1
|
Lodge S, Litton E, Gray N, Ryan M, Millet O, Fear M, Raby E, Currie A, Wood F, Holmes E, Wist J, Nicholson JK. Stratification of Sepsis Patients on Admission into the Intensive Care Unit According to Differential Plasma Metabolic Phenotypes. J Proteome Res 2024; 23:1328-1340. [PMID: 38513133 PMCID: PMC11002934 DOI: 10.1021/acs.jproteome.3c00803] [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: 11/20/2023] [Revised: 02/15/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
Delayed diagnosis of patients with sepsis or septic shock is associated with increased mortality and morbidity. UPLC-MS and NMR spectroscopy were used to measure panels of lipoproteins, lipids, biogenic amines, amino acids, and tryptophan pathway metabolites in blood plasma samples collected from 152 patients within 48 h of admission into the Intensive Care Unit (ICU) where 62 patients had no sepsis, 71 patients had sepsis, and 19 patients had septic shock. Patients with sepsis or septic shock had higher concentrations of neopterin and lower levels of HDL cholesterol and phospholipid particles in comparison to nonsepsis patients. Septic shock could be differentiated from sepsis patients based on different concentrations of 10 lipids, including significantly lower concentrations of five phosphatidylcholine species, three cholesterol esters, one dihydroceramide, and one phosphatidylethanolamine. The Supramolecular Phospholipid Composite (SPC) was reduced in all ICU patients, while the composite markers of acute phase glycoproteins were increased in the sepsis and septic shock patients within 48 h admission into ICU. We show that the plasma metabolic phenotype obtained within 48 h of ICU admission is diagnostic for the presence of sepsis and that septic shock can be differentiated from sepsis based on the lipid profile.
Collapse
Affiliation(s)
- Samantha Lodge
- Australian
National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Edward Litton
- Intensive
Care Unit, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- Intensive
Care Unit, St John of God Hospital, Subiaco, WA 6009, Australia
- School
of Medicine, University of Western Australia, Crawley, WA 6009, Australia
| | - Nicola Gray
- Australian
National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Monique Ryan
- Australian
National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Oscar Millet
- Precision
Medicine and Metabolism Laboratory, CIC
bioGUNE, Parque Tecnológico
de Bizkaia, Bld. 800, Derio 48160, Spain
| | - Mark Fear
- Burn
Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
- Fiona
Wood Foundation, Perth, WA 6150, Australia
| | - Edward Raby
- Department
of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Andrew Currie
- School
of Medical, Molecular & Forensic Sciences, Murdoch University, Perth, WA 6150, Australia
- Centre
for Molecular Medicine & Innovative Therapeutics, Murdoch University, Perth, WA 6150, Australia
- Wesfarmers
Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA 6009, Australia
| | - Fiona Wood
- Burn
Injury Research Unit, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
- Fiona
Wood Foundation, Perth, WA 6150, Australia
- Burns
service of Western Australia, WA Department
of Health, Murdoch, WA 6150, Australia
| | - Elaine Holmes
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Institute
of Global Health Innovation, Faculty of Medicine, Imperial College London, Level 1, Faculty Building, South Kensington Campus, London SW7 2NA, U.K.
| | - Julien Wist
- Australian
National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Center
for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Chemistry
Department, Universidad del Valle, Cali 76001, Colombia
- Department of Metabolism, Digestion and
Reproduction, Faculty of Medicine, Imperial
College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Jeremy K. Nicholson
- Australian
National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA6150, Australia
- Department of Metabolism, Digestion and
Reproduction, Faculty of Medicine, Imperial
College London, Sir Alexander
Fleming Building, South Kensington, London SW7 2AZ, U.K.
| |
Collapse
|
2
|
Valats JC, Perreta S, Swanstrom L, Dargent J, Branche J, Picot MC, Currie A, Georgescu V, Macioce V, Nedelcu M, Rudler F, Nocca D. Prospective evaluation of transoral outlet reduction (TORe) after Roux-en-Y gastric bypass (RYGB) failure. Surg Endosc 2024; 38:1454-1464. [PMID: 38216748 DOI: 10.1007/s00464-023-10650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND AND AIMS Weight regain after RYGB is multifactorial including dilatation of the gastro-jejunal anastomosis. Transoral outlet reduction (TORe) procedure is a minimally invasive alternative to surgical anastomotic revision. METHODS We conducted a prospective, multicenter, simple blind, randomized study in patients with weight regain following RYGB, comparing the efficacy of conventional nutritional and behavioral management associated with a TORe procedure (TORe group) with conventional management alone and a Sham procedure (Sham group). The main objective of this study was to evaluate the percentage of excess weight loss (%EWL) at 12 months after endoscopy. RESULTS From January 2015 to January 2019, 73 subjects were randomized in four French Bariatric centers. The final analysis involved 50 subjects, 25 in each group, 44 women, 6 men, with an average BMI of 40.6 kg/m2. At 12 months, the average %EWL was significantly higher in the TORe group than in the Sham group (13.5 ± 14.1 vs. - 0.77 ± 17.1; p = 0.002). Cohen's d was 0.91, indicating a large effect size of the procedure on the %EWL. There was no significant difference between groups concerning the improvement of obesity-related comorbidities (diabetes and dyslipidemia) and quality of life at 12 months. We report frequent adverse events in the TORe group (20% had adverse events related to the procedure). Three adverse events were serious, including two perforations of the gastro-jejunal anastomosis after TORe group that led to the premature termination of the study. CONCLUSIONS After RYGBP failure linked to the dilatation of the gastro-jejunal anastomosis, TORe procedure with nutritional management results in significantly higher %EWL at 12 months compared to patients with nutritional management alone. As surgery, this minimally invasive endoscopic procedure can be associated with severe adverse events.
Collapse
Affiliation(s)
| | - Silvana Perreta
- Digestive Surgery, IRCAD Strasbourg Hospital, Strasbourg, France
| | - Lee Swanstrom
- Digestive Surgery, IRCAD Strasbourg Hospital, Strasbourg, France
| | - Jérôme Dargent
- Digestive Surgery, Polyclinic Lyon-Nord Rillieux-La-Pape, Rillieux-La-Pape, France
| | - Julien Branche
- Hepato-Gastro-Enterology, Lille University Hospital, Lille, France
| | - Marie-Christine Picot
- Clinical Research and Epidemiology Unit, INSERM, Centre d'Investigation Clinique 1411, CHU Montpellier, Univ Montpellier, 34 295, Montpellier Cedex 5, France
| | - Andrew Currie
- Digestive Surgery, Montpellier University Hospital, Montpellier, France
| | - Vera Georgescu
- Department of Biostatistics and Medical Information, Montpellier University Hospital, Montpellier, France
| | - Valérie Macioce
- Clinical Research and Epidemiology Unit, Montpellier University Hospital, Montpellier, France
| | - Marius Nedelcu
- Digestive Surgery, Montpellier University Hospital, Montpellier, France
| | - Franz Rudler
- Hepato-Gastro-Enterology, Montpellier University Hospital, Montpellier, France
| | - David Nocca
- Digestive Surgery, Montpellier University Hospital, Montpellier, France
| |
Collapse
|
3
|
Brinas P, Joumaa S, Currie A, Boixière M, Valat JC, Nedelcu M, Donici I, Gautier T, Nocca D. Efficacy of Nissen Sleeve Gastrectomy on Mid-term Barrett's Esophagus Regression. Obes Surg 2024; 34:382-388. [PMID: 38183594 DOI: 10.1007/s11695-023-07034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/25/2023] [Accepted: 12/26/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Sleeve gastrectomy is the most commonly performed bariatric operation globally. The main complication is GERD. In the medium term, it can increase the incidence of Barrett's esophagus (BE), which is a risk factor for esophageal adenocarcinoma. Following conventional sleeve gastrectomy, BE is noted in up to 16% of patients postoperatively. Recently, Nissen sleeve gastrectomy (NSG) has been shown to reduce the frequency of postoperative GERD compared to conventional sleeve gastrectomy. This study aims to evaluate the impact of NSG on the incidence and remission of BE in the long term. MATERIAL AND METHOD This bicentric retrospective study included 692 patients who received NSG from September 2013 to July 2021. All patients underwent preoperative upper GI endoscopy and were then scheduled to receive upper GI endoscopy between 1 and 2 years and then between 3 and 5 years postoperatively. BE was systematically confirmed by biopsies. RESULTS Seventy-four patients had endoscopic suspicion of BE, which was confirmed on 54/692 patients by histology. The BE lesions consisted of 18.5% intestinal metaplasia and 75.9% fundal metaplasia. Among these 54 patients, 38 underwent endoscopic investigation within 2 years postoperatively. The biopsies showed healed BE in 25/38 patients (64.1%). At 5 years, two patients had proven BE. Concerning the incidence of BE post NSG: 234 performed the follow-up endoscopy within 2 years. The incidence of de novo BE is nil. CONCLUSION The NSG is associated with healing of known BE in approximately two-thirds of patients at 2-year follow-up. This is consistent with the GERD improvement that has been shown with NSG.
Collapse
Affiliation(s)
- Pierre Brinas
- Bariatric Surgery Unit, University Hospital of Rangueil, 1 Av. du Professeur Jean Poulhès, 31400, Toulouse, France.
| | - Saadeddine Joumaa
- Bariatric Surgery Unit, University Hospital of Saint Eloi, 80 Av. Augustin Fliche, 34090, Montpellier, France
| | - Andrew Currie
- Bariatric Surgery Unit Epsom and St Helier Hospitals NHS Trust, Dorking Rd, Epsom, KT18 7EG, UK
| | - Mégane Boixière
- Bariatric Surgery Unit, University Hospital of Saint Eloi, 80 Av. Augustin Fliche, 34090, Montpellier, France
| | - Jean Christophe Valat
- Gastroenterology Unit, University Hospital of Saint Eloi, 80 Av. Augustin Fliche, 34090, Montpellier, France
| | - Marius Nedelcu
- Bariatric Surgery Unit, ELSAN Clinique Saint Michel, Avenue d'orient, 83100, Toulon, France
| | - Ion Donici
- Bariatric Surgery Unit, University Hospital of Nimes, 4 rue du Professeur Robert Debré, 30900, Nimes, France
| | - Thomas Gautier
- Bariatric Surgery Unit, Clinique Saint Jean, 2 place de l'Europe, 34430, Saint Jean de Vedas, France
| | - David Nocca
- Bariatric Surgery Unit, University Hospital of Saint Eloi, 80 Av. Augustin Fliche, 34090, Montpellier, France
| |
Collapse
|
4
|
Ghori NUH, Mullally CA, Nicol MP, Currie A, Hibbert J, Payne MS, Patole S, Strunk T. Skin-Microbiome Assembly in Preterm Infants during the First Three Weeks of Life and Impact of Topical Coconut Oil Application. Int J Mol Sci 2023; 24:16626. [PMID: 38068949 PMCID: PMC10706365 DOI: 10.3390/ijms242316626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/18/2023] [Accepted: 11/18/2023] [Indexed: 12/18/2023] Open
Abstract
The structure and function of infant skin is not fully developed until 34 weeks of gestation, and this immaturity is associated with risk of late-onset sepsis (LOS). Topical coconut oil improves preterm-infant skin integrity and may reduce LOS. However, data on early-life skin-microbiome succession and potential effects of emollient skin care in preterm infants are scarce. We therefore collected skin-microbiome samples from the ear, axilla, and groin on days 1, 7, 14, and 21 from preterm infants born <30 weeks of gestation as part of a randomized clinical trial of standard skin care vs. topical coconut oil. We found that within-sample microbiome diversity was highest on day 1 after birth, with a subsequent decline and emergence of Staphylococcus genus dominance from day 7. Moreover, microbiome assembly was less diverse in infants receiving coconut oil vs. standard skin care. Our study provides novel data on preterm-infant skin-microbiome composition and highlights the modifying potential of emollient skin care.
Collapse
Affiliation(s)
- Noor-Ul-Huda Ghori
- Division of Infection and Immunity, School of Biomedical Sciences and The Marshall Centre, The University of Western Australia, Perth 6009, Australia (M.P.N.)
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth 6009, Australia
| | - Christopher A. Mullally
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth 6009, Australia
- Centre of Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia
| | - Mark P. Nicol
- Division of Infection and Immunity, School of Biomedical Sciences and The Marshall Centre, The University of Western Australia, Perth 6009, Australia (M.P.N.)
| | - Andrew Currie
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth 6009, Australia
- Centre of Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia
| | - Julie Hibbert
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth 6009, Australia
- Centre of Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia
| | - Matthew S. Payne
- Division of Obstetrics and Gynecology, School of Medicine, The University of Western Australia, Perth 6009, Australia
| | - Sanjay Patole
- Neonatal Directorate, King Edward Memorial Hospital for Women, Child and Adolescent Health Service, Perth 6008, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth 6009, Australia
| | - Tobias Strunk
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth 6009, Australia
- Neonatal Directorate, King Edward Memorial Hospital for Women, Child and Adolescent Health Service, Perth 6008, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Perth 6009, Australia
| |
Collapse
|
5
|
McGlone ER, Carey IM, Currie A, Mahawar K, Welbourn R, Ahmed AR, Pring C, Small PK, Khan OA. Bariatric surgery provision in response to the COVID-19 pandemic: retrospective cohort study of a national registry. Surg Obes Relat Dis 2023; 19:1281-1287. [PMID: 37365067 PMCID: PMC10204276 DOI: 10.1016/j.soard.2023.05.011] [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: 03/06/2023] [Revised: 04/18/2023] [Accepted: 05/06/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND When surgery resumed following the outbreak of the COVID-19 pandemic, guidelines recommended the prioritization of patients with greater obesity-related co-morbidities and/or higher body mass index. OBJECTIVE The aim of this study was to record the effect of the pandemic on total number, patient demographics, and perioperative outcomes of elective bariatric surgery patients in the United Kingdom. SETTING AND METHODS The United Kingdom National Bariatric Surgical Registry was used to identify patients who underwent elective bariatric surgery during the pandemic (1 yr from April 1, 2020). Characteristics of this group were compared with those of a pre-pandemic cohort. Primary outcomes were case volume, case mix, and providers. National Health Service cases were analyzed for baseline health status and perioperative outcomes. Fisher exact, χ2, and Student t tests were used as appropriate. RESULTS The total number of cases decreased to one third of pre-pandemic volume (8615 to 2930). The decrease in operating volume varied, with 36 hospitals (45%) experiencing a 75%-100% reduction. Cases performed in the National Health Service fell from 74% to 53% (P < .0001). There was no change in baseline body mass index (45.2 ± 8.3 kg/m2 from 45.5 ± 8.3 kg/m2; P = .23) or prevalence of type 2 diabetes (26% from 26%; P = .99). Length of stay (median 2 d) and surgical complication rate (1.4% from 2.0%; relative risk = .71; 95% CI .45-1.12; P = .13) were unchanged. CONCLUSIONS In the context of a dramatic reduction in elective bariatric surgery due to the COVID-19 pandemic, patients with more severe co-morbidities were not prioritized for surgery. These findings should inform preparation for future crises.
Collapse
Affiliation(s)
- Emma Rose McGlone
- Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare National Health Service (NHS) Trust, St. Mary's Hospital, London, United Kingdom.
| | - Iain M Carey
- Population Health Research Institute, St. George's University of London, London, United Kingdom
| | - Andrew Currie
- Department of Upper GI and Bariatric Surgery, Somerset NHS Foundation Trust, Taunton, United Kingdom
| | - Kamal Mahawar
- University of Sunderland and Sunderland NHS Foundation Trust, Sunderland, United Kingdom
| | - Richard Welbourn
- Department of Upper GI and Bariatric Surgery, Somerset NHS Foundation Trust, Taunton, United Kingdom
| | - Ahmed R Ahmed
- Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare National Health Service (NHS) Trust, St. Mary's Hospital, London, United Kingdom
| | - Chris Pring
- University of Surrey and Department of Surgery, University Hospitals Sussex NHS Trust Hospital, Chichester, United Kingdom
| | - Peter K Small
- University of Sunderland and Department of Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom
| | - Omar A Khan
- Department of Surgery, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
6
|
Walker R, Currie A, Wiggins T, Markar SR, Blencowe NS, Underwood T, Hollyman M. Results of the ARROW survey of anti-reflux practice in the United Kingdom. Dis Esophagus 2023; 36:doad021. [PMID: 37019630 PMCID: PMC10543366 DOI: 10.1093/dote/doad021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 02/14/2023] [Indexed: 04/07/2023]
Abstract
Gastro-esophageal reflux disease (GERD) is a common, significant health burden. United Kingdom guidance states that surgery should be considered for patients with a diagnosis of GERD not suitable for long-term acid suppression. There is no consensus on many aspects of patient pathways and optimal surgical technique, and an absence of information on how patients are currently selected for surgery. Further detail on the delivery of anti-reflux surgery (ARS) is required. A United Kingdom-wide survey was designed to gather surgeon opinion regarding pre-, peri- and post-operative practice of ARS. Responses were received from 155 surgeons at 57 institutions. Most agreed that endoscopy (99%), 24-hour pH monitoring (83%) and esophageal manometry (83%) were essential investigations prior to surgery. Of 57 units, 30 (53%) had access to a multidisciplinary team to discuss cases; case-loads were higher in those units (median 50 vs. 30, P < 0.024). The most popular form of fundoplication was a Nissen posterior 360° (75% of surgeons), followed by a posterior 270° Toupet (48%). Only seven surgeons stated they had no upper limit of body mass index prior to surgery. A total of 46% of respondents maintain a database of their practice and less than a fifth routinely record quality of life scores before (19%) or after (14%) surgery. While there are areas of consensus, a lack of evidence to support workup, intervention and outcome evaluation is reflected in the variability of practice. ARS patients are not receiving the same level of evidence-based care as other patient groups.
