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Courtene-Jones W, Burgevin F, Munns L, Shillam MBT, De Falco F, Buchard A, Handy RD, Thompson RC, Hanley ME. Deterioration of bio-based polylactic acid plastic teabags under environmental conditions and their associated effects on earthworms. Sci Total Environ 2024:172806. [PMID: 38772795 DOI: 10.1016/j.scitotenv.2024.172806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/23/2024]
Abstract
In response to the plastic waste crisis, teabag producers have substituted the petrochemical-plastic content of their products with bio-based, biodegradable polymers such as polylactic acid (PLA). Despite widespread use, the degradation rate of PLA/PLA-blended materials in natural soil and their effects on soil biota are poorly understood. This study examined the percentage mass deterioration of teabags with differing cellulose:PLA compositions following burial (-10 cm depth) in an arable field margin for 7-months, using a suite of analytical techniques, such as size exclusion chromatography, 1H nuclear magnetic resonance, dynamic scanning calorimetry, and scanning electron microscopy. The effect of 28-d exposure to teabag discs at environmentally relevant concentrations (0.02 %, 0.04 % and 0.07 % w/w) on the survival, growth and reproduction (OECD TG 222 protocol) of the key soil detritivore Eisenia fetida was assessed in laboratory trials. After 7-month burial, Tbag-A (2.4:1 blend) and Tbag-B (3.5:1 cellulose:PLA blend) lost 66 ± 5 % and 78 ± 4 % of their total mass, primarily attributed to degradation of cellulose as identified by FTIR spectroscopy and a reduction in the cellulose:PLA mass ratio, while Tbag-C (PLA) remained unchanged. There were clear treatment and dose-specific effects on the growth and reproductive output of E. fetida. At 0.07 % w/w of Tbag-A adult mortality marginally increased (15 %) and both the quantity of egg cocoons and the average mass of juveniles also increased, while at concentrations ≥0.04 % w/w of Tbag-C, the quantity of cocoons was suppressed. Adverse effects are comparable to those reported for non-biodegradable petrochemical-based plastic, demonstrating that bio-based PLA does not offer a more 'environmentally friendly' alternative. Our study emphasises the necessity to better understand the environmental fate and ecotoxicity of PLA/PLA-blends to ensure interventions developed through the UN Plastic Pollution Treaty to use alternatives and substitutes to conventional plastics do not result in unintended negative consequences.
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Affiliation(s)
- W Courtene-Jones
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK.
| | - F Burgevin
- Institute for Sustainability, Department of Chemistry, University of Bath, Bath BA2 7AY, UK
| | - L Munns
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK
| | - M B T Shillam
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK
| | - F De Falco
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK; School of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, PL4 8AA Plymouth, Devon, UK
| | - A Buchard
- Institute for Sustainability, Department of Chemistry, University of Bath, Bath BA2 7AY, UK
| | - R D Handy
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK
| | - R C Thompson
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK
| | - M E Hanley
- School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK
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Sakhi H, Chawki S, Buchard A, Dardim K, Boulanger H, Mokhtar C, Tomek K, Dominique J, Philippe A, El Karoui K. Impact à long terme du COVID-19 chez les patients dialysés. Nephrol Ther 2021. [PMCID: PMC8435329 DOI: 10.1016/j.nephro.2021.07.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction Les patients dialysés présentent un risque important de forme sévère de COVID-19 avec une mortalité élevée à la phase initiale. Cependant, les conséquences à long terme de cette pathologie dans cette population sont peu décrites. Nous rapportons ici le suivi à long terme des patients en hémodialyse, touchés par le COVID-19. Description Il s’agit d’une étude rétrospective sur patients dialysés affectés par le COVID-19 dans 19 centres de la région parisienne. Méthodes L’analyse concerne la description de la présentation clinique et du suivi à long terme de ces patients. Résultats Dans cette cohorte de 248 patients avec un taux de mortalité initial de 18 %, l’âge, les comorbidités, la dyspnée et un traitement immunosuppresseur antérieur étaient associés au décès dans les 30 premiers jours. Parmi les 203 patients survivants après la phase aiguë, le suivi à long terme (médiane 180 jours) était disponible pour 189 (93 %) patients. Des complications majeurs (cardiovasculaires, infections sévères ou tout autre événement menant à une hospitalisation) sont survenues chez 30 (16 %) patients au cours du suivi, dont 12 décès (6 %) après une médiane de 78 jours à compter de l’apparition des symptômes. Un âge plus avancé, un taux d’albumine plus faible au moment du diagnostic et des comorbidités cardiovasculaires présentaient des tendances d’association avec le décès à long terme. Dans l’ensemble, les événements cardiovasculaires, les infections et les hémorragies gastro-intestinales ont été les principales complications. Une cachexie post-COVID-19 a été observée chez 25/189 (13 %) patients. Une albuminémie initiale plus faible était significativement associée à ce syndrome. Aucune réinfection par le SARS-CoV-2 n’a été observée sur la période de 6 mois. Conclusion Ce travail montre les conséquences à long terme du COVID-19 chez les patients dialysés, mettant en évidence la sévérité initiale et à long terme de la maladie, associé notamment à une cachexie chez 13 % des patients.
