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Hepworth LR, Kirkham JJ, Perkins E, Helliwell B, Howard C, Liptrot M, Tawana S, Wilson E, Rowe FJ. Validation of the brain injury associated visual impairment - impact questionnaire (BIVI-IQ). Qual Life Res 2024; 33:777-791. [PMID: 38112864 PMCID: PMC10894123 DOI: 10.1007/s11136-023-03565-0] [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] [Accepted: 11/11/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to assess the impact of post-stroke visual impairment. The development of the questionnaire used robust methods involving stroke survivors and clinicians. The aim of this study was to assess the validity of the BIVI-IQ in a stroke population. METHODS Stroke survivors with visual impairment were recruited from stroke units, outpatient clinics and non-healthcare settings. Participants were asked to complete questionnaire sets on three separate occasions; the BIVI-IQ at each visit with additional questionnaires at baseline and visit 2. Vision assessment and anchor questions from participants and clinicians were collected. The analysis included assessment of missing data, acceptability, Rasch model analysis, test-retest reliability, construct validity (NEI VFQ-25, EQ-5D-5L) and responsiveness to change. RESULTS 316 stroke survivors completed at least one questionnaire of the 326 recruited. Mean age was 67 years and 64% were male. Adequate fit statistics to the Rasch model were reached (χ2 = 73.12, p = 0.02) with two items removed and thresholds of two adjusted, indicating validity and unidimensionality. Excellent test-retest reliability was demonstrated (ICC = 0.905) with a 3-month interval. Construct validity was demonstrated with a strong significant correlation to the NEI VFQ-25 (r = 0.837, p < 0.01). The BIVI-IQ also demonstrated responsiveness to change with significant differences identified between groups based on participant and clinician anchor questions (X2 = 23.29, p < 0.001; X2 = 24.56, p < 0.001). CONCLUSION The BIVI-IQ has been shown to be valid and practical for 'everyday' use by clinicians and researchers to monitor vision-related quality of life in stroke survivors with visual impairment.
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Affiliation(s)
- L R Hepworth
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK.
- Northern Care Alliance NHS Foundation Trust, Salford, UK.
- Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK.
| | - J J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - E Perkins
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
| | - B Helliwell
- VISable, Patient and Public Representative, Liverpool, UK
| | - C Howard
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
- Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - M Liptrot
- Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK
| | - S Tawana
- Buckinghamshire Healthcare NHS Trust, High Wycombe, UK
| | - E Wilson
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - F J Rowe
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
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Leav O, Cazzolato B, Howard C, Mabrouk B. Steady-state sound propagation through hot exhaust jets in cooler cross-flow: A computational study. J Acoust Soc Am 2023; 154:217-231. [PMID: 37439639 DOI: 10.1121/10.0020069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
An analysis has been carried out to investigate the sound radiation through a heated jet in cooler cross-flow, which is representative of many industrial exhaust systems, using a hybrid steady-state computational fluid dynamics and computational acoustic model. The mean flow and temperature fields are modelled using steady-state computational fluid dynamics, with the turbulence modelled using Reynolds Averaged Navier-Stokes equations. The corresponding mean flow and temperature fields are used in the computational sound propagation model using linearised acoustic wave equation with mean flow based on a scalar flow potential. The results obtained from the computational simulations show that the flow significantly changes the sound propagation path and that the sound levels downstream of the duct outlet are higher than expected from using an acoustic monopole radiation pattern. The dominant mechanism affecting the propagation of sound is the refraction arising from the plume's temperature and velocity gradients. The sound propagation is highly dependent on the proximity from the duct outlet, normalised wavenumber, temperature and the jet to cross-flow mean velocity ratio. This computational study builds upon previous experimental work to analyse the fluid-acoustic interaction for heated jets in cooler cross-flow to understand the complex radiation pattern that leads to higher-than-expected sound levels downstream of the duct outlet.
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Affiliation(s)
- O Leav
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - B Cazzolato
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - C Howard
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - B Mabrouk
- Laboratoire Roberval, Université de Technologie Compiègne, Compiègne, Cedex, France
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Vogel GF, Mozer-Glassberg Y, Landau YE, Schlieben LD, Prokisch H, Feichtinger RG, Mayr JA, Brennenstuhl H, Schröter J, Pechlaner A, Alkuraya FS, Baker JJ, Barcia G, Baric I, Braverman N, Burnyte B, Christodoulou J, Ciara E, Coman D, Das AM, Darin N, Della Marina A, Distelmaier F, Eklund EA, Ersoy M, Fang W, Gaignard P, Ganetzky RD, Gonzales E, Howard C, Hughes J, Konstantopoulou V, Kose M, Kerr M, Khan A, Lenz D, McFarland R, Margolis MG, Morrison K, Müller T, Murayama K, Nicastro E, Pennisi A, Peters H, Piekutowska-Abramczuk D, Rötig A, Santer R, Scaglia F, Schiff M, Shagrani M, Sharrard M, Soler-Alfonso C, Staufner C, Storey I, Stormon M, Taylor RW, Thorburn DR, Teles EL, Wang JS, Weghuber D, Wortmannd S. Genotypic and phenotypic spectrum of infantile liver failure due to pathogenic TRMU variants. Genet Med 2023; 25:100828. [PMID: 37272928 DOI: 10.1016/j.gim.2023.100828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
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Howard C, Gorman I, Crushell E, Knerr I, Hughes J, Boruah R, O'Grady L, Elsammak MY, Brady JJ, Monavari AA. Medium Chain Acyl-CoA Dehydrogenase Deficiency: 3 years of Newborn Screening. Ir Med J 2023; 116:743. [PMID: 37010499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Howard C, Dev‐Borman A, Stokes J, O'Rourke D, Gillespie C, Twomey E, Knerr I, Boruah R. Autonomic instability, arrhythmia and visual impairment in a new presentation of MTFMT-related mitochondrial disease. JIMD Rep 2023; 64:150-155. [PMID: 36873085 PMCID: PMC9981406 DOI: 10.1002/jmd2.12355] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Mitochondrial methionyl-tRNA formyltransferase (MTFMT) is required for the initiation of translation in mitochondria. Pathogenic variants in MTFMT have been described in association with clinical presentations with Leigh syndrome, as well with as multisystem involvement (particularly cardiac and ocular involvement). There is a spectrum of severity, but many reported presentations have been milder with a better prognosis than other pathogenic variants associated with Leigh syndrome. We describe the case of a 9-year-old boy homozygous for a pathogenic MTFMT variant (c.626C > T/p.Ser209Leu) who presented with hypertensive crisis on a background of hyperphagia and visual impairment. His clinical course was complicated by supraventricular tachycardia and severe autonomic instability, requiring intensive care unit admission. He also developed seizures, neurogenic bladder and bowel and had a markedly abnormal eye examination with bilateral optic atrophy. Magnetic resonance image brain showed abnormal high T2/fluid-attenuated inversion recovery signal within the dorsal brainstem and in the right globus pallidus with some reduced diffusivity. Despite recovery from the acute neurological and cardiac manifestations, he has ongoing deficits in his gross motor skills and continues to have hyperphagia with rapid weight gain (approx. 20 kg in 2 years). Ophthalmic findings are persistent. This case expands the phenotype associated with MTFMT disease.
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Affiliation(s)
- Caoimhe Howard
- National Centre for Inherited Metabolic DisordersChildren's Health Ireland at Temple StreetDublinRepublic of Ireland
| | - Arundhati Dev‐Borman
- Bristol Eye HospitalUniversity Hospitals Bristol and NHS Foundation TrustBristolUK
| | - John Stokes
- Department of OphthalmologyUniversity Hospital WaterfordWaterfordRepublic of Ireland
| | - Declan O'Rourke
- Department of NeurologyChildren's Health Ireland at Temple StreetDublinRepublic of Ireland
| | - Ciara Gillespie
- Department of RadiologyChildren's Health Ireland at Temple StreetDublinRepublic of Ireland
| | - Eilish Twomey
- Department of RadiologyChildren's Health Ireland at Temple StreetDublinRepublic of Ireland
| | - Ina Knerr
- National Centre for Inherited Metabolic DisordersChildren's Health Ireland at Temple StreetDublinRepublic of Ireland
- School of MedicineUniversity College DublinDublinRepublic of Ireland
| | - Ritma Boruah
- National Centre for Inherited Metabolic DisordersChildren's Health Ireland at Temple StreetDublinRepublic of Ireland
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Howard C, Golden M, Gavin P, Crushell E. Trainee Knowledge and Perceptions of Less Than Full Time Training. Ir Med J 2022; 114:462. [PMID: 35863329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background Less than full-time (LTFT) training in Ireland is still unusual. Our aim was to identify perceived barriers to LTFT training amongst paediatric trainees and make recommendations to improve knowledge, uptake, and experience of LTFT training. Methods An email questionnaire was disseminated to RCPI paediatric trainees to assess current awareness of and perceptions of barriers to LTFT training. Results 218 questionnaires were distributed, 59 (29%) responded of whom 50 (85%) were female. 17 planned to apply for LTFT training. Seven had no knowledge of LTFT training. The perceived barriers with the highest rankings (% respondents deeming highest possible relevance) were: LTFT post availability (49%), potential impact on career progression (51%), and availability of only 0.5 whole time equivalency (WTE) - i.e. 19.5 hours/week (54%). Trainees noted lack of flexibility, including availability of the scheme only from July to July, restriction to maximum 2 years. Trainees felt applications would be rejected if they were not a parent. Some reported perceptions from teams that LTFT trainees are less committed and that trainees can find it difficult to integrate. Discussion Training options including >0.5WTE posts should be made available to all trainees, and a cultural shift within training bodies and with trainers should be encouraged to recognise LTFT training as an acceptable pathway for all trainees.
