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DeGrace S, Romero-Sanchiz P, Tibbo P, Barrett S, Arenella P, Cosman T, Atasoy P, Cousijn J, Wiers R, Keough MT, Yakovenko I, O'Connor R, Wardell J, Rudnick A, Nicholas Carleton R, Heber A, Stewart SH. Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories? Behav Res Ther 2023; 169:104387. [PMID: 37625353 DOI: 10.1016/j.brat.2023.104387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023]
Abstract
Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.
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Affiliation(s)
- S DeGrace
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada.
| | - P Romero-Sanchiz
- School of Psychology, University of Sussex Sussex House, Falmer, Brighton, BN1 9RH, United Kingdom
| | - P Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - S Barrett
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - P Arenella
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - T Cosman
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - P Atasoy
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - J Cousijn
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - R Wiers
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - M T Keough
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - I Yakovenko
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - R O'Connor
- Concordia University, Department of Psychology, 7141 Sherbrooke West PY-146, Montreal, QC, H4B 1R6, Canada
| | - J Wardell
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - A Rudnick
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - R Nicholas Carleton
- University of Regina, Department of Psychology, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - A Heber
- McMaster University, Department of Psychiatry and Behavioural Neurosciences, 100 West 5th Street, Hamilton, ON, Canada
| | - S H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
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Moore F, Allott C, O'Connor R. Impulsivity, aggression, and impulsive aggression in suicidality. Personality and Individual Differences 2023. [DOI: 10.1016/j.paid.2022.111971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Akhtar A, Brooks A, O'Connor R. EGS P01 The diurnal and seasonal relationships of pedestrian injuries secondary to motor vehicles in young people. Br J Surg 2022. [DOI: 10.1093/bjs/znac404.066] [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: 12/13/2022]
Abstract
Abstract
Background
There remains a significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter.
Methods
Data was retrieved for patients between 10–25 years old from the national Trauma Audit and Research Network (TARN) database, who had been involved as pedestrians in motor vehicle accidents between 2015–2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time and mortality were analysed according to the hours of daylight, darkness and season.
Results
The study identified a seasonal pattern, showing that autumn was the predominant season and lead to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500–1630 correlating to school pick up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124) with moderate injuries (ISS 9–14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%).
Conclusions
We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick up times may play a significant role . This could be addressed through a targeted public health approach to implement change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.
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Affiliation(s)
- Amina Akhtar
- Major trauma centre, Nottingham University Hospitals , Nottingham , United Kingdom
| | - A Brooks
- Major trauma centre, Nottingham University Hospitals , Nottingham , United Kingdom
| | - R O'Connor
- Major trauma centre, Nottingham University Hospitals , Nottingham , United Kingdom
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Nowak Vel Nowakowski P, Makowski D, Jabłoński B, Szajerski P, Pandya SP, O'Connor R, Tieulent R, Barnsley R. Evaluation of optical transmission across the ITER hard x-ray monitor system designed for the first plasma scenarios. Rev Sci Instrum 2022; 93:103512. [PMID: 36319325 DOI: 10.1063/5.0101802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
Hard x-ray (HXR) spectroscopy is applied for diagnostics of runaway electrons in nuclear fusion reactors. The scintillation counter is one of the most commonly used types of detectors for HXR spectroscopy. It consists of a detector that emits light when excited by HXR radiation (scintillator) directly coupled to a PMT (Photomultiplier Tube) that converts light pulses into an electrical signal. This type of detector is commonly used in existing tokamaks, such as Joint European Torus (JET), Experimental Advanced Superconducting Tokamak (EAST), Compact Assembly (COMPASS), and Axially Symmetric Divertor Experiment (ASDEX-U). In all these cases, the scintillator is directly coupled to the PMT to provide the best possible light transmission efficiency. The Hard X-ray Monitor (HXRM) is one among the first plasma diagnostic systems at ITER that provides information about the energy distribution of runaway electrons inside a tokamak by HXR spectroscopy. This system also uses a scintillator and a PMT as a detector. Due to the heavy shielding of the blanket modules, vacuum vessel, and port-plugs, it is not possible to assemble the scintillator outside the tokamak vacuum vessel. The PMT detector cannot be installed in the close vicinity of the tokamak due to either the significant magnetic field or temperature. A possible solution is to decouple the scintillator from the PMT and place the PMT inside the port-cell. Light pulses will be transmitted to the PMT via a 12 m long optical fiber bundle. Evaluation of the optical transmission was carried out to assess the performance of the HXR monitor and verify possible problems related to the PMT pulse discrimination under low light conditions.
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Affiliation(s)
- P Nowak Vel Nowakowski
- Department of Microelectronics and Computer Science, Lodz University of Technology, Lodz 93-005, Poland
| | - D Makowski
- Department of Microelectronics and Computer Science, Lodz University of Technology, Lodz 93-005, Poland
| | - B Jabłoński
- Department of Microelectronics and Computer Science, Lodz University of Technology, Lodz 93-005, Poland
| | - P Szajerski
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz 93-590, Poland
| | | | - R O'Connor
- ITER Organization, Saint-Paul-lès-Durance 13115, France
| | - R Tieulent
- ITER Organization, Saint-Paul-lès-Durance 13115, France
| | - R Barnsley
- ITER Organization, Saint-Paul-lès-Durance 13115, France
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Raywood E, Filipow N, Stanojevic S, Shannon H, Douglas H, Tanriver G, Murray N, O'Connor R, Hill L, Dawson C, Davies G, Stott L, Saul G, Kuzhagaliyev T, van Schaik T, Furtuna B, Liakhovich O, Booth J, Kapoor K, Main E. 276 Effects of quantity and quality of daily airway clearance treatments on lung function in children and young people with cystic fibrosis: Results from Project Fizzyo. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00966-3] [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: 11/07/2022]
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Main E, Filipow N, Raywood E, Tanriver G, Douglas H, Davies G, Murray N, O'Connor R, Stott L, Saul G, Kuzhagaliyev T, Liakhovich O, Furtuna B, van Schaik T, Booth J, Dawson C, Hill L, Kapoor K, Stanojevic S. 271 Impact of habitual levels of moderate to vigorous physical activity on forced expiratory volume in 1 second in children and young people with cystic fibrosis: Results from Project Fizzyo. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00961-4] [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: 11/07/2022]
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7
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Ellebrecht C, Lee C, O'Connor R, Payne A. 024 Asymmetric cell division for fate induction of chimeric antigen receptor (CAR) T cells. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Booth K, Murphy T, O'Connor R, McGuire A. P.89 Management of refractory thrombotic thrombocytopenic purpura presenting in the pregnancy. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Abarkan M, Pirog A, Mafilaza D, Pathak G, N'Kaoua G, Puginier E, O'Connor R, Raoux M, Donahue MJ, Renaud S, Lang J. Vertical Organic Electrochemical Transistors and Electronics for Low Amplitude Micro-Organ Signals. Adv Sci (Weinh) 2022; 9:e2105211. [PMID: 35064774 PMCID: PMC8922095 DOI: 10.1002/advs.202105211] [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] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Indexed: 06/14/2023]
Abstract
Electrical signals are fundamental to key biological events such as brain activity, heartbeat, or vital hormone secretion. Their capture and analysis provide insight into cell or organ physiology and a number of bioelectronic medical devices aim to improve signal acquisition. Organic electrochemical transistors (OECT) have proven their capacity to capture neuronal and cardiac signals with high fidelity and amplification. Vertical PEDOT:PSS-based OECTs (vOECTs) further enhance signal amplification and device density but have not been characterized in biological applications. An electronic board with individually tuneable transistor biases overcomes fabrication induced heterogeneity in device metrics and allows quantitative biological experiments. Careful exploration of vOECT electric parameters defines voltage biases compatible with reliable transistor function in biological experiments and provides useful maximal transconductance values without influencing cellular signal generation or propagation. This permits successful application in monitoring micro-organs of prime importance in diabetes, the endocrine pancreatic islets, which are known for their far smaller signal amplitudes as compared to neurons or heart cells. Moreover, vOECTs capture their single-cell action potentials and multicellular slow potentials reflecting micro-organ organizations as well as their modulation by the physiological stimulator glucose. This opens the possibility to use OECTs in new biomedical fields well beyond their classical applications.
