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Lee IO, Wolstencroft J, Housby H, van den Bree MBM, Chawner SJRA, Hall J, Skuse DH. The inequity of education, health and care plan provision for children and young people with intellectual and developmental disabilities. J Intellect Disabil Res 2024. [PMID: 38777582 DOI: 10.1111/jir.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Children and young people (CYP) with intellectual and developmental disabilities (IDDs) have significant additional educational needs compared with the general population. In England, the government has established a system of education, health and care plans (EHCPs) to support children with special educational needs and disabilities, but disparities exist between the degree of need and the availability of support. We conducted a prospective UK national cohort study (IMAGINE) of children with rare pathogenic genomic variants, all of which are associated with IDD, to investigate associated neuropsychiatric risk. Subsequently, we obtained information from the UK's National Pupil Database on their educational progress through the state school system. We aimed to identify whether they had received EHCP provision and whether that support was associated with their family's socioeconomic status, region of domicile, ethnicity, sex, primary special educational needs (SEN) type, academic performance and mental health well-being. METHODS We recruited 2738 CYP from England into the IMAGINE study between 2014 and 2019. The educational histories of the participants (6-28 years old, mean ± standard deviation = 14 ± 4 years, 56% male) were obtained from the Department for Education's National Pupil Database in 2021. Educational data included attainment scores from the Early Year Foundation Stage (<5 years) to key stage 4 (15-16 years). Each family was assigned an index of multiple deprivation (IMD) score based on their home address postcode. Parents or carers rated their child's emotional and behavioural adjustment on the Strengths and Difficulties Questionnaire (SDQ). The association between receiving an EHCP and the child's IMD score, eligibility for free school meals, English region of domicile, ethnicity, sex, primary SEN type, academic attainment and SDQ score was investigated. RESULTS In this cohort, 78% of participants had received an EHCP. CYP living in the most deprived IMD deciles were substantially less likely to receive EHCP support than those in the least deprived decile, irrespective of their degree of intellectual developmental disability, academic performance or associated mental health problems. There were no sex differences. Children of Asian heritage were more likely to have been granted an EHCP than White children from equivalent IMD deciles. There were striking regional disparities. Participants living in London were significantly more likely to have been awarded an EHCP than participants living anywhere else in England, regardless of their IMD decile; those in the least deprived decile had almost 100% EHCP provision. CONCLUSIONS This study found evidence for nationwide regional inconsistencies in the awarding of EHCP to CYP with significant intellectual impairments of known genetic aetiology. Disparities in funds available to education authorities could be a contributory factor. EHCP support was potentially influenced by how strongly a parent advocates for their child.
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Affiliation(s)
- I O Lee
- Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - J Wolstencroft
- Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - H Housby
- Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - M B M van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S J R A Chawner
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - J Hall
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - D H Skuse
- Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
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Mehta S, Gardner K, Hall J, Rosenfield D, Tse S, Ho K, Grant K, Bradbury-Squires DJ, Lang E, Chartier L. Virtual urgent care is here to stay: driving toward safe, equitable, and sustainable integration within emergency medicine. CAN J EMERG MED 2024; 26:305-311. [PMID: 38334940 DOI: 10.1007/s43678-024-00658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Virtual care in Canada rapidly expanded during the COVID-19 pandemic in a low-rules environment in response to pressing needs for ongoing access to care amid public health restrictions. Emergency medicine specialists now face the challenge of advising on which virtual urgent care services ought to remain as part of comprehensive emergency care. Consideration must be given to safe, quality, and appropriate care as well as issues of equitable access, public demand, and sustainability (financial and otherwise). The aim of this project was to summarize current literature and expert opinion and formulate recommendations on the path forward for virtual care in emergency medicine. METHODS We formed a working group of emergency medicine physicians from across Canada working in a variety of practice settings. The virtual care working group conducted a scoping review of the literature and met monthly to discuss themes and develop recommendations. The final recommendations were circulated to stakeholders for input and subsequently presented at the 2023 Canadian Association of Emergency Physicians (CAEP) Academic Symposium for discussion, feedback, and refinement. RESULTS The working group developed and reached unanimity on nine recommendations addressing the themes of system design, equity and accessibility, quality and patient safety, education and curriculum, financial models, and sustainability of virtual urgent care services in Canada. CONCLUSION Virtual urgent care has become an established service in the Canadian health care system. Emergency medicine specialists are uniquely suited to provide leadership and guidance on the optimal delivery of these services to enhance and complement emergency care in Canada.
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Affiliation(s)
- S Mehta
- Unity Health Toronto, Toronto, ON, Canada
- North York General Hospital, North York, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - K Gardner
- IWK Health, Halifax, NS, Canada.
- Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - J Hall
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - D Rosenfield
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Paediatric Emergency Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
| | - S Tse
- Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario, CHEO Research Institute, Ottawa, ON, Canada
| | - K Ho
- Faculty of Medicine, Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - K Grant
- Faculty of Medicine, Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - D J Bradbury-Squires
- Faculty of Medicine, Disciplines of Family Medicine and Emergency Medicine, Memorial University of Newfoundland, Newfoundland Regional Health Centre, Grand Falls-Windsor, NL, Canada
| | - E Lang
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - L Chartier
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
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Gosling M, Hall J. Combined cystourethroplasty and urethral sphincter occluder placement for treatment of urinary incontinence in a cat with genitourinary dysplasia. J Small Anim Pract 2024. [PMID: 38424735 DOI: 10.1111/jsap.13717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/13/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
A 10-month-old female neutered domestic shorthair cat presented with a history of urinary incontinence and recurrent bacterial cystitis since 2 months of age. Physical examination was unremarkable other than vulval hypoplasia. Genitourinary dysplasia was diagnosed following a physical examination, CT imaging and retrograde positive contrast urethrocystography. Attempted medical management of the urinary incontinence was unsuccessful. Surgical treatment consisted of cystourethroplasty combined with artificial urethral sphincter placement, resulting in marked improvement of urinary continence. Following multiple adjustments of the artificial urethral sphincter near-total continence was achieved, which was maintained at 10 months post-surgery.
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Affiliation(s)
- M Gosling
- Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - J Hall
- Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK
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Kanis JA, Johansson H, McCloskey EV, Liu E, Åkesson KE, Anderson FA, Azagra R, Bager CL, Beaudart C, Bischoff-Ferrari HA, Biver E, Bruyère O, Cauley JA, Center JR, Chapurlat R, Christiansen C, Cooper C, Crandall CJ, Cummings SR, da Silva JAP, Dawson-Hughes B, Diez-Perez A, Dufour AB, Eisman JA, Elders PJM, Ferrari S, Fujita Y, Fujiwara S, Glüer CC, Goldshtein I, Goltzman D, Gudnason V, Hall J, Hans D, Hoff M, Hollick RJ, Huisman M, Iki M, Ish-Shalom S, Jones G, Karlsson MK, Khosla S, Kiel DP, Koh WP, Koromani F, Kotowicz MA, Kröger H, Kwok T, Lamy O, Langhammer A, Larijani B, Lippuner K, Mellström D, Merlijn T, Nordström A, Nordström P, O'Neill TW, Obermayer-Pietsch B, Ohlsson C, Orwoll ES, Pasco JA, Rivadeneira F, Schott AM, Shiroma EJ, Siggeirsdottir K, Simonsick EM, Sornay-Rendu E, Sund R, Swart KMA, Szulc P, Tamaki J, Torgerson DJ, van Schoor NM, van Staa TP, Vila J, Wareham NJ, Wright NC, Yoshimura N, Zillikens MC, Zwart M, Vandenput L, Harvey NC, Lorentzon M, Leslie WD. Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX. Osteoporos Int 2023; 34:2027-2045. [PMID: 37566158 PMCID: PMC7615305 DOI: 10.1007/s00198-023-06870-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/22/2023] [Indexed: 08/12/2023]
Abstract
A large international meta-analysis using primary data from 64 cohorts has quantified the increased risk of fracture associated with a previous history of fracture for future use in FRAX. INTRODUCTION The aim of this study was to quantify the fracture risk associated with a prior fracture on an international basis and to explore the relationship of this risk with age, sex, time since baseline and bone mineral density (BMD). METHODS We studied 665,971 men and 1,438,535 women from 64 cohorts in 32 countries followed for a total of 19.5 million person-years. The effect of a prior history of fracture on the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture, and hip fracture alone was examined using an extended Poisson model in each cohort. Covariates examined were age, sex, BMD, and duration of follow-up. The results of the different studies were merged by using the weighted β-coefficients. RESULTS A previous fracture history, compared with individuals without a prior fracture, was associated with a significantly increased risk of any clinical fracture (hazard ratio, HR = 1.88; 95% CI = 1.72-2.07). The risk ratio was similar for the outcome of osteoporotic fracture (HR = 1.87; 95% CI = 1.69-2.07), major osteoporotic fracture (HR = 1.83; 95% CI = 1.63-2.06), or for hip fracture (HR = 1.82; 95% CI = 1.62-2.06). There was no significant difference in risk ratio between men and women. Subsequent fracture risk was marginally downward adjusted when account was taken of BMD. Low BMD explained a minority of the risk for any clinical fracture (14%), osteoporotic fracture (17%), and for hip fracture (33%). The risk ratio for all fracture outcomes related to prior fracture decreased significantly with adjustment for age and time since baseline examination. CONCLUSION A previous history of fracture confers an increased risk of fracture of substantial importance beyond that explained by BMD. The effect is similar in men and women. Its quantitation on an international basis permits the more accurate use of this risk factor in case finding strategies.
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Affiliation(s)
- J A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
| | - H Johansson
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - E V McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
- MRC Versus Arthritis Centre for Integrated research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - E Liu
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - K E Åkesson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - F A Anderson
- GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - R Azagra
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Health Centre Badia del Valles, Catalan Institute of Health, Barcelona, Spain
- PRECIOSA-Fundación para la investigación, Barberà del Vallés, Barcelona, Spain
| | - C L Bager
- Nordic Bioscience A/S, Herlev, Denmark
| | - C Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Department of Health Services Research, University of Maastricht, Maastricht, the Netherlands
| | - H A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland
- Centre on Aging and Mobility, University of Zurich and City Hospital, Zurich, Switzerland
| | - E Biver
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - O Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - J A Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Philadelphia, USA
| | - J R Center
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia
- St Vincent's Clinical School, School of Medicine and Health, University of New South Wales Sydney, Sydney, NSW, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia
| | - R Chapurlat
- INSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France
| | | | - C Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - C J Crandall
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - S R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - J A P da Silva
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Dawson-Hughes
- Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - A Diez-Perez
- Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain
| | - A B Dufour
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - J A Eisman
- Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia
- St Vincent's Clinical School, School of Medicine and Health, University of New South Wales Sydney, Sydney, NSW, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia
| | - P J M Elders
- Petra JM Elders Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S Ferrari
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Y Fujita
- Center for Medical Education and Clinical Training, Kindai University Faculty of Medicine, Osaka, Japan
| | - S Fujiwara
- Department of Pharmacy, Yasuda Women's University, Hiroshima, Japan
| | - C-C Glüer
- Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - I Goldshtein
- Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Goltzman
- Department of Medicine, McGill University and McGill University Health Centre, Montreal, Canada
| | - V Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - J Hall
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - D Hans
- Interdisciplinary Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland
| | - M Hoff
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Rheumatology, St Olavs Hospital, Trondheim, Norway
| | - R J Hollick
- Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK
| | - M Huisman
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - M Iki
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
| | - S Ish-Shalom
- Endocrine Clinic, Elisha Hospital, Haifa, Israel
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - M K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - S Khosla
- Robert and Arlene Kogod Center on Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - D P Kiel
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - W-P Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - F Koromani
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M A Kotowicz
- IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
- Department of Medicine -Western Health, The University of Melbourne, St Albans, Victoria, Australia
| | - H Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - T Kwok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - O Lamy
- Centre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
- Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - A Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - B Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - K Lippuner
- Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland
| | - D Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital Mölndal, Mölndal, Sweden
| | - T Merlijn
- Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - A Nordström
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - P Nordström
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - T W O'Neill
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - B Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
- Center for Biomarker Research in Medicine, Graz, Austria
| | - C Ohlsson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - E S Orwoll
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - J A Pasco
- IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
- Department of Medicine -Western Health, The University of Melbourne, St Albans, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - F Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A-M Schott
- Université Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France
| | - E J Shiroma
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
| | - K Siggeirsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- Janus Rehabilitation, Reykjavik, Iceland
| | - E M Simonsick
- Translational Gerontology Branch, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | - E Sornay-Rendu
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - R Sund
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - K M A Swart
- Petra JM Elders Department of General Practice, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
| | - P Szulc
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - J Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - D J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - N M van Schoor
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T P van Staa
- Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - J Vila
- Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - N J Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - N C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - N Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan
| | - M C Zillikens
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Zwart
- PRECIOSA-Fundación para la investigación, Barberà del Vallés, Barcelona, Spain
- Health Center Can Gibert del Plà, Catalan Institute of Health, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- GROIMAP/GROICAP (research groups), Unitat de Suport a la Recerca Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Girona, Spain
| | - L Vandenput
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - M Lorentzon
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - W D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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5
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Hall J, Wang K, Lui KP, Darawsheh R, Shumway JW, Carey LA, Hayes KR, Lee CB, Moschos S, Sengupta S, Chaudhary R, Yogendran L, Struve TD, Vatner RE, Pater LE, Breneman JC, Weiner AA, Shen C. Safety and Efficacy of Stereotactic Radiosurgery with Concurrent Targeted Systemic Therapy for Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e107. [PMID: 37784639 DOI: 10.1016/j.ijrobp.2023.06.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Data describing the safety and efficacy of central nervous system (CNS)-active targeted systemic therapies in combination with stereotactic radiosurgery (SRS, 1 fraction) and/or radiotherapy (SRT, 3-5 fractions) for brain metastases are emerging but limited. We report rates of local and intracranial failure and radiation necrosis in patients receiving CNS-active targeted systemic therapy and SRS/SRT. MATERIALS/METHODS We retrospectively identified patients with intact brain metastases at two institutions from 2009-2022 who were treated with SRS/SRT and CNS-active targeted systemic therapy in any sequence. Patients were followed for a minimum of 3 months after SRS/SRT with brain MRI. Patients typically stopped the targeted agent 2-4 days prior to radiation and resumed 2-4 days after. Targeted therapies included inhibitors of ALK/ROS1 (Alectinib, Ceritinib, Crizotinib, Lorlatinib), EGFR (Afatinib, Erlotinib, Gefitinib, Osimertinib), BRAF (Dabrafenib, Encorafenib, Vemurafenib), MEK (Binimetinib, Trametinib), CDK 4/6 (Abemaciclib, Palbociclib, Ribociclib), HER2 (Afatinib, Lapatinib, Neratinib, Pertuzumab, Trastuzumab, T-DM1, T-DXd, Tucatinib), KRAS (Adagrasib and Sotorasib), PARP (Niraparib, Olaparib), VEGF(R) (Axitinib, Bevacizumab, Ramucirumab), and less-selective tyrosine (receptor) kinase inhibitors (Bosutinib, Brigatinib, Entrectinib, Lenvatinib, Pazopanib, Sorafenib, Sunitinib). Local failure (LF) and radiation necrosis were determined radiographically with clinical impression (grade 2 (symptomatic) or higher (G2+)) and compared between different systemic agents. RESULTS The study included 95 patients with 310 metastases (SRS 246, SRT 64 metastases). Most common primary histologies were non-small cell lung cancer (36% 34/95), breast cancer (28% 27/95), and melanoma (16% 15/95). Overall survival at 1 and 2 years was 80% (76/95) and 55% (52/95), respectively. Median follow-up was 16.6 (range 3-91) months. Median tumor size was 7mm (range 1-75mm). Median number of brain metastases per patient was 2.5 (range 1-12). The G2+ radiation necrosis rate was 5.8% (18/310) while the LF rate was 9.7% (30/310) per metastasis. There was no significant difference in G2+ radiation necrosis by class of targeted therapy. Sixty-two percent (59/95) of patients experienced distant intracranial failure. Median intracranial progression free survival (PFS) was 8.0 (range 0.4-61.4) months. CONCLUSION Although heterogeneous, patients treated with SRS/SRT and ongoing CNS-active targeted systemic therapies have on average >6 month intracranial PFS and little evidence of significant toxicity. We observed <6% G2+ radiation necrosis for this cohort, and no particular class of agent was associated with a significantly higher rate of G2+ radiation necrosis.
