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Lloyd A, Roiser JP, Skeen S, Freeman Z, Badalova A, Agunbiade A, Busakhwe C, DeFlorio C, Marcu A, Pirie H, Saleh R, Snyder T, Fearon P, Viding E. Reviewing explore/exploit decision-making as a transdiagnostic target for psychosis, depression, and anxiety. Cogn Affect Behav Neurosci 2024:10.3758/s13415-024-01186-9. [PMID: 38653937 DOI: 10.3758/s13415-024-01186-9] [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] [Accepted: 03/27/2024] [Indexed: 04/25/2024]
Abstract
In many everyday decisions, individuals choose between trialling something novel or something they know well. Deciding when to try a new option or stick with an option that is already known to you, known as the "explore/exploit" dilemma, is an important feature of cognition that characterises a range of decision-making contexts encountered by humans. Recent evidence has suggested preferences in explore/exploit biases are associated with psychopathology, although this has typically been examined within individual disorders. The current review examined whether explore/exploit decision-making represents a promising transdiagnostic target for psychosis, depression, and anxiety. A systematic search of academic databases was conducted, yielding a total of 29 studies. Studies examining psychosis were mostly consistent in showing that individuals with psychosis explored more compared with individuals without psychosis. The literature on anxiety and depression was more heterogenous; some studies found that anxiety and depression were associated with more exploration, whereas other studies demonstrated reduced exploration in anxiety and depression. However, examining a subset of studies that employed case-control methods, there was some evidence that both anxiety and depression also were associated with increased exploration. Due to the heterogeneity across the literature, we suggest that there is insufficient evidence to conclude whether explore/exploit decision-making is a transdiagnostic target for psychosis, depression, and anxiety. However, alongside our advisory groups of lived experience advisors, we suggest that this context of decision-making is a promising candidate that merits further investigation using well-powered, longitudinal designs. Such work also should examine whether biases in explore/exploit choices are amenable to intervention.
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Affiliation(s)
- Alex Lloyd
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sarah Skeen
- Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Ze Freeman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Aygun Badalova
- Institute of Neurology, University College London, London, UK
| | | | | | | | - Anna Marcu
- Young People's Advisor Group, London, UK
| | | | | | | | - Pasco Fearon
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Essi Viding
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
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Viding E, Lloyd A, Law R, Martin P, Lucas L, Wu TCH, Steinbeis N, Midgley N, Veenstra R, Smith J, Ly L, Bird G, Murphy J, Plans D, Munafo M, Penton-Voak I, Deighton J, Richards K, Richards M, Fearon P. Trial protocol for the Building Resilience through Socio-Emotional Training (ReSET) programme: a cluster randomised controlled trial of a new transdiagnostic preventative intervention for adolescents. Trials 2024; 25:143. [PMID: 38395922 PMCID: PMC10885387 DOI: 10.1186/s13063-024-07931-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Adolescence is a period of heightened vulnerability to developing mental health problems, and rates of mental health disorder in this age group have increased in the last decade. Preventing mental health problems developing before they become entrenched, particularly in adolescents who are at high risk, is an important research and clinical target. Here, we report the protocol for the trial of the 'Building Resilience through Socioemotional Training' (ReSET) intervention. ReSET is a new, preventative intervention that incorporates individual-based emotional training techniques and group-based social and communication skills training. We take a transdiagnostic approach, focusing on emotion processing and social mechanisms implicated in the onset and maintenance of various forms of psychopathology. METHODS A cluster randomised allocation design is adopted with randomisation at the school year level. Five-hundred and forty adolescents (aged 12-14) will be randomised to either receive the intervention or not (passive control). The intervention is comprised of weekly sessions over an 8-week period, supplemented by two individual sessions. The primary outcomes, psychopathology symptoms and mental wellbeing, will be assessed pre- and post-intervention, and at a 1-year follow-up. Secondary outcomes are task-based assessments of emotion processing, social network data based on peer nominations, and subjective ratings of social relationships. These measures will be taken at baseline, post-intervention and 1-year follow-up. A subgroup of participants and stakeholders will be invited to take part in focus groups to assess the acceptability of the intervention. DISCUSSION This project adopts a theory-based approach to the development of a new intervention designed to target the close connections between young people's emotions and their interpersonal relationships. By embedding the intervention within a school setting and using a cluster-randomised design, we aim to develop and test a feasible, scalable intervention to prevent the onset of psychopathology in adolescence. TRIAL REGISTRATION ISRCTN88585916. Trial registration date: 20/04/2023.
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Affiliation(s)
- Essi Viding
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Alex Lloyd
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
| | - Roslyn Law
- Anna Freud National Centre for Children and Families, London, UK
| | - Peter Martin
- Applied Health Research Institute of Epidemiology & Health, University College London, London, UK
| | - Laura Lucas
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
| | - Tom Chin-Han Wu
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
| | - Nikolaus Steinbeis
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
| | - Nick Midgley
- Anna Freud National Centre for Children and Families, London, UK
| | - René Veenstra
- Department of Sociology, University of Groningen, Groningen, Germany
| | - Jaime Smith
- Anna Freud National Centre for Children and Families, London, UK
| | - Lili Ly
- Anna Freud National Centre for Children and Families, London, UK
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, London, UK
| | - David Plans
- Department of Psychology, Royal Holloway, University of London, London, UK
| | - Marcus Munafo
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol Medical School, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Ian Penton-Voak
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Jessica Deighton
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
- Anna Freud National Centre for Children and Families, London, UK
| | | | | | - Pasco Fearon
- Clinical, Educational and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
- Centre for Family Research, Department of Psychology, University of Cambridge, Downing Pl, Cambridge, CB2 3EB, UK.
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Lloyd A, Viding E, McKay R, Furl N. Understanding patch foraging strategies across development. Trends Cogn Sci 2023; 27:1085-1098. [PMID: 37500422 DOI: 10.1016/j.tics.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Abstract
Patch foraging is a near-ubiquitous behaviour across the animal kingdom and characterises many decision-making domains encountered by humans. We review how a disposition to explore in adolescence may reflect the evolutionary conditions under which hunter-gatherers foraged for resources. We propose that neurocomputational mechanisms responsible for reward processing, learning, and cognitive control facilitate the transition from exploratory strategies in adolescence to exploitative strategies in adulthood - where individuals capitalise on known resources. This developmental transition may be disrupted by psychopathology, as there is emerging evidence of biases in explore/exploit choices in mental health problems. Explore/exploit choices may be an informative marker for mental health across development and future research should consider this feature of decision-making as a target for clinical intervention.
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Affiliation(s)
- Alex Lloyd
- Clinical, Educational, and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - Essi Viding
- Clinical, Educational, and Health Psychology, Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX, UK
| | - Nicholas Furl
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX, UK
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Lloyd A, Broadbent A, Brooks E, Bulsara K, Donoghue K, Saijaf R, Sampson KN, Thomson A, Fearon P, Lawrence PJ. The impact of family interventions on communication in the context of anxiety and depression in those aged 14-24 years: systematic review of randomised control trials. BJPsych Open 2023; 9:e161. [PMID: 37641851 PMCID: PMC10594091 DOI: 10.1192/bjo.2023.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 07/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The ability to communicate is integral to all human relationships. Previous research has specifically highlighted communication within families as both a risk and protective factor for anxiety disorders and/or depression. Yet, there is limited understanding about whether communication is amenable to intervention in the context of adolescent psychopathology, and whether doing so improves outcomes. AIMS The aim of this systematic review was to determine in which contexts and for whom does addressing communication in families appear to work, not work and why? METHOD We pre-registered our systematic review with PROSPERO (identifier CRD42022298719), followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and assessed study quality with the Risk of Bias 2 tool. RESULTS Seven randomised controlled trials were identified from a systematic search of the literature. There was significant heterogeneity in the features of communication that were measured across these studies. There were mixed findings regarding whether family-focused interventions led to improvements in communication. Although there was limited evidence that family-focused interventions led to improvements in communication relative to interventions without a family-focused component, we discuss these findings in the context of the significant limitations in the studies reviewed. CONCLUSIONS We conclude that further research is required to assess the efficacy of family-focused interventions for improving communication in the context of anxiety and depression in those aged 14-24 years.
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Affiliation(s)
- Alex Lloyd
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | | | | | | | - Kim Donoghue
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | | | - Katie N. Sampson
- National Collaborating Centre for Mental Health, The Royal College of Psychiatrists, London, UK
| | - Abigail Thomson
- Department of Experimental Psychology, University of Oxford, UK
| | - Pasco Fearon
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK; Department of Psychology, University of Cambridge, UK; and Developmental Neuroscience Unit, Anna Freud Centre, London, UK
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Bennett KM, Panzeri A, Derrer-Merk E, Butter S, Hartman TK, Mason L, McBride O, Murphy J, Shevlin M, Gibson-Miller J, Levita L, Martinez AP, McKay R, Lloyd A, Stocks TVA, Bottesi G, Vidotto G, Bentall RP, Bertamini M. Predicting resilience during the COVID-19 Pandemic in the United Kingdom: Cross-sectional and longitudinal results. PLoS One 2023; 18:e0283254. [PMID: 37167208 PMCID: PMC10174573 DOI: 10.1371/journal.pone.0283254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/04/2023] [Indexed: 05/13/2023] Open
Abstract
Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the COVID-19 Psychological Research Consortium (C19PRC) longitudinal study of a representative sample of the United Kingdom (UK) adult population and data from an Italian arm of the study. We first compare data from the third wave of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the EMR, predict resilient and non-resilient outcomes. We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and Post Traumatic Stress Disorder (PTSD) symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes. In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes. The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges.
