start of the project, but no further reductions occurred after PDSA 1 and 2 (Figure 2). The number of patients treated for VAI decreased from a baseline of 1.24/100 ventilator days to 0.66/100 ventilator days. Finally, the proportion of TA cultures ordered that were non-compliant with the guideline recommendations was unchanged throughout the study period (Table 1).
Conclusion
A consensus guideline reduced collection of TA cultures, with a modest reduction in the rate of antibiotic treatment for VAI.
Disclosures
All Authors: No reported disclosures
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Affiliation(s)
| | - Giyoung Lee
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Guy Sydney
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Heather Wolfe
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Hannah Stinson
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Nancy McGowan
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Julie Harab
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Aaditya Dudhia
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Joseph Piccione
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jennalyn Burke
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ashley Doll
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Garrett Keim
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Megan Jennings
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rebecca Harris
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jeffrey Gerber
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Mammadli M, Harris R, Suo L, May A, Gentile T, Waickman AT, Bah A, August A, Nurmemmedov E, Karimi M. Interleukin-2-inducible T-cell kinase (Itk) signaling regulates potent noncanonical regulatory T cells. Clin Transl Med 2021; 11:e625. [PMID: 34919342 PMCID: PMC8679839 DOI: 10.1002/ctm2.625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022] Open
Abstract
Regulatory T cells (Tregs) play an important role in controlling autoimmunity and limiting tissue damage and inflammation. IL2-inducible T cell kinase (Itk) is part of the Tec family of tyrosine kinases and is a critical component of T cell receptor mediated signaling. Here, we showed that either genetic ablation of Itk signaling or inhibition of Itk signaling pathways resulted in increased frequency of "noncanonical" CD4+ CD25- FOXP3+ Tregs (ncTregs), as well as of "canonical" CD4+ CD25+ FOXP3+ Tregs (canTregs). Using in vivo models, we showed that ncTregs can avert the formation of acute graft-versus-host disease (GVHD), in part by reducing conventional T cell proliferation, proinflammatory cytokine production, and tissue damage. This reduction in GVHD occurred without disruption of graft-versus-leukaemia (GVL) effects. RNA sequencing revealed that a number of effector, cell adhesion, and migration molecules were upregulated in Itk-/- ncTregs. Furthermore, disrupting the SLP76: ITK interaction using a specific peptide inhibitor led to enhanced Treg development in both mouse and primary human cells. This peptide inhibitor also significantly reduced inflammatory cytokine production in primary GVHD patient samples and mouse T cells without causing cell death or apoptosis. We provide evidence that specifically targeting Itk signaling could be a therapeutic strategy to treat autoimmune disorders.
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Affiliation(s)
- Mahinbanu Mammadli
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Rebecca Harris
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Liye Suo
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Adriana May
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Teresa Gentile
- Department of Hematology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Adam T Waickman
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Alaji Bah
- Department of Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Avery August
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Elmar Nurmemmedov
- Department of Translational Neurosciences Saint John's Cancer Institute, Santa Monica, California, USA
| | - Mobin Karimi
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York, USA
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Lahoti A, Yu C, Brar PC, Dalgo A, Gourgari E, Harris R, Kamboj MK, Marks S, Nandagopal R, Page L, Raman V, Reynolds DG, Sarafoglou K, Terrell C, Stanley TL. An endocrine perspective on menstrual suppression for adolescents: achieving good suppression while optimizing bone health. J Pediatr Endocrinol Metab 2021; 34:1355-1369. [PMID: 34388330 DOI: 10.1515/jpem-2020-0539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 07/19/2021] [Indexed: 11/15/2022]
Abstract
Suppression of menstruation and/or ovarian function in adolescent girls may be desired for a variety of reasons. Numerous medical options exist. The choice of the appropriate modality for an individual patient depends on several factors based on differences in the efficacy of achieving menstrual suppression as well as in their side effect profiles. Adolescence is also a period of bone mass accrual in girls, and several of these modalities may negatively influence peak bone mass. This review focuses on the efficacy of achieving menstrual suppression and the effect on bone health of the various options through an overview of the current literature and also highlights areas in need of further research.
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Affiliation(s)
- Amit Lahoti
- Pediatric Endocrine Division, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, TN, USA
| | - Christine Yu
- Section of Adult and Pediatric Endocrinology, Diabetes, & Metabolism, University of Chicago, Chicago, IL, USA
| | - Preneet Cheema Brar
- Division of Pediatric Endocrinology and Diabetes, NYU Grossman School of Medicine, New York, NY, USA
| | - Austin Dalgo
- Center for Bioethics and Health Equity, Le Bonheur Children's Hospital and University of Tennessee Health Science Center, Memphis, TN, USA
| | - Evgenia Gourgari
- Pediatric Endocrinology Division, Department of Pediatrics, Georgetown University, Washington, DC, USA
| | - Rebecca Harris
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
| | - Manmohan K Kamboj
- Section of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital at The Ohio State University, Columbus, OH, USA
| | - Seth Marks
- Section of Pediatric Endocrinology and Metabolism, Department of Pediatrics and Child Health, Children's Hospital HSC Winnipeg, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Radha Nandagopal
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Laura Page
- Division of Endocrinology, Department of Pediatrics, Duke University, Durham, NC, USA
| | | | - Danielle G Reynolds
- Diabetes and Endocrinology Center, University of South Florida, Tampa, FL, USA
| | - Kyriakie Sarafoglou
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.,Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, USA
| | - Carrie Terrell
- Division of General Obstetrics, Gynecology, Midwifery and Family Planning at the University of Minnesota Medical School, Minneapolis, MN, USA
| | - Takara L Stanley
- Pediatric Endocrine Unit and Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Harris R, Yang J, Pagan K, Cho SJ, Stout-Delgado H. Antiviral Gene Expression in Young and Aged Murine Lung during H1N1 and H3N2. Int J Mol Sci 2021; 22:ijms222212097. [PMID: 34829979 PMCID: PMC8618707 DOI: 10.3390/ijms222212097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 01/02/2023] Open
Abstract
Influenza is a respiratory virus that alone or in combination with secondary bacterial pathogens can contribute to the development of acute pneumonia in persons >65 years of age. Host innate immune antiviral signaling early in response to influenza is essential to inhibit early viral replication and guide the initiation of adaptive immune responses. Using young adult (3 months) and aged adult mice infected with mouse adapted H1N1 or H3N2, the results of our study illustrate dysregulated and/or diminished activation of key signaling pathways in aged lung contribute to increased lung inflammation and morbidity. Specifically, within the first seven days of infection, there were significant changes in genes associated with TLR and RIG-I signaling detected in aged murine lung in response to H1N1 or H3N2. Taken together, the results of our study expand our current understanding of age-associated changes in antiviral signaling in the lung.