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Affiliation(s)
- J Hall
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - K P Lui
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R Darawsheh
- University of North Carolina, Chapel Hill, NC
| | - J W Shumway
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - L A Carey
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - K Reeder Hayes
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - C B Lee
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - S Moschos
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - R Chaudhary
- Division of Oncology, University of Cincinnati, Cincinnati, OH
| | - L Yogendran
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - T D Struve
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R E Vatner
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - L E Pater
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J C Breneman
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - A A Weiner
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
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6
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Hall J, Dance MJ, Nguyen L, Repka MC, Chen X, Shen C. Hippocampal-Sparing Radiotherapy in Primary Sinonasal and Cutaneous Head and Neck Malignancies: A Feasibility Study. Int J Radiat Oncol Biol Phys 2023; 117:e586-e587. [PMID: 37785776 DOI: 10.1016/j.ijrobp.2023.06.1931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with primary sinonasal and cutaneous head and neck (H&N) malignancies often receive meaningful hippocampal doses, but the hippocampus is not a classic avoidance structure in radiation planning of these primary sites. This series characterizes the feasibility and tradeoffs of hippocampal-sparing radiotherapy (HSRT) for patients with primary sinonasal and cutaneous H&N malignancies. MATERIALS/METHODS We retrospectively identified patients at a single institution treated definitively for primary sinonasal or cutaneous malignancies of the H&N. Each patient received (chemo)radiation and all received clinically-significant radiation dose to one or both hippocampi. We created new HSRT plans for each patient with intensity-modulated radiotherapy using original target and organ-at-risk (OAR) volumes. Hippocampi were contoured based on Radiation Therapy Oncology Group guidelines. Absolute and relative differences in radiation dose to the hippocampi, planning target volumes (PTV), and OARs were recorded. We used paired-samples t-tests to compare hippocampal and PTV dosimetric measures with and without HSRT. RESULTS Thirty-seven patients were included (22 sinonasal, 11 cutaneous H&N, and 4 parotid primary tumors). Median prescription dose was 6600cGy (range: 5000-7440cGy). The most common fractionation regimens were 200cGy/fraction daily (51%, 19/37 patients) and 120cGy/fraction twice daily (41%, 15/37 patients). There were significant decreases in hippocampal Dmax and D100% using HSRT without compromising PTV coverage (Table 1). HSRT resulted in a relative increase of mean lacrimal gland dose by an average of 3.8%, optic chiasm Dmax by 1.3%, and whole brain Dmax of 1.2%. However, other OAR doses were lower with HSRT, including parotid gland mean dose, lens Dmax, optic nerve Dmax, cochlea mean dose, brainstem Dmax, and whole brain mean dose. CONCLUSION HSRT is feasible and results in meaningful radiation dose reduction to the hippocampi without reducing PTV coverage or increasing dose to other OARs. The hippocampi should be regularly included as avoidance structures when treating primary sinonasal and cutaneous H&N tumors with radiation. We suggest target hippocampal constraints of Dmax < 1600cGy and D100% < 500cGy when feasible (without compromising PTV coverage). The clinical significance of HSRT in patients with primary H&N tumors should be investigated prospectively.
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Affiliation(s)
- J Hall
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - M J Dance
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - L Nguyen
- North Carolina School of Science and Mathematics, Durham, NC
| | - M C Repka
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - X Chen
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
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7
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Albakry MF, Alkhatib I, Alonso D, Amaral DWP, Aralis T, Aramaki T, Arnquist IJ, Ataee Langroudy I, Azadbakht E, Banik S, Bathurst C, Bhattacharyya R, Brink PL, Bunker R, Cabrera B, Calkins R, Cameron RA, Cartaro C, Cerdeño DG, Chang YY, Chaudhuri M, Chen R, Chott N, Cooley J, Coombes H, Corbett J, Cushman P, Das S, De Brienne F, Rios M, Dharani S, di Vacri ML, Diamond MD, Elwan M, Fascione E, Figueroa-Feliciano E, Fink CW, Fouts K, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala SR, Hall J, Harms SAS, Hassan N, Hines BA, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Kashyap VKS, Kelsey MH, Kubik A, Kurinsky NA, Lee M, Litke M, Liu J, Liu Y, Loer B, Lopez Asamar E, Lukens P, MacFarlane DB, Mahapatra R, Mast N, Mayer AJ, Meyer Zu Theenhausen H, Michaud É, Michielin E, Mirabolfathi N, Mohanty B, Nebolsky B, Nelson J, Neog H, Novati V, Orrell JL, Osborne MD, Oser SM, Page WA, Pandey L, Pandey S, Partridge R, Pedreros DS, Perna L, Podviianiuk R, Ponce F, Poudel S, Pradeep A, Pyle M, Rau W, Reid E, Ren R, Reynolds T, Tanner E, Roberts A, Robinson AE, Saab T, Sadek D, Sadoulet B, Sahoo SP, Saikia I, Sander J, Sattari A, Schmidt B, Schnee RW, Scorza S, Serfass B, Poudel SS, Sincavage DJ, Sinervo P, Speaks Z, Street J, Sun H, Terry GD, Thasrawala FK, Toback D, Underwood R, Verma S, Villano AN, von Krosigk B, Watkins SL, Wen O, Williams Z, Wilson MJ, Winchell J, Wykoff K, Yellin S, Young BA, Yu TC, Zatschler B, Zatschler S, Zaytsev A, Zeolla A, Zhang E, Zheng L, Zheng Y, Zuniga A, An P, Barbeau PS, Hedges SC, Li L, Runge J. First Measurement of the Nuclear-Recoil Ionization Yield in Silicon at 100 eV. Phys Rev Lett 2023; 131:091801. [PMID: 37721818 DOI: 10.1103/physrevlett.131.091801] [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: 03/21/2023] [Revised: 07/07/2023] [Accepted: 07/26/2023] [Indexed: 09/20/2023]
Abstract
We measured the nuclear-recoil ionization yield in silicon with a cryogenic phonon-sensitive gram-scale detector. Neutrons from a monoenergetic beam scatter off of the silicon nuclei at angles corresponding to energy depositions from 4 keV down to 100 eV, the lowest energy probed so far. The results show no sign of an ionization production threshold above 100 eV. These results call for further investigation of the ionization yield theory and a comprehensive determination of the detector response function at energies below the keV scale.
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Affiliation(s)
- M F Albakry
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - I Alkhatib
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D Alonso
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - D W P Amaral
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - T Aralis
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - T Aramaki
- Department of Physics, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, USA
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - I Ataee Langroudy
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - E Azadbakht
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Banik
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - C Bathurst
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - R Bhattacharyya
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - P L Brink
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Bunker
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Cabrera
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R Calkins
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - R A Cameron
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - C Cartaro
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D G Cerdeño
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - Y-Y Chang
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - M Chaudhuri
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - R Chen
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - N Chott
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - J Cooley
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - H Coombes
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Corbett
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Cushman
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - S Das
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - F De Brienne
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - M Rios
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - S Dharani
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - M L di Vacri
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - M D Diamond
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - M Elwan
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - E Fascione
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Figueroa-Feliciano
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - C W Fink
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K Fouts
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - M Fritts
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Gerbier
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Germond
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Ghaith
- College of Natural and Health Sciences, Zayed University, Dubai, 19282, United Arab Emirates
| | - S R Golwala
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - J Hall
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
- Laurentian University, Department of Physics, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - S A S Harms
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - N Hassan
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - B A Hines
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Z Hong
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - L Hsu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M E Huber
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
- Department of Electrical Engineering, University of Colorado Denver, Denver, Colorado 80217, USA
| | - V Iyer
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - V K S Kashyap
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - M H Kelsey
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A Kubik
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - N A Kurinsky
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - M Lee
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M Litke
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J Liu
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - Y Liu
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E Lopez Asamar
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D B MacFarlane
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Mahapatra
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - N Mast
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A J Mayer
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H Meyer Zu Theenhausen
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - É Michaud
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - E Michielin
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - N Mirabolfathi
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B Mohanty
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - B Nebolsky
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - J Nelson
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - H Neog
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Novati
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - J L Orrell
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - M D Osborne
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S M Oser
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - W A Page
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - L Pandey
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - S Pandey
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Partridge
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D S Pedreros
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - L Perna
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - R Podviianiuk
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - F Ponce
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S Poudel
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Pradeep
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M Pyle
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - W Rau
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E Reid
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - R Ren
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - T Reynolds
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - E Tanner
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A Roberts
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - A E Robinson
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - T Saab
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - D Sadek
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - B Sadoulet
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S P Sahoo
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - I Saikia
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Sattari
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - B Schmidt
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - R W Schnee
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Scorza
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
- Laurentian University, Department of Physics, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - B Serfass
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S S Poudel
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - D J Sincavage
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - P Sinervo
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - Z Speaks
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Street
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - H Sun
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - G D Terry
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - F K Thasrawala
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - D Toback
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - R Underwood
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Verma
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A N Villano
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - B von Krosigk
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - S L Watkins
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - O Wen
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - Z Williams
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - M J Wilson
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - J Winchell
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - K Wykoff
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Yellin
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B A Young
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
| | - T C Yu
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - B Zatschler
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - S Zatschler
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - A Zaytsev
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - A Zeolla
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - E Zhang
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - L Zheng
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - Y Zheng
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - A Zuniga
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - P An
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - P S Barbeau
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - S C Hedges
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - L Li
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - J Runge
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
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8
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Dimitriadis SI, Perry G, Lancaster TM, Tansey KE, Singh KD, Holmans P, Pocklington A, Davey Smith G, Zammit S, Hall J, O’Donovan MC, Owen MJ, Jones DK, Linden DE. Genetic risk for schizophrenia is associated with increased proportion of indirect connections in brain networks revealed by a semi-metric analysis: evidence from population sample stratified for polygenic risk. Cereb Cortex 2023; 33:2997-3011. [PMID: 35830871 PMCID: PMC10016061 DOI: 10.1093/cercor/bhac256] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 02/02/2023] Open
Abstract
Research studies based on tractography have revealed a prominent reduction of asymmetry in some key white-matter tracts in schizophrenia (SCZ). However, we know little about the influence of common genetic risk factors for SCZ on the efficiency of routing on structural brain networks (SBNs). Here, we use a novel recall-by-genotype approach, where we sample young adults from a population-based cohort (ALSPAC:N genotyped = 8,365) based on their burden of common SCZ risk alleles as defined by polygenic risk score (PRS). We compared 181 individuals at extremes of low (N = 91) or high (N = 90) SCZ-PRS under a robust diffusion MRI-based graph theoretical SBN framework. We applied a semi-metric analysis revealing higher SMR values for the high SCZ-PRS group compared with the low SCZ-PRS group in the left hemisphere. Furthermore, a hemispheric asymmetry index showed a higher leftward preponderance of indirect connections for the high SCZ-PRS group compared with the low SCZ-PRS group (PFDR < 0.05). These findings might indicate less efficient structural connectivity in the higher genetic risk group. This is the first study in a population-based sample that reveals differences in the efficiency of SBNs associated with common genetic risk variants for SCZ.
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Affiliation(s)
- S I Dimitriadis
- Neuroscience and Mental Health Research Institute (NMHI), College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Neuroinformatics Group, School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - G Perry
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - T M Lancaster
- Neuroscience and Mental Health Research Institute (NMHI), College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Department of Psychology, Bath University, Claverton Down BA2 7AY, Bath, Wales, UK
| | - K E Tansey
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Queens Road BS8 1QU, Bristol, Wales, UK
| | - K D Singh
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - P Holmans
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - A Pocklington
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - G Davey Smith
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Queens Road BS8 1QU, Bristol, Wales, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road BS8 1NU, Bristol, Wales, UK
| | - S Zammit
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road BS8 1NU, Bristol, Wales, UK
| | - J Hall
- Neuroscience and Mental Health Research Institute (NMHI), College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - M C O’Donovan
- Neuroscience and Mental Health Research Institute (NMHI), College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - M J Owen
- Neuroscience and Mental Health Research Institute (NMHI), College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - D K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
| | - D E Linden
- Neuroscience and Mental Health Research Institute (NMHI), College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff School of Medicine, Cardiff University, Maindy Road CF24 4HQ, Cardiff, Wales, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road BS8 1NU, Bristol, Wales, UK
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40 UNS40 6229 ER, Maastricht, The Netherlands
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Tan A, Alsenani Q, Lanz M, Birchall C, Drage LKL, Picton D, Mowbray C, Ali A, Harding C, Pickard RS, Hall J, Aldridge PD. Evasion of toll-like receptor recognition by Escherichia coli is mediated via population level regulation of flagellin production. Front Microbiol 2023; 14:1093922. [PMID: 37032848 PMCID: PMC10078357 DOI: 10.3389/fmicb.2023.1093922] [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] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Uropathogenic Escherichia coli is a major cause of urinary tract infections. Analysis of the innate immune response in immortalized urothelial cells suggests that the bacterial flagellar subunit, flagellin, is key in inducing host defenses. A panel of 48 clinical uro-associated E. coli isolates recovered from either cystitis, pyelonephritis asymptomatic bacteriuria (ABU) or UTI-associated bacteraemia infections were characterized for motility and their ability to induce an innate response in urothelial cells stably transfected with a NF-κB luciferase reporter. Thirty-two isolates (67%) were identified as motile with strains recovered from cystitis patients exhibiting an uneven motility distribution pattern; seven of the cystitis isolates were associated with a > 5-fold increase in NF-κB signaling. To explore whether the NF-κB signaling response reflected antigenic variation, flagellin was purified from 14 different isolates. Purified flagellin filaments generated comparable NF-κB signaling responses, irrespective of either the source of the isolate or H-serotype. These data argued against any variability between isolates being related to flagellin itself. Investigations also argued that neither TLR4 dependent recognition of bacterial lipopolysaccharide nor growth fitness of the isolates played key roles in leading to the variable host response. To determine the roles, if any, of flagellar abundance in inducing these variable responses, flagellar hook numbers of a range of cystitis and ABU isolates were quantified. Images suggested that up to 60% of the isolate population exhibited flagella with the numbers averaging between 1 and 2 flagella per bacterial cell. These data suggest that selective pressures exist in the urinary tract that allow uro-associated E. coli strains to maintain motility, but exploit population heterogeneity, which together function to prevent host TLR5 recognition and bacterial killing.
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Affiliation(s)
- Aaron Tan
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Qusai Alsenani
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Marcello Lanz
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Christopher Birchall
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lauren K. L. Drage
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - David Picton
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Catherine Mowbray
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ased Ali
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Christopher Harding
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Robert S. Pickard
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Judith Hall
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- *Correspondence: Judith Hall,
| | - Phillip D. Aldridge
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Phillip D. Aldridge,
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10
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Vallée M, Harding C, Hall J, Aldridge PD, TAN A. Exploring the in situ evolution of nitrofurantoin resistance in clinically derived uropathogenic Escherichia coli isolates. J Antimicrob Chemother 2022; 78:373-379. [PMID: 36480295 PMCID: PMC9890214 DOI: 10.1093/jac/dkac398] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/30/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Nitrofurantoin has been re-introduced as a first-choice antibiotic to treat uncomplicated acute urinary tract infections in England and Wales. Highly effective against common uropathogens such as Escherichia coli, its use is accompanied by a low incidence (<10%) of antimicrobial resistance. Resistance to nitrofurantoin is predominantly via the acquisition of loss-of-function, step-wise mutations in the nitroreductase genes nfsA and nfsB. OBJECTIVE To explore the in situ evolution of NitR in E. coli isolates from 17 patients participating in AnTIC, a 12-month open label randomized controlled trial assessing the efficacy of antibiotic prophylaxis in reducing urinary tract infections (UTIs) incidence in clean intermittent self-catheterizing patients. METHODS The investigation of NitR evolution in E. coli used general microbiology techniques and genetics to model known NitR mutations in NitSE. coli strains. RESULTS Growth rate analysis identified a 2%-10% slower doubling time for nitrofurantoin resistant strains: NitS: 20.8 ± 0.7 min compared to NitR: 23 ± 0.8 min. Statistically, these data indicated no fitness advantage of evolved strains compared to the sensitive predecessor (P-value = 0.13). Genetic manipulation of E. coli to mimic NitR evolution, supported no fitness advantage (P-value = 0.22). In contrast, data argued that a first-step mutant gained a selective advantage, at sub-MIC (4-8 mg/L) nitrofurantoin concentrations. CONCLUSION Correlation of these findings to nitrofurantoin pharmacokinetic data suggests that the low incidence of E. coli NitR, within the community, is driven by urine-based nitrofurantoin concentrations that selectively inhibit the growth of E. coli strains carrying the key first-step loss-of-function mutation.