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Affiliation(s)
- Kate M Bennett
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Anna Panzeri
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, United Kingdom
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Jilly Gibson-Miller
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Liat Levita
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, London, United Kingdom
| | - Alex Lloyd
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Thomas V A Stocks
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Gioa Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giulo Vidotto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Marco Bertamini
- Department of General Psychology, University of Padova, Padova, Italy
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Mayadev J, Rong Y, Toita T, Tarnawski R, Mahantshetty U, Rey F, Nunes A, Lloyd A, Wildsmith S, Dry H, Monk B. Durvalumab in Combination with Chemoradiotherapy (CRT) in Locally Advanced Cervical Cancer (LACC): Radiotherapy (RT) Delivery and Subgroup Analyses from CALLA. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McBride O, Butter S, Murphy J, Hartman TK, McKay R, Hyland P, Shevlin M, Bennett KM, Stocks TVA, Lloyd A, Gibson-Miller J, Levita L, Mason L, Martinez AP, Vallières F, Karatzias T, Bentall RP. Tracking the psychological and socio-economic impact of the COVID-19 pandemic in the UK: A methodological report from Wave 5 of the COVID-19 Psychological Research Consortium (C19PRC) Study. Int J Methods Psychiatr Res 2022; 31:e1928. [PMID: 35759532 PMCID: PMC9349513 DOI: 10.1002/mpr.1928] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 05/20/2022] [Accepted: 06/08/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The COVID-19 Psychological Research Consortium (C19PRC) Study was established in March 2020 to monitor the psychological and socio-economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 5 (March-April 2021). METHODS The survey assessed: COVID-19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adults who participated in any previous wave (N = 4949) were re-invited to participate. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was nationally representative in terms of gender, age, and household income, amongst other factors. RESULTS Overall, 2520 adults participated. A total of 2377 adults who participated in the previous survey wave (November-December 2020) were re-interviewed at Wave 5 (61.5% retention rate). Attrition between these two waves was predicted by younger age, lower household income, children living in the household, and treatment for mental health difficulties. Of the adults recruited into the C19PRC study at baseline, 57.4% (N = 1162) participated in Wave 5. The raking procedure re-balanced the longitudinal panel to within 1.5% of population estimates for selected socio-demographic characteristics. CONCLUSION This paper outlines the growing strength of the publicly available C19PRC Study data for COVID-19-related interdisciplinary research.
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Affiliation(s)
| | | | | | | | - Ryan McKay
- Royal Holloway, University of London, Egham, UK
| | | | | | | | | | - Alex Lloyd
- Royal Holloway, University of London, Egham, UK
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Charuvila S, Lloyd A, Bhardwaj N, Lloyd D. 542 Laparoscopic Division of a Congenital Splenogonadal Portosystemic Shunt: A Case Report. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.136] [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: 11/05/2022]
Abstract
Abstract
We describe a rare congenital portosystemic shunt. A 37-year-old woman was found to have a previously unreported congenital shunt following investigations into secondary causes of hypertension. The abnormal venous shunt connected the splenic vein to the left ovarian vein. The patient underwent a laparoscopic procedure to successfully divide the shunt. She made a full recovery without complications. To our knowledge, this is the first presentation of a congenital portosystemic shunt involving the splenic and ovarian veins to be reported. This case demonstrates that such a shunt can be amenable for laparoscopic management. The case report shows preoperative scans and intraoperative images.
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Affiliation(s)
- S Charuvila
- University Hospitals Leicester , Leicester , United Kingdom
| | - A Lloyd
- Hull York Medical School , Hull , United Kingdom
| | - N Bhardwaj
- University Hospitals Leicester , Leicester , United Kingdom
| | - D Lloyd
- University Hospitals Leicester , Leicester , United Kingdom
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Lloyd A, Fiala D, Heyde C, Havenith G. A mathematical model for predicting cardiovascular responses at rest and during exercise in demanding environmental conditions. J Appl Physiol (1985) 2022; 133:247-261. [PMID: 35652831 PMCID: PMC9342140 DOI: 10.1152/japplphysiol.00619.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The present research describes the development and validation of a cardiovascular model (CVR Model) for use in conjunction with advanced thermophysiological models, where usually only a total cardiac output is estimated. The CVR Model detailed herein estimates cardio-dynamic parameters (changes in cardiac output, stroke volume, and heart rate), regional blood flow, and muscle oxygen extraction, in response to rest and physical workloads, across a range of ages and aerobic fitness levels, as well as during exposure to heat, dehydration, and altitude. The model development strategy was to first establish basic resting and exercise predictions for cardio-dynamic parameters in an "ideal" environment (cool, sea level, and hydrated person). This basic model was then advanced for increasing levels of altitude, heat strain, and dehydration, using meta-analysis and reaggregation of published data. Using the estimated altitude- and heat-induced changes in maximum oxygen extraction and maximum cardiac output, the decline in maximum oxygen consumption at high altitude and in the heat was also modeled. A validation of predicted cardiovascular strain using heart rate was conducted using a dataset of 101 heterogeneous individuals (1,371 data points) during rest and exercise in the heat and at altitude, demonstrating that the CVR Model performs well (R2 = 0.82-0.84) in predicting cardiovascular strain, particularly at a group mean level (R2 = 0.97). The development of the CVR Model is aimed at providing the Fiala thermal Physiology & Comfort (FPC) Model and other complex thermophysiological models with improved estimations of cardiac strain and exercise tolerance, across a range of individuals during acute exposure to environmental stressors.NEW & NOTEWORTHY The present research promotes the adaption of thermophysiological modeling to the estimation of cardiovascular strain in individuals exercising under acute environmental stress. Integration with advanced models of human thermoregulation opens doors for detailed numerical analysis of athletes' performance and physiology during exercise, occupational safety, and individual work tolerability. The research provides a simple-to-validate metric of cardiovascular function (heart rate), as well as a method to evaluate key principles influencing exercise- and thermoregulation in humans.
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Affiliation(s)
- Alex Lloyd
- 1Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Dusan Fiala
- 2ERGONSIM—Human Thermal Modelling, Messstetten, Germany
| | | | - George Havenith
- 1Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Law BS, Madani G, Lloyd A, Gonsalves L, Hall L, Sujaraj A, Brassil T, Turbill C. Australia's 2019–20 mega‐fires are associated with lower occupancy of a rainforest‐dependent bat. Anim Conserv 2022. [DOI: 10.1111/acv.12805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- B. S. Law
- Forest Science, NSW Primary Industries Australia
| | | | - A. Lloyd
- Department of Planning Industry and Environment Coffs Harbour NSW Australia
| | - L. Gonsalves
- Forest Science, NSW Primary Industries Australia
| | - L. Hall
- 148 Headland Drive Gerroa NSW Australia
| | - A. Sujaraj
- 66 Oatlands St Wentworthville NSW Australia
| | - T. Brassil
- Forest Science, NSW Primary Industries Australia
| | - C. Turbill
- School of Science Western Sydney University, Hawkesbury Campus Richmond NSW Australia
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Hennessy G, Boland M, Bambrick M, Crone L, Lloyd A, Abdelwahab S, Downey E, Staunton M, Hambly N, Mhuircheartaigh NN, Kerr J, Power C, Duke D, Hill ADK. Value of long-term follow-up in surgically excised lesions of uncertain malignant potential in the breast – Is 5 years necessary? Clin Breast Cancer 2022; 22:699-704. [DOI: 10.1016/j.clbc.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/30/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
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McBride O, Butter S, Murphy J, Shevlin M, Hartman TK, Bennett KM, Stocks TVA, Lloyd A, McKay R, Gibson-Miller J, Levita L, Mason L, Martinez AP, Hyland P, Vallières F, Karatzias T, Valiente C, Vazquez C, Bentall RP. Design, content, and fieldwork procedures of the COVID-19 Psychological Research Consortium (C19PRC) Study - Wave 4. Int J Methods Psychiatr Res 2022; 31:e1899. [PMID: 34739156 PMCID: PMC8646695 DOI: 10.1002/mpr.1899] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This paper outlines fieldwork procedures for Wave 4 of the COVID-19 Psychological Research Consortium (C19PRC) Study in the UK during November-December 2020. METHODS Respondents provided data on socio-political attitudes, beliefs, and behaviours, and mental health disorders (anxiety, depression, and posttraumatic stress). In Phase 1, adults (N = 2878) were reinvited to participate. At Phase 2, new recruitment: (i) replenished the longitudinal strand to account for attrition; and (ii) oversampled from the devolved UK nations to facilitate robust between-country analyses for core study outcomes. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was representative of the baseline sample characteristics. RESULTS In Phase 1, 1796 adults were successfully recontacted and provided full interviews at Wave 4 (62.4% retention rate). In Phase 2, 292 new respondents were recruited to replenish the panel, as well as 1779 adults from Wales, Scotland, and Northern Ireland, who were representative of the socio-political composition of the adult populations in these nations. The raking procedure successfully re-balanced the longitudinal panel to within 1% of population estimates for selected socio-demographic characteristics. CONCLUSION The C19PRC Study offers a unique opportunity to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID-19 pandemic.