Collapse
Affiliation(s)
| | - Robert Walker
- Guys and St Thomas’ Oesophago-Gastric Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
- Faculty of Medicine, School of Cancer Sciences, University of Southampton, Southampton, UK
| | - Andrew Currie
- Service de Chirurgie Digestive A Pôle Digestif, CHU de Montpellier, Montpellier, France
| | - Tom Wiggins
- Department of Bariatric Surgery, University Hospitals Birmingham, Birmingham, UK
| | - Sheraz R Markar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Nuffield Department of Surgery, University of Oxford, Oxford, UK
| | - Natalie S Blencowe
- Population Health Sciences, University of Bristol, Bristol, UK
- Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Tim Underwood
- Faculty of Medicine, School of Cancer Sciences, University of Southampton, Southampton, UK
| | - Marianne Hollyman
- Upper Gastrointestinal Surgery Department, Musgrove Park Hospital, Taunton, UK
| |
Collapse
|
7
|
Aalbers J, Akerib DS, Akerlof CW, Al Musalhi AK, Alder F, Alqahtani A, Alsum SK, Amarasinghe CS, Ames A, Anderson TJ, Angelides N, Araújo HM, Armstrong JE, Arthurs M, Azadi S, Bailey AJ, Baker A, Balajthy J, Balashov S, Bang J, Bargemann JW, Barry MJ, Barthel J, Bauer D, Baxter A, Beattie K, Belle J, Beltrame P, Bensinger J, Benson T, Bernard EP, Bhatti A, Biekert A, Biesiadzinski TP, Birch HJ, Birrittella B, Blockinger GM, Boast KE, Boxer B, Bramante R, Brew CAJ, Brás P, Buckley JH, Bugaev VV, Burdin S, Busenitz JK, Buuck M, Cabrita R, Carels C, Carlsmith DL, Carlson B, Carmona-Benitez MC, Cascella M, Chan C, Chawla A, Chen H, Cherwinka JJ, Chott NI, Cole A, Coleman J, Converse MV, Cottle A, Cox G, Craddock WW, Creaner O, Curran D, Currie A, Cutter JE, Dahl CE, David A, Davis J, Davison TJR, Delgaudio J, Dey S, de Viveiros L, Dobi A, Dobson JEY, Druszkiewicz E, Dushkin A, Edberg TK, Edwards WR, Elnimr MM, Emmet WT, Eriksen SR, Faham CH, Fan A, Fayer S, Fearon NM, Fiorucci S, Flaecher H, Ford P, Francis VB, Fraser ED, Fruth T, Gaitskell RJ, Gantos NJ, Garcia D, Geffre A, Gehman VM, Genovesi J, Ghag C, Gibbons R, Gibson E, Gilchriese MGD, Gokhale S, Gomber B, Green J, Greenall A, Greenwood S, van der Grinten MGD, Gwilliam CB, Hall CR, Hans S, Hanzel K, Harrison A, Hartigan-O'Connor E, Haselschwardt SJ, Hernandez MA, Hertel SA, Heuermann G, Hjemfelt C, Hoff MD, Holtom E, Hor JYK, Horn M, Huang DQ, Hunt D, Ignarra CM, Jacobsen RG, Jahangir O, James RS, Jeffery SN, Ji W, Johnson J, Kaboth AC, Kamaha AC, Kamdin K, Kasey V, Kazkaz K, Keefner J, Khaitan D, Khaleeq M, Khazov A, Khurana I, Kim YD, Kocher CD, Kodroff D, Korley L, Korolkova EV, Kras J, Kraus H, Kravitz S, Krebs HJ, Kreczko L, Krikler B, Kudryavtsev VA, Kyre S, Landerud B, Leason EA, Lee C, Lee J, Leonard DS, Leonard R, Lesko KT, Levy C, Li J, Liao FT, Liao J, Lin J, Lindote A, Linehan R, Lippincott WH, Liu R, Liu X, Liu Y, Loniewski C, Lopes MI, Lopez Asamar E, López Paredes B, Lorenzon W, Lucero D, Luitz S, Lyle JM, Majewski PA, Makkinje J, Malling DC, Manalaysay A, Manenti L, Mannino RL, Marangou N, Marzioni MF, Maupin C, McCarthy ME, McConnell CT, McKinsey DN, McLaughlin J, Meng Y, Migneault J, Miller EH, Mizrachi E, Mock JA, Monte A, Monzani ME, Morad JA, Morales Mendoza JD, Morrison E, Mount BJ, Murdy M, Murphy ASJ, Naim D, Naylor A, Nedlik C, Nehrkorn C, Neves F, Nguyen A, Nikoleyczik JA, Nilima A, O'Dell J, O'Neill FG, O'Sullivan K, Olcina I, Olevitch MA, Oliver-Mallory KC, Orpwood J, Pagenkopf D, Pal S, Palladino KJ, Palmer J, Pangilinan M, Parveen N, Patton SJ, Pease EK, Penning B, Pereira C, Pereira G, Perry E, Pershing T, Peterson IB, Piepke A, Podczerwinski J, Porzio D, Powell S, Preece RM, Pushkin K, Qie Y, Ratcliff BN, Reichenbacher J, Reichhart L, Rhyne CA, Richards A, Riffard Q, Rischbieter GRC, Rodrigues JP, Rodriguez A, Rose HJ, Rosero R, Rossiter P, Rushton T, Rutherford G, Rynders D, Saba JS, Santone D, Sazzad ABMR, Schnee RW, Scovell PR, Seymour D, Shaw S, Shutt T, Silk JJ, Silva C, Sinev G, Skarpaas K, Skulski W, Smith R, Solmaz M, Solovov VN, Sorensen P, Soria J, Stancu I, Stark MR, Stevens A, Stiegler TM, Stifter K, Studley R, Suerfu B, Sumner TJ, Sutcliffe P, Swanson N, Szydagis M, Tan M, Taylor DJ, Taylor R, Taylor WC, Temples DJ, Tennyson BP, Terman PA, Thomas KJ, Tiedt DR, Timalsina M, To WH, Tomás A, Tong Z, Tovey DR, Tranter J, Trask M, Tripathi M, Tronstad DR, Tull CE, Turner W, Tvrznikova L, Utku U, Va'vra J, Vacheret A, Vaitkus AC, Verbus JR, Voirin E, Waldron WL, Wang A, Wang B, Wang JJ, Wang W, Wang Y, Watson JR, Webb RC, White A, White DT, White JT, White RG, Whitis TJ, Williams M, Wisniewski WJ, Witherell MS, Wolfs FLH, Wolfs JD, Woodford S, Woodward D, Worm SD, Wright CJ, Xia Q, Xiang X, Xiao Q, Xu J, Yeh M, Yin J, Young I, Zarzhitsky P, Zuckerman A, Zweig EA. First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment. Phys Rev Lett 2023; 131:041002. [PMID: 37566836 DOI: 10.1103/physrevlett.131.041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 08/13/2023]
Abstract
The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.
Collapse
Affiliation(s)
- J Aalbers
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - D S Akerib
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C W Akerlof
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A K Al Musalhi
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - F Alder
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - A Alqahtani
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S K Alsum
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C S Amarasinghe
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A Ames
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Anderson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - N Angelides
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - H M Araújo
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Armstrong
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - M Arthurs
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S Azadi
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - A J Bailey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baker
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J Balajthy
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - S Balashov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Bang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J W Bargemann
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M J Barry
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Barthel
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Bauer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baxter
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - K Beattie
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Belle
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Beltrame
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Bensinger
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T Benson
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E P Bernard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Bhatti
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - A Biekert
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T P Biesiadzinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - H J Birch
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - B Birrittella
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - G M Blockinger
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - K E Boast
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - B Boxer
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Bramante
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C A J Brew
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - P Brás
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J H Buckley
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - V V Bugaev
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - S Burdin
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - J K Busenitz
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Buuck
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R Cabrita
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - C Carels
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D L Carlsmith
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - B Carlson
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - M Cascella
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C Chan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Chawla
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - H Chen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J J Cherwinka
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N I Chott
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Cole
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Coleman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M V Converse
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Cottle
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - G Cox
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - W W Craddock
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - O Creaner
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Curran
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - A Currie
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Cutter
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - C E Dahl
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - A David
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Davis
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - T J R Davison
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Delgaudio
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Dey
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - L de Viveiros
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - A Dobi
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J E Y Dobson
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Dushkin
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T K Edberg
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - W R Edwards
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M M Elnimr
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W T Emmet
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - S R Eriksen
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - C H Faham
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Fan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - S Fayer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - N M Fearon
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Fiorucci
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H Flaecher
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - P Ford
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - V B Francis
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - E D Fraser
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - T Fruth
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R J Gaitskell
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N J Gantos
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Garcia
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Geffre
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Genovesi
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C Ghag
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R Gibbons
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - E Gibson
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - S Gokhale
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Gomber
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Green
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - A Greenall
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - S Greenwood
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | | | - C B Gwilliam
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - S Hans
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - K Hanzel
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Harrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Hartigan-O'Connor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S J Haselschwardt
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M A Hernandez
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S A Hertel
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - G Heuermann
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - C Hjemfelt
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M D Hoff
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E Holtom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Y-K Hor
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Horn
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Q Huang
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Hunt
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - C M Ignarra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R G Jacobsen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - O Jahangir
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R S James
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - S N Jeffery
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - W Ji
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Johnson
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A C Kaboth
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A C Kamaha
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| | - K Kamdin
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - V Kasey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - K Kazkaz
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J Keefner
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M Khaleeq
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Khazov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - I Khurana
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - Y D Kim
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - C D Kocher
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Kodroff
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - L Korley
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - E V Korolkova
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Kras
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - H Kraus
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Kravitz
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H J Krebs
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - L Kreczko
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Krikler
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - V A Kudryavtsev
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - S Kyre
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - B Landerud
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E A Leason
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Lee
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Lee
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - D S Leonard
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - R Leonard
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - C Levy
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J Li
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - F-T Liao
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - J Liao
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J Lin
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Lindote
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - R Linehan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - W H Lippincott
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Liu
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - X Liu
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - Y Liu
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C Loniewski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M I Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Lopez Asamar
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - B López Paredes
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W Lorenzon
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - D Lucero
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Luitz
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J M Lyle
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - P A Majewski
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Makkinje
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D C Malling
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Manalaysay
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - L Manenti
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R L Mannino
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N Marangou
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - M F Marzioni
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Maupin
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M E McCarthy
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - C T McConnell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D N McKinsey
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J McLaughlin
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - Y Meng
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Migneault
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E H Miller
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Mizrachi
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J A Mock
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - A Monte
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - M E Monzani
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Vatican Observatory, Castel Gandolfo, V-00120, Vatican City State
| | - J A Morad
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - J D Morales Mendoza
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - E Morrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - B J Mount
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - M Murdy
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - A St J Murphy
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - D Naim
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A Naylor
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - C Nedlik
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - C Nehrkorn
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - F Neves
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Nguyen
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J A Nikoleyczik
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - A Nilima
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J O'Dell
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - F G O'Neill
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - K O'Sullivan
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Olcina
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M A Olevitch
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - K C Oliver-Mallory
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J Orpwood
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - D Pagenkopf
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - S Pal
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - K J Palladino
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Palmer
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - M Pangilinan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N Parveen
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - S J Patton
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E K Pease
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - B Penning
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - C Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Perry
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - T Pershing
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - I B Peterson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Piepke
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Podczerwinski
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - D Porzio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - S Powell
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R M Preece
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - K Pushkin
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - Y Qie
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - B N Ratcliff
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J Reichenbacher
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - L Reichhart
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C A Rhyne
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Richards
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Q Riffard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - G R C Rischbieter
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J P Rodrigues
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Rodriguez
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - H J Rose
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Rosero
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - P Rossiter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - T Rushton
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - G Rutherford
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Rynders
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - J S Saba
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Santone
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A B M R Sazzad
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - R W Schnee
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - P R Scovell
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - D Seymour
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S Shaw
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - T Shutt
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J J Silk
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - C Silva
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Sinev
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K Skarpaas
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - W Skulski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - R Smith
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M Solmaz
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - V N Solovov
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Soria
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Stancu
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M R Stark
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Stevens
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - T M Stiegler
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K Stifter
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Studley
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - B Suerfu
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T J Sumner
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - P Sutcliffe
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - N Swanson
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - M Szydagis
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - M Tan
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D J Taylor
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - R Taylor
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W C Taylor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D J Temples
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - B P Tennyson
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - P A Terman
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K J Thomas
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D R Tiedt
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M Timalsina
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - W H To
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - A Tomás
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Z Tong
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - D R Tovey
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Tranter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - M Trask
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Tripathi
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - D R Tronstad
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C E Tull
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - W Turner
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - L Tvrznikova
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - U Utku
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Va'vra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - A Vacheret
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A C Vaitkus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J R Verbus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E Voirin
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - W L Waldron
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Wang
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - B Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J J Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W Wang
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - Y Wang
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J R Watson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - R C Webb
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - A White
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D T White
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - J T White
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - R G White
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Whitis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Williams
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - W J Wisniewski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - J D Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - S Woodford
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - D Woodward
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - S D Worm
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - C J Wright
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xia
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - X Xiang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xiao
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Xu
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - M Yeh
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - J Yin
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - I Young
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Zarzhitsky
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - A Zuckerman
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E A Zweig
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| |
Collapse
|
8
|
Tang JW, Mousa HA, Twells R, Bodley M, Kelf S, Toovey OT, Bandi S, Cusack J, Frain I, Currie A. Congenital CMV infection following a CMV PCR negative amniotic fluid result. J Med Virol 2023; 95:e28647. [PMID: 36892177 DOI: 10.1002/jmv.28647] [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: 01/11/2023] [Revised: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 03/10/2023]
Abstract
Cytomegalovirus DNA PCR testing on amniotic fluid is a routine method to determine if a foetus is CMV-infected (congenital CMV infection, cCMV) following a diagnosis of maternal primary CMV infection. However, a negative CMV PCR result on an amniotic fluid sample taken at one time-point does not always preclude foetal CMV infection later in pregnancy, in the context of ongoing maternal CMV viremia. Here we describe a case of confirmed congenital CMV (cCMV) infection, diagnosed at birth in a baby, following a negative CMV PCR result on an amniotic fluid taken at 25 + 1/40 gestation. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Julian W Tang
- Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK.,Respiratory Sciences, University of Leicester, Leicester, UK
| | - Hatem A Mousa
- Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ruth Twells
- Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Marit Bodley
- Fetal Medicine Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Stefan Kelf
- Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Oliver Tr Toovey
- Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Srini Bandi
- Leicester Children's Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Jonathan Cusack
- Neonatalogy, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Isobel Frain
- Ear, Nose and Throat, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Andrew Currie
- Neonatalogy, University Hospitals of Leicester NHS Trust, Leicester, UK
| |
Collapse
|
9
|
Bolckmans R, Askari A, Currie A, Ahmed AR, Batterham RL, Byrne J, Hopkins J, Khan OA, Mahawar K, Miras AD, Pring CM, Small PK, Welbourn R. Clinical characteristics of patients undergoing primary bariatric surgery in the United Kingdom based on the National Bariatric Surgery Registry. Clin Obes 2023; 13:e12585. [PMID: 36807508 DOI: 10.1111/cob.12585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 02/23/2023]
Abstract
Baseline demographic characteristics and operations undertaken for patients having bariatric surgery in the United Kingdom are largely unknown. This study aimed to describe the profile of patients having primary bariatric surgery in the National Health Service (NHS) or by self-pay, and associated operations performed for both pathways. The National Bariatric Surgery Registry dataset for 5 years between January 2015 and December 2019 was used. 34 580 patients underwent primary bariatric surgery, of which 75.9% were NHS patients. Mean patient age and initial body mass index were significantly higher for NHS compared to self-pay patients (mean age 45.8 ± 11.3 [SD] vs. 43.0 ± 12.0 years and initial body mass index 48.0 ± 7.9 vs. 42.9 ± 7.3 kg/m2 , p < .001). NHS patients were more likely to have obesity-related complications compared to self-pay patients: prevalence of Type 2 diabetes mellitus 27.7% versus 8.3%, hypertension 37.1% versus 20.1%, obstructive sleep apnoea 27.4% versus 8.9%, severely impaired functional status 19.3% versus 13.9%, musculoskeletal pain 32.5% versus 20.1% and being on medication for depression 31.0% versus 25.9%, respectively (all p < .001). Gastric bypass was the most commonly performed primary NHS bariatric operation 57.2%, but sleeve gastrectomy predominated in self-pay patients 48.7% (both p < .001). In contrast to self-pay patients, NHS patients are receiving bariatric surgery only once they are older and at a much more advanced stage of obesity-related disease complications.