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Affiliation(s)
- C Howard
- Faculty of Paediatrics, Royal College of Physicians of Ireland
| | - M Golden
- Faculty of Paediatrics, Royal College of Physicians of Ireland
| | - P Gavin
- Faculty of Paediatrics, Royal College of Physicians of Ireland
| | - E Crushell
- Faculty of Paediatrics, Royal College of Physicians of Ireland
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Vogel GF, Mozer-Glassberg Y, Landau YE, Schlieben LD, Prokisch H, Feichtinger RG, Mayr JA, Brennenstuhl H, Schröter J, Pechlaner A, Alkuraya FS, Baker JJ, Barcia G, Baric I, Braverman N, Burnyte B, Christodoulou J, Ciara E, Coman D, Das AM, Darin N, Della Marina A, Distelmaier F, Eklund EA, Ersoy M, Fang W, Gaignard P, Ganetzky RD, Gonzales E, Howard C, Hughes J, Konstantopoulou V, Kose M, Kerr M, Khan A, Lenz D, McFarland R, Margolis MG, Morrison K, Müller T, Murayama K, Nicastro E, Pennisi A, Peters H, Piekutowska-Abramczuk D, Rötig A, Santer R, Scaglia F, Schiff M, Shagrani M, Sharrard M, Soler-Alfonso C, Staufner C, Storey I, Stormon M, Taylor RW, Thorburn DR, Teles EL, Wang JS, Weghuber D, Wortmann S. Genotypic and phenotypic spectrum of infantile liver failure due to pathogenic TRMU variants. Genet Med 2022:S1098-3600(22)00953-4. [DOI: 10.1016/j.gim.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
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Affiliation(s)
- C Sorensen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Emergency Medicine, Columbia Irving Medical Center, New York, NY, USA
| | - C Howard
- Cumming School of Medicine, University of Calgary, Calgary, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - P Prabhakaran
- Centre for Environmental Health, Public Health Foundation of India, India
- Centre for Chronic Disease Control, New Delhi, India
| | - G Horton
- School of Medicine and Public Health, University of Newcastle, Australia
| | - R Basu
- Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, Oakland, CA, USA
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McIntire R, Howard C, Stewart C, McIntosh H, Vassar M. The use of superlatives in news articles pertaining to asthma treatment. Pulmonology 2022; 28:228-230. [DOI: 10.1016/j.pulmoe.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022] Open
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Leav O, Cazzolato B, Howard C. Sound propagation through elevated, heated jets in cooler cross-flow: An experimental study. J Acoust Soc Am 2021; 150:82. [PMID: 34340484 DOI: 10.1121/10.0005489] [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] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
Sound propagation through hot exhaust plumes with cooler cross-winds is present in many real world systems. One particular example is the sound propagation from exhaust stacks attached to open cycle gas turbine power stations. The research presented in this paper investigates the sound propagation from a reduced-scale exhaust stack, with a cross-flow from experiments conducted in a wind tunnel. Experimental measurements of the flow and temperature fields provide insight into the complex sound radiation characteristics. Results from the acoustic measurements show the change in the sound directivity arising from the inclusion of the hot exhaust plume, leading to non-axisymmetric sound directivity and a concentration of sound downwind of the exhaust stack outlet. In certain cross-flow conditions, the hot exhaust plume can increase the sound observed downwind by up to 11 dB when compared to the scenario of sound propagation from an exhaust stack in the absence of a heated jet or cross-flow. This paper describes the acoustic directivity at various radial distances from the exhaust stack, acoustic frequencies, jet temperatures, and cross-flow free-stream velocity. The results from this paper emphasise the importance of taking into consideration the hot exhaust plume with cooler cross-flow when estimating sound levels downwind of the stack.
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Affiliation(s)
- O Leav
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - B Cazzolato
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - C Howard
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
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11
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Livesey LC, Yorke E, Parra A, Gray Q, Davies C, Weldon D, Schumacher J, Kimura S, Howard C, Sierra‐Rodriguez T, Mora‐Pereira M. Use of a carbonated beverage to disintegrate a phytobezoar obstructing the intrathoracic portion of the oesophagus of a horse. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L. C. Livesey
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - E. Yorke
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - A. Parra
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - Q. Gray
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - C. Davies
- Tuskegee University College of Veterinary Medicine Auburn AlabamaUSA
| | - D. Weldon
- Southeast Equine Veterinary Services Phenix City AlabamaUSA
| | - J. Schumacher
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - S. Kimura
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - C. Howard
- Bluegrass Animal Clinic Grayson Kentucky USA
| | - T. Sierra‐Rodriguez
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
| | - M. Mora‐Pereira
- J.T. Vaughan Large Animal Teaching Hospital Auburn University College of Veterinary Medicine Auburn Alabama USA
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Aharmim B, Ahmed S, Anthony A, Barros N, Beier E, Bellerive A, Beltran B, Bergevin M, Biller S, Blucher E, Bonventre R, Boudjemline K, Boulay M, Cai B, Callaghan E, Caravaca J, Chan Y, Chauhan D, Chen M, Cleveland B, Cox G, Dai X, Deng H, Descamps F, Detwiler J, Doe P, Doucas G, Drouin PL, Dunford M, Elliott S, Evans H, Ewan G, Farine J, Fergani H, Fleurot F, Ford R, Formaggio J, Gagnon N, Gilje K, Goon J, Graham K, Guillian E, Habib S, Hahn R, Hallin A, Hallman E, Harvey P, Hazama R, Heintzelman W, Heise J, Helmer R, Hime A, Howard C, Huang M, Jagam P, Jamieson B, Jelley N, Jerkins M, Keeter K, Klein J, Kormos L, Kos M, Kraus C, Krauss C, Krüger A, Kutter T, Kyba C, Labe K, Land B, Lange R, LaTorre A, Law J, Lawson I, Lesko K, Leslie J, Levine I, Loach J, MacLellan R, Majerus S, Mak H, Maneira J, Martin R, Mastbaum A, McCauley N, McDonald A, McGee S, Miller M, Monreal B, Monroe J, Nickel B, Noble A, O’Keeffe H, Oblath N, Okada C, Ollerhead R, Orebi Gann G, Oser S, Ott R, Peeters S, Poon A, Prior G, Reitzner S, Rielage K, Robertson B, Robertson R, Schwendener M, Secrest J, Seibert S, Simard O, Sinclair D, Skensved P, Sonley T, Stonehill L, Tešić G, Tolich N, Tsui T, Van Berg R, VanDevender B, Virtue C, Wall B, Waller D, Wan Chan Tseung H, Wark D, Wendland J, West N, Wilkerson J, Wilson J, Winchester T, Wright A, Yeh M, Zhang F, Zuber K. Search for
hep
solar neutrinos and the diffuse supernova neutrino background using all three phases of the Sudbury Neutrino Observatory. Int J Clin Exp Med 2020. [DOI: 10.1103/physrevd.102.062006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Sandstrom A, MacKenzie L, Pizzo A, Fine A, Rempel S, Howard C, Stephens M, Patterson VC, Drobinin V, Van Gestel H, Howes Vallis E, Zwicker A, Propper L, Abidi S, Bagnell A, Lovas D, Cumby J, Alda M, Uher R, Pavlova B. Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychol Med 2020; 50:1050-1056. [PMID: 31120010 DOI: 10.1017/s0033291719001089] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children of parents with mood and psychotic disorders are at elevated risk for a range of behavioral and emotional problems. However, as the usual reporter of psychopathology in children is the parent, reports of early problems in children of parents with mood and psychotic disorders may be biased by the parents' own experience of mental illness and their mental state. METHODS Independent observers rated psychopathology using the Test Observation Form in 378 children and youth between the ages of 4 and 24 (mean = 11.01, s.d. = 4.40) who had a parent with major depressive disorder, bipolar disorder, schizophrenia, or no history of mood and psychotic disorders. RESULTS Observed attentional problems were elevated in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia (effect sizes ranging between 0.31 and 0.56). Oppositional behavior and language/thought problems showed variable degrees of elevation (effect sizes 0.17 to 0.57) across the three high-risk groups, with the greatest difficulties observed in offspring of parents with bipolar disorder. Observed anxiety was increased in offspring of parents with major depressive disorder and bipolar disorder (effect sizes 0.19 and 0.25 respectively) but not in offspring of parents with schizophrenia. CONCLUSIONS Our results suggest that externalizing problems and cognitive and language difficulties may represent a general manifestation of familial risk for mood and psychotic disorders, while anxiety may be a specific marker of liability for mood disorders. Observer assessment may improve early identification of risk and selection of youth who may benefit from targeted prevention.
