1
|
Fitton Davies K, Clarke S, Martins R, Rudd JR, Duncan M. The effect of a home-based, gamified stability skills intervention on 4-5-year-old children's physical and cognitive outcomes: A pilot study. Psychol Sport Exerc 2024; 73:102636. [PMID: 38588787 DOI: 10.1016/j.psychsport.2024.102636] [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] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Stability skills (e.g., static/dynamic balance) are a precursor for other movement skill development (e.g., jumping, catching). However, young children consistently demonstrate low stability and movement skill ability. There is therefore a need to develop effective strategies to improve stability skills in early childhood. AIM To pilot the effect of a home-based gamified stability skills intervention on 4-5-year-old children's physical skills, self-perceptions and cognitions. METHODS One-hundred-and-eleven 4-5-year-old children participated from three schools. Two schools were allocated into the intervention group (n = 66 children, 33 boys) and one to the control group (n = 45 children, 25 boys). Stability, fundamental movement skills, perceived motor competence, and cognition were assessed at baseline and at post-intervention. The intervention group was given a booklet detailing the 12-week gamified stability skill intervention. The control group participated in their usual weekly activities. RESULTS A series of ANCOVAs controlling for baseline values demonstrated significantly higher stability skills (F(1,93) = 24.79, p < 0.001, partial η2 = 0.212), fundamental movement skills (F(1,94) = 15.5, p = < 0.001, partial η2 = 0.139), perceived motor competence (F(1,96) = 5.48, p = 0.021, partial η2 = 0.054) and cognition (F(1,96) = 15.5, p = < 0.001, partial η2 = 0.139) at post-test for the intervention versus control groups. DISCUSSION This study demonstrates that a home-based, gamified, stability skills intervention enhances stability skills, fundamental movement skills, perceived motor competence and cognition in children aged 4-5-years old.
Collapse
Affiliation(s)
- K Fitton Davies
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Copperas Hill, Liverpool, L3 5GE, UK; Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
| | - S Clarke
- Centre for Arts, Memory and Communities, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
| | - R Martins
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
| | - J R Rudd
- Norwegian School of Sport Sciences, Sognsveien 220, 0863, Oslo, Norway; Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway.
| | - M Duncan
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
| |
Collapse
|
2
|
Owen-Smith A, Porter J, Thomas CM, Clarke S, Ogrodnick MM, Hand LJ, Dawson-Hahn E, O'Connor MH, Feinberg I, Adde S, Desta R, Yubo Z, Chin A, Safi M. 'Getting control of Corona takes many angles': COVID-19 vaccine knowledge, attitudes and beliefs among refugee/immigrant/migrant communities in four US cities. Health Educ Res 2024; 39:182-196. [PMID: 38300230 DOI: 10.1093/her/cyae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/21/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024]
Abstract
The objectives of the study were to (i) document refugee, immigrant and migrant (RIM) communities' knowledge, attitudes and beliefs (KABs) related to the Coronavirus disease (COVID-19) vaccine and (ii) identify best practices for developing and disseminating culturally and linguistically responsive health messaging addressing those KABs. Thirteen online focus groups (OFGs) in 10 languages were conducted. Each OFG was conducted in the participants' native language. OFGs were recorded, transcribed, translated and uploaded to qualitative software for coding. A thematic analysis was conducted. Results suggest that while there was some variation between different language groups (e.g. whether religious leaders were seen as trusted sources of information about COVID), there were also important commonalities. Most language groups (i) alluded to hearing about or having gaps in knowledge about COVID-19/the COVID-19 vaccine, (ii) reported hearing negative or conflicting stories about the vaccine and (iii) shared concerns about the negative side effects of the vaccine. There continues to be a need for health messaging in RIM communities that is culturally and linguistically concordant and follows health literacy guidelines. Message content about the COVID-19 vaccine should focus on vaccine importance, effectiveness and safety, should be multimodal and should be primarily delivered by healthcare professionals and community members who have already been vaccinated.
Collapse
Affiliation(s)
- A Owen-Smith
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - J Porter
- International Rescue Committee UK, 100 Wood Street, London EC2V 7AN, United Kingdom
| | - C M Thomas
- Department of Medicine, University of Minnesota, Division of Infectious Diseases and International Medicine, 401 East River Parkway, Minneapolis, MN 55455, USA
| | - S Clarke
- Society of Refugee Healthcare Providers, 172 Colby St, Spencerport, New York 14559
| | - M M Ogrodnick
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - L J Hand
- Department of Communication, Georgia State University, 800 Twenty Five Park Place NE, Atlanta, GA 30303, USA
- School of Communication and Media, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA 30144, USA
| | - E Dawson-Hahn
- Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - M H O'Connor
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - I Feinberg
- College of Education and Human Development, Georgia State University, 30 Pryor St. SW, Atlanta, GA 30303, USA
| | - S Adde
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - R Desta
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - Z Yubo
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - A Chin
- Department of Health Policy and Behavioral Sciences, Georgia State University, School of Public Health, 140 Decatur Street, Atlanta, GA 30303, USA
| | - M Safi
- International Rescue Committee UK, 100 Wood Street, London EC2V 7AN, United Kingdom
| |
Collapse
|
3
|
De Silva M, Tse BCY, Diakos CI, Clarke S, Molloy MP. Immunogenic cell death in colorectal cancer: a review of mechanisms and clinical utility. Cancer Immunol Immunother 2024; 73:53. [PMID: 38353760 PMCID: PMC10866783 DOI: 10.1007/s00262-024-03641-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024]
Abstract
Colorectal cancer (CRC) is a major cause of cancer-related morbidity and mortality worldwide. Despite several clinical advances the survival of patients with advanced colorectal cancer remains limited, demanding newer approaches. The immune system plays a central role in cancer development, propagation, and treatment response. Within the bowel, the colorectal mucosa is a key barrier and site of immune regulation that is generally immunosuppressive. Nonetheless, within this tumour microenvironment, it is evident that anti-neoplastic treatments which cause direct cytotoxic and cytostatic effects may also induce immunogenic cell death (ICD), a form of regulated cell death that leads to an anti-tumour immune response. Therefore, novel ICD inducers and molecular biomarkers of ICD action are urgently needed to advance treatment options for advanced CRC. This article reviews our knowledge of ICD in CRC.
Collapse
Affiliation(s)
- M De Silva
- Bowel Cancer and Biomarker Research Laboratory, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, NSW, Australia
| | - B C Y Tse
- Bowel Cancer and Biomarker Research Laboratory, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - C I Diakos
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - S Clarke
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - M P Molloy
- Bowel Cancer and Biomarker Research Laboratory, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
4
|
Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
Collapse
|
5
|
Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, Emberson JR, Preiss D, Ng SYA, Roddick AJ, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Massey D, Landray MJ, Baigent C, Haynes R, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
Collapse
|
6
|
Al-Julandani DA, Bagri NK, Tsang N, Clarke S, Upadhyay A, Guly C, Ramanan AV. Outcome of adalimumab monotherapy in paediatric non-infectious uveitis. Pediatr Rheumatol Online J 2023; 21:21. [PMID: 36864437 PMCID: PMC9983208 DOI: 10.1186/s12969-023-00794-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/20/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Adalimumab in combination with other disease-modifying antirheumatic drugs (DMARD) such as methotrexate has a proven efficacy in the management of paediatric non-infectious uveitis. However, many children experience significant intolerance to methotrexate while on this combination, leaving a dilemma for clinicians for choosing the subsequent therapeutic roadmap. Continuation of adalimumab monotherapy might be an alternative feasible option under such settings. This study aims to investigate the efficacy of adalimumab monotherapy in paediatric non-infectious uveitis. METHODS Children with non-infectious uveitis on adalimumab monotherapy (from August 2015 to June 2022) following intolerance to accompanying methotrexate or mycophenolate mofetil were included in this retrospective study. Data were collected at the initiation of adalimumab monotherapy and at three monthly intervals until the last visit. The primary outcome was to evaluate disease control on adalimumab monotherapy as determined by the proportion of patients who had less than a 2-step worsening in uveitis (as per SUN score) and no additional systemic immunosuppression during follow-up. Secondary outcome measures were visual outcome, complications and side-effect profile of adalimumab monotherapy. RESULTS Data was collected for 28 patients (56 eyes). The most common uveitis type and course were anterior and chronic uveitis respectively. Juvenile idiopathic arthritis-associated uveitis was the most common underlying diagnosis. During the study period, 23 (82.14%) of the study subjects met the primary outcome. On Kaplan-Meier survival analysis 81.25% (95% CI; 60.6-91.7%) children maintained remission at 12 months on adalimumab monotherapy. CONCLUSION Continuation of adalimumab monotherapy is an effective therapeutic option for the treatment of non-infectious uveitis in children who are intolerant to the combination of adalimumab and methotrexate or mycophenolate mofetil.
Collapse
Affiliation(s)
- D A Al-Julandani
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK
| | - N K Bagri
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK
- Division of Paediatric Rheumatology, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - N Tsang
- University of Bristol, Bristol, UK
| | - S Clarke
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK
- School of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - A Upadhyay
- Scientist II CRU, All India Institute of Medical Sciences, New Delhi, India
| | - C Guly
- Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - A V Ramanan
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK.
- Translational Health Science, University of Bristol, Bristol, UK.
| |
Collapse
|
7
|
Ravicini S, Kent A, Dunning M, Baines S, Clarke S, Allerton F. Description and outcome of dogs with primary immune-mediated polyarthritis: 73 cases (2012-2017). J Small Anim Pract 2023; 64:142-148. [PMID: 36321528 DOI: 10.1111/jsap.13565] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/18/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To provide a description of primary idiopathic immune-mediated polyarthritis, including long-term outcome and relapse rates, for dogs starting treatment with corticosteroids alone or corticosteroids with a second immunosuppressant. MATERIALS AND METHODS Medical records were reviewed between January 2012 and December 2017 to identify dogs diagnosed with primary immune-mediated polyarthritis. Data including signalment, clinicopathological findings, type and duration of treatment, relapse and outcome were recorded. RESULTS Seventy-three dogs were included. Fifty-four dogs were started on corticosteroid monotherapy (an additional immunosuppressant was introduced later in 27/54 dogs) and 19 dogs were treated with multi-modal immunosuppression from the outset. Ninety-five percent (69/73) of dogs responded favourably to therapy although death was attributed to immune-mediated polyarthritis in 19% (14/73) of dogs. Relapse of clinical signs was reported in 53% (39/73) dogs (31/39 while on treatment), with multiple relapses observed in 17 dogs. Complete cure (permanent withdrawal of immunosuppressive medication) was achieved in 46 dogs (63%). Overall, 81% of dogs had a well-managed disease for an extended timeframe (≥1131 days). Fourteen of 19 (74%) dogs that started treatment with multi-modal immunosuppression and 32 of 54 (59%) started on corticosteroids alone achieved a complete cure. CLINICAL SIGNIFICANCE This study provides extended follow-up information for a large cohort of dogs with primary immune-mediated polyarthritis. Immunosuppressive therapy was discontinued in the majority of dogs but disease-associated mortality remains high.
Collapse
Affiliation(s)
- S Ravicini
- Washington State University, College of Veterinary Medicine, Pullman, WA, USA
| | - A Kent
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - M Dunning
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK.,School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - S Baines
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - S Clarke
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| |
Collapse
|
8
|
Wei J, Yuile A, Khou V, Itchins M, Kong B, Pavlakis N, Chan D, Clarke S. 338P Anti PD1 is superior to anti PDL1 when combined with chemotherapy in first-line treatment for metastatic non-small cell lung cancer (mNSCLC): A network meta-analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
|
9
|
Kong B, Wei J, Smith S, Chan W, Harden S, Khou V, Alexander M, Brown C, Itchins M, Lee J, Mersiades A, Gray L, Boyer M, Pavlakis N, Clarke S, Jayamanne D, Kao SH. 347P Real-world efficacy of first-line therapy in wild-type non-small cell lung cancer (NSCLC) patients with brain metastases. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
|
10
|
Mohamed M, Banerjee A, Clarke S, De Belder M, Goodwin A, Gale C, Curzen N, Mamas M. Impact of COVID-19 on cardiac procedure activity in England and associated 30-day mortality. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2848] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The COVID-19 pandemic had a significant impact on the quality of healthcare provision across all specialities and disciplines. However, there are limited data on the scale of its disruption to cardiac procedure activity from a national perspective and whether procedural outcomes different before and during the COVID-19 pandemic.
Methods
Major cardiac procedures (n=374,899) performed between 1st January and 31st May for the years 2018, 2019 and 2020 were analysed, stratified by procedure type and time-period (pre-COVID: January-May 2018 and 2019 and January-February 2020 and COVID: March-May 2020). Multivariable logistic regression modelling was undertaken to examine the odds ratio (OR) of 30-day mortality for procedures performed in the COVID period (vs. pre-COVID).
Results
There was a deficit of 45,501 procedures during the COVID period compared to the monthly averages (March-May) in 2018–2019. Cardiac catheterisation and cardiac electronic device implantations were the most affected in terms of numbers (n=19,637 and n=10,453) while surgical procedures including mitral valve replacement, other valve replacement/repair, atrial and ventricular septal defect repair, and CABG were the most affected as a relative percentage difference (D) to previous years' averages. TAVR was the least affected (D-10.6%). No difference in 30-day mortality was observed between pre-COVID and COVID time-periods for all cardiac procedures except cardiac catheterisation (OR 1.25 95% confidence interval (CI) 1.07–1.47, p=0.006) and cardiac device implantation (OR 1.35 95% CI 1.15–1.58, p<0.001).