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Affiliation(s)
- Myriam Abarkan
- UMR CNRS 5248 (CBMN, Chemistry and Biology of Membranes)Univ. BordeauxAv Geoffroy St HilairePessacF‐33600France
| | - Antoine Pirog
- UMR CNRS 5218 (IMS, Integration of Materials into Systems)Univ. BordeauxBordeaux Institut National Polytechnique351 Cours de la LibérationTalenceF‐33405France
| | - Donnie Mafilaza
- UMR CNRS 5218 (IMS, Integration of Materials into Systems)Univ. BordeauxBordeaux Institut National Polytechnique351 Cours de la LibérationTalenceF‐33405France
| | - Gaurav Pathak
- Department of BioelectronicsMines Saint EtienneCMP‐EMSEMOCGardanne13541France
- Linköping UniversityDepartment of Science and Technology (ITN)Laboratory of Organic ElectronicsLinköpingSE‐581 83Sweden
| | - Gilles N'Kaoua
- UMR CNRS 5218 (IMS, Integration of Materials into Systems)Univ. BordeauxBordeaux Institut National Polytechnique351 Cours de la LibérationTalenceF‐33405France
| | - Emilie Puginier
- UMR CNRS 5248 (CBMN, Chemistry and Biology of Membranes)Univ. BordeauxAv Geoffroy St HilairePessacF‐33600France
| | - Rodney O'Connor
- Department of BioelectronicsMines Saint EtienneCMP‐EMSEMOCGardanne13541France
| | - Matthieu Raoux
- UMR CNRS 5248 (CBMN, Chemistry and Biology of Membranes)Univ. BordeauxAv Geoffroy St HilairePessacF‐33600France
| | - Mary J. Donahue
- Department of BioelectronicsMines Saint EtienneCMP‐EMSEMOCGardanne13541France
- Linköping UniversityDepartment of Science and Technology (ITN)Laboratory of Organic ElectronicsLinköpingSE‐581 83Sweden
| | - Sylvie Renaud
- UMR CNRS 5218 (IMS, Integration of Materials into Systems)Univ. BordeauxBordeaux Institut National Polytechnique351 Cours de la LibérationTalenceF‐33405France
| | - Jochen Lang
- UMR CNRS 5248 (CBMN, Chemistry and Biology of Membranes)Univ. BordeauxAv Geoffroy St HilairePessacF‐33600France
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Mohamed H, McAuliffe N, O'Connor R, Ceballos Salazar A, Zohaib Aslam M, Kallidaikurichi Srinivasan K, Iohom G, Shorten G. Proficiency-based progression training: implementing a novel approach to training for epidural analgesia in labour. Int J Obstet Anesth 2021; 48:103213. [PMID: 34500191 DOI: 10.1016/j.ijoa.2021.103213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/04/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Epidural insertion is a challenging anaesthetic procedural skill to learn and may require up to 75 attempts to achieve competency. Proficiency-based progression (PbP) training based on unambiguously defined metrics was associated with a 53% reduction in epidural failure rate. The aim of this observational study was to examine the feasibility of implementation of innovative PbP training for labour epidural insertion performed by novices in a busy tertiary hospital. METHODS All trainees who were scheduled to commence their obstetric anaesthesia training were invited to participate. Novices undertook intensive PbP training with one-to-one supervision by an anaesthetist trained in PbP. Trainees proceeded to the clinical phase only after attaining the pre-defined proficiency benchmark. All subsequent attempts at labour epidural catheter placement were evaluated. RESULTS All 12 novice trainees who were scheduled for their initial exposure to obstetric anaesthesia completed PbP training in epidural catheter insertion successfully. The average duration of the training courses was 70 (SD 11) min. Trainee characteristics were broadly similar. They performed a total of 180 labour epidural catheter placements with an overall epidural failure rate of 12.2% (22/180). The proportion of supervisor takeover was 6% (11/179). The incidence of complications was 4% (8/180) and difficulty in epidural catheter insertion due to patient factors was 16% (29/180). Patient satisfaction rates were 80% (satisfied or very satisfied), with 20% unsatisfied with their experience of epidural insertion. CONCLUSION In our experience, PbP training in epidural placement is feasible within existing departmental resources in a busy tertiary teaching hospital setting.
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Affiliation(s)
- H Mohamed
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, Cairo University, Cairo, Egypt; Department of Anaesthesia and Intensive Care, Leeds Teaching Hospitals, Leeds, UK.
| | - N McAuliffe
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - R O'Connor
- Department of Anaesthesia, University College Cork, Cork, Ireland
| | - A Ceballos Salazar
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK
| | - M Zohaib Aslam
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | | | - G Iohom
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland; Department of Anaesthesia, University College Cork, Cork, Ireland
| | - G Shorten
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland; Department of Anaesthesia, University College Cork, Cork, Ireland; Insight II SFI Research Centre, Ireland
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Kaszas A, Szalay G, Slézia A, Bojdán A, Vanzetta I, Hangya B, Rózsa B, O'Connor R, Moreau D. Two-photon GCaMP6f imaging of infrared neural stimulation evoked calcium signals in mouse cortical neurons in vivo. Sci Rep 2021; 11:9775. [PMID: 33963220 PMCID: PMC8105372 DOI: 10.1038/s41598-021-89163-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/22/2021] [Indexed: 02/07/2023] Open
Abstract
Infrared neural stimulation is a promising tool for stimulating the brain because it can be used to excite with high spatial precision without the need of delivering or inserting any exogenous agent into the tissue. Very few studies have explored its use in the brain, as most investigations have focused on sensory or motor nerve stimulation. Using intravital calcium imaging with the genetically encoded calcium indicator GCaMP6f, here we show that the application of infrared neural stimulation induces intracellular calcium signals in Layer 2/3 neurons in mouse cortex in vivo. The number of neurons exhibiting infrared-induced calcium response as well as the amplitude of those signals are shown to be both increasing with the energy density applied. By studying as well the spatial extent of the stimulation, we show that reproducibility of the stimulation is achieved mainly in the central part of the infrared beam path. Stimulating in vivo at such a degree of precision and without any exogenous chromophores enables multiple applications, from mapping the brain's connectome to applications in systems neuroscience and the development of new therapeutic tools for investigating the pathological brain.
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Affiliation(s)
- Attila Kaszas
- Mines Saint-Etienne, Centre CMP, Département BEL, F - 13541, Gardanne, France
- Institut de Neurosciences de la Timone, CNRS UMR 7289 & Aix-Marseille Université, 13005, Marseille, France
| | - Gergely Szalay
- Laboratory of 3D Functional Network and Dendritic Imaging, Institute of Experimental Medicine, Budapest, 1083, Hungary
| | - Andrea Slézia
- Mines Saint-Etienne, Centre CMP, Département BEL, F - 13541, Gardanne, France
- Lendület Laboratory of Systems Neuroscience, Institute of Experimental Medicine, Budapest, 1083, Hungary
| | - Alexandra Bojdán
- Laboratory of 3D Functional Network and Dendritic Imaging, Institute of Experimental Medicine, Budapest, 1083, Hungary
| | - Ivo Vanzetta
- Institut de Neurosciences de la Timone, CNRS UMR 7289 & Aix-Marseille Université, 13005, Marseille, France
| | - Balázs Hangya
- Lendület Laboratory of Systems Neuroscience, Institute of Experimental Medicine, Budapest, 1083, Hungary
| | - Balázs Rózsa
- Laboratory of 3D Functional Network and Dendritic Imaging, Institute of Experimental Medicine, Budapest, 1083, Hungary
- Two-Photon Laboratory, Faculty of Information Technology, Pázmány Péter Catholic University, Budapest, 1083, Hungary
| | - Rodney O'Connor
- Mines Saint-Etienne, Centre CMP, Département BEL, F - 13541, Gardanne, France
- Institut de Neurosciences de la Timone, CNRS UMR 7289 & Aix-Marseille Université, 13005, Marseille, France
| | - David Moreau
- Mines Saint-Etienne, Centre CMP, Département BEL, F - 13541, Gardanne, France.
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Akhtar A, O'Connor R, Rosen J, Brooks A. 1002 Calcium administration in Major haemorrhage Protocol. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.523] [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: 11/14/2022]
Abstract
Abstract
Introduction
Calcium gluconate is an essential part of the major haemorrhage protocol (MHP). It minimizes the exacerbation of transfusion coagulopathies due to the citrate preservative. As fifty percent of trauma patients present with hypocalcaemia prior to transfusion, the risk is pertinent. Given the importance of the issue, surprisingly current guidelines remain sparse. We analysed the percentage of patients who received calcium and their hypocalcaemia incidence.
Method
A Retrospective review of red traumas during June to August 2019. The frequency of MHP and the patient’s ionised plasma calcium levels on VBG (1.15-1.26mmol/L) were identified. Our standard stated 100% of MHP should receive calcium. A massive transfusion was defined as 10 red blood cells units in 24 hours or 4 blood products within 30mins.