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Affiliation(s)
- A Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - L MacKenzie
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychology, Dalhousie University, Halifax, NS, Canada
| | - A Pizzo
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - A Fine
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Rempel
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - C Howard
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - M Stephens
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - V C Patterson
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Psychology, Dalhousie University, Halifax, NS, Canada
| | - V Drobinin
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - H Van Gestel
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - E Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - A Zwicker
- Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - L Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - S Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - D Lovas
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - J Cumby
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - R Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - B Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
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Howard C, Powell AS, Pavlidis E, Pavel A, Finn D, Allen A, Olavarria‐Ramirez L, Clarke G, Livingstone V, Boylan GB, Dempsey EM. No effect of a musical intervention on stress response to venepuncture in a neonatal population. Acta Paediatr 2020; 109:511-517. [PMID: 31532835 DOI: 10.1111/apa.15018] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/04/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022]
Abstract
AIM To investigate the effect of a musical intervention on neonatal stress response to venepuncture as measured by salivary cortisol levels and pain profile scores. METHODS In a randomised control crossover trial, participants were randomised to both a control arm (sucrose) and intervention arm (sucrose and music) for routine venepuncture procedures. Salivary swabs were collected at baseline, 20 minutes post-venepuncture and 4 hours post-venepuncture. Pain levels were assessed using the Premature Infant Pain Profile (PIPP). A total of 16 preterm neonates participated in both arms to complete the study. RESULTS Cortisol values were elevated at all timepoints in the intervention arm (baseline, 20 minutes, and 4 hours post-procedure) but not significantly so (P = .056, P = .3, and P = .575, respectively). Median change in cortisol values from baseline was +128.48 pg/mL (-47.66 to 517.02) at 20 minutes and +393.52 pg/mL (47.88-1221.34) at 4 hours post-procedure in the control arm compared to -69.564 pg/mL (-860.96 to 397.289) and +100.48 pg/mL (-560.46 to 842.99) at 20 minutes and 4 hours post-procedure in the intervention arm. There was no statistically significant difference observed between groups (P = .311 at 20 minutes, and P = .203 at 4 hours post-procedure). PIPP scores were not significantly different between study arms. CONCLUSION Our findings did not support the additional benefit of music intervention on neonatal stress response to venepuncture in preterm infants.
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Affiliation(s)
- Caoimhe Howard
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
| | - Anna S. Powell
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
| | - Elena Pavlidis
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Andreea Pavel
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Daragh Finn
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Andrew Allen
- APC Microbiome Ireland Biosciences Institute University College Cork Cork Ireland
| | | | - Gerard Clarke
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
- APC Microbiome Ireland Biosciences Institute University College Cork Cork Ireland
- Department of Psychiatry and Neurobehavioural Science University College Cork Cork Ireland
| | - Vicki Livingstone
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Geraldine B. Boylan
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Eugene M. Dempsey
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
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15
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Ikanga J, Braggs P, Howard C, Stringer A. African Enculturation and Performance on the African Neuropsychological Battery. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
To test a core assumption of the African Neuropsychology Battery (ANB) that greater African enculturation is associated with better performance.
Method
Subjects were 27 African immigrants to the U.S. [mean age = 39 (SD = 11.5), mean education = 16.3 years (SD = 2.9)], 32 African-Americans [mean age = 34.0 (SD = 11.2), mean education = 16.2 (SD = 2.5)], and 21 U.S. Caucasians [mean age = 45.7 (SD = 13.8), mean education = 17.2 (SD = 2.3)]. All subjects completed a questionnaire on familiarity with elements of African culture. The ANB was administered one-on-one, by trained technicians, in English, in a single session. ANB tests measured visuospatial perception, naming, memory, and abstract reasoning utilizing content drawn from sub-Saharan African cultures.
Results
Groups differed significantly in age (p < .05), but not education or gender, and age was used as a covariate in subsequent group comparisons. African immigrants showed highest African enculturation, followed by African Americans, and Caucasians [F(2, 74) = 36.16, p < .000], with all groups differing significantly from one another in post-hoc comparisons (p < .02). African enculturation correlated significantly only with ability to identify pictures of African fruits (Pearson r = .58, p < .001) and objects (r = .25, p < .03). Analysis of Covariance followed by Bonferroni post-hoc comparisons confirmed that African immigrants were superior to Caucasians (p < .001) and African-Americans (p < .001) in identifying fruits, with the latter two groups not differing significantly from one another. African immigrants were superior to Caucasians in object identification (p < .05), but did not differ significantly from African-Americans.
Conclusions
African enculturation influences performance on some ANB tests and results support the potential of the ANB to assess performance in a less culturally-biased manner in African immigrants.
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Howard C, Macken WL, Connolly A, Keegan M, Coghlan D, Webb DW. Percutaneous endoscopic gastrostomy for refractory epilepsy and medication refusal. Arch Dis Child 2019; 104:690-692. [PMID: 30833283 DOI: 10.1136/archdischild-2018-315629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Current guidelines for percutaneous endoscopic gastrostomy (PEG) placement focus largely on maintaining enteral feeding when oral feeding is no longer possible or adequate with an emphasis on nutrition and quality of life (QOL). Previous publications have also alluded to potential benefits in medication adherence, for example, in children with HIV, renal disease and neurodisability. We describe a cohort of children with refractory epilepsy who refused oral medication and in whom PEG tube placement was initiated for the purpose of drug administration. DESIGN We identified children from the medical records of two tertiary paediatric units over a 9-year period who had PEG tube placement for administration of antiepileptic drug (AED) therapy and collected demographic and clinical details from chart reviews. We assessed parent-reported changes in seizure control and QOL using a structured questionnaire. RESULTS Ten patients met the inclusion criteria. All families reported an improvement in ease of administering medications and eight reported a significant improvement in QOL. Nine children had a decrease in seizure frequency (lasting more than 12 months) following PEG tube placement, including two who underwent surgical intervention for their epilepsy during that period. Four had either a decrease in the number of drugs administered or their doses and four went on to receive fluids and nutrition through their tube on a regular basis. Seven reported PEG complications, which did not require removal of the PEG. CONCLUSIONS This case series of children with resistant epilepsy demonstrates improvement in seizure control and QOL following PEG tube placement for AED administration.