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Affiliation(s)
| | - Chris Harding
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, UK
- Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
| | - Judith Hall
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | | | - Aaron TAN
- Current address: SCELSE, Nanyang Technological University, SBS-01N-27, 60 Nanyang Drive, 637551, Singapore
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11
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Hall J, Sud S, Casey D, Poellmann M, Bu J, Wang A, Hong S, Shen C. Prospective Characterization of Circulating Tumor Cell Kinetics in Patients with Locoregional Head and Neck Cancer Receiving Definitive Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Shenouda G, Petrecca K, Abdulkarim B, Owen S, Panet-Raymond V, Diaz R, Guiot M, Carvalho T, Charbonneau M, Hall J, Souhami L. Comparison of Two Phase II Trials of Neoadjuvant Temozolomide Followed with Concomitant and Adjuvant Temozolomide and Hypofractionated Accelerated Radiotherapy with or without Metformin in Patients with Newly Diagnosed Glioblastoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.449] [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: 10/31/2022]
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13
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Dahan-Oliel N, van Bosse H, Darsaklis VB, Rauch F, Bedard T, Bardai G, James M, Raney E, Freese K, Hyer L, Altiok H, Pellett J, Giampietro P, Hall J, Hamdy RC. Epidemiology, aetiology, interventions and genomics in children with arthrogryposis multiplex congenita: protocol for a multisite registry. BMJ Open 2022; 12:e060591. [PMID: 36307157 PMCID: PMC9621187 DOI: 10.1136/bmjopen-2021-060591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Arthrogryposis multiplex congenita (AMC) is an umbrella term including hundreds of conditions with the common clinical manifestation of multiple congenital contractures. AMC affects 1 in 3000 live births and is caused by lack of movement in utero. To understand the long-term needs of individuals diagnosed with a rare condition, it is essential to know the prevalence, aetiology and functional outcomes in a large sample. The development and implementation of a multicentre registry is critical to gather this data. This registry aims to improve health through genetic and outcomes research, and ultimately identify new therapeutic targets and diagnostics for treating children with AMC. METHODS AND ANALYSIS Participants for the AMC registry will be recruited from seven orthopaedic hospitals in North America. Enrollment occurs in two phases; Part 1 focuses on epidemiology, aetiology and interventions. For this part, retrospective and cross-sectional data will be collected using a combination of patient-reported outcomes and clinical measures. Part 2 focuses on core subset of the study team, including a geneticist and bioinformatician, identifying causative genes and linking the phenotype to genotype via whole genome sequencing to identify genetic variants and correlating these findings with pedigree, photographs and clinical information. Descriptive analyses on the sample of 400 participants and logistic regression models to evaluate relationships between outcomes will be conducted. ETHICS AND DISSEMINATION Ethical approval has been granted from corresponding governing bodies in North America. Dissemination of findings will occur via traditional platforms (conferences, manuscripts) for the scientific community. Other modalities will be employed to ensure that all stakeholders, including youth, families and patient support groups, may be provided with findings derived from the registry. Ensuring the findings are circulated to a maximum amount of interested parties will ensure that the registry can continue to serve as a platform for hypothesis-driven research and further advancement for AMC.
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Affiliation(s)
- Noémi Dahan-Oliel
- Research, Shriners Hospital for Children, Montreal, Quebec, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Québec, Canada
| | - Harold van Bosse
- Orthopaedic Surgery, Shriners Hospitals for Children Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Frank Rauch
- Research, Shriners Hospital for Children, Montreal, Quebec, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Québec, Canada
| | - Tanya Bedard
- Clinical Genetics, Alberta Congenital Anomalies Surveillance System, Alberta Health Services, Calgary, Alberta, Canada
| | - Ghalib Bardai
- Shriners Hospitals for Children Canada, Montreal, Québec, Canada
| | - Michelle James
- Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California, USA
| | - Ellen Raney
- Orthopaedic Surgery, Shriners Hospitals for Children Portland, Portland, Oregon, USA
| | - Krister Freese
- Shriners Hospitals for Children Canada, Montreal, Québec, Canada
| | - Lauren Hyer
- Orthopaedic Surgery, Shriners Hospitals for Children Greenville, Greenville, South Carolina, USA
| | - Haluk Altiok
- Orthopaedic Surgery, Shriners Hospital for Children, Chicago, Illinois, USA
| | - Jonathan Pellett
- Orthopaedic Surgery, Shriners Hospitals for Children Honolulu, Honolulu, Hawaii, USA
| | | | - Judith Hall
- Department of Medical Genetics, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Reggie Charles Hamdy
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Québec, Canada
- Orthopaedic Surgery, Shriners Hospitals for Children Canada, Montreal, Quebec, Canada
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14
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Bourne K, Karalasingham K, Sheldon R, Exner D, Siddiqui T, Hall J, Raj S. WAIST-HIGH COMPRESSION GARMENTS REDUCE ORTHOSTATIC TACHYCARDIA IN PATIENTS WITH POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME IN A COMMUNITY SETTING. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.099] [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: 11/02/2022] Open
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15
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Vandenput L, Johansson H, McCloskey EV, Liu E, Åkesson KE, Anderson FA, Azagra R, Bager CL, Beaudart C, Bischoff-Ferrari HA, Biver E, Bruyère O, Cauley JA, Center JR, Chapurlat R, Christiansen C, Cooper C, Crandall CJ, Cummings SR, da Silva JAP, Dawson-Hughes B, Diez-Perez A, Dufour AB, Eisman JA, Elders PJM, Ferrari S, Fujita Y, Fujiwara S, Glüer CC, Goldshtein I, Goltzman D, Gudnason V, Hall J, Hans D, Hoff M, Hollick RJ, Huisman M, Iki M, Ish-Shalom S, Jones G, Karlsson MK, Khosla S, Kiel DP, Koh WP, Koromani F, Kotowicz MA, Kröger H, Kwok T, Lamy O, Langhammer A, Larijani B, Lippuner K, Mellström D, Merlijn T, Nordström A, Nordström P, O'Neill TW, Obermayer-Pietsch B, Ohlsson C, Orwoll ES, Pasco JA, Rivadeneira F, Schei B, Schott AM, Shiroma EJ, Siggeirsdottir K, Simonsick EM, Sornay-Rendu E, Sund R, Swart KMA, Szulc P, Tamaki J, Torgerson DJ, van Schoor NM, van Staa TP, Vila J, Wareham NJ, Wright NC, Yoshimura N, Zillikens MC, Zwart M, Harvey NC, Lorentzon M, Leslie WD, Kanis JA. Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan. Osteoporos Int 2022; 33:2103-2136. [PMID: 35639106 DOI: 10.1007/s00198-022-06435-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/18/2022] [Indexed: 12/15/2022]
Abstract
UNLABELLED We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. INTRODUCTION The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors. METHODS A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible. RESULTS Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed. CONCLUSIONS These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).
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Affiliation(s)
- L Vandenput
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - H Johansson
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - E V McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
- MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - E Liu
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - K E Åkesson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Orthopedics, Skåne University Hospital, Malmö, Sweden
| | - F A Anderson
- GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - R Azagra
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Health Center Badia del Valles, Catalan Institute of Health, Barcelona, Spain
- GROIMAP (Research Group), Unitat de Suport a La Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Santa Coloma de Gramenet, Barcelona, Spain
| | - C L Bager
- Nordic Bioscience A/S, Herlev, Denmark
| | - C Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - H A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland
- Centre On Aging and Mobility, University of Zurich and City Hospital, Zurich, Switzerland
| | - E Biver
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - O Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Philadelphia, USA
| | - J R Center
- Bone Biology, Healthy Ageing Theme, Garvan Institute of Medical Research, Sydney, NSW, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia
| | - R Chapurlat
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | | | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- National Institute for Health Research Oxford Biomedical Research Unit, , University of Oxford, Oxford, UK
| | - C J Crandall
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - S R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - J A P da Silva
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Rheumatology Department, University Hospital and University of Coimbra, Coimbra, Portugal
| | - B Dawson-Hughes
- Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston, MA, USA
| | - A Diez-Perez
- Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain
| | - A B Dufour
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - J A Eisman
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia
- Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - P J M Elders
- Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S Ferrari
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Y Fujita
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
| | - S Fujiwara
- Department of Pharmacy, Yasuda Women's University, Hiroshima, Japan
| | - C-C Glüer
- Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - I Goldshtein
- Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Goltzman
- Department of Medicine, McGill University and McGill University Health Centre, Montreal, Canada
| | - V Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - J Hall
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - D Hans
- Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - M Hoff
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Rheumatology, St Olavs Hospital, Trondheim, Norway
| | - R J Hollick
- Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK
| | - M Huisman
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - M Iki
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
| | - S Ish-Shalom
- Endocrine Clinic, Elisha Hospital, Haifa, Israel
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - M K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
| | - S Khosla
- Robert and Arlene Kogod Center On Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - D P Kiel
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - W-P Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - F Koromani
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M A Kotowicz
- IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
- Department of Medicine - Western Health, The University of Melbourne, St Albans, Victoria, Australia
| | - H Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - T Kwok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - O Lamy
- Centre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
- Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - A Langhammer
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway
| | - B Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - K Lippuner
- Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland
| | - D Mellström
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Sahlgrenska University Hospital Mölndal, Mölndal, Sweden
| | - T Merlijn
- Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - A Nordström
- Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- School of Sport Sciences, Arctic University of Norway, Tromsø, Norway
| | - P Nordström
- Unit of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - T W O'Neill
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - B Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria
- Center for Biomarker Research in Medicine, Graz, Austria
| | - C Ohlsson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - E S Orwoll
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - J A Pasco
- Institute for Physical and Mental Health and Clinical Translation (IMPACT), Deakin University, Geelong, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia
- Barwon Health, Geelong, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - F Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - B Schei
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Gynecology, St Olavs Hospital, Trondheim, Norway
| | - A-M Schott
- Université Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France
| | - E J Shiroma
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA
| | - K Siggeirsdottir
- Icelandic Heart Association, Kopavogur, Iceland
- Janus Rehabilitation, Reykjavik, Iceland
| | - E M Simonsick
- Translational Gerontology Branch, National Institute On Aging Intramural Research Program, Baltimore, MD, USA
| | | | - R Sund
- Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - K M A Swart
- Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - P Szulc
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - J Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - D J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - N M van Schoor
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - T P van Staa
- Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - J Vila
- Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - N J Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - N C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - N Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan
| | - M C Zillikens
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Zwart
- Health Center Can Gibert del Plà, Catalan Institute of Health, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
- GROIMAP (Research Group), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - N C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M Lorentzon
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Geriatric Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Mölndal, Sweden
| | - W D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - J A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK.
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Hunter D, Schnitzer T, Hall J, Semel D, Davignon I, Cappelleri J, Bushmakin A, Abraham L. Time to first and sustained improvement in WOMAC domains among patients with osteoarthritis receiving tanezumab. Osteoarthritis and Cartilage Open 2022; 4:100294. [DOI: 10.1016/j.ocarto.2022.100294] [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: 02/17/2022] [Revised: 06/15/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022] Open
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Liu Y, Tice MM, Schmidt ME, Treiman AH, Kizovski TV, Hurowitz JA, Allwood AC, Henneke J, Pedersen DAK, VanBommel SJ, Jones MWM, Knight AL, Orenstein BJ, Clark BC, Elam WT, Heirwegh CM, Barber T, Beegle LW, Benzerara K, Bernard S, Beyssac O, Bosak T, Brown AJ, Cardarelli EL, Catling DC, Christian JR, Cloutis EA, Cohen BA, Davidoff S, Fairén AG, Farley KA, Flannery DT, Galvin A, Grotzinger JP, Gupta S, Hall J, Herd CDK, Hickman-Lewis K, Hodyss RP, Horgan BHN, Johnson JR, Jørgensen JL, Kah LC, Maki JN, Mandon L, Mangold N, McCubbin FM, McLennan SM, Moore K, Nachon M, Nemere P, Nothdurft LD, Núñez JI, O'Neil L, Quantin-Nataf CM, Sautter V, Shuster DL, Siebach KL, Simon JI, Sinclair KP, Stack KM, Steele A, Tarnas JD, Tosca NJ, Uckert K, Udry A, Wade LA, Weiss BP, Wiens RC, Williford KH, Zorzano MP. An olivine cumulate outcrop on the floor of Jezero crater, Mars. Science 2022; 377:1513-1519. [PMID: 36007094 DOI: 10.1126/science.abo2756] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The geological units on the floor of Jezero crater, Mars, are part of a wider regional stratigraphy of olivine-rich rocks, which extends well beyond the crater. We investigate the petrology of olivine and carbonate-bearing rocks of the Séítah formation in the floor of Jezero. Using multispectral images and x-ray fluorescence data, acquired by the Perseverance rover, we performed a petrographic analysis of the Bastide and Brac outcrops within this unit. We find that these outcrops are composed of igneous rock, moderately altered by aqueous fluid. The igneous rocks are mainly made of coarse-grained olivine, similar to some Martian meteorites. We interpret them as an olivine cumulate, formed by settling and enrichment of olivine through multi-stage cooling of a thick magma body.