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Chawki S, Sakhi H, Buchard A, Dardim K, Chawki M, Boulanger H, Kofman T, Joly D, El Karoui K, Attias P. COVID-19 chez les patients dialysés, expérience multicentrique en Île-de-France. Nephrol Ther 2020. [PMCID: PMC7494279 DOI: 10.1016/j.nephro.2020.07.055] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction La pandémie de COVID-19 a été à l’origine d’une crise sanitaire sans précédent. Nous décrivons la présentation clinique, l’évolution et les facteurs pronostiques au sein d’une vaste cohorte de patients hémodialysés. Description/Méthodes Il s’agit d’une étude rétrospective de l’ensemble des patients COVID-19 diagnostiqués par PCR ou imagerie compatible dans dix-neuf centres de dialyse en Île-de-France entre le 5 février et le 1er mai 2020. Nous rapportons l’évolution des patients à un mois. Les facteurs de risque de mortalité à la fin du suivi ont été déterminés par une régression logistique multivariée et l’effet des traitements a été analysé par score de propension. Résultats Une maladie COVID-19 a été diagnostiquée chez 248 patients (hommes 66 %, âge 67 ± 15 ans, ancienneté en dialyse de 5 ± 5 ans, suivi moyen de 39 ± 20 jours). La présentation clinique incluait fièvre (n = 152 ; 61 %), toux (n = 121 ; 49 %) et asthénie (n = 101 ; 41 %). Une diarrhée aiguë était présente dans 12 % des cas (n = 29). Cent quarante-deux patients (57 %) ont été hospitalisés et 46 sont décédés (mortalité globale 18 %, mortalité des hospitalisés 30 %). En analyse multivariée, un traitement immunosuppresseur (OR = 7,54 [2,39–24,96] ; p < 0,001) ; l’âge (OR = 1,06 [1,02–1,10] ; p = 0,002), ainsi que la dyspnée (OR = 2,9 [1,24–7,07] ; p = 0,014) étaient prédicteurs de la mortalité. La prescription d’hydroxychloroquine (avec ou sans azithromycine) (OR = 0,94 [0,38–2,09] ; p = 0,9) et les différents traitements antibiotiques n’étaient associés à aucune réduction significative de la mortalité. Conclusion Notre étude montre une mortalité importante des patients hémodialysés atteints de COVID-19. L’âge, le traitement immunosuppresseur et la présence d’une dyspnée étaient les prédicteurs indépendants du décès dans cette cohorte.