Results
27 red traumas were accepted to audit, MHP was activated in 85%. Out of these 75% received calcium and on average after 6.4 units of blood products. The incidence of ionised hypocalcaemia in all MHP patients was 67%.
Conclusions
We identified a standard that supplementary calcium should be supplemented in all MHPs. Hypocalcaemia was more frequency than our research stipulated. Improvement needs to be made to meet standards. We recommend incorporation of Calcium gluconate into major haemorrhage pack and transfusion guidelines.
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Affiliation(s)
- A Akhtar
- Nottingham University Hospital, Nottingham, United Kingdom
| | - R O'Connor
- Nottingham University Hospital, Nottingham, United Kingdom
| | - J Rosen
- Nottingham University Hospials, Nottingham, United Kingdom
| | - A Brooks
- Nottingham University Hospital, Nottingham, United Kingdom
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13
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Cho WS, Bonduelle Q, Ghasemi A, Baskaran V, O'Connor R, Shah J, Andrewartha F, Fergie N. Prognosticating patients with necrotising otitis externa based on response to treatment. Ann R Coll Surg Engl 2021; 103:285-290. [PMID: 33682472 DOI: 10.1308/rcsann.2020.7133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Necrotising otitis externa (NOE) is a severe infection of the temporal bone. The traditional severity based staging system does not fully prognosticate all patients with NOE. We hypothesise that a patient response staging system would more accurately capture the disease process and guide prognosis. METHODS We carried out a retrospective notes review of patients diagnosed with NOE from January 2017 to December 2018 in a regional tertiary referral centre. Patient outcomes from our proposed patient response staging system were compared to a modified previously published severity based Gleeson staging system with patients requiring prolonged treatment classified as having a poor outcome. RESULTS A total of 34 patients were treated for NOE. The majority were male (n=24) and had diabetes (n=25). Patients with the most severe Gleeson staging did not have the worst outcome. Daily delay in resolution of otorrhoea was associated with an increased need for more than six weeks of treatment. Rapid responders are patients who had resolution of otalgia, otorrhoea and C-reactive protein normalisation within 14 days, and all were cured following standard 6 weeks of treatment. CONCLUSIONS The Gleeson staging system was valuable in assessing the extent of disease and all early Gleeson staged patients had good outcomes. However, patients with higher severity staging on the Gleeson system did not necessarily require prolonged treatment. There is a role for a joint approach in staging patients based on both modified Gleeson and treatment response, which would subsequently guide prognosis, duration of treatment and early diagnosis of potential fungal NOE.
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Affiliation(s)
- W S Cho
- Nottingham University Hospitals NHS Trust, UK
| | - Q Bonduelle
- Nottingham University Hospitals NHS Trust, UK
| | - A Ghasemi
- Nottingham University Hospitals NHS Trust, UK
| | - V Baskaran
- Nottingham University Hospitals NHS Trust, UK
| | - R O'Connor
- Nottingham University Hospitals NHS Trust, UK
| | - J Shah
- Nottingham University Hospitals NHS Trust, UK
| | | | - N Fergie
- Nottingham University Hospitals NHS Trust, UK
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Goodson AMC, Parmar S, Ganesh S, Zakai D, Shafi A, Wicks C, O'Connor R, Yeung E, Khalid F, Tahim A, Gowrishankar S, Hills A, Williams EM. Printed titanium implants in UK craniomaxillofacial surgery. Part I: access to digital planning and perceived scope for use in common procedures. Br J Oral Maxillofac Surg 2020; 59:312-319. [PMID: 33280946 DOI: 10.1016/j.bjoms.2020.08.087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Abstract
This first part of a two-part study examines perceived applications for and barriers to using printed titanium in light of current caseloads, funding pathways, and use of digital planning. It aims to demonstrate the scope for printed titanium in modern practice and to guide industry about the needs of UK surgeons. A cross-sectional study over 14 weeks was performed electronically with support from the British Association of Oral and Maxillofacial Surgeons (BAOMS) and a national trainee-led recruitment team. Ethics approval was obtained at the lead centre. A total of 132 participants joined the study (70% consultants, 25% specialty registrars, and 5% other), approximating a 29% response rate from consultant/registrar BAOMS members throughout mainland UK. Eighty-eight per cent used CAD-CAM design, with highly variable funding/access, design/manufacturing workflows (in-house/outsourced). Eighty-eight per cent were involved with trauma, 61% with orthognathic, and 52% with oncology-reconstruction surgery. Favourite applications for printed titanium were orbital floor repair (89%) and free-flap jaw reconstruction (87%). Most participants also cited maxillary/zygomatic osteotomies and cranioplasty (range 61%-73%). Although a popular application (78%), the evidence base in temporomandibular joint surgery is limited. Those performing orthognathic surgery perceived more indications than those who did not (p=0.013). Key barriers included cost, turnaround time and logistics, and the need to be trained in traditional techniques. Printed titanium was useful for both common and niche procedures, but was specifically limited in emergency trauma. Most surgeons had experience in CAD-CAM surgery but technical understanding appeared unclear. Limiting factors included variable funding and production pathways, perceived costs, and logistics, but in-house design can minimise them. In part II, we quantify perceived benefits and limitations and whether surgeons' understanding and knowledge are sufficient to rationalise them.
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Affiliation(s)
- A M C Goodson
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - S Parmar
- University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom.
| | - S Ganesh
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - D Zakai
- Health Education England (West Midlands), 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, United Kingdom.
| | - A Shafi
- NHS Education for Scotland, Westport 102, West Port, Edinburgh, EH3 9DN, United Kingdom.
| | - C Wicks
- Health Education England (South West), Park House, Newbrick Rd, Stoke Gifford, Bristol BS34 8YU, United Kingdom.
| | - R O'Connor
- Health Education England (East Midlands), Westbridge Place, 1 Westbridge Close, Leicester, LE3 5DR, United Kingdom.
| | - E Yeung
- Health Education England (South London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - F Khalid
- Health Education England (North West), 3 Piccadilly Place, Manchester, M1 3BN, United Kingdom.
| | - A Tahim
- Health Education England (North Central and East London, North West London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - S Gowrishankar
- Health Education England (Thames Valley), Chancellor Court, John Smith Drive, Oxford Business Park, Oxford, OX4 2GX, United Kingdom.
| | - A Hills
- Health Education England (Kent, Surrey & Sussex), 7 Bermondsey Street, London, SE1 2DD, United Kingdom.
| | - E M Williams
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
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Goodson AMC, Parmar S, Ganesh S, Zakai D, Shafi A, Wicks C, O'Connor R, Yeung E, Khalid F, Tahim A, Gowrishankar S, Hills A, Williams EM. Printed titanium implants in UK craniomaxillofacial surgery. Part II: perceived performance (outcomes, logistics, and costs). Br J Oral Maxillofac Surg 2020; 59:320-328. [PMID: 33280945 DOI: 10.1016/j.bjoms.2020.08.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
Abstract
This second part explores perceptions and understanding of clinical performance, turnaround, and costs for printed titanium implants or plates in common procedures, evaluating both 'in-house' and 'outsourced' CAD-CAM pathways. A cross-sectional study, supported by the British Association of Oral and Maxillofacial Surgeons (BAOMS) and a national trainee-led recruitment team, was conducted over 14 weeks. A total of 132 participants took part (demographic data is reported in Part I). For fibular-flap mandibular reconstruction, most participants (69% - 91%) perceived printed titanium as superior to intraoperatively or preoperatively hand-bent plates for surgical duration, accuracy, dental restorability, and aesthetics. There was less agreement about complications and plate-failure risks. Most perceived printed plates to be superior to traditional wafer-based maxillary osteotomy for surgical duration (61%) and maxillary positioning (60%). For orbital floor repair, most perceived improvements in surgical duration (83%, especially higher-volume operators p=0.009), precision (84%), and ease of placement (69%). Rarely (less than 5%) was any outcome rated inferior to traditional techniques for any procedure. Perceived turnaround times and costs were variable, but the greatest consensus was for two-segment fibular-flap reconstructions and orbital floor repair. Industry estimates were generally consistent between two company representatives, but manufacturing-only costs differed when using in-house (departmental) designers. Costs and turnaround times are questionable barriers since few understand 'real-world' figures. Designing in-house can dramatically alter costs. Improved accuracy and surgical duration are common themes but biomechanical benefits are less-well understood. This study paints a picture of the potentially routine applications and benefits of printed titanium, capacity for uptake, understanding amongst surgeons, and areas for improvement.