Conclusion
There was a significant decline in national cardiac procedural activity in England during the COVID-19 pandemic, with a deficit in excess of 45000 procedures over the study period. However, there was no increase in risk of mortality for most cardiac procedures performed during the pandemic. While health service pressures are gradually easing given the increased roll out of vaccination and decline in infection rates, there is a need for major restructuring of cardiac services deal with this significant backlog of procedures, which would inevitably impact longer-term morbidity and mortality.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- M Mohamed
- Keele University , Keele , United Kingdom
| | - A Banerjee
- University College London , London , United Kingdom
| | - S Clarke
- Royal Papworth Hospital NHS Foundation Trust , Cambridge , United Kingdom
| | - M De Belder
- National Institute for Cardiovascular Outcomes Research , London , United Kingdom
| | - A Goodwin
- National Institute for Cardiovascular Outcomes Research , London , United Kingdom
| | - C Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, Cardiology , Leeds , United Kingdom
| | - N Curzen
- University of Southampton, Cardiology , Southampton , United Kingdom
| | - M Mamas
- Keele University , Keele , United Kingdom
| |
Collapse
|
11
|
Wren MWD, Petts D, Guthrie G, Clarke S, Nation BR, Peters L, Mortlock S, Sturdgess I, Wright M, Burt C. Pestilence, Plague and Pandemics: A Troubled History. Ulster Med J 2022; 91:143-151. [PMID: 36474849 PMCID: PMC9720592] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Humankind has lived with the danger of endemic, epidemic and pandemic disease for thousands of years. The effects of these outbreaks have often devastated human populations. Sixteen pandemic events causing an estimated 147 million deaths have occurred since the eighth century, The Black Death and the influenza pandemic of 1918-1920 probably having the greatest impact. Animal populations, both wild and domestic, have similarly suffered devastating outbreaks of disease which, on occasions, have translated into serious effects on human health. The deliberate or accidental introduction of animals into virgin areas has given rise to unforeseen disease events occasionally leading to extinction. Similarly, human intent or negligence and the vagaries of nature itself has resulted in ill health and loss of life. This paper describes the history of pandemics, epidemics and disasters, and the attempts to bring them under control.
Collapse
Affiliation(s)
| | | | | | | | - BR Nation
- Correspondence: Brian Nation CSci FIBMS,
| | | | | | | | | | | |
Collapse
|
12
|
Orlando G, Bubbear J, Clarke S, Keen R, Roy M, Anilkumar A, Schini M, Walsh JS, Javaid MK, Ireland A. Physical function and physical activity in adults with X-linked hypophosphatemia. Osteoporos Int 2022; 33:1485-1491. [PMID: 35122145 DOI: 10.1007/s00198-022-06318-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/20/2022] [Indexed: 12/17/2022]
Abstract
UNLABELLED We described physical function and activity in UK adults with X-linked hypophosphatemia (XLH). Our data indicate that low physical activity and impaired mobility are common in adults with XLH. Deficits in lower limbs muscle power and functional capacity contribute to the loss of physical function in adults with XLH. INTRODUCTION There is a dearth of literature on physical function and physical activity in adults with X-linked hypophosphatemia (XLH). We described muscle strength and power, functional capacity, mobility and physical activity level and explored the relationships among these variables in adults with XLH. METHODS Participants were recruited as part of a UK-based prospective cohort study, the RUDY Study. They underwent a clinical visit and physical examination, including assessment of handgrip strength, jump power (mechanography), six-minute walk test (6MWT) and short physical performance battery (SPPB), and completed the International Physical Activity Questionnaire (IPAQ). Performance data were analysed using parametric and non-parametric tests, whereas correlations were assessed by univariate analysis. RESULTS Twenty-six adults with XLH (50% males) with a mean age of 44 ± 16.1 years were recruited. Jump power and 6MWT distances (p < 0.0001) were 54.4% and 38.6% lower respectively in individuals with XLH compared with normative values. These deficits were not associated with age or sex. Handgrip strength values were similar to expected values. Deficits in muscle power were more pronounced than those reported at 6MWT (p < 0.0001). Univariate analysis revealed only a correlation between total physical activity and muscle power (r = 0.545, p = 0.019). CONCLUSIONS Adults with XLH have a marked deficit in lower limb muscle power and a reduced functional capacity, with a high incidence of impaired mobility and inactivity. In addition to metabolic effects of XLH, low physical activity may contribute to deficits in lower limb power. Further studies are required to develop novel treatment approaches to improve physical function and mobility.
Collapse
Affiliation(s)
- G Orlando
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK.
| | - J Bubbear
- Rheumatology & Metabolic Bone Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - S Clarke
- Department of Rheumatology, University Hospitals Bristol, Bristol, UK
| | - R Keen
- Rheumatology & Metabolic Bone Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - M Roy
- Department of Rheumatology, University Hospitals Bristol, Bristol, UK
| | - A Anilkumar
- Department of Rheumatology, University Hospitals Bristol, Bristol, UK
| | - M Schini
- Academic Unit of Bone Metabolism, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - J S Walsh
- Academic Unit of Bone Metabolism, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - M K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - A Ireland
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK
| |
Collapse
|
13
|
Berman M, Ali A, Macklam D, Garcia Saez D, Jothidasan A, Husain M, Stock U, Mehta V, Venkateswaran R, Curry P, Messer S, Mukadam M, Mascaro J, Clarke S, Baxter J, Tsui S, Large S, Osman M, Kaul P, Boda G, Jenkins D, Simmonds J, Quigley R, Whitney J, Gardiner D, Watson C, Rubino A, Currie I, Foley J, Macleod A, Slater C, Marley F, Downward L, Rushton S, Armstrong L, Ayton L, Ryan M, Parker M, Gibson S, Spence S, Quinn K, Watson S, Forsythe J. UK National DCD Heart Transplant Program - First Year Experience. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
14
|
Geraghty A, Castro PD, Reynolds C, McBean L, Browne S, Clyne B, Bury G, Bradley C, Finnigan K, Clarke S, McCullagh L, Perrotta C, Murrin C, Gibney E, Kennelly S, Corish C. Evaluation of an online malnutrition management education module for general practitioners: the onspres project. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.098] [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: 10/19/2022]
|
15
|
Aetesam-Ur-Rahman M, Zhao T, Paques K, Oliveira J, Khialani B, Kyranis S, Braganza D, Clarke S, Bennett M, West N, Hoole S. Whole cycle non-hyperaemic pressure ratios have better stability than diastolic ratios after percutaneous coronary intervention due to changes in diastolic coronary haemodynamics. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2093] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Post percutaneous intervention (PCI) fractional flow reserve (FFR) value of ≥0.90 is an accepted marker of procedural success, and similarly, a cut-off of ≥0.95 has recently been proposed for post-PCI instantaneous wave free ratio (iFR). However, the stability of non-hyperaemic pressure ratios (NHPRs) and microcirculatory resistance post-PCI, is not well characterised. as submaximal hyperaemia post-PCI may affect them.
Purpose
We performed this study to assess stability and reproducibility of NHPRs measured immediately post-PCI and repeated at 30 minutes post-PCI.
Methods
Seventy-seven patients undergoing pressure wire guided PCI (age 63.77±10.67 years, male 71%,) had haemodynamic assessment done immediately post-PCI and after a recovery period 30 minutes (Figure A, B). Manual offline analysis was performed to derive resting pressure ratios during whole cycle: average ratio of distal coronary pressure to proximal aortic pressure at rest (Pd/Pa) and resting full cycle ratio (RFR); and during diastolic phase: average diastolic pressure ratio (dPR) and mathematically calculated iFRmat, measured by average Pd/Pa during wave free period (WFP) (from 25% into diastole until 5 msec before the end of diastole). We also measured coronary flow velocity by thermo-dilution time (Tmn) and basal microvascular resistance (BMR = Pa × Tmn × [(Pd − Pw) / (Pa − Pw)] baseline) corrected for coronary wedge pressure (Pw). Test-retest statistics was performed between NHPRs values immediately post-PCI and at 30 minutes. Moreover, crossover of NHPRs across the cut-off value of 0.95 was analysed to assess clinical utility of these indices for procedural success. p value of <0.05 was deemed statistically significant.
Results
There were no differences in the baseline characteristics of the study patients. Sub-maximal hyperaemia was demonstrated by Tmn of 0.54 sec (0.32, 0.75) immediately post-PCI which settled by 30 minutes, Tmn of 0.67 sec (0.43, 0.91), p=0.01 (Figure C). The median BMR increased from 49.25 mmHg sec (32.74, 61.61) to 59.60 mmHg sec (39.24, 76.91) at 30 minutes, p=0.04 (Figure D). Despite this, there were no significant differences in the values of resting whole cycle ratios (Pd/Pa and RFR) as well as diastolic ratios (dPR and iFRmat), with whole cardiac cycle NHPRs having best stability post-PCI (Table). Furthermore, crossover above or below the cut-off value of 0.95 occurred in approximately 1 in 5 diastolic NHPRs measurements but was three-fold lower for whole cycle NHPRs.
Conclusion
NHPRs remain stable post-PCI, despite submaximal hyperaemia being detected and may legitimately be used immediately post-PCI to determine procedural success. However, the test-retest reproducibility and clinical utility of diastolic NHPRs (dPR and iFR) was inferior to whole cycle NHPRs (Pd/Pa and RFR).
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NIHR
Collapse
Affiliation(s)
- M Aetesam-Ur-Rahman
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - T Zhao
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - K Paques
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - J Oliveira
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - B Khialani
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - S Kyranis
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - D Braganza
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - S Clarke
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - M Bennett
- University of Cambridge, Department of Cardiovascular Medicine, Cambridge, United Kingdom
| | - N West
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| | - S Hoole
- Royal Papworth Hospital NHS Foundation Trust, Interventional Cardiology, Cambridge, United Kingdom
| |
Collapse
|
16
|
Itchins M, Liang S, Barnes T, Marx G, Chin V, Kao S, Yip P, Nagrial A, Peters G, Bray V, Lewis C, Shaffer T, Li M, Clarke S, Li B, Brown C, Solomon B, Pavlakis N. P24.03 Dynamic Circulating Tumor DNA Interim Results From The ALKternate Clinical Trial. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Dean S, Ainsworth H, Alexander M, Dharmaraj D, O’Connell R, Mitchell P, Torres J, Saqib A, Ladwa R, Pavlakis N, Clarke S, Tay R, Solomon B, John T, Moore M, Yip P, Kao S, Itchins M, Parakh S. P16.02 Atezolizumab, Bevacizumab and Chemotherapy (IMpower150) in Stage IV Non-Small Cell Lung Cancer: The Australian Experience. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
18
|
Kerr C, Adle-Biassette H, Moloney PB, Hutchinson S, Cryan JB, Clarke S, Mulcahy F, Devitt E. CD8 encephalitis with CSF EBV viraemia and HIV drug resistance, a case series. Brain Behav Immun Health 2021; 9:100164. [PMID: 34589901 PMCID: PMC8474158 DOI: 10.1016/j.bbih.2020.100164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/21/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction CD8 encephalitis is a relatively recently described condition in the setting of HIV infection. It is becoming increasingly recognised in recent years though is still likely underdiagnosed. Methods We present three cases of encephalitis in HIV-positive black African females initially presenting with neurological pathology. Two cases concern recent presentations of patients attending HIV services at a large tertiary referral hospital and the third case involves a retrospective analysis of an archived case. Results and discussion MRI brain demonstrated periventricular white matter changes in 2 cases and a cerebellar lesion in the third case. CSF examination revealed lymphocytosis and elevated protein levels. CSF HIV viral load analysis showed viral escape along with new antiretroviral drug resistance mutations. CSF flow cytometry studies demonstrated a reversed CD4:CD8 ratio with a high CD8+ cells percentage. All patients had EBV DNA detected in their CSF. Brain biopsy in two patients confirmed CD8 encephalitis and also revealed isolated cells demonstrating EBV positivity by in-situ hybridization using EBER (Epstein–Barr virus-encoded small RNAs). Treatment with steroids and ART optimisation led to significant clinical and radiological improvements in all cases. Discussion CD8 encephalitis should be considered as a cause of neurological symptoms and confusion in the HIV-positive patient, particularly if poor ART adherence or viral resistance are suspected. Brain biopsy should be considered in HIV-positive patients with encephalopathy of uncertain cause. Early treatment with high-dose corticosteroids when suspecting this diagnosis is essential for a favourable outcome. The prognosis is variable but can be favourable even following severe encephalopathy. The presence of new INSTI mutations in the CSF but absent peripherally in two INSTI-era patients is a novel finding for this case series in the context of CD8 encephalitis. The role played by EBV in this disease remains unclear and warrants further investigation.
