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Astridge DJ, McKenna M, Campbell A, Turner AP. Haemoglobin mass responses and performance outcomes among high-performance swimmers following a 3-week live-high, train-high camp at 2320 m. Eur J Appl Physiol 2024:10.1007/s00421-024-05454-x. [PMID: 38526610 DOI: 10.1007/s00421-024-05454-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
AIM Greater quantification and characterisation of training load (TL) throughout Live-high, train-high (LHTH) altitude (ALT) training is required to identify periodisation strategies that may lead to physiological and performance improvements in swimmers. PURPOSE This study aimed to examine the physiological responses and performance outcomes of 14 high-performance swimmers (FINA points: 836.0 ± 35.1) following 3 weeks of LHTH at 2320 m, while characterising the training load periodisation strategy adopted during the intervention. METHODS Haemoglobin (Hb) mass was measured pre-, 7 and 14 days post-ALT via CO rebreathing. Performance in each athlete's primary event at national standard meets were converted to FINA points and compared from pre-to-post-ALT. TL was quantified at sea level (SL) and ALT through session rating of perceived exertion (RPE), where duration of each session was multiplied by its RPE for each athlete, with all sessions totalled to give a weekly TL. Pre-to-post-ALT changes were evaluated using repeated-measures ANOVA. RESULTS Hb mass increased significantly from 798 ± 182 g pre-ALT to 828 ± 187 g at 7 days post (p = 0.013) and 833 ± 205 g 14 days post-ALT (p = 0.026). Weekly TL increased from SL (3179 ± 638 au) during week one (4797 ± 1349 au, p < 0.001) and week two (4373 ± 967 au, p < 0.001), but not week three (3511 ± 730 au, p = 0.149). No evidence of improved SL swimming performance was identified. CONCLUSION A periodisation strategy characterised by a sharp spike in TL followed by a slight de-load towards the end of a LHTH intervention led to improved physiological characteristics but no change in the competitive performance of high-performance swimmers.
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Affiliation(s)
- Daniel J Astridge
- Human Performance Science Research Group, Institute of Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK.
| | - Michael McKenna
- Performance Physiology Department, Sportscotlandscotland Institute of Sport, Stirling, Scotland, UK
| | - Adrian Campbell
- Performance Physiology Department, Sportscotlandscotland Institute of Sport, Stirling, Scotland, UK
| | - Anthony P Turner
- Human Performance Science Research Group, Institute of Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK
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Patel KP, McKenna M, Thornton GD, Vandermolen S, Abdulelah ZA, Awad W, Baumbach A, Mathur A, Treibel TA, Lloyd G, Mullen MJ, Bhattacharyya S. Predictors of outcome in patients with moderate mixed aortic valve disease. Heart 2023:heartjnl-2023-323321. [PMID: 38148159 DOI: 10.1136/heartjnl-2023-323321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES Grading the severity of moderate mixed aortic stenosis and regurgitation (MAVD) is challenging and the disease poorly understood. Identifying markers of haemodynamic severity will improve risk stratification and potentially guide timely treatment. This study aims to identify prognostic haemodynamic markers in patients with moderate MAVD. METHODS Moderate MAVD was defined as coexisting moderate aortic stenosis (aortic valve area (AVA) 1.0-1.5 cm2) and moderate aortic regurgitation (vena contracta (VC) 0.3-0.6 cm). Consecutive patients diagnosed between 2015 and 2019 were included from a multicentre registry. The primary composite outcome of death or heart failure hospitalisation was evaluated among these patients. Demographics, comorbidities, echocardiography and treatment data were assessed for their prognostic significance. RESULTS 207 patients with moderate MAVD were included, aged 78 (66-84) years, 56% male sex, AVA 1.2 (1.1-1.4) cm2 and VC 0.4 (0.4-0.5) cm. Over a follow-up of 3.5 (2.5-4.7) years, the composite outcome was met in 89 patients (43%). Univariable associations with the primary outcome included older age, previous myocardial infarction, previous cerebrovascular