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MESH Headings
- A549 Cells
- Animals
- DEAD Box Protein 58/genetics
- Disease Models, Animal
- Gene Expression Regulation, Viral/genetics
- Humans
- Immunity, Innate/genetics
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/pathogenicity
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/pathogenicity
- Influenza, Human/genetics
- Influenza, Human/microbiology
- Influenza, Human/virology
- Lung/metabolism
- Lung/microbiology
- Lung/pathology
- Mice
- Orthomyxoviridae Infections/genetics
- Orthomyxoviridae Infections/microbiology
- Orthomyxoviridae Infections/virology
- Pneumonia/genetics
- Pneumonia/microbiology
- Pneumonia/virology
- Toll-Like Receptors/genetics
- Virus Replication/genetics
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Quertermous B, Seigler N, Looney J, Crandall R, Blackburn M, Harris R. 267: Tissue oxygen utilization and ventilatory parameters during exercise in patients with cystic fibrosis: The role of HbA1c. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Harris R, Batterham M, Neale E, Ferreira I. 1463Impact of missing outcome data in meta-analyses of lifestyle interventions during pregnancy to reduce postpartum-weight-retention. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.265] [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
Background
High risk of bias associated with missing outcome data (MOD) in meta-analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR), casts doubt on whether such interventions can be relied upon as truly effective, since estimates are deemed valid only if MOD was missing at random (MAR).
Methods
We conducted a systematic overview of MAs to examine the impact of MOD on the estimation of meta-analytic summary intervention effects and conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption.
Results
Three relevant MAs were identified, all with high MOD rates in the RCTs included (median>30%), and all reporting beneficial intervention effects on PPWR (in kg) estimated based on complete case analyses: [-0.78 (95%CI: -1.39,-0.16), -0.81 (-1.57,-0.06), and -0.94 (-1.52,-0.37)] in MAs of any lifestyle, exercise, or diet + exercise interventions, respectively. In plausible scenarios where the outcome for the intervention group in participants with vs without MOD was worse (by 0.5kg), effect estimates were attenuated in all and no longer significant in 2 of the MAs [-0.58 (-1.29,0.13), -0.70 (-1.50,0.10) and -0.88 (-1.73,-0.02)].
Conclusions
Statistical significance was retained when all 19 RCTs identified across MAs were meta-analysed: -0.63 (-0.17,-0.08).
Key messages
The clinical relevancy of effects of this magnitude remains unclear.
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Affiliation(s)
- Rebecca Harris
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Marijka Batterham
- School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Elizabeth Neale
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Isabel Ferreira
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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Harris R, Stubbings DR, De Claire K. Factors Predictive of Behavioural and Emotional Dysfunction in Adolescents in a Secure Children's Home. J Child Adolesc Trauma 2021; 14:299-310. [PMID: 34466182 PMCID: PMC8357882 DOI: 10.1007/s40653-020-00329-7] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 06/13/2023]
Abstract
The aim of the present study was to investigate what factors are predictive of behavioural and emotional dysfunction in adolescence. A sample of 60 young people accommodated under a welfare or youth custody service order in a UK secure children's home between 2016 and 2018 was used. Data regarding young people's Adverse Childhood Experiences (ACE's) history, scores on standard assessments and factors thought to indicate behavioural and emotional dysfunction were collected from file information. Correlations and regression models were used to analyse the data. Analyses found that young people in this setting had been exposed to more ACEs than the general population. Furthermore, signs of behavioural and emotional dysfunction as a result of exposure to ACE's appeared to be present from early adolescence. It was found that exposure to verbal and sexual abuse were the greatest predictors of involvement in risk incidents. The young person's substance misuse habits were the best predictor of the length of stay in the secure children's home. These findings may have policy implications and highlight the need for early interventions with young people exposed to ACE's.
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Affiliation(s)
- Rebecca Harris
- Hillside Secure Children’s Home, Neath, UK
- School of Sport and Health Sciences: Applied Psychology Department, Cardiff Metropolitan University, Cardiff, UK
| | - Daniel R. Stubbings
- School of Sport and Health Sciences: Applied Psychology Department, Cardiff Metropolitan University, Cardiff, UK
| | - Karen De Claire
- School of Sport and Health Sciences: Applied Psychology Department, Cardiff Metropolitan University, Cardiff, UK
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