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Affiliation(s)
- A M C Goodson
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - S Parmar
- University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom.
| | - S Ganesh
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - D Zakai
- Health Education England (West Midlands), 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, United Kingdom.
| | - A Shafi
- NHS Education for Scotland, Westport 102, West Port, Edinburgh, EH3 9DN, United Kingdom.
| | - C Wicks
- Health Education England (South West), Park House, Newbrick Rd, Stoke Gifford, Bristol BS34 8YU, United Kingdom.
| | - R O'Connor
- Health Education England (East Midlands), Westbridge Place, 1 Westbridge Close, Leicester, LE3 5DR, United Kingdom.
| | - E Yeung
- Health Education England (South London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - F Khalid
- Health Education England (North West), 3 Piccadilly Place, Manchester, M1 3BN, United Kingdom.
| | - A Tahim
- Health Education England (North Central and East London, North West London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - S Gowrishankar
- Health Education England (Thames Valley), Chancellor Court, John Smith Drive, Oxford Business Park, Oxford, OX4 2GX, United Kingdom.
| | - A Hills
- Health Education England (Kent, Surrey & Sussex), 7 Bermondsey Street, London, SE1 2DD, United Kingdom.
| | - E M Williams
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
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Ghassemi S, O'Connor R, Nunez-Cruz S, Leferovich J, Patel J, Milone M. Chimeric Antigen Receptor (CAR) T cells on demand: developing potent CAR T cells in less than 24 hr for adoptive immunotherapy. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Ghassemi S, Martinez-Becerra F, Master A, Richman S, Heo D, Leferovich J, Tu Y, Garcia-Canaveras J, Ayari A, Lu Y, Wang A, Rabinowitz J, Milone M, O'Connor R. Novel media formulations to enhance Chimeric Antigen Receptor (CAR) T-cell potency and anti-tumor cell function for adoptive immunotherapy. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Polajžer T, Dermol-Černe J, Reberšek M, O'Connor R, Miklavčič D. Cancellation effect is present in high-frequency reversible and irreversible electroporation. Bioelectrochemistry 2019; 132:107442. [PMID: 31923714 DOI: 10.1016/j.bioelechem.2019.107442] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 12/21/2022]
Abstract
It was recently suggested that applying high-frequency short biphasic pulses (HF-IRE) reduces pain and muscle contractions in electrochemotherapy and irreversible ablation treatments; however, higher amplitudes with HF-IRE pulses are required to achieve a similar effect as with monophasic pulses. HF-IRE pulses are in the range of a microseconds, thus, the so-called cancellation effect could be responsible for the need to apply pulses of higher amplitudes. In cancellation effect, the effect of first pulse is reduced by the second pulse of opposite polarity. We evaluated cancellation effect with high-frequency biphasic pulses on CHO-K1 in different electroporation buffers. We applied eight bursts of 1-10 µs long pulses with inter-phase delays of 0.5 µs - 10 ms and evaluated membrane permeability and cell survival. In permeability experiments, cancellation effect was not observed in low-conductivity buffer. Cancellation effect was, however, observed in treatments with high-frequency biphasic pulses looking at survival in all of the tested electroporation buffers. In general, cancellation effect depended on inter-phase delay as well as on pulse duration, i.e. longer pulses and longer interphase delay cause less pronounced cancellation effect. Cancellation effect could be partially explained by the assisted discharge and not by the hyperpolarization by the chloride channels.
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Affiliation(s)
- Tamara Polajžer
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia
| | - Janja Dermol-Černe
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia
| | - Matej Reberšek
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia
| | - Rodney O'Connor
- École des Mines de Saint-Étienne, Department of Bioelectronics, Georges Charpak Campus, Centre Microélectronique de Provence, 880 Route de Mimet, 13120 Gardanne, France
| | - Damijan Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška 25, 1000 Ljubljana, Slovenia.
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Vinton D, Weng H, Hardigree S, O'Connor R, Chiota-McCollum N. 233 The Impact of a Large Vessel Screening Tool to Reduce Delays in Evaluation and Intervention in Emergency Department Stroke Patients. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Raywood E, Douglas H, Kapoor K, Murray N, O'Connor R, Shannon H, Davies G, Main E. ePS3.07 The complexity of defining adherence to airway clearance treatments in clinical trials. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30265-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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O'Connor R, Slater K, Ball L, Jones A, Mitchell L, Rollo ME, Williams LT. The tension between efficiency and effectiveness: a study of dietetic practice in primary care. J Hum Nutr Diet 2019; 32:259-266. [PMID: 30604495 DOI: 10.1111/jhn.12617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary healthcare dietitians have a vital role to play in the prevention and management of chronic disease. Working in primary care requires efficient and effective management of practice to ensure client and practitioner needs are met. The present study aimed to explore the way in which primary care dietitians in Australia view the constructs of efficiency and effectiveness within the context of their practice. METHODS The study used an exploratory qualitative design within a pragmatist framework. Individual semi-structured telephone interviews were conducted with Australian primary care dietitians. All interviews were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach. RESULTS Twenty dietitians (17 females) working as private practitioners in primary care from three Australian states participated in the present study. Three themes emerged from the data. The first theme revealed that seeking efficiency and especially effectiveness were important to primary care dietitians and that there was a tension between the two. The second theme identified that efficiency and effectiveness are influenced by personal and structural factors. The final theme explored how dietitians are actively seeking ways to be more efficient and effective, including supportive networks, as well as the utilisation of technology. CONCLUSIONS Achieving a balance between efficiency and effectiveness in primary care dietetics is challenging to practitioners, who may require further training and support to enhance productivity, time management and resource utilisation. Structured issues exist for the workface. Further studies are required to quantify these findings and to explore whether it is possible to optimise efficiency and effectiveness and achieve sustainability of the dietetic workforce in primary care.
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Affiliation(s)
- R O'Connor
- Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - K Slater
- Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - L Ball
- Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - A Jones
- Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - L Mitchell
- Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - M E Rollo
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia.,Nutrition and Dietetics, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - L T Williams
- Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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22
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Dermol-Černe J, Miklavčič D, Reberšek M, Mekuč P, Bardet SM, Burke R, Arnaud-Cormos D, Leveque P, O'Connor R. Plasma membrane depolarization and permeabilization due to electric pulses in cell lines of different excitability. Bioelectrochemistry 2018; 122:103-114. [PMID: 29621662 DOI: 10.1016/j.bioelechem.2018.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 12/18/2022]
Abstract
In electroporation-based medical treatments, excitable tissues are treated, either intentionally (irreversible electroporation of brain cancer, gene electrotransfer or ablation of the heart muscle, gene electrotransfer of skeletal muscles), or unintentionally (excitable tissues near the target area). We investigated how excitable and non-excitable cells respond to electric pulses, and if electroporation could be an effective treatment of the tumours of the central nervous system. For three non-excitable and one excitable cell line, we determined a strength-duration curve for a single pulse of 10ns-10ms. The threshold for depolarization decreased with longer pulses and was higher for excitable cells. We modelled the response with the Lapicque curve and the Hodgkin-Huxley model. At 1μs a plateau of excitability was reached which could explain why high-frequency irreversible electroporation (H-FIRE) electroporates but does not excite cells. We exposed cells to standard electrochemotherapy parameters (8×100μs pulses, 1Hz, different voltages). Cells behaved similarly which indicates that electroporation most probably occurs at the level of lipid bilayer, independently of the voltage-gated channels. These results could be used for optimization of electric pulses to achieve maximal permeabilization and minimal excitation/pain sensation. In the future, it should be established whether the in vitro depolarization correlates to nerve/muscle stimulation and pain sensation in vivo.
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Affiliation(s)
- Janja Dermol-Černe
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia.
| | - Damijan Miklavčič
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia.
| | - Matej Reberšek
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia.
| | - Primož Mekuč
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, SI-1000 Ljubljana, Slovenia
| | - Sylvia M Bardet
- University of Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France.
| | - Ryan Burke
- University of Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France
| | | | - Philippe Leveque
- University of Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France.
| | - Rodney O'Connor
- École des Mines de Saint-Étienne, Department of Bioelectronics, Georges Charpak Campus, Centre Microélectronique de Provence, 880 Route de Mimet, 13120 Gardanne, France.