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Affiliation(s)
- Y Liu
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M M Tice
- Department of Geology and Geophysics, Texas A&M University, College Station, TX 77843, USA
| | - M E Schmidt
- Department of Earth Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - A H Treiman
- Lunar and Planetary Institute, Universities Space Research Association, Houston TX 77058, USA
| | - T V Kizovski
- Department of Earth Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - J A Hurowitz
- Department of Geosciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - A C Allwood
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J Henneke
- Department of Space, Measurement and Instrumentation, Technical University of Denmark,, Lyngby, Denmark
| | - D A K Pedersen
- Department of Space, Measurement and Instrumentation, Technical University of Denmark,, Lyngby, Denmark
| | - S J VanBommel
- McDonnell Center for the Space Sciences, Department of Earth and Planetary Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - M W M Jones
- Central Analytical Research Facility, and School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - A L Knight
- McDonnell Center for the Space Sciences, Department of Earth and Planetary Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - B J Orenstein
- School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - B C Clark
- Space Science Institute, Boulder, CO 80301, USA
| | - W T Elam
- Applied Physics Lab and Department of Earth and Space Sciences, University of Washington, Seattle, WA 98052, USA
| | - C M Heirwegh
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - T Barber
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - L W Beegle
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - K Benzerara
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Centre National de la Recherche Scientifique (CNRS), Muséum National d'Histoire Naturelle, Sorbonne Université, Paris 75005, France
| | - S Bernard
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Centre National de la Recherche Scientifique (CNRS), Muséum National d'Histoire Naturelle, Sorbonne Université, Paris 75005, France
| | - O Beyssac
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Centre National de la Recherche Scientifique (CNRS), Muséum National d'Histoire Naturelle, Sorbonne Université, Paris 75005, France
| | - T Bosak
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | | | - E L Cardarelli
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - D C Catling
- Department of Earth and Space Sciences, University of Washington, Seattle WA 98195, USA
| | - J R Christian
- McDonnell Center for the Space Sciences, Department of Earth and Planetary Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - E A Cloutis
- Department of Geography, University of Winnipeg, Winnipeg, Manitoba R3B 2E9, Canada
| | - B A Cohen
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - S Davidoff
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A G Fairén
- Centro de Astrobiología, Consejo Superior de Investigaciones Cientificas - Instituto Nacional de Tecnica Aeroespacial, Madrid 28850, Spain.,Dept. of Astronomy, Cornell University, Ithaca, NY 14853, USA
| | - K A Farley
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - D T Flannery
- School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - A Galvin
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - J P Grotzinger
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - S Gupta
- Department of Earth Science and Engineering, Imperial College London, London SW7 2AZ, UK
| | - J Hall
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - C D K Herd
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Alberta T6G 2E3, Canada
| | - K Hickman-Lewis
- Department of Earth Sciences, The Natural History Museum, South Kensington, London, SW7 5BD, UK.,Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Università di Bologna, via Zamboni 67, I-40126 Bologna, Italy
| | - R P Hodyss
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - B H N Horgan
- Department of Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - J R Johnson
- Johns Hopkins University Applied Physics Laboratory Laurel, MD 20723, USA
| | - J L Jørgensen
- Department of Space, Measurement and Instrumentation, Technical University of Denmark,, Lyngby, Denmark
| | - L C Kah
- Department of Earth and Planetary Sciences, University of Tennessee, Knoxville TN 37996, USA
| | - J N Maki
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - L Mandon
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris-Université Paris Sciences et Lettres, CNRS, Sorbonne Université, Université de Paris Cité, Meudon 92190, France
| | - N Mangold
- Laboratoire Planetologie et Geosciences, Centre National de Recherches Scientifiques, Universite Nantes, Universite Angers, Unite Mixte de Recherche 6112, Nantes 44322, France
| | - F M McCubbin
- NASA Johnson Space Center, Houston, TX 77058, USA
| | - S M McLennan
- Department of Geosciences, Stony Brook University, Stony Brook, NY 11794, USA
| | - K Moore
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - M Nachon
- Department of Geology and Geophysics, Texas A&M University, College Station, TX 77843, USA
| | - P Nemere
- School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - L D Nothdurft
- School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - J I Núñez
- Johns Hopkins University Applied Physics Laboratory Laurel, MD 20723, USA
| | - L O'Neil
- Applied Physics Lab and Department of Earth and Space Sciences, University of Washington, Seattle, WA 98052, USA
| | - C M Quantin-Nataf
- Laboratoire de Geologie de Lyon-Terre Planetes Environnement, Univ Lyon, Universite Claude Bernard Lyon 1, Ecole Normale Superieure Lyon, Centre National de Recherches Scientifiques, 69622 Villeurbanne, France
| | - V Sautter
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Centre National de la Recherche Scientifique (CNRS), Muséum National d'Histoire Naturelle, Sorbonne Université, Paris 75005, France
| | - D L Shuster
- Dept. Earth and Planetary Science, University of California, Berkeley, CA 94720, USA
| | - K L Siebach
- Department of Earth, Environmental, and Planetary Sciences, Rice University, Houston, TX 77005, USA
| | - J I Simon
- NASA Johnson Space Center, Houston, TX 77058, USA
| | - K P Sinclair
- Applied Physics Lab and Department of Earth and Space Sciences, University of Washington, Seattle, WA 98052, USA
| | - K M Stack
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A Steele
- Earth and Planets Laboratory, Carnegie Institution for Science, Washington, DC 20015, USA
| | - J D Tarnas
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - N J Tosca
- Department of Earth Sciences, University of Cambridge, Cambridge, CB2 3EQ, UK
| | - K Uckert
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A Udry
- Department of Geosciences University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - L A Wade
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - B P Weiss
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - R C Wiens
- Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - K H Williford
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA.,Blue Marble Space Institute of Science, 600 1st Ave. Seattle, WA 98104, USA
| | - M-P Zorzano
- Centro de Astrobiología, Consejo Superior de Investigaciones Cientificas - Instituto Nacional de Tecnica Aeroespacial, Madrid 28850, Spain
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Thwaites A, Hall J, Barrett G, Stephenson J. P-734 How common is spontaneous pregnancy after In vitro Fertilisation (IVF) Livebirth? Systematic review and meta-analysis. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
How common is spontaneous pregnancy after IVF resulting in livebirth? How can this evidence inform future pregnancy planning by women who have successful IVF?
Summary answer
Current evidence suggests that spontaneous pregnancy occurs in at least one in five women in the first three years after having a baby via IVF.
What is known already
It is known that some women having IVF go on to conceive naturally. This reproductive history is of media interest often described as “miracle” pregnancies (1). Women with this experience also identify themselves as a rarity, and their subsequent pregnancies include rapid-repeat, unplanned and unwelcomed pregnancies (2).
Study design, size, duration
An initial scoping review revealed few, heterogeneous studies reporting rates of spontaneous pregnancy or livebirth after successful IVF. These studies suggested that this event is not rare, prompting this first systematic review and meta-analysis. This aims to identify, appraise and synthesise the current evidence on the rate of spontaneous pregnancy after successful IVF.
Participants/materials, setting, methods
Ovid Medline, Embase and PsycINFO were searched on 24/09/2021 using a strategy containing thesaurus and free text terms for the concepts of spontaneous pregnancy, assisted reproduction and livebirth. The search was limited to English language, human studies and publications from 1980. Results were de-duplicated and managed in EndNote, screened by title/abstract and then full text. Random-effects meta-analyses were used to produce a pooled effect estimate of the incidence of spontaneous pregnancy after IVF livebirth.
Main results and the role of chance
1108 distinct references were identified, reducing to 54 when screened by title and abstract. On evaluation of full text, 11 studies were included in this review. Rates of spontaneous pregnancy after IVF livebirth ranged from 10-33% of women. However, studies varied widely according to methodology, population, cause of subfertility, type and outcome of fertility treatment and length of follow-up. Different covariates were investigated and inconsistently found to be associated with spontaneous conception after IVF including younger age, shorter duration of subfertility, fewer number of treatment cycles prior to first delivery and specific causes of subfertility (unexplained, no male factor). The pooled estimate for the rate of spontaneous pregnancy after IVF livebirth was 19% (95% CI, 16%-22%). The pooled estimate was robust when stratifying by IVF/intracytoplasmic sperm injection (ICSI), outcome measure and follow up period. It is a likely underestimate as some studies reported on livebirths (i.e. excluding adverse pregnancy outcomes) and did not include spontaneous births that occurred outside of the study region. Moreover, no studies gave due consideration to contraception, plannedness of pregnancies, change in partner, nor serial spontaneous pregnancies in the same woman.
Limitations, reasons for caution
The current evidence is relatively scarce and diverse. Sample sizes are typically small with only two studies of over a thousand women. Better evidence, in the form of national, data-linked studies, is needed to provide more accurate estimates of this rate, analysis of associated factors and trends over time.
Wider implications of the findings
These findings refute a widely held misconception that spontaneous pregnancy after IVF livebirth is a rare phenomenon. They should be used to counsel women having babies via IVF and inform their decision-making regarding the timing and mode of conception of future pregnancies and contraception use.
Trial registration number
N/A
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Affiliation(s)
- A Thwaites
- University College London, Institute for Women's Health , London, United Kingdom
| | - J Hall
- University College London, Institute for Women's Health , London, United Kingdom
| | - G Barrett
- University College London, Institute for Women's Health , London, United Kingdom
| | - J Stephenson
- University College London, Institute for Women's Health , London, United Kingdom
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Mowbray C, Tan A, Vallée M, Fisher H, Chadwick T, Brennand C, Walton KE, Pickard RS, Harding C, Aldridge PD, Hall J. Multidrug-resistant Uro-associated Escherichia coli Populations and Recurrent Urinary Tract Infections in Patients Performing Clean Intermittent Self-catheterisation. EUR UROL SUPPL 2022; 37:90-98. [PMID: 35243393 PMCID: PMC8883198 DOI: 10.1016/j.euros.2021.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 12/18/2022] Open
Abstract
Background The AnTIC trial linked continuous low-dose antibiotic prophylaxis treatments to a lower incidence of symptomatic urinary tract infections (UTIs) among individuals performing clean intermittent self-catheterisation (CISC). Objective To explore potential mechanisms underlying the protective effects of low-dose antibiotic prophylaxis treatments, blood and urine samples and uro-associated Escherichia coli isolates from AnTIC participants were analysed. Design, setting, and participants Blood samples (n = 204) were analysed for TLR gene polymorphisms associated with UTI susceptibility and multiple urine samples (n = 558) were analysed for host urogenital responses. E.coli sequence data for 45 temporal isolates recovered from the urine samples of 16 trial participants in the prophylaxis (n = 9) and no-prophylaxis (n = 7) study arms, and characterised by multidrug resistance (MDR), were used to classify individual strains. Outcome measurements and statistical analysis TLR polymorphism data were analysed using Poisson regression. Concentrations of urine host defence markers were analysed using linear mixed-effects models, which accounted for repeated urine samples. Results and limitations Urine samples from CISC users, irrespective of antibiotic treatment regimens, were associated with robust urothelial innate responses. No links were identified between TLR genotype and CISC user susceptibility to recurrent UTIs. Microbiological study data were limited to the predominant MDR E. coli population; participants prescribed low-dose prophylactic antibiotics were predominantly colonised by a single uro-associated E. coli strain, while participants given acute antibiotic treatments were each colonised by more than one E. coli strain. Conclusions Antibiotic treatments did not impact urogenital responses to infection in CISC users. Host genetics in terms of TLR polymorphisms played no role in determining CISC user susceptibility to or protection from recurrent UTIs. Prophylactic antibiotic treatments associated with MDR E. coli were associated with colonisation by stable uro-associated E. coli genotypes. Patient summary Our findings show that the natural urogenital defences of clean intermittent self-catheterisation (CISC) users were not impacted by antibiotic treatments. For some CISC users, prophylaxis with low-dose antibiotics selected for a stable, predominantly, Esherichia coli rich uromicrobiota.
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Affiliation(s)
- Catherine Mowbray
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Aaron Tan
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Maxime Vallée
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - Holly Fisher
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas Chadwick
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Brennand
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine E Walton
- Department of Microbiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Robert S Pickard
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Harding
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Judith Hall
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Burgess R, Hall J, Bishop A, Lewis M, Hill J. Costing methodology and key drivers of healthcare costs within economic analyses in musculoskeletal community/primary care services: A systematic review. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.254] [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]
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Rao K, Engelbart JM, Yanik J, Hall J, Swenson S, Policeni B, Maley J, Galet C, Granchi T, Skeete DA. Accuracy and Clinical Utility of Reports from Outside Hospitals for CT of the Cervical Spine in Blunt Trauma. AJNR Am J Neuroradiol 2021; 42:2254-2260. [PMID: 34737184 DOI: 10.3174/ajnr.a7337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/18/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Multidetector CT is the workhorse for detecting blunt cervical spine injury. There is no standard of care for re-interpretation of radiology images for patients with blunt trauma transferred to a higher level of care. The clinical impact of discrepancies of cervical spine CT reads remains unclear. We evaluated the discordance between primary (from referring hospitals) and secondary radiology interpretations (from a receiving level I tertiary trauma center) of cervical spine CT scans in patients with blunt trauma and assessed the clinical implications of missed cervical spine fractures. MATERIALS AND METHODS Medical records of patients with blunt trauma transferred to our institution between 2008 and 2015 were reviewed. Primary and secondary interpretations were compared and categorized as concordant and discordant. Two senior neuroradiologists adjudicated discordant reports. The benefit of re-interpretation was determined. For discordant cases, outcomes at discharge, injury severity pattern, treatment, and arrival in a cervical collar were assessed. RESULTS Six hundred fifty patients were included; 608 (94%) presented with concordant reports: 401 (61.7%) with fractures and 207 (31.8%) with no fractures. There were 42 (6.5%) discordant reports; 18 (2.8%) were cervical spine injuries undetected on the primary interpretation. Following adjudication, the secondary interpretation improved the sensitivity (99.3% versus 95.7%) and specificity (99.1% versus 91.7%) in detecting cervical spine fractures compared with the primary interpretation alone (P < .001). CONCLUSIONS There was an overall 6.5% discordance rate between primary and secondary interpretations of cervical spine CT scans. The secondary interpretation of the cervical spine CT increased the sensitivity and specificity of detecting cervical spine fractures in patients with blunt trauma transferred to higher-level care.
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Affiliation(s)
- K Rao
- From the Departments of Radiology (K.R., B.P., J.M.)
| | - J M Engelbart
- Surgery (J.M.E., C.G., T.G., D.A.S.), Acute Care Surgery Division
| | - J Yanik
- Orthopedics and Rehabilitation (J.Y., J.H., S.S.), University of Iowa, Iowa City, Iowa
| | - J Hall
- Orthopedics and Rehabilitation (J.Y., J.H., S.S.), University of Iowa, Iowa City, Iowa
| | - S Swenson
- Orthopedics and Rehabilitation (J.Y., J.H., S.S.), University of Iowa, Iowa City, Iowa
| | - B Policeni
- From the Departments of Radiology (K.R., B.P., J.M.)
| | - J Maley
- From the Departments of Radiology (K.R., B.P., J.M.)
| | - C Galet
- Surgery (J.M.E., C.G., T.G., D.A.S.), Acute Care Surgery Division
| | - T Granchi
- Surgery (J.M.E., C.G., T.G., D.A.S.), Acute Care Surgery Division
| | - D A Skeete
- Surgery (J.M.E., C.G., T.G., D.A.S.), Acute Care Surgery Division
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22
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Sud S, Hall J, Tan X, Roberts O, Green R, Park S, Poellmann M, Bu J, Hong S, Wang A, Casey D. Prospective Characterization of Circulating Tumor Cell Kinetics in Patients With Oligometastatic Disease Receiving Definitive Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Hall J, Fried D, Marks L, Gupta G, Jones E, Elmore S, Downs-Canner S, Gallagher K, Carr J, Ogunleye Y, Casey D. Dosimetric and Clinical Factors Associated With Increased Risk of Reconstruction Complications in Patients With Breast Cancer Receiving Post-Mastectomy Radiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.770] [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: 10/20/2022]
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24
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Zlochiver V, Perez Moreno AC, Hall J, Hommeida M, Allaqaband SQ, Bajwa T, Jan MF. Impact of COVID-19 lockdowns on STEMI percutaneous interventions. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Measures taken to mitigate the spread of coronavirus disease 2019 (COVID-19) have been correlated to a decline in the number of patients seeking medical care for emergency cardiovascular illness. Here we evaluate the impact of a state-wide lockdown on ST-elevation myocardial infarction (STEMI) care.
Purpose
The purpose of this study is to help understand the impact of COVID-related lockdowns on STEMI interventions.
Methods
All consecutive adult patients admitted with an acute STEMI diagnosis and percutaneous intervention (PCI) performed between January 17, 2020, and July 14, 2020, at five sites across our health care network, were included in this study. Patient demographics, medical history and procedure details were collected retrospectively from electronic medical records. Data were segregated according to date into pre-lockdown, lockdown (March 17 to May 13, 2020) and post-lockdown groups.
Results
A total of 225 patients formed the study cohort. Median age was 62 (IQR: 53–71) years. Patients were predominantly male (n=154, 68%), white (n=208, 92%), hypertensive (n=139, 61%) and dyslipidemic (n=135, 60%). The average weekly rate of STEMI PCIs performed pre-lockdown decreased by 40% during the lockdown from 10.9 to 6.5 PCIs per week (p<0.05). Door-to-balloon (D2B) times increased from 42 (IQR: 28–68) min pre-lockdown to 53 (IQR: 40–72) min during the lockdown (p=0.01). No significant differences were observed in in-hospital mortality or cardiac troponin measurements within 24 h of procedure between the three groups.