Collapse
Affiliation(s)
- C Kerr
- Department of GU Medicine and Infectious Diseases (GUIDe), St. James's Hospital, Dublin, Ireland.,Department of Clinical Medicine, School of Medicine, St. James's Hospital, Trinity College Dublin, Ireland
| | - H Adle-Biassette
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,Service d'Anatomie Pathologique, Hôpital Lariboisière, APHP, Paris, France.,Biobank BB, 0033-00064, Hôpital Lariboisière, Paris, France
| | - P B Moloney
- Department of Neurology, St. James's Hospital, Dublin, Ireland
| | - S Hutchinson
- Department of Neurology, St. James's Hospital, Dublin, Ireland
| | - J B Cryan
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - S Clarke
- Department of GU Medicine and Infectious Diseases (GUIDe), St. James's Hospital, Dublin, Ireland
| | - F Mulcahy
- Department of GU Medicine and Infectious Diseases (GUIDe), St. James's Hospital, Dublin, Ireland
| | - E Devitt
- Department of GU Medicine and Infectious Diseases (GUIDe), St. James's Hospital, Dublin, Ireland
| |
Collapse
|
19
|
Vilizzi L, Copp GH, Hill JE, Adamovich B, Aislabie L, Akin D, Al-Faisal AJ, Almeida D, Azmai MNA, Bakiu R, Bellati A, Bernier R, Bies JM, Bilge G, Branco P, Bui TD, Canning-Clode J, Cardoso Ramos HA, Castellanos-Galindo GA, Castro N, Chaichana R, Chainho P, Chan J, Cunico AM, Curd A, Dangchana P, Dashinov D, Davison PI, de Camargo MP, Dodd JA, Durland Donahou AL, Edsman L, Ekmekçi FG, Elphinstone-Davis J, Erős T, Evangelista C, Fenwick G, Ferincz Á, Ferreira T, Feunteun E, Filiz H, Forneck SC, Gajduchenko HS, Gama Monteiro J, Gestoso I, Giannetto D, Gilles AS, Gizzi F, Glamuzina B, Glamuzina L, Goldsmit J, Gollasch S, Goulletquer P, Grabowska J, Harmer R, Haubrock PJ, He D, Hean JW, Herczeg G, Howland KL, İlhan A, Interesova E, Jakubčinová K, Jelmert A, Johnsen SI, Kakareko T, Kanongdate K, Killi N, Kim JE, Kırankaya ŞG, Kňazovická D, Kopecký O, Kostov V, Koutsikos N, Kozic S, Kuljanishvili T, Kumar B, Kumar L, Kurita Y, Kurtul I, Lazzaro L, Lee L, Lehtiniemi M, Leonardi G, Leuven RSEW, Li S, Lipinskaya T, Liu F, Lloyd L, Lorenzoni M, Luna SA, Lyons TJ, Magellan K, Malmstrøm M, Marchini A, Marr SM, Masson G, Masson L, McKenzie CH, Memedemin D, Mendoza R, Minchin D, Miossec L, Moghaddas SD, Moshobane MC, Mumladze L, Naddafi R, Najafi-Majd E, Năstase A, Năvodaru I, Neal JW, Nienhuis S, Nimtim M, Nolan ET, Occhipinti-Ambrogi A, Ojaveer H, Olenin S, Olsson K, Onikura N, O'Shaughnessy K, Paganelli D, Parretti P, Patoka J, Pavia RTB, Pellitteri-Rosa D, Pelletier-Rousseau M, Peralta EM, Perdikaris C, Pietraszewski D, Piria M, Pitois S, Pompei L, Poulet N, Preda C, Puntila-Dodd R, Qashqaei AT, Radočaj T, Rahmani H, Raj S, Reeves D, Ristovska M, Rizevsky V, Robertson DR, Robertson P, Ruykys L, Saba AO, Santos JM, Sarı HM, Segurado P, Semenchenko V, Senanan W, Simard N, Simonović P, Skóra ME, Slovák Švolíková K, Smeti E, Šmídová T, Špelić I, Srėbalienė G, Stasolla G, Stebbing P, Števove B, Suresh VR, Szajbert B, Ta KAT, Tarkan AS, Tempesti J, Therriault TW, Tidbury HJ, Top-Karakuş N, Tricarico E, Troca DFA, Tsiamis K, Tuckett QM, Tutman P, Uyan U, Uzunova E, Vardakas L, Velle G, Verreycken H, Vintsek L, Wei H, Weiperth A, Weyl OLF, Winter ER, Włodarczyk R, Wood LE, Yang R, Yapıcı S, Yeo SSB, Yoğurtçuoğlu B, Yunnie ALE, Zhu Y, Zięba G, Žitňanová K, Clarke S. A global-scale screening of non-native aquatic organisms to identify potentially invasive species under current and future climate conditions. Sci Total Environ 2021; 788:147868. [PMID: 34134389 DOI: 10.1016/j.scitotenv.2021.147868] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 05/22/2023]
Abstract
The threat posed by invasive non-native species worldwide requires a global approach to identify which introduced species are likely to pose an elevated risk of impact to native species and ecosystems. To inform policy, stakeholders and management decisions on global threats to aquatic ecosystems, 195 assessors representing 120 risk assessment areas across all six inhabited continents screened 819 non-native species from 15 groups of aquatic organisms (freshwater, brackish, marine plants and animals) using the Aquatic Species Invasiveness Screening Kit. This multi-lingual decision-support tool for the risk screening of aquatic organisms provides assessors with risk scores for a species under current and future climate change conditions that, following a statistically based calibration, permits the accurate classification of species into high-, medium- and low-risk categories under current and predicted climate conditions. The 1730 screenings undertaken encompassed wide geographical areas (regions, political entities, parts thereof, water bodies, river basins, lake drainage basins, and marine regions), which permitted thresholds to be identified for almost all aquatic organismal groups screened as well as for tropical, temperate and continental climate classes, and for tropical and temperate marine ecoregions. In total, 33 species were identified as posing a 'very high risk' of being or becoming invasive, and the scores of several of these species under current climate increased under future climate conditions, primarily due to their wide thermal tolerances. The risk thresholds determined for taxonomic groups and climate zones provide a basis against which area-specific or climate-based calibrated thresholds may be interpreted. In turn, the risk rankings help decision-makers identify which species require an immediate 'rapid' management action (e.g. eradication, control) to avoid or mitigate adverse impacts, which require a full risk assessment, and which are to be restricted or banned with regard to importation and/or sale as ornamental or aquarium/fishery enhancement.
Collapse
Affiliation(s)
- Lorenzo Vilizzi
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Gordon H Copp
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland; Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK; Centre for Ecology, Environment and Sustainability, Bournemouth University, Poole, Dorset BH12 5BB, UK; School of the Environment, Trent University, Peterborough, Ontario K9L 0G2, Canada
| | - Jeffrey E Hill
- Tropical Aquaculture Laboratory, Program in Fisheries and Aquatic Sciences, School of Forest Resources and Conservation, University of Florida, Ruskin, FL 33570, USA
| | - Boris Adamovich
- Faculty of Biology, Belarusian State University, 220030 Minsk, Belarus
| | - Luke Aislabie
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK
| | - Daniel Akin
- College of Science and Mathematics, Auburn University, Auburn, AL 36849, USA
| | - Abbas J Al-Faisal
- Marine Science Centre, University of Basrah, PO Box 49, Basrah, Iraq
| | - David Almeida
- Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo CEU, 28003 Madrid, Spain
| | - M N Amal Azmai
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia
| | - Rigers Bakiu
- Department of Aquaculture and Fisheries, Faculty of Agriculture and Environment, Agricultural University of Tirana, Tirana 1000, Albania; Albanian Center for Environmental Protection and Sustainable Development, Tirana 1000, Albania
| | - Adriana Bellati
- Department of Ecological and Biological Sciences, University of Tuscia, 01100 Viterbo, Italy
| | - Renée Bernier
- Fisheries and Oceans Canada, Gulf Fisheries Centre, Moncton, New Brunswick E1C 5K4, Canada
| | - Jason M Bies
- Department of Wildlife, Fisheries & Aquaculture, Mississippi State University, Mississippi State, MS 39762, USA
| | - Gökçen Bilge
- Department of Basic Sciences, Faculty of Fisheries, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | - Paulo Branco
- Forest Research Centre, School of Agriculture, University of Lisbon, Tapada da Ajuda 1349-017, Lisbon, Portugal
| | - Thuyet D Bui
- Faculty of Marine Science, Hanoi University of Natural Resources and Environment, 41A Phu Dien, Bac Tu Liem, Hanoi, Viet Nam
| | - João Canning-Clode
- MARE - Marine and Environmental Sciences Centre, Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), 9020-105 Funchal, Madeira, Portugal; Smithsonian Environmental Research Center, Edgewater, MD 21037, USA
| | - Henrique Anatole Cardoso Ramos
- Coordination of Sustainable Use of Fisheries Resources, Department of Species Conservation, Ministry of Environment, 70068-900 Brasilia, Brazil
| | - Gustavo A Castellanos-Galindo
- Leibniz Centre for Tropical Marine Research (ZMT), 28359 Bremen, Germany; Smithsonian Tropical Research Institute, Apartado 2072, Balboa, Panamá
| | - Nuno Castro
- MARE - Marine and Environmental Sciences Centre, Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), 9020-105 Funchal, Madeira, Portugal
| | - Ratcha Chaichana
- Department of Environmental Technology and Management, Faculty of Environment, Kasetsart University, Bangkok 10900, Thailand
| | - Paula Chainho
- MARE - Marine and Environmental Sciences Centre, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal; Department of Animal Biology, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal; Polytechnic Institute of Setúbal, 2910-761 Setúbal, Portugal
| | - Joleen Chan
- Department of Biological Sciences, National University of Singapore, 117558, Singapore
| | - Almir M Cunico
- Laboratory of Ecology, Fisheries and Ichthyology, Biodiversity Department - Palotina Sector, Federal University of Paraná (UFPR), Curitiba 80060-000, Brazil
| | - Amelia Curd
- Laboratory of Coastal Benthic Ecology, French Research Institute for Exploitation of the Sea (IFREMER), 29280 Plouzané, France
| | - Punyanuch Dangchana
- Division of Research Policy and Plan, National Research Council of Thailand, Bangkok 10900, Thailand
| | - Dimitriy Dashinov
- Department of General and Applied Hydrobiology, Faculty of Biology, Sofia University, 1164 g.k. Lozenets, Sofia, Bulgaria
| | - Phil I Davison
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK
| | - Mariele P de Camargo
- Laboratory of Ecology, Fisheries and Ichthyology, Biodiversity Department - Palotina Sector, Federal University of Paraná (UFPR), Curitiba 80060-000, Brazil
| | - Jennifer A Dodd
- Animal and Plant Sciences Group, Edinburgh Napier University, Sighthill, Edinburgh EH11 4BN, UK
| | - Allison L Durland Donahou
- Tropical Aquaculture Laboratory, Program in Fisheries and Aquatic Sciences, School of Forest Resources and Conservation, University of Florida, Ruskin, FL 33570, USA; Florida Southern College, Lakeland, FL 33801, USA
| | - Lennart Edsman
- Department of Aquatic Resources, Institute of Freshwater Research, Swedish University of Agricultural Sciences, SE-750 07 Drottningholm, Sweden
| | - F Güler Ekmekçi
- Hydrobiology section, Department of Biology, Faculty of Science, Hacettepe University, Çankaya-Ankara 06800, Turkey
| | | | - Tibor Erős
- Centre for Ecological Research, Balaton Limnological Institute, Tihany 8237, Hungary
| | - Charlotte Evangelista
- Centre for Ecological and Evolutionary Synthesis, University of Oslo, NO-0316 Oslo, Norway
| | - Gemma Fenwick
- Lancaster Environment Centre, Lancaster University, Lancaster, Lancashire LA1 4YW, UK
| | - Árpád Ferincz
- Institute for Natural Resources Conservation, Department of Aquaculture, Faculty of Agriculture and Environmental Sciences, Szent István University, Gödöllő 2100, Hungary
| | - Teresa Ferreira
- Department of Natural Resources, Environment and Landscape, School of Agriculture, University of Lisbon, 1349-017 Lisbon, Portugal
| | - Eric Feunteun
- Muséum National d'Histoire Naturelle, Laboratoire Biologie des Organismes et Ecosystèmes Aquatiques, BOREA (MNHN, CNRS, Sorbonne Université, Université de Caen, IRD, Université de Guadeloupe Antilles), Station Marine de Dinard, CRESCO, 35800 Dinard, France
| | - Halit Filiz
- Department of Basic Sciences, Faculty of Fisheries, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | - Sandra C Forneck
- Laboratory of Ecology, Fisheries and Ichthyology, Biodiversity Department - Palotina Sector, Federal University of Paraná (UFPR), Curitiba 80060-000, Brazil
| | - Helen S Gajduchenko
- Laboratory of Ichthyology, Scientific and Practical Center for Bioresources, National Academy of Sciences of Belarus, Minsk 220072, Belarus
| | - João Gama Monteiro