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O'Connor R, O'Regan A, O'Doherty J. Management of Bone Fragility in Primary Care in Ireland. Ir Med J 2018; 111:674. [PMID: 29869855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study evaluated the prevention of bone fragility fractures in a representative sample of four Irish general practices. The clinical records of 243 patients potentially at risk of bone fragility were studied. One hundred and fourteen (47%) had a dual energy x-ray absorptiometry (DEXA) scan. Osteoporosis was established in 42 (17%) and osteopaenia in 28 (11%). One hundred and fifty-two (63%) were currently being prescribed bisphosphonates. Thirty-four (22%) of those on bisphosphonates did not have a baseline DEXA scan performed prior to commencing treatment and further analysis did not show a clear rationale for initiation of the treatment in this group of patients. Forty-six (30%) patients on bisphosphonates had been prescribed them for over 5 years without any apparent review to see if they were still indicated. There was no record of any of the practices having carried out a fracture risk score assessment prior to commencing bone fragility treatment. The implications are that bone fragility management warrants urgent review.
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Affiliation(s)
- R O'Connor
- Department of General Practice, Graduate Entry Medical School, University of Limerick, Plassey, Limerick
| | - A O'Regan
- Department of General Practice, Graduate Entry Medical School, University of Limerick, Plassey, Limerick
| | - J O'Doherty
- Department of General Practice, Graduate Entry Medical School, University of Limerick, Plassey, Limerick
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24
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Jimenez H, Blackman C, Lesser G, Debinski W, Chan M, Sharma S, Watabe K, Lo HW, Thomas A, Godwin D, Blackstock W, Mudry A, Posey J, O'Connor R, Brezovich I, Bonin K, Kim-Shapiro D, Barbault A, Pasche B. Use of non-ionizing electromagnetic fields for the treatment of cancer. Front Biosci (Landmark Ed) 2018; 23:284-297. [PMID: 28930547 DOI: 10.2741/4591] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cancer treatment and treatment options are quite limited in circumstances such as when the tumor is inoperable, in brain cancers when the drugs cannot penetrate the blood-brain-barrier, or when there is no tumor-specific target for generation of effective therapeutic antibodies. Despite the fact that electromagnetic fields (EMF) in medicine have been used for therapeutic or diagnostic purposes, the use of non-ionizing EMF for cancer treatment is a new emerging concept. Here we summarize the history of EMF from the 1890's to the novel and new innovative methods that target and treat cancer by non-ionizing radiation.
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Affiliation(s)
- Hugo Jimenez
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Carl Blackman
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Glenn Lesser
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Waldemar Debinski
- Brain Tumor Center of Excellence (BTCOE), Thomas K Hearn, Jr. Brain Tumor Research Center, Comprehensive Cancer Center Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Michael Chan
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sambad Sharma
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Kounosuke Watabe
- Department of Cancer Biology, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157
| | - Hui-Wen Lo
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Alexandra Thomas
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Dwayne Godwin
- Department of Neurobiology and Anatomy, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - William Blackstock
- Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Albert Mudry
- Department of Otolaryngology, Stanford University, Stanford, CA
| | - James Posey
- Department of Medical Oncology, Division of Solid Tumor, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Rodney O'Connor
- Bioelectronics Department, Ecole des Mines de Saint-Etienne, France
| | - Ivan Brezovich
- Department of Radiation Oncology, University of Alabama at Birmingham, AL
| | - Keith Bonin
- Department of Physics, Wake Forest University, Winston-Salem, NC
| | | | | | - Boris Pasche
- Comprehensive Cancer Center of Wake Forest Baptist Medical Center, Winston-Salem, NC,
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O'Connor R, Morley D, Relihan E, Broderick A, Merry C, Bergin C. Interventions to Improve the Treatment of Malaria in an Acute Teaching Hospital in Ireland. Ir Med J 2017; 110:659. [PMID: 29465849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Malaria is the most serious parasitic infection. At our institution over a two year period there were treatment errors in 18% (n=3) of cases. The aim of this multidisciplinary study was to ensure appropriate and timely treatment of malaria by implementation of a cluster of interventions: reconfiguration of existing guidelines, provision of prescribing information; delivery of education sessions to front-line staff and enabling rapid access to medication. Staff feedback was assessed through a questionnaire. Perceived benefits gained included awareness of guidelines (91%, n= 39), how to diagnose (81%, n =35), how to treat (86%, n=37), that treatment must be prompt (77%, n=33) and where to find treatment out of hours (84%, n=36). 'Others' perceived benefits (5% n= 2) noted referred to treatment in pregnancy. Going forward, a programme of on-going staff education, repeated audits of guideline compliance and promotion of reporting of medication errors should help ensure that these benefits are sustained.
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Affiliation(s)
- R O'Connor
- Pharmacy Dept, St James's Hospital, Dublin 8, Ireland
| | - D Morley
- Department of GU Medicine and Infectious Diseases St James's Hospital, Dublin 8, Ireland
| | - E Relihan
- Pharmacy Dept, St James's Hospital, Dublin 8, Ireland
| | - A Broderick
- Department of GU Medicine and Infectious Diseases St James's Hospital, Dublin 8, Ireland
| | - C Merry
- Department of GU Medicine and Infectious Diseases St James's Hospital, Dublin 8, Ireland
| | - C Bergin
- National Department of GU Medicine and Infectious Diseases St James's Hospital, Dublin 8, Ireland
- Trinity College Dublin, Ireland
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26
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Kirthi S, Hellen R, O'Connor R, Connolly M, Tobin AM, McNamara D. Hidradenitis Suppurativa and Crohn's Disease: A Case Series. Ir Med J 2017; 110:618. [PMID: 29169000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hidradenitis Suppurativa (HS) is characterized by chronic recurrent abscesses, nodules and draining sinus tracts with scar formation. Cutaneous Crohn's Disease (CD) may also present similarly. We wished to identify and describe an Irish cohort with combined HS and CD, with a view to a better recognition of clinical manifestations and understanding of the pathophysiology underlying these two overlapping conditions. Cases were identified using the HIPE Code at Tallaght Hospital from 1990-2014 and retrospective review was performed. Seven patients with both HS and CD were identified, 5(71%) female. The median age of diagnosis with both conditions was 37 years. In all cases, CD had preceded the diagnosis of HS. All patients smoked. Six had an increased BMI and 43% had additional autoimmune conditions. All patients required treatment with a TNF-alpha inhibitor for HS with 5 of 6 subjects having reduced frequency of flare ups and clinically less active HS on follow up.
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Affiliation(s)
- S Kirthi
- Department of Dermatology, The Adelaide and Meath Hospital, Dublin
- Trinity Academic Gastroenterology Group (TAGG), Trinity College Dublin (TCD)
| | - R Hellen
- Department of Dermatology, The Adelaide and Meath Hospital, Dublin
| | - R O'Connor
- Department of Dermatology, The Adelaide and Meath Hospital, Dublin
| | - M Connolly
- Department of Dermatology, The Adelaide and Meath Hospital, Dublin
| | - A M Tobin
- Department of Dermatology, The Adelaide and Meath Hospital, Dublin
- Trinity Academic Gastroenterology Group (TAGG), Trinity College Dublin (TCD)
| | - D McNamara
- Department of Dermatology, The Adelaide and Meath Hospital, Dublin
- Trinity Academic Gastroenterology Group (TAGG), Trinity College Dublin (TCD)
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Sehl J, O'Doherty J, O'Connor R, O'Sullivan B, O'Regan A. Adherence to COPD management guidelines in general practice? A review of the literature. Ir J Med Sci 2017; 187:403-407. [PMID: 28735500 DOI: 10.1007/s11845-017-1651-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive illness that is mostly managed in the general practice setting. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are the international gold standard, and it is important to understand how these are being applied in general practice. AIMS This review aimed to assess the current level of adherence to international best practice guidelines among general practitioners in relation to COPD. METHODS PubMed and EMBASE searches (from 2012 to 2016) were performed and used the search terms guidelines, COPD, general practitioners, and primary care. Papers were excluded if they were not primary sources, were published before 2012, or did not pertain to a general practice setting. RESULTS After applying set inclusion and exclusion criteria, 11 studies were retrieved. These papers were grouped under three categories: diagnosis, pharmacological, and non-pharmacological management, based on the GOLD guidelines. CONCLUSIONS Current studies show significant variability in adherence to the GOLD guidelines. Barriers identified include lack of clarity, unfamiliarity with recommendations, and lack of familiarity with the guidelines. If general practice is expected to manage COPD and other chronic diseases, health service investment is needed to provide appropriate focused guidelines, to support their dissemination and resources to implement them in practice.