event, atrial fibrillation, New York Heart Association >2, worse renal function, tricuspid regurgitation ≥2 and mitral regurgitation ≥2. Markers of biventricular systolic function, cardiac remodelling and transaortic valve haemodynamics demonstrated an inverse association with the primary composite outcome. In multivariable analysis, peak aortic jet velocity (Vmax) was independently and inversely associated with the composite outcome (HR: 0.63, 95% CI 0.43 to 0.93; p=0.021) in an adjusted model along with age (HR: 1.05, 95% CI 1.03 to 1.08; p<0.001), creatinine (HR: 1.002, 95% CI 1.001 to 1.003; p=0.005), previous cerebrovascular event (85% vs 42%; HR: 3.04, 95% CI 1.54 to 5.99; p=0.001) and left ventricular ejection fraction (LVEF) (HR: 0.97, 95% CI 0.95 to 0.99; p=0.007). Patients with Vmax ≤2.8 m/s and LVEF ≤50% (n=27) had the worst outcome compared with the rest of the population (72% vs 41%; HR: 3.87, 95% CI 2.20 to 6.80; p<0.001). CONCLUSIONS Patients with truly moderate MAVD have a high incidence of death and heart failure hospitalisation (43% at 3.5 (2.5-4.7) years). Within this group, a high-risk group characterised by disproportionately low aortic Vmax (≤2.8 m/s) and adverse remodelling (LVEF ≤50%) have the worst outcomes.
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Affiliation(s)
- Kush P Patel
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, West Smithfield, London, UK
| | | | - George D Thornton
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, West Smithfield, London, UK
| | - Sebastian Vandermolen
- Institute of Cardiovascular Science, University College London, London, UK
- The William Harvey Research Institute, Queen Mary University, London, UK
| | | | - Wael Awad
- Barts Heart Centre, West Smithfield, London, UK
| | - Andreas Baumbach
- Barts Heart Centre, West Smithfield, London, UK
- The William Harvey Research Institute, Queen Mary University, London, UK
| | - Anthony Mathur
- Barts Heart Centre, West Smithfield, London, UK
- The William Harvey Research Institute, Queen Mary University, London, UK
| | - Thomas A Treibel
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, West Smithfield, London, UK
| | - Guy Lloyd
- Barts Heart Centre, West Smithfield, London, UK
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Yelverton CA, O'Keeffe LM, Bartels HC, McDonnell C, Geraghty AA, O'Brien EC, Killeen SL, Twomey P, Kilbane M, Crowley RK, McKenna M, McAuliffe FM. Association between maternal blood lipids during pregnancy and offspring growth trajectories in a predominantly macrosomic cohort: findings from the ROLO longitudinal birth cohort study. Eur J Pediatr 2023; 182:5625-5635. [PMID: 37819419 DOI: 10.1007/s00431-023-05251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/26/2023] [Accepted: 10/01/2023] [Indexed: 10/13/2023]
Abstract
The purpose of this study is to examine associations between maternal lipid profiles in pregnancy and offspring growth trajectories in a largely macrosomic cohort. This is a secondary analysis of the ROLO birth cohort (n = 293), which took place in the National Maternity Hospital, Dublin, Ireland. Infants were mostly macrosomic, with 55% having a birthweight > 4 kg. Maternal mean age was 32.4 years (SD 3.9 years), mean BMI was 26.1 kg/m2 (SD 4.4 kg/m2) and 48% of children born were males. Total cholesterol, high density lipoprotein cholesterol (HDL-cholesterol), low density lipoprotein cholesterol (LDL-cholesterol) and triglycerides were measured from fasting blood samples of mothers at 14 and 28 week gestation. The change in maternal lipid levels from early to late pregnancy was also examined. Offspring abdominal circumference and weight were measured at 20- and 34-week gestation, birth, 6 months, 2 years and 5 years postnatal. Linear spline multilevel models examined associations between maternal blood lipid profiles and offspring growth. We found some weak, significant associations between maternal blood lipids and trajectories of offspring growth. Significant findings were close to the null, providing limited evidence. For instance, 1 mmol/L increase in maternal triglycerides was associated with faster infant weight growth from 20- to 34-week gestation (0.01 kg/week, 95% CI - 0.02, - 0.001) and slower abdominal circumference from 2 to 