- MARE - Marine and Environmental Sciences Centre, Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), 9020-105 Funchal, Madeira, Portugal
| | - Ignacio Gestoso
- MARE - Marine and Environmental Sciences Centre, Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), 9020-105 Funchal, Madeira, Portugal; Smithsonian Environmental Research Center, Edgewater, MD 21037, USA
| | - Daniela Giannetto
- Department of Biology, Faculty of Science, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | - Allan S Gilles
- Department of Biological Sciences, College of Science, Research Center for the Natural and Applied Sciences, Graduate School, University of Santo Tomas, Manila, 1008, Metro Manila, Philippines
| | - Francesca Gizzi
- MARE - Marine and Environmental Sciences Centre, Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), 9020-105 Funchal, Madeira, Portugal
| | - Branko Glamuzina
- Department of Applied Ecology, University of Dubrovnik, 20000 Dubrovnik, Croatia
| | - Luka Glamuzina
- Department of Applied Ecology, University of Dubrovnik, 20000 Dubrovnik, Croatia
| | - Jesica Goldsmit
- Fisheries and Oceans Canada, Maurice Lamontagne Institute, Mont-Joli, Quebec G5H 3Z4, Canada; Arctic and Aquatic Research Division, Freshwater Institute, Fisheries and Oceans Canada, Winnipeg, Quebec MB R3T 2N6, Canada
| | | | - Philippe Goulletquer
- Scientific Direction, French Research Institute for Exploitation of the Sea (IFREMER), 44980 Nantes, France
| | - Joanna Grabowska
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Rogan Harmer
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK
| | - Phillip J Haubrock
- Senckenberg Research Institute and Natural History Museum Frankfurt, Department of River Ecology and Conservation, 63571 Gelnhausen, Germany; Nature and Environment Management Operators s.r.l., 50121 Florence, Italy; Department of Biology, University of Florence, 50121 Florence, Italy
| | - Dekui He
- The Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430071, China
| | - Jeffrey W Hean
- DST/NRF Research Chair in Inland Fisheries and Freshwater Ecology, South African Institute for Aquatic Biodiversity, Grahamstown 6140, South Africa; GroundTruth, Water, Wetlands and Environmental Engineering, Hilton, KwaZulu-Natal 3245, South Africa
| | - Gábor Herczeg
- Behavioural Ecology Group, Department of Systematic Zoology and Ecology, ELTE Eötvös Loránd University, H-1117 Budapest, Hungary
| | - Kimberly L Howland
- Arctic and Aquatic Research Division, Freshwater Institute, Fisheries and Oceans Canada, Winnipeg, Quebec MB R3T 2N6, Canada
| | - Ali İlhan
- Faculty of Fisheries, Ege University, 35100 Bornova, Izmir, Turkey
| | - Elena Interesova
- Tomsk State University, Tomsk 634050, Russia; Institute of Systematics and Ecology of Animals, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia; Novosibirsk branch of Russian Federal Research Institute of Fisheries and Oceanography, Novosibirsk 630090, Russia
| | - Katarína Jakubčinová
- Department of Ecology, Faculty of Natural Sciences, Comenius University, 841 04 Bratislava, Slovakia
| | - Anders Jelmert
- Institute of Marine Research, Flødevigen Research Station, NO-7485 His, Norway
| | - Stein I Johnsen
- Norwegian Institute for Nature Research, NO-7485 Trondheim, Norway
| | - Tomasz Kakareko
- Department of Ecology and Biogeography, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Kamalaporn Kanongdate
- Faculty of Environment and Resource Studies, Mahidol University, Salaya 73170, Thailand
| | - Nurçin Killi
- Department of Basic Sciences, Faculty of Fisheries, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | - Jeong-Eun Kim
- College of Biological Sciences and Biotechnology, Chungnam National University, Daejeon 305-764, Republic of Korea
| | | | - Dominika Kňazovická
- Department of Zoology and Fisheries, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, 165 00 Praha, Czechia
| | - Oldřich Kopecký
- Department of Zoology and Fisheries, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, 165 00 Praha, Czechia
| | - Vasil Kostov
- Department of Fisheries, Institute of Animal Science, Ss Cyril and Methodius University, Skopje 1000, Macedonia
| | - Nicholas Koutsikos
- Institute of Marine Biological Resources & Inland Waters, Hellenic Centre for Marine Research, Anavissos, 19013, Attica, Greece
| | - Sebastian Kozic
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Tatia Kuljanishvili
- Department of Zoology and Fisheries, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, 165 00 Praha, Czechia
| | - Biju Kumar
- Department of Aquatic Biology & Fisheries, University of Kerala, Thiruvananthapuram, Kerala 695034, India
| | - Lohith Kumar
- REF Division, ICAR-Central Inland Fisheries Research Institute, Kolkata, West Bengal 700120, India
| | - Yoshihisa Kurita
- Fishery Research Laboratory, Kyushu University, Fukutsu, Fukuoka 811-3304, Japan
| | - Irmak Kurtul
- Faculty of Fisheries, Ege University, 35100 Bornova, Izmir, Turkey
| | - Lorenzo Lazzaro
- Department of Biology, University of Florence, 50121 Florence, Italy
| | - Laura Lee
- Department of Evolution, Ecology and Behaviour, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7TX, England, United Kingdom
| | - Maiju Lehtiniemi
- Marine Research Centre, Finnish Environment Institute, 00790 Helsinki, Finland
| | | | - Rob S E W Leuven
- Department of Animal Ecology and Physiology, Institute for Water and Wetland Research, Radboud University & Netherlands Centre of Expertise on Exotic Species, 6500 GL Nijmegen, the Netherlands
| | - Shan Li
- Natural History Research Center, Shanghai Natural History Museum, Branch of Shanghai Science & Technology Museum, Shanghai 200041, China
| | - Tatsiana Lipinskaya
- Laboratory of Hydrobiology, Scientific and Practical Center for Bioresources, National Academy of Sciences of Belarus, Minsk 220072, Belarus
| | - Fei Liu
- Aquatic Science Institute, Tibet Academy of Agriculture and Animal Husbandry Science, Lhasa 850009, China
| | - Lance Lloyd
- Lloyd Environmental Pty Ltd, Somers, Victoria 3927, Australia; School of Health and Life Sciences, Federation University Australia, Ballarat, Victoria 3350, Australia
| | - Massimo Lorenzoni
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, 06123 Perugia, Italy
| | - Sergio Alberto Luna
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico
| | - Timothy J Lyons
- Tropical Aquaculture Laboratory, Program in Fisheries and Aquatic Sciences, School of Forest Resources and Conservation, University of Florida, Ruskin, FL 33570, USA; New Mexico Biopark Society, Albuquerque, NM 87102, USA
| | - Kit Magellan
- South African Institute for Aquatic Biodiversity, Grahamstown 6140, South Africa; University of Battambang, 02360 Battambang, Cambodia
| | - Martin Malmstrøm
- Norwegian Scientific Committee for Food and Environment (VKM), NO-0213 Oslo, Norway
| | - Agnese Marchini
- Department of Earth and Environmental Sciences, University of Pavia, 27100 Pavia, Italy
| | - Sean M Marr
- DST/NRF Research Chair in Inland Fisheries and Freshwater Ecology, South African Institute for Aquatic Biodiversity, Grahamstown 6140, South Africa
| | - Gérard Masson
- Laboratoire interdisciplinaire des environnements continentaux, Centre national de la recherche scientifique, Université de Lorraine, 57000 Metz, France
| | - Laurence Masson
- Freshwater Fish Ecology Laboratory, Ecosystem Science and Management Program, University of Northern British Columbia, Prince George, British Columbia V2N 4Z9, Canada
| | - Cynthia H McKenzie
- Northwest Atlantic Fisheries Centre, Fisheries and Oceans Canada, St. John's, Newfoundland and Labrador A1A 5J7, Canada
| | - Daniyar Memedemin
- Faculty of Natural and Agricultural Sciences, Ovidius University of Constanta, Constanta 900527, Romania
| | - Roberto Mendoza
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico
| | - Dan Minchin
- Marine Organism Investigations, Marina Village, Ballina, Killaloe, Clare V94 767X, Ireland; Marine Research Institute, Klaipėda University, 92294 Klaipėda, Lithuania
| | - Laurence Miossec
- Scientific Direction, French Research Institute for Exploitation of the Sea (IFREMER), 44980 Nantes, France
| | - Seyed Daryoush Moghaddas
- Department of Biodiversity and Ecosystems Management, Environmental Sciences Research Institute, Shahid Beheshti University, 1983963113 Tehran, Iran
| | - Moleseng C Moshobane
- South African National Biodiversity Institute, Biological Invasions Directorate, Pretoria 0001, South Africa; Department of Biology, Sefako Makgatho Health Sciences University, Gauteng 0208, South Africa; Young Water Professionals, South African Chapter, Limpopo 1685, South Africa
| | - Levan Mumladze
- Institute of Zoology, Ilia State University, Tbilisi 0162, Georgia
| | - Rahmat Naddafi
- Swedish University of Agricultural Sciences, Department of Aquatic Resources, Division of Coastal Research, SE-453 30 Oregrund, Sweden
| | - Elnaz Najafi-Majd
- Department of Biology, Faculty of Sciences, Ege University, 35040 Izmir, Turkey
| | - Aurel Năstase
- Department of Biodiversity Conservation and Sustainable Use of Natural Resources, Danube Delta National Institute for Research and Development, Tulcea 820112, Romania
| | - Ion Năvodaru
- Department of Biodiversity Conservation and Sustainable Use of Natural Resources, Danube Delta National Institute for Research and Development, Tulcea 820112, Romania
| | - J Wesley Neal
- Department of Wildlife, Fisheries & Aquaculture, Mississippi State University, Mississippi State, MS 39762, USA
| | - Sarah Nienhuis
- Ontario Ministry of Natural Resources and Forestry, Peterborough, Ontario K9J 8M5, Canada
| | - Matura Nimtim
- Department of Environmental Technology and Management, Faculty of Environment, Kasetsart University, Bangkok 10900, Thailand
| | - Emma T Nolan
- Department of Life and Environmental Sciences, Faculty of Science and Technology, Bournemouth University, Talbot Campus, Poole BH12 5BB, UK
| | - Anna Occhipinti-Ambrogi
- Department of Ecological and Biological Sciences, University of Tuscia, 01100 Viterbo, Italy
| | - Henn Ojaveer
- University of Tartu, 80012 Pärnu, Estonia; National Institute of Aquatic Resources, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Sergej Olenin
- Marine Research Institute, Klaipėda University, 92294 Klaipėda, Lithuania
| | - Karin Olsson
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK; School of Zoology, Tel Aviv University, Tel Aviv 6997801, Israel; The Inter-University Institute for Marine Sciences in Eilat, Coral Beach, Eilat 8810302, Israel
| | - Norio Onikura
- Fishery Research Laboratory, Kyushu University, Fukutsu, Fukuoka 811-3304, Japan
| | - Kathryn O'Shaughnessy
- Texas Parks and Wildlife Department, Coastal Fisheries, 4200 Smith School Rd., Austin, TX 78744, USA
| | | | - Paola Parretti
- MARE - Marine and Environmental Sciences Centre, Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), 9020-105 Funchal, Madeira, Portugal; CIBIO, Research Center in Biodiversity and Genetic Resources, InBIO Associate Laboratory and Faculty of Sciences and Technologies, University of the Azores, 9500-321 Ponta Delgada, Portugal
| | - Jiří Patoka
- Department of Zoology and Fisheries, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, 165 00 Praha, Czechia
| | - Richard Thomas B Pavia
- Department of Biological Sciences, College of Science, Research Center for the Natural and Applied Sciences, Graduate School, University of Santo Tomas, Manila, 1008, Metro Manila, Philippines
| | | | | | - Elfritzson M Peralta
- Department of Biological Sciences, College of Science, Research Center for the Natural and Applied Sciences, Graduate School, University of Santo Tomas, Manila, 1008, Metro Manila, Philippines
| | - Costas Perdikaris
- Department of Fisheries, Regional Unit of Thesprotia, Epirus, 46 100, Igoumenitsa, Greece
| | - Dariusz Pietraszewski
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Marina Piria
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland; Department of Fisheries, Apiculture, Wildlife Management and Special Zoology, University of Zagreb Faculty of Agriculture, 10000 Zagreb, Croatia.