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Affiliation(s)
- Caoimhe Howard
- Department of Neurology, Our Lady's Children's Hospital, Dublin, Ireland.,Department of Paediatrics, Adelaide and Meath Hospital Dublin, incorporating the National Children's Hospital, Dublin, Ireland
| | - William L Macken
- Department of Neurology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Ann Connolly
- Department of Paediatrics, Adelaide and Meath Hospital Dublin, incorporating the National Children's Hospital, Dublin, Ireland
| | - Maria Keegan
- Department of Neurology, Our Lady's Children's Hospital, Dublin, Ireland
| | - David Coghlan
- Department of Paediatrics, Adelaide and Meath Hospital Dublin, incorporating the National Children's Hospital, Dublin, Ireland
| | - David W Webb
- Department of Neurology, Our Lady's Children's Hospital, Dublin, Ireland.,Department of Paediatrics, Adelaide and Meath Hospital Dublin, incorporating the National Children's Hospital, Dublin, Ireland
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Souza A, Henthorn L, Martin F, Bowery R, Howard C. WELLBEING: A PHOTOVOICE EXPLORATION OF HEALTH AMONG OLDER ADULTS EXPERIENCING HOMELESSNESS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Souza
- University of Washington School of Nursing
| | - L Henthorn
- University of Washington School of Nursing
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18
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Scoggin C, Makloski-Cohorn C, Embertson R, Benedetto C, Howard C, Bradecamp E, Schnobrich M. Recurrence of Cervical Defects and Live-Foal Rates in Thoroughbred Broodmares Undergoing One or More Surgeries for Defects of the Cervix. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.05.144] [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]
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19
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Rowe FJ, Conroy EJ, Bedson E, Cwiklinski E, Drummond A, García- Fiñana M, Howard C, Pollock A, Shipman T, Dodridge C, MacIntosh C, Johnson S, Noonan C, Barton G, Sackley C. Choice of outcome measures for the VISION pilot trial of interventions for hemianopia. Acta Neurol Scand 2017; 136:551-553. [PMID: 28980307 DOI: 10.1111/ane.12772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2017] [Indexed: 11/27/2022]
Affiliation(s)
- F. J. Rowe
- Department of Health Services Research; University of Liverpool; Liverpool UK
| | - E. J. Conroy
- Department of Biostatistics; University of Liverpool; Liverpool UK
| | - E. Bedson
- Clinical Trials Research Unit; University of Liverpool; Liverpool UK
| | - E. Cwiklinski
- Clinical Trials Research Unit; University of Liverpool; Liverpool UK
| | - A. Drummond
- School of Health Sciences; University of Nottingham; Nottingham UK
| | | | - C. Howard
- Department of Orthoptics; Salford Royal NHS Foundation Trust; Manchester UK
| | - A. Pollock
- Nursing Midwifery and Allied Health Professions Research Unit; Glasgow Caledonian University; Glasgow UK
| | - T. Shipman
- Department of Orthoptics; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - C. Dodridge
- Department of Orthoptics; Oxford University Hospitals NHS Trust; Oxford UK
| | - C. MacIntosh
- Department of Orthoptics; Oxford University Hospitals NHS Trust; Oxford UK
| | - S. Johnson
- Eye Clinic Impact Team; Royal National Institute for the Blind; Birmingham UK
| | - C. Noonan
- Department of Ophthalmology; Aintree University Hospital NHS Foundation Trust; Liverpool UK
| | - G. Barton
- Department of Elderly Care; Warrington and Halton Hospitals NHS Foundation Trust; Warrington UK
| | - C. Sackley
- Division of Health and Social Care; King's College; London UK
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20
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Rowe FJ, Conroy EJ, Bedson E, Cwiklinski E, Drummond A, García-Fiñana M, Howard C, Pollock A, Shipman T, Dodridge C, MacIntosh C, Johnson S, Noonan C, Barton G, Sackley C. A pilot randomized controlled trial comparing effectiveness of prism glasses, visual search training and standard care in hemianopia. Acta Neurol Scand 2017; 136:310-321. [PMID: 28028819 DOI: 10.1111/ane.12725] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Pilot trial to compare prism therapy and visual search training, for homonymous hemianopia, to standard care (information only). METHODS Prospective, multicentre, parallel, single-blind, three-arm RCT across fifteen UK acute stroke units. PARTICIPANTS Stroke survivors with homonymous hemianopia. INTERVENTIONS Arm a (Fresnel prisms) for minimum 2 hours, 5 days per week over 6 weeks. Arm b (visual search training) for minimum 30 minutes, 5 days per week over 6 weeks. Arm c (standard care-information only). INCLUSION CRITERIA Adult stroke survivors (>18 years), stable hemianopia, visual acuity better than 0.5 logMAR, refractive error within ±5 dioptres, ability to read/understand English and provide consent. OUTCOMES Primary outcomes were change in visual field area from baseline to 26 weeks and calculation of sample size for a definitive trial. Secondary measures included Rivermead Mobility Index, Visual Function Questionnaire 25/10, Nottingham Extended Activities of Daily Living, Euro Qual, Short Form-12 questionnaires and Radner reading ability. Measures were post-randomization at baseline and 6, 12 and 26 weeks. RANDOMIZATION Randomization block lists stratified by site and partial/complete hemianopia. BLINDING Allocations disclosed to patients. Primary outcome assessor blind to treatment allocation. RESULTS Eighty-seven patients were recruited: 27-Fresnel prisms, 30-visual search training and 30-standard care; 69% male; mean age 69 years (SD 12). At 26 weeks, full results for 24, 24 and 22 patients, respectively, were compared to baseline. Sample size calculation for a definitive trial determined as 269 participants per arm for a 200 degree2 visual field area change at 90% power. Non-significant relative change in area of visual field was 5%, 8% and 3.5%, respectively, for the three groups. Visual Function Questionnaire responses improved significantly from baseline to 26 weeks with visual search training (60 [SD 19] to 68.4 [SD 20]) compared to Fresnel prisms (68.5 [SD 16.4] to 68.2 [18.4]: 7% difference) and standard care (63.7 [SD 19.4] to 59.8 [SD 22.7]: 10% difference), P=.05. Related adverse events were common with Fresnel prisms (69.2%; typically headaches). CONCLUSIONS No significant change occurred for area of visual field area across arms over follow-up. Visual search training had significant improvement in vision-related quality of life. Prism therapy produced adverse events in 69%. Visual search training results warrant further investigation.
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Affiliation(s)
- F. J. Rowe
- Department of Health Services Research; University of Liverpool; Liverpool UK
| | - E. J. Conroy
- Department of Biostatistics; University of Liverpool; Liverpool UK
| | - E. Bedson
- Clinical Trials Research Unit; University of Liverpool; Liverpool UK
| | - E. Cwiklinski
- Clinical Trials Research Unit; University of Liverpool; Liverpool UK
| | - A. Drummond
- School of Health Sciences; University of Nottingham; Nottingham UK
| | - M. García-Fiñana
- Department of Biostatistics; University of Liverpool; Liverpool UK
| | - C. Howard
- Department of Orthoptics; Salford Royal NHS Foundation Trust; Manchester UK
| | - A. Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit; Glasgow Caledonian University; Glasgow UK
| | - T. Shipman
- Department of Orthoptics; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - C. Dodridge
- Department of Orthoptics; Oxford University Hospitals NHS Trust; Oxford UK
| | - C. MacIntosh
- Department of Orthoptics; Oxford University Hospitals NHS Trust; Oxford UK
| | - S. Johnson
- Eye Clinic Impact Team; Royal National Institute for the Blind; Birmingham UK
| | - C. Noonan
- Department of Ophthalmology; Aintree University Hospital NHS Foundation Trust; Liverpool UK
| | - G. Barton
- Department of Elderly Care; Warrington and Halton Hospitals NHS Foundation Trust; Warrington UK
| | - C. Sackley
- Division of Health and Social Care; King's College; London UK
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21
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Scotti F, Mali P, Masiero E, Booker A, Sgamma T, Howard C, Agapouda A, Frommenwiler D, Reich E, Slater A, Heinrich M. Hypericum perforatum – a comparison of commercial samples using DNA-barcoding and chemical approaches. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F Scotti
- Research Cluster Biodiversity and Medicines/Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, WC1N 1AX, London, United Kingdom
| | - P Mali
- School of Allied Health Sciences, De Montfort University, The Gateway, LE1 9BH, Leicester, United Kingdom
| | - E Masiero
- School of Allied Health Sciences, De Montfort University, The Gateway, LE1 9BH, Leicester, United Kingdom
| | - A Booker
- Research Cluster Biodiversity and Medicines/Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, WC1N 1AX, London, United Kingdom
- Division of Herbal and East Asian Medicine, Department of Life Sciences, University of Westminster 3Division of Herbal and East Asian Medicine, Department of Life Sciences, University of Westminster, W1W 6UW, London, United Kingdom
| | - T Sgamma
- School of Allied Health Sciences, De Montfort University, The Gateway, LE1 9BH, Leicester, United Kingdom
| | - C Howard
- 4BP-NIBSC Herbal Laboratory, National Institute for Biological Standards and Controls, Blanche LAne, South Mimms, EN6 3QG, Potters Bar, United Kingdom
| | - A Agapouda
- Research Cluster Biodiversity and Medicines/Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, WC1N 1AX, London, United Kingdom
| | | | - E Reich
- CAMAG, Sonnenmattstrasse 11, 4132, Muttenz, Switzerland
| | - A Slater
- School of Allied Health Sciences, De Montfort University, The Gateway, LE1 9BH, Leicester, United Kingdom
| | - M Heinrich
- Research Cluster Biodiversity and Medicines/Centre for Pharmacognosy and Phytotherapy, UCL School of Pharmacy, WC1N 1AX, London, United Kingdom
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22
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Donelan C, Wagar M, Howard C, Benson S, Dahl C. Implementation of an Undergraduate Medical Education Course in Global
Health Based on the Consortium of Universities for Global Health Core
Competencies: A Pilot Program. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Jennings J, Robinson C, Wallace A, Howard C, Brower J, Sayed D, Tran N, Vrionis F, Lekht I, Chang E, Bagla S, Papadouris D, Vadlamudi V, Meyer J, Timmerman R, Barr J, Chason D, Sichlau M, Sewall L, So G, Baek D, Tutton S, Lea W, Morris J, Callstrom M. Prospective, multicenter evaluation of targeted radiofrequency ablation (t-RFA) and vertebral augmentation (VA) prior to or following radiation therapy (RT) to treat painful metastatic vertebral body tumors (STARRT Study): Interim analysis. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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24
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Alston CL, Howard C, Oláhová M, Hardy SA, He L, Murray PG, O'Sullivan S, Doherty G, Shield JPH, Hargreaves IP, Monavari AA, Knerr I, McCarthy P, Morris AAM, Thorburn DR, Prokisch H, Clayton PE, McFarland R, Hughes J, Crushell E, Taylor RW. A recurrent mitochondrial p.Trp22Arg NDUFB3 variant causes a distinctive facial appearance, short stature and a mild biochemical and clinical phenotype. J Med Genet 2016; 53:634-41. [PMID: 27091925 PMCID: PMC5013090 DOI: 10.1136/jmedgenet-2015-103576] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/27/2016] [Indexed: 11/05/2022]
Abstract
Background Isolated Complex I deficiency is the most common paediatric mitochondrial disease presentation, associated with poor prognosis and high mortality. Complex I comprises 44 structural subunits with at least 10 ancillary proteins; mutations in 29 of these have so far been associated with mitochondrial disease but there are limited genotype-phenotype correlations to guide clinicians to the correct genetic diagnosis. Methods Patients were analysed by whole-exome sequencing, targeted capture or candidate gene sequencing. Clinical phenotyping of affected individuals was performed. Results We identified a cohort of 10 patients from 8 families (7 families are of unrelated Irish ancestry) all of whom have short stature (<9th centile) and similar facial features including a prominent forehead, smooth philtrum and deep-set eyes associated with a recurrent homozygous c.64T>C, p.Trp22Arg NDUFB3 variant. Two sibs presented with primary short stature without obvious metabolic dysfunction. Analysis of skeletal muscle from three patients confirmed a defect in Complex I assembly. Conclusions Our report highlights that the long-term prognosis related to the p.Trp22Arg NDUFB3 mutation can be good, even for some patients presenting in acute metabolic crisis with evidence of an isolated Complex I deficiency in muscle. Recognition of the distinctive facial features—particularly when associated with markers of mitochondrial dysfunction and/or Irish ancestry—should suggest screening for the p.Trp22Arg NDUFB3 mutation to establish a genetic diagnosis, circumventing the requirement of muscle biopsy to direct genetic investigations.
