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Siva S, McMahon R, Bressel M, Dsouza C, Castle RG, DiIulio J, Jennens R, Thai A, Tan L, Morris T, Dawson SJ, Shaw M, Plumridge N, Neeson P, Ball DL, Solomon B. SABRSeq: A Randomized Phase Ib Trial of SABR Sequencing with Pembrolizumab in Metastatic Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2023; 117:e58. [PMID: 37785761 DOI: 10.1016/j.ijrobp.2023.06.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The optimal sequencing of stereotactic ablative body radiotherapy (SABR) with anti-PD1 checkpoint blockade is unknown. The purpose of SABRseq was to assess the toxicity of the combination of SABR delivered either before or after the commencement of pembrolizumab. The central hypothesis is that the treatment combination will have a safety profile that is clinically acceptable and demonstrate anti-tumor efficacy. Furthermore, we hypothesize that differences in systemic immune activation will be observed between treatment arms. MATERIALS/METHODS This was a single institutional phase Ib randomized clinical trial (Trial ID NCT03307759). Eligible patients had metastatic NSCLC, ECOG performance 0-1, and had not received prior checkpoint immunotherapy, high-dose radiation (>36 Gy) within 6 months, or either systemic or radiation therapy within 4 weeks of randomization. Eligible patients had either TPS≥50% PD-L1 expression in the first-line or TPS≥1% PD-L1 expression with prior chemotherapy exposure. Patients were randomized to SABR before the commencement of pembrolizumab [ARM1] or SABR commencing after pembrolizumab [ARM2]. SABR was delivered in a single fraction of 18-20 Gy to 1-3 lesions. The primary endpoint was treatment-related adverse events (AE's) related to SABR and/or pembrolizumab. Secondary endpoints included best overall response (BOR), overall survival (OS), and progression-free survival (PFS). Translational objectives included the evaluation of longitudinal changes in immunological cellular subsets within peripheral blood to explore changes in systemic immunity and circulating tumor DNA (ctDNA) dynamics. RESULTS Between December 2017 and December 2019, 13 patients were randomized. The median follow-up was 37 months. The study was closed early due to poor accrual. Median age was 66 years, with 11 patients (84%) having adenocarcinoma. Nine (69%) were enrolled in the first-line setting. The median [range] number of lesions was 6 [3-11]. The median [range] cycles of pembrolizumab delivered in ARM 1 was 13 [12-32] and ARM 2 was 9 [3-34]. Grade 3 treatment-related AEs were experienced in 0 of 5 patients in ARM1 and in 1 of 8 patients in ARM 2 (hyperglycemia). There were no grade 4 or 5 adverse events reported. The BOR by both RECIST and iRECIST criteria was CR in one patient, PR in seven patients, SD in five patients. Median (95% Cis) PFS was 12.4 months (6.3-21.0), and median (95% Cis) OS was 47.1 months (12.6-not reached; 2-year point estimate 62% [31-82]). Mass cytometry was used on serial peripheral blood samples to examine changes in the frequency of immune cells, changes in T cell activation, differentiation and functional polarization state. Targeted sequencing was performed to assess ctDNA. Translational outcomes will be presented. CONCLUSION There was no evidence of a concerning safety signal from either SABR before or after start of pembrolizumab. The combination demonstrated activity with promising PFS and OS and is worthy of evaluation in larger randomized trials.
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Affiliation(s)
- S Siva
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - R McMahon
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Bressel
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - C Dsouza
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - R G Castle
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J DiIulio
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - R Jennens
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - A Thai
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - L Tan
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - T Morris
- Southern Blood and Cancer Service, Dunedin, New Zealand
| | - S J Dawson
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - M Shaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - N Plumridge
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - P Neeson
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - D L Ball
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - B Solomon
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
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Stahl EC, Sabo JK, Kang MH, Allen R, Applegate E, Kim SE, Kwon Y, Seth A, Lemus N, Salinas-Rios V, Soczek KM, Trinidad M, Vo LT, Jeans C, Wozniak A, Morris T, Kimberlin A, Foti T, Savage DF, Doudna JA. Genome editing in the mouse brain with minimally immunogenic Cas9 RNPs. Mol Ther 2023; 31:2422-2438. [PMID: 37403358 PMCID: PMC10422012 DOI: 10.1016/j.ymthe.2023.06.019] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/18/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023] Open
Abstract
Transient delivery of CRISPR-Cas9 ribonucleoproteins (RNPs) into the central nervous system (CNS) for therapeutic genome editing could avoid limitations of viral vector-based delivery including cargo capacity, immunogenicity, and cost. Here, we tested the ability of cell-penetrant Cas9 RNPs to edit the mouse striatum when introduced using a convection-enhanced delivery system. These transient Cas9 RNPs showed comparable editing of neurons and reduced adaptive immune responses relative to one formulation of Cas9 delivered using AAV serotype 9. The production of ultra-low endotoxin Cas9 protein manufactured at scale further improved innate immunity. We conclude that injection-based delivery of minimally immunogenic CRISPR genome editing RNPs into the CNS provides a valuable alternative to virus-mediated genome editing.
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Affiliation(s)
- Elizabeth C Stahl
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; California Institute for Quantitative Biosciences (QB3), University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jennifer K Sabo
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Min Hyung Kang
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Ryan Allen
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Elizabeth Applegate
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Shin Eui Kim
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Yoonjin Kwon
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Anmol Seth
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Nicholas Lemus
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Viviana Salinas-Rios
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Katarzyna M Soczek
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; California Institute for Quantitative Biosciences (QB3), University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Marena Trinidad
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Linda T Vo
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Chris Jeans
- California Institute for Quantitative Biosciences (QB3), University of California, Berkeley, Berkeley, CA 94720, USA
| | | | | | | | | | - David F Savage
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA; Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jennifer A Doudna
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA; California Institute for Quantitative Biosciences (QB3), University of California, Berkeley, Berkeley, CA 94720, USA; Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA; Howard Hughes Medical Institute, University of California, Berkeley, Berkeley, CA 94720, USA; Department of Chemistry, University of California, Berkeley, Berkeley, CA 94720, USA; MBIB Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; Gladstone Institutes, University of California, Berkeley, San Francisco, CA 94114, USA.
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3
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Smyth R, Kabrhel C, Morris T. Treatment of Intermediate-Risk Pulmonary Embolism. N Engl J Med 2023; 389:184-187. [PMID: 37437150 DOI: 10.1056/nejmclde2301330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
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4
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Shanahan EM, Gill TK, Briggs E, Hill CL, Bain G, Morris T. Suprascapular nerve block for the treatment of adhesive capsulitis: a randomised double-blind placebo-controlled trial. RMD Open 2022; 8:rmdopen-2022-002648. [DOI: 10.1136/rmdopen-2022-002648] [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] [Received: 08/08/2022] [Accepted: 10/14/2022] [Indexed: 11/24/2022] Open
Abstract
ObjectiveAdhesive capsulitis is a common painful shoulder condition. Treatment for the condition remains unsatisfactory. Suprascapular nerve block (SSNB) shows promise as a treatment option for adhesive capsulitis but there are no randomised controlled trials that examine its effect on pain or duration of the condition. The objective of this study was to examine the efficacy of SSNB for the management of adhesive capsulitis.MethodsA randomised double-blind placebo-controlled trial of SSNB and standard therapy versus placebo and standard therapy was performed. In total, 54 patients were enrolled in the study. 27 patients received a glenohumeral joint (GHJ) injection and physiotherapy plus a 3-month SSNB, and 27 patients received a GHJ injection and physiotherapy plus a 3-month placebo injection. Patients were followed to resolution of their symptoms as measured by a combination of range of movement, pain scores, Shoulder Pain and Disability Index (SPADI) scores and perceived recovery scores. The primary outcome measure was time to resolution of symptoms.ResultsParticipants who received the SSNB reduced the duration of their symptoms of adhesive capsulitis by an average of 6 months (mean time to resolution 5.4 (95% CI 4.4 to 6.3) months vs 11.2 (95% CI 9.3 to 13) months) in the placebo group. They also had reduced pain scores, improved range of movement and lower SPADI scores compared with the placebo group across all time points.ConclusionSSNB reduced the duration of adhesive capsulitis and resulted in improved pain and disability experience for patients.Trial registration numberAustralian New Zealand Clinical Trials Registry (ANCTRN 12615001378516).
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Rullan A, Adkins D, Bossi P, Cohen E, Daste A, Harrington K, Le Tourneau C, Licitra L, Little N, Morris T, Ottensmeier C, Reinwald M, Rutkowski T. 703TiP A randomised, double-blind, placebo-controlled phase II study of setanaxib plus pembrolizumab for the treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (rmSCCHN). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.827] [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] Open
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6
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Morris T, Sue E, Geniesse C, Brieher WM, Tang VW. Synaptopodin stress fiber and contractomere at the epithelial junction. J Cell Biol 2022; 221:213132. [PMID: 35416930 PMCID: PMC9011326 DOI: 10.1083/jcb.202011162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 10/07/2021] [Accepted: 02/09/2022] [Indexed: 12/27/2022] Open
Abstract
The apical junction of epithelial cells can generate force to control cell geometry and perform contractile processes while maintaining barrier function and adhesion. Yet, the structural basis for force generation at the apical junction is not fully understood. Here, we describe two synaptopodin-dependent actomyosin structures that are spatially, temporally, and structurally distinct. The first structure is formed by the retrograde flow of synaptopodin initiated at the apical junction, creating a sarcomeric stress fiber that lies parallel to the apical junction. Contraction of the apical stress fiber is associated with either clustering of membrane components or shortening of junctional length. Upon junction maturation, apical stress fibers are disassembled. In mature epithelial monolayer, a motorized “contractomere” capable of “walking the junction” is formed at the junctional vertex. Actomyosin activities at the contractomere produce a compressive force evident by actin filament buckling and measurement with a new α-actinin-4 force sensor. The motility of contractomeres can adjust junctional length and change cell packing geometry during cell extrusion and intercellular movement. We propose a model of epithelial homeostasis that utilizes contractomere motility to support junction rearrangement while preserving the permeability barrier.