5 years (0.01 cm/week, 95% CI - 0.02, - 0.001). These findings do not provide evidence of a clinically meaningful effect. Conclusion: These findings raise questions about the efficacy of interventions targeting maternal blood lipid profiles in pregnancies at risk of macrosomia. New studies on this topic are needed. What is Known: • Maternal fat accumulation during early pregnancy may potentially support fetal growth in the third trimester by providing a reserve of lipids that are broken down and transferred to the infant across the placental barrier. • There are limited studies exploring the impact of maternal lipid profiles on infant and child health using growth trajectories spanning prenatal to postnatal life. What is New: • Maternal blood lipid profiles were not associated with offspring growth trajectories of weight and abdominal circumference during pregnancy up to 5 years of age in a largely macrosomic cohort, as significant findings were close to the null, providing limited evidence for a clinically meaningful relationship. • Strengths of this work include the use of infant growth trajectories that span prenatal to postnatal life and inclusion of analyses of the change of maternal lipid levels from early to late pregnancy and their associations with offspring growth trajectories from 20-week gestation to 5 years of age.
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Affiliation(s)
- C A Yelverton
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - L M O'Keeffe
- School of Public Health, University College Cork, Cork, Ireland
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - H C Bartels
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - C McDonnell
- Department of Paediatric Endocrinology & Diabetes, Children's Health Ireland, Temple Street Hospital, Dublin, Ireland
| | - A A Geraghty
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - E C O'Brien
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| | - S L Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - P Twomey
- Department of Clinical Chemistry, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - M Kilbane
- Department of Clinical Chemistry, St Vincent's University Hospital, Dublin, Ireland
| | - R K Crowley
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Endocrinology & Diabetes Mellitus, St Vincent's University Hospital, Dublin, Ireland
| | - M McKenna
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Endocrinology & Diabetes Mellitus, St Vincent's University Hospital, Dublin, Ireland
| | - F M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
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Chandasana H, Marnoch R, McKenna M, Double J, Seal C, Bontempo G, Wolstenholme A, Buchanan A. Effect of Food on the Pediatric Dispersible Tablet Formulations of TRIUMEQ and DOVATO in Healthy Adult Participants. Pharmaceutics 2023; 15:pharmaceutics15051470. [PMID: 37242711 DOI: 10.3390/pharmaceutics15051470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
This randomized food effect study in healthy adult participants examined dispersible tablet formulations of fixed-dose combinations of dolutegravir/abacavir/lamivudine (TRIUMEQ) and dolutegravir/lamivudine (DOVATO). While adult tablet formulations of these combinations are currently approved for the treatment of human immunodeficiency virus, alternate formulations for children are urgently needed to facilitate appropriate pediatric dosing for patients who may have difficulty swallowing a conventional tablet. This study compared the effect of a high-fat, high-calorie meal on the pharmacokinetics, safety, and tolerability of dispersible tablet (DT) formulations of the two-drug and three-drug regimens, with administration under fasting conditions. Both the two-drug and three-drug dispersible tablet formulations, administered under fasting conditions and following a high-fat, high-calorie meal, were well tolerated in healthy participants. There were no clinically relevant differences in drug exposure for either regimen when administered with a high-fat meal as compared to under fasting conditions. Safety observations were similar for both treatments, either in the fed or fasted state. Both TRIUMEQ DT and DOVATO DT formulations can be administer with or without food.