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Affiliation(s)
- Charlotte L Alston
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Caoimhe Howard
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Monika Oláhová
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Steven A Hardy
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Langping He
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Philip G Murray
- Centre for Paediatrics and Child Health, Institute of Human Development, Faculty of Medical & Human Sciences, University of Manchester, & Manchester Academic Health Science Centre, Manchester, UK
| | - Siobhan O'Sullivan
- Department of Metabolic Paediatrics, Royal Hospital for Sick Children, Belfast, UK
| | - Gary Doherty
- Department of Metabolic Paediatrics, Royal Hospital for Sick Children, Belfast, UK
| | - Julian P H Shield
- University of Bristol and Bristol Royal Hospital for Children, Bristol, UK
| | - Iain P Hargreaves
- Neurometabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - Ardeshir A Monavari
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Ina Knerr
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Peter McCarthy
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Andrew A M Morris
- Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - David R Thorburn
- Department of Paediatrics, The Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Parkville, Australia
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Peter E Clayton
- Centre for Paediatrics and Child Health, Institute of Human Development, Faculty of Medical & Human Sciences, University of Manchester, & Manchester Academic Health Science Centre, Manchester, UK
| | - Robert McFarland
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Joanne Hughes
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Ellen Crushell
- National Centre for Inherited Metabolic Disorders, Temple Street Children's University Hospital, Dublin, Ireland
| | - Robert W Taylor
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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Howard C, MacBean V, Lunt A, Greenough A. P287 Offline Fractional Exhaled Nitric Oxide and Breath Frequency: Abstract P287 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Howard C, Holley A, Sasse A, Harding S, Larsen P. Is the incidence of high on treatment platelet reactivity (HOTPR) reduced in acute coronary syndrome (ACS) patients treated with ticagrelor? Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Rowe FJ, Barton PG, Bedson E, Breen R, Conroy EJ, Cwiklinski E, Dodridge C, Drummond A, Garcia-Finana M, Howard C, Johnson S, MacIntosh C, Noonan CP, Pollock A, Rockliffe J, Sackley C, Shipman T. A randomised controlled trial to compare the clinical and cost-effectiveness of prism glasses, visual search training and standard care in patients with hemianopia following stroke: a protocol. BMJ Open 2014; 4:e005885. [PMID: 25034632 PMCID: PMC4120412 DOI: 10.1136/bmjopen-2014-005885] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Homonymous hemianopia is a common and disabling visual problem after stroke. Currently, prism glasses and visual scanning training are proposed to improve it. The aim of this trial is to determine the effectiveness of these interventions compared to standard care. METHODS AND ANALYSIS The trial will be a multicentre three arm individually randomised controlled trial with independent assessment at 6 week, 12 week and 26 week post-randomisation. Recruitment will occur in hospital, outpatient and primary care settings in UK hospital trusts. A total of 105 patients with homonymous hemianopia and without ocular motility impairment, visual inattention or pre-existent visual field impairment will be randomised to one of three balanced groups. Randomisation lists will be stratified by site and hemianopia level (partial or complete) and created using simple block randomisation by an independent statistician. Allocations will be disclosed to patients by the treating clinician, maintaining blinding for outcome assessment. The primary outcome will be change in visual field assessment from baseline to 26 weeks. Secondary measures will include the Rivermead Mobility Index, Visual Function Questionnaire 25/10, Nottingham Extended Activities of Daily Living, Euro Qual-5D and Short Form-12 questionnaires. Analysis will be by intention to treat. ETHICS AND DISSEMINATION This study has been developed and supported by the UK Stroke Research Network Clinical Studies Group working with service users. Multicentre ethical approval was obtained through the North West 6 Research ethics committee (Reference 10/H1003/119). The trial is funded by the UK Stroke Association. Trial Registration: Current Controlled Trials ISRCTN05956042. Dissemination will consider usual scholarly options of conference presentation and journal publication in addition to patient and public dissemination with lay summaries and articles. TRIAL REGISTRATION Current Controlled Trials ISRCTN05956042.
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Affiliation(s)
- F J Rowe
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - P G Barton
- Department of Elderly Care, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK
| | - E Bedson
- Clinical Trials Research Unit, University of Liverpool, Liverpool, UK
| | - R Breen
- Clinical Trials Research Unit, University of Liverpool, Liverpool, UK
| | - E J Conroy
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - E Cwiklinski
- Clinical Trials Research Unit, University of Liverpool, Liverpool, UK
| | - C Dodridge
- Department of Orthoptics, Oxford University Hospitals NHS Trust, Oxford, UK
| | - A Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - M Garcia-Finana
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - C Howard
- Department of Orthoptics, Salford Royal NHS Foundation Trust, Manchester, UK
| | - S Johnson
- Eye Clinic Impact Team, Royal National Institute for the Blind, Birmingham, UK
| | - C MacIntosh
- Department of Orthoptics, Oxford University Hospitals NHS Trust, Oxford, UK
| | - C P Noonan
- Department of Ophthalmology, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - A Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | | | - C Sackley
- Faculty of Medicine and Health, University of East Anglia, Norwich, UK
| | - T Shipman
- Department of Orthoptics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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28
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Buetefisch CM, Howard C, Korb C, Haut MW, Shuster L, Pergami P, Smith C, Hobbs G. Conditions for enhancing the encoding of an elementary motor memory by rTMS. Clin Neurophysiol 2014; 126:581-93. [PMID: 25113275 DOI: 10.1016/j.clinph.2014.07.006] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 06/12/2014] [Accepted: 07/07/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Motor learning results in changes of movement representation in primary motor cortex (M1) a process involving long-term potentiation (LTP). Pairing motor training with repetitive transcranial magnetic stimulation (rTMS) of M1 enhances the formation of a motor memory. Here we determined the effect of pairing M1 stimulation and the execution of training movements at different times and frequencies on the formation of a motor memory. METHODS Formation of a motor memory was defined as increases in motor evoked potentials (MEP) of the training agonist (extensor carpi ulnaris muscle, ECU) and increases in peak acceleration of the trained movements that last more than 60min. Training consisted of auditory-paced ballistic wrist extension movements (30min, 0.5Hz) paired with 0.1, 0.25 or 0.5Hz subthreshold rTMS. The rTMS pulse was applied at either the onset, 100ms prior to or 300ms after the onset of training movement related increases in electromyographic (EMG) activity of ECU. This was compared to a Sham condition. RESULTS Only 0.1Hz rTMS applied at the onset of the training related increase in ECU-EMG activity resulted in increases in MEP amplitudes and peak acceleration when compared to the Sham. CONCLUSIONS The formation of motor memory is enhanced above the naïve level by co-administration of low frequency rTMS at the time of execution of training movements. SIGNIFICANCE These results indicate the importance of time and frequency of rTMS in these settings and should be considered in the design of rehabilitation treatment strategies using rTMS.