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Affiliation(s)
- Timothy Morris
- Department of Cell and Developmental Biology, University of Illinois, Urbana-Champaign, IL
| | - Eva Sue
- Department of Cell and Developmental Biology, University of Illinois, Urbana-Champaign, IL
| | - Caleb Geniesse
- Department of Cell and Developmental Biology, University of Illinois, Urbana-Champaign, IL
| | - William M Brieher
- Department of Cell and Developmental Biology, University of Illinois, Urbana-Champaign, IL
| | - Vivian W Tang
- Department of Cell and Developmental Biology, University of Illinois, Urbana-Champaign, IL
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Morris T, Tham S. Association between sinonasal symptoms and epidural anaesthesia. Anaesth Rep 2022; 10:e12163. [PMID: 35434635 PMCID: PMC9005263 DOI: 10.1002/anr3.12163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- T. Morris
- North West School of Anaesthesia Manchester UK
| | - S‐M. Tham
- North West School of Anaesthesia Manchester UK
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Dashtban M, Mizani M, Gonzalez-Izquierdo A, Corbett R, Quint J, Denaxas S, Mamza J, Morris T, Hemingway H, Banerjee A. POS-283 HIERARCHICAL CLUSTERING FOR SUBTYPE DISCOVERY OF INCIDENT CHRONIC KIDNEY DISEASE FROM LARGE LONGITUDINAL ELECTRONIC HEALTH RECORDS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.303] [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] Open
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9
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Ai M, Morris T, Chaddock-Heyman L, Loui P, Whitfield-Gabrieli S, Hillman C, McAuley E, Kramer A. Musical experience relates to functional connectivity in older adults. Innov Aging 2021. [PMCID: PMC8681186 DOI: 10.1093/geroni/igab046.2654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Previous studies have shown that engaging in musical activities throughout the lifespan may buffer age-related decline in auditory and motor function, as well as in general cognitive function. MRI studies have demonstrated that individuals with musical training and experience exhibited greater grey matter volume and functional connectivity in extensive brain regions, especially in auditory and motor systems, compared to matched controls with no particular musical training or experience. Therefore, musical activity is a potential protective factor for brain health across lifespan. However, how lifespan musical experience shapes functional connectivity in older adults is still unknown. The current analysis investigated whether general musical experience (Goldsmith Music Sophistication Index) is associated with functional connectivity in older adults (age=65.7±4.4, n=69), focusing on seed regions in primary motor areas (bilateral precentral gyrus) and primary auditory regions (bilateral anterior/posterior superior temporal gyrus) and their functional connectivity towards other areas throughout the whole brain. We found that older adults with more musical experience showed greater functional connectivity between anterior superior temporal gyrus and insula (R2=0.10, p=0.01), and between posterior superior temporal gyrus and cerebellum (R2=0.08, p=0.02). However, musical experience and music-related functional connectivity was not significantly correlated with general cognitive functions in our sample. Overall, our findings suggest that older adults with more musical experience might be more efficient in some aspects of auditory processing and auditory-motor skills, but this may not transfer towards domain-general cognitive tests. Our results support the notion that even non-professional engagement in musical experiences may afford benefits to the aging brain.
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Affiliation(s)
- Meishan Ai
- Northeastern University, Brookline, Massachusetts, United States
| | - Timothy Morris
- Northeastern University, Boston, Massachusetts, United States
| | | | - Psyche Loui
- Northeastern University, Boston, Massachusetts, United States
| | | | - Charles Hillman
- Northeastern University, Boston, Massachusetts, United States
| | - Edward McAuley
- University of Illinois at Urbana-Champaign, Boston, Massachusetts, United States
| | - Arthur Kramer
- Northeastern University, Boston, Massachusetts, United States
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Carr H, Morris T, Williams M, Jacob G, Courtney M, Kanakala V. P-P04 The cost of acute pancreatitis is amylasing! Br J Surg 2021. [DOI: 10.1093/bjs/znab430.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Amylase is the key serum biomarker in the diagnosis of acute pancreatitis, however there is no indication for repeat/serial measurement once the diagnosis is established. It is estimated that £27,000pa is spent unnecessarily on repeat amylase investigations without clinical indication1.
Anecdotally, within the department, unnecessary repeats were being routinely performed. Resultantly, we audited in 2019 and 2020 to understand the extent of the issue. Following the first cycle, pre-rotation departmental talks were given to all relevant healthcare staff.
Aim(s)
Methods
Data was collected and analysed retrospectively over 2 audit cycles (C1 & C2) from 79 patient episodes of admissions to the surgical department of a Northern Major Trauma Centre with confirmed diagnoses of acute pancreatitis between 01/05/2019 – 31/07/2019 and 01/08/2020 – 31/12/2020.
Resources used included: patient notes, IMPAX and WebICE.
Data was collected and analysed by one author in C1 but multiple authors in C2.
Results
Mean age = 60 years.
Male:Female ratio was 8:16 and 24:31, respectively.
Initial amylase was diagnostic in > 75% (61/79).
81 unnecessary repeats performed.
Most patients underwent imaging (75% and 67%) however, only approximately one-third (30.8% and 32.4%) of scans were performed to confirm the diagnosis.
• Despite imaging confirming the diagnosis in 88%, >50% of imaged patients had repeat amylase testing.
Conclusions
The results demonstrate that our intervention, a pre-rotation departmental talk, has significantly reduced the over-requesting of amylase and current practice is of a good standard.
Improvements are still required. Resultantly, we are additionally producing an electronic ‘alert’ into our investigations software that, on requesting a repeat amylase, will prompt clinicians to consider its necessity.
Other centres offering acute treatment for similar patients may benefit from performing a similar audit to optimise care while reducing overall clinical costs.
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Affiliation(s)
- Harry Carr
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Timothy Morris
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Matthew Williams
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Georgina Jacob
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Michael Courtney
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Venkatesh Kanakala
- Department of General Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
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Chausheva S, Redwan B, Sharma S, Marella N, Schossleitner K, Mueller AC, Petzelbauer P, Morris T, Lang IM. Synthetic Fibrin-Derived Bβ 15-42 Peptide Delays Thrombus Resolution in a Mouse Model. Arterioscler Thromb Vasc Biol 2021; 41:2168-2180. [PMID: 34078093 DOI: 10.1161/atvbaha.121.316404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Stella Chausheva
- Division of Cardiology, Department of Internal Medicine II (S.C., S.S., I.M.L.), Medical University of Vienna, Austria
| | - Bassam Redwan
- Department of Thoracic Surgery, Klinik am Park, Klinikum Westfalen, Luenen, Germany (B.R.)
| | - Smriti Sharma
- Division of Cardiology, Department of Internal Medicine II (S.C., S.S., I.M.L.), Medical University of Vienna, Austria
| | - Nara Marella
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Austria (N.M., A.C.M.)
| | - Klaudia Schossleitner
- Skin and Endothelial Research Division, Department of Dermatology (K.S., P.P.), Medical University of Vienna, Austria
| | - André C Mueller
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Austria (N.M., A.C.M.)
| | - Peter Petzelbauer
- Skin and Endothelial Research Division, Department of Dermatology (K.S., P.P.), Medical University of Vienna, Austria
| | - Timothy Morris
- Division of Pulmonary and Critical Care Medicine, University of California San Diego (T.M.)
| | - Irene M Lang
- Division of Cardiology, Department of Internal Medicine II (S.C., S.S., I.M.L.), Medical University of Vienna, Austria
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Zhang R, Mamza J, Morris T, Godfrey G, Asselbergs F, Denaxas S, Hemingway H, Banerjee A. Lifetime risk of cardiovascular-renal disease in type 2 diabetes: a population-based study in 473399 individuals. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3313] [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
Lifetime risks of cardiovascular (CV) and renal diseases are high, particularly in type 2 diabetes (T2D), but rarely studied together, and relative disease contributions are unknown. Knowledge of lifetime risk of cardiovascular-renal disease (CVRD) will better reflect disease burden in T2D.
Purpose
To investigate the lifetime risks (LTRs) of composite and individual components of major adverse reno-cardiovascular events, MARCE in T2D patients.
Method
In a population-based cohort study using national electronic health records, we studied 473399 individuals aged 45–99 years with T2D in England 2007–2018. The LTR of composite and individual components of MARCE (including CV death and CVRD: heart failure, HF; chronic kidney disease stage 3 and above, CKD; myocardial infarction, MI; stroke or peripheral artery disease, PAD) were estimated. LTRs by baseline CVRD comorbidity status were compared with individuals free from CVRD at baseline, accounting for the competing risk of death.
Results
Among T2D patients aged ≥45 years, the LTR of MARCE was 80% for individuals free from CVRD at baseline. LTR of MARCE was 97%, 93%, 98%, 89% and 91% for individuals with specific CVRD comorbidities for HF, CKD, MI, stroke and PAD, respectively at baseline. Within the CVRD-free cohort, LTR of CKD was highest at 54%, followed by CV death (41%), HF (29%), stroke (20%), MI (19%) and PAD (9%). Compared to CVRD-free, HF, MI and CKD at baseline were associated with the highest LTR of MARCE and its component diseases (Table).