Collapse
Affiliation(s)
- Roel Bolckmans
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| | | | - Andrew Currie
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| | - Ahmed R Ahmed
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Rachel L Batterham
- Department of Medicine, Centre for Obesity Research, University College London, London, UK
- National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK
| | - James Byrne
- University Hospital Southampton, Southampton, UK
| | - James Hopkins
- Department of Bariatric and Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Omar A Khan
- Population Health Research Institute, St George's Hospital, University of London, London, UK
- Department Upper Gastrointestinal and Bariatric Surgery, St George's Hospital, London, UK
| | - Kamal Mahawar
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, UK
| | - Alexander Dimitri Miras
- School of Medicine, Ulster University, Belfast, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Chris M Pring
- Department of Upper Gastrointestinal and Bariatric Surgery, University Hospitals Sussex (St Richard's Hospital), Chichester, UK
| | - Peter K Small
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, UK
| | - Richard Welbourn
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| |
Collapse
|
10
|
Fontbonne A, Currie A, Tounian P, Picot MC, Foulatier O, Nedelcu M, Nocca D. Prevalence of Overweight and Obesity in France: The 2020 Obepi-Roche Study by the "Ligue Contre l'Obésité". J Clin Med 2023; 12:jcm12030925. [PMID: 36769573 PMCID: PMC9918095 DOI: 10.3390/jcm12030925] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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] [Received: 12/02/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Obepi-Roche 2020 by the "Ligue Contre l'Obésité" (League Against Obesity) estimated overweight and obesity prevalence in France. The adopted methodology was chosen to be as similar as possible to that of a series of quota-based surveys conducted every three years from 1997 to 2012 (Obepi-Roche studies). The 2020 survey was conducted online from 24th September to 5th October 2020 by the Odoxa polling institute on a sample of metropolitan French subjects aged 18 years or over. Participants (n = 9598) self-measured their height and weight according to detailed instructions. Prevalence estimates were produced for all categories of body mass index. The prevalence of excess weight was 47.3% (17.0% of subjects with obesity), with higher values in the north and east of France. When comparing these 2020 estimates to previous Obepi-Roche estimates in order to visualize trends since 1997, it appeared that overweight fluctuated around 30%, and obesity prevalence increased steadily at a rapid pace. The increase was even steeper in the youngest age groups and for severe and complex obesity. Given the slightly different methodologies between the 1997-2012 studies and the 2020 survey, the worrying trends in obesity prevalence since 1997 must be confirmed, calling for a reedition of the Obepi-Roche series.
Collapse
Affiliation(s)
- Annick Fontbonne
- Centre of Clinical Investigation, Inserm, Montpellier University Hospital, 34295 Montpellier, France
- Centre for Epidemiology and Population Health, Inserm, Paris-Saclay University, USQV, 94805 Villejuif, France
- Correspondence: ; Tel.: +33-6-8418-3611
| | - Andrew Currie
- Department of Upper GI Surgery, Epsom & St Helier NHS Trust, Epsom KT18 7EG, UK
- Saint Eloi Hospital, Montpellier University Hospital, 34295 Montpellier, France
| | - Patrick Tounian
- Pediatric Nutrition and Gastroenterology Department, Trousseau Hospital, APHP, Sorbonne University, 75571 Paris, France
| | - Marie-Christine Picot
- Centre of Clinical Investigation, Inserm, Montpellier University Hospital, 34295 Montpellier, France
- Clinical Research and Epidemiology Unit (Department of Medical Information), Inserm, Montpellier University Hospital, 34295 Montpellier, France
| | - Olivier Foulatier
- Scientific Council, “Ligue Contre l’Obésité” (League Against Obesity), 75008 Paris, France
| | - Marius Nedelcu
- ELSAN, Saint Michel Clinic, Surgical Centre for Obesity, 83100 Toulon, France
- ELSAN, Bouchard Clinic, 13006 Marseille, France
| | - David Nocca
- Saint Eloi Hospital, Montpellier University Hospital, 34295 Montpellier, France
- Institute for Functional Genomics, UMR 5023 CNRS-U1191, Inserm, Montpellier University, 34295 Montpellier, France
| |
Collapse
|
11
|
Currie A, Bolckmans R, Askari A, Byrne J, Ahmed AR, Batterham RL, Mahawar K, Miras AD, Pring CM, Small PK, Welbourn R. Bariatric-metabolic surgery for NHS patients with type 2 diabetes in the United Kingdom National Bariatric Surgery Registry. Diabet Med 2023; 40:e15041. [PMID: 36648127 DOI: 10.1111/dme.15041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/07/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023]
Abstract
AIM Bariatric-metabolic surgery is approved by the National Institute of Health and Care Excellence (NICE) for people with severe obesity and type 2 diabetes (T2DM) (including class 1 obesity after 2014). This study analysed baseline characteristics, disease severity and operations undertaken in people with obesity and T2DM undergoing bariatric-metabolic surgery in the UK National Health Service (NHS) compared to those without T2DM. METHODS Baseline characteristics, trends over time and operations undertaken were analysed for people undergoing primary bariatric-metabolic surgery in the NHS using the National Bariatric Surgical Registry (NBSR) for 11 years from 2009 to 2019. Clinical practice before and after the publication of the NICE guidance (2014) was examined. Multivariate logistic regression was used to determine associations with T2DM status and the procedure undertaken. RESULTS 14,948/51,715 (28.9%) participants had T2DM, with 10,626 (71.1%) on oral hypoglycaemics, 4322 (28.9%) on insulin/other injectables, and with T2DM diagnosed 10+ years before surgery in 3876 (25.9%). Participants with T2DM, compared to those without T2DM, were associated with older age (p < 0.001), male sex (p < 0.001), poorer functional status (p < 0.001), dyslipidaemia (OR: 3.58 (CI: 3.39-3.79); p < 0.001), hypertension (OR: 2.32 (2.19-2.45); p < 0.001) and liver disease (OR: 1.73 (1.58-1.90); p < 0.001), but no difference in body mass index was noted. Fewer people receiving bariatric-metabolic surgery after 2015 had T2DM (p < 0.001), although a very small percentage increase of those with class I obesity and T2DM was noted. Gastric bypass was the commonest operation overall. T2DM status was associated with selection for gastric bypass compared to sleeve gastrectomy (p < 0.001). CONCLUSION NHS bariatric-metabolic surgery is used for people with T2DM much later in the disease process when it is less effective. National guidance on bariatric-metabolic surgery and data from multiple RCTs have had little impact on clinical practice.
Collapse
Affiliation(s)
- Andrew Currie
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| | - Roel Bolckmans
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| | - Alan Askari
- Department of Bariatric Surgery, Bedfordshire Hospitals NHS Trust, Luton, UK
| | - James Byrne
- Department of Upper GI and Bariatric Surgery, University Hospital Southampton, Southampton, UK
| | - Ahmed R Ahmed
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Rachel L Batterham
- Department of Medicine, Centre for Obesity Research, University College London, London, UK
- National Institute of Health Research, University College London Hospitals Biomedical Research Centre, London, UK
| | - Kamal Mahawar
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, UK
| | - Alexander Dimitri Miras
- School of Medicine, Ulster University, Ulster, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Chris M Pring
- Department of Upper Gastrointestinal and Bariatric Surgery, University Hospitals Sussex (St Richard's Hospital), Chichester, UK
| | - Peter K Small
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, UK
| | - Richard Welbourn
- Department of Upper Gastrointestinal and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK
| |
Collapse
|
12
|
Robinson D, Zakeri R, Laing R, Choh C, Abouelazayem M, Askari A, Bradley A, Brown L, Currie A, Elmasry M, Evans R, Gall T, Jerome E, Raftery N, Samuel M, Spiers H, Chan B. OGBN O04 Upper Gastrointestinal Training in the UK & Ireland – a Roux Group Study. Br J Surg 2022. [DOI: 10.1093/bjs/znac404.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract
Background
Surgical training programmes in the United Kingdom and Ireland (UK&I) are in a transition period evidenced by new surgical curricula. This study is the first to collate the opinions of UK&I trainee and consultant surgeons regarding the current Upper Gastrointestinal (UGI) training model.
Methods
A questionnaire was developed and distributed via national UGI societies and the social media platform, Twitter. A total of 241 responses were received with all UK&I regions represented.
Results
The median time to Certificate of Completion of Training (CCT) of 13 years was considered reasonable (50.2%), however the majority (67.2%) found training to be unfocused. The suggested targets for publications, presentations and audits were 3–5 (trainee vs consultant <3 vs 3–5, p<0.001), <3 (<3 vs 3–5, p=0.002) and 3–5 (<3 vs 3–5, p<0.001) respectively. The majority (61.9%) considered a higher academic degree advantageous but felt it should not be compulsory. Interestingly, most respondents (63.5%) had or planned to undertake one. Crucially, there were geographical discrepancies in access to training, particularly in bariatrics, robotic surgery, and endoscopy. Proficiency in diagnostic endoscopy was deemed essential for CCT and consultant practice (81.7% and 67.6% respectively). The current index UGI operative requirements were felt to be achievable (87.6%) but inadequate for day one consultant practice (74.7%), an opinion shared by both the trainee and consultant groups (p=0.662). Reassuringly, most respondents (76.3%) deemed there to be a role for on-the-job operative training following consultant appointment. Post-CCT fellowships were not considered necessary for consultant appointment, however the majority (73.6%) again recognised its advantage.
Conclusions
While variations were seen in the opinions of trainee and consultant surgeons, the current CCT requirements as outlined by the Joint Committee on Surgical Training are consistent with the overall perspective of the UGI community. Areas for improvement include flexibility in geographical working and provisions for endoscopy training, to ensure equal access.
Collapse
Affiliation(s)
| | | | | | - Clarisa Choh
- University Hospitals Bristol and Weston , Bristol , United Kingdom
| | | | - Alan Askari
- Mid and South Essex NHS Foundation Trust , Chelmsford , United Kingdom
| | | | - Leo Brown
- Royal Infirmary of Edinburgh , Edinburgh , United Kingdom
| | | | | | - Richard Evans
- West Midlands Postgraduate School of Surgery , Birmingham , United Kingdom
| | - Tamara Gall
- Royal North Shore Hospital , Sydney , Australia
| | - Ellen Jerome
- King's College Hospital , London , United Kingdom
| | - Nicola Raftery
- The Mater Misericordiae University Hospital , Dublin , United Kingdom
| | - Maria Samuel
- Royal Victoria Infirmary , Newcastle , United Kingdom
| | - Harry Spiers
- Addenbrooke's Hospital , Cambridge , United Kingdom
| | - Benjamin Chan
- Aintree University Hospital , Liverpool , United Kingdom
- University of Liverpool , Liverpool , United Kingdom
| |
Collapse
|
13
|
Murdoch M, Waser A, Morantes G, Dubovcova B, Akepsimaidis G, Currie A, Pillai S. A new proposed validation method for low energy electron beam processing of dry spices. INNOV FOOD SCI EMERG 2022. [DOI: 10.1016/j.ifset.2022.103141] [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: 11/25/2022]
|
14
|
Hightow-Weidman LB, Muessig K, Soberano Z, Rosso MT, Currie A, Adams Larsen M, Knudtson K, Vecchio A. Tough Talks Virtual Simulation HIV Disclosure Intervention for Young Men Who Have Sex With Men: Development and Usability Testing. JMIR Form Res 2022; 6:e38354. [PMID: 36074551 PMCID: PMC9501675 DOI: 10.2196/38354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background
HIV status disclosure is an important decision with barriers specific to young men who have sex with men (YMSM), who have the highest rates of new HIV infections in the United States. Behavioral and social determinants of the difficulty to disclose can include fear of rejection, stigma, loss of financial stability, and lack of communication skills. Once able to disclose, a person may have increased access to social support and improved informed risk reduction conversations and medication adherence. Despite the known challenges and advantages of disclosure, there are few effective tools supporting this behavior.
Objective
To address this gap in disclosure interventions, the Tough Talks (TT) app, an mHealth intervention using artificial intelligence (AI)–facilitated role-playing scenarios, was developed for YMSM. This paper reports stages of development of the integrated app and results of the usability testing.
Methods
Building on the successful development and testing of a stand-alone interactive dialogue feature in phases 1-3, we conducted additional formative research to further refine and enhance the disclosure scenarios and develop and situate them within the context of a comprehensive intervention app to support disclosure. We assessed the new iteration for acceptability and relevance in a usability study with 8 YMSM with HIV. Participants completed a presurvey, app modules, and a semistructured qualitative interview.
Results
TT content and activities were based on social cognitive theory and disclosure process model framework and expanded to a 4-module curriculum. The AI-facilitated scenarios used dialogue from an utterance database developed using language crowdsourced through a comic book contest. In usability testing, YMSM reported high satisfaction with TT, with 98% (31/33) of activities receiving positive ratings. Participants found the AI-facilitated scenarios and activities to be representative and relevant to their lived experiences, although they noted difficulty having nuanced disclosure conversations with the AI.
Conclusions
TT was an engaging and practical intervention for self-disclosure among YMSM with HIV. Facilitating informed disclosure decisions has the potential to impact engagement in sexual risk behaviors and HIV care. More information is needed about the ideal environment, technical assistance, and clinical support for an mHealth disclosure intervention. TT is being tested as a scalable intervention in a multisite randomized controlled trial to address outstanding questions on accessibility and effect on viral suppression.
Trial Registration
ClinicalTrials.gov NCT03414372; https://clinicaltrials.gov/ct2/show/NCT03414372
Collapse
Affiliation(s)
- Lisa B Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kathryn Muessig
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Zach Soberano
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Matthew T Rosso
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | | | - Kelly Knudtson
- School of Medicine, University of Washington, Seattle, WA, United States
| | - Alyssa Vecchio
- Department of Family & Community Medicine, University of New Mexico, Albuquerque, NM, United States
| |
Collapse
|
15
|
Woods C, Woolley L, Partridge G, Chen M, Haney EF, Hancock REW, Buller N, Currie A. Assessing the Activity of Antimicrobial Peptides Against Common Marine Bacteria Located in Rotifer (Brachionus plicatilis) Cultures. Probiotics Antimicrob Proteins 2022; 14:620-629. [PMID: 35612776 PMCID: PMC9246773 DOI: 10.1007/s12602-022-09928-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 11/05/2022]
Abstract
Rotifers are used as the first feed for marine fish larvae and are grown in large cultures that have high loads of organic matter and heterotrophic bacteria; these bacteria are passed on to the developing fish larvae and can potentially lead to bacterial infections. A modified minimum inhibitory concentration (MIC) protocol for antimicrobial peptides was used to determine the potency of ten antimicrobial peptides (AMPs) in artificial seawater relevant to a rotifer culture (salinity of 25‰) against common marine pathogens. All of the AMPs had antimicrobial activity against the bacterial isolates when the salt concentration was approximately zero. However, in high salt concentrations, the majority of the AMPs had an MIC value greater than 65 µg mL−1 in artificial seawater (25‰). The only exceptions were 2009 (32.5 µg mL−1) and 3002 (32.5 µg mL−1) against Vibrio rotiferianus and Tenacibaculum discolor, respectively. The selected synthetic AMPs were not effective at reducing the bacterial load in brackish salt concentrations of a typical commercial rotifer culture (25‰).
Collapse
Affiliation(s)
- Chelsea Woods
- College of Science, Murdoch University, Engineering & Education, HealthPerth, WA, Australia. .,Department of Primary Industries and Regional Development, Fremantle, Perth, WA, 6160, Australia.
| | - Lindsey Woolley
- College of Science, Murdoch University, Engineering & Education, HealthPerth, WA, Australia.,Department of Primary Industries and Regional Development, Fremantle, Perth, WA, 6160, Australia
| | - Gavin Partridge
- College of Science, Murdoch University, Engineering & Education, HealthPerth, WA, Australia.,Department of Primary Industries and Regional Development, Fremantle, Perth, WA, 6160, Australia
| | - Mengqi Chen
- Department of Primary Industries and Regional Development, Fremantle, Perth, WA, 6160, Australia
| | - Evan F Haney
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Robert E W Hancock
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Nicky Buller
- College of Science, Murdoch University, Engineering & Education, HealthPerth, WA, Australia.,Department of Primary Industries and Regional Development, Fremantle, Perth, WA, 6160, Australia
| | - Andrew Currie
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| |
Collapse
|
16
|
Doualeh M, Payne M, Litton E, Raby E, Currie A. Molecular Methodologies for Improved Polymicrobial Sepsis Diagnosis. Int J Mol Sci 2022; 23:ijms23094484. [PMID: 35562877 PMCID: PMC9104822 DOI: 10.3390/ijms23094484] [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: 03/28/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 12/19/2022] Open
Abstract
Polymicrobial sepsis is associated with worse patient outcomes than monomicrobial sepsis. Routinely used culture-dependent microbiological diagnostic techniques have low sensitivity, often leading to missed identification of all causative organisms. To overcome these limitations, culture-independent methods incorporating advanced molecular technologies have recently been explored. However, contamination, assay inhibition and interference from host DNA are issues that must be addressed before these methods can be relied on for routine clinical use. While the host component of the complex sepsis host–pathogen interplay is well described, less is known about the pathogen’s role, including pathogen–pathogen interactions in polymicrobial sepsis. This review highlights the clinical significance of polymicrobial sepsis and addresses how promising alternative molecular microbiology methods can be improved to detect polymicrobial infections. It also discusses how the application of shotgun metagenomics can be used to uncover pathogen/pathogen interactions in polymicrobial sepsis cases and their potential role in the clinical course of this condition.