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Affiliation(s)
- C M Buetefisch
- Department of Neurology, West Virginia University, Morgantown, WV, USA; Department of Neurology, Emory University, Atlanta, GA, USA; Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA; Department of Radiology, Emory University, Atlanta, GA, USA.
| | - C Howard
- Department of Neurology, West Virginia University, Morgantown, WV, USA
| | - C Korb
- Department of Neurology, West Virginia University, Morgantown, WV, USA
| | - M W Haut
- Department of Behavioral Medicine, West Virginia University, Morgantown, WV, USA
| | - L Shuster
- Department of Language Speech Pathology, West Virginia University, Morgantown, WV, USA
| | - P Pergami
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - C Smith
- Department of Neurology, West Virginia University, Morgantown, WV, USA
| | - G Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV, USA
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Zhu X, Santos L, Howard C, Sankar R, Chou FC, Chamon C, El-Batanouny M. Electron-phonon coupling on the surface of the topological insulator Bi2Se3 determined from surface-phonon dispersion measurements. Phys Rev Lett 2012; 108:185501. [PMID: 22681089 DOI: 10.1103/physrevlett.108.185501] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Indexed: 06/01/2023]
Abstract
In this Letter, we report measurements of the coupling between Dirac fermion quasiparticles (DFQs) and phonons on the (001) surface of the strong topological insulator Bi2Se3. While most contemporary investigations of this coupling have involved examining the temperature dependence of the DFQ self-energy via angle-resolved photoemission spectroscopy measurements, we employ inelastic helium-atom scattering to explore, for the first time, this coupling from the phonon perspective. Using a Hilbert transform, we are able to obtain the imaginary part of the phonon self-energy associated with a dispersive surface-phonon branch identified in our previous work [Phys. Rev. Lett. 107, 186102 (2011)] as having strong interactions with the DFQs. From this imaginary part of the self-energy we obtain a branch-specific electron-phonon coupling constant of 0.43, which is stronger than the values reported from the angle-resolved photoemission spectroscopy measurements.
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Affiliation(s)
- Xuetao Zhu
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
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Alder J, Howard C, Ruiz C. Videoconference Interviews as an Adjunct to Traditional Resident Recruitment Interviews. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.086] [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]
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Sato K, Moy OJ, Peimer CA, Nakamura T, Howard C, Ko SH, Lee TC, Nishiwaki Y. An experimental study on costal osteochondral graft. Osteoarthritis Cartilage 2012; 20:172-83. [PMID: 22179032 DOI: 10.1016/j.joca.2011.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [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] [Received: 01/25/2011] [Revised: 12/01/2011] [Accepted: 12/06/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate usefulness of osteochondral grafting from the costo-osteochondral junction as a repair technique for articular cartilage defects histologic and biochemical analysis of grafted cartilage in rabbit knees was evaluated up to 48 weeks after transplantation. METHODS Twenty New Zealand White rabbits were used. A costal osteochondral plug was harvested from a middle rib. After trimming, it was transplanted into a cylindrical osteochondral 2.5 mm diameter and 5 mm deep defect created in the knee. The animals were sacrificed at 6, 12, 24, and 48 weeks after transplantation. Defect sites were inspected macroscopically, and then by light microscopy. Samples were evaluated for cell viability using a fluorescent in situ double-staining protocol with confocal laser microscopic analysis. Samples were also processed to assess type I & II collagen and aggrecan mRNA expression using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS Histologically, bone union was achieved in all plugs. Confocal microscopic analysis revealed chondrocyte viability in the 48-week grafts; the distribution of chondrocytes was similar to surrounding articular cartilage. The expression of type II collagen and aggrecan mRNA in the grafted cartilage was consistent with normal articular cartilage and normal costal cartilage. These results were observed over 6-48 weeks. CONCLUSIONS Our study revealed that chondrocytes in the grafted cartilage were viable at least up to 48 weeks and that mRNA expression of type II collagen and aggrecan was also similar to that of normal articular cartilage. These results suggest that costal osteochondral grafting can be a useful alternative in the treatment of osteochondral defects.
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Affiliation(s)
- K Sato
- Hand and Shoulder Center of Western New York, Department of Orthopaedic Surgery, University at Buffalo, State University of New York, USA.
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Zhu X, Santos L, Sankar R, Chikara S, Howard C, Chou FC, Chamon C, El-Batanouny M. Interaction of phonons and dirac fermions on the surface of Bi2Se3: a strong Kohn anomaly. Phys Rev Lett 2011; 107:186102. [PMID: 22107648 DOI: 10.1103/physrevlett.107.186102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Indexed: 05/31/2023]
Abstract
We report the first measurements of phonon dispersion curves on the (001) surface of the strong three-dimensional topological insulator Bi2Se3. The surface phonon measurements were carried out with the aid of coherent helium beam surface scattering techniques. The results reveal a prominent signature of the exotic metallic Dirac fermion quasiparticles, including a strong Kohn anomaly. The signature is manifest in a low energy isotropic convex dispersive surface phonon branch with a frequency maximum of 1.8 THz and having a V-shaped minimum at approximately 2kF that defines the Kohn anomaly. Theoretical analysis attributes this dispersive profile to the renormalization of the surface phonon excitations by the surface Dirac fermions. The contribution of the Dirac fermions to this renormalization is derived in terms of a Coulomb-type perturbation model.
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Affiliation(s)
- Xuetao Zhu
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
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Howard C, Carpenter M, Kisi E. Predicting switchable multi-ferroic Ruddlesden-Popper phases and phase transitions. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311082195] [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: 11/11/2022] Open
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Davies L, Bell JNB, Bone J, Head M, Hill L, Howard C, Hobbs SJ, Jones DT, Power SA, Rose N, Ryder C, Seed L, Stevens G, Toumi R, Voulvoulis N, White PCL. Open Air Laboratories (OPAL): a community-driven research programme. Environ Pollut 2011; 159:2203-10. [PMID: 21458125 DOI: 10.1016/j.envpol.2011.02.053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 02/28/2011] [Accepted: 02/28/2011] [Indexed: 05/23/2023]
Abstract
OPAL is an English national programme that takes scientists into the community to investigate environmental issues. Biological monitoring plays a pivotal role covering topics of: i) soil and earthworms; ii) air, lichens and tar spot on sycamore; iii) water and aquatic invertebrates; iv) biodiversity and hedgerows; v) climate, clouds and thermal comfort. Each survey has been developed by an inter-disciplinary team and tested by voluntary, statutory and community sectors. Data are submitted via the web and instantly mapped. Preliminary results are presented, together with a discussion on data quality and uncertainty. Communities also investigate local pollution issues, ranging from nitrogen deposition on heathlands to traffic emissions on roadside vegetation. Over 200,000 people have participated so far, including over 1000 schools and 1000 voluntary groups. Benefits include a substantial, growing database on biodiversity and habitat condition, much from previously unsampled sites particularly in urban areas, and a more engaged public.
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Affiliation(s)
- L Davies
- Imperial College London, London SW7 2AZ, UK.