Conclusion
The lifetime risk of CV disease and CKD in T2D patients is estimated to be over 60% and 50% respectively (1–3). When considered together, the LTR of MARCE is 80% in CVRD-free T2D patients, while nearly all those with T2D and HF will develop MARCE over their lifetime. Of the individual components of MARCE, LTR of CKD and HF were the highest among CVRD-free T2D patients. Preventive measures in T2D patients should be a priority in clinical practice to mitigate the burden of these complications.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): AstraZeneca
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Affiliation(s)
- R Zhang
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - J Mamza
- AstraZeneca, Luton, United Kingdom
| | - T Morris
- AstraZeneca, Luton, United Kingdom
| | | | - F Asselbergs
- University College London, London, United Kingdom
| | - S Denaxas
- University College London, London, United Kingdom
| | - H Hemingway
- University College London, Health Data Research UK, London, United Kingdom
| | - A Banerjee
- University College London Hospitals, Department of Cardiology, London, United Kingdom
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Salzberg NT, Sivalogan K, Bassat Q, Taylor AW, Adedini S, El Arifeen S, Assefa N, Blau DM, Chawana R, Cain CJ, Cain KP, Caneer JP, Garel M, Gurley ES, Kaiser R, Kotloff KL, Mandomando I, Morris T, Nyamthimba Onyango P, Sazzad HMS, Scott JAG, Seale AC, Sitoe A, Sow SO, Tapia MD, Whitney EA, Worrell MC, Zielinski-Gutierrez E, Madhi SA, Raghunathan PL, Koplan JP, Breiman RF. Mortality Surveillance Methods to Identify and Characterize Deaths in Child Health and Mortality Prevention Surveillance Network Sites. Clin Infect Dis 2020; 69:S262-S273. [PMID: 31598664 PMCID: PMC6785672 DOI: 10.1093/cid/ciz599] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Despite reductions over the past 2 decades, childhood mortality remains high in low- and middle-income countries in sub-Saharan Africa and South Asia. In these settings, children often die at home, without contact with the health system, and are neither accounted for, nor attributed with a cause of death. In addition, when cause of death determinations occur, they often use nonspecific methods. Consequently, findings from models currently utilized to build national and global estimates of causes of death are associated with substantial uncertainty. Higher-quality data would enable stakeholders to effectively target interventions for the leading causes of childhood mortality, a critical component to achieving the Sustainable Development Goals by eliminating preventable perinatal and childhood deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) Network tracks the causes of under-5 mortality and stillbirths at sites in sub-Saharan Africa and South Asia through comprehensive mortality surveillance, utilizing minimally invasive tissue sampling (MITS), postmortem laboratory and pathology testing, verbal autopsy, and clinical and demographic data. CHAMPS sites have established facility- and community-based mortality notification systems, which aim to report potentially eligible deaths, defined as under-5 deaths and stillbirths within a defined catchment area, within 24–36 hours so that MITS can be conducted quickly after death. Where MITS has been conducted, a final cause of death is determined by an expert review panel. Data on cause of death will be provided to local, national, and global stakeholders to inform strategies to reduce perinatal and childhood mortality in sub-Saharan Africa and South Asia.
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Affiliation(s)
- Navit T Salzberg
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | | | - Quique Bassat
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.,Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain.,Consorcio de Investigacion Biomedica en Red de Epidemiologia y Salud, Spain
| | - Allan W Taylor
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sunday Adedini
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | | | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dianna M Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard Chawana
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | | | - Kevin P Cain
- US Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
| | - J Patrick Caneer
- Public Health Informatics Institute, The Task Force for Global Health, Atlanta, Georgia, USA
| | - Mischka Garel
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Emily S Gurley
- icddr,b, Dhaka, Bangladesh.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Reinhard Kaiser
- US Centers for Disease Control and Prevention-Sierra Leone, Freetown, Sierra Leone
| | - Karen L Kotloff
- Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Instituto Nacional de Saude, Ministerio de Saude, Maputo, Mozambique
| | - Timothy Morris
- Public Health Informatics Institute, The Task Force for Global Health, Atlanta, Georgia, USA
| | | | - Hossain M S Sazzad
- University of New South Wales, Sydney, Australia.,PEI, Infectious Disease Division, icddr,b, Dhaka, Bangladesh
| | - J Anthony G Scott
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anna C Seale
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Antonio Sitoe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Samba O Sow
- Centre pour le Développement des Vaccins (CVD-Mali), Ministère de la Santé, Bamako, Mali
| | - Milagritos D Tapia
- Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ellen A Whitney
- International Association of National Public Health Institutes, US Office at Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Mary Claire Worrell
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Pratima L Raghunathan
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeffrey P Koplan
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
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14
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Blau DM, Caneer JP, Philipsborn RP, Madhi SA, Bassat Q, Varo R, Mandomando I, Igunza KA, Kotloff KL, Tapia MD, Johnstone S, Chawana R, Rahman A, El Arifeen S, Onyango D, Kaiser R, Seale AC, Assefa N, Morris T, Raghunathan PL, Breiman RF. Overview and Development of the Child Health and Mortality Prevention Surveillance Determination of Cause of Death (DeCoDe) Process and DeCoDe Diagnosis Standards. Clin Infect Dis 2020; 69:S333-S341. [PMID: 31598661 PMCID: PMC6785670 DOI: 10.1093/cid/ciz572] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/18/2019] [Indexed: 11/25/2022] Open
Abstract
Mortality surveillance and cause of death data are instrumental in improving health, identifying diseases and conditions that cause a high burden of preventable deaths, and allocating resources to prevent these deaths. The Child Health and Mortality Prevention Surveillance (CHAMPS) network uses a standardized process to define, assign, and code causes of stillbirth and child death (<5 years of age) across the CHAMPS network. A Determination of Cause of Death (DeCoDe) panel composed of experts from a local CHAMPS site analyzes all available individual information, including laboratory, histopathology, abstracted clinical records, and verbal autopsy findings for each case and, if applicable, also for the mother. Using this information, the site panel ascertains the underlying cause (event that precipitated the fatal sequence of events) and other antecedent, immediate, and maternal causes of death in accordance with the International Classification of Diseases, Tenth Revision and the World Health Organization death certificate. Development and use of the CHAMPS diagnosis standards—a framework of required evidence to support cause of death determination—assures a homogenized procedure leading to a more consistent interpretation of complex data across the CHAMPS network. This and other standardizations ensures future comparability with other sources of mortality data produced externally to this project. Early lessons learned from implementation of DeCoDe in 5 CHAMPS sites in sub-Saharan Africa and Bangladesh have been incorporated into the DeCoDe process, and the implementation of DeCoDe has the potential to spur health systems improvements and local public health action.
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Affiliation(s)
- Dianna M Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J Patrick Caneer
- Public Health Informatics Institute, The Task Force for Global Health, Atlanta, Georgia, USA
| | | | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Quique Bassat
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.,Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Consorcio de Investigacion Biomedica en Red de Epidemiologia y Salud, Spain
| | - Rosauro Varo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Instituto Nacional de Saude, Ministerio de Saude, Maputo, Mozambique
| | - Kitiezo Aggrey Igunza
- Kenya Medical Research Unit, Kenya Medical Research Institute (KEMRI), Kisusmu, Kenya
| | - Karen L Kotloff
- Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Milagritos D Tapia
- Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Siobhan Johnstone
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Richard Chawana
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Afruna Rahman
- PEI, Infectious Disease Division, icddr,b, Dhaka, Bangladesh
| | | | | | - Reinhard Kaiser
- US Centers for Disease Control and Prevention--Sierra Leone, Freetown, Sierra Leone
| | - Anna C Seale
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Timothy Morris
- Public Health Informatics Institute, The Task Force for Global Health, Atlanta, Georgia, USA
| | - Pratima L Raghunathan
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
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15
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Taylor AW, Blau DM, Bassat Q, Onyango D, Kotloff KL, Arifeen SE, Mandomando I, Chawana R, Baillie VL, Akelo V, Tapia MD, Salzberg NT, Keita AM, Morris T, Nair S, Assefa N, Seale AC, Scott JAG, Kaiser R, Jambai A, Barr BAT, Gurley ES, Ordi J, Zaki SR, Sow SO, Islam F, Rahman A, Dowell SF, Koplan JP, Raghunathan PL, Madhi SA, Breiman RF. Initial findings from a novel population-based child mortality surveillance approach: a descriptive study. Lancet Glob Health 2020; 8:e909-e919. [PMID: 32562647 PMCID: PMC7303945 DOI: 10.1016/s2214-109x(20)30205-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/12/2020] [Accepted: 04/14/2020] [Indexed: 10/28/2022]
Abstract
BACKGROUND Sub-Saharan Africa and south Asia contributed 81% of 5·9 million under-5 deaths and 77% of 2·6 million stillbirths worldwide in 2015. Vital registration and verbal autopsy data are mainstays for the estimation of leading causes of death, but both are non-specific and focus on a single underlying cause. We aimed to provide granular data on the contributory causes of death in stillborn fetuses and in deceased neonates and children younger than 5 years, to inform child mortality prevention efforts. METHODS The Child Health and Mortality Prevention Surveillance (CHAMPS) Network was established at sites in seven countries (Baliakandi, Bangladesh; Harar and Kersa, Ethiopia; Siaya and Kisumu, Kenya; Bamako, Mali; Manhiça, Mozambique; Bombali, Sierra Leone; and Soweto, South Africa) to collect standardised, population-based, longitudinal data on under-5 mortality and stillbirths in sub-Saharan Africa and south Asia, to improve the accuracy of determining causes of death. Here, we analysed data obtained in the first 2 years after the implementation of CHAMPS at the first five operational sites, during which surveillance and post-mortem diagnostics, including minimally invasive tissue sampling (MITS), were used. Data were abstracted from all available clinical records of deceased children, and relevant maternal health records were also extracted for stillbirths and neonatal deaths, to incorporate reported pregnancy or delivery complications. Expert panels followed standardised procedures to characterise causal chains leading to death, including underlying, intermediate (comorbid or antecedent causes), and immediate causes of death for stillbirths, neonatal deaths, and child (age 1-59 months) deaths. FINDINGS Between Dec 10, 2016, and Dec 31, 2018, MITS procedures were implemented at five sites in Mozambique, South Africa, Kenya, Mali, and Bangladesh. We screened 2385 death notifications for inclusion eligibility, following which 1295 families were approached for consent; consent was provided for MITS by 963 (74%) of 1295 eligible cases approached. At least one cause of death was identified in 912 (98%) of 933 cases (180 stillbirths, 449 neonatal deaths, and 304 child deaths); two or more conditions were identified in the causal chain for 585 (63%) of 933 cases. The most common underlying causes of stillbirth were perinatal asphyxia or hypoxia (130 [72%] of 180 stillbirths) and congenital infection or sepsis (27 [15%]). The most common underlying causes of neonatal death were preterm birth complications (187 [42%] of 449 neonatal deaths), perinatal asphyxia or hypoxia (98 [22%]), and neonatal sepsis (50 [11%]). The most common underlying causes of child deaths were congenital birth defects (39 [13%] of 304 deaths), lower respiratory infection (37 [12%]), and HIV (35 [12%]). In 503 (54%) of 933 cases, at least one contributory pathogen was identified. Cytomegalovirus, Escherichia coli, group B Streptococcus, and other infections contributed to 30 (17%) of 180 stillbirths. Among neonatal deaths with underlying prematurity, 60% were precipitated by other infectious causes. Of the 275 child deaths with infectious causes, the most common contributory pathogens were Klebsiella pneumoniae (86 [31%]), Streptococcus pneumoniae (54 [20%]), HIV (40 [15%]), and cytomegalovirus (34 [12%]), and multiple infections were common. Lower respiratory tract infection contributed to 174 (57%) of 304 child deaths. INTERPRETATION Cause of death determination using MITS enabled detailed characterisation of contributing conditions. Global estimates of child mortality aetiologies, which are currently based on a single syndromic cause for each death, will be strengthened by findings from CHAMPS. This approach adds specificity and provides a more complete overview of the chain of events leading to death, highlighting multiple potential interventions to prevent under-5 mortality and stillbirths. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Allan W Taylor
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dianna M Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Quique Bassat
- ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain; Pediatrics Department, Pediatric Infectious Diseases Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Karen L Kotloff
- Department of Pediatrics, Center for Vaccine Development and Global Health and Division of Infectious Disease and Tropical Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Richard Chawana
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, School of Pathology and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vicky L Baillie
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, School of Pathology and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Milagritos D Tapia
- Department of Pediatrics, Center for Vaccine Development and Global Health and Division of Infectious Disease and Tropical Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Navit T Salzberg
- Emory Global Health Institute, Emory University, Atlanta, GA, USA
| | | | - Timothy Morris
- Emory Global Health Institute, Emory University, Atlanta, GA, USA; Public Health Informatics Institute, Task Force for Global Health, Atlanta, GA, USA
| | - Shailesh Nair
- Emory Global Health Institute, Emory University, Atlanta, GA, USA; Public Health Informatics Institute, Task Force for Global Health, Atlanta, GA, USA
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Anna C Seale
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Amara Jambai
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Beth A Tippet Barr
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily S Gurley
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jaume Ordi
- ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Sherif R Zaki
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samba O Sow
- Centre for Vaccine Development, Bamako, Mali
| | - Farzana Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Afruna Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Jeffrey P Koplan
- Emory Global Health Institute, Emory University, Atlanta, GA, USA
| | - Pratima L Raghunathan
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shabir A Madhi
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, School of Pathology and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, GA, USA.