Collapse
Affiliation(s)
- Mariam Doualeh
- Centre for Molecular Medicine & Innovative Therapeutics, Murdoch University, Murdoch, WA 6150, Australia;
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA 6009, Australia
- Women and Infants Research Foundation, Perth, WA 6008, Australia;
| | - Matthew Payne
- Women and Infants Research Foundation, Perth, WA 6008, Australia;
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA 6008, Australia
| | - Edward Litton
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, WA 6150, Australia;
- Intensive Care Unit, St. John of God Hospital, Subiaco, WA 6009, Australia
| | - Edward Raby
- State Burns Unit, Fiona Stanley Hospital, Murdoch, WA 6150, Australia;
- Microbiology Department, Path West Laboratory Medicine, Murdoch, WA 6150, Australia
| | - Andrew Currie
- Centre for Molecular Medicine & Innovative Therapeutics, Murdoch University, Murdoch, WA 6150, Australia;
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA 6009, Australia
- Women and Infants Research Foundation, Perth, WA 6008, Australia;
- Correspondence: ; Tel.: +61-(08)-9360-7426
| |
Collapse
|
17
|
Hibbert J, Strunk T, Nathan E, Prosser A, Doherty D, Simmer K, Richmond P, Burgner D, Currie A. Composition of early life leukocyte populations in preterm infants with and without late-onset sepsis. PLoS One 2022; 17:e0264768. [PMID: 35235604 PMCID: PMC8890632 DOI: 10.1371/journal.pone.0264768] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Composition of leukocyte populations in the first month of life remains incompletely characterised, particularly in preterm infants who go on to develop late-onset sepsis (LOS).
Aim
To characterise and compare leukocyte populations in preterm infants with and without LOS during the first month of life.
Study design
Single-centre prospective observational cohort study.
Participants
Infants born <30 weeks gestational age (GA).
Outcome measures
Peripheral blood samples were collected at 1, 7, 14, 21 and 28 days of life. Leukocyte populations were characterised using 5-fluorophore-6-marker flow cytometry. Absolute leukocyte counts and frequency of total CD45+ leukocytes of each population were adjusted for GA, birth weight z-scores, sex and total leukocyte count.
Results
Of 119 preterm infants enrolled, 43 (36%) had confirmed or clinical LOS, with a median onset at 13 days (range 6–26). Compared to infants without LOS, the adjusted counts and frequency of neutrophils, basophils and non-cytotoxic T lymphocytes were generally lower and immature granulocytes were higher over the first month of life in infants who developed LOS. Specific time point comparisons identified lower adjusted neutrophil counts on the first day of life in those infants who developed LOS more than a week later, compared to those without LOS, albeit levels were within the normal age-adjusted range. Non-cytotoxic T lymphocyte counts and/or frequencies were lower in infants following LOS on days 21 and 28 when compared to those who did not develop LOS.
Conclusion
Changes in non-cytotoxic T lymphocytes occurred following LOS suggesting sepsis-induced immune suppression.
Collapse
Affiliation(s)
- Julie Hibbert
- Neonatal Directorate, Child and Adolescent Health Service, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Tobias Strunk
- Neonatal Directorate, Child and Adolescent Health Service, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Elizabeth Nathan
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Amy Prosser
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Dorota Doherty
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Karen Simmer
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Richmond
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Currie
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Centre for Molecular Medicine and Innovation Therapeutics, Murdoch University, Perth, Western Australia, Australia
- * E-mail:
| |
Collapse
|
18
|
Hibbert J, Armstrong NJ, Granland C, Ng S, Simmer K, Richmond P, Burgner D, Strunk T, Currie A. Plasma secretory phospholipase A2 as an early marker for late-onset sepsis in preterm infants-a pilot study. Acta Paediatr 2021; 110:3011-3013. [PMID: 34091943 DOI: 10.1111/apa.15969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 11/29/2022]
Abstract
Preterm infants are particularly susceptible to bacterial late-onset sepsis (LOS). Diagnosis by blood culture and inflammatory markers have sub-optimal sensitivity and specificity and prolonged reporting times. There is an urgent need for more rapid, accurate adjunctive diagnostics in LOS to improve management and minimise antibiotic exposure. We measured the diagnostic performance of secretory phospholipase A2 type IIA (sPLA2-IIA) in very preterm infants (<30 weeks gestational age) with suspected LOS. Plasma sPLA2-IIA levels were elevated in infants with LOS (n = 28) compared to those without LOS (n = 21; median 30,970 vs. 2534 pg/ml, p < 0.0001). The mean area under the curve was 0.884 (95% CI: 0.771, 0.977) with a sensitivity of 0.907 (95% CI: 0.667, 1.00) and specificity of 0.804 (95% CI: 0.600, 1.00). The positive and negative predictive values were 0.833 (95% CI: 0.664, 0.927) and 0.842 (95% CI: 0.624, 0.945), respectively. This pilot study suggests that sPLA2-IIA may have clinical utility for the early diagnosis of LOS in very preterm infants, potentially informing clinical management and antibiotic stewardship.
Collapse
Affiliation(s)
- Julie Hibbert
- Neonatal Directorate, Child and Adolescent Health Service Perth WA Australia
- School of Medicine University of Western Australia Perth WA Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases Telethon Kids Institute Perth WA Australia
| | | | - Caitlyn Granland
- Wesfarmers Centre of Vaccines and Infectious Diseases Telethon Kids Institute Perth WA Australia
| | - Sherrianne Ng
- Imperial College Parturition Research Group Imperial College London London UK
- March of Dimes European Prematurity Research Centre Imperial College London London UK
| | - Karen Simmer
- School of Medicine University of Western Australia Perth WA Australia
| | - Peter Richmond
- School of Medicine University of Western Australia Perth WA Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases Telethon Kids Institute Perth WA Australia
| | - David Burgner
- Murdoch Children’s Research Institute Royal Children’s Hospital Parkville VIC Australia
- Department of Paediatrics University of Melbourne Melbourne VIC Australia
| | - Tobias Strunk
- Neonatal Directorate, Child and Adolescent Health Service Perth WA Australia
- School of Medicine University of Western Australia Perth WA Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases Telethon Kids Institute Perth WA Australia
| | - Andrew Currie
- Wesfarmers Centre of Vaccines and Infectious Diseases Telethon Kids Institute Perth WA Australia
- Centre for Molecular Medicine & Innovative Therapeutics Murdoch University Perth WA Australia
| |
Collapse
|
19
|
Stefanova I, Currie A, Newton R, Albon L, Hawkins W, Pring C. SP5.1.4 A meta-analysis on the impact of bariatric surgery on lower urinary tract symptoms in men. Br J Surg 2021. [DOI: 10.1093/bjs/znab361.114] [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: 11/15/2022]
Abstract
Abstract
Background
Obesity is a chronic disease with multisystem morbidity. There are multiple studies reporting the effect of bariatric surgery on cardiovascular and metabolic disease but only few examine its impact on lower urinary tract symptoms. This article aims to perform a systematic review with meta-analysis in order to determine the effects of bariatric surgery on lower urinary tract symptoms in male patients.
Methods
Medline, Embase, conference proceeding and reference lists were searched for studies reporting the quantative measurement of lower urinary tract symptoms score pre- and post-weight loss surgery. The primary outcome was International Prostate Symptom Score (IPSS) before and after bariatric surgery. Secondary outcomes were change in Body Mass Index (BMI) and Total Body Weight (TBW). Weighted mean differences (MD) were calculated for continuous outcomes.
Results
Seven studies were included in the analysis of 334 patients undergoing bariatric surgery. Mean study follow-up was between 3 and 36 months. There was a statistically significant improvement in the IPSS score following bariatric surgery (MD 2.82, 95% CI 0.96 to 4.69, p = 0.003). Bariatric surgery also resulted in statistically significant reduction of BMI and TBW.
Conclusion
Bariatric surgery produces a significant improvement on lower urinary tract symptoms in men with obesity. This may be due to improvement of insulin sensitivity, testosterone levels or lipid profile associated with weight loss. Further studies are necessary to investigate in detail the pathophysiological mechanisms through which lower urinary tract symptoms develop in obese patients, and their improvement following weight loss surgery.
Collapse
|
20
|
Annamalay AA, Abbott S, Khoo SK, Hibbert J, Bizzintino J, Zhang G, Laing I, Currie A, Le Souëf PN, Green RJ. The impact of cytokine levels in young South African children with and without HIV-associated acute lower respiratory infections. J Med Virol 2021; 93:3647-3655. [PMID: 33314189 DOI: 10.1002/jmv.26730] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 11/09/2022]
Abstract
Altered host immune responses are considered to play a key role in the pathogenesis of acute lower respiratory infections (ALRI). The existing literature on cytokine responses in ALRI is largely focussed on adults from developed countries and there are few reports describing the role of cytokines in childhood ALRI, particularly in African or human immunodeficiency virus (HIV)-infected populations. To measure systemic cytokine levels in blood plasma from young South African children with and without ALRI and with and without HIV to determine associations between cytokine responses and disease status and respiratory viral identification. Blood plasma samples were collected from 106 hospitalized ALRI cases and 54 non-ALRI controls less than 2 years of age. HIV status was determined. Blood plasma concentrations of 19 cytokines, 7 chemokines, and 4 growth factors (epidermal growth factor, fibroblast growth factor-basic, hepatocyte growth factor, and vascular endothelial) were measured using The Human Cytokine 30-Plex Panel. Common respiratory viruses were identified by PCR. Mean cytokine concentrations for G-CSF, interferon (IFN)-γ, interleukin (IL)-5, and MCP-1 were significantly higher in ALRI cases than in nonrespiratory controls. Within the ALRI cases, several cytokines were higher in children with a virus compared with children without a virus. Mean cytokine concentrations for IFN-α, IFN-γ, IL-4, IL-5, IL-13, tumour necrosis factor-α, and MIP-1α were significantly lower in HIV-infected cases than in HIV-uninfected cases, while IP-10 and monokine induced by interferon-γ were significantly higher in HIV-infected cases than in HIV-uninfected cases. Certain cytokines are likely to play an important role in the host immune response to ALRI. HIV-infected children have impaired inflammatory responses to respiratory infections compared with HIV-uninfected children.
Collapse
Affiliation(s)
- Alicia A Annamalay
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Salome Abbott
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Siew-Kim Khoo
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Julie Hibbert
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Joelene Bizzintino
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Guicheng Zhang
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Ingrid Laing
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Currie
- Medical, Molecular, and Forensic Sciences, Murdoch University, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Peter N Le Souëf
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Robin J Green
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
21
|
Litton E, Currie A, Raby E. Probiotics and sepsis: separating the signal from the noise. Intensive Care Med 2021; 47:924-925. [PMID: 34014376 DOI: 10.1007/s00134-021-06427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 09/29/2022]
Affiliation(s)
- Edward Litton
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia. .,Intensive Care Unit, St John of God Hospital, Subiaco, 6009, Australia. .,School of Medicine, University of Western Australia, Crawley, 6009, Australia.
| | - Andrew Currie
- Molecular and Forensic Sciences, Murdoch University, Perth, 6150, Australia
| | - Edward Raby
- Infectious Diseases, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | | |
Collapse
|
22
|
Strunk T, Hibbert J, Doherty D, Nathan E, Simmer K, Richmond P, Currie A, Burgner D. Impaired Cytokine Responses to Live Staphylococcus epidermidis in Preterm Infants Precede Gram-positive, Late-onset Sepsis. Clin Infect Dis 2021; 72:271-278. [PMID: 31960030 DOI: 10.1093/cid/ciaa063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 10/25/2019] [Accepted: 01/17/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Late-onset sepsis (LOS) with Staphylococcus epidermidis is common in preterm infants, but the immunological mechanisms underlying heightened susceptibility are poorly understood. Our aim is to characterize the ontogeny of cytokine responses to live S. epidermidis in preterm infants with and without subsequent Gram-positive LOS. METHODS We conducted a prospective, observational cohort study of preterm infants (<30 weeks gestational age [GA]) with blood sampling on Days 1, 7, 14, 21, and 28 of life. Cytokine responses in peripheral whole blood stimulated with live S. epidermidis were analyzed by 11-plex immunoassay. RESULTS Of 129 infants (mean GA, 26.2 weeks; mean birth weight, 887g), 23 (17.8%) had confirmed LOS with Gram-positive organisms and 15 (11.6%) had clinical sepsis, with median onsets at 13 and 15 days, respectively. Blood cytokine responses to an in vitro S. epidermidis challenge were similar between infected and uninfected infants on Day 1, but diverged thereafter. Infants with subsequent LOS displayed broadly reduced S. epidermidis-induced responses from Day 7 onwards, compared to those who did not develop LOS. This pattern was observed with chemokines (interleukin [IL]-8, monocyte chemotactic protein-1, and macrophage inflammatory protein-1α), pro-inflammatory cytokines (IL-1, IL-6, and tumor necrosis factor-α) and the regulatory cytokine IL-10. CONCLUSIONS Cytokine responses to a live S. epidermidis challenge are impaired in infants with LOS and precede the onset of clinical illness. Quantifying pathogen-specific cytokine responses at Day 7 may identify those high-risk preterm infants at the greatest risk of LOS, and prospective replication is warranted.
Collapse
Affiliation(s)
- Tobias Strunk
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Australia.,Telethon Kids Institute, Perth, Australia.,School of Medicine, University of Western Australia, Perth, Australia
| | - Julie Hibbert
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Australia.,School of Medicine, University of Western Australia, Perth, Australia
| | - Dorota Doherty
- School of Medicine, University of Western Australia, Perth, Australia
| | - Elizabeth Nathan
- School of Medicine, University of Western Australia, Perth, Australia
| | - Karen Simmer
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Australia.,Telethon Kids Institute, Perth, Australia.,School of Medicine, University of Western Australia, Perth, Australia
| | - Peter Richmond
- School of Medicine, University of Western Australia, Perth, Australia.,Department of Immunology, Perth Children's Hospital, Perth, Australia
| | - Andrew Currie
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| |
Collapse
|
23
|
Litton E, Anstey M, Broadhurst D, Chapman A, Currie A, Ferrier J, Gummer J, Higgins A, Lim J, Manning L, Myers E, Orr K, Palermo AM, Paparini A, Pellicano S, Raby E, Rammohan A, Regli A, Richter B, Salman S, Strunk T, Waterson S, Weight D, Wibrow B, Wood F. Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: the randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT). Intensive Care Med 2021; 47:307-315. [PMID: 33566129 PMCID: PMC7873510 DOI: 10.1007/s00134-020-06322-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/07/2020] [Indexed: 12/16/2022]
Abstract
Purpose In adults requiring treatment in an intensive care unit, probiotic therapy using Lactobacillus plantarum 299v may reduce nosocomial infection. The aim of this study was to determine whether early and sustained L. plantarum 299v therapy administered to adult ICU patients increased days alive and at home. Methods A multicentre, parallel group, placebo-controlled, randomised clinical trial was conducted. Adult patients within 48 h of intensive care admission and expected to require intensive care beyond the day after recruitment were eligible to participate. L plantarum 299v or placebo were administered immediately after enrolment and continued for 60 days. The primary outcome was days alive and out of hospital to Day 60 (DAOH60). Secondary outcomes included nosocomial infections. Results The median [interquartile range (IQR)] number of DAOH60 in the probiotic (n = 110) and placebo group (n = 108) was 49.5 (IQR 37.0–53.0) and 49.0 (IQR 43.8–53.0) respectively, between-group difference of 0.0 [95% confidence interval (CI) − 6.10 to 7.1, P = 0.55]. Nosocomial infection occurred in 8 (7.3%) and 5 (4.6%) of the probiotic and placebo group participants, respectively, odds ratio 1.62 (95% CI 0.51–5.10), P = 0.57. There were no serious, or probiotic-associated adverse events. Conclusion Early and sustained untargeted administration of probiotic therapy with Lactobacillus plantarum 299v to adult patients admitted to the ICU is safe, but not associated with improved patient outcomes. Electronic supplementary material The online version of this article (10.1007/s00134-020-06322-w) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Edward Litton
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia.
- Intensive Care Unit, St John of God Hospital, Subiaco, 6009, Australia.