| | - Sophie Pitois
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK
| | - Laura Pompei
- Department of Chemistry, Biology and Biotechnologies, University of Perugia, 06123 Perugia, Italy
| | - Nicolas Poulet
- Pôle écohydraulique OFB-IMFT-P, French Agency for Biodiversity, 31400 Toulouse, France
| | - Cristina Preda
- Faculty of Natural and Agricultural Sciences, Ovidius University of Constanta, Constanta 900527, Romania
| | - Riikka Puntila-Dodd
- Marine Research Centre, Finnish Environment Institute, 00790 Helsinki, Finland
| | | | - Tena Radočaj
- Department of Fisheries, Apiculture, Wildlife Management and Special Zoology, University of Zagreb Faculty of Agriculture, 10000 Zagreb, Croatia
| | - Hossein Rahmani
- Sari Agricultural Sciences and Natural Resources University, Sari, 4816118771, Mazandaran, Iran
| | - Smrithy Raj
- Department of Aquatic Biology & Fisheries, University of Kerala, Thiruvananthapuram, Kerala 695034, India; National Centre for Biological Sciences, Bangalore 560065, India
| | - David Reeves
- National Fish and Wildlife Foundation, Baton Rouge, LA 70808, USA
| | - Milica Ristovska
- Institute of Biology, Faculty of Natural Sciences and Mathematics, Ss Cyril and Methodius University, 1000 Skopje, Macedonia
| | - Viktor Rizevsky
- Laboratory of Ichthyology, Scientific and Practical Center for Bioresources, National Academy of Sciences of Belarus, Minsk 220072, Belarus
| | - D Ross Robertson
- Smithsonian Tropical Research Institute, Apartado 2072, Balboa, Panamá
| | - Peter Robertson
- Modelling, Evidence and Policy Group, School of Natural and Environmental Resources, Newcastle University, Newcastle NE1 7RU, UK
| | - Laura Ruykys
- Nature and Biodiversity Conservation Agency, Vietnam Environment Administration, Ministry of Natural Resources and Environment, 10 Ton That Thuyet, Nam Tu Liem District, Hanoi, Viet Nam; Flora and Fauna Division, Department of Environment and Natural Resources, Palmerston, Northern Territory 0828, Australia
| | - Abdulwakil O Saba
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400 Seri Kembangan, Selangor, Malaysia; School of Agriculture, Lagos State University, Epe Campus, 106101 Epe, Lagos State, Nigeria
| | - José M Santos
- Forest Research Centre, School of Agriculture, University of Lisbon, Tapada da Ajuda 1349-017, Lisbon, Portugal
| | - Hasan M Sarı
- Faculty of Fisheries, Ege University, 35100 Bornova, Izmir, Turkey
| | - Pedro Segurado
- Forest Research Centre, School of Agriculture, University of Lisbon, Tapada da Ajuda 1349-017, Lisbon, Portugal
| | - Vitaliy Semenchenko
- Laboratory of Hydrobiology, Scientific and Practical Center for Bioresources, National Academy of Sciences of Belarus, Minsk 220072, Belarus
| | - Wansuk Senanan
- Department of Aquatic Science, Faculty of Science, Burapha University, Chon Buri 20130, Thailand
| | - Nathalie Simard
- Fisheries and Oceans Canada, Maurice Lamontagne Institute, Mont-Joli, Quebec G5H 3Z4, Canada
| | - Predrag Simonović
- Faculty of Biology & Institute for Biological Research "Siniša Stanković", University of Belgrade, Belgrade 11000, Serbia
| | - Michał E Skóra
- University of Gdańsk, Faculty of Oceanography and Geography, Institute of Oceanography, Professor Krzysztof Skóra Hel Marine Station, 84-150 Hel, Poland
| | - Kristína Slovák Švolíková
- Department of Ecology, Faculty of Natural Sciences, Comenius University, 841 04 Bratislava, Slovakia
| | - Evangelia Smeti
- Institute of Marine Biological Resources & Inland Waters, Hellenic Centre for Marine Research, Anavissos, 19013, Attica, Greece
| | - Tereza Šmídová
- Department of Zoology and Fisheries, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, 165 00 Praha, Czechia
| | - Ivan Špelić
- Department of Fisheries, Apiculture, Wildlife Management and Special Zoology, University of Zagreb Faculty of Agriculture, 10000 Zagreb, Croatia
| | - Greta Srėbalienė
- Marine Research Institute, Klaipėda University, 92294 Klaipėda, Lithuania
| | | | - Paul Stebbing
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, Dorset DT4 8UB, UK; APEM Ltd, A17 Embankment, Business Park, Heaton Mersey, Manchester, Cheshire SK4 3GN, UK
| | - Barbora Števove
- Department of Ecology, Faculty of Natural Sciences, Comenius University, 841 04 Bratislava, Slovakia
| | - Vettath R Suresh
- Division of Mariculture, Central Marine Fisheries Research Institute, Cochin, Kerala 682018, India
| | - Bettina Szajbert
- Behavioural Ecology Group, Department of Systematic Zoology and Ecology, ELTE Eötvös Loránd University, H-1117 Budapest, Hungary
| | - Kieu Anh T Ta
- Nature and Biodiversity Conservation Agency, Vietnam Environment Administration, Ministry of Natural Resources and Environment, 10 Ton That Thuyet, Nam Tu Liem District, Hanoi, Viet Nam
| | - Ali Serhan Tarkan
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland; Department of Basic Sciences, Faculty of Fisheries, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | | | - Thomas W Therriault
- Pacific Biological Station, Fisheries and Oceans Canada, Nanaimo, British Columbia V9T 6N7, Canada
| | - Hannah J Tidbury
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, Dorset DT4 8UB, UK
| | - Nildeniz Top-Karakuş
- Department of Basic Sciences, Faculty of Fisheries, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | - Elena Tricarico
- Department of Biology, University of Florence, 50121 Florence, Italy
| | - Débora F A Troca
- Institute of Oceanography, Federal University of Rio Grande, 96203-900 Rio Grande, Brazil
| | - Konstantinos Tsiamis
- Institute of Oceanography, Hellenic Centre for Marine Research, Attica, Anavyssos 19013, Greece
| | - Quenton M Tuckett
- Tropical Aquaculture Laboratory, Program in Fisheries and Aquatic Sciences, School of Forest Resources and Conservation, University of Florida, Ruskin, FL 33570, USA
| | - Pero Tutman
- Laboratory for Ichthyology and Coastal Fisheries, Institute of Oceanography and Fisheries, 21000 Split, Croatia
| | - Umut Uyan
- Skretting Turkey, Güllük Milas, 48670, Muğla, Turkey
| | - Eliza Uzunova
- Department of General and Applied Hydrobiology, Faculty of Biology, Sofia University, 1164 g.k. Lozenets, Sofia, Bulgaria
| | - Leonidas Vardakas
- Institute of Marine Biological Resources & Inland Waters, Hellenic Centre for Marine Research, Anavissos, 19013, Attica, Greece
| | - Gaute Velle
- Norwegian Research Centre, 5007 Bergen, Norway; Department of Biological Sciences, University of Bergen, 5007 Bergen, Norway
| | - Hugo Verreycken
- Research Institute for Nature and Forest (INBO), B-1630 Linkebeek, Belgium
| | - Lizaveta Vintsek
- Institute of Botany, Faculty of Biology, Jagiellonian University, 30-387 Kraków, Poland
| | - Hui Wei
- Pearl River Fisheries Research Institute, Chinese Academy of Fishery Science, Guangzhou 510380, China; Key Laboratory of Recreational fisheries Research, Ministry of Agriculture and Rural Affairs, Guangzhou 510380, China
| | - András Weiperth
- Institute for Natural Resources Conservation, Department of Aquaculture, Faculty of Agriculture and Environmental Sciences, Szent István University, Gödöllő 2100, Hungary
| | - Olaf L F Weyl
- Centre for Invasion Biology, South African Institute for Aquatic Biodiversity, Makhanda 6139, South Africa; DST/NRF Research Chair in Inland Fisheries and Freshwater Ecology, South African Institute for Aquatic Biodiversity, Grahamstown 6140, South Africa
| | - Emily R Winter
- Department of Life and Environmental Sciences, Faculty of Science and Technology, Bournemouth University, Talbot Campus, Poole BH12 5BB, UK
| | - Radosław Włodarczyk
- Department of Biodiversity Studies and Bioeducation, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Louisa E Wood
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, Dorset DT4 8UB, UK
| | - Ruibin Yang
- College of Fisheries, Huazhong Agricultural University, Wuhan 430070, China
| | - Sercan Yapıcı
- Department of Basic Sciences, Faculty of Fisheries, Muğla Sıtkı Koçman University, 48000 Menteşe, Muğla, Turkey
| | - Shayne S B Yeo
- Department of Biological Sciences, National University of Singapore, 117558, Singapore
| | - Baran Yoğurtçuoğlu
- Hydrobiology section, Department of Biology, Faculty of Science, Hacettepe University, Çankaya-Ankara 06800, Turkey
| | | | - Yunjie Zhu
- Aquaculture Technology Promotion Station of Nantong, Nantong, China
| | - Grzegorz Zięba
- Department of Ecology and Vertebrate Zoology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland
| | - Kristína Žitňanová
- Department of Ecology, Faculty of Natural Sciences, Comenius University, 841 04 Bratislava, Slovakia
| | - Stacey Clarke
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, Suffolk NR33 0HT, UK
| |
Collapse
|
20
|
Malik F, Ghazal-Asswad R, Clarke S. Carbon Monoxide: The Invisible as well as Silent Killer? A Quality Improvement Project raising awareness in the Emergency Department. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00562-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
21
|
Outinen O, Bailey SA, Broeg K, Chasse J, Clarke S, Daigle RM, Gollasch S, Kakkonen JE, Lehtiniemi M, Normant-Saremba M, Ogilvie D, Viard F. Exceptions and exemptions under the ballast water management convention - Sustainable alternatives for ballast water management? J Environ Manage 2021; 293:112823. [PMID: 34044234 DOI: 10.1016/j.jenvman.2021.112823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
The International Convention for the Control and Management of Ships' Ballast Water and Sediments (BWM Convention) aims to mitigate the introduction risk of harmful aquatic organisms and pathogens (HAOP) via ships' ballast water and sediments. The BWM Convention has set regulations for ships to utilise exceptions and exemptions from ballast water management under specific circumstances. This study evaluated local and regional case studies to provide clarity for situations, where ships could be excepted or exempted from ballast water management without risking recipient locations to new introductions of HAOP. Ships may be excepted from ballast water management if all ballasting operations are conducted in the same location (Regulation A-3.5 of the BWM Convention). The same location case study determined whether the entire Vuosaari harbour (Helsinki, Finland) should be considered as the same location based on salinity and composition of HAOP between the two harbour terminals. The Vuosaari harbour case study revealed mismatching occurrences of HAOP between the harbour terminals, supporting the recommendation that exceptions based on the same location concept should be limited to the smallest feasible areas within a harbour. The other case studies evaluated whether ballast water exemptions could be granted for ships using two existing risk assessment (RA) methods (Joint Harmonised Procedure [JHP] and Same Risk Area [SRA]), consistent with Regulation A-4 of the BWM Convention. The JHP method compares salinity and presence of target species (TS) between donor and recipient ports to indicate the introduction risk (high or low) attributed to transferring unmanaged ballast water. The SRA method uses a biophysical model to determine whether HAOP could naturally disperse between ports, regardless of their transportation in ballast water. The results of the JHP case study for the Baltic Sea and North-East Atlantic Ocean determined that over 97% of shipping routes within these regions resulted in a high-risk indication. The one route assessed in the Gulf of Maine, North America also resulted in a high-risk outcome. The SRA assessment resulted in an overall weak connectivity between all ports assessed within the Gulf of the St. Lawrence, indicating that a SRA-based exemption would not be appropriate for the entire study area. In summary, exceptions and exemptions should not be considered as common alternatives for ballast water management. The availability of recent and detailed species occurrence data was considered the most important factor to conduct a successful and reliable RA. SRA models should include biological factors that influence larval dispersal and recruitment potential (e.g., pelagic larval duration, settlement period) to provide a more realistic estimation of natural dispersal.
Collapse
Affiliation(s)
- Okko Outinen
- Marine Research Centre, Finnish Environment Institute, Latokartanonkaari 11, 00790, Helsinki, Finland.
| | - Sarah A Bailey
- Great Lakes Laboratory for Fisheries and Aquatic Sciences, Fisheries and Oceans Canada, Burlington, ON, Canada
| | - Katja Broeg
- Bundesamt für Seeschifffahrt und Hydrographie, Bernhard-Nocht-Straße 78, 20359, Hamburg, Germany
| | - Joël Chasse
- Gulf Fisheries Centre, Fisheries and Oceans Canada, Moncton, New Brunswick, Canada
| | - Stacey Clarke
- Centre for Environment, Fisheries and Aquaculture Science (CEFAS), Lowestoft, Suffolk, England, UK
| | - Rémi M Daigle
- Bedford Institute of Oceanography, Fisheries and Oceans Canada, Dartmouth, Nova Scotia, Canada; Marine Affairs Program, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Jenni E Kakkonen
- Marine Services, Harbour Authority Building, Scapa, Orkney, KW15 1SD, Scotland, UK
| | - Maiju Lehtiniemi
- Marine Research Centre, Finnish Environment Institute, Latokartanonkaari 11, 00790, Helsinki, Finland
| | - Monika Normant-Saremba
- University of Gdańsk, Faculty of Oceanography and Geography, Institute of Oceanography, Department of Experimental Ecology of Marine Organisms, Al. M. Piłsudskiego 46, 81-378, Gdynia, Poland
| | - Dawson Ogilvie
- Great Lakes Laboratory for Fisheries and Aquatic Sciences, Fisheries and Oceans Canada, Burlington, ON, Canada
| | | |
Collapse
|
22
|
Clarke S, Alves F, Martins N, Ahmed M, Sanchez L, Donovan J, Kouranos V, Wechalekar K. Blood ketone measurement as a test for dietary compliance in cardiac sarcoid patients undergoing 18f-fluorodeoxyglucose positron emission tomography. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Imaging with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is used as part of diagnosis and monitoring response to therapy in patients with cardiac sarcoidosis. In order to supress myocardial uptake of 18F-FDG patients prepare with a low carbohydrate diet followed by an 18-hour overnight fast. Failure to comply with the protocol results in diffuse myocardial 18F-FDG uptake which confounds diagnostic interpretation.