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16
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Morris T, Strömmer S, Vogel C, Harvey NC, Cooper C, Inskip H, Woods-Townsend K, Baird J, Barker M, Lawrence W. Improving pregnant women's diet and physical activity behaviours: the emergent role of health identity. BMC Pregnancy Childbirth 2020; 20:244. [PMID: 32334540 PMCID: PMC7183631 DOI: 10.1186/s12884-020-02913-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 03/29/2020] [Indexed: 02/08/2023] Open
Abstract
Background Women who gain too much weight in pregnancy are at increased risk of disease and of having children with increased risk. Interventions to improve health behaviours are usually designed for a general population of pregnant women, and trial outcomes show an average impact that does not represent the differences between individuals. To inform the development of future interventions, this study explored the factors that influenced women’s diet and physical activity during pregnancy and aimed to identify the needs of these women with regards to lifestyle support. Methods Women who completed a trial of vitamin D supplementation and nurse support in pregnancy were invited to take part in an interview. Seventeen women were interviewed about their lifestyles during pregnancy, the support they had, and the support they wanted. Interview transcripts were coded thematically and analysed to understand the factors that influenced the diets and physical activity levels of these women and their engagement with resources that could provide support. Results Women identified barriers to eating well or being physically active, and pregnancy-specific issues like nausea and pain were common. Women’s interest in maintaining a healthy lifestyle and their engagement with lifestyle support was related to the extent to which they self-identified as healthy people. Health-disengaged women were disinterested in talking about their lifestyles while health-focused women did not feel that they needed extra support. Women between these ends of the ‘health identity’ spectrum were interested in improving their health, and were able to identify barriers as well as sources of support. Conclusions Lifestyle interventions in pregnancy should be adapted to meet the needs of individuals with different health identities, and encouraging a change in health identity may be one way of supporting sustained change in health behaviours.
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Affiliation(s)
- T Morris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK. .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - S Strömmer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Vogel
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K Woods-Townsend
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - J Baird
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - W Lawrence
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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17
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Morris T, Redondo M, Cattaneo G, Macia D, Delgado-Galen S, Alviárez V, Solana-Sanchez J, Tormos Muñoz J, Batres-Faz D, Pascual-Leone A, Shafi M. P163 Fronto-parietal effective connectivity revealed via TMS is associated with global cognitive functioning. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.274] [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]
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18
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Morris T, Sandow T, Gimenez J, Gulotta P, Thevenot P, Nunez K, Gilbert P, Marsala A, Bohorquez H, Cohen A, Kay D, Ramalingam V. 3:36 PM Abstract No. 302 Effect of bridging locoregional therapy on hepatic arterial complications following liver transplant: 3-year, multicenter, retrospective analysis of 608 patients. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.355] [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] Open
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19
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Diaz MH, Waller JL, Theodore MJ, Patel N, Wolff BJ, Benitez AJ, Morris T, Raghunathan PL, Breiman RF, Whitney CG, Blau DM, Winchell JM. Development and Implementation of Multiplex TaqMan Array Cards for Specimen Testing at Child Health and Mortality Prevention Surveillance Site Laboratories. Clin Infect Dis 2019; 69:S311-S321. [PMID: 31598666 PMCID: PMC7108207 DOI: 10.1093/cid/ciz571] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Child Health and Mortality Prevention Surveillance (CHAMPS) laboratories are employing a variety of laboratory methods to identify infectious agents contributing to deaths of children <5 years old and stillbirths in sub-Saharan Africa and South Asia. In support of this long-term objective, our team developed TaqMan Array Cards (TACs) for testing postmortem specimens (blood, cerebrospinal fluid, lung tissue, respiratory tract swabs, and rectal swabs) for >100 real-time polymerase chain reaction (PCR) targets in total (30-45 per card depending on configuration). Multipathogen panels were configured by syndrome and customized to include pathogens of significance in young children within the regions where CHAMPS is conducted, including bacteria (57 targets covering 30 genera), viruses (48 targets covering 40 viruses), parasites (8 targets covering 8 organisms), and fungi (3 targets covering 3 organisms). The development and application of multiplex real-time PCR reactions to the TAC microfluidic platform increased the number of targets in each panel while maintaining assay efficiency and replicates for heightened sensitivity. These advances represent a substantial improvement in the utility of this technology for infectious disease diagnostics and surveillance. We optimized all aspects of the CHAMPS molecular laboratory testing workflow including nucleic acid extraction, quality assurance, and data management to ensure comprehensive molecular testing of specimens and high-quality data. Here we describe the development and implementation of multiplex TACs and associated laboratory protocols for specimen processing, testing, and data management at CHAMPS site laboratories.
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Affiliation(s)
- Maureen H Diaz
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica L Waller
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Bernard J Wolff
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alvaro J Benitez
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Timothy Morris
- Public Health Informatics Institute, The Task Force for Global Health, Atlanta, Georgia, USA
| | - Pratima L Raghunathan
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Cynthia G Whitney
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Dianna M Blau
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonas M Winchell
- Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Howell S, Campone M, Cortés J, Duhoux F, Ross S, Morris T, Franklin S. Final results of the STEM trial: SFX-01 in the treatment and evaluation of ER+ Her2- metastatic breast cancer (mBC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Murphy T, Windermere S, Holtzman L, Slish J, Morris T, Becker T. 305 Bystander Cardiopulmonary Resuscitation in the Courtroom: Legal Risk of Return of Spontaneous Circulation. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The majority of research on factors associated with women participation in physical activity (PA) has been in developed countries with limited research in developing countries. Few women in Malaysia are active at the recommended levels for health, and activity rates are less than developed countries. Little research has focused specially on physically active Malaysian women and the factors that contribute to them becoming and staying active in PA programs. This lack of knowledge hinders the tailored development and implementation of PA programs to meet their needs. The aim of this study was to identify the factors of participation in PA programs for Malaysian women. The social-ecological model was used to investigate and theme the factors. Focus group discussion was conducted with participants in six PA programs targeted specifically to women. Thirty-seven women were involved in the focus group discussion, with ages ranging from 19 to 82 years. Inductive and deductive content analysis was conducted from verbatim transcripts using NVivo. Inductive content analysis allowed raw data and second-order themes to emerge. Findings revealed social support structures, tailored programs for women, and location were key contributors that encouraged women to participate in these programs. The similarity in contributors between women in non-western and western countries signifies a prime opportunity for bi-lateral relationships to be formed to enable the enhancement of program development relevant to different ethnicities and cultures within or across countries.