- School of Medicine, University of Western Australia, Crawley, 6009, Australia.
| | - Matt Anstey
- School of Medicine, University of Western Australia, Crawley, 6009, Australia
- Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, 6009, Australia
| | - David Broadhurst
- School of Science, Edith Cowan University, Joondalup, 6027, Australia
| | - Andy Chapman
- Intensive Care Unit, Royal Perth Hospital, Perth, 6000, Australia
| | - Andrew Currie
- Molecular and Forensic Sciences, Murdoch University, Perth, 6150, Australia
| | - Janet Ferrier
- Intensive Care Unit, St John of God Hospital, Subiaco, 6009, Australia
| | - Joel Gummer
- Health Futures Institute, Murdoch University, Perth, 6150, Australia
| | - Alisa Higgins
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, 3800, Australia
| | - Jolene Lim
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | - Laurens Manning
- Infectious Diseases, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | - Erina Myers
- Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, 6009, Australia
| | - Katrina Orr
- Pharmacy, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | | | | | - Susan Pellicano
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | - Edward Raby
- Infectious Diseases, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | - Anu Rammohan
- Department of Economics, University of Western Australia, Crawley, 6009, Australia
| | - Adrian Regli
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia
- Intensive Care Unit, St John of God Hospital Murdoch, Murdoch, 6150, Australia
| | - Bernhard Richter
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia
- Medical University of Vienna, Waehringer Guertel, Vienna, Austria
| | - Sam Salman
- School of Medicine, University of Western Australia, Crawley, 6009, Australia
| | - Tobias Strunk
- Neonatal Directorate, King Edward Memorial Hospital, Subiaco, 6009, Australia
| | - Sharon Waterson
- Intensive Care Unit, Royal Perth Hospital, Perth, 6000, Australia
| | - David Weight
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, 6150, Australia
| | - Bradley Wibrow
- Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, 6009, Australia
| | - Fiona Wood
- Burns Service, Fiona Stanley Hospital, Murdoch, 6150, Australia
| |
Collapse
|
24
|
Bali V, Weaver J, Turzhitsky V, Schelfhout J, Paudel M, Hulbert E, Peterson-Brandt J, Currie A, Bakka D. D200 DEVELOPMENT OF AN EHR-BASED ALGORITHM TO IDENTIFY PATIENTS WITH CHRONIC COUGH. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
25
|
Litton E, Anstey M, Broadhurst D, Chapman AR, Currie A, Ferrier J, Gummer J, Higgins A, Lim J, Manning L, Myers E, Orr K, Palermo AM, Paparini A, Pellicano S, Raby E, Rammohan A, Regli A, Richter B, Salman S, Strunk T, Waterson S, Wibrow B, Wood FM. Study protocol for the safety and efficacy of probiotic therapy on days alive and out of hospital in adult ICU patients: the multicentre, randomised, placebo-controlled Restoration Of gut microflora in Critical Illness Trial (ROCIT). BMJ Open 2020; 10:e035930. [PMID: 32565465 PMCID: PMC7311035 DOI: 10.1136/bmjopen-2019-035930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The effect of early and sustained administration of daily probiotic therapy on patients admitted to the intensive care unit (ICU) remains uncertain. METHODS AND ANALYSIS The Restoration Of gut microflora in Critical Illness Trial (ROCIT) study is a multicentre, randomised, placebo-controlled, parallel-group, two-sided superiority trial that will enrol 220 patients in five ICUs. Adult patients who are within 48 hours of admission to an ICU and are expected to require intensive care beyond the next calendar day will be randomised in a 1:1 ratio to receive early and sustained Lactobacillus plantarum 299v probiotic therapy in addition to usual care or placebo in addition to usual care. The primary endpoint is days alive and out of hospital to day 60. ETHICS AND DISSEMINATION ROCIT has been approved by the South Metropolitan Health Service Human Research Ethics Committee (ref: RGS00000004) and the St John of God Health Care Human Research Ethics Committee (ref: 1183). The trial results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registry (ANZCTR12617000783325); Pre-results.
Collapse
Affiliation(s)
- Edward Litton
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Intensive Care Unit, St John of God Hospital, Subiaco, Western Australia, Australia
| | - Matthew Anstey
- Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - David Broadhurst
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Andy R Chapman
- Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Andrew Currie
- Murdoch University, Murdoch, Western Australia, Australia
| | - Janet Ferrier
- Intensive Care Unit, St John of God Hospital, Subiaco, Western Australia, Australia
| | - Joel Gummer
- Murdoch University, Murdoch, Western Australia, Australia
| | - Alisa Higgins
- Australian and New Zealand Intensive Care Research Centre, Monash University, Clayton, Victoria, Australia
| | - Jolene Lim
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Laurens Manning
- University of Western Australia, Perth, Western Australia, Australia
| | - Erina Myers
- Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Katrina Orr
- Pharmacy, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Anne-Marie Palermo
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | | | - Susan Pellicano
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Edward Raby
- Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Anu Rammohan
- Department of Economics, University of Western Australia, Crawley, Western Australia, Australia
| | - Adrian Regli
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Intensive Care Unit, St John of God Hospital, Murdoch, Western Australia, Australia
| | - Bernhard Richter
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Division of Cardiology, Medical University of Vienna, Wien, Wien, Austria
| | - Sam Salman
- University of Western Australia, Perth, Western Australia, Australia
| | - Tobias Strunk
- Neonatal Directorate, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Sharon Waterson
- Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Brad Wibrow
- Intensive Care Unit, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Fiona M Wood
- University of Western Australia, Perth, Western Australia, Australia
- Burns Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| |
Collapse
|
26
|
Ng S, Strunk T, Lee AH, Gill EE, Falsafi R, Woodman T, Hibbert J, Hancock REW, Currie A. Whole blood transcriptional responses of very preterm infants during late-onset sepsis. PLoS One 2020; 15:e0233841. [PMID: 32479514 PMCID: PMC7263612 DOI: 10.1371/journal.pone.0233841] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 12/18/2019] [Accepted: 05/12/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Host immune responses during late-onset sepsis (LOS) in very preterm infants are poorly characterised due to a complex and dynamic pathophysiology and challenges in working with small available blood volumes. We present here an unbiased transcriptomic analysis of whole peripheral blood from very preterm infants at the time of LOS. METHODS RNA-Seq was performed on peripheral blood samples (6-29 days postnatal age) taken at the time of suspected LOS from very preterm infants <30 weeks gestational age. Infants were classified based on blood culture positivity and elevated C-reactive protein concentrations as having confirmed LOS (n = 5), possible LOS (n = 4) or no LOS (n = 9). Bioinformatics and statistical analyses performed included pathway over-representation and protein-protein interaction network analyses. Plasma cytokine immunoassays were performed to validate differentially expressed cytokine pathways. RESULTS The blood leukocyte transcriptional responses of infants with confirmed LOS differed significantly from infants without LOS (1,317 differentially expressed genes). However, infants with possible LOS could not be distinguished from infants with no LOS or confirmed LOS. Transcriptional alterations associated with LOS included genes involved in pathogen recognition (mainly TLR pathways), cytokine signalling (both pro-inflammatory and inhibitory responses), immune and haematological regulation (including cell death pathways), and metabolism (altered cholesterol biosynthesis). At the transcriptional-level cytokine responses during LOS were characterised by over-representation of IFN-α/β, IFN-γ, IL-1 and IL-6 signalling pathways and up-regulation of genes for inflammatory responses. Infants with confirmed LOS had significantly higher levels of IL-1α and IL-6 in their plasma. CONCLUSIONS Blood responses in very preterm infants with LOS are characterised by altered host immune responses that appear to reflect unbalanced immuno-metabolic homeostasis.
Collapse
Affiliation(s)
- Sherrianne Ng
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, WA, Australia
- Division of the Institute of Reproductive and Developmental Biology, Imperial College Parturition Research Group, Imperial College London, London, United Kingdom
- March of Dimes European Prematurity Research Centre, Imperial College London, London, United Kingdom
| | - Tobias Strunk
- Department of Health, Neonatal Directorate, King Edward Memorial Hospital, Child and Adolescent Health Service, Perth, WA, Australia
- Neonatal Infection & Immunity Team, Wesfarmers Centre of Vaccine & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Amy H. Lee
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Erin E. Gill
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Reza Falsafi
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tabitha Woodman
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, WA, Australia
- Neonatal Infection & Immunity Team, Wesfarmers Centre of Vaccine & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Julie Hibbert
- Neonatal Infection & Immunity Team, Wesfarmers Centre of Vaccine & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Robert E. W. Hancock
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Microbial Diseases and Immunity Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Currie
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, WA, Australia
- Neonatal Infection & Immunity Team, Wesfarmers Centre of Vaccine & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- * E-mail:
| |
Collapse
|
27
|
Hibbert J, Strunk T, Simmer K, Richmond P, Burgner D, Currie A. Plasma cytokine profiles in very preterm infants with late-onset sepsis. PLoS One 2020; 15:e0232933. [PMID: 32407417 PMCID: PMC7224469 DOI: 10.1371/journal.pone.0232933] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/22/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Deficiencies in innate immune responses may contribute to the increased susceptibility to infection in preterm infants. In vivo cytokine profiles in response to sepsis in very preterm infants are not fully understood. AIMS To characterise plasma pro- and anti-inflammatory cytokine concentrations and pre-defined ratios in very preterm infants with late-onset sepsis (LOS). METHODS In this observational study, peripheral blood samples were collected at the time of evaluation for suspected LOS from 31 preterm infants (<30 weeks gestational age). Plasma cytokine concentrations were determined by 12-plex immunoassay. RESULTS IL-10, IFN-γ, IL-12p70, IP-10, IL-6 and CCL2 were elevated in the majority infants with LOS (n = 12) compared to those without LOS (n = 19). There was no difference in TNF-α, IL-1β, IL-17AF, IL-8 and IL-15 concentrations between groups. IL-10/TNF-α ratios were increased, while CCL2/IL-10 and IL-12p70/IL-10 ratios were decreased in infants with LOS compared to those without. CONCLUSION Very preterm infants have a marked innate inflammatory response at the time of LOS. The increase in IL-10/TNF-α ratio may indicate early immune hypo-responsiveness. Longitudinal studies with a larger number of participants are required to understand immune responses and clinical outcomes following LOS in preterm infants.
Collapse
MESH Headings
- Australia/epidemiology
- Biomarkers/blood
- Case-Control Studies
- Cytokines/blood
- Female
- Gestational Age
- Humans
- Infant
- Infant, Newborn
- Infant, Premature/blood
- Infant, Premature/immunology
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/immunology
- Infant, Very Low Birth Weight/blood
- Infant, Very Low Birth Weight/immunology
- Inflammation/blood
- Inflammation/diagnosis
- Inflammation/epidemiology
- Inflammation/immunology
- Male
- Prospective Studies
- Sepsis/blood
- Sepsis/diagnosis
- Sepsis/epidemiology
- Sepsis/immunology
Collapse
Affiliation(s)
- Julie Hibbert
- Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Tobias Strunk
- Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Karen Simmer
- Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Peter Richmond
- Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Currie
- Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, Western Australia, Australia
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Western Australia, Australia
| |
Collapse
|
28
|
Lai JCY, Svedin P, Ek CJ, Mottahedin A, Wang X, Levy O, Currie A, Strunk T, Mallard C. Vancomycin Is Protective in a Neonatal Mouse Model of Staphylococcus epidermidis-Potentiated Hypoxic-Ischemic Brain Injury. Antimicrob Agents Chemother 2020; 64:e02003-19. [PMID: 31818825 PMCID: PMC7038267 DOI: 10.1128/aac.02003-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/06/2019] [Indexed: 12/27/2022] Open
Abstract
Infection is correlated with increased risk of neurodevelopmental sequelae in preterm infants. In modeling neonatal brain injury, Toll-like receptor agonists have often been used to mimic infections and induce inflammation. Using the most common cause of bacteremia in preterm infants, Staphylococcus epidermidis, we present a more clinically relevant neonatal mouse model that addresses the combined effects of bacterial infection together with subsequent hypoxic-ischemic brain insult. Currently, there is no neuroprotective treatment for the preterm population. Hence, we tested the neuroprotective effects of vancomycin with and without adjunct therapy using the anti-inflammatory agent pentoxifylline. We characterized the effects of S. epidermidis infection on the inflammatory response in the periphery and the brain, as well as the physiological changes in the central nervous system that might affect neurodevelopmental outcomes. Intraperitoneal injection of postnatal day 4 mice with a live clinical isolate of S. epidermidis led to bacteremia and induction of proinflammatory cytokines in the blood, as well as transient elevations of neutrophil and monocyte chemotactic cytokines and caspase 3 activity in the brain. When hypoxia-ischemia was induced postinfection, more severe brain damage was observed in infected animals than in saline-injected controls. This infection-induced inflammation and potentiated brain injury was inoculum dose dependent and was alleviated by the antibiotic vancomycin. Pentoxifylline did not provide any additional neuroprotective effect. Thus, we show for the first time that live S. epidermidis potentiates hypoxic-ischemic preterm brain injury and that peripheral inhibition of inflammation with antibiotics, such as vancomycin, reduces the extent of brain injury.
Collapse
Affiliation(s)
- Jacqueline C Y Lai
- Center for Perinatal Medicine and Health, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Pernilla Svedin
- Center for Perinatal Medicine and Health, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Joakim Ek
- Center for Perinatal Medicine and Health, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Amin Mottahedin
- Center for Perinatal Medicine and Health, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Xiaoyang Wang
- Center for Perinatal Medicine and Health, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Andrew Currie
- Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Western Australia, Australia
| | - Tobias Strunk
- Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia
- Neonatal Directorate, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
| | - Carina Mallard
- Center for Perinatal Medicine and Health, Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
29
|
Strunk T, Hibbert JE, Doherty D, Nathan E, Simmer K, Patole SK, Trend S, Richmond P, Burgner D, Currie A. Lactoferrin Expression Is Not Associated with Late-Onset Sepsis in Very Preterm Infants. Neonatology 2020; 117:606-611. [PMID: 32862184 DOI: 10.1159/000509404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/15/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Preterm infants are at a high risk of developing late-onset sepsis (LOS). Lactoferrin is one of the most abundant endogenous antimicrobial proteins expressed in breast milk, stools, and blood, and a candidate for preventive intervention. Large clinical trials have recently investigated whether enteral supplementation with bovine lactoferrin reduces LOS. AIM To characterize lactoferrin levels in preterm infants with and without LOS during the first month of life. METHODS Very preterm and term infants were recruited and serial biosamples collected during the first month of life. Lactoferrin levels were determined by immunoassay in cord blood and peripheral blood on days 1, 7, 14, 21, and 28; in the stools on days 1 and 28; and in the mother's breast milk on days 7 and 21. Furthermore, we assessed the capacity of the peripheral blood to release lactoferrin in response to an in vitro challenge with live Staphylococcus epidermidis, lipopolysaccharide, and fibroblast-stimulating lipopeptide 1. RESULTS Plasma lactoferrin levels were higher in cord blood and day 1 peripheral blood and declined during the first month of life. Plasma lactoferrin levels were similar in term infants and in preterm infants with (n = 32) and without LOS (n = 53). S. epidermidis-induced lactoferrin levels were lower following the sepsis episode. CONCLUSIONS Endogenous lactoferrin expression in preterm infants does not appear to affect their risk of developing LOS. These findings are in line with the lack of benefit recently observed in large trials of enteral supplementation with bovine lactoferrin to prevent LOS.
Collapse
Affiliation(s)
- Tobias Strunk
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Washington, Australia, .,Wesfarmers' Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Washington, Australia, .,School of Medicine, University of Western Australia, Perth, Washington, Australia,
| | - Julie Elizabeth Hibbert
- Wesfarmers' Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Washington, Australia.,School of Medicine, University of Western Australia, Perth, Washington, Australia
| | - Dorota Doherty
- School of Medicine, University of Western Australia, Perth, Washington, Australia
| | - Elizabeth Nathan
- School of Medicine, University of Western Australia, Perth, Washington, Australia
| | - Karen Simmer
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Washington, Australia.,Wesfarmers' Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Washington, Australia.,School of Medicine, University of Western Australia, Perth, Washington, Australia
| | - Sanjay Keshav Patole
- Neonatal Directorate, King Edward Memorial Hospital, Perth, Washington, Australia.,School of Medicine, University of Western Australia, Perth, Washington, Australia
| | - Stephanie Trend
- Wesfarmers' Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Washington, Australia.,Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Washington, Australia
| | - Peter Richmond
- Wesfarmers' Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Washington, Australia.,School of Medicine, University of Western Australia, Perth, Washington, Australia.,Department of Immunology, Perth Children's Hospital, Perth, Washington, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Currie
- Wesfarmers' Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Washington, Australia.,Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Washington, Australia
| |
Collapse
|
30
|
Currie A, Soop M, Demartines N, Fearon K, Kennedy R, Ljungqvist O. Erratum to: Enhanced Recovery After Surgery Interactive Audit System: 10 Years' Experience with an International Web-Based Clinical and Research Perioperative Care Database. Clin Colon Rectal Surg 2019; 32:e1. [PMID: 30976206 DOI: 10.1055/s-0039-1678573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
[This corrects the article DOI: 10.1055/s-0038-1673357.].