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Affiliation(s)
- J Sehl
- University of Limerick Graduate Entry Medical School, Limerick, Ireland.
| | - J O'Doherty
- University of Limerick Graduate Entry Medical School, Limerick, Ireland
| | - R O'Connor
- University of Limerick Graduate Entry Medical School, Limerick, Ireland
| | | | - A O'Regan
- University of Limerick Graduate Entry Medical School, Limerick, Ireland
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Affiliation(s)
- R O'Connor
- Department of Dermatology, Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin, Ireland
| | - A Flynn
- Department of Dermatology, Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin, Ireland
| | - S Crowther
- Department of Pathology, Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin, Ireland
| | - A-M Tobin
- Department of Dermatology, Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin, Ireland
| | - M Connolly
- Department of Dermatology, Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin, Ireland
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Phelan JP, Reen FJ, Dunphy N, O'Connor R, O'Gara F. Bile acids destabilise HIF-1α and promote anti-tumour phenotypes in cancer cell models. BMC Cancer 2016; 16:476. [PMID: 27416726 PMCID: PMC4946243 DOI: 10.1186/s12885-016-2528-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 02/23/2016] [Accepted: 07/06/2016] [Indexed: 12/22/2022] Open
Abstract
Background The role of the microbiome has become synonymous with human health and disease. Bile acids, as essential components of the microbiome, have gained sustained credibility as potential modulators of cancer progression in several disease models. At physiological concentrations, bile acids appear to influence cancer phenotypes, although conflicting data surrounds their precise physiological mechanism of action. Previously, we demonstrated bile acids destabilised the HIF-1α subunit of the Hypoxic-Inducible Factor-1 (HIF-1) transcription factor. HIF-1 overexpression is an early biomarker of tumour metastasis and is associated with tumour resistance to conventional therapies, and poor prognosis in a range of different cancers. Methods Here we investigated the effects of bile acids on the cancer growth and migratory potential of cell lines where HIF-1α is known to be active under hypoxic conditions. HIF-1α status was investigated in A-549 lung, DU-145 prostate and MCF-7 breast cancer cell lines exposed to bile acids (CDCA and DCA). Cell adhesion, invasion, migration was assessed in DU-145 cells while clonogenic growth was assessed in all cell lines. Results Intracellular HIF-1α was destabilised in the presence of bile acids in all cell lines tested. Bile acids were not cytotoxic but exhibited greatly reduced clonogenic potential in two out of three cell lines. In the migratory prostate cancer cell line DU-145, bile acids impaired cell adhesion, migration and invasion. CDCA and DCA destabilised HIF-1α in all cells and significantly suppressed key cancer progression associated phenotypes; clonogenic growth, invasion and migration in DU-145 cells. Conclusions These findings suggest previously unobserved roles for bile acids as physiologically relevant molecules targeting hypoxic tumour progression.
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Affiliation(s)
- J P Phelan
- BIOMERIT Research Centre, School of Microbiology, University College Cork - National University of Ireland, Cork, Ireland
| | - F J Reen
- BIOMERIT Research Centre, School of Microbiology, University College Cork - National University of Ireland, Cork, Ireland
| | - N Dunphy
- BIOMERIT Research Centre, School of Microbiology, University College Cork - National University of Ireland, Cork, Ireland
| | - R O'Connor
- School of Biochemistry and Cell Biology, University College Cork - National University of Ireland, Cork, Ireland
| | - F O'Gara
- BIOMERIT Research Centre, School of Microbiology, University College Cork - National University of Ireland, Cork, Ireland. .,School of Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, 6102, Australia.
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Abstract
The clinical diagnosis or sapheno-femoral incompetence is frequently inaccurate. Using a simple Doppler technique described below 94% of 155 limbs in 107 patients were correctly diagnosed. In the same group of patients the cough impulse test gave an accurate positive result in only 79%, while in the first 100 limbs of the series tourniquet and tap tests were even less reliable. Since the Doppler technique is readily applicable to large numbers of patients it is concluded that it will be of use in distinguishing those in whom surgery is required from others in whom compression sclerotherapy will be effective.
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Affiliation(s)
| | - E. Dinn
- Sir Patrick Dun's Hospital, Dublin 2, Ireland
| | - R. O'Connor
- Sir Patrick Dun's Hospital, Dublin 2, Ireland
| | - D. Greene
- Sir Patrick Dun's Hospital, Dublin 2, Ireland
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Schmidt A, Christiansen N, Alice L, O'Connor R, Lambert C, Cowlard J, Blakeley K, Keane C, Sharpe S, McLean M, Kalsi H, Brown S, Nwokoro C, Pao C. ePS02.6 Improving efficiency in an outpatient setting – Experience from a paediatric CF centre in East London. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30202-8] [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: 11/29/2022]
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Rutledge S, Chalissery A, O'Connor R, Mahon S, Connolly S, Farrell M, Crowley P, MacSweeney F, Tubridy N. Anti-NMDA-receptor antibody-mediated cortical blindness: a case report. QJM 2016; 109:127-8. [PMID: 26319702 DOI: 10.1093/qjmed/hcv151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Rutledge
- From the Department of Neurology, St Vincent's University Hospital, Dublin 4, Ireland,
| | - A Chalissery
- From the Department of Neurology, St Vincent's University Hospital, Dublin 4, Ireland
| | - R O'Connor
- From the Department of Neurology, St Vincent's University Hospital, Dublin 4, Ireland
| | - S Mahon
- Department of Pathology, St Vincent's University Hospital, Dublin 4, Ireland
| | - S Connolly
- Department of Clinical Neurophysiology, St Vincent's University Hospital, Dublin 4, Ireland
| | - M Farrell
- Department of Neuropathology, Beaumont Hospital, Dublin 9, Ireland
| | - P Crowley
- Department of Neurology, St Luke's General Hospital, Kilkenny, Ireland
| | - F MacSweeney
- Department of Pathology, University Hospital Waterford, Waterford, Ireland
| | - N Tubridy
- From the Department of Neurology, St Vincent's University Hospital, Dublin 4, Ireland
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Ramahenina H, O'Connor R, Chamberlain M. Problems encountered by parents of infants with clubfoot treated by the Ponseti method in Madagascar: A study to inform better practice. J Rehabil Med 2016; 48:481. [DOI: 10.2340/16501977-2082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Roberts C, Guillard G, Bowes M, O'Connor R, Maguire N, Morgan A, Parker G, Hodgson R, Vital E, Bird P, Vincent G, Emery P, Conaghan P. SAT0601 A Novel, Fully 3-Dimensional Dynamic Contrast MRI Method in the Hand Reveals Details of Synovial Inflammation and Provides a Sensitive Measure of Change. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Segers LS, Nuding SC, Ott MM, Dean JB, Bolser DC, O'Connor R, Morris KF, Lindsey BG. Peripheral chemoreceptors tune inspiratory drive via tonic expiratory neuron hubs in the medullary ventral respiratory column network. J Neurophysiol 2014; 113:352-68. [PMID: 25343784 DOI: 10.1152/jn.00542.2014] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Models of brain stem ventral respiratory column (VRC) circuits typically emphasize populations of neurons, each active during a particular phase of the respiratory cycle. We have proposed that "tonic" pericolumnar expiratory (t-E) neurons tune breathing during baroreceptor-evoked reductions and central chemoreceptor-evoked enhancements of inspiratory (I) drive. The aims of this study were to further characterize the coordinated activity of t-E neurons and test the hypothesis that peripheral chemoreceptors also modulate drive via inhibition of t-E neurons and disinhibition of their inspiratory neuron targets. Spike trains of 828 VRC neurons were acquired by multielectrode arrays along with phrenic nerve signals from 22 decerebrate, vagotomized, neuromuscularly blocked, artificially ventilated adult cats. Forty-eight of 191 t-E neurons fired synchronously with another t-E neuron as indicated by cross-correlogram central peaks; 32 of the 39 synchronous pairs were elements of groups with mutual pairwise correlations. Gravitational clustering identified fluctuations in t-E neuron synchrony. A network model supported the prediction that inhibitory populations with spike synchrony reduce target neuron firing probabilities, resulting in offset or central correlogram troughs. In five animals, stimulation of carotid chemoreceptors evoked changes in the firing rates of 179 of 240 neurons. Thirty-two neuron pairs had correlogram troughs consistent with convergent and divergent t-E inhibition of I cells and disinhibitory enhancement of drive. Four of 10 t-E neurons that responded to sequential stimulation of peripheral and central chemoreceptors triggered 25 cross-correlograms with offset features. The results support the hypothesis that multiple afferent systems dynamically tune inspiratory drive in part via coordinated t-E neurons.