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Affiliation(s)
- Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | | | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | | | | | | | - Alex Lloyd
- Royal Holloway, University of London, London, England
| | - Ryan McKay
- Royal Holloway, University of London, London, England
| | | | | | - Liam Mason
- University College London, London, England
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McBride O, Butter S, Hartman TK, Murphy J, Hyland P, Shevlin M, Gibson-Miller J, Levita L, Mason L, Martinez AP, McKay R, Lloyd A, Stocks TVA, Bennett KM, Vallières F, Karatzias T, Valiente C, Vazquez C, Contreras A, Bertamini M, Panzeri A, Bruno G, Bentall RP. Sharing data to better understand one of the world's most significant shared experiences: data resource profile of the longitudinal COVID-19 psychological research consortium (C19PRC) study. Int J Popul Data Sci 2022; 5:1704. [PMID: 35310464 PMCID: PMC8900652 DOI: 10.23889/ijpds.v5i4.1704] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This paper serves to alert IJPDS readers to the availability of a major new longitudinal survey data resource, the COVID-19 Psychological Research Consortium (C19PRC) Study, which is being released for secondary use via the Open Science Framework. The C19PRC Study is a rich and detailed dataset that provides a convenient and valuable foundation from which to study the social, political, and health status of European adults during an unprecedented time of change as a direct result of the COVID-19 pandemic and Brexit. Here, we provide an overview of the C19PRC Study design, with the purpose of stimulating interest about the study among social scientists and maximising use of this resource.
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Affiliation(s)
- Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland, BT52 1SA
| | - Sarah Butter
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
| | - Todd K. Hartman
- Department of Social Statistics, University of Manchester, Manchester, England, M13 9PL
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, Northern Ireland, BT52 1SA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland, W23 F2K8
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, BT52 1SA
| | - Jilly Gibson-Miller
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, England, WC1E 6BT
| | - Anton P. Martinez
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, London, England, TW20 0EX
| | - Alex Lloyd
- Department of Psychology, Royal Holloway, University of London, London, England, TW20 0EX
| | - Thomas VA Stocks
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
| | - Kate M Bennett
- Department of Psychology, University of Liverpool, Liverpool, England, L69 3BX
| | | | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, EH11 4BN
| | - Carmen Valiente
- Department of Psychology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Carmelo Vazquez
- Department of Psychology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Alba Contreras
- Department of Psychology Université Catholique de Louvain, 1348 Ottignies-Louvain-la-Neuve, Belgium
| | - Marco Bertamini
- Department of Psychology, University of Liverpool, Liverpool, England, L69 3BX
- Department of Psychology, University of Padua, 35122 Padova, Italy
| | - Anna Panzeri
- School of Psychology, Ulster University, Coleraine, Northern Ireland, BT52 1SA
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
| | - Giovanni Bruno
- Department of Psychology, University of Padua, 35122 Padova, Italy
| | - Richard P. Bentall
- Department of Psychology, University of Sheffield, Sheffield, England, S10 2TN
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Lloyd A, McKay RT, Furl N. Individuals with adverse childhood experiences explore less and underweight reward feedback. Proc Natl Acad Sci U S A 2022; 119:e2109373119. [PMID: 35046026 PMCID: PMC8794829 DOI: 10.1073/pnas.2109373119] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
Adverse childhood experiences (ACEs) are extreme stressors that lead to negative psychosocial outcomes in adulthood. Nonhuman animals explore less after exposure to early stress. Therefore, in this preregistered study, we hypothesized that reduced exploration following ACEs would also be evident in human adults. Further, we predicted that adults with ACEs, in a foraging task, would adopt a decision-making policy that relies on the most-recent reward feedback, a rational strategy for unstable environments. We analyzed data from 145 adult participants, 47 with four or more ACEs and 98 with fewer than four ACEs. In the foraging task, participants evaluated the trade-off between exploiting a known patch with diminishing rewards and exploring a novel one with a fresh distribution of rewards. Using computational modeling, we quantified the degree to which participants' decisions weighted recent feedback. As predicted, participants with ACEs explored less. However, contrary to our hypothesis, they underweighted recent feedback. These unexpected findings indicate that early adversity may dampen reward sensitivity. Our results may help to identify cognitive mechanisms that link childhood trauma to the onset of psychopathology.
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Affiliation(s)
- Alex Lloyd
- Department of Psychology, Royal Holloway, University of London, Egham TW20 0EX, England
| | - Ryan Thomas McKay
- Department of Psychology, Royal Holloway, University of London, Egham TW20 0EX, England
| | - Nicholas Furl
- Department of Psychology, Royal Holloway, University of London, Egham TW20 0EX, England
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O'Keeffe K, Dean J, Hodder S, Lloyd A. Self-Selected Motivational Music Enhances Physical Performance in Normoxia and Hypoxia in Young Healthy Males. Front Psychol 2021; 12:787496. [PMID: 34956012 PMCID: PMC8702523 DOI: 10.3389/fpsyg.2021.787496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Humans exposed to hypoxia are susceptible to physiological and psychological impairment. Music has ergogenic effects through enhancing psychological factors such as mood, emotion, and cognition. This study aimed to investigate music as a tool for mitigating the performance decrements observed in hypoxia. Thirteen males (mean ± SD; 24 ± 4 years) completed one familiarization session and four experimental trials; (1) normoxia (sea level, 0.209 FiO2) and no music; (2) normoxia (0.209 FiO2) with music; (3) normobaric hypoxia (∼3800 m, 0.13 FiO2) and no music; and (4) normobaric hypoxia (0.13 FiO2) with music. Experimental trials were completed at 21°C with 50% relative humidity. Music was self-selected prior to the familiarization session. Each experimental trial included a 15-min time trial on an arm bike, followed by a 60-s isometric maximal voluntary contraction (MVC) of the biceps brachii. Supramaximal nerve stimulation quantified central and peripheral fatigue with voluntary activation (VA%) calculated using the doublet interpolation method. Average power output (W) was reduced with a main effect of hypoxia (p = 0.02) and significantly increased with a main effect of music (p = 0.001). When combined the interaction was additive (p = 0.87). Average MVC force (N) was reduced in hypoxia (p = 0.03) but VA% of the biceps brachii was increased with music (p = 0.02). Music reduced subjective scores of mental effort, breathing discomfort, and arm discomfort in hypoxia (p < 0.001). Music increased maximal physical exertion through enhancing neural drive and diminishing detrimental mental processes, enhancing performance in normoxia (6.3%) and hypoxia (6.4%).
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Affiliation(s)
- Kate O'Keeffe
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Jacob Dean
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
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Hainsworth L, Kosti A, Lloyd A, Kiddle A, Bamford R, Hunter I. Teaching the management of trauma patients through virtual reality. Ann R Coll Surg Engl 2021; 104:330-333. [PMID: 34928710 DOI: 10.1308/rcsann.2021.0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Virtual reality (VR) fully immersive interactive video teaching (VR FIIT) allows learners to develop through observing and interacting with complex realistic environments, developing technical and nontechnical skills. One such complex clinical environment is managing a trauma patient. Despite the significant developments in managing these patients, foundation doctors are frequently highly anxious due to their limited knowledge and experience. The aim of this project was twofold; to improve foundation doctor performance of managing trauma patients and to reduce their associated anxiety, through the use of VR teaching. METHODS A total of 14 foundation doctors were divided into two groups. One group underwent departmental teaching. The second group underwent departmental teaching and VR FIIT. We assessed the doctors via two methods. First, time taken to complete tasks correctly in trauma simulations was compared. Second, the doctors completed a self-reported level-based assessment questionnaire regarding anxiety and stress around trauma calls. RESULTS The VR FIIT intervention group were able to complete each task on average 118s faster than the standard group. The standard group missed essential tasks such as C-spine immobilisation. The VR FIIT group self-reported significantly lower levels of anxiety related to trauma calls. CONCLUSION VR teaching improves foundation doctor performance at managing simulated major trauma patients and decreases foundation doctor anxiety towards management and exposure of these clinical situations.