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Affiliation(s)
- C Hanlon
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, VIC, Australia
| | - S Khoo
- Sports Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - T Morris
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, VIC, Australia
| | - R Eime
- Institute of Sport, Exercise and Active Living, Victoria University, Federation University of Ballarat, Australia
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Morris T, Shafi M, Bartres-Faz D, Delgado-Gallén S, Camós MR, Alviárez V, Cattaneo G, Sanchez JS, Albu S, Macia D, Muñoz JT, Pascual-Leone A. Intracortical inhibition of the parietal cortex is associated with cognitive function in older adults: A TMS-EEG study. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.483] [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: 10/27/2022] Open
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24
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Wozniak MJ, Sullo N, Qureshi S, Dott W, Cardigan R, Wiltshire M, Morris T, Nath M, Bittar N, Bhudia SK, Kumar T, Goodall AH, Murphy GJ. Randomized trial of red cell washing for the prevention of transfusion-associated organ injury in cardiac surgery. Br J Anaesth 2018; 118:689-698. [PMID: 28475670 PMCID: PMC5430295 DOI: 10.1093/bja/aex083] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 12/18/2022] Open
Abstract
Background. Experimental studies suggest that mechanical cell washing to remove pro-inflammatory components that accumulate in the supernatant of stored donor red blood cells (RBCs) might reduce inflammation and organ injury in transfused patients. Methods. Cardiac surgery patients at increased risk of large-volume RBC transfusion were eligible. Participants were randomized to receive either mechanically washed allogenic RBCs or standard care RBCs. The primary outcome was serum interleukin-8 measured at baseline and at four postsurgery time points. A mechanism substudy evaluated the effects of washing on stored RBCs in vitro and on markers of platelet, leucocyte, and endothelial activation in trial subjects. Results. Sixty adult cardiac surgery patients at three UK cardiac centres were enrolled between September 2013 and March 2015. Subjects received a median of 3.5 (interquartile range 2–5.5) RBC units, stored for a mean of 21 (sd 5.2) days, within 48 h of surgery. Mechanical washing reduced concentrations of RBC-derived microvesicles but increased cell-free haemoglobin concentrations in RBC supernatant relative to standard care RBC supernatant. There was no difference between groups with respect to perioperative serum interleukin-8 values [adjusted mean difference 0.239 (95% confidence intervals −0.231, 0.709), P=0.318] or concentrations of plasma RBC microvesicles, platelet and leucocyte activation, plasma cell-free haemoglobin, endothelial activation, or biomarkers of heart, lung, or kidney injury. Conclusions. These results do not support a hypothesis that allogenic red blood cell washing has clinical benefits in cardiac surgery. Clinical trial registration. ISRCTN 27076315.
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Affiliation(s)
- M J Wozniak
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - N Sullo
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - S Qureshi
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - W Dott
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - R Cardigan
- National Health Service Blood and Transplant, Cambridge CB2 0PT, UK
| | - M Wiltshire
- National Health Service Blood and Transplant, Cambridge CB2 0PT, UK
| | - T Morris
- Leicester Clinical Trials Unit, Leicester Diabetes Centre, Leicester General Hospital, Leicester LE5 4PW, UK
| | - M Nath
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - N Bittar
- Blackpool Victoria Hospital NHS Trust, Blackpool, Lancashire FY3 8NR, UK
| | - S K Bhudia
- University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - T Kumar
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - A H Goodall
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - G J Murphy
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
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Alexeyev OA, Dekio I, Layton AM, Li H, Hughes H, Morris T, Zouboulis CC, Patrick S. Why we continue to use the name Propionibacterium acnes. Br J Dermatol 2018; 179:1227. [PMID: 30101491 DOI: 10.1111/bjd.17085] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- O A Alexeyev
- Department of Pathology, Umeå University, Umeå, Sweden
| | - I Dekio
- Microbe Division/Japan Collection of Microorganisms, RIKEN BioResource Research Center, Tsukuba, Japan
| | - A M Layton
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, U.K
| | - H Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA,, U.S.A
| | - H Hughes
- Anaerobe Reference Unit, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, U.K
| | - T Morris
- Anaerobe Reference Unit, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, U.K
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - S Patrick
- The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, U.K
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Powell C, Bamber D, Long J, Garratt R, Brown J, Rudge S, Morris T, Bhupendra Jaicim N, Plachcinski R, Dyson S, Boyle EM, St James-Roberts I. Mental health and well-being in parents of excessively crying infants: Prospective evaluation of a support package. Child Care Health Dev 2018; 44:607-615. [PMID: 29667223 DOI: 10.1111/cch.12566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/22/2018] [Accepted: 03/17/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND During the first 4 months of age, approximately 20% of infants cry a lot without an apparent reason. Most research has targeted the crying, but the impact of the crying on parents, and subsequent outcomes, need to receive equal attention. This study reports the findings from a prospective evaluation of a package of materials designed to support the well-being and mental health of parents who judge their infant to be crying excessively. The resulting "Surviving Crying" package comprised a website, printed materials, and programme of Cognitive Behaviour Therapy-based support sessions delivered to parents by a qualified practitioner. It was designed to be suitable for United Kingdom (UK) National Health Service (NHS) use. METHODS Parents were referred to the study by 12 NHS Health Visitor/Community Public Health Nurse teams in one UK East Midlands NHS Trust. Fifty-two of 57 parents of excessively crying babies received the support package and completed the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7 anxiety questionnaire, as well as other measures, before receiving the support package and afterwards. RESULTS Significant reductions in depression and anxiety were found, with numbers of parents meeting clinical criteria for depression or anxiety halving between baseline and outcome. These improvements were not explained by reductions in infant crying. Reductions also occurred in the number of parents reporting the crying to be a large or severe problem (from 28 to 3 parents) or feeling very or extremely frustrated by the crying (from 31 to 1 parent). Other findings included increases in parents' confidence, knowledge of infant crying, and improvements in parents' sleep. CONCLUSIONS The findings suggest that the Surviving Crying package may be effective in supporting the well-being and mental health of parents of excessively crying babies. Further, large-scale controlled trials of the package in NHS settings are warranted.
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Affiliation(s)
- C Powell
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - D Bamber
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - J Long
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - R Garratt
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - J Brown
- Nursing and Midwifery Research Centre, De Montfort University, Leicester, UK
| | - S Rudge
- Counseling Psychologist & CBT Practitioner, Leicester, UK
| | - T Morris
- Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
| | | | | | - S Dyson
- School of Health and Education, Middlesex University, London, UK
| | - E M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - I St James-Roberts
- Thomas Coram Research Unit, UCL Institute of Education, University College London, London, UK
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Veloo ACM, Jean-Pierre H, Justesen US, Morris T, Urban E, Wybo I, Kostrzewa M, Friedrich AW, On Behalf Of The Enria Workgroup. An overview of the data obtained during the validation of an optimized MALDI-TOF MS Biotyper database for the identification of anaerobic bacteria. Data Brief 2018; 18:1484-1496. [PMID: 29904651 PMCID: PMC5998164 DOI: 10.1016/j.dib.2018.04.070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/01/2022] Open
Abstract
This data in brief article presents the data obtained during the validation of the optimized Biotyper Matrix Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) database. The validation was performed by the different expertise laboratories, collaborating within the European Network for the Rapid Identification of Anaerobes (ENRIA) project, using 6309 human clinical anaerobic bacterial strains. Different databases were compared with each other; the db 5989 database (V5 database); the V5 database complimented with Main Spectral Profiles (MSPs) of ENRIA strains added to the next update of the database; and the V5 database complimented with the MSPs of all anaerobic clinical isolates collected within the ENRIA project. For a comprehensive discussion of the full dataset, please see the research article that accompanies this data article (Veloo et al., 2018) [1]
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Affiliation(s)
- A C M Veloo
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands
| | - H Jean-Pierre
- Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.,Université Montpellier 1, UMR5119 ECOSYM, Equipe Pathogènes Hydriques Santé Environnements, UMR 5569 Hydrosciences, UFR Pharmacie, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - U S Justesen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - T Morris
- UK Anaerobe Reference Unit, Public Health Wales Microbiology, Cardiff, UK
| | - E Urban
- Institute of Clinical Microbiology, University of Szeged, Hungary
| | - I Wybo
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - A W Friedrich
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands
| | - On Behalf Of The Enria Workgroup
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands.,Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.,Université Montpellier 1, UMR5119 ECOSYM, Equipe Pathogènes Hydriques Santé Environnements, UMR 5569 Hydrosciences, UFR Pharmacie, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France.,Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.,UK Anaerobe Reference Unit, Public Health Wales Microbiology, Cardiff, UK.,Institute of Clinical Microbiology, University of Szeged, Hungary.,Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Bruker Daltonics, Bremen, Germany
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O'Sullivan GA, Hanlon C, Dentry T, Morris T, Banting L. A qualitative exploration of the client experience of inter-professional practice in the delivery of ActivePlus: a combined smoking cessation and physical activity intervention. BMC Health Serv Res 2018; 18:195. [PMID: 29562905 PMCID: PMC5863488 DOI: 10.1186/s12913-018-3004-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research investigating interprofessional practice (IPP) frameworks has predominately focused on the service delivery of IPP or educating practitioners through interprofessional education. Minimal research has addressed client outcomes or the experience of clients with IPP in real world contexts. In this paper, we explore the experience of seven participants in the ActivePlus program, an IPP-based smoking cessation intervention combined with physical activity promotion. METHODS Participants informed on their program experiences through post-program in-depth interviews. A thematic analysis drew out themes pertaining to participant experiences of the joint practice element of the IPP model of care. RESULTS Analysis identified two major themes: the joint practice experience, and the client-centered approach of the IPP model of care. Participants reflected on the ways that having two health practitioners in joint sessions benefited their intervention experience, as well as providing some critical feedback. Participants also reported observing and valuing aspects of client-centered practice that strengthened the rapport within the practitioner-client team and aided their behaviour change progress. The client-centered practice was instrumental in overcoming initial teething issues with joint session delivery and alleviating pre-program participant concerns about being outnumbered by multiple practitioners. CONCLUSION Despite some early teething issues, participants reported a positive acceptance of the IPP and joint session delivery model, which added value to the overall ActivePlus program. Results from this research can provide practitioners with a client perspective on the key aspects they perceive as important in IPP joint session delivery. Further investigation into the client perception in similar interventions is recommended with larger samples and non-clinical groups.