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Affiliation(s)
- L S Segers
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
| | - S C Nuding
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
| | - M M Ott
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
| | - J B Dean
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
| | - D C Bolser
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - R O'Connor
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
| | - K F Morris
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
| | - B G Lindsey
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and
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Fawsi M, Di Luca A, Henry M, Meleady P, O'Connor R, O'Donovan N, Crown J. Proteomic Profiling of Chemotherapy Treated Triple Negative Breast Cancer Cells. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu358.41] [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: 11/13/2022] Open
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Lane G, Dunne C, English A, Finucane P, O'Connor R, Griffin M, O'Sullivan B, Hanrahan C, McGrath D, O'Donovan N, Cullen W. General practice career intentions among graduate-entry students: a cross-sectional study at Ireland's newest medical school. Ir Med J 2014; 107:55-57. [PMID: 24654489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Increased care provision and clinical activity in General Practice in Ireland will have important manpower implications. Recent developments in medical education policy including the introduction of graduate-entry medical degree programmes may help address this issue. The aim of this study was to determine GP career intentions among students on an Irish graduate-entry medical degree programme and to identify factors that influence these. An electronic cross-sectional study of students at University of Limerick Graduate-Entry Medical School (UL-GEMS) was undertaken. We received 139 replies (78% response rate). 41 (29%) reported GP was their current preferred career choice, while 29 (19%) reported it was their preferred career choice on entry to medical school. This first study to present data on GP career intentions among graduate-entry students in Ireland highlights the specialty as a popular preferred career choice among students, both on entry to, and during medical school. The study also identifies factors which are likely to be important in determining career intentions. Further research to examine this issue at other graduate-entry medical schools in Ireland and to determine whether our findings are pursued over time amongst graduates is a priority.
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O'Connor R, Mannix M, Cullen W, Mullen J, Healy M, Saunders J, Griffin M, O'Sullivan G. Care of type 2 diabetes in unresourced general practice: current practice in the Mid-West. Ir Med J 2014; 107:43-45. [PMID: 24654481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It is estimated that 4.5% of the Irish population have type 2 diabetes. The HSE intends to move the care of uncomplicated type 2 diabetes to General Practice (GP). The study reviewed current General Practice diabetes care in the Irish Mid-West. The files of randomly selected patients from 12 GP teaching practices attached to the University of Limerick were audited. 842 patients were identified (62% male, 38% female). The mean age was 66 years. 75% were GMS patients. A practice protocol was used in 71% of patients. Average Cholesterol (4.3 mmol/l), creatinine (85.3 mmol/l), HbA1c (56.7 mmol/mol) and systolic blood pressure (SBP) (134 mmHg) measurements were well documented and controlled. However the rates of and mean intervals for foot review (60.2%), BMI measurement (52.3%), retinopathy screening (62.0%) and influenza vaccination (63.0%) were unacceptably low. Current management of type 2 diabetes in unresourced general practices is suboptimal although some biochemical parameters are well controlled.
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Fogarty FM, O'Keeffe J, Zhadanov A, Papkovsky D, Ayllon V, O'Connor R. HRG-1 enhances cancer cell invasive potential and couples glucose metabolism to cytosolic/extracellular pH gradient regulation by the vacuolar-H+ ATPase. Oncogene 2013; 33:4653-63. [DOI: 10.1038/onc.2013.403] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 07/29/2013] [Accepted: 08/23/2013] [Indexed: 12/14/2022]
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Maurovich-Horvat P, Karolyi M, Kolossvary M, O'Connor R, Szeplaki G, Bartykowszki A, Geller L, Merkely B. Low-dose "step-and-shoot" CT in patients with atrial fibrillation: Is simultaneous assessment of the left atrium and coronary arteries feasible? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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O'Connor R, McGurk M. The plunging ranula: diagnostic difficulties and a less invasive approach to treatment. Int J Oral Maxillofac Surg 2013; 42:1469-74. [PMID: 23726274 DOI: 10.1016/j.ijom.2013.03.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/22/2013] [Accepted: 03/26/2013] [Indexed: 11/18/2022]
Abstract
Plunging ranulas arise when a simple ranula extends beyond the floor of the mouth into the neck. Diagnosis is difficult even with modern imaging techniques as they mimic other neck lesions, and traditional treatment involves enucleation of the cyst from the neck. Despite this invasive surgery they tend to recur. We describe a less invasive approach to treatment and review the diagnostic pitfalls. From 2002 to 2011, eight patients presented with a plunging ranula. They were split into two groups: those for whom an incorrect diagnosis was made and those where a less invasive treatment approach was employed. Three patients were misdiagnosed with cervical lymphangioma and had inappropriately invasive surgery. Five patients with established plunging ranulas were treated using an intraoral approach alone, eliminating the need for a cervical incision. Misdiagnosis of a plunging ranula leads to extensive and unnecessary surgery. We propose an algorithm to simplify investigation that employs a low threshold for fine-needle aspiration cytology. The cases presented indicate that these lesions can be managed by a less invasive procedure than currently practised.
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Affiliation(s)
- R O'Connor
- Department of Oral and Maxillofacial Surgery, Guy's, King's and St. Thomas' Hospitals, London, UK
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Abstract
Abstract
Management of moisture penetration and hydrolytic degradation of polylactide (PLA) is extremely important during manufacturing, shipping, storage, and end-use of PLA products. Crystallinity in PLA was measured with Differential Scanning Calorimetry (DSC) and X-Ray Diffraction (XRD). Moisture sorption isotherms in PLA films were measured with Quartz Crystal Microbalance (QCM) and Dynamic Vapor Sorption (DVS) experiments with samples of varying crystallinity. A surprising result is that crystalline and amorphous PLA films exhibit nearly identical sorption isotherms, within the accuracy of the experiments. The effect of hydrophobicity of PLA end groups on degradation was evaluated by synthesizing PLA with hydrophobic and hydrophilic end groups.
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Affiliation(s)
- R. A. Cairncross
- Chemical and Biological Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - S. Ramaswamy
- Bio-Based Products, University of Minnesota, St. Paul, Minnesota, USA
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O'Connor R, Mannix M, Mullen J, Powys L, Mannion M, Nolan HA, Kearney E, Cullen W, Griffin M, Saunders J. Structured care of diabetes in general practice: a qualitative study of the barriers and facilitators. Ir Med J 2013; 106:77-80. [PMID: 23951976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This qualitative study explored general practitioner's and practice nurse's perceptions of barriers and facilitators to the proposed transfer of diabetes care to general practice. Qualitative data were collected through five focus groups. Participants included GPs (n = 55) and practice nurses (n = 11) representing urban (44%), rural (29%) and mixed (27%) practices, in the Irish Mid-West region. Barriers and facilitators were mentioned 631 times (100%). Barriers were mentioned 461 times (73%), facilitators 170 times (27%). The most frequently identified barriers were lack of financial incentive (119/631; 19%), lack of access to secondary resources (93/631; 15%), lack of staff and increased workload (59/631; 9%) and time constraints (52/631; 8%). Identified facilitators were access to secondary care (49/631;7.8%), the holistic nature of general practice and continuity of care (48/631;7.6%). Although many are enthusiastic, there remains significant reluctance among GPs and practice nurses to take responsibility for diabetes care without addressing these barriers.
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Affiliation(s)
- R O'Connor
- Graduate Entry Medical School, Mid-West Specialist Training Programme in General Practice, University of Limerick, Limerick.
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Power C, O'Connor R, Dunne S, Finucane P, Cullen W, Dunne C. An evidence-based assessment of primary care needs in an economically deprived urban community. Ir J Med Sci 2013; 182:457-61. [PMID: 23361634 DOI: 10.1007/s11845-013-0913-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 01/17/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND As healthcare and longevity improve and fertility rates decline, we see a demographic shift towards a predominantly elderly population. Because ageing brings its own physiological changes and complications, the need arises for practical and feasible approaches in providing the healthcare required by this population. With government strategy promoting enhanced community-based healthcare, the development of primary care infrastructure should reflect population needs. AIMS To describe the profile of older patients attending a general practice in an underprivileged urban setting, specifically initial medical presentation, referrals for secondary care, and the medicines prescribed to them. To thereby enhance our understanding of the primary care requirements of elderly people in this setting. METHODS The anonymised records of an older patient cohort (n=427, age>55 years) that presented to a General Practice over a 12-month period were retrospectively analysed to determine the nature of the clinical encounters, subsequent referral patterns and drugs prescribed. RESULTS There were 3,448 discrete clinical encounters (mean=8.0 per patient), predominantly for respiratory conditions, leading to 401 issued scripts and to 216 patients being referred for secondary care. Women were referred more often than men. There was a notable need for specialised dietary advice and drug prescribing was often complex. CONCLUSION This study provides evidence of primary care needs in an economically deprived area of an Irish city highlighting the complexity of associated prescribing and secondary care referrals in this setting.