Purpose
To assess if point of care blood ketones could be used as a marker of dietary compliance and association with suppression of myocardial 18F-FDG uptake on PET scan.
Method
Patients (n = 26, 57 ± 4 years, 65% Male) from a single centre were instructed to follow standard preparation protocol prior to 18F-FDG PET/CT. After confirmation of dietary compliance, blood glucose and blood ketones were recorded using point of care devices. Images were graded based on the pattern of myocardial 18F-FDG uptake.
Results
There was no clear correlation between blood ketones in relation to dietary compliance or myocardial 18F-fluorodeoxyglucose uptake. In those with myocardial 18F-FDG uptake maximum standardized uptake value (SUV max) within the myocardium ranged from 2.3 to 9.8 (Mean 5.3) and ketone from 0.1 – 0.7 (normal <0.6).
Non-diabetic patients and those on steroids achieved adequate fasting glucose without significant rise in blood ketones. 60% of diabetic patients demonstrated mildly elevated ketones between 0.6-1.5mmol/L.
Conclusion
Current protocol with low carbohydrate diet and 18-hour fast achieves adequate quality of images in majority of patients, without significant change in blood ketones. Therefore, blood ketones cannot be used to confirm dietary compliance. Diabetic patients on insulin may benefit from ketone measurement due to risk of diabetic ketoacidosis.
Collapse
Affiliation(s)
- S Clarke
- Royal Brompton and Harefield Hospital, Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - F Alves
- Royal Brompton and Harefield Hospital, Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - N Martins
- Royal Brompton and Harefield Hospital, Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - M Ahmed
- Royal Brompton and Harefield Hospital, Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - L Sanchez
- Royal Brompton and Harefield Hospital, Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| | - J Donovan
- Royal Brompton and Harefield Hospital, Clinical Biochemistry, London, United Kingdom of Great Britain & Northern Ireland
| | - V Kouranos
- Royal Brompton and Harefield Hospital, Interstitial Lung Disease Unit, London, United Kingdom of Great Britain & Northern Ireland
| | - K Wechalekar
- Royal Brompton and Harefield Hospital, Nuclear Medicine, London, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
23
|
Liu J, Itchins M, Nagrial A, Cooper W, De Silva M, Barnet M, Varikatt W, Sivasubramaniam V, Davis A, Gill A, Blinman P, Lee K, Hui R, Gao B, Pavlakis N, Clarke S, Lee J, Boyer M, Kao S. P76.08 High Tumour PD-L1 Is Associated With Poor Outcomes in EGFR-Mutant Lung Cancer Treated With First Generation EGFR TKIs. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
Petts D, Wren MWD, Nation BR, Guthrie G, Kyle B, Peters L, Mortlock S, Clarke S, Burt C. A SHORT HISTORY OF OCCUPATIONAL DISEASE: 1. LABORATORY-ACQUIRED INFECTIONS. Ulster Med J 2021; 90:28-31. [PMID: 33642631 PMCID: PMC7907906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 11/15/2022]
Abstract
Laboratory-acquired infections are as old as laboratories themselves. As soon as the culture of microorganisms was introduced, so too was their transfer to laboratory workers. It is only in relatively recent history that such infections have been fully understood, and methods of spread and their prevention or avoidance developed. This paper endeavours to provide an overview of the history of laboratory-acquired infection and the steps taken, particularly in the UK, for its prevention.
Collapse
|
25
|
Machin G, Simpson R, Sutton G, Bond W, Heaps E, Hayes M, Korniliou S, McMillan J, Norman J, Sposito A, Panicker V, Adamska A, Allen A, Bernard R, Clarke S, Clifford J, Gallagher C, Jowsey J. Novel thermometry approaches to facilitate safe and effective monitoring of nuclear material containers. Nuclear Engineering and Design 2021. [DOI: 10.1016/j.nucengdes.2020.110939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
26
|
Petts D, Wren MWD, Nation BR, Guthrie G, Kyle B, Peters L, Mortlock S, Clarke S, Burt C. A SHORT HISTORY OF OCCUPATIONAL DISEASE: 2. ASBESTOS, CHEMICALS, RADIUM AND BEYOND. Ulster Med J 2021; 90:32-34. [PMID: 33642632 PMCID: PMC7907902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 10/28/2022]
Abstract
Historically, the weighing out and manipulation of dangerous chemicals frequently occurred without adequate protection from inhalation or accidental ingestion. The use of gloves, eye protection using goggles, masks or visors was scant. From Canary Girls and chimney sweeps to miners, stone cutters and silo fillers, these are classic exemplars of the subtle (and in some cases not so subtle) effects that substances, environments and practices can have on individual health.
Collapse
|
27
|
Jorgensen SJ, Micheli F, White TD, Van Houtan KS, Alfaro-Shigueto J, Andrzejaczek S, Arnoldi NS, Baum JK, Block B, Britten GL, Butner C, Caballero S, Cardeñosa D, Chapple TK, Clarke S, Cortés E, Dulvy NK, Fowler S, Gallagher AJ, Gilman E, Godley BJ, Graham RT, Hammerschlag N, Harry AV, Heithaus M, Hutchinson M, Huveneers C, Lowe CG, Lucifora LO, MacKeracher T, Mangel JC, Barbosa Martins AP, McCauley DJ, McClenachan L, Mull C, Natanson LJ, Pauly D, Pazmiño DA, Pistevos JCA, Queiroz N, Roff G, Shea BD, Simpfendorfer CA, Sims DW, Ward-Paige C, Worm B, Ferretti F. Emergent research and priorities for shark and ray conservation. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
28
|
Petts D, Wren MWD, Nation BR, Guthrie G, Kyle B, Peters L, Mortlock S, Clarke S, Burt C. A SHORT HISTORY OF OCCUPATIONAL DISEASE: 3. LEISURE CAN MAKE YOU SICK. Ulster Med J 2021; 90:35-36. [PMID: 33642633 PMCID: PMC7907915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Indexed: 11/15/2022]
Abstract
The risk of infection associated with occupations can, and does, extend to certain leisure and sports activities. Generally, such pastimes are regarded as important for human health and mental wellbeing. However, infections may, rarely, be acquired during leisure activities that include water sports and water-related relaxation, and certain sports.
Collapse
|
29
|
Alattraqchi A, Rahman N, Ismail S, Cleary D, Clarke S, Yeo C. Multidrug-resistant Acinetobacter baumannii AC1633 encodes the NDM-1 and OXA-58 carbapenemase genes on a large, potentially transmissible plasmid. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.176] [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: 10/22/2022] Open
|
30
|
Grimison P, Mersiades A, Kirby A, Lintzeris N, Morton R, Haber P, Olver I, Walsh A, McGregor I, Cheung Y, Tognela A, Hahn C, Briscoe K, Aghmesheh M, Fox P, Abdi E, Clarke S, Della-Fiorentina S, Shannon J, Gedye C, Begbie S, Simes J, Stockler M. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Ann Oncol 2020; 31:1553-1560. [DOI: 10.1016/j.annonc.2020.07.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
|
31
|
Söreskog E, Borgström F, Shepstone L, Clarke S, Cooper C, Harvey I, Harvey NC, Howe A, Johansson H, Marshall T, O'Neill TW, Peters TJ, Redmond NM, Turner D, Holland R, McCloskey E, Kanis JA. Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting: the SCOOP study. Osteoporos Int 2020; 31:1499-1506. [PMID: 32239237 PMCID: PMC7115896 DOI: 10.1007/s00198-020-05372-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/28/2020] [Indexed: 12/30/2022]
Abstract
UNLABELLED Community-based screening and treatment of women aged 70-85 years at high fracture risk reduced fractures; moreover, the screening programme was cost-saving. The results support a case for a screening programme of fracture risk in older women in the UK. INTRODUCTION The SCOOP (screening for prevention of fractures in older women) randomized controlled trial investigated whether community-based screening could reduce fractures in women aged 70-85 years. The objective of this study was to estimate the long-term cost-effectiveness of screening for fracture risk in a UK primary care setting compared with usual management, based on the SCOOP study. METHODS A health economic Markov model was used to predict the life-time consequences in terms of costs and quality of life of the screening programme compared with the control arm. The model was populated with costs related to drugs, administration and screening intervention derived from the SCOOP study. Fracture risk reduction in the screening arm compared with the usual management arm was derived from SCOOP. Modelled fracture risk corresponded to the risk observed in SCOOP. RESULTS Screening of 1000 patients saved 9 hip fractures and 20 non-hip fractures over the remaining lifetime (mean 14 years) compared with usual management. In total, the screening arm saved costs (£286) and gained 0.015 QALYs/patient in comparison with usual management arm. CONCLUSIONS This analysis suggests that a screening programme of fracture risk in older women in the UK would gain quality of life and life years, and reduce fracture costs to more than offset the cost of running the programme.
Collapse
Affiliation(s)
| | - F Borgström
- Quantify Research, Stockholm, Sweden
- LIME/MMC, Karolinska Institutet, Stockholm, Sweden
| | - L Shepstone
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - S Clarke
- Department of Rheumatology, University Hospitals Bristol, Bristol, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - I Harvey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Howe
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - H Johansson
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - T Marshall
- Norfolk and Norwich University Hospital, Norwich, UK
| | - T W O'Neill
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - T J Peters
- Bristol Medical School, University of Bristol, Bristol, UK
| | - N M Redmond
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation, Bristol, UK
| | - D Turner
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - R Holland
- Leicester Medical School, Centre for Medicine, University of Leicester, Leicester, UK
| | - E McCloskey
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Centre for Integrated research into Musculoskeletal Ageing, University of Sheffield Medical School, Sheffield, UK
- Academic Unit of Bone Metabolism, Department of Oncology and Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
| | - J A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
| | | |
Collapse
|
32
|
Sweeney E, Curtin N, de Barra E, Burns K, O'Neill E, Feeney E, Jackson A, Gavin P, Clarke S, O'Connell S, Muldoon E. National Guidelines on the Provision of Outpatient Parenteral Antimicrobial Therapy (OPAT). Ir Med J 2020; 113:123. [PMID: 35575598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Aim Outpatient parenteral antimicrobial therapy (OPAT) is an option in patients who require parenteral antimicrobial administration and are clinically well enough for hospital discharge. This is an update of the Irish National OPAT guidelines which were last reviewed in 2011. Methods The guideline was devised through a collaborative process with the national OPAT Working Group and a review of the literature. It is intended for clinicians who prescribe any intravenous (IV) antimicrobials outside of the inpatient setting in the Republic of Ireland. Results Patient care while on OPAT should be provided by a designated OPAT service, with clear managerial and clinical governance lines of responsibility. It should be conducted using a team approach with a clinical lead on each site either as an infection specialist, or a general medical physician with infection specialist input and an OPAT nurse. An antimicrobial pharmacist is also desirable. Several factors must be considered when assessing patient's suitability for OPAT including exclusion criteria, infection-specific factors, and patient specific factors such as physical, social and logistic criteria. Conclusion This updated guideline advocates a more individualised OPAT approach, with the recognition that specific antimicrobials and/or specific delivery models may be more appropriate for certain patient groups. Full guidelines are available through www.opat.ie.
Collapse
Affiliation(s)
- E Sweeney
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James's Hospital, Dublin
| | - N Curtin
- National OPAT Programme, Health Service Executive, DR Steeven's Hospital, Dublin
| | - E de Barra
- Department of Infectious Diseases, Beaumont Hospital, Dublin
| | - K Burns
- Department of Clinical Microbiology, Beaumont Hospital, Dublin
| | - E O'Neill
- Department of Clinical Microbiology, Connolly Hospital, Dublin
| | - E Feeney
- Department of Infectious Diseases, St Vincent's University Hospital, Dublin
| | - A Jackson
- Department of Infectious Diseases, Mercy University Hospital, Cork
| | - P Gavin
- Department of Infectious Diseases, Children's Health Ireland, Crumlin, Dublin
| | - S Clarke
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James's Hospital, Dublin
| | - S O'Connell
- Department of Infectious Diseases, University Hospital Limerick, Limerick
| | - E Muldoon
- National OPAT Programme, Health Service Executive, DR Steeven's Hospital, Dublin
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin
| |
Collapse
|
33
|
Hennessy M, Ryan D, Clarke S, Higgins C, Logan M, O’Brien E, Morgan R. Optimal Timing of CT Scanning in the Rapid Access Lung Cancer Clinic. Ir Med J 2020; 113:121. [PMID: 32924372] [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: 06/11/2023]
Abstract
Aims To investigate whether a ‘CT first’ approach to Rapid Access Lung Cancer Clinic (RALC) review could be feasible in an Irish context. Methods A retrospective review of our institution’s Lung Cancer Database was performed. All RALC first attendances from 2012-2018 were identified. Timing of CT was assessed as well as CT imaging findings. Results Total first attendances in this period were 2372, of whom 91% had CT thorax as part of their evaluation. 866 patients (37%) were diagnosed with lung cancer, all had an abnormal CT. 1290 patients (54%) underwent CT but did not have lung cancer after clinical work up. 34% of patients diagnosed with Lung Cancer had their CT scan post RALC. Time to diagnosis was longer in those who had post RALC CT (34.5 versus 21 days) Conclusion CT scanning plays a vital role in the RALC pathway. Initial delays in obtaining CT can result in delayed time to diagnosis. These findings warrant close consideration when devising future national lung cancer policy.