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Affiliation(s)
- G A O'Sullivan
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia.
| | - Clare Hanlon
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
| | - T Dentry
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
| | - T Morris
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
| | - L Banting
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
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Knetsch CW, Kumar N, Forster SC, Connor TR, Browne HP, Harmanus C, Sanders IM, Harris SR, Turner L, Morris T, Perry M, Miyajima F, Roberts P, Pirmohamed M, Songer JG, Weese JS, Indra A, Corver J, Rupnik M, Wren BW, Riley TV, Kuijper EJ, Lawley TD. Zoonotic Transfer of Clostridium difficile Harboring Antimicrobial Resistance between Farm Animals and Humans. J Clin Microbiol 2018; 56:e01384-17. [PMID: 29237792 PMCID: PMC5824051 DOI: 10.1128/jcm.01384-17] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 08/29/2017] [Accepted: 12/08/2017] [Indexed: 11/20/2022] Open
Abstract
The emergence of Clostridium difficile as a significant human diarrheal pathogen is associated with the production of highly transmissible spores and the acquisition of antimicrobial resistance genes (ARGs) and virulence factors. Unlike the hospital-associated C. difficile RT027 lineage, the community-associated C. difficile RT078 lineage is isolated from both humans and farm animals; however, the geographical population structure and transmission networks remain unknown. Here, we applied whole-genome phylogenetic analysis of 248 C. difficile RT078 strains from 22 countries. Our results demonstrate limited geographical clustering for C. difficile RT078 and extensive coclustering of human and animal strains, thereby revealing a highly linked intercontinental transmission network between humans and animals. Comparative whole-genome analysis reveals indistinguishable accessory genomes between human and animal strains and a variety of antimicrobial resistance genes in the pangenome of C. difficile RT078. Thus, bidirectional spread of C. difficile RT078 between farm animals and humans may represent an unappreciated route disseminating antimicrobial resistance genes between humans and animals. These results highlight the importance of the "One Health" concept to monitor infectious disease emergence and the dissemination of antimicrobial resistance genes.
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Affiliation(s)
- C W Knetsch
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - N Kumar
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - S C Forster
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
| | - T R Connor
- Cardiff School of Biosciences, Sir Martin Evans Building, Cardiff, United Kingdom
| | - H P Browne
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - C Harmanus
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - I M Sanders
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - S R Harris
- Pathogen Genomics, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - L Turner
- Public Health Wales, Microbiology, Wales, United Kingdom
| | - T Morris
- Public Health Wales, Microbiology, Wales, United Kingdom
| | - M Perry
- Public Health Wales, Microbiology, Wales, United Kingdom
| | - F Miyajima
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - P Roberts
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - M Pirmohamed
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - J G Songer
- Department of Veterinary Science and Microbiology, The University of Arizona, Tucson, Arizona, USA
| | - J S Weese
- Department of Pathobiology, Canada Veterinary College, University of Guelph, Guelph, Canada
| | - A Indra
- Institute of Medical Microbiology and Hygiene, Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES), Vienna, Austria
| | - J Corver
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - M Rupnik
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
- National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - B W Wren
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - T V Riley
- Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Western Australia, Australia
- Microbiology & Immunology, School of Pathology & Laboratory Medicine, The University of Western Australia, Western Australia, Australia
| | - E J Kuijper
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - T D Lawley
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
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Khan TKA, Morris T, Marchant D. Portable devices for delivering imagery and modelling interventions: effects on netball players’ adherence, shooting performance, and self-efficacy. J Fundam and Appl Sci 2018. [DOI: 10.4314/jfas.v9i6s.98] [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: 11/17/2022] Open
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Morris T, Letnic M. Removal of an apex predator initiates a trophic cascade that extends from herbivores to vegetation and the soil nutrient pool. Proc Biol Sci 2018; 284:rspb.2017.0111. [PMID: 28490624 DOI: 10.1098/rspb.2017.0111] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/13/2017] [Indexed: 11/12/2022] Open
Abstract
It is widely assumed that organisms at low trophic levels, particularly microbes and plants, are essential to basic services in ecosystems, such as nutrient cycling. In theory, apex predators' effects on ecosystems could extend to nutrient cycling and the soil nutrient pool by influencing the intensity and spatial organization of herbivory. Here, we take advantage of a long-term manipulation of dingo abundance across Australia's dingo-proof fence in the Strzelecki Desert to investigate the effects that removal of an apex predator has on herbivore abundance, vegetation and the soil nutrient pool. Results showed that kangaroos were more abundant where dingoes were rare, and effects of kangaroo exclusion on vegetation, and total carbon, total nitrogen and available phosphorus in the soil were marked where dingoes were rare, but negligible where dingoes were common. By showing that a trophic cascade resulting from an apex predator's lethal effects on herbivores extends to the soil nutrient pool, we demonstrate a hitherto unappreciated pathway via which predators can influence nutrient dynamics. A key implication of our study is the vast spatial scale across which apex predators' effects on herbivore populations operate and, in turn, effects on the soil nutrient pool and ecosystem productivity could become manifest.
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Affiliation(s)
- Timothy Morris
- Centre for Ecosystem Science, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Mike Letnic
- Centre for Ecosystem Science, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
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Mitchell S, Gurung PMS, Choong S, Morris T, Smith D, Woodhouse C, Philp T. Percutaneous Nephrolithotomy and Spina Bifida: Complex Major Stone Surgery? J Endourol 2018; 32:205-212. [PMID: 29343086 DOI: 10.1089/end.2017.0775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The incidence of spina bifida (SB) is ∼1:1000, and risk of stone disease is substantially raised in SB. This is the unique published study of the outcome of patients with SB undergoing percutaneous nephrolithotomy (PCNL) compared to a neurologically intact historically matched control group at the same institution. PATIENTS AND METHOD A series of 96 PCNLs in 13 SB and 50 non-SB patients was analyzed. The following measurements were recorded: (1) Comorbidities; (2) Preoperative: (renal function, American Society of Anesthesiologists [ASA] score); (3) Intraoperative: (anesthesia time, number of tracks, stone-free rate); and (4) Postoperative: (sepsis, intensive therapy unit and total length of stay, transfusion rate, stone composition, rate of stone disease-related nephrectomy). RESULTS Retrograde access to the ureter was impossible in all cases of SB. The median ASA grade (OR 10.5, 95% confidence interval [CI] 2.6-42.7) and operative time (median difference 30 minutes, 95% CI 20-40) were both higher in the SB cohort. Surgeon's estimate of stone-free rate was significantly lower in the SB cohort (46% vs 82%). Intensive care requirement (0.29 days/PCNL vs 0.1 days/PCNL); total hospital stay (7 days vs 4 days); postoperative transfusion rate (11.8% vs 1.6%); and sepsis rate (38% vs 1.6%) were all significantly higher in the SB group. Repeat PCNL and nephrectomy for recurrent stone disease were both significantly increased in SB cohort compared to control group. CONCLUSIONS PCNL in patients with SB is associated with multiple parameters of poor outcome. Patients with SB should be counseled about increased peri-operative risk and likelihood of stone recurrence. In an era where hospitals are judged according to comparative outcomes, a case may be made for comparing PCNL in this cohort of patients separately because of the significantly increased peri- and postoperative morbidity.
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Affiliation(s)
- Stephen Mitchell
- 1 Department of Urology, Barnsley and Mid Yorkshire NHS Foundation Hospital Trusts , London, United Kingdom
| | | | - Simon Choong
- 3 Department of Urology, University College London Hospital NHS Foundation Trust , London, United Kingdom
| | - Timothy Morris
- 4 Department of Medical Statistics, MRC Clinical Trials Unit , London, United Kingdom
| | - Daron Smith
- 3 Department of Urology, University College London Hospital NHS Foundation Trust , London, United Kingdom
| | - Christopher Woodhouse
- 3 Department of Urology, University College London Hospital NHS Foundation Trust , London, United Kingdom
| | - Timothy Philp
- 3 Department of Urology, University College London Hospital NHS Foundation Trust , London, United Kingdom
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Athanasopoulou A, Moss-Cowan A, Smets M, Morris T. Claiming the corner office: Female CEO careers and implications for leadership development. Hum Resour Manage 2017. [DOI: 10.1002/hrm.21887] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Andromachi Athanasopoulou
- School of Business and Management; Queen Mary University of London
- Saïd Business School; University of Oxford
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Veloo ACM, Jean-Pierre H, Justesen US, Morris T, Urban E, Wybo I, Shah HN, Friedrich AW, Morris T, Shah HN, Jean-Pierre H, Justesen US, Nagy E, Urban E, Kostrzewa M, Veloo A, Friedrich AW. A multi-center ring trial for the identification of anaerobic bacteria using MALDI-TOF MS. Anaerobe 2017; 48:94-97. [PMID: 28797803 DOI: 10.1016/j.anaerobe.2017.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 11/15/2022]
Abstract
Inter-laboratory reproducibility of Matrix Assisted Laser Desorption Time-of-Flight Mass Spectrometry (MALDI-TOF MS) of anaerobic bacteria has not been shown before. Therefore, ten anonymized anaerobic strains were sent to seven participating laboratories, an initiative of the European Network for the Rapid Identification of Anaerobes (ENRIA). On arrival the strains were cultured and identified using MALDI-TOF MS. The spectra derived were compared with two different Biotyper MALDI-TOF MS databases, the db5627 and the db6903. The results obtained using the db5627 shows a reasonable variation between the different laboratories. However, when a more optimized database is used, the variation is less pronounced. In this study we show that an optimized database not only results in a higher number of strains which can be identified using MALDI-TOF MS, but also corrects for differences in performance between laboratories.