Collapse
Affiliation(s)
- Andrew Currie
- Department of Surgery, St Mark's Hospital, Harrow, United Kingdom
| | - Mattias Soop
- Department of Surgery, University of Manchester, Manchester, United Kingdom.,Department of Surgery, Salford Royal Hospital, Manchester, United Kingdom
| | - Nicolas Demartines
- Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland
| | - Kenneth Fearon
- Department of Surgery, University of Edinburgh and Colorectal Unit, Western General Hospital, Edinburgh, United Kingdom
| | - Robin Kennedy
- Department of Surgery, St Mark's Hospital, Harrow, United Kingdom.,Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Olle Ljungqvist
- Department of Surgery, Örebro University Hospital, Örebro, Sweden
| |
Collapse
|
31
|
Decker E, Currie A, Baig MK. Prolene hernia system versus Lichtenstein repair for inguinal hernia: a meta-analysis. Hernia 2019; 23:541-546. [PMID: 30771031 DOI: 10.1007/s10029-019-01897-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/20/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lichtenstein repair is standard practice for inguinal herniorrhaphy, but there is increasing public concern in the use of mesh and postoperative chronic pain. New mesh technology, such as the prolene hernia system, has a preperitoneal component to reinforce the myopectineal orifice aim to reduce the risk of recurrence and chronic pain. This meta-analysis compares outcomes using prolene hernia system versus lichenstein repair for inguinal hernias. METHODS Randomized-controlled trials comparing prolene hernia system and Lichtenstein repair were identified using Embase, Medline, and published conference abstracts. Primary outcomes were recurrence and chronic pain. Secondary outcomes were mean operating time, composite complications, surgical reintervention, and time to normal activities. Odds ration and standardized mean differences were calculated. RESULTS 1377 hernia repairs were identified from a total of 7 trials. Mean follow-up was 12-91 months. There was no difference between the techniques for recurrence [pooled analysis odds ratio: 0.86 (95% CI 0.32-2.28); p = 0.76] and chronic pain [pooled analysis odds ratio: 1.00 (95% CIs 0.65-1.55); p = 1]. Prolene hernia system demonstrated a shorter time to return to normal activities [pooled weighted mean difference - 0.54 (95% CI - 1.07 to - 0.01); p = 0.04]. Other outcomes were similar in mean operating time, composite complications, and surgical reintervention. CONCLUSION Both prolene hernia system and Lichenstein repair appear comparable acceptable techniques for inguinal herniorrhaphy. Further longer-term studies of new mesh technologies will improve information available to surgeons and their patients.
Collapse
Affiliation(s)
- E Decker
- Department of General Surgery, Worthing Hospital, Lyndhurst Road, Worthing, BN11 2DH, UK.
| | - A Currie
- Department of General Surgery, Worthing Hospital, Lyndhurst Road, Worthing, BN11 2DH, UK
| | - M K Baig
- Department of General Surgery, Worthing Hospital, Lyndhurst Road, Worthing, BN11 2DH, UK
| |
Collapse
|
32
|
Currie A, Soop M, Demartines N, Fearon K, Kennedy R, Ljungqvist O. Enhanced Recovery After Surgery Interactive Audit System: 10 Years' Experience with an International Web-Based Clinical and Research Perioperative Care Database. Clin Colon Rectal Surg 2019; 32:75-81. [PMID: 30647549 DOI: 10.1055/s-0038-1673357] [Citation(s) in RCA: 17] [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] [Indexed: 12/20/2022]
Abstract
The Enhanced Recovery After Surgery (ERAS) is a managed care program that has shown the ability to reduce complications following elective colorectal surgery. In 2006, the ERAS ® Society developed the ERAS ® Interactive Audit System (EIAS), which has allowed centers in over 20 countries to enter perioperative patient data to benchmark against international practice within the audit system and act as a stimulus for quality improvement. The de-identified patient data are coded in SQL (a relational database), stored on secure servers, and data governance aspects have been secured in all involved countries. A collaborative approach is undertaken within involved units toward research questions with published cohort data from the audit system having demonstrated the importance of overall compliance on improving patient outcomes and less cost of care. The EIAS has shown that collaborative clinical effort can drive quality improvement in a short time frame in an international context.
Collapse
Affiliation(s)
- Andrew Currie
- Department of Surgery, St Mark's Hospital, Harrow, United Kingdom
| | - Mattias Soop
- Department of Surgery, University of Manchester, Manchester, United Kingdom.,Department of Surgery, Salford Royal Hospital, Manchester, United Kingdom
| | - Nicolas Demartines
- Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland
| | - Kenneth Fearon
- Department of Surgery, University of Edinburgh and Colorectal Unit, Western General Hospital, Edinburgh, United Kingdom
| | - Robin Kennedy
- Department of Surgery, St Mark's Hospital, Harrow, United Kingdom.,Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Olle Ljungqvist
- Department of Surgery, Örebro University Hospital, Örebro, Sweden
| |
Collapse
|
33
|
Strunk T, Gummer JPA, Abraham R, Abraham S, Hibbert J, Patole S, Currie A. Topical Coconut Oil Contributes to Systemic Monolaurin Levels in Very Preterm Infants. Neonatology 2019; 116:299-301. [PMID: 31330518 DOI: 10.1159/000501280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Tobias Strunk
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Washington, Australia, .,Centre for Neonatal Research and Education, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Washington, Australia,
| | - Joel P A Gummer
- Separation Science and Metabolomics Laboratory, Murdoch University, Murdoch, Washington, Australia.,Metabolomics Australia, Western Australia Node, Murdoch University, Murdoch, Washington, Australia
| | - Rebecca Abraham
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Washington, Australia
| | - Sam Abraham
- Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Washington, Australia
| | - Julie Hibbert
- Centre for Neonatal Research and Education, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Washington, Australia
| | - Sanjay Patole
- Neonatal Directorate, King Edward Memorial Hospital for Women, Perth, Washington, Australia.,Centre for Neonatal Research and Education, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Washington, Australia
| | - Andrew Currie
- Centre for Neonatal Research and Education, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Washington, Australia.,Medical, Molecular and Forensic Sciences, Murdoch University, Perth, Washington, Australia
| |
Collapse
|
34
|
Abstract
Neonatal sepsis remains a significant cause of morbidity and mortality especially in the preterm infant population. The ability to promptly and accurately diagnose neonatal sepsis based on clinical evaluation and laboratory blood tests remains challenging. Advances in high-throughput molecular technologies have increased investigations into the utility of transcriptomic, proteomic and metabolomic approaches as diagnostic tools for neonatal sepsis. A systems-level understanding of neonatal sepsis, obtained by using omics-based technologies (at the transcriptome, proteome or metabolome level), may lead to new diagnostic tools for neonatal sepsis. In particular, recent omic-based studies have identified distinct transcriptional signatures and metabolic or proteomic biomarkers associated with sepsis. Despite the emerging need for a systems biology approach, future studies have to address the challenges of integrating multi-omic data with laboratory and clinical meta-data in order to translate outcomes into precision medicine for neonatal sepsis. Omics-based analytical approaches may advance diagnostic tools for neonatal sepsis. More research is needed to validate the recent systems biology findings in order to integrate multi-dimensional data (clinical, laboratory and multi-omic) for future translation into precision medicine for neonatal sepsis. This review will discuss the possible applications of omics-based analyses for identification of new biomarkers and diagnostic signatures for neonatal sepsis, focusing on the immune-compromised preterm infant and considerations for clinical translation.
Collapse
Affiliation(s)
- Sherrianne Ng
- Medical and Molecular Sciences, School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Tobias Strunk
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, WA, Australia
| | - Pingping Jiang
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Tik Muk
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Per T Sangild
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Andrew Currie
- Medical and Molecular Sciences, School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia.,Centre for Neonatal Research and Education, The University of Western Australia, Perth, WA, Australia
| |
Collapse
|
35
|
Currie A, Limb C, Decker E, Munday J, Baig K. Outcomes of prophylactic ureteric stenting for elective colorectal surgery within an enhanced recovery programme. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Pettengill M, Matute JD, Tresenriter M, Hibbert J, Burgner D, Richmond P, Millán JL, Ozonoff A, Strunk T, Currie A, Levy O. Correction: Human alkaline phosphatase dephosphorylates microbial products and is elevated in preterm neonates with a history of late-onset sepsis. PLoS One 2018; 13:e0197532. [PMID: 29746597 PMCID: PMC5945041 DOI: 10.1371/journal.pone.0197532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
37
|
McAllister-Williams RH, Christmas DMB, Cleare AJ, Currie A, Gledhill J, Insole L, Malizia AL, McGeever M, Morriss R, Robinson LJ, Scott M, Stokes PRA, Talbot PS, Young AH. Multiple-therapy-resistant major depressive disorder: a clinically important concept. Br J Psychiatry 2018; 212:274-278. [PMID: 30517072 DOI: 10.1192/bjp.2017.33] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Many novel therapeutic options for depression exist that are either not mentioned in clinical guidelines or recommended only for use in highly specialist services. The challenge faced by clinicians is when it might be appropriate to consider such 'non-standard' interventions. This analysis proposes a framework to aid this decision.Declaration of interestIn the past 3 years R.H.M.W. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending advisory boards) from various pharmaceutical companies including Astra Zeneca, Cyberonics, Eli Lilly, Janssen, LivaNova, Lundbeck, MyTomorrows, Otsuka, Pfizer, Roche, Servier, SPIMACO and Sunovion. D.M.B.C. has received fees from LivaNova for attending an advisory board. In the past 3 years A.J.C. has received fees for lecturing from Astra Zeneca and Lundbeck; fees for consulting from LivaNova, Janssen and Allergan; and research grant support from Lundbeck.In the past 3 years A.C. has received fees for lecturing from pharmaceutical companies namely Lundbeck and Sunovion. In the past 3 years A.L.M. has received support for attending seminars and fees for consultancy work (including advisory board) from Medtronic Inc and LivaNova. R.M. holds joint research grants with a number of digital companies that investigate devices for depression including Alpha-stim, Big White Wall, P1vital, Intel, Johnson and Johnson and Lundbeck through his mindTech and CLAHRC EM roles. M.S. is an associate at Blueriver Consulting providing intelligence to NHS organisations, pharmaceutical and devices companies. He has received honoraria for presentations and advisory boards with Lundbeck, Eli Lilly, URGO, AstraZeneca, Phillips and Sanofi and holds shares in Johnson and Johnson. In the past 3 years P.R.A.S. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending an advisory board) from life sciences companies including Corcept Therapeutics, Indivior and LivaNova. In the past 3 years P.S.T. has received consultancy fees as an advisory board member from the following companies: Galen Limited, Sunovion Pharmaceuticals Europe Ltd, myTomorrows and LivaNova. A.H.Y. has undertaken paid lectures and advisory boards for all major pharmaceutical companies with drugs used in affective and related disorders and LivaNova. He has received funding for investigator initiated studies from AstraZeneca, Eli Lilly, Lundbeck and Wyeth.
Collapse
Affiliation(s)
- R H McAllister-Williams
- Institute of Neuroscience,Newcastle University,Newcastle upon Tyne and Regional Affective Disorders Service,Northumberland Tyne and Wear NHS Foundation Trust,Newcastle upon Tyne
| | - D M B Christmas
- Advanced Interventions Service,Ninewells Hospital & Medical School,Dundee
| | - A J Cleare
- Centre for Affective Disorders,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London and Maudsley NHS Foundation Trust,London
| | - A Currie
- Regional Affective Disorders Service,Northumberland Tyne and Wear NHS Foundation Trust,Newcastle upon Tyne
| | - J Gledhill
- North Durham Clinical Commissioning Group,County Durham
| | - L Insole
- North East Community Mental Health Team,Northumberland Tyne and Wear NHS Foundation Trust,Newcastle upon Tyne
| | - A L Malizia
- Neuropsychopharmacology and Neuromodulation,Rosa Burden Centre,Southmead Hospital,North Bristol NHS Trust,Bristol
| | - M McGeever
- Benfield Park Medical Group, Newcastle Gateshead Clinical Commissioning Group,Newcastle upon Tyne
| | - R Morriss
- Centre for Mood Disorders,Institute of Mental Health,University of Nottingham,Nottingham
| | - L J Robinson
- Institute of Neuroscience,Newcastle University,Newcastle upon Tyne and Regional Affective Disorders Service,Northumberland Tyne and Wear NHS Foundation Trust,Newcastle upon Tyne
| | - M Scott
- Newburn Surgery,Newcastle Gateshead Clinical Commissioning Group,Newcastle upon Tyne
| | - P R A Stokes
- Centre for Affective Disorders,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London and Maudsley NHS Foundation Trust,London
| | - P S Talbot
- Wolfson Molecular Imaging Centre,University of Manchester and Specialist Service for Affective Disorders,Greater Manchester Mental Health NHS Foundation Trust,Manchester
| | - A H Young
- Centre for Affective Disorders,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London and South London and Maudsley NHS Foundation Trust,London
| |
Collapse
|
38
|
Abstract
Neonates, especially those born preterm, are at increased risk of sepsis and adverse long-term effects associated with infection-related inflammation. Distinct neonatal immune responses and dysregulated inflammation are central to this unique susceptibility. The traditional separation of sepsis into an initial hyper-inflammatory response followed by hypo-inflammation is continually under review with new developments in this area of research. There is evidence to support the association of mortality in the early acute phase of sepsis with an overwhelming hyper-inflammatory immune response. Emerging evidence from adults suggests that hypo- and hyper-inflammation can occur during any phase of sepsis and that sepsis-immunosuppression is associated with increased mortality, morbidity, and risk to subsequent infection. In adults, sepsis-induced immunosuppression (SII) is characterised by alterations of innate and adaptive immune responses, including, but not limited to, a prominent bias toward anti-inflammatory cytokine secretion, diminished antigen presentation to T cells, and reduced activation and proliferation of T cells. It is unclear if sepsis-immunosuppression also plays a role in the adverse outcomes associated with neonatal sepsis. This review will focus on exploring if key characteristics associated with SII in adults are observed in neonates with sepsis.
Collapse
Affiliation(s)
- Julie E Hibbert
- Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia
| | - Andrew Currie
- Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia.,School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Tobias Strunk
- Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia.,Neonatal Directorate, King Edward Memorial Hospital for Women, Subiaco, WA, Australia
| |
Collapse
|
39
|
Lawford-Smith H, Currie A. Accelerating the carbon cycle: the ethics of enhanced weathering. Biol Lett 2017; 13:rsbl.2016.0859. [PMID: 28381632 DOI: 10.1098/rsbl.2016.0859] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/03/2016] [Indexed: 11/12/2022] Open
Abstract
Enhanced weathering, in comparison to other geoengineering measures, creates the possibility of a reduced cost, reduced impact way of decreasing atmospheric carbon, with positive knock-on effects such as decreased oceanic acidity. We argue that ethical concerns have a place alongside empirical, political and social factors as we consider how to best respond to the critical challenge that anthropogenic climate change poses. We review these concerns, considering the ethical issues that arise (or would arise) in the large-scale deployment of enhanced weathering. We discuss post-implementation scenarios, failures of collective action, the distribution of risk and externalities and redress for damage. We also discuss issues surrounding 'dirty hands' (taking conventionally immoral action to avoid having to take action that is even worse), whether enhanced weathering research might present a moral hazard, the importance of international governance and the notion that the implementation of large-scale enhanced weathering would reveal problematic hubris. Ethics and scientific research interrelate in complex ways: some ethical considerations caution against research and implementation, while others encourage them. Indeed, the ethical perspective encourages us to think more carefully about how, and what types of, geoengineering should be researched and implemented.
Collapse
Affiliation(s)
- H Lawford-Smith
- Department of Philosophy, University of Sheffield, Sheffield S3 7QB, UK
| | - A Currie
- CRASSH, University of Cambridge, Cambridge, Cambridgeshire CB2 3QY, UK
| |
Collapse
|
40
|
Strunk T, Hibbert J, Doherty D, Granland C, Trend S, Simmer K, Burgner D, Patole S, Currie A. Probiotics and antimicrobial protein and peptide levels in preterm infants. Acta Paediatr 2017; 106:1747-1753. [PMID: 28294428 DOI: 10.1111/apa.13826] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/22/2017] [Accepted: 03/07/2017] [Indexed: 12/26/2022]
Abstract
AIM To characterise the secreted and inducible antimicrobial protein and peptide (APP) levels in a prospective cohort of preterm infants (<30 weeks gestational age) with or without Bifidobacterium breve M16V supplementation during the first month of life. METHODS We analysed serial biosamples of infants who did (n = 13) or did not receive (n = 62) B. breve (3 × 109 cfu/day). Peripheral blood was obtained on days 1, 14 and 28, and infant stool prior to commencement of probiotic supplementation and on day 21. Levels of APP (bactericidal/permeability inducing protein (BPI), beta defensins 1 and 2, lactoferrin, human cathelicidin, secretory phospholipase A2) in plasma and stool were determined. Further, we characterised induced APP levels in whole blood cultured with live S. epidermidis or with agonists of Toll-like receptors 2/6 and 4. RESULTS Stool, plasma and stimulated blood APP levels changed significantly during the first month of life. Supplementation with B. breve did not affect basal or stimulated APP levels except for a transient increase in inducible BPI. CONCLUSION Supplementation with B. breve does not appear to act via modulation of systemic or enteric APP expression in preterm infants although small effects cannot be excluded. Further work with other probiotic preparations is warranted.