Conclusion
Adverse effects of COVID-19-related lockdowns on acute STEMI care include a decrease in PCI volumes and prolonged D2B times. Our results provide valuable data-driven criteria to help inform patient decisions to seek care and to find ways to protect healthcare workers without compromising timely critical intervention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Zlochiver
- Advocate Aurora Health, Advocate Aurora Research Institute, Milwaukee, United States of America
| | - A C Perez Moreno
- Advocate Aurora Health, Advocate Aurora Research Institute, Milwaukee, United States of America
| | - J Hall
- Advocate Aurora Health, Aurora Cardiovascular and Thoracic Services, Milwaukee, United States of America
| | - M Hommeida
- Advocate Aurora Health, Aurora Cardiovascular and Thoracic Services, Milwaukee, United States of America
| | - S Q Allaqaband
- Advocate Aurora Health, Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - T Bajwa
- Advocate Aurora Health, Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - M F Jan
- Advocate Aurora Health, Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, United States of America
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25
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Bailey H, Nasirova F, Sermon J, Rodrigues B, Khela K, Hall J, Last M, Penton J. 1232P Understanding the diagnostic and treatment landscape in EGFRm advanced non-small cell lung cancer (aNSCLC) patients with exon 20 insertion mutations (Ex20ins). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1837] [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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26
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Balachandren N, Davies M, Hall J, Mavrelos D, Yasmin E. P–384 First trimester pregnancy outcomes after confirmed SARS-CoV–2 infection in the community; a nationwide prospective longitudinal study of 10,000 pregnant women from the COVID–19 pandemic. Hum Reprod 2021. [PMCID: PMC8385875 DOI: 10.1093/humrep/deab130.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Study question Are pregnant women in the community with confirmed diagnosis of SARS-CoV–2 infection, at increased risk of an early miscarriage? Summary answer Women diagnosed with COVID–19 in their first trimester were not at increased risk of an early miscarriage. What is known already: In the earliest stages of the pandemic, the Human Fertilisation and Embryology Authority and the European Society of Human Reproduction and Embryology, independently advised against starting assisted reproductive treatments. At the time of this recommendation, among other reasons, there were concerns about the complications of SARS-CoV–2 during pregnancy and the potential for vertical transmission. We now having growing evidence that pregnant women are at an increased risk of severe illness along with higher rates of preterm births in those with severe acute respiratory syndrome. However, data on the impact of community infections of SARS-CoV–2 in early pregnancy has been sparse. Study design, size, duration This is an online survey study undertaken in the UK between May and November 2020. Pregnant women at any stage in their pregnancy were invited to participate in the study. Study participants were asked to complete online surveys at the end of each trimester. 10, 430 women were recruited to take part in the study. Participants/materials, setting, methods: We analysed pregnancy outcomes from women who were under 13 weeks gestation at the time of registration. We compared miscarriage rates among women with a confirmed diagnosis of SARS-CoV–2 infection to healthy controls. Those in the control group had not been diagnosed with or had symptoms of SARS-CoV–2 infection nor did they have any household contacts that were diagnosed with or had symptoms of SARS-CoV–2 infection. Main results and the role of chance 10, 430 pregnant women were recruited to participate in the study. 2934 were under 13 weeks gestation at the time of registration. The median age was 32.6 [IQR 29.8–35.6]. The median gestational age at registration was 8 weeks [IQR [6–10]. 246 women reported a miscarriage before 13 weeks of gestation. The overall miscarriage rate before 13 weeks of gestation was 8.4% (95% CI 7.3%–9.4%). 68 women reported a confirmed diagnosis of SARS-CoV–2 infection in their first trimester. The overall rate of confirmed SARS-CoV–2 infections in the first trimester was 2.3% (95% CI 1.8–2.9%). 3/68 (4.4%) were asymptomatic. Among those reporting symptoms, the commonest symptoms were fatigue (82%), headache (69%) and loss of smell/taste (69%). Only 38% of those with a confirmed diagnosis reported a fever. None of the 68 women with confirmed diagnosis of SARS-CoV–2 infection were hospitalised. The rate of miscarriage before 13 weeks of gestation in women who were diagnosed with SARS-CoV–2 infections was not significantly higher compared to healthy controls (11.8% versus 9.3%, p = 0.35). A further 35 women had household contacts with confirmed SARS-CoV–2 infection although they themselves had not been diagnosed. No miscarriages were reported in this group. Limitations, reasons for caution None of the 68 patients diagnosed with SARS-CoV–2 were hospitalised. We do not know whether the rate of miscarriage among hospitalised women with SARS-CoV–2 infection is the same as those with community infections. Wider implications of the findings: The overall rate of miscarriage during the pandemic was not higher than rates occurring outside of the pandemic. The rate of miscarriage among women diagnosed with SARS-CoV–2 infection was not significantly higher compared to healthy controls. This data can be used to counsel women planning a pregnancy during this pandemic Trial registration number Not applicable
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Affiliation(s)
- N Balachandren
- University College London Hospital, Reproductive Medicine Unit, New Malden, United Kingdom
| | - M Davies
- University College London Hospital, Reproductive Medicine Unit, London, United Kingdom
| | - J Hall
- University College London, Institute for Women’s Health, London, United Kingdom
| | - D Mavrelos
- University College London Hospital, Reproductive Medicine Unit, New Malden, United Kingdom
| | - E Yasmin
- University College London Hospital, Reproductive Medicine Unit, New Malden, United Kingdom
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27
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Thwaites A, Hall J, Geraldine B, Stephenson J. P–743 The fertility paradox: the need for contraception after in vitro fertilisation. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What are a woman’s contraceptive needs after successful in vitro fertilisation (IVF) pregnancy? and how should services respond to help prevent unintended pregnancies?
Summary answer
Women who have IVF pregnancies require tailored, postnatal contraception counselling. Services must provide evidence-based information about the risks of spontaneous conception to engage them effectively.
What is known already
Women undergoing IVF are an increasingly heterogeneous group with a wide range of causative subfertility factors. Furthermore, increasingly, women are accessing treatment primarily for reasons other than subfertility. The evidence relating to rates of spontaneous conception post assisted conception varies widely according to population, cause of subfertility, type and outcome of fertility treatment and length of follow-up. A recent large retrospective UK cohort study estimated the treatment-independent live birth rate after IVF live birth over 5 year follow up as 15% [https://doi.org/10.1093/humrep/dez099]. We aim to explore the experiences and views about contraception among this diverse group of women.
Study design, size, duration
A qualitative study of the views of women who have had spontaneous pregnancies after successful IVF was conducted in September/October 2020. A qualitative approach of in-depth interviews was chosen to allow exploration of individual experiences in an area not much studied previously. The sample consisted of twenty interviewees from around the UK.
Participants/materials, setting, methods
Purposive and snowballing sampling methods were used with eligible participants recruited from a range of sources including social media and peer networks. The sample included a wide range of spontaneous pregnancy outcomes after successful IVF, including single and multiple livebirths, miscarriage, ectopic pregnancy and termination of pregnancy. The framework method was used for analysis using NVivo12 software.
Main results and the role of chance
Contraceptive choices were subject to a complex and dynamic interaction of influencing factors including i) beliefs regarding their own subfertility, ii) desire for more children and iii) their views on contraception. After IVF pregnancy, the majority of women (n = 15) used no contraception or ineffective methods (inconsistent condom use or withdrawal) before their next pregnancy with only two women using hormonal methods (progesterone-only pill). Spontaneous pregnancy was not universally welcomed in this group and the inter-pregnancy intervals were often short (n = 15, less than 18 months) or very short (n = 6, less than 12 months). After subsequent spontaneous pregnancy, use of contraception and the most effective (long-acting reversible) methods remained low. Women held persistent beliefs regarding their subfertility despite subsequent spontaneous pregnancy (or pregnancies). Women associated aspects of the IVF process (e.g. need for multiple cycles, low numbers of eggs collected etc.) with a sense of personal failure, despite an ultimately “successful” outcome resulting in livebirth. This may contribute to or reinforce their self-belief in subfertility. Other specific barriers to contraception use, in women having IVF, included lack of knowledge of the likelihood of spontaneous pregnancy, lack of contraceptive experience and inherent incentives towards shorter inter-pregnancy intervals.
Limitations, reasons for caution
There is potential recall bias with some women recalling experiences associated with IVF treatment more than ten years ago. However our sample included women who were currently pregnant as well as women who were further towards the end of their reproductive life to capture a range of experiences.
Wider implications of the findings: The contraceptive needs of women having IVF pregnancies are being overlooked. Fertility services should take responsibility for providing accurate information on the risks of subsequent spontaneous pregnancy in this population. Maternity and community healthcare professionals must address women’s perceptions of their fertility in order to engage them in contraception counselling.
Trial registration number
N/A
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Affiliation(s)
- A Thwaites
- University College London, Institute for Women’s Health, London, United Kingdom
| | - J Hall
- University College London, Institute for Women’s Health, London, United Kingdom
| | - B Geraldine
- University College London, Institute for Women’s Health, London, United Kingdom
| | - J Stephenson
- University College London, Institute for Women’s Health, London, United Kingdom
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Varghese A, Esteves S, Kovacic B, Chatziparasidou A, Nijs M, Dakka M, Hall J, Perugini M, Nguyen T, Hreinsson J. P–782 A natural language processing approach of global survey results on what the embryologist thinks and faces. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
What are the major problems faced by embryologists at 1) Clinic level, 2) Professional level, 3) Personal level, and 4) What are their career goals?
Summary answer
Embryologists, essential professionals of Fertility Centres, are less satisfied in many quantifiable aspects, but they love their profession and have many aspirational goals.
What is known already
IVF success depends in part on embryologists’ skills. The need to recognize clinical embryology as a specialty and clinical embryologists’ educational level, responsibilities, and workload have been addressed by a few national societies. However, data are lacking from the embryologists’ viewpoint at a global level about their profession. Qualitative data-analysis methods provide thick, rich descriptions of subjects’ thoughts, feelings, and lived experiences but can be time-consuming, labor-intensive, and prone to bias.
Study design, size, duration
A questionnaire was prepared using SurveyMonkey online software (SurveyMonkey, Inc., USA) and distributed to IVF lab professionals through embryology societies, online social media, and email databases. The questionnaire consisted of open-ended questions focused on identifying problems faced by embryologists at the clinic, in the profession, and in a personal level, as well as questions about their career outlook. The survey was active from May 2016 until February 2017. From 73 countries, 720 responses were obtained.
Participants/materials, setting, methods
Using natural language processing (NLP), the top 15 most frequently used keywords were identified and correlated with each other. Stronger correlation (≥0.5) between semantically similar words expressing a strong signal from each answer, and their usage was further analyzed for positive versus negative sentiment. By normalizing the frequency of positive/negative samples for each keyword as a percentage, “sentiment wheels” were produced, identifying the key concepts that respondents answered and quantifying how they felt about them.
Main results and the role of chance
The responses received were from 80% private, 17% public and 3% other ART settings distributed all over the world. From the embryologists’ viewpoints reported and after the NLP processing it was shown that the common topics related to strong negative sentiments were: embryologists’ remuneration (0.6) at the Clinic level; certification (0.7), recognition (0.5), respect (0.5), learn (0.5) and experience (0.5) at the Professional level; and remuneration (0.7), emotional (0.5) dealing (0.5) at the Personal level. Renumeration was reported and strongly related to embryologists’ viewpoint at both the clinic and personal level in combination with the need for certification, recognition and ongoing development at the Professional level. Moreover, the NLP processing demonstrated that the common topics on career goal analysis related to strong positive sentiments were: teaching (0.7), education (0.7), and continuation (0.5) all three topics are compatible with a professional orientation open to ongoing development and practice advancement. The NLP and the manual data analysis project an image of the typical embryologist as a knowledge seeking professional who is deeply dedicated to the job but feels the need for professional development and suffers some lack of recognition and feels in some cases not fairly treated as an employee.
Limitations, reasons for caution
The data obtained is limited. Only one natural language processing model was used to analyze the results. Different analysts using other methods may have different results. For these reasons, the results should be interpreted with caution.
Wider implications of the findings: It is important to focus on the lab as an organization and not just a service for the patients in treatment at the moment. The NLP results ultimately obtained may help streamline professional satisfaction efforts, and guide future quality management strategies
Trial registration number
Not applicable
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Affiliation(s)
- A Varghese
- Astra Fertility Clinic, ART Laboratories, Mississauga, Canada
- CRAFT Hospital & Research Centre, IVF LAboratory, Kerala, India
| | - S Esteves
- ANDROFERT- Andrology and Human Reproduction Clinic, IVF Laboratory, Campinas, Brazil
| | - B Kovacic
- University Medical Centre Maribor, Department of Reproductive Medicine & Gynaecological Endocrinology, Maribor, Slovenia
| | | | - M Nijs
- Embryolab Academy, Embryology, Thessaloniki, Greece
| | - M Dakka
- Presagen and Life Whisperer Diagnostics, Company, Adelaide, Australia
| | - J Hall
- Presagen and Life Whisperer Diagnostics, Company, Adelaide, Australia
- University of Adelaide, Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, Australia
| | - M Perugini
- Presagen and Life Whisperer Diagnostics, Company, Adelaide, Australia
| | - T Nguyen
- Presagen and Life Whisperer Diagnostics, Company, Adelaide, Australia
| | - J Hreinsson
- Presagen and Life Whisperer Diagnostics, Company, Adelaide, Australia
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VerMilyea M, Diakiw S, Hall J, Dakka M, Nguyen T, Perugini D, Perugini M. P–228 AI-based assessment of embryo viability correlates with features of embryo ploidy. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Do AI models used to assess embryo viability (based on pregnancy outcome) also correlate with known embryo quality measures such as ploidy status?
Summary answer
An AI for embryo viability assessment correlated with ploidy status, and with karyotypic features of aneuploidy, supporting its use for embryo selection.
What is known already
One factor that can influence pregnancy success is the genetic status of the embryo. PGT-A is commonly used to test for embryo ploidy, with the aim of identifying karyotypically normal embryos (euploid embryos), for preferential transfer. There is evidence suggesting that transfer of euploid embryos produces favorable clinical outcomes over aneuploid embryos.
Given the AI model was trained to evaluate clinical pregnancy, it was hypothesized that the score might also correlate with ploidy status, and with different types of aneuploidies. Little is known about morphological correlations with embryo ploidy status, so we also sought to explore this relationship.
Study design, size, duration
This study involved analysis of a retrospective dataset of single static Day 5 embryo (blastocyst) images with associated PGT-A results and AI viability scores. The dataset comprised images of 5,469 embryos from 2,615 consecutive patients treated at five US IVF clinics between February 2015 and April 2020. The AI was trained on thousands of Day 5 embryo images from multiple IVF laboratories in multiple countries, but was not trained on data used in this study.
Participants/materials, setting, methods
Average patient age was 36.2 years, and average embryo cohort size was 2.1/patient. PGT-A analysis was performed on embryos at time of evaluation. The dataset comprised 3,251 (59.4%) euploid embryos, 1,815 (33.2%) aneuploid embryos, and 403 (7.4%) mosaic embryos. The AI was retrospectively used to provide a score between 0 (predicted non-viable) and 10 (predicted viable) for each image. Correlation between the AI viability score and euploid, mosaic and aneuploid embryos was then assessed.
Main results and the role of chance
Results showed a statistically significant correlation between AI viability score and PGT-A outcome, consistent with a relationship between pregnancy outcome and ploidy status. The average score for euploid embryos was 8.20, which was significantly higher than the average score for aneuploid embryos of 7.80 (p < 0.0001).
There was a significant linear increase in confidence score from full aneuploid embryos, through mosaic embryos (average score 7.97), to full euploid embryos (mosaic threshold of 20–80%). High mosaic embryos tended to have a lower average score (7.60) than low mosaic embryos (7.96), consistent with correlation of viability (pregnancy outcome) with the degree of mosaicism. AI viability score also correlated with ploidy features believed to affect pregnancy outcomes. Trisomic changes had higher average scores than monosomic changes. Segmental changes had higher average scores than full gain or loss. The AI score differentiated euploid from aneuploid status more efficiently in embryos with poorer morphology than those with good morphology.