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Spencer A, Rivero-Arias O, Wong R, Tsuchiya A, Bleichrodt H, Edward R, Norman R, Lloyd A, Clarke P. The QALY at 50: One story many voices. Soc Sci Med 2021; 296:114653. [DOI: 10.1016/j.socscimed.2021.114653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
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Lu YJ, Wheeler LW, Chu H, Kleindl PJ, Pugh M, You F, Rao S, Garcia G, Wu HY, da Cunha AP, Johnson R, Westrick E, Cross V, Lloyd A, Dircksen C, Klein PJ, Vlahov IR, Low PS, Leamon CP. Targeting folate receptor beta on monocytes/macrophages renders rapid inflammation resolution independent of root causes. Cell Rep Med 2021; 2:100422. [PMID: 34755134 PMCID: PMC8561236 DOI: 10.1016/j.xcrm.2021.100422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 05/18/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022]
Abstract
Provoked by sterile/nonsterile insults, prolonged monocyte mobilization and uncontrolled monocyte/macrophage activation can pose imminent or impending harm to the affected organs. Curiously, folate receptor beta (FRβ), with subnanomolar affinity for the vitamin folic acid (FA), is upregulated during immune activation in hematopoietic cells of the myeloid lineage. This phenomenon has inspired a strong interest in exploring FRβ-directed diagnostics/therapeutics. Previously, we have reported that FA-targeted aminopterin (AMT) therapy can modulate macrophage function and effectively treat animal models of inflammation. Our current investigation of a lead compound (EC2319) leads to discovery of a highly FR-specific mechanism of action independent of the root causes against inflammatory monocytes. We further show that EC2319 suppresses interleukin-6/interleukin-1β release by FRβ+ monocytes in a triple co-culture leukemic model of cytokine release syndrome with anti-CD19 chimeric antigen receptor T cells. Because of its chemical stability and metabolically activated linker, EC2319 demonstrates favorable pharmacokinetic characteristics and cross-species translatability to support future pre-clinical and clinical development. Functional folate receptor beta is transiently expressed on inflammatory monocytes EC2319 is an enhancement of traditional dihydrofolate reductase inhibitors EC2319 anti-monocyte activity correlates with local/systemic therapeutic benefit EC2319 inhibition of cytokine release suggests emergency use for hyperinflammation
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Affiliation(s)
- Yingjuan J Lu
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Leroy W Wheeler
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Haiyan Chu
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Paul J Kleindl
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Michael Pugh
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Fei You
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Satish Rao
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Gabriela Garcia
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
| | - Henry Y Wu
- Department of Ophthalmology, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Andre P da Cunha
- Department of Ophthalmology, Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Richard Johnson
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
| | - Elaine Westrick
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Vicky Cross
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Alex Lloyd
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | | | - Patrick J Klein
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Iontcho R Vlahov
- Novartis Institutes for Biomedical Research, Cambridge, MA 02139, USA
| | - Philip S Low
- Department of Chemistry, Purdue Institute for Drug Discovery, and Purdue Center for Cancer Research, Purdue University, West Lafayette, IN 47907, USA
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20
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Lloyd A, McKay R, Hartman TK, Vincent BT, Murphy J, Gibson-Miller J, Levita L, Bennett K, McBride O, Martinez AP, Stocks TVA, Vallières F, Hyland P, Karatzias T, Butter S, Shevlin M, Bentall RP, Mason L. Delay discounting and under-valuing of recent information predict poorer adherence to social distancing measures during the COVID-19 pandemic. Sci Rep 2021; 11:19237. [PMID: 34584175 PMCID: PMC8479072 DOI: 10.1038/s41598-021-98772-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic has brought about unprecedented global changes in individual and collective behaviour. To reduce the spread of the virus, public health bodies have promoted social distancing measures while attempting to mitigate their mental health consequences. The current study aimed to identify cognitive predictors of social distancing adherence and mental health symptoms, using computational models derived from delay discounting (the preference for smaller, immediate rewards over larger, delayed rewards) and patch foraging (the ability to trade-off between exploiting a known resource and exploring an unknown one). In a representative sample of the UK population (N = 442), we find that steeper delay discounting predicted poorer adherence to social distancing measures and greater sensitivity to reward magnitude during delay discounting predicted higher levels of anxiety symptoms. Furthermore, under-valuing recently sampled information during foraging independently predicted greater violation of lockdown guidance. Our results suggest that those who show greater discounting of delayed rewards struggle to maintain social distancing. Further, those who adapt faster to new information are better equipped to change their behaviour in response to public health measures. These findings can inform interventions that seek to increase compliance with social distancing measures whilst minimising negative repercussions for mental health.
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Affiliation(s)
- Alex Lloyd
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX, England.
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX, England
| | | | | | | | | | | | | | | | | | | | | | - Philip Hyland
- National University of Ireland, Maynooth, Republic of Ireland
| | | | | | | | | | - Liam Mason
- University College London, London, England
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21
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Aylwin PE, Racinais S, Bermon S, Lloyd A, Hodder S, Havenith G. The use of infrared thermography for the dynamic measurement of skin temperature of moving athletes during competition; methodological issues. Physiol Meas 2021; 42. [PMID: 34320480 DOI: 10.1088/1361-6579/ac1872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/28/2021] [Indexed: 01/28/2023]
Abstract
Objective. To investigate the use of infrared thermography (IRT) for skin temperature measurement of moving athletes during competition and its sensitivity to factors that are traditionally standardised.Approach. Thermograms were collected for 18 female athletes during the 20 km racewalk at the 2019 World Athletics Championships, with a medium-wave, cooled indium antimonide medium wave infrared band (MWIR) and a long-wave, uncooled microbolometer longwave infrared band (LWIR) infrared camera.Main results. The MWIR provided greater clarity images of motion due to a shorter exposure and response time and produced a higher percentage of acceptable images. Analysing acceptable images only, the LWIR and WMIR produced good levels of agreement, with a bias of -0.1 ± 0.6 °C in mean skin temperature for the LWIR. As the surface area of an ROI was reduced, the measured temperature became less representative of the whole ROI. Compared to measuring the whole area ROI, a single central pixel produced a bias of 0.3 ± 0.3 °C (MWIR) and 0.1 ± 0.4 °C (LWIR) whilst using the maximum and minimum temperature pixels resulted in deviations of 1.3 ± 0.4 °C and -1.1 ± 0.3 °C (MWIR) and 1.2 ± 0.3 °C and -1.3 ± 0.4 °C (LWIR). The sensitivity to air and reflected temperatures was lower for the LWIR camera, due to the higher emissivity of skin in its wavelength.Significance. IRT provides an appropriate tool for the measurement of skin temperature during real-world competition and critically during athlete motion. The cheaper LWIR camera provides a feasible alternative to the MWIR in low rate of motion scenarios, with comparable precision and sensitivity to analysis. However, the LWIR is limited when higher speeds prevent the accurate measurement and ability to capture motion.
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Affiliation(s)
- Polly E Aylwin
- Environmental Ergonomics Research Centre, Loughborough University, United Kingdom
| | | | - Stéphane Bermon
- World Athletics, Health and Science Department, Principality of Monaco, Europe.,LAMHESS, Université Côte d'Azur, France
| | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, United Kingdom
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough University, United Kingdom
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, United Kingdom
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22
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Gero D, Vannijvel M, Okkema S, Deleus E, Lloyd A, Lo Menzo E, Tadros G, Raguz I, San Martin A, Kraljević M, Mantziari S, Frey S, Gensthaler L, Sammalkorpi H, Garcia-Galocha JL, Zapata A, Tatarian T, Wiggins T, Bardisi E, Goreux JP, Vonlanthen R, Widmer J, Thalheimer A, Himpens J, Hollymann M, Welbourn R, Aggarwal R, Beekley A, Sepulveda M, Torres A, Juuti A, Salminen P, Prager G, Iannelli A, Suter M, Peterli R, Boza C, Rosenthal R, Higa K, Lannoo M, Hazebroek EJ, Dillemans B, Clavien PA, Puhan M, Raptis DA, Bueter M. Defining global benchmarks in elective secondary bariatric surgery comprising conversional, revisional and reversal procedures. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Management of poor response and of long-term complications after bariatric surgery (BS) is complex and under-investigated. Indications and types of reoperations vary widely and postoperative complication rates are higher compared to primary BS. Benchmarking uses best performance in a given field as reference point for improvement. Our aim was to define ‘‘best possible’’ outcomes for elective secondary BS.
Methods
The establishment of benchmarks in secondary BS followed a standardized methodology, based on recommendations of a Delphi consensus panel of experts. This multicenter study analyzed patients undergoing elective secondary BS in 18 high-volume centers on 4 continents from 06/2013 to 05/2019. Twenty-one outcome benchmarks were established in low-risk patients, defined as the 75th percentile of the median outcome values of the centers. Benchmark cases had no: previous laparotomy, diabetes, sleep apnea, cardiopathy, renal insufficiency, inflammatory bowel disease, immunosuppression, history of thromboembolic events, BMI>50kg/m2 or age>65 years. Descriptive statistics, multivariate logistic regression and data visualization were performed using the R software.
Results
Out of 44’884 elective bariatric procedures performed in the participating centers, 5’328 secondary BS cases were identified. The benchmark cohort included 3143 cases, mainly females (85%), aged 43.8±10 years, 8.4±5.3 years after primary BS, with a body mass index 35.2±7kg/m2. Main indications were insufficient weight loss (43%) and gastro-esophageal reflux disease/dysphagia (25%). 90-days postoperatively, 14.57% of benchmark patients presented ≥1 complication, mortality was 0.06% (n = 2). Significantly higher morbidity was observed in non-benchmark cases (OR 1.36) and after conversional or revisional procedures with gastrointestinal suture/stapling (OR 1.7). Benchmark cutoffs at 90-days postoperatively were ≤5.8% re-intervention and ≤8.8% re-operation rate. At 2-years (IQR 1-3) 15.6% of benchmark patients required a reoperation.