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Peiffer-Smadja N, Rawson TM, Ahmad R, Buchard A, Georgiou P, Lescure FX, Birgand G, Holmes AH. Corrigendum to 'machine learning for clinical decision support in infectious diseases: a narrative review of current applications' clinical microbiology and infection (2020) 584-595. Clin Microbiol Infect 2020; 26:1118. [PMID: 32450256 DOI: 10.1016/j.cmi.2020.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- N Peiffer-Smadja
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK; French Institute for Medical Research (Inserm), Infection Antimicrobials Modelling Evolution (IAME), UMR, 1137, University Paris Diderot, Paris, France.
| | - T M Rawson
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - R Ahmad
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | | | - P Georgiou
- Department of Electrical and Electronic Engineering, Imperial College, London, UK
| | - F-X Lescure
- French Institute for Medical Research (Inserm), Infection Antimicrobials Modelling Evolution (IAME), UMR, 1137, University Paris Diderot, Paris, France; Infectious Diseases Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hˆopitaux de Paris, Paris, France
| | - G Birgand
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - A H Holmes
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
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Peiffer-Smadja N, Rawson TM, Ahmad R, Buchard A, Georgiou P, Lescure FX, Birgand G, Holmes AH. Machine learning for clinical decision support in infectious diseases: a narrative review of current applications. Clin Microbiol Infect 2019; 26:584-595. [PMID: 31539636 DOI: 10.1016/j.cmi.2019.09.009] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [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: 06/27/2019] [Revised: 08/29/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Machine learning (ML) is a growing field in medicine. This narrative review describes the current body of literature on ML for clinical decision support in infectious diseases (ID). OBJECTIVES We aim to inform clinicians about the use of ML for diagnosis, classification, outcome prediction and antimicrobial management in ID. SOURCES References for this review were identified through searches of MEDLINE/PubMed, EMBASE, Google Scholar, biorXiv, ACM Digital Library, arXiV and IEEE Xplore Digital Library up to July 2019. CONTENT We found 60 unique ML-clinical decision support systems (ML-CDSS) aiming to assist ID clinicians. Overall, 37 (62%) focused on bacterial infections, 10 (17%) on viral infections, nine (15%) on tuberculosis and four (7%) on any kind of infection. Among them, 20 (33%) addressed the diagnosis of infection, 18 (30%) the prediction, early detection or stratification of sepsis, 13 (22%) the prediction of treatment response, four (7%) the prediction of antibiotic resistance, three (5%) the choice of antibiotic regimen and two (3%) the choice of a combination antiretroviral therapy. The ML-CDSS were developed for intensive care units (n = 24, 40%), ID consultation (n = 15, 25%), medical or surgical wards (n = 13, 20%), emergency department (n = 4, 7%), primary care (n = 3, 5%) and antimicrobial stewardship (n = 1, 2%). Fifty-three ML-CDSS (88%) were developed using data from high-income countries and seven (12%) with data from low- and middle-income countries (LMIC). The evaluation of ML-CDSS was limited to measures of performance (e.g. sensitivity, specificity) for 57 ML-CDSS (95%) and included data in clinical practice for three (5%). IMPLICATIONS Considering comprehensive patient data from socioeconomically diverse healthcare settings, including primary care and LMICs, may improve the ability of ML-CDSS to suggest decisions adapted to various clinical contexts. Currents gaps identified in the evaluation of ML-CDSS must also be addressed in order to know the potential impact of such tools for clinicians and patients.
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Affiliation(s)
- N Peiffer-Smadja
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK; French Institute for Medical Research (Inserm), Infection Antimicrobials Modelling Evolution (IAME), UMR 1137, University Paris Diderot, Paris, France.