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Affiliation(s)
- Hardik Chandasana
- Clinical Pharmacology Modeling and Simulation, GSK, Collegeville, PA 19426, USA
| | | | | | - Julia Double
- Safety and Medical Governance, GSK, London TW8 9GS, UK
| | - Ciara Seal
- In Vitro/In Vivo Translation, GSK, Collegeville, PA 19426, USA
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Reed BD, Meyer MJ, Abramzon V, Ad O, Ad O, Adcock P, Ahmad FR, Alppay G, Ball JA, Beach J, Belhachemi D, Bellofiore A, Bellos M, Beltrán JF, Betts A, Bhuiya MW, Blacklock K, Boer R, Boisvert D, Brault ND, Buxbaum A, Caprio S, Choi C, Christian TD, Clancy R, Clark J, Connolly T, Croce KF, Cullen R, Davey M, Davidson J, Elshenawy MM, Ferrigno M, Frier D, Gudipati S, Hamill S, He Z, Hosali S, Huang H, Huang L, Kabiri A, Kriger G, Lathrop B, Li A, Lim P, Liu S, Luo F, Lv C, Ma X, McCormack E, Millham M, Nani R, Pandey M, Parillo J, Patel G, Pike DH, Preston K, Pichard-Kostuch A, Rearick K, Rearick T, Ribezzi-Crivellari M, Schmid G, Schultz J, Shi X, Singh B, Srivastava N, Stewman SF, Thurston TR, Thurston TR, Trioli P, Tullman J, Wang X, Wang YC, Webster EAG, Zhang Z, Zuniga J, Patel SS, Griffiths AD, van Oijen AM, McKenna M, Dyer MD, Rothberg JM. Real-time dynamic single-molecule protein sequencing on an integrated semiconductor device. Science 2022; 378:186-192. [PMID: 36227977 DOI: 10.1126/science.abo7651] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Studies of the proteome would benefit greatly from methods to directly sequence and digitally quantify proteins and detect posttranslational modifications with single-molecule sensitivity. Here, we demonstrate single-molecule protein sequencing using a dynamic approach in which single peptides are probed in real time by a mixture of dye-labeled N-terminal amino acid recognizers and simultaneously cleaved by aminopeptidases. We annotate amino acids and identify the peptide sequence by measuring fluorescence intensity, lifetime, and binding kinetics on an integrated semiconductor chip. Our results demonstrate the kinetic principles that allow recognizers to identify multiple amino acids in an information-rich manner that enables discrimination of single amino acid substitutions and posttranslational modifications. With further development, we anticipate that this approach will offer a sensitive, scalable, and accessible platform for single-molecule proteomic studies and applications.
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Affiliation(s)
| | | | | | - Omer Ad
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | - Omer Ad
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | - Pat Adcock
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | - Gün Alppay
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mel Davey
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | | | | | | | | | - Zhaoyu He
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | - Le Huang
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | - Ali Kabiri
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | - An Li
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | - Peter Lim
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | - Caixia Lv
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | | | - Roger Nani
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xin Wang
- Quantum-Si, Inc., Guilford, CT 06437, USA
| | | | | | | | | | - Smita S Patel
- Department of Biochemistry and Molecular Biology, Rutgers University, Piscataway, NJ 08854, USA
| | - Andrew D Griffiths
- Laboratoire de Biochimie, ESPCI Paris, Université PSL, CNRS UMR 8231, Paris, France
| | - Antoine M van Oijen
- Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
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McKenna M, Filteau JR, Butler B, Sluis K, Chungyoun M, Schimek N, Nance E. Organotypic whole hemisphere brain slice models to study the effects of donor age and oxygen-glucose-deprivation on the extracellular properties of cortical and striatal tissue. J Biol Eng 2022; 16:14. [PMID: 35698088 PMCID: PMC9195469 DOI: 10.1186/s13036-022-00293-w] [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: 02/10/2022] [Accepted: 05/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The brain extracellular environment is involved in many critical processes associated with neurodevelopment, neural function, and repair following injury. Organization of the extracellular matrix and properties of the extracellular space vary throughout development and across different brain regions, motivating the need for platforms that provide access to multiple brain regions at different stages of development. We demonstrate the utility of organotypic whole hemisphere brain slices as a platform to probe regional and developmental changes