Conclusion
Secondary BS is safe, although postoperative morbidity exceeds the established benchmarks for primary BS. The excess morbidity is due to an increased risk of gastrointestinal leakage and higher need for intensive care. The considerable rate of tertiary BS warrants expertise and future research to optimize the management of non-success after BS.
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Affiliation(s)
- D Gero
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - M Vannijvel
- Department of General Surgery, AZ Sint Jan Brugge-Oostende, Bruges, Belgium
| | - S Okkema
- Department of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, Netherlands
| | - E Deleus
- Department of Surgery, University Hospital Leuven, Leuven, Belgium
| | - A Lloyd
- Department of Minimally Invasive and Bariatric Surgery, Fresno Heart and Surgical Hospital, Fresno, USA
| | - E Lo Menzo
- The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, USA
| | - G Tadros
- The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, USA
| | - I Raguz
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - A San Martin
- Department of Surgery, Clinica Las Condes, Santiago de Chile, Chile
| | - M Kraljević
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - S Mantziari
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - S Frey
- Digestive Surgery and Liver Transplantation Unit, University Hospital Nice, University Côte d’Azur, Nice, France
| | - L Gensthaler
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - H Sammalkorpi
- Department of Surgery, University Hospital of Helsinki, Helsinki, Finland
| | - J L Garcia-Galocha
- Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
| | - A Zapata
- Bariatric and Metabolic Surgery Center, Dipreca Hospital, Santiago de Chile, Chile
| | - T Tatarian
- Bariatric and Metabolic Surgery Department, Thomas Jefferson University Hospitals, Philadelphia, USA
| | - T Wiggins
- Bariatric and Metabolic Surgery Center, Musgrove Park Hospital, Taunton, United Kingdom
| | - E Bardisi
- Department of Surgery, St Blasius Hospital, Dendermonde, Belgium
| | - J -P Goreux
- Department of Surgery, Delta CHIREC Hospital, Brussels, Belgium
| | - R Vonlanthen
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - J Widmer
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - A Thalheimer
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - J Himpens
- Department of Surgery, St Blasius Hospital, Dendermonde, Belgium
| | - M Hollymann
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom
| | - R Welbourn
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom
| | - R Aggarwal
- Bariatric and Metabolic Surgery Department, Thomas Jefferson University Hospitals, Philadelphia, USA
| | - A Beekley
- Bariatric and Metabolic Surgery Center, Thomas Jefferson University Hospitals, Philadelphia, USA
| | - M Sepulveda
- Bariatric and Metabolic Surgery Center, Dipreca Hospital, Santiago de Chile, Chile
| | - A Torres
- Department of Surgery, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
| | - A Juuti
- Department of Surgery, University Hospital of Helsinki, Helsinki, Finland
| | - P Salminen
- Department of Surgery, University of Turku, Turku, Finland
| | - G Prager
- Department of Surgery, Medical University Vienna, Vienna, Austria
| | - A Iannelli
- Digestive Surgery and Liver Transplantation Unit, University Hospital Nice, University Côte d’Azur, Nice, France
| | - M Suter
- Department of Surgery, Riviera-Chablais Hospital, Rennaz, Switzerland
| | - R Peterli
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - C Boza
- Department of Surgery, Clinica Las Condes, Santiago de Chile, Chile
| | - R Rosenthal
- Bariatric and Metabolic Surgery Department, Cleveland Clinic Florida, Weston, USA
| | - K Higa
- Bariatric and Metabolic Surgery Center, Fresno Heart and Surgical Hospital, Fresno, USA
| | - M Lannoo
- Department of Surgery, University Hospital Leuven, Leuven, Belgium
| | - E J Hazebroek
- Department of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, Netherlands
| | - B Dillemans
- Department of Surgery, AZ Sint Jan Brugge-Oostende, Bruges, Belgium
| | - P -A Clavien
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - M Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - D A Raptis
- Department of Hepatobiliary and Pancreas Surgery and Liver Transplantation, Royal Free Hospital, London, United Kingkom
| | - M Bueter
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
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Affiliation(s)
| | | | - Nathan Smith
- College of Science, Health, Engineering and EducationMurdoch UniversityPerth
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Lloyd A, Ryan E, Boland M, Medani S, Elwahab A, Malone C, Sweeney K, Barry K, McLaughlin R, Lowery A, Kerin M. O39: THE HISTOPATHOLOGICAL AND MOLECULAR FEATURES OF BREAST CARCINOMA WITH HIGH-GRADE TUMOUR BUDDING. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Tumour budding (TB) is an adverse histological feature in many cancers. It is thought to represent epithelial-to-mesenchymal transition, a key step in the metastatic process. The role of TB in breast carcinoma (BC) remains unclear.
Aim
To investigate the relationship between TB and other histological and molecular features of BC.
Method
A systematic search was performed to identify studies that compared features of BC based on the presence or absence of high-grade TB. Dichotomous variables were pooled as odds ratios (OR) using the Cochran–Mantel–Haenszel method. Quality assessment of the included studies was performed using the Newcastle-Ottawa scale (NOS).
Result
Seven studies with a total of 1040 patients (high grade TB n=519, 49.9%; low grade TB n=521, 50.1%) were included. A moderate- to high-risk of bias was noted. The median NOS was 7 (range 6-8). High-grade TB was significantly associated with lymph node involvement (OR 2.28, 95% c.i. 1.74 to 2.98, P<0.001) and lymphovascular invasion (OR 3.08, 95% c.i. 2.13 to 4.47, P<0.001). Regarding molecular subtypes, there was an increased likelihood of high-grade TB in oestrogen- (OR 1.66, 95% c.i. 1.21 to 2.29, P=0.002) and progesterone-receptor positive (OR 1.68, 95% c.i. 1.10 to 2.59, P=0.02) tumours. In contrast triple negative breast cancer had a reduced incidence of high-grade TB (OR 0.46, 95% c.i. 0.30 to 0.72, P=0.0006).
Conclusion
High-grade TB is enriched in hormone-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic processes of luminal BC.
Take-home message
High-grade TB is enriched in hormone-positive BC and is associated with known adverse prognostic variables. TB may offer new insights into the metastatic processes of luminal BC.
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Affiliation(s)
- A Lloyd
- Royal College of Surgeons Ireland
| | - E Ryan
- Galway University Hospital
| | - M Boland
- Royal College of Surgeons Ireland
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Thomas E, Lloyd A, Leopold N. 150 The Association Between Increasing Frailty and Greater Co-Morbidity and Surviving Cardio Pulmonary Resuscitation. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Population ageing is a triumph of public health and medical advancement but it can equally lead to burdensome and futile interventions at the end of natural life. This is especially relevant when offering treatments such as cardiopulmonary resuscitation (CPR) that can carry a significant burden of harm. The aim of this study was to investigate the association between increasing frailty and greater co-morbidity and surviving CPR.
Method
A retrospective analysis of prospectively collected data from contemporaneous patient notes and electronic patient records of all patients that suffered an in-hospital cardiac arrest between 1st April 2017 and March 31st 2018 in a tertiary hospital (that includes tertiary cardiology) in South Wales was undertaken.
Results
A total of 113 patient records were assessed. Average patient age was 74. Patient frailty was assessed based on calculation of Rockwood score (RS) and co-morbidity assessment based on Charlson index (CI). We identified a strong linear correlation between increasing CI and poor survival and rates of ROSC. No patient with a Charlson index of above 6 survived one year. Similarly, patients with a RS between 1–3 had a survival to discharge, 30 day and 1 year survival rate of 45.7%. Only 10.3% of those with a RS between 5–9 survived 1 year post cardiac arrest. No patient with a RS above 6 survived one year. No association between duration of CPR and patient frailty was identified. Increasing age was also found to be linearly associated with reduced likelihood of survival. This association was much less significant than the association with increasing RS or CI.
Conclusion
It is clear from our findings that both increasing patient frailty and level of co-morbidity significantly adversely affect survival from CPR. Accurate individualised assessment of both of these factors is therefore imperative when assessing the appropriateness of undertaking CPR.
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Affiliation(s)
- E Thomas
- Swansea Bay Health Board, Swansea
| | - A Lloyd
- Swansea Bay Health Board, Swansea
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O'Keeffe K, Raccuglia G, Hodder S, Lloyd A. Mental fatigue independent of boredom and sleepiness does not impact self-paced physical or cognitive performance in normoxia or hypoxia. J Sports Sci 2021; 39:1687-1699. [PMID: 33678152 DOI: 10.1080/02640414.2021.1896104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study investigated the individual and combined effects of mental fatigue (MF) and hypoxia (HYP) on physical and cognitive performance. Fifteen males (24 ± 3 years) completed one familiarization session and six experimental trials, including: 1) normoxia (0.209 FiO2) and no MF; 2) normoxia (0.209 FiO2) with MF; 3) mild normobaric HYP (0.13 FiO2) and no MF; 4) mild normobaric HYP (0.13 FiO2) with MF; 5) severe normobaric HYP (0.10 FiO2) and no MF; 6) severe normobaric HYP (0.10 FiO2) with MF. Each condition included a 15-min self-paced time trial, followed by a 60-s isometric maximal voluntary contraction of the biceps brachii. MF was induced using a 16-min individualized cognitive test prior to exercise performance. Following each time trial, participants performed the Tower of Hanoi cognitive test. A main effect of HYP was observed on average power output, oxygen consumption and muscle oxygenation (P ≤ 0.004), with no effect of MF (P ≥ 0.599). Voluntary activation of the biceps brachii was also reduced in HYP (68.42 ± 5.64%, P = 0.039). No effect of MF or HYP was observed on cognitive performance (P ≥ 0.138). HYP impacted physical performance, whilst MF had no effect on self-paced physical or cognitive performance.