Collapse
Affiliation(s)
- Tobias Strunk
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Neonatal Clinical Care Unit; King Edward Memorial Hospital; Perth WA Australia
| | - Julie Hibbert
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
| | - Dorota Doherty
- School of Women's and Infant's Health; University of Western Australia; Perth WA Australia
| | - Caitlyn Granland
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
| | - Stephanie Trend
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
| | - Karen Simmer
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Neonatal Clinical Care Unit; King Edward Memorial Hospital; Perth WA Australia
| | - David Burgner
- Murdoch Childrens Research Institute; Royal Children's Hospital; Parkville VIC Australia
- Department of Paediatrics; University of Melbourne; Melbourne VIC Australia
| | - Sanjay Patole
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- Neonatal Clinical Care Unit; King Edward Memorial Hospital; Perth WA Australia
| | - Andrew Currie
- Centre for Neonatal Research and Education; School of Paediatrics and Child Health; University of Western Australia; Perth WA Australia
- School of Veterinary and Life Sciences; Murdoch University; Perth WA Australia
| |
Collapse
|
41
|
Lim FH, Lovering AM, Currie A, Jenkins DR. Linezolid and lactation: measurement of drug levels in breast milk and the nursing infant. J Antimicrob Chemother 2017; 72:2677-2678. [DOI: 10.1093/jac/dkx159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
42
|
Akerib DS, Alsum S, Aquino C, Araújo HM, Bai X, Bailey AJ, Balajthy J, Beltrame P, Bernard EP, Bernstein A, Biesiadzinski TP, Boulton EM, Brás P, Byram D, Cahn SB, Carmona-Benitez MC, Chan C, Chiller AA, Chiller C, Currie A, Cutter JE, Davison TJR, Dobi A, Dobson JEY, Druszkiewicz E, Edwards BN, Faham CH, Fallon SR, Fiorucci S, Gaitskell RJ, Gehman VM, Ghag C, Gibson KR, Gilchriese MGD, Hall CR, Hanhardt M, Haselschwardt SJ, Hertel SA, Hogan DP, Horn M, Huang DQ, Ignarra CM, Jacobsen RG, Ji W, Kamdin K, Kazkaz K, Khaitan D, Knoche R, Larsen NA, Lee C, Lenardo BG, Lesko KT, Lindote A, Lopes MI, Manalaysay A, Mannino RL, Marzioni MF, McKinsey DN, Mei DM, Mock J, Moongweluwan M, Morad JA, Murphy ASJ, Nehrkorn C, Nelson HN, Neves F, O'Sullivan K, Oliver-Mallory KC, Palladino KJ, Pease EK, Reichhart L, Rhyne C, Shaw S, Shutt TA, Silva C, Solmaz M, Solovov VN, Sorensen P, Stephenson S, Sumner TJ, Szydagis M, Taylor DJ, Taylor WC, Tennyson BP, Terman PA, Tiedt DR, To WH, Tripathi M, Tvrznikova L, Uvarov S, Velan V, Verbus JR, Webb RC, White JT, Whitis TJ, Witherell MS, Wolfs FLH, Xu J, Yazdani K, Young SK, Zhang C. First Searches for Axions and Axionlike Particles with the LUX Experiment. Phys Rev Lett 2017; 118:261301. [PMID: 28707937 DOI: 10.1103/physrevlett.118.261301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Indexed: 06/07/2023]
Abstract
The first searches for axions and axionlike particles with the Large Underground Xenon experiment are presented. Under the assumption of an axioelectric interaction in xenon, the coupling constant between axions and electrons g_{Ae} is tested using data collected in 2013 with an exposure totaling 95 live days ×118 kg. A double-sided, profile likelihood ratio statistic test excludes g_{Ae} larger than 3.5×10^{-12} (90% C.L.) for solar axions. Assuming the Dine-Fischler-Srednicki-Zhitnitsky theoretical description, the upper limit in coupling corresponds to an upper limit on axion mass of 0.12 eV/c^{2}, while for the Kim-Shifman-Vainshtein-Zhakharov description masses above 36.6 eV/c^{2} are excluded. For galactic axionlike particles, values of g_{Ae} larger than 4.2×10^{-13} are excluded for particle masses in the range 1-16 keV/c^{2}. These are the most stringent constraints to date for these interactions.
Collapse
Affiliation(s)
- D S Akerib
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - S Alsum
- University of Wisconsin-Madison, Department of Physics, 1150 University Avenue, Madison, Wisconsin 53706, USA
| | - C Aquino
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - H M Araújo
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - X Bai
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
| | - A J Bailey
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J Balajthy
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - P Beltrame
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - E P Bernard
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - A Bernstein
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - T P Biesiadzinski
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - E M Boulton
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - P Brás
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - D Byram
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S B Cahn
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, 104 Davey Lab, University Park, Pennsylvania 16802-6300, USA
| | - C Chan
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - A A Chiller
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - C Chiller
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - A Currie
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J E Cutter
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - T J R Davison
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - A Dobi
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - J E Y Dobson
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - B N Edwards
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C H Faham
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S R Fallon
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - S Fiorucci
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - R J Gaitskell
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C Ghag
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - K R Gibson
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - M Hanhardt
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S J Haselschwardt
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - S A Hertel
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337 USA
| | - D P Hogan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - M Horn
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - D Q Huang
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - C M Ignarra
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - R G Jacobsen
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - W Ji
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - K Kamdin
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - K Kazkaz
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - R Knoche
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - N A Larsen
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C Lee
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - B G Lenardo
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - A Lindote
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M I Lopes
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Manalaysay
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - R L Mannino
- Texas A & M University, Department of Physics, College Station, Texas 77843, USA
| | - M F Marzioni
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - D N McKinsey
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - D-M Mei
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - J Mock
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - M Moongweluwan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - J A Morad
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - A St J Murphy
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - C Nehrkorn
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - H N Nelson
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - F Neves
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - K O'Sullivan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - K C Oliver-Mallory
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - K J Palladino
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
- University of Wisconsin-Madison, Department of Physics, 1150 University Avenue, Madison, Wisconsin 53706, USA
| | - E K Pease
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - L Reichhart
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - C Rhyne
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - S Shaw
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - T A Shutt
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - C Silva
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M Solmaz
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - V N Solovov
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Stephenson
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - T J Sumner
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - M Szydagis
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - D J Taylor
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - W C Taylor
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - B P Tennyson
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - P A Terman
- Texas A & M University, Department of Physics, College Station, Texas 77843, USA
| | - D R Tiedt
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
| | - W H To
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - M Tripathi
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - L Tvrznikova
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - S Uvarov
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - V Velan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - J R Verbus
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - R C Webb
- Texas A & M University, Department of Physics, College Station, Texas 77843, USA
| | - J T White
- Texas A & M University, Department of Physics, College Station, Texas 77843, USA
| | - T J Whitis
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - J Xu
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - K Yazdani
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - S K Young
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - C Zhang
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| |
Collapse
|
43
|
Akerib DS, Alsum S, Araújo HM, Bai X, Bailey AJ, Balajthy J, Beltrame P, Bernard EP, Bernstein A, Biesiadzinski TP, Boulton EM, Brás P, Byram D, Cahn SB, Carmona-Benitez MC, Chan C, Chiller AA, Chiller C, Currie A, Cutter JE, Davison TJR, Dobi A, Dobson JEY, Druszkiewicz E, Edwards BN, Faham CH, Fallon SR, Fiorucci S, Gaitskell RJ, Gehman VM, Ghag C, Gilchriese MGD, Hall CR, Hanhardt M, Haselschwardt SJ, Hertel SA, Hogan DP, Horn M, Huang DQ, Ignarra CM, Jacobsen RG, Ji W, Kamdin K, Kazkaz K, Khaitan D, Knoche R, Larsen NA, Lee C, Lenardo BG, Lesko KT, Lindote A, Lopes MI, Manalaysay A, Mannino RL, Marzioni MF, McKinsey DN, Mei DM, Mock J, Moongweluwan M, Morad JA, Murphy ASJ, Nehrkorn C, Nelson HN, Neves F, O'Sullivan K, Oliver-Mallory KC, Palladino KJ, Pease EK, Reichhart L, Rhyne C, Shaw S, Shutt TA, Silva C, Solmaz M, Solovov VN, Sorensen P, Stephenson S, Sumner TJ, Szydagis M, Taylor DJ, Taylor WC, Tennyson BP, Terman PA, Tiedt DR, To WH, Tripathi M, Tvrznikova L, Uvarov S, Velan V, Verbus JR, Webb RC, White JT, Whitis TJ, Witherell MS, Wolfs FLH, Xu J, Yazdani K, Young SK, Zhang C. Limits on Spin-Dependent WIMP-Nucleon Cross Section Obtained from the Complete LUX Exposure. Phys Rev Lett 2017; 118:251302. [PMID: 28696768 DOI: 10.1103/physrevlett.118.251302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Indexed: 06/07/2023]
Abstract
We present experimental constraints on the spin-dependent WIMP-nucleon elastic cross sections from the total 129.5 kg yr exposure acquired by the Large Underground Xenon experiment (LUX), operating at the Sanford Underground Research Facility in Lead, South Dakota (USA). A profile likelihood ratio analysis allows 90% C.L. upper limits to be set on the WIMP-neutron (WIMP-proton) cross section of σ_{n}=1.6×10^{-41} cm^{2} (σ_{p}=5×10^{-40} cm^{2}) at 35 GeV c^{-2}, almost a sixfold improvement over the previous LUX spin-dependent results. The spin-dependent WIMP-neutron limit is the most sensitive constraint to date.
Collapse
Affiliation(s)
- D S Akerib
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - S Alsum
- University of Wisconsin-Madison, Department of Physics, 1150 University Avenue, Madison, Wisconsin 53706, USA
| | - H M Araújo
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - X Bai
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
| | - A J Bailey
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J Balajthy
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - P Beltrame
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - E P Bernard
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - A Bernstein
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - T P Biesiadzinski
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - E M Boulton
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - P Brás
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - D Byram
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S B Cahn
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, 104 Davey Lab, University Park, Pennsylvania 16802-6300, USA
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - C Chan
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - A A Chiller
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - C Chiller
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - A Currie
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J E Cutter
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - T J R Davison
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - A Dobi
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - J E Y Dobson
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - B N Edwards
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C H Faham
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S R Fallon
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - S Fiorucci
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - R J Gaitskell
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C Ghag
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - M Hanhardt
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S J Haselschwardt
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - S A Hertel
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - D P Hogan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - M Horn
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - D Q Huang
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - C M Ignarra
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - R G Jacobsen
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - W Ji
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - K Kamdin
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - K Kazkaz
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - R Knoche
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - N A Larsen
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C Lee
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - B G Lenardo
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - A Lindote
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M I Lopes
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Manalaysay
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - R L Mannino
- Texas A&M University, Department of Physics, College Station, Texas 77843, USA
| | - M F Marzioni
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - D N McKinsey
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - D-M Mei
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - J Mock
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - M Moongweluwan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - J A Morad
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - A St J Murphy
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - C Nehrkorn
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - H N Nelson
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - F Neves
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - K O'Sullivan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - K C Oliver-Mallory
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - K J Palladino
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
- University of Wisconsin-Madison, Department of Physics, 1150 University Avenue, Madison, Wisconsin 53706, USA
| | - E K Pease
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - L Reichhart
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - C Rhyne
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - S Shaw
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - T A Shutt
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - C Silva
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M Solmaz
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - V N Solovov
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Stephenson
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - T J Sumner
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - M Szydagis
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - D J Taylor
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - W C Taylor
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - B P Tennyson
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - P A Terman
- Texas A&M University, Department of Physics, College Station, Texas 77843, USA
| | - D R Tiedt
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
| | - W H To
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
- California State University Stanislaus, Department of Physics, 1 University Circle, Turlock, California 95382, USA
| | - M Tripathi
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - L Tvrznikova
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Uvarov
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - V Velan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - J R Verbus
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - R C Webb
- Texas A&M University, Department of Physics, College Station, Texas 77843, USA
| | - J T White
- Texas A&M University, Department of Physics, College Station, Texas 77843, USA
| | - T J Whitis
- Case Western Reserve University, Department of Physics, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - J Xu
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - K Yazdani
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - S K Young
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - C Zhang
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| |
Collapse
|
44
|
Jong E, Strunk T, Burgner D, Lavoie PM, Currie A. The phenotype and function of preterm infant monocytes: implications for susceptibility to infection. J Leukoc Biol 2017. [DOI: 10.1189/jlb.4ru0317-111r] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Emma Jong
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
| | - Tobias Strunk
- School of Paediatrics and Child Health, University of Western Australia, Crawley, Australia
- Neonatal Clinical Care Unit, King Edward Memorial and Princess Margaret Hospitals, Subiaco, Australia
| | - David Burgner
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- Department of Paediatrics, Monash University, Clayton, Australia; and
| | - Pascal M. Lavoie
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - Andrew Currie
- School of Paediatrics and Child Health, University of Western Australia, Crawley, Australia
| |
Collapse
|
45
|
Burgner DP, Doherty D, Humphreys J, Currie A, Simmer K, Charles A, Strunk T. Maternal Chorioamnionitis and Postneonatal Respiratory Tract Infection in Ex-Preterm Infants. J Pediatr 2017; 184:62-67.e2. [PMID: 28233549 DOI: 10.1016/j.jpeds.2017.01.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/16/2016] [Accepted: 01/12/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess whether exposure to histologically confirmed chorioamnionitis (ie, histologic chorioamnionitis [HCA]) is associated with altered risk of infection-related hospitalization (IRH) during the first 24 months of life in very preterm infants. STUDY DESIGN This single-center retrospective cohort study analyzed data on 1218 infants born at <30 weeks gestational age (GA). Semiquantitative placental histology, obstetric, and neonatal data were extracted from hospital databases and linked with discharge diagnoses on rehospitalization until age 24 months from statewide statutory data. The associations between HCA and overall and clinical categories of IRH were analyzed by Cox proportional hazards regression with left-truncated failure times. RESULTS Mean GA was 27 weeks, and HCA was present in 577 placentas (47.4%). Among the 1088 infants surviving until the birth-related discharge, 684 (62.9%) of had at least 1 IRH by age 24 months, of whom 287 included a diagnosis of acute lower respiratory tract infection (ALRTI). Following adjustment for sex, birth weight z-score, GA, early-onset sepsis, late-onset sepsis, previous antibiotic use, age at birth-related discharge, and chronic lung disease, HCA was associated with a 32% increased risk of hospitalization with ALRTI (HR, 1.32; 95% CI, 1.02-1.70; P = .033). There was no association with infection overall or with other infection categories. CONCLUSIONS HCA is associated with a significantly increased risk of hospitalization with ALRTI that is independent of known risk factors, including chronic lung disease.
Collapse
Affiliation(s)
- David P Burgner
- Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Australia; Department of Paediatrics, Monash University, Australia; Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia.
| | - Dorota Doherty
- School of Women's and Infants' Health, University of Western Australia, Australia; Women and Infants Research Foundation, Perth, Australia
| | | | - Andrew Currie
- Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia; Molecular and Biomedical Sciences, Murdoch University, Australia
| | - Karen Simmer
- Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia; Neonatal Clinical Care Unit, King Edward Memorial and Princess Margaret Hospitals, Subiaco, WA
| | - Adrian Charles
- Department of Pathology, Sidra Medical and Research Center, Doha, Qatar
| | - Tobias Strunk
- Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Australia; Neonatal Clinical Care Unit, King Edward Memorial and Princess Margaret Hospitals, Subiaco, WA
| |
Collapse
|
46
|
Askari A, Nachiappan S, Currie A, Bottle A, Abercrombie J, Athanasiou T, Faiz O. Who requires emergency surgery for colorectal cancer and can national screening programmes reduce this need? Int J Surg 2017; 42:60-68. [PMID: 28456708 DOI: 10.1016/j.ijsu.2017.04.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/16/2017] [Accepted: 04/22/2017] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Patients undergoing emergency colorectal cancer (CRC) surgery are at higher risk of poor outcome than those managed electively. The aim of this national study is to identify groups at high risk of undergoing unplanned CRC surgery and assess short and long-term outcome in this cohort subsequent morbidity and mortality as well as quantify their long-term survival. The aim of this national study is to identify groups at high risk of undergoing unplanned CRC surgery and assess short and long-term outcome, subsequent morbidity and mortality as well as quantify their long-term survival. METHODS The Hospital Episode Statistics (HES) database between the years of 1997-2012 was used to identify all patients that had undergone surgery for colorectal cancer. Multivariable logistic regression analysis and cox regression analyses were undertaken to identify patient factors predictive of undergoing emergency and quantify their long-term survival. RESULTS A total of 286,591 patients underwent resection for CRC between April 1997 and April 2012, of which 24.3% (69,718 patients) were admitted as emergencies and underwent emergency surgery. Independent predictors of undergoing emergency surgery were female gender (OR 1.23, CI: 1.21-1.25, p < 0.001), older age (>79 years old OR 1.55, CI: 1.50-1.60, p < 0.001), social deprivation (most deprived quintile, OR 1.64, CI: 1.50-1.80, p < 0.001) and Black African/Caribbean ethnicity (OR 1.36, CI: 1.21-1.66, p < 0.001). All cause 30- and 90-day mortality within the emergency group was significantly higher than that for the electively managed patients group (13.3% versus compared with 3.4% at 30-days) as was 90-day (20.0% versus compared with 5.8% at 90-days). Amongst patients eligible for bowel screening there was an approximate 40% significant reduction in the proportion of patients requiring emergency surgery before and after its introduction in 2006 (23.4%-14.9%, p < 0.001). This reduction in emergency surgery included both proximal and distal cancer resections. CONCLUSION Older, socially deprived and ethnic minority patients with colorectal cancer are more likely to present as emergencies requiring CRC surgery. Public health initiatives, such as bowel cancer screening, appear to have concomitantly reduced emergency and increased elective surgical rates within the eligible cohort. This is likely to have a beneficial impact on population survival. Strategies aimed at preventing emergency presentation by identifying patients at specific risk could improve survival outcome for colorectal cancer surgery in England.