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Howard C, Holcombe AO. Progressively poorer perceptual precision and progressively greater perceptual lag: Tracking the changing features of one, two and four objects. J Vis 2010. [DOI: 10.1167/6.6.785] [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: 11/24/2022] Open
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Howard C, Gilchrist I, Troscianko T, Behera A, Hogg D. Monitoring CCTV and watching football: expert-novice differences in the magnitude of a visuo-motor buffer. J Vis 2010. [DOI: 10.1167/9.8.416] [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: 11/24/2022] Open
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Aharmim B, Ahmed SN, Amsbaugh JF, Anthony AE, Banar J, Barros N, Beier EW, Bellerive A, Beltran B, Bergevin M, Biller SD, Boudjemline K, Boulay MG, Bowles TJ, Browne MC, Bullard TV, Burritt TH, Cai B, Chan YD, Chauhan D, Chen M, Cleveland BT, Cox-Mobrand GA, Currat CA, Dai X, Deng H, Detwiler J, DiMarco M, Doe PJ, Doucas G, Drouin PL, Duba CA, Duncan FA, Dunford M, Earle ED, Elliott SR, Evans HC, Ewan GT, Farine J, Fergani H, Fleurot F, Ford RJ, Formaggio JA, Fowler MM, Gagnon N, Germani JV, Goldschmidt A, Goon JTM, Graham K, Guillian E, Habib S, Hahn RL, Hallin AL, Hallman ED, Hamian AA, Harper GC, Harvey PJ, Hazama R, Heeger KM, Heintzelman WJ, Heise J, Helmer RL, Henning R, Hime A, Howard C, Howe MA, Huang M, Jagam P, Jamieson B, Jelley NA, Keeter KJ, Klein JR, Kormos LL, Kos M, Krüger A, Kraus C, Krauss CB, Kutter T, Kyba CCM, Lange R, Law J, Lawson IT, Lesko KT, Leslie JR, Loach JC, MacLellan R, Majerus S, Mak HB, Maneira J, Martin R, McBryde K, McCauley N, McDonald AB, McGee S, Mifflin C, Miller GG, Miller ML, Monreal B, Monroe J, Morissette B, Myers A, Nickel BG, Noble AJ, Oblath NS, O'Keeffe HM, Ollerhead RW, Gann GDO, Oser SM, Ott RA, Peeters SJM, Poon AWP, Prior G, Reitzner SD, Rielage K, Robertson BC, Robertson RGH, Rollin E, Schwendener MH, Secrest JA, Seibert SR, Simard O, Simpson JJ, Sinclair L, Skensved P, Smith MWE, Steiger TD, Stonehill LC, Tesić G, Thornewell PM, Tolich N, Tsui T, Tunnell CD, Van Wechel T, Van Berg R, VanDevender BA, Virtue CJ, Walker TJ, Wall BL, Waller D, Tseung HWC, Wendland J, West N, Wilhelmy JB, Wilkerson JF, Wilson JR, Wouters JM, Wright A, Yeh M, Zhang F, Zuber K. Independent measurement of the total active 8B solar neutrino flux using an array of 3He proportional counters at the Sudbury Neutrino Observatory. Phys Rev Lett 2008; 101:111301. [PMID: 18851271 DOI: 10.1103/physrevlett.101.111301] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Indexed: 05/26/2023]
Abstract
The Sudbury Neutrino Observatory (SNO) used an array of 3He proportional counters to measure the rate of neutral-current interactions in heavy water and precisely determined the total active (nu_x) 8B solar neutrino flux. This technique is independent of previous methods employed by SNO. The total flux is found to be 5.54_-0.31;+0.33(stat)-0.34+0.36(syst)x10(6) cm(-2) s(-1), in agreement with previous measurements and standard solar models. A global analysis of solar and reactor neutrino results yields Deltam2=7.59_-0.21;+0.19x10(-5) eV2 and theta=34.4_-1.2;+1.3 degrees. The uncertainty on the mixing angle has been reduced from SNO's previous results.
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Affiliation(s)
- B Aharmim
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6, Canada
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Verghese M, Richardson J, Boateng J, Shackelfor L, Howard C, Walker L, Chawan C. Dietary Lycopene Has a Protective Effect on Cardiovascular Disease in New Zealand Male Rabbits. ACTA ACUST UNITED AC 2008. [DOI: 10.3923/jbs.2008.268.277] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pettitt DJ, Ospina P, Howard C, Zisser H, Jovanovic L. Efficacy, safety and lack of immunogenicity of insulin aspart compared with regular human insulin for women with gestational diabetes mellitus. Diabet Med 2007; 24:1129-35. [PMID: 17888133 PMCID: PMC2121124 DOI: 10.1111/j.1464-5491.2007.02247.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2007] [Indexed: 01/14/2023]
Abstract
AIM The efficacy and safety of insulin aspart (IAsp), a rapid-acting human insulin analogue, were compared with regular human insulin (HI) as the bolus component of basal-bolus therapy for subjects with gestational diabetes mellitus (GDM). METHODS In a randomized, parallel-group, open-labelled trial, 27 women with GDM (age 30.7 +/- 6.3 years, HbA(1c) < 7%) were randomized to receive IAsp (5 min before meal) or HI (30 min before meal). The trial period extended from diagnosis of GDM (18-28 weeks) to 6 weeks postpartum. RESULTS Both treatment groups maintained good overall glycaemic control during the study (beginning and end of study HbA(1c)< or = 6%). During the meal test, mean glucose at week 6 (IAsp 4.2 +/- 0.57 mmol/l, HI 4.8 +/- 0.86 mmol/l) was slightly lower than at week 0 (IAsp 4.9 +/- 0.59 mmol/l, HI 5.1 +/- 0.36 mmol/l). However, change from baseline values for average glucose (IAsp -1.09 +/- 0.54 mmol/l, HI -0.54 +/- 0.74 mmol/l; P = 0.003) and C-peptide (IAsp -0.50 +/- 0.67 nmol/l, HI -0.30 +/- 0.70 nmol/l; P = 0.027) were significantly lower after IAsp treatment than HI treatment. No major hypoglycaemic events were reported during the study. Cross-reacting insulin antibody binding increased slightly from baseline in both treatments groups (end of study: IAsp 2.1 +/- 5.4%, HI 6.4 +/- 13.9%), whereas antibodies specific to IAsp or HI remained relatively low (< 1% binding). CONCLUSION IAsp was more effective than HI in decreasing postprandial glucose concentrations. Duration of IAsp injection 5 min before a meal rather than 30 min prior to meals offers a more convenient therapy for subjects with GDM. Overall safety and effectiveness of IAsp were comparable to HI in pregnant women with GDM.
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Affiliation(s)
- D J Pettitt
- Sansum Diabetes Research Institute, Santa Barbara, CA 93105, USA
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Carpenter CM, Hall ER, Randall R, McKenzie R, Cassels F, Diaz N, Thomas N, Bedford P, Darsley M, Gewert C, Howard C, Sack RB, Sack DA, Chang HS, Gomes G, Bourgeois AL. Comparison of the antibody in lymphocyte supernatant (ALS) and ELISPOT assays for detection of mucosal immune responses to antigens of enterotoxigenic Escherichia coli in challenged and vaccinated volunteers. Vaccine 2006; 24:3709-18. [PMID: 16153753 DOI: 10.1016/j.vaccine.2005.07.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In the present study we compared the ELISPOT and antibody in lymphocyte supernatants (ALS) assays as surrogate measures of mucosal immunity. In separate studies, 20 inpatient volunteers received oral doses of 6 x 10(8) or 4 x 10(9)cfu of ETEC strain E24377A (LT+, ST+, CS1+, CS3+) and 20 subjects received 1 (n = 9) or 2 (n = 11) oral doses of the attenuated ETEC vaccine, PTL-003 expressing CFA/II (CS1+ and CS3+) (2 x 10(9)cfu/dose). Peripheral blood mononuclear cells (PBMCs) from all subjects were assayed for anti-colonization factor or toxin-specific IgA antibody responses using the ALS and ELISPOT procedures. ALS responses were measured using a standard ELISA, as well as by time-resolved fluorescence (TRF). Following challenge with E24377A, significant anti-CS3, CS1 and LT ALS responses were detected in the lymphocyte supernatants of 75-95% of the subjects. A similar proportion (75%) of subjects mounted an ALS response to CFA/II antigen after vaccination with the PTL-003 vaccine. Inter-assay comparisons between ALS and ELISPOT methods also revealed a high degree of correlation in both immunization groups. ALS sensitivity versus the ELISPOT assay for LT, CS3 and CS1-specific responses following challenge were 95%, 94% and 78%, respectively and 83% for the ALS response to CFA/II antigen after vaccination with PTL-003. Correlation coefficients for the LT and CS3 antigens were 0.94 (p<0.001) and 0.82 (p<0.001), respectively after challenge and 0.78 (p<0.001) after vaccination. The association between ALS and ELISPOT for the CS1 antigen was however, significant only when ALS supernatants were tested by TRF (r = 0.91, p<0.001). These results demonstrate the value and flexibility of the ALS assay as an alternative to ELISPOT for the measurement of mucosal immune responses to ETEC antigens, particularly when the complexities of ELISPOT may make it impractical to perform.