Whilst there was an evident correlation between pregnancy outcome and ploidy status, the AI was only weakly predictive of euploidy, with an accuracy of 57.3% using an AI viability score threshold of 7.5/10.This suggests pregnancy-related morphological features are somewhat correlated with embryo ploidy, but not completely.
Limitations, reasons for caution
The PGT-A technique is held to have some limitations for evaluating ploidy status, therefore it would be of benefit to perform additional confirmatory studies on independent datasets. It would be of interest to conduct prospective studies evaluating correlations between the AI’s evaluation of morphology and pregnancy outcome with ploidy status.
Wider implications of the findings: The AI score correlated with genetic features of embryos that are known to correlate with pregnancy, which further supports the efficacy and use of AI for embryo viability assessment. The AI identified morphological features that are somewhat predictive of ploidy status, with potential application to embryos of poorer Gardner score.
Trial registration number
none
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Affiliation(s)
| | - S Diakiw
- Presagen, Life Whisperer, Adelaide, Australia
| | - J Hall
- Presagen, Life Whisperer, Adelaide, Australia
- Australia/Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, Australia
| | - M Dakka
- Presagen, Life Whisperer, Adelaide, Australia
| | - T Nguyen
- Presagen, Life Whisperer, Adelaide, Australia
| | - D Perugini
- Presagen, Life Whisperer, Adelaide, Australia
| | - M Perugini
- Presagen, Life Whisperer, Adelaide, Australia
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30
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Lacasse C, Rose K, Allen M, Ward MP, Pulscher LA, Giles A, Hall J, Phalen DN. Investigation into clinicopathological and pathological findings, prognosis, and aetiology of lorikeet paralysis syndrome in rainbow lorikeets (Trichoglossus haematodus). Aust Vet J 2021; 99:432-444. [PMID: 34258761 PMCID: PMC8518122 DOI: 10.1111/avj.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
Objective To report the temporal and spatial distribution of rainbow lorikeets presenting with lorikeet paralysis syndrome (LPS) and their clinicopathologic and pathologic findings, exposure to toxins, and response to treatment. Methods Records of lorikeets admitted in 2017 and 2018 to facilities in south‐east Queensland (QLD) were reviewed and LPS and non‐LPS cases were mapped and their distribution compared. Plasma biochemistries and complete blood counts were done on 20 representative lorikeets from south‐east QLD and Grafton, New South Wales (NSW). Tissues from 28 lorikeets were examined histologically. Samples were tested for pesticides (n = 19), toxic elements (n = 23), botulism (n = 15) and alcohol (n = 5). Results LPS occurred in warmer months. Affected lorikeets were found across south‐east QLD. Hotspots were identified in Brisbane and the Sunshine Coast. Lorikeets had a heterophilic leucocytosis, elevated muscle enzymes, uric acid and sodium and chloride. Specific lesions were not found. Exposure to cadmium was common in LPS and non‐LPS lorikeets. Treated lorikeets had a 60–93% See Table 2 depending on severity of signs. Clinical significance The primary differential diagnosis for lorikeets presenting with lower motor neuron signs during spring, summer and autumn in northern NSW and south‐east Queensland should be LPS. With supportive care, prognosis is fair to good.
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Affiliation(s)
- C Lacasse
- RSPCA Queensland, 139 Wacol Station Road, Wacol, Queensland, 4076, Australia
| | - K Rose
- Australian Registry of Wildlife Health, Taronga Conservation Society, Bradleys Head Rd., Mosman, New South Wales, 2088, Australia
| | - M Allen
- Sydney School of Veterinary Science, University of Sydney, Camden, New South Wales, 2570, Australia
| | - M P Ward
- Sydney School of Veterinary Science, University of Sydney, Camden, New South Wales, 2570, Australia
| | - L A Pulscher
- Sydney School of Veterinary Science, University of Sydney, Camden, New South Wales, 2570, Australia
| | - A Giles
- Grafton Veterinary Clinic, 128 Baron St., Grafton, New South Wales, 2460, Australia
| | - J Hall
- Australian Registry of Wildlife Health, Taronga Conservation Society, Bradleys Head Rd., Mosman, New South Wales, 2088, Australia
| | - D N Phalen
- Sydney School of Veterinary Science, University of Sydney, Camden, New South Wales, 2570, Australia.,Schubot Exotic Bird Health Center, Department of Pathobiology, Texas A&M College of Veterinary Sciences and Biomedical Education, Texas A&M University, College Station, Texas, 77843, USA
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Gladstone DJ, Aviv RI, Demchuk AM, Hill MD, Thorpe KE, Khoury JC, Sucharew HJ, Al-Ajlan F, Butcher K, Dowlatshahi D, Gubitz G, De Masi S, Hall J, Gregg D, Mamdani M, Shamy M, Swartz RH, Del Campo CM, Cucchiara B, Panagos P, Goldstein JN, Carrozzella J, Jauch EC, Broderick JP, Flaherty ML. Effect of Recombinant Activated Coagulation Factor VII on Hemorrhage Expansion Among Patients With Spot Sign-Positive Acute Intracerebral Hemorrhage: The SPOTLIGHT and STOP-IT Randomized Clinical Trials. JAMA Neurol 2021; 76:1493-1501. [PMID: 31424491 DOI: 10.1001/jamaneurol.2019.2636] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Intracerebral hemorrhage (ICH) is a devastating stroke type that lacks effective treatments. An imaging biomarker of ICH expansion-the computed tomography (CT) angiography spot sign-may identify a subgroup that could benefit from hemostatic therapy. Objective To investigate whether recombinant activated coagulation factor VII (rFVIIa) reduces hemorrhage expansion among patients with spot sign-positive ICH. Design, Setting, and Participants In parallel investigator-initiated, multicenter, double-blind, placebo-controlled randomized clinical trials in Canada ("Spot Sign" Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy [SPOTLIGHT]) and the United States (The Spot Sign for Predicting and Treating ICH Growth Study [STOP-IT]) with harmonized protocols and a preplanned individual patient-level pooled analysis, patients presenting to the emergency department with an acute primary spontaneous ICH and a spot sign on CT angiography were recruited. Data were collected from November 2010 to May 2016. Data were analyzed from November 2016 to May 2017. Interventions Eligible patients were randomly assigned 80 μg/kg of intravenous rFVIIa or placebo as soon as possible within 6.5 hours of stroke onset. Main Outcomes and Measures Head CT at 24 hours assessed parenchymal ICH volume expansion from baseline (primary outcome) and total (ie, parenchymal plus intraventricular) hemorrhage volume expansion (secondary outcome). The pooled analysis compared hemorrhage expansion between groups by analyzing 24-hour volumes in a linear regression model adjusted for baseline volumes, time from stroke onset to treatment, and trial. Results Of the 69 included patients, 35 (51%) were male, and the median (interquartile range [IQR]) age was 70 (59-80) years. Baseline median (IQR) ICH volumes were 16.3 (9.6-39.2) mL in the rFVIIa group and 20.4 (8.6-32.6) mL in the placebo group. Median (IQR) time from CT to treatment was 71 (57-96) minutes, and the median (IQR) time from stroke onset to treatment was 178 (138-197) minutes. The median (IQR) increase in ICH volume from baseline to 24 hours was small in both the rFVIIa group (2.5 [0-10.2] mL) and placebo group (2.6 [0-6.6] mL). After adjustment, there was no difference between groups on measures of ICH or total hemorrhage expansion. At 90 days, 9 of 30 patients in the rFVIIa group and 13 of 34 in the placebo group had died or were severely disabled (P = .60). Conclusions and Relevance Among patients with spot sign-positive ICH treated a median of about 3 hours from stroke onset, rFVIIa did not significantly improve radiographic or clinical outcomes. Trial Registration ClinicalTrials.gov identifier: NCT01359202 and NCT00810888.
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Affiliation(s)
- David J Gladstone
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Richard I Aviv
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Andrew M Demchuk
- Department of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael D Hill
- Department of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences and Medicine, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Heidi J Sucharew
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Fahad Al-Ajlan
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ken Butcher
- University of New South Wales, Prince of Wales Clinical School, Sydney, New South Wales, Australia
| | - Dar Dowlatshahi
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Gord Gubitz
- Division of Neurology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephanie De Masi
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - Judith Hall
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | - David Gregg
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston
| | - Muhammad Mamdani
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Richard H Swartz
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - C Martin Del Campo
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brett Cucchiara
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Peter Panagos
- Department of Emergency Medicine, Washington University in St Louis, St Louis, Missouri
| | - Joshua N Goldstein
- Department of Emergency Medicine, Massachusetts General Hospital, Boston
| | - Janice Carrozzella
- Department of Radiology, University of Cincinnati Academic Health Center, Cincinnati, Ohio
| | - Edward C Jauch
- Mission Research Institute, Mission Health System, Asheville, North Carolina
| | - Joseph P Broderick
- Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, Ohio
| | - Matthew L Flaherty
- Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, Ohio
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Graham J, Novosat T, Sun H, Piper B, Boscarino J, Duboski V, Kern M, Wright E, Robinson R, Casey E, Beck C, Hall J, Schepman P. POS1089 ASSOCIATION BETWEEN PAIN SEVERITY AND HEALTHCARE UTILIZATION IN AN OSTEOARTHRITIS POPULATION: AN 18-YEAR RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Osteoarthritis (OA) is a common disease that varies in severity among patients. A standardized definition to classify patients into different severity levels is lacking, however, due to the disease’s complex pathogenesis and presentation. Prior studies have shown associations between pain severity and higher healthcare resource utilization (HRU) and costs. We investigated an association between pain severity and higher healthcare resource utilization by examining the use of specific OA-related treatments across pain intensity levels in a large, integrated health system’s OA population over an 18-year period.Objectives:Our aim was to compare use of medications and other treatments among OA patients experiencing mild, moderate, or severe pain.Methods:This was a retrospective study of electronic health records from 2001 to 2018 at Geisinger, an integrated health system in Pennsylvania. Patients were included with a diagnosis code for OA (ICD-9: 715.*, ICD-10 M15-19) on a problem list or encounter or an OA-specific procedure (hip or knee replacement, arthroscopy or injection). We examined pain scores (0-10 scale, with 10 being worst pain) taken after the first OA diagnosis date and defined pain episodes starting on the pain score’s date and lasting for 90 days. If a new pain score was measured before 90 days elapsed, the episode was extended for an additional 90 days, with this process repeated as necessary. Each episode was categorized as mild (pain score 0-3), moderate (4-6), or severe (7-10) based on initial score, and patients could contribute multiple episodes to the analysis. Descriptive statistics were used to quantify treatment utilization during each patients’ mild, moderate and severe episodes. Percentages of patients who had any use of 10 medication types (tramadol, non-tramadol opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), injectable corticosteroids, acetaminophen, salicylates, duloxetine, homeopathic medications, other topical medications, and other over-the-counter (OTC) medications were compared across pain episode types. Percentages of patients with knee or hip surgeries, spine or joint imaging procedures (x-ray, computed tomography or magnetic resonance) and consults to OA-related care (pain management, orthopedics or physical medicine and rehabilitation) were also compared. All analyses used logistic regression with p-values <0.05 considered significant.Results:We identified 290,897 patients with OA, representing 34% of the health system population in 2018; 58% were female with mean age of 49 years and mean BMI of 30.5 kg/m2. A total of 801,144 pain episodes were defined, with 75% of patients having at least one pain score. The two most frequently occurring pain scores were 0 (17%) and 5 (13%), and pain episodes were classified as 43% mild, 32% moderate and 25% severe. Significantly higher percentages of patients used certain medication types (NSAIDs, injectable corticosteroids, non-tramadol opioid, duloxetine) in both moderate and severe pain episodes as compared to mild episodes, but other medication types were less likely to be used as pain severity increased (acetaminophen, salicylates, homeopathic medications, other OTC medications). Knee or hip surgeries, imaging, and consults to OA-related specialists were all consistently significantly more likely to occur in patients during moderate or severe pain episodes versus mild episodes (relative risk ratios of 1.76, 1.25 and 1.35 for moderate vs mild, respectively, and 2.00, 1.44 and 1.46 for severe vs mild, all p-values <0.05).Conclusion:While pain is generally recognized to be a subjective measure that could be influenced by other unmeasured factors and can be confounded with treatment effectiveness, it is nevertheless the primary symptom of OA. It is important to understand the relationship between pain intensity and treatment utilization, and our results support an overall association between pain and utilization but provide new details on the extent to which it depends on specific utilization type.Acknowledgements:Pfizer and Eli Lilly and Company for sponsoring this study.Disclosure of Interests:Jove Graham Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Tonia Novosat Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Haiyan Sun Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Brian Piper Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Joseph Boscarino Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Vanessa Duboski Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Melissa Kern Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Eric Wright Grant/research support from: I am an employee of Geisinger which received financial support from Pfizer and Eli Lilly and Company in connection with the development of this abstract, Rebecca Robinson Shareholder of: Eli Lilly & Co., Employee of: Eli Lilly & Co., Edward Casey Shareholder of: Pfizer, Inc., Paid instructor for: As an employee of Pfizer, Inc. this is part of my role., Employee of: Pfizer, Inc., Craig Beck Shareholder of: Pfizer, Inc., Employee of: Pfizer, Inc., Jerry Hall Shareholder of: Eli Lilly & Co., Employee of: Eli Lilly & Co., Patricia Schepman Shareholder of: Pfizer, Inc., Employee of: Pfizer, Inc.
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Holdsworth E, Lukanova R, Hughes M, Hall J, Austin J, Taylor-Stokes G, Piercy J. POS1205 THE IMPACT OF COVID-19 ON PATIENT MANAGEMENT AND PRESCRIBING STRATEGY ACROSS THE EU AND US: A REAL-WORLD SURVEY OF RHEUMATOLOGISTS, DERMATOLOGISTS, AND GASTROENTEROLOGISTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The COVID-19 pandemic is expected to have impacted patient management on a global level. However, the degree of impact on patient management and prescribing strategy in the fields of rheumatology, dermatology and gastroenterology is unclear.Objectives:Assess the impact of COVID-19 on patient management and prescribing strategy across the EU and US, as described by rheumatologists, dermatologists, and gastroenterologists.Methods:Data were drawn from physician surveys in France, Germany, Italy, Spain, UK and US between July and December 2020. Physicians completed an online or telephone survey assessing how COVID-19 has impacted type and frequency of consultations; choice and prescription of medication.Results:847 physicians took part; 355 rheumatologists, 200 dermatologists (Germany, Spain, UK, and US only), and 282 gastroenterologists. As a result of COVID-19, most physicians stated they have moved at least some patients to video or telephone consultations (70% rheumatologists; 55% dermatologists; 60% gastroenterologists) and reduced overall frequency of consultations with patients (59% rheumatologists; 64% dermatologists; 51% gastroenterologists) (Table 1).35% of rheumatologists, 22% of dermatologists, and 14% of gastroenterologists described COVID-19 as changing the way they choose and prescribe medication, with differences observed between countries (Figure 1). Of those who stated they have made medication changes, rheumatologists stated changing medication to self-administration (62%) and not starting new patients on an advanced therapy (biologic DMARD or targeted synthetic DMARD) (58%) as most frequent. Dermatologists stated changes include changing treatment to more COVID-appropriate treatment (71%) and prescribing repeat prescriptions more regularly without consultation (56%). Gastroenterologists stated changes include changing medication to self-administration (55%) and prescribing a longer course of medication (48%).Comparing across countries, for all specialties, the greatest changes were observed in the UK followed by Spain, with least changes in Germany and Italy.Conclusion:There have been changes in the process of how healthcare is delivered, although treatment prescription was impacted to a lesser extent than consultation type and frequency. This varies across geographies, which may be due to differences in reported prevalence of COVID-19. Differences are also observed across specialities, which may be due to guidance received from specialty bodies. It is unknown what the long-term impact of changes in the management of patients due to COVID-19 will be on patient outcomes, satisfaction, engagement and adherence, and further research is needed.Table 1.Rheumatologist, Dermatologist, and Gastroenterologist described impact on patient management, by countryGlobal(n=847)France(n=90)Germany(n=168)Italy(n=122)Spain(n=161)UK(n=133)US(n=163)Rheumatologistsn=365n=50n=58n=59n=57n=50n=81Moving to video/telephone consultation70%70% 36%47%86%94%84%Fewer visits for individual patients (reduced visiting schedule)59%80%0%41%96%76%65%Dermatologistsn=200-n=50-n=50n=50n=50Moving to video/telephone consultation55%-40%-58%66%56%Fewer visits for individual patients (reduced visiting schedule)64%-60%-54%72%72%Gastroenterologistsn=282n=40n=60n=63n=54n=33n=32Moving to video/telephone consultation60%63%18%54%83%100%69%Fewer visits for individual patients (reduced visiting schedule)51%35%43%51%43%79%69%Figure 1.Proportion of rheumatologists, dermatologists, and gastroenterologists reporting changing the way they choose and prescribe medication as a result of COVID-19Disclosure of Interests:None declared.