Collapse
Affiliation(s)
- Alan Askari
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom.
| | - Subramanian Nachiappan
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom
| | - Andrew Currie
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom
| | - Alex Bottle
- Faculty of Medicine, School of Public Health, Dr Foster Unit, Imperial College London, United Kingdom
| | | | - Thanos Athanasiou
- Faculty of Medicine, Department of Surgery & Cancer, St Mary's Hospital, Praed Street, London, W21NY, United Kingdom
| | - Omar Faiz
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom; Department of Surgery, Imperial College, St Mary's Hospital, Praed Street, London, W21NY, United Kingdom
| |
Collapse
|
47
|
Pettengill M, Matute JD, Tresenriter M, Hibbert J, Burgner D, Richmond P, Luis Millán J, Ozonoff A, Strunk T, Currie A, Levy O. Human alkaline phosphatase dephosphorylates microbial products and is elevated in preterm neonates with a history of late-onset sepsis. PLoS One 2017; 12:e0175936. [PMID: 28448526 PMCID: PMC5407836 DOI: 10.1371/journal.pone.0175936] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 07/06/2016] [Accepted: 04/03/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A host defense function for Alkaline phosphatases (ALPs) is suggested by the contribution of intestinal ALP to detoxifying bacterial lipopolysaccharide (endotoxin) in animal models in vivo and the elevation of ALP activity following treatment of human cells with inflammatory stimuli in vitro. However the activity of ALP in human plasma (primarily tissue-nonspecific ALP; TNAP) on lipopolysaccharide and other microbial products has not been assessed, nor has its expression been studied in preterm newborns, a vulnerable population at high risk of sepsis. In this context, the aim of our study was to characterize the activity of TNAP on Toll-like receptor (TLR) agonists and assess the concentrations of plasma ALP during late-onset sepsis in preterm newborns. METHODS Recombinant human TNAP was incubated with microbial products and phosphate release was measured by malachite green assay. Plasma ALP activity was measured serially in a cohort of preterm (N = 129) infants at high risk of late-onset sepsis (LOS). RESULTS TNAP dephosphorylates poly-inosine:cytosine (Toll-like receptor (TLR) 3 agonist) and LPS from Klebsiella pneumoniae and Salmonella minnesota (TLR4 agonists). Plasma ALP significantly increased postnatally over the first 4 weeks of life in preterm and term newborns. Bacteremic LOS in preterm infants (gestational age ≤ 30 weeks) was associated with significantly elevated plasma ALP at 4 weeks postnatal age. CONCLUSIONS TNAP, the main circulating isozyme of ALP, de-phosphorylates TLR agonists, demonstrates a post-natal age dependent increase in preterm and term plasma across the first 4 weeks of life, and is elevated in association with preterm LOS.
Collapse
Affiliation(s)
- Matthew Pettengill
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Juan D. Matute
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Megan Tresenriter
- University of California Davis School of Medicine, Davis, California, United States of America
| | - Julie Hibbert
- The University of Western Australia, Crawley, Western Australia, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Peter Richmond
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - José Luis Millán
- Sanford Children's Health Research Center, Sanford-Burnham Medical Research Institute, LaJolla, California, United States of America
| | - Al Ozonoff
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Tobias Strunk
- The University of Western Australia, Crawley, Western Australia, Australia
| | - Andrew Currie
- The University of Western Australia, Crawley, Western Australia, Australia
- School of Veterinary & Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| |
Collapse
|
48
|
Askari A, Nachiappan S, Currie A, Latchford A, Stebbing J, Bottle A, Athanasiou T, Faiz O. The relationship between ethnicity, social deprivation and late presentation of colorectal cancer. Cancer Epidemiol 2017; 47:88-93. [PMID: 28167416 DOI: 10.1016/j.canep.2017.01.007] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/14/2017] [Accepted: 01/16/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Tumour staging at time of presentation is an important factor in determining survival in colorectal cancer. The aim of this paper is to investigate the relationship between ethnicity and deprivation in late (Stage IV) presentation of colorectal cancer. METHODS Data from the Thames Cancer Registry comprising 77,057 colorectal cancer patients between the years 2000 and 2012 were analysed. RESULTS A total of 17,348 patients were identified with complete data, of which 53.9% were male. Patients from a Black Afro/Caribbean background were diagnosed with CRC at a much younger age than the White British group (median age 67 compared with 72, p<0.001). In multiple regression, ethnicity, deprivation and age were positive predictors of presenting with advanced tumour stage at time of diagnosis. Black patients were more likely to present with Stage IV tumours than white patients (OR 1.37, 95% CI 1.18-1.59, p<0.001). Social deprivation was also a predictor of Stage IV cancer presentation, with the most deprived group (Quintile 5) 1.26 times more likely to be diagnosed with Stage IV cancer compared with the most affluent group (CI 1.13-1.40, p<0.001). Sub-group analyses demonstrated that Black & Affluent patients were still at greater risk of Stage IV CRC than their White & Affluent counterparts (OR 1.24, 95% CI 1.11-1.45, p=0.023). Patients with rectal cancer were less likely to present with Stage IV CRC (OR 0.66, 95% CI 0.61-0.71, p<0.001). CONCLUSION Racial and age related disparities exist in tumour presentation in the United Kingdom. Patients from black and socially deprived backgrounds as well as the elderly are more likely to present with advanced tumours at time of diagnosis.
Collapse
Affiliation(s)
- Alan Askari
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom.
| | - Subramanian Nachiappan
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom.
| | - Andrew Currie
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom
| | - Andrew Latchford
- Department of Gastroenterology, St Mark's Hospital, Harrow, Middlesex, HA1 3UJ, United Kingdom; Imperial College London, United Kingdom.
| | - Justin Stebbing
- Department of Surgery and Cancer, Imperial College, United Kingdom.
| | - Alex Bottle
- Faculty of Medicine, School of Public Health, Dr Foster Unit, Imperial College London, United Kingdom.
| | | | - Omar Faiz
- Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom; Department of Surgery and Cancer, Imperial College, United Kingdom.
| |
Collapse
|
49
|
Akerib DS, Alsum S, Araújo HM, Bai X, Bailey AJ, Balajthy J, Beltrame P, Bernard EP, Bernstein A, Biesiadzinski TP, Boulton EM, Bramante R, Brás P, Byram D, Cahn SB, Carmona-Benitez MC, Chan C, Chiller AA, Chiller C, Currie A, Cutter JE, Davison TJR, Dobi A, Dobson JEY, Druszkiewicz E, Edwards BN, Faham CH, Fiorucci S, Gaitskell RJ, Gehman VM, Ghag C, Gibson KR, Gilchriese MGD, Hall CR, Hanhardt M, Haselschwardt SJ, Hertel SA, Hogan DP, Horn M, Huang DQ, Ignarra CM, Ihm M, Jacobsen RG, Ji W, Kamdin K, Kazkaz K, Khaitan D, Knoche R, Larsen NA, Lee C, Lenardo BG, Lesko KT, Lindote A, Lopes MI, Manalaysay A, Mannino RL, Marzioni MF, McKinsey DN, Mei DM, Mock J, Moongweluwan M, Morad JA, Murphy ASJ, Nehrkorn C, Nelson HN, Neves F, O'Sullivan K, Oliver-Mallory KC, Palladino KJ, Pease EK, Phelps P, Reichhart L, Rhyne C, Shaw S, Shutt TA, Silva C, Solmaz M, Solovov VN, Sorensen P, Stephenson S, Sumner TJ, Szydagis M, Taylor DJ, Taylor WC, Tennyson BP, Terman PA, Tiedt DR, To WH, Tripathi M, Tvrznikova L, Uvarov S, Verbus JR, Webb RC, White JT, Whitis TJ, Witherell MS, Wolfs FLH, Xu J, Yazdani K, Young SK, Zhang C. Results from a Search for Dark Matter in the Complete LUX Exposure. Phys Rev Lett 2017; 118:021303. [PMID: 28128598 DOI: 10.1103/physrevlett.118.021303] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Indexed: 06/06/2023]
Abstract
We report constraints on spin-independent weakly interacting massive particle (WIMP)-nucleon scattering using a 3.35×10^{4} kg day exposure of the Large Underground Xenon (LUX) experiment. A dual-phase xenon time projection chamber with 250 kg of active mass is operated at the Sanford Underground Research Facility under Lead, South Dakota (USA). With roughly fourfold improvement in sensitivity for high WIMP masses relative to our previous results, this search yields no evidence of WIMP nuclear recoils. At a WIMP mass of 50 GeV c^{-2}, WIMP-nucleon spin-independent cross sections above 2.2×10^{-46} cm^{2} are excluded at the 90% confidence level. When combined with the previously reported LUX exposure, this exclusion strengthens to 1.1×10^{-46} cm^{2} at 50 GeV c^{-2}.
Collapse
Affiliation(s)
- D S Akerib
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - S Alsum
- University of Wisconsin-Madison, Department of Physics, 1150 University Avenue, Madison, Wisconsin 53706, USA
| | - H M Araújo
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - X Bai
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
| | - A J Bailey
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J Balajthy
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - P Beltrame
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - E P Bernard
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - A Bernstein
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - T P Biesiadzinski
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - E M Boulton
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - R Bramante
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - P Brás
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - D Byram
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S B Cahn
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - M C Carmona-Benitez
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - C Chan
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - A A Chiller
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - C Chiller
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - A Currie
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - J E Cutter
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - T J R Davison
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - A Dobi
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - J E Y Dobson
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - B N Edwards
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C H Faham
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Fiorucci
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - R J Gaitskell
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C Ghag
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - K R Gibson
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - M Hanhardt
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - S J Haselschwardt
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - S A Hertel
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - D P Hogan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - M Horn
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - D Q Huang
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - C M Ignarra
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - M Ihm
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - R G Jacobsen
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - W Ji
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - K Kamdin
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - K Kazkaz
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - R Knoche
- University of Maryland, Department of Physics, College Park, Maryland 20742, USA
| | - N A Larsen
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - C Lee
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - B G Lenardo
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - A Lindote
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M I Lopes
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Manalaysay
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - R L Mannino
- Texas A and M University, Department of Physics, College Station, Texas 77843, USA
| | - M F Marzioni
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - D N McKinsey
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - D-M Mei
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| | - J Mock
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - M Moongweluwan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - J A Morad
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - A St J Murphy
- SUPA, School of Physics and Astronomy, University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - C Nehrkorn
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - H N Nelson
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - F Neves
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - K O'Sullivan
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - K C Oliver-Mallory
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
| | - K J Palladino
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
- University of Wisconsin-Madison, Department of Physics, 1150 University Avenue, Madison, Wisconsin 53706, USA
| | - E K Pease
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - P Phelps
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
| | - L Reichhart
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - C Rhyne
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - S Shaw
- Department of Physics and Astronomy, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - T A Shutt
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - C Silva
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - M Solmaz
- University of California Santa Barbara, Department of Physics, Santa Barbara, California 93106, USA
| | - V N Solovov
- LIP-Coimbra, Department of Physics, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - S Stephenson
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - T J Sumner
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - M Szydagis
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - D J Taylor
- South Dakota Science and Technology Authority, Sanford Underground Research Facility, Lead, South Dakota 57754, USA
| | - W C Taylor
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - B P Tennyson
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - P A Terman
- Texas A and M University, Department of Physics, College Station, Texas 77843, USA
| | - D R Tiedt
- South Dakota School of Mines and Technology, 501 East St. Joseph Street, Rapid City, South Dakota 57701, USA
| | - W H To
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - M Tripathi
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - L Tvrznikova
- University of California Berkeley, Department of Physics, Berkeley, California 94720, USA
- Yale University, Department of Physics, 217 Prospect Street, New Haven, Connecticut 06511, USA
| | - S Uvarov
- University of California Davis, Department of Physics, One Shields Avenue, Davis, California 95616, USA
| | - J R Verbus
- Brown University, Department of Physics, 182 Hope Street, Providence, Rhode Island 02912, USA
| | - R C Webb
- Texas A and M University, Department of Physics, College Station, Texas 77843, USA
| | - J T White
- Texas A and M University, Department of Physics, College Station, Texas 77843, USA
| | - T J Whitis
- Case Western Reserve University, Department of Physics, 10900 Euclid Ave, Cleveland, Ohio 44106, USA
- SLAC National Accelerator Laboratory, 2575 Sand Hill Road, Menlo Park, California 94205, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, California 94309, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627, USA
| | - J Xu
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94551, USA
| | - K Yazdani
- Imperial College London, High Energy Physics, Blackett Laboratory, London SW7 2BZ, United Kingdom
| | - S K Young
- University at Albany, State University of New York, Department of Physics, 1400 Washington Avenue, Albany, New York 12222, USA
| | - C Zhang
- University of South Dakota, Department of Physics, 414E Clark Street, Vermillion, South Dakota 57069, USA
| |
Collapse
|
50
|
Nachiappan S, Askari A, Mamidanna R, Munasinghe A, Currie A, Stebbing J, Faiz O. Initiation of adjuvant chemotherapy within 8 weeks of elective colorectal resection improves overall survival regardless of reoperation. Colorectal Dis 2016; 18:1041-1049. [PMID: 27807941 DOI: 10.1111/codi.13308] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 01/08/2016] [Indexed: 02/08/2023]
Abstract
AIM Reoperation after elective colorectal resection may delay the start of adjuvant chemotherapy (AC). The study investigated the dual impact of a reoperation and AC delay on overall survival (OS). METHOD The Hospital Episode Statistics database was analysed between 1997 and 2012. Patients were divided into colon and rectal cancer cohorts and data were analysed based on whether there was delay in receiving AC beyond 8 weeks and whether a patient suffered reoperation within 30 days. Multivariate regression analysis was undertaken to investigate the relationship between delay in giving AC and reoperation and their combined effect on OS. RESULTS Logistic regression showed reoperation, amongst other things, to be an independent predictor of AC delay, in both colon and rectal cancer (colon, odds ratio 2.31, P < 0.001; rectal, odds ratio 2.19, P < 0.001). There was no significant difference in OS between patients who had no AC delay but suffered a reoperation and patients who had no AC delay and no reoperation. Patients who had AC delay but no reoperation, however, had significantly worse OS compared to those who had no AC delay and no reoperation [colon, hazard ratio (HR) 1.16, P < 0.001; rectal, HR 1.17, P < 0.001]. Individuals who had both AC delay and a reoperation also had worse OS compared with patients who had neither (colon, HR 1.33, P = 0.037; rectal, HR 1.38, P < 0.001). CONCLUSION Delayed receipt of AC beyond 8 weeks after surgery is associated with significantly reduced OS regardless of reoperation status in both colon and rectal cancer patients.
Collapse
Affiliation(s)
- S Nachiappan
- Surgical Epidemiology, Trials and Outcomes Centre (SETOC), St Mark's Hospital and Academic Institute, Watford Road, Harrow, Middlesex. .,Department of Surgery and Cancer, Imperial College London, London, UK.
| | - A Askari
- Surgical Epidemiology, Trials and Outcomes Centre (SETOC), St Mark's Hospital and Academic Institute, Watford Road, Harrow, Middlesex.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - R Mamidanna
- Surgical Epidemiology, Trials and Outcomes Centre (SETOC), St Mark's Hospital and Academic Institute, Watford Road, Harrow, Middlesex.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Munasinghe
- Surgical Epidemiology, Trials and Outcomes Centre (SETOC), St Mark's Hospital and Academic Institute, Watford Road, Harrow, Middlesex.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Currie
- Surgical Epidemiology, Trials and Outcomes Centre (SETOC), St Mark's Hospital and Academic Institute, Watford Road, Harrow, Middlesex.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - J Stebbing
- Department of Surgery and Cancer, Imperial College London, London, UK.,Hammersmith Hospital, London, UK
| | - O Faiz
- Surgical Epidemiology, Trials and Outcomes Centre (SETOC), St Mark's Hospital and Academic Institute, Watford Road, Harrow, Middlesex.,Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|