Collapse
Affiliation(s)
- M Hennessy
- Dept of Medical Oncology, Beaumont Hospital, Dublin
| | - D Ryan
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| | - S Clarke
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| | - C Higgins
- Cancer Data Department, Beaumont Hospital, Dublin
| | - M Logan
- Dept of Radiology, Beaumont Hospital, Dublin
| | - E O’Brien
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| | - R Morgan
- Dept of Respiratory Medicine, Beaumont Hospital, Dublin
| |
Collapse
|
34
|
Watts P, Breedon P, Nduka C, Neville C, Venables V, Clarke S. Cloud Computing Mobile Application for Remote Monitoring of Bell's Palsy. J Med Syst 2020; 44:149. [PMID: 32725321 PMCID: PMC7387374 DOI: 10.1007/s10916-020-01605-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/15/2020] [Indexed: 12/31/2022]
Abstract
Mobile applications provide the healthcare industry with a means of connecting with patients in their own home utilizing their own personal mobile devices such as tablets and phones. This allows therapists to monitor the progress of people under their care from a remote location and all with the added benefit that patients are familiar with their own mobile devices; thereby reducing the time required to train patients with the new technology. There is also the added benefit to the health service that there is no additional cost required to purchase devices for use. The Facial Remote Activity Monitoring Eyewear (FRAME) mobile application and web service framework has been designed to work on the IOS and android platforms, the two most commonly used today. Results: The system utilizes secure cloud based data storage to collect, analyse and store data, this allows for near real time, secure access remotely by therapists to monitor their patients and intervene when required. The underlying framework has been designed to be secure, anonymous and flexible to ensure compliance with the data protection act and the latest General Data Protection Regulation (GDPR); this new standard came into effect in April 2018 and replaces the Data Protection Act in the UK and Europe.
Collapse
Affiliation(s)
- P Watts
- Medical Engineering Design Research Group, Nottingham Trent University, Nottingham, UK
| | - P Breedon
- Medical Engineering Design Research Group, Nottingham Trent University, Nottingham, UK.
| | - C Nduka
- Queen Victoria Hospital, NHS Trust, East Grinstead, West Sussex, UK
- Emteq Ltd, Sussex Innovation Centre, Brighton, UK
| | - C Neville
- Queen Victoria Hospital, NHS Trust, East Grinstead, West Sussex, UK
| | - V Venables
- Queen Victoria Hospital, NHS Trust, East Grinstead, West Sussex, UK
| | - S Clarke
- Emteq Ltd, Sussex Innovation Centre, Brighton, UK
| |
Collapse
|
35
|
Mulligan K, Hirani S, Clarke S, Evans N, Flood C, Taylor J, Wedderburn L, Newman S. PARE0018 WEBSITE FOR PARENTS OF CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS REDUCES PARENTING STRESS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Having a child with JIA presents many challenges. Many parents experience considerable stress. Parental distress and functioning have been found to be related to child outcomes (Cousino, 2013), therefore interventions that help parents to manage their child’s illness are important for both parents and child. We developed a website for parents of children with newly diagnosed JIA to help increase parental confidence in managing their child’s arthritis and reduce parenting stress.Objectives:To evaluate the efficacy of a web-based tool ‘WebParC’ for parents of children with JIA.Methods:Design:Multi-centre randomised controlled trial conducted in 16 tertiary paediatric rheumatology centres in England.Participants:Parent(s) of children aged ≤12 years, diagnosed with JIA within the previous six months.Procedures:Parents were enrolled when they attended the rheumatology service and were randomised by household to either the intervention arm (I) who were given access to the website in addition to their child’s standard care or the control arm (C) who received standard care alone.The primary outcome was parenting stress, measured with the Pediatric Inventory for Parents (PIP) (Streisand, 2001), which parents completed prior to randomisation and at 4-months and 12-months post randomisation.Website content was developed by a multidisciplinary team including rheumatology, physiotherapy, ophthalmology, social work, podiatry, occupational therapy, clinical and health psychology along with parents of children with JIA. It includes information about JIA and its treatment plus a ‘toolkit’ for parents. The toolkit is based on cognitive-behavioural principles to develop skills for managing JIA-related issues.Analysis:We conducted linear mixed models to examine the main effect of trial arm (I vs C), main effect of time (between 4M and 12M scores), and interaction between trial arm and time on PIP scores, after controlling for baseline scores.Results:A total of 220 parents (183 mothers, 37 fathers) of 203 children were randomised, 106 intervention and 114 controls. Parents mean (SD) age was 36.5 (6.5). Their children with JIA were mostly female (137/203, 67.5%), mean (SD) age of 6.1 (3.4) years. There were 107 (52.7%) with oligoarthritis, 65 (32%) polyarthritis, 8 (3.9%) systemic and 23 (11.3%) other JIA subtypes. Seventy (34.5%) were prescribed methotrexate.Trial arms did not differ significantly at baseline except for parent education, which was higher in the intervention group and was controlled for in the analysis.Follow-up assessments were completed by 133 (I60, C73) at 4M and 124 (I58, C66) at 12M.We found significant main effects of trial arm on PIP Difficulty (p=0.022, Control (Mean=93.62, SE=2.717) > Intervention (Mean=84.23, SE=3.025)) and PIP Frequency (p= 0.008, Control (Mean=95.78, SE=2.400) > Intervention (Mean=86.23, SE=2.622), with Controls reporting significantly greater frequency and difficulty of stressful events than the Intervention group (Fig 1).Conclusion:This trial found that a website for parents of children with JIA can help to reduce parenting stress.References:[1]Cousino MK, Hazen RA. J Pediatr Psychol 2013; 38(8):809-28[2]Streisand R, Braniecki S, Tercyak KP, Kazak AE. J Pediatr Psychol 2001; 26(3):155-62.Acknowledgments:We thank all parent participants, the health professionals and parents who developed website content and the clinical teams who supported recruitment.Funded by NIHR RfPB.Disclosure of Interests:Kathleen Mulligan: None declared, Shashivadan Hirani: None declared, Sally Clarke: None declared, Neil Evans: None declared, Chris Flood: None declared, Jo Taylor: None declared, Lucy Wedderburn Speakers bureau: Pfizer, Stanton Newman Grant/research support from: Yes Baxter Healthcare Educational Grants not in relation to rheumatology, Speakers bureau: Yes Baxter Healthcare and Merke Sharp and Dome
Collapse
|
36
|
Condurache CI, Chiu S, Chotiyarnwong P, Johansson H, Shepstone L, Lenaghan E, Cooper C, Clarke S, Khioe RFS, Fordham R, Gittoes N, Harvey I, Harvey NC, Heawood A, Holland R, Howe A, Kanis JA, Marshall T, O'Neill TW, Peters TJ, Redmond NM, Torgerson D, Turner D, McCloskey E. Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study. Osteoporos Int 2020; 31:457-464. [PMID: 31960099 DOI: 10.1007/s00198-019-05270-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022]
Abstract
UNLABELLED A reduction in hip fracture incidence following population screening might reflect the effectiveness of anti-osteoporosis therapy, behaviour change to reduce falls, or both. This post hoc analysis demonstrates that identifying high hip fracture risk by FRAX was not associated with any alteration in falls risk. INTRODUCTION To investigate whether effectiveness of an osteoporosis screening programme to reduce hip fractures was mediated by modification of falls risk in the screening arm. METHODS The SCOOP study recruited 12,483 women aged 70-85 years, individually randomised to a control (n = 6250) or screening (n = 6233) arm; in the latter, osteoporosis treatment was recommended to women at high risk of hip fracture, while the control arm received usual care. Falls were captured by self-reported questionnaire. We determined the influence of baseline risk factors on future falls, and then examined for differences in falls risk between the randomisation groups, particularly in those at high fracture risk. RESULTS Women sustaining one or more falls were slightly older at baseline than those remaining falls free during follow-up (mean difference 0.70 years, 95%CI 0.55-0.85, p < 0.001). A higher FRAX 10-year probability of hip fracture was associated with increased likelihood of falling, with fall risk increasing by 1-2% for every 1% increase in hip fracture probability. However, falls risk factors were well balanced between the study arms and, importantly, there was no evidence of a difference in falls occurrence. In particular, there was no evidence of interaction (p = 0.18) between baseline FRAX hip fracture probabilities and falls risk in the two arms, consistent with no impact of screening on falls in women informed to be at high risk of hip fracture. CONCLUSION Effectiveness of screening for high FRAX hip fracture probability to reduce hip fracture risk was not mediated by a reduction in falls.
Collapse
Affiliation(s)
- C I Condurache
- Centre for Integrated Research in Musculoskeletal Aging, University of Sheffield Medical School, Sheffield, UK
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
| | - S Chiu
- Centre for Integrated Research in Musculoskeletal Aging, University of Sheffield Medical School, Sheffield, UK
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
| | - P Chotiyarnwong
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
- Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - H Johansson
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - L Shepstone
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - E Lenaghan
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - S Clarke
- Department of Rheumatology, University Hospitals Bristol, Bristol, UK
| | - R F S Khioe
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - R Fordham
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - N Gittoes
- Centre for Endocrinology, Diabetes and Metabolism, Queen Elizabeth Hospital, Birmingham, UK
| | - I Harvey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Heawood
- Bristol Medical School, University of Bristol, Bristol, UK
| | - R Holland
- Leicester Medical School, Centre for Medicine, University of Leicester, Leicester, UK
| | - A Howe
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - T Marshall
- Norfolk and Norwich University Hospital, Norwich, UK
| | - T W O'Neill
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - T J Peters
- Bristol Medical School, University of Bristol, Bristol, UK
| | - N M Redmond
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation, Bristol, UK
| | - D Torgerson
- Department of Health Sciences, University of York, York, UK
| | - D Turner
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - E McCloskey
- Centre for Integrated Research in Musculoskeletal Aging, University of Sheffield Medical School, Sheffield, UK.
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK.
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
| | | |
Collapse
|
37
|
Parsons CM, Harvey N, Shepstone L, Kanis JA, Lenaghan E, Clarke S, Fordham R, Gittoes N, Harvey I, Holland R, Redmond NM, Howe A, Marshall T, Peters TJ, Torgerson D, O'Neill TW, McCloskey E, Cooper C. Systematic screening using FRAX ® leads to increased use of, and adherence to, anti-osteoporosis medications: an analysis of the UK SCOOP trial. Osteoporos Int 2020; 31:67-75. [PMID: 31606826 PMCID: PMC6952271 DOI: 10.1007/s00198-019-05142-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/20/2019] [Indexed: 12/01/2022]
Abstract
UNLABELLED In the large community-based SCOOP trial, systematic fracture risk screening using FRAX® led to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. INTRODUCTION In the SCreening of Older wOmen for Prevention of fracture (SCOOP) trial, we investigated the effect of the screening intervention on subsequent long-term self-reported adherence to anti-osteoporosis medications (AOM). METHODS SCOOP was a primary care-based UK multicentre trial of screening for fracture risk. A total of 12,483 women (70-85 years) were randomised to either usual NHS care, or assessment using the FRAX® tool ± dual-energy X-ray absorptiometry (DXA), with medication recommended for those found to be at high risk of hip fracture. Self-reported AOM use was obtained by postal questionnaires at 6, 12, 24, 36, 48 and 60 months. Analysis was limited to those who initiated AOM during follow-up. Logistic regression was used to explore baseline determinants of adherence (good ≥ 80%; poor < 80%). RESULTS The mean (SD) age of participants was 75.6 (4.2) years, with 6233 randomised to screening and 6250 to the control group. Of those participants identified at high fracture risk in the screening group, 38.2% of those on treatment at 6 months were still treated at 60 months, whereas the corresponding figure for the control group was 21.6%. Older age was associated with poorer adherence (OR per year increase in age 0.96 [95% CI 0.93, 0.99], p = 0.01), whereas history of parental hip fracture was associated with greater rate adherence (OR 1.67 [95% CI 1.23, 2.26], p < 0.01). CONCLUSIONS Systematic fracture risk screening using FRAX® leads to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care.