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Affiliation(s)
- C M Carpenter
- Center for Immunization Research, Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, 624 N. Broadway, HH, Rm 205, Baltimore, MD 21205, USA
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Abstract
BACKGROUND Failed manipulative reduction of avulsion fractures of the tibial insertion of the anterior cruciate ligament has been attributed to interposition of soft tissues, particularly the anterior horn of the medial meniscus. The objectives of the present report were (1) to show that the failure to reduce Meyers and McKeever type-III tibial eminence fractures was not due to interposition of soft tissues and (2) to discuss the relevance of the finding that the anterior third of the lateral meniscus was attached to the avulsed anterior cruciate ligament insertion site in all patients studied. METHODS Twelve patients who had had a failed manipulative reduction of a type-III tibial eminence fracture underwent arthroscopic reduction and fixation of the avulsed fragment. RESULTS A number of consistent findings were noted. The avulsed intercondylar eminence was displaced superiorly into the intercondylar notch. Attached to this fragment was not only the anterior cruciate ligament, but also, in all cases, the anterior horn of the lateral meniscus. The anterior third of the lateral meniscus had been torn from its tibial attachment and displaced together with the osseous fragment into the intercondylar notch. No interposition of bone or soft tissue was observed. Reduction of the osseous fragment was facilitated by traction on, or sutures passed around, the anterior horn of the lateral meniscus. Standard fixation methods were utilized. CONCLUSIONS The concept that avulsion fractures of the tibial insertion of the anterior cruciate ligament cannot be reduced by manipulation because of soft-tissue interposition was not supported by the findings of the present study. The attachment of the anterior horn of the lateral meniscus to the avulsed tibial insertion of the anterior cruciate ligament may not be an irrelevant incidental finding. The observation that the displaced osseous fragment was attached simultaneously to the anterior cruciate ligament and to the anterior horn of the lateral meniscus, both pulling in different directions, may explain why type-III tibial eminence fractures are irreducible by manipulation.
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Affiliation(s)
- J Lowe
- Sports Injury and Arthroscopy Unit, Hadassah University Hospital, Mount Scopus, Jerusalem 91240, Israel.
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Langelaar M, Koets A, Müller K, van Eden W, Noordhuizen J, Howard C, Hope J, Rutten V. Mycobacterium paratuberculosis heat shock protein 70 as a tool in control of paratuberculosis. Vet Immunol Immunopathol 2002; 87:239-44. [PMID: 12072241 DOI: 10.1016/s0165-2427(02)00089-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Paratuberculosis in cattle is a chronic intestinal disease in which a distinctive cellular reactivity of a Th1-type preceeds the phase in which antibody titers are easily detectable and the animal becomes clinically ill. During infection with Mycobacterium avium ssp. paratuberculosis (M.a.p), a decrease in CD4 T-helper cells has been observed in the clinical phase. Our ultimate aim is to elicit a cytotoxic reaction against infected macrophages, using recombinant Hsp70 (rHsp70) of M.a.p. as a tool to shuttle antigen into the MHC class I antigen presentation pathway. To investigate the mechanism of rHsp70 as a carrier for antigen into the cell, we studied the interaction between APC and Fitc-labelled rHsp70, using FACS analysis and confocal microscopy. Interaction of rHsp70 with the cell surface of bovine APC, presumably via a receptor, was shown on monocytes, monocyte derived macrophages and dendritic cell (DC). The interaction is detectable on the complete population of freshly derived monocytes, although peak intensity of fluorescence is lower on these cells than on macrophages and DCs. DCs show interaction on a high percentage of the cells, with high intensity, while in the case of macrophages only a subpopulation interacts with rHsp70. Efficient uptake of rHsp70 as compared to OVA is shown. Preincubation of DC with unlabelled rHsp70 leads to a decreased interaction with rHsp70-FITC. DC interacting with rHsp70 in addition showed high expression of MHC I, MHC II, Myd-1 (CD172a) and CD40. Further research will focus on loading of the rHsp70 with M.a.p. antigen for presentation in MHC class I.
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Affiliation(s)
- M Langelaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Division of Immunology, Utrecht, The Netherlands.
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Robinson K, Neal KR, Howard C, Stockton J, Atkinson K, Scarth E, Moran J, Robins A, Todd I, Kaczmarski E, Gray S, Muscat I, Slack R, Ala'Aldeen DAA. Characterization of humoral and cellular immune responses elicited by meningococcal carriage. Infect Immun 2002; 70:1301-9. [PMID: 11854214 PMCID: PMC127751 DOI: 10.1128/iai.70.3.1301-1309.2002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
In order to study the immune response elicited by asymptomatic carriage of Neisseria meningitidis, samples of serum, peripheral blood mononuclear cells (PBMCs), and saliva were collected from a cohort of more than 200 undergraduate students in Nottingham, United Kingdom, who were subject to high rates of acquisition and carriage of meningococci. Serum immunoglobulin G levels were elevated following increases in the rate of carriage, and these responses were specific for the colonizing strains. In order to investigate T-cell responses, PBMCs from 15 individuals were stimulated with a whole-cell lysate of the H44/76 meningococcal strain (B:15:P1.7,16), stained to detect cell surface markers and intracellular cytokines, and examined by flow cytometry. The cells were analyzed for expression of CD69 (to indicate activation), gamma interferon (IFN-gamma) (a representative T-helper 1 subset [Th1]-associated cytokine), and interleukin-5 (IL-5) (a Th2-associated cytokine). Following a brief meningococcal stimulation, the numbers of CD69(+) IFN-gamma(+) CD56/16(+) NK cells were much higher than cytokine-positive CD4(+) events. Both IFN-gamma(+) and IL-5(+) events were detected among the CD69(+) CD4(+) population, leading to the conclusion that an unbiased T-helper subset response was elicited by meningococcal carriage.
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Affiliation(s)
- K. Robinson
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - K. R. Neal
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - C. Howard
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - J. Stockton
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - K. Atkinson
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - E. Scarth
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - J. Moran
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - A. Robins
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - I. Todd
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - E. Kaczmarski
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - S. Gray
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - I. Muscat
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - R. Slack
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
| | - D. A. A. Ala'Aldeen
- Divisions of Microbiology and Infectious Diseases, Public Health Medicine and Epidemiology, Immunology, Molecular Bacteriology and Immunology Group, University Hospital, Nottingham, Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester, Department of Pathology, The General Hospital, Jersey, United Kingdom
- Corresponding author. Mailing address: Division of Microbiology and Infectious Diseases, School of Clinical Laboratory Sciences, A Floor West Block, University Hospital, Nottingham NG7 2UH, United Kingdom. Phone: 44 (0)115-849-3321. Fax: 44 (0)115-970-9233. E-mail:
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47
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Chadwick P, Trail A, Howard C, Keaney M, Cockcroft A, Callaghan J, Drury A. Development of an E-learning package to support training in infection control. J Infect 2002. [DOI: 10.1016/s0163-4453(02)90318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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48
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Hooper SR, Walker NW, Howard C. Training school psychologists in traumatic brain injury. The North Carolina model. N C Med J 2001; 62:350-4. [PMID: 11729464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- S R Hooper
- Department of Psychiatry, Clinical Center, UNC School of Medicine, USA
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49
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Abstract
Three cases are presented of recurrent synovitis of the knee in children caused by the presence of foreign material. There was no clear history of trauma. Arthroscopy is a useful method providing early diagnosis and simultaneous treatment of this condition.
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Affiliation(s)
- L Kandel
- Department of Orthopaedic Surgery, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
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50
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Doering OC, Ribaudo M, Diaz-Hermelo F, Heimlich R, Hitzhusen F, Howard C, Kazmierczak R, Lee J, Libby L, Milon W, Peters M, Prato A. Economic analysis as a basis for large-scale nitrogen control decisions: reducing nitrogen loads to the Gulf of Mexico. ScientificWorldJournal 2001; 1 Suppl 2:968-75. [PMID: 12805894 PMCID: PMC6084031 DOI: 10.1100/tsw.2001.270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Economic analysis can be a guide to determining the level of actions taken to reduce nitrogen (N) losses and reduce environmental risk in a cost-effective manner while also allowing consideration of relative costs of controls to various groups. The biophysical science of N control, especially from nonpoint sources such as agriculture, is not certain. Widespread precise data do not exist for a river basin (or often even for a watershed) that couples management practices and other actions to reduce nonpoint N losses with specific delivery from the basin. The causal relationships are clouded by other factors influencing N flows, such as weather, temperature, and soil characteristics. Even when the science is certain, economic analysis has its own sets of uncertainties and simplifying economic assumptions. The economic analysis of the National Hypoxia Assessment provides an example of economic analysis based on less than complete scientific information that can still provide guidance to policy makers about the economic consequences of alternative approaches. One critical value to policy makers comes from bounding the economic magnitude of the consequences of alternative actions. Another value is the identification of impacts outside the sphere of initial concerns. Such analysis can successfully assess relative impacts of different degrees of control of N losses within the basin as well as outside the basin. It can demonstrate the extent to which costs of control of any one action increase with the intensity of application of control.
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Affiliation(s)
- O C Doering
- Agricultural Economics Department, Purdue University, West Lafayette, IN 47906, USA.
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