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Affiliation(s)
- A C M Veloo
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - H Jean-Pierre
- Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France; Université Montpellier 1, UMR5119 ECOSYM, Equipe Pathogènes Hydriques Santé Environnements, UMR 5569 Hydrosciences, UFR Pharmacie, 15 avenue Charles Flahault, 34093 Montpellier Cedex 5, France
| | - U S Justesen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - T Morris
- UK Anaerobe Reference Unit, Public Health Wales Microbiology, Cardiff, UK
| | - E Urban
- Institute of Clinical Microbiology, University of Szeged, Hungary
| | - I Wybo
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - H N Shah
- Department of Natural Sciences, Middlesex University, London NW4 4BT, UK
| | - A W Friedrich
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, The Netherlands
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Zhang R, Findlay I, Morris T, Berry C, McConnachie A, Berry C. P4892Service delivery and 1-year mortality of patients from an Acute Coronary Syndrome e-Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p4892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R. Zhang
- University of Glasgow, Glasgow, United Kingdom
| | - I. Findlay
- Royal Alexandra Hospital, Glasgow, United Kingdom
| | - T. Morris
- AstraZeneca UK, Luton, United Kingdom
| | - C. Berry
- University of Glasgow, Glasgow, United Kingdom
| | | | - C. Berry
- Golden Jubilee National Hospital, Glasgow, United Kingdom
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Kumar S, Ren M, Morris T, Kaval A, Madi S, Matin A, Turpin S. 45IMPROVING MULTIDISCIPLINARY TEAM MEETINGS IN GERIATRIC EMERGENCY MEDICINE USING QI METHOD. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hamilton KC, Richardson MT, Owens T, Morris T, Hathaway ED, Higginbotham JC. A Community-Based Participatory Research Intervention to Promote Physical Activity Among Rural Children: Theory and Design. Fam Community Health 2017; 40:3-10. [PMID: 27870747 DOI: 10.1097/fch.0000000000000132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The overall objective of Project SHAPE (Shaping Health using Activity Photovoice and E-Video) was to improve physical activity levels of rural, medically underserved children by designing and implementing a culturally relevant physical activity intervention. This objective was met by using a community-based participatory research approach to design and implement an intervention that would positively affect the psychosocial constructs related to increasing physical activity, which, in turn, would lead to increases in the time spent in daily physical activity. This article describes the unique design of the intervention including its theoretical framework, its interrelated components, and the logistics involved.
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Affiliation(s)
- Kara C Hamilton
- Department of Health and Human Performance, The University of Tennessee at Chattanooga (Drs Hamilton and Hathaway); and Departments of Kinesiology (Dr Richardson and Mr Morris) and Community and Rural Medicine (Dr Higginbotham), The University of Alabama, Tuscaloosa. Ms Owens is Prevention Coordinator, Aliceville, Alabama
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Demirbag M, Tavernier G, Morris T, Hince K, Ustabasi C, Jones D, Fowler S. S54 CPAP reduces exacerbations in tracheobronchomalacia. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Morris T, Gomes Osman J, Tormos Muñoz JM, Costa Miserachs D, Pascual Leone A. The role of physical exercise in cognitive recovery after traumatic brain injury: A systematic review. Restor Neurol Neurosci 2016; 34:977-988. [DOI: 10.3233/rnn-160687] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Timothy Morris
- The Guttmann University Institute for Neurorehabilitation, Universitat Autónoma de Barcelona, Badalona, Spain
- Departament de Psicobiologia i Ciéncies de la Salut, Institut de Neurociéncies, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Joyce Gomes Osman
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Physical Therapy, University of Miami, Miller School of Medicine, Miami, USA
| | - Jose Maria Tormos Muñoz
- The Guttmann University Institute for Neurorehabilitation, Universitat Autónoma de Barcelona, Badalona, Spain
| | - David Costa Miserachs
- Departament de Psicobiologia i Ciéncies de la Salut, Institut de Neurociéncies, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Alvaro Pascual Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Carr R, Ozdag H, Tekin N, Morris T, Conget P, Bruna F, Timar B, Gagyi E, Basak R, Naik O, Auewarakul C, Srithana N, Dimamay MP, Natividad F, Chung JK, Belder N, Kuzu I, Omidvar N, Paez D, Padua RA. The effect of biological heterogeneity on R-CHOP treatment outcome in diffuse large B-cell lymphoma across five international regions. Leuk Lymphoma 2016; 58:1178-1183. [PMID: 27724056 DOI: 10.1080/10428194.2016.1231308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Addressing the global burden of cancer, understanding its diverse biology, and promoting appropriate prevention and treatment strategies around the world has become a priority for the United Nations and International Atomic Energy Agency (IAEA), the WHO, and International Agency for Research on Cancer (IARC). The IAEA sponsored an international prospective cohort study to better understand biology, treatment response, and outcomes of diffuse large B-cell lymphoma (DLBCL) in low and middle-income countries across five UN-defined geographical regions. We report an analysis of biological variation in DLBCL across seven ethnic and environmentally diverse populations. In this cohort of 136 patients treated to a common protocol, we demonstrate significant biological differences between countries, characterized by a validated prognostic gene expression score (p < .0001), but International Prognostic Index (IPI)-adjusted survivals in all participating countries were similar. We conclude that DLBCL treatment outcomes in these populations can be benchmarked to international standards, despite biological heterogeneity.
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Affiliation(s)
- Robert Carr
- a Department of Haematology , Guy's & St. Thomas' Hospital, King's College , London , UK
| | - Hilal Ozdag
- b Biotechnology Institute, Ankara University , Ankara , Turkey
| | - Nilgun Tekin
- b Biotechnology Institute, Ankara University , Ankara , Turkey
| | - Timothy Morris
- c Medical Research Council Clinical Trials Unit , University College London , London , UK
| | - Paulette Conget
- d Facultad de Medicina Clínica Alemana, Universidad del Desarrollo , Santiago , Chile
| | - Flavia Bruna
- d Facultad de Medicina Clínica Alemana, Universidad del Desarrollo , Santiago , Chile
| | - Botond Timar
- e 1st Department of Pathology and Experimental Cancer Research , Semmelweis University , Budapest , Hungary
| | - Eva Gagyi
- e 1st Department of Pathology and Experimental Cancer Research , Semmelweis University , Budapest , Hungary
| | - Ranjan Basak
- f Department of Medical Oncology and Pathology , Tata Memorial Hospital , Mumbai , India
| | - Omkar Naik
- f Department of Medical Oncology and Pathology , Tata Memorial Hospital , Mumbai , India
| | | | | | - Mark Pierre Dimamay
- h Research and Biology Division , St. Luke's Medical Centre , Manila , Philippines
| | - Filipinas Natividad
- h Research and Biology Division , St. Luke's Medical Centre , Manila , Philippines
| | - June-Key Chung
- i Oncology Clinic , Seoul National University Hospital , Seoul , Republic of Korea
| | - Nevin Belder
- b Biotechnology Institute, Ankara University , Ankara , Turkey
| | - Isinsu Kuzu
- j Department of Pathology , Ankara University , Ankara , Turkey
| | - Nader Omidvar
- k Department of Haematology , University of Cardiff , Cardiff , UK
| | - Diana Paez
- l Nuclear Medicine Section, International Atomic Energy Agency , Vienna , Austria
| | - Rose Ann Padua
- m INSERM 1131 , University Paris-Diderot, Hôpital Saint-Louis , Paris , France
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Morris T. The connection between pulmonary embolism and chronic thromboembolic pulmonary hypertension: research session at the American Thoracic Society 2016 Meeting. J Thorac Dis 2016; 8:S573-5. [PMID: 27606098 DOI: 10.21037/jtd.2016.07.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Timothy Morris
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, San Diego, CA 92103, USA
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Marconi A, Di Marcantonio P, D'Odorico V, Cristiani S, Maiolino R, Oliva E, Origlia L, Riva M, Valenziano L, Zerbi FM, Abreu M, Adibekyan V, Allende Prieto C, Amado PJ, Benz W, Boisse I, Bonfils X, Bouchy F, Buchhave L, Buscher D, Cabral A, Canto Martins BL, Chiavassa A, Coelho J, Christensen LB, Delgado-Mena E, de Medeiros JR, Di Varano I, Figueira P, Fisher M, Fynbo JPU, Glasse ACH, Haehnelt M, Haniff C, Hansen CJ, Hatzes A, Huke P, Korn AJ, Leão IC, Liske J, Lovis C, Maslowski P, Matute I, McCracken RA, Martins CJAP, Monteiro MJPFG, Morris S, Morris T, Nicklas H, Niedzielski A, Nunes NJ, Palle E, Parr-Burman PM, Parro V, Parry I, Pepe F, Piskunov N, Queloz D, Quirrenbach A, Rebolo Lopez R, Reiners A, Reid DT, Santos N, Seifert W, Sousa S, Stempels HC, Strassmeier K, Sun X, Udry S, Vanzi L, Vestergaard M, Weber M, Zackrisson E. EELT-HIRES the high-resolution spectrograph for the E-ELT. ACTA ACUST UNITED AC 2016. [DOI: 10.1117/12.2231653] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | - V. D'Odorico
- INAF - Osservatorio Astronomico di Trieste (Italy)
| | - S. Cristiani
- INAF - Osservatorio Astronomico di Trieste (Italy)
| | | | - E. Oliva
- INAF - Osservatorio Astrofisico di Arcetri (Italy)
| | - L. Origlia
- INAF - Osservatorio Astronomico di Bologna (Italy)
| | - M. Riva
- INAF - Osservatorio Astronomico di Brera (Italy)
| | | | | | | | | | | | - P. J. Amado
- Instituto de Astrofísica de Andalucía (Spain)
| | | | - I. Boisse
- Lab. d'Astrophysique de Marseille (France)
| | - X. Bonfils
- Observatoire de Science de l'Univ. de Grenoble (France)
| | | | | | | | | | | | - A. Chiavassa
- Lab. Lagrange, Univ. Côte d'Azur, Observatoire de la Côte d'Azur (France)
| | | | | | | | | | - I. Di Varano
- Leibniz-Institut für Astrophysik Potsdam (Germany)
| | | | | | | | | | | | | | | | - A. Hatzes
- Thüringer Landessternwarte Tautenburg (Germany)
| | - P. Huke
- Univ. of Göttingen (Germany)
| | | | - I. C. Leão
- Federal Univ. of Rio Grande do Norte (Brazil)
| | | | | | | | | | | | | | | | | | | | | | | | | | - E. Palle
- Instituto de Astrofísica de Canarias (Spain)
| | | | - V. Parro
- Instituto Mauá de Tecnologia (Brazil)
| | - I. Parry
- Univ. of Cambridge (United Kingdom)
| | - F. Pepe
- Univ. de Genève (Switzerland)
| | | | | | | | | | | | | | | | | | | | | | | | - X. Sun
- Univ. of Cambridge (United Kingdom)
| | - S. Udry
- Univ. de Genève (Switzerland)
| | - L. Vanzi
- Pontificia Univ. Católica de Chile (Chile)
| | | | - M. Weber
- Leibniz-Institut für Astrophysik Potsdam (Germany)
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Veloo ACM, de Vries ED, Jean-Pierre H, Justesen US, Morris T, Urban E, Wybo I, van Winkelhoff AJ. The optimization and validation of the Biotyper MALDI-TOF MS database for the identification of Gram-positive anaerobic cocci. Clin Microbiol Infect 2016; 22:793-798. [PMID: 27404365 DOI: 10.1016/j.cmi.2016.06.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/13/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
Abstract
Gram-positive anaerobic cocci (GPAC) account for 24%-31% of the anaerobic bacteria isolated from human clinical specimens. At present, GPAC are under-represented in the Biotyper MALDI-TOF MS database. Profiles of new species have yet to be added. We present the optimization of the matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) database for the identification of GPAC. Main spectral profiles (MSPs) were created for 108 clinical GPAC isolates. Identity was confirmed using 16S rRNA gene sequencing. Species identification was considered to be reliable if the sequence similarity with its closest relative was ≥98.7%. The optimized database was validated using 140 clinical isolates. The 16S rRNA sequencing identity was compared with the MALDI-TOF MS result. MSPs were added from 17 species that were not yet represented in the MALDI-TOF MS database or were under-represented (fewer than five MSPs). This resulted in an increase from 53.6% (75/140) to 82.1% (115/140) of GPAC isolates that could be identified at the species level using MALDI-TOF MS. An improved log score was obtained for 51.4% (72/140) of the strains. For strains with a sequence similarity <98.7% with their closest relative (n = 5) or with an inconclusive sequence identity (n = 4), no identification was obtained by MALDI-TOF MS or in the latter case an identity with one of its relatives. For some species the MSP of the type strain was not part of the confined cluster of the corresponding clinical isolates. Also, not all species formed a homogeneous cluster. It emphasizes the necessity of adding sufficient MSPs of human clinical isolates.