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Affiliation(s)
- Kate O'Keeffe
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Giuseppe Raccuglia
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
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Bentall RP, Lloyd A, Bennett K, McKay R, Mason L, Murphy J, McBride O, Hartman TK, Gibson-Miller J, Levita L, Martinez AP, Stocks TVA, Butter S, Vallières F, Hyland P, Karatzias T, Shevlin M. Pandemic buying: Testing a psychological model of over-purchasing and panic buying using data from the United Kingdom and the Republic of Ireland during the early phase of the COVID-19 pandemic. PLoS One 2021; 16:e0246339. [PMID: 33503049 PMCID: PMC7840055 DOI: 10.1371/journal.pone.0246339] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/15/2021] [Indexed: 01/25/2023] Open
Abstract
The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as 'panic buying' and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises.
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Affiliation(s)
| | - Alex Lloyd
- Royal Holloway, University of London, Egham, England
| | | | - Ryan McKay
- Royal Holloway, University of London, Egham, England
| | - Liam Mason
- University College London, London, England
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Lloyd A, McKay R, Sebastian CL, Balsters JH. Are adolescents more optimal decision-makers in novel environments? Examining the benefits of heightened exploration in a patch foraging paradigm. Dev Sci 2020; 24:e13075. [PMID: 33305510 DOI: 10.1111/desc.13075] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 12/28/2022]
Abstract
Adolescence is a period of heightened exploration relative to adulthood and childhood. This predisposition has been linked with negative behaviours related to risk-taking, including dangerous driving, substance misuse and risky sexual practices. However, recent models have argued that adolescents' heightened exploration serves a functional purpose within the lifespan, allowing adolescents to develop experiential knowledge of their surroundings. Yet, there is limited evidence that heightened exploration in adolescence is associated with positive outcomes. To address this, the present pre-registered study utilised a foraging paradigm with a sample of adolescents aged 16-17 (N = 68) and of adults aged 21 and above (N = 69). Participants completed a patch foraging task, which required them to choose between exploiting a known resource which gradually yields fewer rewards, and exploring a novel, unknown resource with a fresh distribution of rewards. Findings demonstrated that adolescents explored more than adults, which - in the context of the current task-represented more optimal patch foraging behaviour. These findings indicate that adolescents' heightened exploration can be beneficial, as they were able to effectively navigate unknown environments and accrue rewards more successfully than adults. This provides evidence that heightened exploration in adolescence, relative to adulthood, can lead to positive outcomes and contributes to our understanding of the role increased novelty-seeking plays at this point in the lifespan.
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Affiliation(s)
- Alex Lloyd
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | | | - Joshua H Balsters
- Department of Psychology, Royal Holloway, University of London, Egham, UK
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O'Keeffe K, Hodder S, Lloyd A. A comparison of methods used for inducing mental fatigue in performance research: individualised, dual-task and short duration cognitive tests are most effective. Ergonomics 2020; 63:1-12. [PMID: 31680632 DOI: 10.1080/00140139.2019.1687940] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 10/27/2019] [Indexed: 06/10/2023]
Abstract
Despite research indicating the negative impact that mental fatigue has on physical and cognitive performance, whether this is a result of mental fatigue or a state of under-arousal remains unclear. The current research aimed to explore the effectiveness of the methods being used to induce mental fatigue. Twelve participants attended six sessions in which two cognitive tests, the AX-continuous performance test (AX-CPT) and the TloadDback test, were compared for their effectiveness in inducing mental fatigue. Both tests were set at a standard processing speed (1.2 ms) for two conditions, and a further condition involved the individualisation of the TloadDback test. Participants presented significantly higher physiological and psychological arousal (p < 0.05) in the individualised dual-task test compared to the AX-CPT. The individualised TloadDback test is a more effective method of inducing mental fatigue compared to the AX-CPT, as it sustains physiological arousal whilst inducing measurable reductions in mental resources. Practitioner summary: Mental fatigue negatively impacts physical and cognitive performance. It is unclear whether the current methods being used to induce mental fatigue are effective. This study compared different methods and confirmed that short, individualised and dual-task tests are most effective for inducing mental fatigue whilst maintaining arousal.
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Affiliation(s)
- Kate O'Keeffe
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
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Özgüroğlu M, Goldman J, Reinmuth N, Chen Y, Dvorkin M, Trukhin D, Statsenko G, Hotta K, Ji J, Hochmair M, Voitko O, Havel L, Poltoratskiy A, Losonczy G, Verderame F, Thomas M, Zheng Y, Lloyd A, Jiang H, Paz-Ares L. LBA2 First-line durvalumab plus platinum-etoposide in extensive-stage (ES)-SCLC: Safety, pharmacokinetics (PK) and immunogenicity in CASPIAN. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz453.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Raccuglia M, Heyde C, Lloyd A, Hodder S, Havenith G. The use of infrared thermal imaging to measure spatial and temporal sweat retention in clothing. Int J Biometeorol 2019; 63:885-894. [PMID: 30919096 DOI: 10.1007/s00484-019-01701-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/16/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
In our previous laboratory study a 'destructive' gravimetric method was developed to quantify local garment sweat absorption. While this currently is the only methodology that permits direct and analytical measurements of garment regional sweat absorption, the latter approach is time-consuming and expensive, therefore, of limited applicability. As such, in this study, we wanted to assess whether infrared thermography could be used as an indirect method to estimate garment regional sweat absorption, right after exercise, in a 'non-destructive' fashion. Spatial and temporal sweat absorption data, obtained in our previous study, were correlated with spatial and temporal temperature data obtained in the same experiment with an infrared thermal camera. The data suggest that infrared thermography is a good tool to qualitatively predict regional sweat absorption in garments at separate individual time points; however, temporal changes are not predicted well, due to a moisture content threshold above which variations in sweat content cannot be discriminated by further temperature changes.
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Affiliation(s)
- Margherita Raccuglia
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | | | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
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Lloyd A, Döring AK. When do peers influence adolescent males' risk taking? Examining decision making under conditions of risk and ambiguity. J Behav Dec Making 2019. [DOI: 10.1002/bdm.2141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alex Lloyd
- Department of PsychologyUniversity of Westminster London UK
| | - Anna K. Döring
- Department of PsychologyUniversity of Westminster London UK
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O'Keeffe K, Dean J, Hodder S, Lloyd A. The Individual and Combined Effect of Hypoxia and Music on Physical Performance. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000563182.87192.da] [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: 11/21/2022]
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Lloyd A, Havenith G. Comment on: Subjective thermal strain impairs endurance performance in a temperate environment. Physiol Behav 2019; 204:275-276. [DOI: 10.1016/j.physbeh.2019.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/08/2019] [Indexed: 11/16/2022]
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Scovil CY, Delparte JJ, Walia S, Flett HM, Guy SD, Wallace M, Burns AS, Wolfe DL, Wolfe D, Kras-Dupuis A, Walia S, Guy S, Askes H, Casalino A, Fraser C, Paiva M, Miles S, Gagliardi J, Orenczuk S, Sommerdyk J, Genereaux M, Jarvis D, Wesenger J, Bloetjes L, Flett H, Burns A, Scovil C, Delparte J, Leber D, McMillan L, Domingo T, Wallace M, Stoesz B, Aguillon G, Koning C, Mumme L, Cwiklewich M, Bayless K, Crouse L, Crocker J, Erickson G, Mark M, Charbonneau R, Lloyd A, Van Doesburg C, Knox J, Wright P, Mouneimne M, Parmar R, Isaacs T, Reader J, Oga C, Birchall N, McKenzie N, Nicol S, Joly C, Laramée M, Robidoux I, Casimir M, Côté S, Lubin C, Lemay J, Beaulieu J, Truchon C, Noreau L, Lemay V, Vachon J, Bélanger D, Proteau F, O'Connell C, Savoie J, McCullum S, Brown J, Duda M, Bassett-Spiers K, Riopelle R, Hsieh J, Reinhart-McMillan W, Joshi P, Noonan V, Humphreys S, Hamilton L, MacIsaac G. Implementation of Pressure Injury Prevention Best Practices Across 6 Canadian Rehabilitation Sites: Results From the Spinal Cord Injury Knowledge Mobilization Network. Arch Phys Med Rehabil 2019; 100:327-335. [DOI: 10.1016/j.apmr.2018.07.444] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 07/11/2018] [Accepted: 07/20/2018] [Indexed: 12/19/2022]
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Raccuglia M, Heyde C, Lloyd A, Ruiz D, Hodder S, Havenith G. Anchoring biases affect repeated scores of thermal, moisture, tactile and comfort sensations in transient conditions. Int J Biometeorol 2018; 62:1945-1954. [PMID: 30083800 PMCID: PMC6182318 DOI: 10.1007/s00484-018-1595-2] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/13/2018] [Accepted: 07/26/2018] [Indexed: 06/08/2023]
Abstract
In this study, we addressed potential biases which can occur when sensorial scores of temperature, wetness and discomfort are repeatedly reported, in transient exercise conditions. We pointed out that, when repeatedly reported, previous sensorial scores can be set by the participants as reference values and the subsequent score may be given based on the previous point of reference, the latter phenomenon leading to a bias which we defined as 'anchoring bias'. Indeed, the findings shown that subsequent sensorial scores are prone to anchoring biases and that the bias consisted in a systematically higher magnitude of sensation as compared to when reported a single time only. As such, the study allowed recognition, quantification and mitigation of the identified bias which can improve the methodological rigour of research studies involving assessments of sensorial data in transient conditions.