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Affiliation(s)
- C Power
- Centre for Interventions in Infection, Inflammation and Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Kerr E, Holohan C, McLaughlin KM, Majkut J, Dolan S, Redmond K, Riley J, McLaughlin K, Stasik I, Crudden M, Van Schaeybroeck S, Fenning C, O'Connor R, Kiely P, Sgobba M, Haigh D, Johnston PG, Longley DB. Identification of an acetylation-dependant Ku70/FLIP complex that regulates FLIP expression and HDAC inhibitor-induced apoptosis. Cell Death Differ 2012; 19:1317-27. [PMID: 22322857 PMCID: PMC3392639 DOI: 10.1038/cdd.2012.8] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [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: 07/15/2011] [Revised: 12/21/2011] [Accepted: 12/21/2011] [Indexed: 12/31/2022] Open
Abstract
FLIP is a potential anti-cancer therapeutic target that inhibits apoptosis by blocking caspase 8 activation by death receptors. We report a novel interaction between FLIP and the DNA repair protein Ku70 that regulates FLIP protein stability by inhibiting its polyubiquitination. Furthermore, we found that the histone deacetylase (HDAC) inhibitor Vorinostat (SAHA) enhances the acetylation of Ku70, thereby disrupting the FLIP/Ku70 complex and triggering FLIP polyubiquitination and degradation by the proteasome. Using in vitro and in vivo colorectal cancer models, we further demonstrated that SAHA-induced apoptosis is dependant on FLIP downregulation and caspase 8 activation. In addition, an HDAC6-specific inhibitor Tubacin recapitulated the effects of SAHA, suggesting that HDAC6 is a key regulator of Ku70 acetylation and FLIP protein stability. Thus, HDAC inhibitors with anti-HDAC6 activity act as efficient post-transcriptional suppressors of FLIP expression and may, therefore, effectively act as 'FLIP inhibitors'.
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Affiliation(s)
- E Kerr
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - C Holohan
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - K M McLaughlin
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - J Majkut
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - S Dolan
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - K Redmond
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - J Riley
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - K McLaughlin
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - I Stasik
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - M Crudden
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - S Van Schaeybroeck
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - C Fenning
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - R O'Connor
- Cell Biology Laboratory, Department of Biochemistry, University College Cork, Cork, Republic of Ireland
| | - P Kiely
- Cell Biology Laboratory, Department of Biochemistry, University College Cork, Cork, Republic of Ireland
| | - M Sgobba
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - D Haigh
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - P G Johnston
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
| | - D B Longley
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, UK
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Segers LS, Nuding SC, Vovk A, Pitts T, Baekey DM, O'Connor R, Morris KF, Lindsey BG, Shannon R, Bolser DC. Discharge Identity of Medullary Inspiratory Neurons is Altered during Repetitive Fictive Cough. Front Physiol 2012; 3:223. [PMID: 22754536 PMCID: PMC3386566 DOI: 10.3389/fphys.2012.00223] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [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: 03/15/2012] [Accepted: 06/03/2012] [Indexed: 11/13/2022] Open
Abstract
This study investigated the stability of the discharge identity of inspiratory decrementing (I-Dec) and augmenting (I-Aug) neurons in the caudal (cVRC) and rostral (rVRC) ventral respiratory column during repetitive fictive cough in the cat. Inspiratory neurons in the cVRC (n = 23) and rVRC (n = 17) were recorded with microelectrodes. Fictive cough was elicited by mechanical stimulation of the intrathoracic trachea. Approximately 43% (10 of 23) of I-Dec neurons shifted to an augmenting discharge pattern during the first cough cycle (C1). By the second cough cycle (C2), half of these returned to a decrementing pattern. Approximately 94% (16 of 17) of I-Aug neurons retained an augmenting pattern during C1 of a multi-cough response episode. Phrenic burst amplitude and inspiratory duration increased during C1, but decreased with each subsequent cough in a series of repetitive coughs. As a step in evaluating the model-driven hypothesis that VRC I-Dec neurons contribute to the augmentation of inspiratory drive during cough via inhibition of VRC tonic expiratory neurons that inhibit premotor inspiratory neurons, cross-correlation analysis was used to assess relationships of tonic expiratory cells with simultaneously recorded inspiratory neurons. Our results suggest that reconfiguration of inspiratory-related sub-networks of the respiratory pattern generator occurs on a cycle-by-cycle basis during repetitive coughing.
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Affiliation(s)
- L S Segers
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida Tampa, FL, USA
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Carroll M, O'Connor R. Storage of schedule 2 controlled drugs by general practitioners in the HSE West region. Ir Med J 2012; 105:187-188. [PMID: 22973662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Zhdanov AV, Favre C, O'Flaherty L, Adam J, O'Connor R, Pollard PJ, Papkovsky DB. Comparative bioenergetic assessment of transformed cells using a cell energy budget platform. Integr Biol (Camb) 2011; 3:1135-42. [PMID: 22005712 DOI: 10.1039/c1ib00050k] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aberrant expression and functional activity of proteins involved in ATP production pathways may cause a crisis in energy generation for cells and compromise their survival under stressful conditions such as excitation, starvation, pharmacological treatment or disease states. Under resting conditions such defects are often compensated for, and therefore masked by, alternative pathways which have significant spare capacity. Here we present a multiplexed 'cell energy budget' platform which facilitates metabolic assessment and cross-comparison of different cells and the identification of genes directly or indirectly involved in ATP production. Long-decay emitting O(2) and pH sensitive probes and time-resolved fluorometry are used to measure changes in cellular O(2) consumption, glycolytic and total extracellular acidification (ECA), along with the measurement of total ATP and protein content in multiple samples. To assess the extent of spare capacity in the main energy pathways, the cells are also analysed following double-treatment with carbonyl cyanide p-(trifluoromethoxy)phenylhydrazone and oligomycin. The four-parametric platform operating in a high throughput format has been validated with two panels of transformed cells: mouse embryonic fibroblasts (MEFs) lacking the Krebs cycle enzyme fumarate hydratase (Fh1) and HeLa cells with reduced expression of pyrimidine nucleotide carrier 1. In both cases, a marked reduction in both respiration and spare respiratory capacity was observed, accompanied by a compensatory activation of glycolysis and consequent maintenance of total ATP levels. At the same time, in Fh1-deficient MEFs the contribution of non-glycolytic pathways to the ECA did not change.
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Affiliation(s)
- A V Zhdanov
- Biochemistry Department, University College Cork, Cavanagh Pharmacy Building, College Road, Cork, Ireland
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Smear M, Shusterman R, O'Connor R, Bozza T, Rinberg D. Perception of sniff phase in mouse olfaction. Nature 2011; 479:397-400. [PMID: 21993623 DOI: 10.1038/nature10521] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 09/02/2011] [Indexed: 11/09/2022]
Abstract
Olfactory systems encode odours by which neurons respond and by when they respond. In mammals, every sniff evokes a precise, odour-specific sequence of activity across olfactory neurons. Likewise, in a variety of neural systems, ranging from sensory periphery to cognitive centres, neuronal activity is timed relative to sampling behaviour and/or internally generated oscillations. As in these neural systems, relative timing of activity may represent information in the olfactory system. However, there is no evidence that mammalian olfactory systems read such cues. To test whether mice perceive the timing of olfactory activation relative to the sniff cycle ('sniff phase'), we used optogenetics in gene-targeted mice to generate spatially constant, temporally controllable olfactory input. Here we show that mice can behaviourally report the sniff phase of optogenetically driven activation of olfactory sensory neurons. Furthermore, mice can discriminate between light-evoked inputs that are shifted in the sniff cycle by as little as 10 milliseconds, which is similar to the temporal precision of olfactory bulb odour responses. Electrophysiological recordings in the olfactory bulb of awake mice show that individual cells encode the timing of photoactivation in relation to the sniff in both the timing and the amplitude of their responses. Our work provides evidence that the mammalian olfactory system can read temporal patterns, and suggests that timing of activity relative to sampling behaviour is a potent cue that may enable accurate olfactory percepts to form quickly.
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Affiliation(s)
- Matthew Smear
- Janelia Farm Research Campus, Howard Hughes Medical Institute, Ashburn, Virginia 20147, USA
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Wong S, Mills P, Tawashy A, Mikhail D, O'Connor R, Warburton D, Taunton J, Eng J, Campbell D, Krassioukov A. Autonomic function and symptoms of orthostatic hypotension in wheelchair athletes. Auton Neurosci 2011. [DOI: 10.1016/j.autneu.2011.05.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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