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Anderson T, Beever L, Hall J, Moores A, Llanos C, Adams R, Meakin L, Coppola M, Bowlt-Blacklock K, Holmes MA, Barnes D. Outcome following surgery to treat septic peritonitis in 95 cats in the United Kingdom. J Small Anim Pract 2021; 62:744-749. [PMID: 33999425 DOI: 10.1111/jsap.13346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To review the cause, management and outcome in cats with septic peritonitis within the United Kingdom (2008 to 2018) and to identify if previously identified prognostic factors were associated with survival in this population. MATERIALS AND METHODS Clinical records from 10 referral hospitals in United Kingdom were reviewed. Data collected included signalment, clinicopathological data and management techniques. Serum albumin, glucose, lactate and ionised calcium concentration; presence of intraoperative hypotension and correct empirical antibiosis were analysed via logistic regression for association with survival. RESULTS Ninety-five cats were included. The overall survival rate was 66%. Lethargy (89%) and anorexia (75%) were the most common clinical signs, with abdominal pain and vomiting in 44% and 27% of cases, respectively. Gastro-intestinal leakage was the most common source of contamination. The presence of an abdominal mass on clinical examination was not strongly predictive of the presence of neoplasia on histology and did not confer a worse prognosis. Cats presenting with dehiscence of a previous enterotomy/enterectomy did not have a worse prognosis than those presenting with other aetologies. Intraoperative hypotension (adjusted odds ratio 0.173, 95% confidence intervals 0.034 to 0.866, P=0.033) was associated with non-survival. Cats that survived beyond 1 day postoperatively had an improved likelihood of survival (87.5%). All cats that survived beyond 6 days were successfully discharged. CLINICAL SIGNIFICANCE This study describes the largest group of cats with septic peritonitis with an overall survival rate of 66%. The presence of an abdominal mass on clinical examination or having dehiscence of a previous gastrointestinal surgery did not confer a worse prognosis.
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Affiliation(s)
- T Anderson
- Surgery Department, Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - L Beever
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hertfordshire, AL9 7TA, UK
| | - J Hall
- Surgery Department, Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK.,Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Midlothian, Edinburgh, EH25 9RG, UK
| | - A Moores
- Surgery Department, Anderson Moores Veterinary Specialists, Winchester, Hampshire, SO21 2LL, UK
| | - C Llanos
- Surgery Department, Willows Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - R Adams
- Surgery Department, Northern Ireland Veterinary Specialists, Hillsborough, Co. Down, NI, BT26 6 PB, UK.,Surgery Department, Davies Veterinary Specialists, Higham Gobion, Hitchin, SG5 3HR, UK
| | - L Meakin
- Surgery Department, Langford Vets, Langford, BS40 5DU, UK
| | - M Coppola
- Surgery Department, University of Glasgow, Glasgow, G61 1QH, UK
| | - K Bowlt-Blacklock
- Surgery Department, Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK
| | - M A Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - D Barnes
- Surgery Department, Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
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Hodgetts J, Glover R, Cole J, Hall J, Boonham N. Genomics informed design of a suite of real-time PCR assays for the specific detection of each Xylella fastidiosa subspecies. J Appl Microbiol 2021; 131:855-872. [PMID: 33098196 DOI: 10.1111/jam.14903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/27/2020] [Accepted: 10/15/2020] [Indexed: 11/27/2022]
Abstract
AIMS Existing methods for the identification of the subspecies of Xylella fastidiosa are time-consuming which can lead to delays in diagnosis and the associated plant health response to outbreaks and interceptions. METHODS AND RESULTS Diagnostic markers were identified using a comparative genomics approach to allow fine differentiation of the very closely related subspecies. Five qPCR assays were designed to allow specific detection of X. fastidiosa subsp. fastidiosa, X. fastidiosa subsp. multiplex, X. fastidiosa subsp. pauca, X. fastidiosa subsp. morus and X. fastidiosa subsp. sandyi. All assays were validated according to the European and Mediterranean Plant Protection Organisation (EPPO) standard PM7/98(2). CONCLUSIONS All of the assays were shown to be specific to the target subspecies and all the assays could be used to detect femtogram quantities of X. fastidiosa DNA. SIGNIFICANCE AND IMPACT OF THE STUDY At present, diagnosing the subspecies of X. fastidiosa requires multiple conventional PCR assays (although only available for three of the five subspecies) or multi-locus sequence typing which takes several days. By comparison, the new assays provide a substantial reduction in the turnaround time for direct identification to the subspecies level in as little as 75 min.
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Affiliation(s)
- J Hodgetts
- Fera Science Ltd, The National Agri-Food Innovation Campus, York, UK
| | - R Glover
- Fera Science Ltd, The National Agri-Food Innovation Campus, York, UK
| | - J Cole
- Fera Science Ltd, The National Agri-Food Innovation Campus, York, UK
| | - J Hall
- Fera Science Ltd, The National Agri-Food Innovation Campus, York, UK
| | - N Boonham
- Fera Science Ltd, The National Agri-Food Innovation Campus, York, UK.,Institute for Agri-Food Research and Innovation, University of Newcastle, Newcastle upon Tyne, UK
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Requena S, Oppel S, Bond AL, Hall J, Cleeland J, Crawford RJM, Davies D, Dilley BJ, Glass T, Makhado A, Ratcliffe N, Reid TA, Ronconi RA, Schofield A, Steinfurth A, Wege M, Bester M, Ryan PG. Marine hotspots of activity inform protection of a threatened community of pelagic species in a large oceanic jurisdiction. Anim Conserv 2020. [DOI: 10.1111/acv.12572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- S. Requena
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
| | - S. Oppel
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
| | - A. L. Bond
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
- Bird Group Department of Life Sciences The National History Museum Tring UK
| | - J. Hall
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
| | - J. Cleeland
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
| | - R. J. M. Crawford
- Department of Environmental Affairs Branch Oceans and Coasts Cape Town South Africa
| | - D. Davies
- FitzPatrick Institute of African Ornithology DST‐NRF Centre of Excellence University of Cape Town Rondebosch South Africa
| | - B. J. Dilley
- FitzPatrick Institute of African Ornithology DST‐NRF Centre of Excellence University of Cape Town Rondebosch South Africa
| | - T. Glass
- Tristan da Cunha Conservation Department Edinburgh of the Seven Seas Tristan da Cunha
| | - A. Makhado
- Department of Environmental Affairs Branch Oceans and Coasts Cape Town South Africa
- FitzPatrick Institute of African Ornithology DST‐NRF Centre of Excellence University of Cape Town Rondebosch South Africa
| | | | - T. A. Reid
- FitzPatrick Institute of African Ornithology DST‐NRF Centre of Excellence University of Cape Town Rondebosch South Africa
| | - R. A. Ronconi
- Department of Biology Dalhousie University Halifax Nova Scotia Canada
- Canadian Wildlife Service Environment and Climate Change Canada Dartmouth Nova Scotia Canada
| | - A. Schofield
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
| | - A. Steinfurth
- RSPB Centre for Conservation Science Royal Society for the Protection of Birds Sandy UK
| | - M. Wege
- Department of Zoology and Entomology Mammal Research Institute University of Pretoria Pretoria South Africa
| | - M. Bester
- Department of Zoology and Entomology Mammal Research Institute University of Pretoria Pretoria South Africa
| | - P. G. Ryan
- FitzPatrick Institute of African Ornithology DST‐NRF Centre of Excellence University of Cape Town Rondebosch South Africa
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Hall J. Designing family-centred preconception services. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
In order to support women and their partners to improve their health before pregnancy, we need to be able to identify who is likely to become pregnant within a given timeframe so that interventions can be targeted accordingly. There is no agreed, predictive tool currently available to do this. This presentation will describe the different ways of conceptualising the preconception population and how these populations can be identified to inform intervention delivery and development. We will overview what is known about the preferences of women and men with regards to preconception health services, with a particular focus on digital innovations, and will discuss how the effectiveness of preconception health interventions can be evaluated to contribute to the evidence base.
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Affiliation(s)
- J Hall
- Institute for Women's Health, UCL, London, UK
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Vallée M, Mowbray C, Fisher H, Ming Zhi Tan A, Harding C, Hall J, Aldridge P. Impact d’une antibioprophylaxie prolongée sur la colonisation urinaire par E. coli chez des patients aux auto-sondages intermittents et dynamique des interactions entre antibiotiques et uropathogènes lors d’infections urinaires récidivantes. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.288] [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: 11/28/2022]
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Pulok MH, van Gool K, Hall J. Inequity in healthcare use among the indigenous population living in non-remote areas of Australia. Public Health 2020; 186:35-43. [PMID: 32768622 DOI: 10.1016/j.puhe.2020.06.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although several studies have examined the gap in healthcare use between indigenous and non-indigenous people, empirical evidence on inequity in healthcare use within indigenous populations is limited. This study aims to fill this gap in the literature by investigating income-related inequity (unequal use for equal need) in healthcare use among indigenous Australians living in non-remote areas. STUDY DESIGN This is a cross-sectional study. METHODS This study used data from the Australian Aboriginal and Torres Strait Islander Health Survey, 2012-13. Logistic regression analysis was used to determine the association of income with the probability of a general practitioner (GP) visit, a specialist visit and inpatient admission. The horizontal inequity (HI) index and decomposition analysis were also used to quantify and explain inequity in healthcare use. RESULTS No consistent association was found between income and the probability of GP visit or inpatient admission after controlling for health need. However, the likelihood of visiting a specialist was about three times (odds ratio = 2.96, P = 0.028) higher for the richest compared with the poorest population subgroups. The inequity index was 0.016 (P < 0.001), indicating a pro-rich inequity for the probability of visiting a specialist. Income inequality, unequal distribution of private health insurance and inequality in education were the main factors explaining the pro-rich inequity in specialist utilisation. CONCLUSIONS Although there was no income-related inequity in GP visits or inpatient admissions, wealthier indigenous Australians had a higher probability of visiting a specialist than their poorer counterparts, after adjusting for need. Specific policies and initiatives are required to address the inequity faced by low-income indigenous people in Australia.
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Affiliation(s)
- M H Pulok
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia; Nova Scotia Health Authority, Halifax, NS, Canada.
| | - K van Gool
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia
| | - J Hall
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia
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Moulding HA, Bartsch U, Hall J, Jones MW, Linden DE, Owen MJ, van den Bree MBM. Sleep problems and associations with psychopathology and cognition in young people with 22q11.2 deletion syndrome (22q11.2DS). Psychol Med 2020; 50:1191-1202. [PMID: 31144615 DOI: 10.1017/s0033291719001119] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 12/17/2022]
Abstract
BACKGROUND Young people with 22q11.2 deletion syndrome (22q11.2DS) are at high risk for neurodevelopmental disorders. Sleep problems may play a role in this risk but their prevalence, nature and links to psychopathology and cognitive function remain undescribed in this population. METHOD Sleep problems, psychopathology, developmental coordination and cognitive function were assessed in 140 young people with 22q11.2DS (mean age = 10.1, s.d. = 2.46) and 65 unaffected sibling controls (mean age = 10.8, s.d.SD = 2.26). Primary carers completed questionnaires screening for the children's developmental coordination and autism spectrum disorder. RESULTS Sleep problems were identified in 60% of young people with 22q11.2DS compared to 23% of sibling controls (OR 5.00, p < 0.001). Two patterns best-described sleep problems in 22q11.2DS: restless sleep and insomnia. Restless sleep was linked to increased ADHD symptoms (OR 1.16, p < 0.001) and impaired executive function (OR 0.975, p = 0.013). Both patterns were associated with elevated symptoms of anxiety disorder (restless sleep: OR 1.10, p = 0.006 and insomnia: OR 1.07, p = 0.045) and developmental coordination disorder (OR 0.968, p = 0.0023, and OR 0.955, p = 0.009). The insomnia pattern was also linked to elevated conduct disorder symptoms (OR 1.53, p = 0.020). CONCLUSIONS Clinicians and carers should be aware that sleep problems are common in 22q11.2DS and index psychiatric risk, cognitive deficits and motor coordination problems. Future studies should explore the physiology of sleep and the links with the neurodevelopment in these young people.
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Affiliation(s)
- H A Moulding
- MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
| | - U Bartsch
- School Physiology, Pharmacology & Neuroscience, University of Bristol, Biomedical Sciences Building, University Walk, BS8 1TD, UK
- Lilly UK, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - J Hall
- MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - M W Jones
- School Physiology, Pharmacology & Neuroscience, University of Bristol, Biomedical Sciences Building, University Walk, BS8 1TD, UK
| | - D E Linden
- MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
- Cardiff University Brain Research Imaging Centre, Maindy Road, Cardiff, CF24 4HQ, UK
| | - M J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
| | - M B M van den Bree
- MRC Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK
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Dolton HR, Gell FR, Hall J, Hall G, Hawkes LA, Witt MJ. Assessing the importance of Isle of Man waters for the basking shark Cetorhinus maximus. ENDANGER SPECIES RES 2020. [DOI: 10.3354/esr01018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Satellite tracking of endangered or threatened animals can facilitate informed conservation by revealing priority areas for their protection. Basking sharks Cetorhinus maximus (n = 11) were tagged during the summers of 2013, 2015, 2016 and 2017 in the Isle of Man (IoM; median tracking duration 378 d, range: 89-804 d; median minimum straight-line distance travelled 541 km, range: 170-10406 km). Tracking revealed 3 movement patterns: (1) coastal movements within IoM and Irish waters, (2) summer northward movements to Scotland and (3) international movements to Morocco and Norway. One tagged shark was bycaught and released alive in the Celtic Sea. Basking sharks displayed inter-annual site fidelity to the Irish Sea (n = 3), a Marine Nature Reserve (MNR) in IoM waters (n = 1), and Moroccan waters (n = 1). Core distribution areas (50% kernel density estimation) of 5 satellite tracked sharks in IoM waters were compared with 3902 public sightings between 2005 and 2017, highlighting west and south coast hotspots. Location data gathered from satellite tagging broadly correspond to the current boundaries of MNRs in IoM waters. However, minor modifications of some MNR boundaries would incorporate ~20% more satellite tracking location data from this study, and protective measures for basking sharks in IoM waters could further aid conservation of the species at local, regional and international scales. We also show the first documented movement of a basking shark from the British Isles to Norway, and the longest ever track for a tagged basking shark (2 yr and 2 mo, 804 d).