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Affiliation(s)
- Margherita Raccuglia
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
- Adidas FUTURE Sport Science, Herzogenaurach, Germany.
| | | | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Daniel Ruiz
- Adidas FUTURE Sport Science, Herzogenaurach, Germany
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
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Raccuglia M, Heyde C, Lloyd A, Hodder S, Havenith G. Spatial and temporal migration of sweat: from skin to clothing. Eur J Appl Physiol 2018; 118:2155-2169. [PMID: 30027521 PMCID: PMC6153606 DOI: 10.1007/s00421-018-3941-9] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/09/2018] [Indexed: 11/17/2022]
Abstract
Purpose Moisture accumulation in clothing affects human performance and productivity through its impact on thermal balance and various aspects of discomfort. Building on our laboratory’s work on mapping sweat production across the body, this study aimed to obtain detailed spatial and temporal maps showing how this sweat migrates into a single clothing layer (T-shirt) during physical exercise. Method Eight male participants performed running exercise in a warm environment. Garment sweat absorption was mapped over a total running time of 50 min, in 10 separated running trials of different durations (5 min increments). After running, the garment was dissected into 22 different parts and local sweat absorption (ABSlocal) was quantified by weighing each garment part before and after drying. From ABSlocal, garment total sweat absorption (ABStotal) was estimated. Results After 50 min, Tcore rose from 37 ± 0.2 to 38.6 ± 0.3 °C, HR increased from 69 ± 15 to 163 ± 12 bpm (p < 0.001), GSL was 586 ± 86 g m−2. Clear patterns of sweat absorption reduction from superior-to-inferior and from medial-to-lateral T-shirt zones were observed, with the mid back medial and the low front hem showing the highest, respectively. Conclusions Quantitative data on garment total and regional sweat absorption were obtained and considerable variation between different garment zones was identified. These data can support the development of sport and personal protective clothing with the end goal to prevent workers’ heat-related injuries as well as maximise human performance and productivity. Electronic supplementary material The online version of this article (10.1007/s00421-018-3941-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Margherita Raccuglia
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.,Adidas FUTURE Sport Science, Herzogenaurach, Germany
| | | | - Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
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Arnold JT, O'Keeffe K, Raccuglia GA, McDaniel C, Hodder S, Havenith G, Lloyd A. A Preliminary Investigation Into The Effect Of Nauseogenic Vection And Whole‐Body Heating On Motion Sickness Severity: A Combined And Individual Stressors Approach. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.590.24] [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: 11/11/2022]
Affiliation(s)
- Josh T. Arnold
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Kate O'Keeffe
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Giuseppe A. Raccuglia
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Chloe McDaniel
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Simon Hodder
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - George Havenith
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Alex Lloyd
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
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Lloyd A, Raccuglia G, Grainger J, Hodder S, Havenith G. The effect of winter clothing ensembles and hypoxia on performance and exercise‐related sensations during uphill walking: A combined and individual stressors approach. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.909.5] [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: 11/11/2022]
Affiliation(s)
- Alex Lloyd
- Loughborough UniversityLoughboroughUnited Kingdom
| | | | | | - Simon Hodder
- Loughborough UniversityLoughboroughUnited Kingdom
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Lawes M, Raccuglia G, O'Keeffe K, Havenith G, Lloyd A. The effect of cognitive fatigue and hypoxia on repeated arm bike sprint performance: A combined and individual stressors approach. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.909.4] [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: 11/11/2022]
Affiliation(s)
- Micheala Lawes
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Giuseppe Raccuglia
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Kate O'Keeffe
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - George Havenith
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
| | - Alex Lloyd
- Environmental Ergonomics Research CentreLoughborough UniversityLoughboroughUnited Kingdom
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Gollins S, Massalha S, Mullard A, Williams RM, Lloyd A, Morris J, Garcia-Alonso A. A Prospective Phase I/II Study of Docetaxel, Cisplatin and Continuous Capecitabine in Advanced Oesophago-Gastric Cancer (NWCOG-3). Clin Oncol (R Coll Radiol) 2018; 30:409-417. [PMID: 29573846 DOI: 10.1016/j.clon.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/24/2018] [Indexed: 10/17/2022]
Abstract
AIMS This open-label prospective phase I/II dose-escalation study determined the maximum tolerated dose (MTD) and then evaluated response, safety and feasibility of a novel combination of docetaxel, cisplatinum and capecitabine (DCC) in chemotherapy-naive patients with advanced oesophago-gastric carcinoma. MATERIALS AND METHODS Patients with adenocarcinoma or squamous cell carcinoma of the oesophagus or stomach, of good performance status, deemed too advanced for curative treatment, were given systematically increasing doses of 3 weekly DCC to ascertain the MTD. Phase II administered up to six cycles of DCC at the MTD, assessing response and toxicity. RESULTS Between November 2007 and November 2012, 15 patients were recruited into phase I and 41 into phase II. The MDT was a 21 day cycle of docetaxel 60 mg/m2 IV day 1, cisplatinum 60 mg/m2 IV day 1 and oral capecitabine 1000 mg/m2 daily in two divided doses for days 1-21. The most common phase II grade 3-4 toxicities were neutropenia 88% (10% febrile neutropenia), fatigue 15%, sensory neuropathy 10% and non-neutropenic infection 10%. The overall response rate was 51%, median progression-free survival was 7.4 months (confidence interval 6.7-9.4) and median overall survival was 10.9 months (confidence interval 7.7-13.7). CONCLUSION DCC was tolerable and feasible with promising efficacy, and may be suitable for future investigation in both first-line metastatic and neoadjuvant settings.
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Affiliation(s)
- S Gollins
- North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Bodelwyddan, UK.
| | - S Massalha
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, UK
| | - A Mullard
- Ysbyty Gwynedd, Penrhosgarnedd, Bangor, UK
| | | | - A Lloyd
- North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Bodelwyddan, UK
| | - J Morris
- North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Bodelwyddan, UK
| | - A Garcia-Alonso
- North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Bodelwyddan, UK
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Lloyd A, Picton L, Raccuglia M, Hodder S, Havenith G. Localized and systemic variations in central motor drive at different local skin and muscle temperatures. Am J Physiol Regul Integr Comp Physiol 2017; 313:R219-R228. [PMID: 28592458 DOI: 10.1152/ajpregu.00055.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/12/2017] [Accepted: 06/05/2017] [Indexed: 11/22/2022]
Abstract
This study investigated the ability to sustain quadriceps central motor drive while subjected to localized heat and metaboreceptive feedback from the contralateral leg. Eight active males each completed two counter-balanced trials, in which muscle temperature (Tm) of a single-leg (TEMP-LEG) was altered to 29.4°C (COOL) or 37.6°C (WARM), while the contralateral leg (CL-LEG) remained thermoneutral: 35.3°C and 35.2°C Tm in COOL and WARM, respectively. To activate metaboreceptive feedback, participants first performed one 120-s isometric maximal voluntary contraction (MVC) of the knee extensors in the TEMP-LEG, immediately followed by postexercise muscle ischemia (PEMI) via femoral blood flow occlusion. To assess central motor drive of a remote muscle group immediately following PEMI, another 120-s MVC was subsequently performed in the CL-LEG. Voluntary muscle activation (VA) was assessed using the twitch interpolation method. Perceived mental effort and limb discomfort were also recorded. In a cooled muscle, a significant increase in mean force output and mean VA (force, P < 0.001; VA, P < 0.05), as well as a significant decrease in limb discomfort (P < 0.05) occurred during the sustained MVC in the TEMP-LEG. However, no differences between Tm were observed in mean force output, mean VA, or limb discomfort during the sustained MVC in the CL-LEG (force, P = 0.33; VA, P > 0.68; and limb discomfort, P = 0.73). The present findings suggest that elevated local skin temperature and Tm can increase limb discomfort and decrease central motor drive, but this does not limit systemic motor activation of a thermoneutral muscle group.