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Affiliation(s)
- A C M Veloo
- Department of Medical Microbiology, University of Groningen, University Medical Centre Groningen, The Netherlands.
| | - E D de Vries
- Department of Medical Microbiology, University of Groningen, University Medical Centre Groningen, The Netherlands
| | - H Jean-Pierre
- Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Laboratoire de Bactériologie, Montpellier, France; Université Montpellier 1, UMR5119 ECOSYM, Equipe Pathogènes Hydriques Santé Environnements, UMR 5569 Hydrosciences, UFR Pharmacie, Montpellier, France
| | - U S Justesen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - T Morris
- UK Anaerobe Reference Unit, Public Health Wales Microbiology, Cardiff, UK
| | - E Urban
- Institute of Clinical Microbiology, University of Szeged, Hungary
| | - I Wybo
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - A J van Winkelhoff
- Department of Medical Microbiology, University of Groningen, University Medical Centre Groningen, The Netherlands; Department of Dentistry and Oral Hygiene, University of Groningen, University Medical Centre Groningen, The Netherlands
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Abstract
The adoption of the incorporated form of ownership in preference to partnership is linked to the shift to a more modem organizational archetype in professional firms. Yet existing empirical research offers insufficient insight into the organizational processes of this transformation in different professional arenas. Where ownership and control become separated, there is a clearer theoretical explanation of the implications for the way the firm is run. Where ownership and control remain inside the firm, however, the consequences are not so clear and have not been well explored. Using survey and interview materials derived from a study of architecture practices, we examine the processes by which differences based on ownership emerge. Then, by drawing on Weberian theories, where they are concerned with professionalization as a project with material and social rewards, we specify more clearly the context for change in professional firms' archetypes. This, we conclude, provides a stronger basis for understanding the change trajectories of firms within professions and comparative organizational analysis between professions.
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Murphy GJ, Verheyden V, Wozniak M, Sullo N, Dott W, Bhudia S, Bittar N, Morris T, Ring A, Tebbatt A, Kumar T. Trial protocol for a randomised controlled trial of red cell washing for the attenuation of transfusion-associated organ injury in cardiac surgery: the REDWASH trial. Open Heart 2016; 3:e000344. [PMID: 26977309 PMCID: PMC4785436 DOI: 10.1136/openhrt-2015-000344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/11/2015] [Accepted: 01/11/2016] [Indexed: 11/29/2022] Open
Abstract
Introduction It has been suggested that removal of proinflammatory substances that accumulate in stored donor red cells by mechanical cell washing may attenuate inflammation and organ injury in transfused cardiac surgery patients. This trial will test the hypotheses that the severity of the postoperative inflammatory response will be less and postoperative recovery faster if patients undergoing cardiac surgery receive washed red cells compared with standard care (unwashed red cells). Methods and analysis Adult (≥16 years) cardiac surgery patients identified at being at increased risk for receiving large volume red cell transfusions at 1 of 3 UK cardiac centres will be randomly allocated in a 1:1 ratio to either red cell washing or standard care. The primary outcome is serum interleukin-8 measured at 5 postsurgery time points up to 96 h. Secondary outcomes will include measures of inflammation, organ injury and volumes of blood transfused and cost-effectiveness. Allocation concealment, internet-based randomisation stratified by operation type and recruiting centre, and blinding of outcome assessors will reduce the risk of bias. The trial will test the superiority of red cell washing versus standard care. A sample size of 170 patients was chosen in order to detect a small-to-moderate target difference, with 80% power and 5% significance (2-tailed). Ethics and dissemination The trial protocol was approved by a UK ethics committee (reference 12/EM/0475). The trial findings will be disseminated in scientific journals and meetings. Trial registration number ISRCTN 27076315.
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Affiliation(s)
- G J Murphy
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit , University of Leicester, Clinical Sciences Wing, Glenfield Hospital , Leicester , UK
| | - V Verheyden
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit , University of Leicester, Clinical Sciences Wing, Glenfield Hospital , Leicester , UK
| | - M Wozniak
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit , University of Leicester, Clinical Sciences Wing, Glenfield Hospital , Leicester , UK
| | - N Sullo
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit , University of Leicester, Clinical Sciences Wing, Glenfield Hospital , Leicester , UK
| | - W Dott
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit , University of Leicester, Clinical Sciences Wing, Glenfield Hospital , Leicester , UK
| | - S Bhudia
- University Hospitals Coventry and Warwickshire NHS Trust , Coventry , UK
| | - N Bittar
- Blackpool Victoria Hospital NHS Trust , Blackpool , UK
| | - T Morris
- Leicester Clinical Trials Unit , Leicester Diabetes Centre, Leicester General Hospital , Leicester , UK
| | - A Ring
- Leicester Clinical Trials Unit , Leicester Diabetes Centre, Leicester General Hospital , Leicester , UK
| | - A Tebbatt
- Department of Clinical Perfusion , University Hospital Leicester NHS Trust, Glenfield Hospital , Leicester , UK
| | - T Kumar
- Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit , University of Leicester, Clinical Sciences Wing, Glenfield Hospital , Leicester , UK
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Morris T, Mason S, O'Keeffe C, Moulton C. WHAT PROPORTION OF PATIENTS ARE ATTENDING THE ED AVOIDABLY? AN ANALYSIS OF THE ROYAL COLLEGE OF EMERGENCY MEDICINE'S SENTINEL SITE SURVEY. Arch Emerg Med 2015. [DOI: 10.1136/emermed-2015-205372.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Morris T, Mason S, O'Keeffe C. ANALYSING VARIATION IN STAFFING LEVELS, ATTENDANCES AND PERFORMANCE AGAINST THE 4-HOUR TARGET USING DATA FROM THE ROYAL COLLEGE OF EMERGENCY MEDICINE'S SENTINEL SITE SURVEY. Arch Emerg Med 2015. [DOI: 10.1136/emermed-2015-205372.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Koehn S, Stavrou NAM, Young JA, Morris T. The applied model of imagery use: Examination of moderation and mediation effects. Scand J Med Sci Sports 2015; 26:975-84. [PMID: 26247483 DOI: 10.1111/sms.12525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Abstract
The applied model of mental imagery use proposed an interaction effect between imagery type and imagery ability. This study had two aims: (a) the examination of imagery ability as a moderating variable between imagery type and dispositional flow, and (b) the testing of alternative mediation models. The sample consisted of 367 athletes from Scotland and Australia, who completed the Sport Imagery Questionnaire, Sport Imagery Ability Questionnaire, and Dispositional Flow Scale-2. Hierarchical regression analysis showed direct effects of imagery use and imagery ability on flow, but no significant interaction. Mediation analysis revealed a significant indirect path, indicating a partially mediated relationship (P = 0.002) between imagery use, imagery ability, and flow. Partial mediation was confirmed when the effect of cognitive imagery use and cognitive imagery ability was tested, and a full mediation model was found between motivational imagery use, motivational imagery ability, and flow. The results are discussed in conjunction with potential future research directions on advancing theory and applications.
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Affiliation(s)
- S Koehn
- School of Health Sciences, Liverpool Hope University, Liverpool, UK
| | - N A M Stavrou
- Faculty of Physical Education and Sport Science, National & Kapodistrian University of Athens, Athens, Greece.,ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - J A Young
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living, Victoria University of Technology, Melbourne, Australia
| | - T Morris
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living, Victoria University of Technology, Melbourne, Australia
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