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Affiliation(s)
- HR Dolton
- University of Exeter College of Life and Environmental Sciences, Hatherly Laboratories, Prince of Wales Road, Exeter EX4 4PS, UK
- University of Exeter, Environment and Sustainability Institute, Penryn Campus, Cornwall TR10 9FE, UK
| | - FR Gell
- Department of Environment, Food and Agriculture, Thie Slieau Whallian, Foxdale Road, St John’s IM4 3AS, Isle of Man
| | - J Hall
- Manx Basking Shark Watch, Glenchass Farmhouse, Port St Mary IM9 5PJ, Isle of Man
| | - G Hall
- Manx Basking Shark Watch, Glenchass Farmhouse, Port St Mary IM9 5PJ, Isle of Man
| | - LA Hawkes
- University of Exeter College of Life and Environmental Sciences, Hatherly Laboratories, Prince of Wales Road, Exeter EX4 4PS, UK
| | - MJ Witt
- University of Exeter College of Life and Environmental Sciences, Hatherly Laboratories, Prince of Wales Road, Exeter EX4 4PS, UK
- University of Exeter, Environment and Sustainability Institute, Penryn Campus, Cornwall TR10 9FE, UK
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Serebriakoff P, Hartley F, Hall J, Porter K. An update on firearm police medical response. Trauma 2020. [DOI: 10.1177/1460408619885523] [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: 11/16/2022]
Affiliation(s)
| | - Fiona Hartley
- Palliative Care Medicine, Woodlands Hospice, Liverpool, UK
| | - J Hall
- Royal College of Surgeons of Edinburgh, Edinburgh, UK
| | - K Porter
- Department of Clinical Traumatology, University Hospital Birmingham, Queen Elizabeth, Birmingham, UK
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Frandrup J, Hall J, Reed D, Young J, Ward A, Sun X. Predicting Early Stages of Beef Respiratory Disease Using Thermal Imaging Technology. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesThe objective of this research was to utilize thermal imaging technology to estimate body temperature, so that an early stage of BRD can be detected.Materials and MethodsNinety-two steers were restrained in a squeeze chute that is housed in an indoor handling facility on 6 separate occasions. At least one image was taken of each side of the head using a thermal infrared camera (FLIR E8 WiFi, FLIR, Wilsonville, OR). The distance at which the images were taken was approximately 1 m from the steer. The rectal temperature was used as the control method to compare thermal imaging data. After thermal image acquisition, images were analyzed using the FLIR ResearchIR Max software (v. 4.40.8.28, FLIR, Wilsonville, OR), with the regions of interest being the eye and nasal cavity.ResultsThe analysis focused on minimum (MIN), maximum (MAX), mean, standard deviation (SD), and range of temperatures in the regions of interest. The REG procedure in SAS (v. 9.4, SAS Institute, Inc., Cary, NC) was used to perform stepwise regression to predict rectal temperature from the outdoor temperature (OTEMP) and all imaging features. When OTEMP was greater than –17.8°C, the regression model contained OTEMP, left nasal MAX, left nasal SD, and left eye MAX temperature and right eye temperature range, with an R2 of 0.24. When OTEMP was above freezing (0°C), the regression model contained left nasal temperature range, right eye temperature range, and average nasal mean temperature, with an R2 increase to 0.50. When using all data, the regression model fit left nasal MAX, right nasal MIN, average nasal mean, and left eye MAX temperatures and right eye temperature range, with an R2 of 0.08. These results show that thermal imaging technology has higher prediction accuracy in warmer temperature ranges than extreme cold conditions.ConclusionMore validation research on this thermal imaging technology needs to be conducted at warmer temperatures since all the current data was collected on cold winter days and a large portion of U.S. cattle are reared in more temperate and warmer areas than North Dakota such as Nebraska, Kansas, Texas, Oklahoma, and Florida. Overall, these results show promise for using thermal imaging technology to help detect BRD in an earlier stage by detecting fever before other clinical signs of BRD are present.
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Affiliation(s)
- J. Frandrup
- North Dakota State University Animal Science
| | - J. Hall
- North Dakota State University Animal Science
| | - D. Reed
- North Dakota State University Animal Science
| | - J. Young
- North Dakota State University Animal Science
| | - A. Ward
- North Dakota State University Animal Science
| | - X. Sun
- North Dakota State University Agricultural & Biosystems Engineering
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Pegram C, Brodbelt DC, Church DB, Hall J, Owen L, Chang Y, O'Neill DG. Associations between neutering and early-onset urinary incontinence in UK bitches under primary veterinary care. J Small Anim Pract 2019; 60:723-733. [PMID: 31589340 PMCID: PMC6916619 DOI: 10.1111/jsap.13072] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/02/2019] [Accepted: 09/02/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate association between neutering and early-onset urinary incontinence in bitches under primary veterinary care in the UK. MATERIALS AND METHODS A retrospective cohort study of bitches within VetCompass born between January 1, 2010 and December 31, 2012 that were followed until March 31, 2018. The clinical records were automatically searched and manually validated for incontinence cases. Incidence risk and rate over the study period were calculated. Cox regression modelling separately evaluated the hazard of urinary incontinence and association with neutering: (1) from the date of birth for all bitches, both neutered and entire; and, (2) from the date of neutering for the neutered subset. Other variables considered included breed, bodyweight and veterinary practice group. RESULTS Overall, 492 bitches were identified with early-onset urinary incontinence from a total of 72,971 included in the study period. Incidence risk was 0.68% (95% confidence intervals 0.62 to 0.74), while incidence rate increased with age. After accounting for confounding factors, increased hazard of early-onset urinary incontinence was identified in: (1) neutered bitches, with the effect increasing with age; and, (2) bitches neutered before 6 months, within the first 2 years following neutering. In both models, increased hazard was additionally associated with increasing bodyweight and breed. CLINICAL SIGNIFICANCE Neutering itself and early-age neutering (<6 months) are major risk factors for early-onset urinary incontinence. These results should be taken into account in making evidence-based recommendations on neutering and its timing.
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Affiliation(s)
- C. Pegram
- Pathobiology and Population ScienceThe Royal Veterinary CollegeHatfieldHertsAL9 7TAUK
| | - D. C. Brodbelt
- Pathobiology and Population ScienceThe Royal Veterinary CollegeHatfieldHertsAL9 7TAUK
| | - D. B. Church
- Clinical Sciences and ServicesThe Royal Veterinary CollegeHatfieldHertsAL9 7TAUK
| | - J. Hall
- Royal (Dick) School of Veterinary StudiesUniversity of Edinburgh, Easter BushRoslinEH25 9RGUK
| | - L. Owen
- Department of Veterinary MedicineUniversity of CambridgeCambridgeCB3 0ESUK
| | - Y.‐M. Chang
- Research Support OfficeThe Royal Veterinary CollegeHatfieldHertsAL9 7TAUK
| | - D. G. O'Neill
- Pathobiology and Population ScienceThe Royal Veterinary CollegeHatfieldHertsAL9 7TAUK
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Martins F, Couturier DL, de Santiago I, Vias M, Sanders D, Piskorz A, Hall J, Jimenez-Linan M, Hosking K, Crawford R, Brenton J. Combination of mTOR inhibition and paclitaxel as a personalised strategy in the context of MYC-amplified high-grade serous ovarian cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.038] [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: 11/14/2022] Open
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Shah A, McAllister D, Astengo F, Perez J, Lee KK, Gallacher P, Hall J, Bing R, Anand A, Newby D, Mills N, Cruden N. 3325Incidence, outcomes and microbiology in patients with infective endocarditis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Despite recent improvements in management, infective endocarditis remains associated with high morbidity and mortality. Over the last few decades, several factors have impacted on both the incidence and outcomes following infective endocarditis.
Purpose
Using a national linkage approach, we describe the changing age- and sex-stratified incidence and outcomes of infective endocarditis in Scotland over the last 25 years.
Methods
We conducted a consecutive retrospective individual patient linkage study across multiple national databases. Using data extracted from the Scottish hospital discharge dataset held by the Information Services Division of NHS National Services Scotland, we extracted episodes for all patients aged 20 years or older who were admitted with infective endocarditis between January 1, 1990, and December 31, 2014 in Scotland, UK. Patient episodes with infective endocarditis were linked to national prescribing and microbiology databases. The primary outcome was 1-year mortality following the index presentation. Generalised additive models were constructed to estimate the crude and age- and sex-stratified incidence rates (using a poison distribution) as well as trends in mortality (using a binomial distribution) adjusted for age, sex and comorbidity.
Results
Across 12,446 individual patients, there were a total of 12,667 hospitalisations (mean age 68±17 years, 55% females) with infective endocarditis using a 5-year look back period. The estimated crude rate of hospitalisation increased from 7.38 per 100,000 (95% CI 6.58 to 8.28) in 1990 to 15.09 per 100,000 (95% CI 13.90 to 16.39) in 2014 (p<0.001). Over the period of the study, 31% (3,877/12,667) of people admitted to hospital with infective endocarditis died within one year of admission. Case fatality fell markedly in both men and women from 1990 to 2014 (Figure). Microbiology was status was available for 34% of all hospitalisations with staphylococcus cultures associated with worse outcomes.
Conclusions
Despite the crude incidence of infective endocarditis doubling over the last 25 years and case fatality remaining high, the risk of death has markedly fallen over the last two decades. Staphylococcus cultures remain an independent marker of poor prognosis in this cohort.
Acknowledgement/Funding
British Heart Foundation
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Affiliation(s)
- A Shah
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | | | - F Astengo
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Perez
- University of Glasgow, Glasgow, United Kingdom
| | - K K Lee
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - P Gallacher
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - J Hall
- University of Edinburgh, Edinburgh, United Kingdom
| | - R Bing
- University of Edinburgh, Edinburgh, United Kingdom
| | - A Anand
- University of Edinburgh, Edinburgh, United Kingdom
| | - D Newby
- University of Edinburgh, Edinburgh, United Kingdom
| | - N Mills
- University of Edinburgh, Edinburgh, United Kingdom
| | - N Cruden
- University of Edinburgh, Edinburgh, United Kingdom
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Akhavan A, Johnson N, Friedman B, Jablonowski K, Hall J, Hall M, Henning D. 355 Assessing the Prognostic Value of Lactate Levels in the Presence of Ethanol Among Emergency Department Patients. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dieterich K, Le Tanno P, Kimber E, Jouk PS, Hall J, Giampietro P. The diagnostic workup in a patient with AMC: Overview of the clinical evaluation and paraclinical analyses with review of the literature. Am J Med Genet C Semin Med Genet 2019; 181:337-344. [PMID: 31368648 DOI: 10.1002/ajmg.c.31730] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 11/10/2022]
Abstract
Arthrogryposis multiplex congenita, or AMC, is a clinical sign defined as congenital contractures of at least two joint levels. These joint contractures are always secondary to diminished fetal movement which can have numerous causes that affect any part of the anatomical structures implicated in movement: the central nervous system, the anterior horn cell, the nerve, the neuromuscular junction, the muscle, or the joint itself. Make a precise diagnosis of the cause in a patient with multiple joint contractures is therefore challenging. The aim of this article is to summarize the use and diagnostic value of common examinations and analyses performed postnatally in patients affected by AMC from a literature review. We also compare this data with results from our clinical practice. Even though it is difficult to give precise guidelines today, it appears that genetic studies, such as whole exome or genome analysis in all patients and chromosomal microarray analysis in patients with intellectual disability and AMC should be preferred as first tier investigations over EMG and muscle biopsy.
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Affiliation(s)
- Klaus Dieterich
- University of Grenoble Alpes, Inserm, U1216, GIN, Grenoble, France.,Department of Medical Genetics, CHU Grenoble Alpes, Génétique Médicale, Grenoble, France
| | - Pauline Le Tanno
- Department of Medical Genetics, CHU Grenoble Alpes, Génétique Médicale, Grenoble, France
| | - Eva Kimber
- Department of Pediatrics, Sahlgrenska Academy, Goteborg, Sweden
| | - Pierre-Simon Jouk
- Department of Medical Genetics, CHU Grenoble Alpes, Génétique Médicale, Grenoble, France
| | - Judith Hall
- Children's & Women's Health Centre of BC, Medical Genetics, UBC, Vancouver, British Columbia, Canada
| | - Philip Giampietro
- Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, New Jersey, USA
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Drage LKL, Robson W, Mowbray C, Ali A, Perry JD, Walton KE, Harding C, Pickard R, Hall J, Aldridge PD. Elevated urine IL-10 concentrations associate with Escherichia coli persistence in older patients susceptible to recurrent urinary tract infections. Immun Ageing 2019; 16:16. [PMID: 31338112 PMCID: PMC6625057 DOI: 10.1186/s12979-019-0156-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/01/2019] [Indexed: 12/19/2022]
Abstract
Background Age is a significant risk factor for recurrent urinary tract (rUTI) infections, but the clinical picture is often confused in older patients who also present with asymptomatic bacteriuria (ASB). Yet, how bacteriuria establishes in such patients and the factors underpinning and/or driving symptomatic UTI episodes are still not understood. To explore this further a pilot study was completed in which 30 male and female community based older patients (mean age 75y) presenting clinically with ASB / rUTIs and 15 control volunteers (72y) were recruited and monitored for up to 6 months. During this period symptomatic UTI episodes were recorded and urines collected for urinary cytokine and uropathogenic Escherichia coli (UPEC) analyses. Results Eighty-six per cent of patients carried E. coli (102 ≥ 105 CFU/ml urine) at some point throughout the study and molecular typing identified 26 different E. coli strains in total. Analyses of urine samples for ten different cytokines identified substantial patient variability. However, when examined longitudinally the pro-inflammatory markers, IL-1 and IL-8, and the anti-inflammatory markers, IL-5 and IL-10, were significantly different in the patient urines compared to those of the controls (P < 0.0001). Furthermore, analysing the cytokine data of the rUTI susceptible cohort in relation to E. coli carriage, showed the mean IL-10 concentration to be significantly elevated (P = 0.04), in patients displaying E. coli numbers ≥105 CFU/ml. Conclusions These pilot study data suggest that bacteriuria, characteristic of older rUTI patients, is associated with an immune homeostasis in the urinary tract involving the synthesis and activities of the pro and anti-inflammatory cytokines IL-1, IL-5, IL-8 and IL-10. Data also suggests a role for IL-10 in regulating bacterial persistence.
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Affiliation(s)
- Lauren K L Drage
- 1Centre for Bacterial Cell Biology, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK.,2Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, NE2 4AH UK.,Present Address: GlaxoSmithKline, Gunnels Wood Road, Stevenage, SG1 2NY UK
| | - Wendy Robson
- 3Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Catherine Mowbray
- 2Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, NE2 4AH UK
| | - Ased Ali
- 2Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, NE2 4AH UK.,3Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,4Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,7Present Address: Department of Urology, Pinderfields Hospital, Wakefield, WF1 4DG UK
| | - John D Perry
- 5Microbiology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Katherine E Walton
- 5Microbiology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Christopher Harding
- 3Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Robert Pickard
- 3Urology Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,4Institute for Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Judith Hall
- 2Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, NE2 4AH UK
| | - Phillip D Aldridge
- 1Centre for Bacterial Cell Biology, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK.,2Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, NE2 4AH UK
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Amole C, Ardid M, Arnquist I, Asner D, Baxter D, Behnke E, Bressler M, Broerman B, Cao G, Chen C, Chowdhury U, Clark K, Collar J, Cooper P, Coutu C, Cowles C, Crisler M, Crowder G, Cruz-Venegas N, Dahl C, Das M, Fallows S, Farine J, Felis I, Filgas R, Girard F, Giroux G, Hall J, Hardy C, Harris O, Hillier T, Hoppe E, Jackson C, Jin M, Klopfenstein L, Kozynets T, Krauss C, Laurin M, Lawson I, Leblanc A, Levine I, Licciardi C, Lippincott W, Loer B, Mamedov F, Mitra P, Moore C, Nania T, Neilson R, Noble A, Oedekerk P, Ortega A, Piro MC, Plante A, Podviyanuk R, Priya S, Robinson A, Sahoo S, Scallon O, Seth S, Sonnenschein A, Starinski N, Štekl I, Sullivan T, Tardif F, Vázquez-Jáuregui E, Walkowski N, Weima E, Wichoski U, Wierman K, Yan Y, Zacek V, Zhang J. Dark matter search results from the complete exposure of the PICO-60
C3F8
bubble chamber. Int J Clin Exp Med 2019. [DOI: 10.1103/physrevd.100.022001] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [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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