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Affiliation(s)
- Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - Lewis Picton
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - Margherita Raccuglia
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
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Cunningham E, Amin J, Bretana N, Luciani F, Degenhardt L, Larney S, Hajarizadeh B, Dore G, Lloyd A, Grebely J. P10 Injecting risk behaviours among people who inject drugs in an Australian prison setting, 2005–2014: the HITS-p study. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30751-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bergin ART, Hovey E, Lloyd A, Marx G, Parente P, Rapke T, de Souza P. Docetaxel-related fatigue in men with metastatic prostate cancer: a descriptive analysis. Support Care Cancer 2017; 25:2871-2879. [PMID: 28429147 DOI: 10.1007/s00520-017-3706-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 04/10/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Fatigue is a prevalent and debilitating side effect of docetaxel chemotherapy in metastatic prostate cancer. A better understanding of the kinetics and nature of docetaxel-related fatigue may provide a framework for intervention. METHODS This secondary analysis was performed using the MOTIF database, from a phase III, randomised, double-blind, placebo-controlled study of modafinil (200 mg/day for 15 days) for docetaxel-related fatigue in men with metastatic prostate cancer [1]. The pattern of fatigue was analysed using the MDASI (MD Anderson Symptom Inventory) score. The impact of modafinil, cumulative docetaxel exposure, age and smoking status on fatigue kinetics were explored. Fatigue-related symptoms were assessed using the SOMA6 (fatigue and related symptoms) subset of the SPHERE (Somatic and Psychological Health Report). Mood was tracked using the short form 36 health survey questionnaire (SF-36). RESULTS Across four docetaxel cycles, fatigue scores were higher in the first week and decreased over weeks two and three. Whilst men randomised to modafinil had reduced fatigue scores, cumulative docetaxel had little impact. Younger men (55-68 years) had significantly reduced fatigue scores, whereas current and ex-smokers had higher scores. There was no significant change in mood status or haemoglobin across treatment cycles. Men described both 'somnolence' and 'muscle fatigue' contributing significantly to their symptom complex. CONCLUSIONS Assessment and management of docetaxel-related fatigue remains an important challenge. Given the complex, multifactorial nature of fatigue, identification through structured interview and interventions targeted to specific 'at risk' groups may be the most beneficial. Understanding the temporal pattern (kinetics) and nature of fatigue is critical to guide this process.
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Affiliation(s)
- A R T Bergin
- Eastern Health, Box Hill Hospital, 8 Arnold St, Box Hill, Victoria, Australia.
| | - E Hovey
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Barker St, Randwick, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia
| | - A Lloyd
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Barker St, Randwick, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia.,Inflammation and Infection Research Centre (IIRC), School of Medical Sciences and National Centre for Cancer Survivorship (NCCS), Randwick, New South Wales, Australia
| | - G Marx
- Sydney Adventist Hospital Clinical Trials Unit & Integrated Cancer Centre, 185 Fox Valley Rd, Wahroonga, New South Wales, Australia.,University of Sydney, Sydney, New South Wales, Australia
| | - P Parente
- Eastern Health, Box Hill Hospital, 8 Arnold St, Box Hill, Victoria, Australia.,Eastern Health, Monash University Clinical School, 5 Arnold St, Box Hill, Victoria, Australia
| | - T Rapke
- Sanofi Aventis, Sydney, New South Wales, Australia
| | - P de Souza
- Liverpool Hospital, Goulburn Street, Liverpool, New South Wales, Australia.,Western Sydney University, Penrith, New South Wales, Australia
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Lu YJ, Wheeler LW, Cross V, Westrick E, Lloyd A, Leamon CP. Abstract 262: Combination therapy of folate-targeted chemotherapeutics with anti-PD-1 antibody against folate receptor-positive tumors in immunocompetent murine models. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The PD-1/PD-L1 (programmed cell death protein 1; programmed death-ligand 1) pathway plays a key role in immunological tolerance and autoimmunity. PD-1 is primarily expressed on activated T and B cells while its receptor, PD-L1, is expressed in a variety of cell types including resting lymphocytes, DCs, and macrophages. Recently, multiple human solid tumor types (melanoma, NSCLC, RCC, ovarian, and colorectal cancer) have been found to overexpress PD-L1 within its tumor microenvironment. More importantly, PD-1/PD-L1 blocking agents (pembrolizumab, nivolumab, lambrolizumab, MPDL3280A) have been found active as a single agent or in combination with chemotherapy and some have produced durable clinical responses. On the other hand, human epithelial tumors are also known to overexpress the high-affinity folate receptor (FR)-alpha that is capable of bringing folate-linked drugs into the cell cytosol via endocytosis. Using flow cytometry, we assessed PD-L1 expression in various FR-positive syngeneic mouse tumor models (M109, Renca, L1210A, 4T1-Cl2, ID8-Cl15). PD-L1 expression was found to vary significantly among different tumor types and could be found not only on CD45- malignant cells but also on tumor stromal cells such as F4/80+CD11b+ tumor-associated macrophages. Using a rat anti-mouse PD-1 antibody (clone RMP1-14), we studied in-vivo efficacy of a folate-targeted chemotherapy in combination with PD-1/PD-L1 blockage in PD-L1-expressing tumor models. In syngeneic models with high PD-L1 expression and tumor-infiltrating lymphocytes, a synergistic and curable anti-tumor effect was observed and the animals developed tumor-protective immunity against rechallenge. Thus, our preliminary results suggest that folate-targeted chemotherapeutics may also be enhanced by PD-1/PD-L1 blockage by means of overcoming tumor-mediated immune suppression
Citation Format: Yingjuan June Lu, Leroy W. Wheeler, Vicky Cross, Elaine Westrick, Alex Lloyd, Christopher P. Leamon. Combination therapy of folate-targeted chemotherapeutics with anti-PD-1 antibody against folate receptor-positive tumors in immunocompetent murine models. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 262.
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Brison DR, Hooper M, Critchlow JD, Hunter HR, Arnesen R, Lloyd A, Horne G. Reducing risk in the IVF laboratory: implementation of a double witnessing system. ACTA ACUST UNITED AC 2016. [DOI: 10.1258/1356262041591131] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Affiliation(s)
- Alex Lloyd
- Environmental Ergonomics Research Center, Design School Loughborough University , Loughborough, UK
| | - George Havenith
- Environmental Ergonomics Research Center, Design School Loughborough University , Loughborough, UK
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Hagan A, Macfarlane W, Lloyd A, Phillips G, Holden R, Bascal Z, Whomsley R, Kilpatrick H, Tang Y, Lewis A, Namur J, Pascale F, Pelage J. In vitro and in vivo characterisation of a multiple tyrosine kinase inhibitor drug eluting bead. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.224] [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: 10/22/2022] Open
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Lloyd A, Raccuglia M, Hodder S, Havenith G. Interaction between environmental temperature and hypoxia on central and peripheral fatigue during high-intensity dynamic knee extension. J Appl Physiol (1985) 2016; 120:567-79. [PMID: 26769955 DOI: 10.1152/japplphysiol.00876.2015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/06/2016] [Indexed: 11/22/2022] Open
Abstract
This study investigated causative factors behind the expression of different interaction types during exposure to multistressor environments. Neuromuscular fatigue rates and time to exhaustion (TTE) were investigated in active men (n = 9) exposed to three climates [5 °C, 50% relative humidity (rh); 23 °C, 50% rh; and 42 °C, 70% rh] at two inspired oxygen fractions (0.209 and 0.125 FiO2; equivalent attitude = 4,100 m). After a 40-min rest in the three climatic conditions, participants performed constant-workload (high intensity) knee extension exercise until exhaustion, with brief assessments of neuromuscular function every 110 s. Independent exposure to cold, heat, and hypoxia significantly (P < 0.01) reduced TTE from thermoneutral normoxia (reductions of 190, 405, and 505 s from 915 s, respectively). The TTE decrease was consistent with a faster rate of peripheral fatigue development (P < 0.01) compared with thermoneutral normoxia (increase of 1.6, 3.1, and 4.9%/min from 4.1%/min, respectively). Combined exposure to hypoxic-cold resulted in an even greater TTE reduction (-589 s), likely due to an increase in the rate of peripheral fatigue development (increased by 7.6%/min), but this was without significant interaction between stressors (P > 0.198). In contrast, combined exposure to hypoxic heat reduced TTE by 609 s, showing a significant antagonistic interaction (P = 0.003) similarly supported by an increased rate of peripheral fatigue development (which increased by 8.3%/min). A small decline (<0.4%/min) in voluntary muscle activation was observed only in thermoneutral normoxia. In conclusion, interaction type is influenced by the impact magnitude of the effect of the individual stressors' effect on exercise capacity, whereby the greater the effect of stressors, the greater the probability that one stressor will be abolished by the other. This indicates that humans respond to severe and simultaneous physiological strains on the basis of a worst-strain-takes-precedence principle.
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Affiliation(s)
- Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Margherita Raccuglia
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
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Raccuglia M, Lloyd A, Filingeri D, Hodder S, Havenith G. The use of optimised heating trousers and the role of the blood flow on the reduction in muscle temperature post warm up. Extrem Physiol Med 2015. [PMCID: PMC4580844 DOI: 10.1186/2046-7648-4-s1-a77] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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