Collapse
Affiliation(s)
- C M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
- Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia
| | | | - S Clarke
- Bristol Medical School, University of Bristol, Bristol, UK
| | - R Fordham
- University of East Anglia, Norwich, UK
| | - N Gittoes
- Centre for Endocrinology, Diabetes and Metabolism, Queen Elizabeth Hospital, Birmingham, UK
| | - I Harvey
- University of East Anglia, Norwich, UK
| | - R Holland
- University of East Anglia, Norwich, UK
| | - N M Redmond
- Bristol Medical School, University of Bristol, Bristol, UK
- NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A Howe
- University of East Anglia, Norwich, UK
| | | | - T J Peters
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - T W O'Neill
- Arthritis Research UK Centre for Epidemiology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University Hospitals Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
- Mellanby Centre for Bone Research, Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
| | | |
Collapse
|
38
|
Cho B, Lee K, Ahn MJ, Geater SL, Ngoc T, Wang CC, Cho E, Lee J, Sriuranpong V, Bui Q, Clarke S, Kuyama S, Nakagawa K, Liu F, Clemett D, Scheuring U, Peters S, Rizvi N. Efficacy and safety of first-line durvalumab (D) ± tremelimumab (T) vs chemotherapy (CT) in Asian patients with metastatic NSCLC: Results from MYSTIC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437] [Citation(s) in RCA: 4] [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: 11/14/2022] Open
|
39
|
Tu H, Xu C, Tong-Li C, Offin M, Razavi P, Schapira E, Namakydoust A, Lee A, Pavlakis N, Clarke S, Diakos C, Chan D, Myers M, Makhnin A, Jain H, Martinez A, Iqbal Z, Adamski A, Li H, Hernandez J, Watford S, Hosseini A, Shaffer T, Lim L, Li M, Drilon A, Ladanyi M, Arcila M, Rusch V, Jones D, Rudin C, Rimner A, Isbell J, Li B. P1.01-122 A Clinical Utility Study of Plasma DNA Next Generation Sequencing Guided Treatment of Uncommon Drivers in Advanced Non-Small-Cell Lung Cancers. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
40
|
Itchins M, Hayes S, Hudson A, Howell V, Tan S, Clarke S, Solomon B, Pavlakis N. P2.01-11 ALKternate: A Proof of Concept Study in ALK-Rearranged NSCLC Alternating Lorlatinib with Crizotinib After Disease Progression. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1355] [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: 11/30/2022]
|
41
|
Itchins M, Hudson A, Hayes S, Harvie R, Wei G, Buckland M, Clarke S, Howell V, Pavlakis N. P1.01-129 Preclinical Genetic Evaluation of Alternating ALK TKI Therapy Versus Continuous Dosing in ALK NSCLC to Inform the ALKternate Clinical Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.844] [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]
|
42
|
Itchins M, Hudson A, Harvie R, Zaw T, Mckay M, Clarke S, Howell V, Pavlakis N, Hayes S. P1.01-24 Preclinical Proteomic Evaluation of Alternating ALK TKI Therapy Versus Continuous Dosing in ALK NSCLC to Inform the ALKternate Clinical Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.739] [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: 11/15/2022]
|
43
|
Javle M, Borbath I, Clarke S, Hitre E, Louvet C, Macarulla T, Oh D, Spratlin J, Valle J, Weiss K, Berman C, Howland M, Ye Y, Cho T, Moran S, Abou-Alfa G. Phase 3 multicenter, open-label, randomized study of infigratinib versus gemcitabine plus cisplatin in the first-line treatment of patients with advanced cholangiocarcinoma with FGFR2 gene fusions/translocations: the PROOF trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
44
|
Abstract
Chemotherapy and radiotherapy treatment regimens for gastrointestinal, peritoneal and pelvic tumours can disrupt the intestinal microbiome and intestinal epithelia. Such disturbances can provoke symptoms such as diarrhoea, nausea and vomiting. Chemotherapy and radiotherapy induced gastrointestinal toxicity aggravating intestinal microbiome dysbiosis is postulated to adversely alter the intestinal microbiome, with a consequent induced pro-inflammatory effect that disrupts the intestinal microbiome-epithelia-mucosal immunity axis. Although not widely recognised, the intestinal mucosa is the largest and most densely and dynamically populated immune-environment. Cancer treatment adverse effects that affect intestinal and mucosal cells inadvertently target and disrupt resident intestinal macrophages, the cells that marshal immune activity in the intestinal mucosa by shaping pro-inflammatory and anti-inflammatory activities to control and eradicate infectious insults and maintain local homeostasis. Pathobionts (bacteria capable of pathogenic pro-inflammatory activity) and noxious environmental and bacterial antigens use the intestinal epithelia and gap junctions as a point of entry into the systemic circulation. This translocation movement promotes toxic sequelae that obstruct intestinal macrophage functions resulting in uncontrolled local and systemic pro-inflammatory activity, loss of phagocytic function and loss of expression of tight junction proteins. Probiotic bacteria as an adjunctive treatment shows efficacy in ameliorating enteropathies such as mucositis/diarrhoea resulting from chemotherapy or radiotherapy regimens. As such we posit that an important benefit that warrants a further focused research effort is the administration of adjuvant probiotics to help reduce the incidence of febrile neutropenia.
Collapse
Affiliation(s)
- M Thomsen
- 1 The University of Sydney, School of Medicine, Faculty of Medicine and Health, NSW 2006, Australia
| | - S Clarke
- 1 The University of Sydney, School of Medicine, Faculty of Medicine and Health, NSW 2006, Australia.,2 Northern Clinical School, Kolling Institute of Medical Research, Pacific Hwy, St Leonards NSW 2065, Australia
| | - L Vitetta
- 1 The University of Sydney, School of Medicine, Faculty of Medicine and Health, NSW 2006, Australia.,3 Medlab Clinical Ltd., 66 McCauley St., Sydney, 2006 NSW, Australia
| |
Collapse
|
45
|
Cardwell K, Clyne B, Moriarty F, Wallace E, Fahey T, Boland F, McCullagh L, Clarke S, Finnigan K, Daly M, Barry M, Smith SM. Supporting prescribing in Irish primary care: protocol for a non-randomised pilot study of a general practice pharmacist (GPP) intervention to optimise prescribing in primary care. Pilot Feasibility Stud 2018; 4:122. [PMID: 30002869 PMCID: PMC6034254 DOI: 10.1186/s40814-018-0311-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 06/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Prescribing for patients taking multiple medicines (i.e. polypharmacy) is challenging for general practitioners (GPs). Limited evidence suggests that the integration of pharmacists into the general practice team could improve the management of these patients. The aim of this study is to develop and test an intervention involving pharmacists, working within GP practices, to optimise prescribing in Ireland, which has a mixed public and private primary healthcare system. Methods This non-randomised pilot study will use a mixed-methods approach. Four general practices will be purposively sampled and recruited. A pharmacist will join the practice team for 6 months. They will participate in the management of repeat prescribing and undertake medication reviews (which will address high-risk prescribing and potentially inappropriate prescribing, deprescribing and cost-effective and generic prescribing) with adult patients. Pharmacists will also provide prescribing advice regarding the use of preferred drugs, undertake clinical audits, join practice team meetings and facilitate practice-based education. Throughout the 6-month intervention period, anonymised practice-level medication (e.g. medication changes) and cost data will be collected. A nested Patient Reported Outcome Measure (PROM) study will be undertaken during months 4 and 5 of the 6-month intervention period to explore the impact of the intervention in older adults (aged ≥ 65 years). For this, a sub-set of 50 patients aged ≥ 65 years with significant polypharmacy (≥ 10 repeat medicines) will be recruited from each practice and invited to a medication review with the pharmacist. PROMs and healthcare utilisation data will be collected using patient questionnaires, and a 6-week follow-up review conducted. Acceptability of the intervention will be explored using pre- and post-intervention semi-structured interviews with key stakeholders. Quantitative and qualitative data analysis will be undertaken and an economic evaluation conducted. Discussion This non-randomised pilot study will provide evidence regarding the feasibility and potential effectiveness of general practice-based pharmacists in Ireland and provide data on whether a randomised controlled trial of this intervention is indicated. It will also provide a deeper understanding as to how a pharmacist working as part of the general practice team will affect organisational processes and professional relationships in a mixed public and private primary healthcare system.
Collapse
Affiliation(s)
- Karen Cardwell
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - B Clyne
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - F Moriarty
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - E Wallace
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - T Fahey
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - F Boland
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | - L McCullagh
- 2Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
| | - S Clarke
- 3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - K Finnigan
- 3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - M Daly
- 3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - M Barry
- 2Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland.,3Health Service Executive Medicines Management Programme, Dublin, Ireland
| | - S M Smith
- 1Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
| | | |
Collapse
|
46
|
Lewis CT, Malein WL, Chesner I, Clarke S. High altitude arterialised capillary earlobe blood gas measurement using the Abbott i-STAT. J ROY ARMY MED CORPS 2018; 164:335-337. [DOI: 10.1136/jramc-2017-000902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 11/04/2022]
Abstract
IntroductionMeasurement of physiological parameters in extreme environments is essential to advancing knowledge, prophylaxis and treatment of altitude sickness. Point-of-care testing facilitates investigation in non-specialist and remote settings, as well as becoming increasingly popular at the bedside for real-time results in the clinical environment. Arterialised capillary earlobe blood gases are recommended as a valid alternative to arterial sampling in research. This study aimed to test the feasibility of obtaining and analysing daily earlobe samples at high altitude.MethodsFrom 17 to 24 January 2016, 24 participants on a research expedition to Ecuador underwent daily earlobe blood gas measurements including pH, partial pressure of oxygen and partial pressure of carbon dioxide to 5043 m. Samples were analysed using an Abbott i-STAT blood gas analyser and G3+ cartridges.ResultsDaily measurements were successfully obtained and analysed at the point of care in 23/24 participants and were well tolerated with no adverse events. 12% (27/220) cartridges failed and required repeat sampling.ConclusionsDaily earlobe blood gas analysis using the Abbott i-STAT is feasible in a protected environment at high altitude. Participants and equipment should be kept warm before and during testing. Spare cartridges should be available. This methodology may be useful for both research and therapeutic measurements in remote, rural and wilderness medicine.
Collapse
|
47
|
Clarke S, Faivre-Finn C, Woolf DK. Current Practice of Whole Brain Radiotherapy in Metastatic Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2018; 30:e40. [PMID: 29449056 DOI: 10.1016/j.clon.2018.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/29/2018] [Indexed: 11/16/2022]
Affiliation(s)
- S Clarke
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - C Faivre-Finn
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - D K Woolf
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK.
| |
Collapse
|
48
|
Waqas S, Bannan C, Fe Talento A, Byrne D, O'Connell S, Clarke S, Merry C. A Unique Case of Concurrent Long Bone Osteomyelitis and Empyema Caused by Fusobacterium nucleatum. Ir Med J 2018; 111:675. [PMID: 29869856] [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
We describe a patient presenting with constitutional symptoms, poor oral hygiene and leg swelling who was diagnosed with Fusobacterium nucleatum osteomyelitis of femur and empyema. Long bone osteomyelitis is rarely caused by this microorganism. This unusual case was successfully managed with drainage and antimicrobial therapy.
Collapse
Affiliation(s)
- S Waqas
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James' Hospital, Dublin
| | - C Bannan
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James' Hospital, Dublin
| | - A Fe Talento
- Department of Clinical Microbiology, St. James' Hospital, Dublin
| | - D Byrne
- Acute Medical Assessment Unit, St. James' Hospital, Dublin
| | - S O'Connell
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James' Hospital, Dublin
| | - S Clarke
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James' Hospital, Dublin
| | - C Merry
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James' Hospital, Dublin
| |
Collapse
|
49
|
Jones GG, Logishetty K, Clarke S, Collins R, Jaere M, Harris S, Cobb JP. Do patient-specific instruments (PSI) for UKA allow non-expert surgeons to achieve the same saw cut accuracy as expert surgeons? Arch Orthop Trauma Surg 2018; 138:1601-1608. [PMID: 30178169 PMCID: PMC6182679 DOI: 10.1007/s00402-018-3031-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION High-volume unicompartmental knee arthroplasty (UKA) surgeons have lower revision rates, in part due to improved intra-operative component alignment. This study set out to determine whether PSI might allow non-expert surgeons to achieve the same level of accuracy as expert surgeons. MATERIALS AND METHODS Thirty-four surgical trainees with no prior experience of UKA, and four high-volume UKA surgeons were asked to perform the tibial saw cuts for a medial UKA in a sawbone model using both conventional and patient-specific instrumentation (PSI) with the aim of achieving a specified pre-operative plan. Half the participants in each group started with conventional instrumentation, and half with PSI. CT scans of the 76 cut sawbones were then segmented and reliably orientated in space, before saw cut position in the sagittal, coronal and axial planes was measured, and compared to the pre-operative plan. RESULTS The compound error (absolute error in the coronal, sagittal and axial planes combined) for experts using conventional instruments was significantly less than that of the trainees (11.6°±4.0° v 7.7° ±2.3º, p = 0.029). PSI improved trainee accuracy to the same level as experts using conventional instruments (compound error 5.5° ±3.4º v 7.7° ±2.3º, p = 0.396) and patient-specific instruments (compound error 5.5° ±3.4º v 7.3° ±4.1º, p = 0.3). PSI did not improve the accuracy of high-volume surgeons (p = 0.3). CONCLUSIONS In a sawbone model, PSI allowed inexperienced surgeons to achieve more accurate saw cuts, equivalent to expert surgeons, and thus has the potential to reduce revision rates. The next test will be to determine whether these results can be replicated in a clinical trial.
Collapse
Affiliation(s)
- Gareth G. Jones
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| | - K. Logishetty
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| | - S. Clarke
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| | - R. Collins
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| | - M. Jaere
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| | - S. Harris
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| | - J. P. Cobb
- MSk Lab, Imperial College London, 7th Floor Lab Block Charing Cross Hospital, London, W6 8RF UK
| |
Collapse
|
50
|
Itchins M, Kao S, Hayes S, Howell V, Gill A, Cooper W, O'Connell R, Clarke S, Pavlakis N. P1.01-011 Pattern of Care and Survival of ALK Rearranged Non-Small Cell Lung Cancer in Two Australian Referral Centers. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|