| | - T M Rawson
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - R Ahmad
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | | | - P Georgiou
- Department of Electrical and Electronic Engineering, Imperial College, London, UK
| | - F-X Lescure
- French Institute for Medical Research (Inserm), Infection Antimicrobials Modelling Evolution (IAME), UMR 1137, University Paris Diderot, Paris, France; Infectious Diseases Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - G Birgand
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - A H Holmes
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
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Schultz ANØ, Høiby N, Nielsen XC, Pressler T, Dalhoff K, Duno M, Buchard A, Johansen HK, Wang H, Dalbøge CS. Individual pharmacokinetic variation leads to underdosing of ciprofloxacin in some cystic fibrosis patients. Pediatr Pulmonol 2017; 52:319-323. [PMID: 28221736 DOI: 10.1002/ppul.23638] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/11/2016] [Revised: 10/15/2016] [Accepted: 10/25/2016] [Indexed: 11/09/2022]
Abstract
Ciprofloxacin (CIP) is frequently used when treating cystic fibrose (CF) patients with intermittent Pseudomonas aeruginosa (P. aeruginosa) lung colonization. However, approximately 20% of the patients progress to chronic infection despite early intervention. The aim of this study, was to investigate the pharmacokinetics of CIP, to evaluate if CYP3A4-related metabolism is involved and to find the optimal dose needed to eradicate intermittently colonizing bacteria in the lungs of CF patients. Methods An open-label, prospective pharmacokinetic study was performed. Twenty-two adult CF-patients were each given 500 mg CIP orally. One blood sample was taken at t = 0, and the following 12 hr, nine blood samples were collected. The optimal dose and interval was then calculated by Monte Carlo simulation. CYP3A4-activity was mesured using the Erythromycin Breath Test (ERMBT). Results A 14-fold variation in AUC for the 500 mg CIP (median 473.5 µg/ml × min), and a 30-fold variation in Cmax for CIP (median 2 µg/ml) was found. For CYP3A4-activity the variation was 8-fold. No correlation was found between the CYP3A4-activity and CIP-concentrations. The probability of eradicating intermittent P. aeruginosa colonization in the lungs of CF patients was found to be 57% (3 doses/day), when 500 mg CIP was given. It was calculated to be 89% (2 doses/day) and 94% (3 doses/day), respectivly if 750 mg CIP had been given. Conclusion A large pharmacokinetic difference of CIP in CF patiens was found, not explained by CYP3A4 variation. CIP should be given at 750 mg two or three times daily to adult CF patients with intermittently colonization. Pediatr Pulmonol. 2017;52:319-323. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- A N Ø Schultz
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark
| | - N Høiby
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark.,Insitute of Immunology and Microbiology, University of Copenhagen, Denmark
| | - X C Nielsen
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark
| | - T Pressler
- Cystic Fibrosis Center, Rigshospitalet, University of Copenhagen, Denmark
| | - K Dalhoff
- Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark
| | - M Duno
- Department of Clinical Genetics, Rigshospitalet, University of Copenhagen, Denmark
| | - A Buchard
- Department of Forensic Medicine, University of Copenhagen, Denmark
| | - H K Johansen
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark
| | - H Wang
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark
| | - C S Dalbøge
- Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark
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Schultz A, Høiby N, Nielsen X, Pressler T, Dalhoff K, Duno M, Buchard A, Johansen H, Dalbøge C. 116 Pharmacokinetic variability of ciprofloxacin in cystic fibrosis – is CYP3A4 involved? J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30293-9] [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: 10/23/2022]
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Dalbøge C, Nielsen X, Dalhoff K, Alffenaar J, Duno M, Buchard A, Uges D, Jensen A, Jürgens G, Pressler T, Johansen H, Høiby N. Pharmacokinetic variability of clarithromycin and differences in CYP3A4 activity in patients with cystic fibrosis. J Cyst Fibros 2014; 13:179-85. [DOI: 10.1016/j.jcf.2013.08.008] [Citation(s) in RCA: 10] [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] [Received: 04/28/2013] [Revised: 07/08/2013] [Accepted: 08/20/2013] [Indexed: 01/02/2023]
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Dalsgaard S, Rockenbauer E, Buchard A, Mogensen H, Frank-Hansen R, Børsting C, Morling N. Non-uniform phenotyping of D12S391 resolved by second generation sequencing. Forensic Sci Int Genet 2014; 8:195-9. [DOI: 10.1016/j.fsigen.2013.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/23/2013] [Accepted: 09/24/2013] [Indexed: 11/30/2022]
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Dalboege C, Nielsen X, Dalhoff K, Duno M, Buchard A, Jensen A, Pressler T, Wang H, Høiby N, Johansen H. WS5.3 Wide pharmacokinetic variability of ciprofloxacin in patients with cystic fibrosis (CF) – a reason of treatment failure? J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60036-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ney R, Podlesch I, Buchard A, Seemann K, Wandel A. [Indications for active surgical procedures within the area hyperbaric oxygen therapy for gas edema. Experiences with 42 gas edema infections]. Langenbecks Arch Chir 1970; 327:766-71. [PMID: 5111161 DOI: 10.1007/bf01259129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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