in the brain extracellular environment. We also leverage whole hemisphere brain slices to characterize the impact of cerebral ischemia on different regions of brain tissue. RESULTS Whole hemisphere brain slices taken from postnatal (P) day 10 and P17 rats retained viable, metabolically active cells through 14 days in vitro (DIV). Oxygen-glucose-deprivation (OGD), used to model a cerebral ischemic event in vivo, resulted in reduced slice metabolic activity and elevated cell death, regardless of slice age. Slices from P10 and P17 brains showed an oligodendrocyte and microglia-driven proliferative response after OGD exposure, higher than the proliferative response seen in DIV-matched normal control slices. Multiple particle tracking in oxygen-glucose-deprived brain slices revealed that oxygen-glucose-deprivation impacts the extracellular environment of brain tissue differently depending on brain age and brain region. In most instances, the extracellular space was most difficult to navigate immediately following insult, then gradually provided less hindrance to extracellular nanoparticle diffusion as time progressed. However, changes in diffusion were not universal across all brain regions and ages. CONCLUSIONS We demonstrate whole hemisphere brain slices from P10 and P17 rats can be cultured up to two weeks in vitro. These brain slices provide a viable platform for studying both normal physiological processes and injury associated mechanisms with control over brain age and region. Ex vivo OGD impacted cortical and striatal brain tissue differently, aligning with preexisting data generated in in vivo models. These data motivate the need to account for both brain region and age when investigating mechanisms of injury and designing potential therapies for cerebral ischemia.
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Affiliation(s)
- Michael McKenna
- Department of Chemical Engineering, University of Washington, 105 Benson Hall, Box 351750, Seattle, WA, 98195-1750, USA
| | - Jeremy R Filteau
- Department of Chemical Engineering, University of Washington, 105 Benson Hall, Box 351750, Seattle, WA, 98195-1750, USA
| | - Brendan Butler
- Department of Chemical Engineering, University of Washington, 105 Benson Hall, Box 351750, Seattle, WA, 98195-1750, USA
| | - Kenneth Sluis
- Department of Chemical Engineering, University of Washington, 105 Benson Hall, Box 351750, Seattle, WA, 98195-1750, USA
| | - Michael Chungyoun
- Department of Chemical Engineering, University of Washington, 105 Benson Hall, Box 351750, Seattle, WA, 98195-1750, USA
| | - Nels Schimek
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | - Elizabeth Nance
- Department of Chemical Engineering, University of Washington, 105 Benson Hall, Box 351750, Seattle, WA, 98195-1750, USA. .,e-Science Institute, University of Washington, Seattle, WA, USA. .,Department of Bioengineering, University of Washington, Seattle, WA, USA.
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7
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Sinha A, McKenna M, Kollikonda S, Yao M, Mei L, Valentine L, Russo ML, Hornacek D, Kho R. The risk of venous thromboembolism in patients with and without leiomyomas undergoing hysterectomy. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.113] [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: 11/01/2022]
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McKenna M, Ye T, Nannapaneni R, Patel C. 58 Should Single Group and Save (G&S) Sampling be Implemented in Spinal Cord Stimulation Surgery (SCSS)? Br J Surg 2021. [DOI: 10.1093/bjs/znab259.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
SCSS is offered to patients who have persistent chronic neuropathic pain after trials of conservative management. Although severe bleeding complications are rare, it is common practice to take two G&S samples from patients pre-operatively. Unnecessary testing can induce patient anxiety and is a financial burden to the NHS. We aim to determine if a single G&S sample before SCSS would be beneficial, and to assess the association between number of risk factors for bleeding and blood loss in SCSS.
Method
Retrospective analysis of 100 patients in one centre who had SCSS over a 3-year period. Bleeding risk factors, haemoglobin levels and complications were recorded for each patient. A review of current literature along with a cost analysis was subsequently performed.
Results
An average drop in haemoglobin levels of 9g/L post-operatively was seen. No patients required blood transfusions. There was no statistically significant difference (P = 0.364) between number of risk factors and blood loss.
Conclusions
The results obtained suggest that SCSS carries a low risk of adverse bleeding requiring blood transfusions. With the lack of guidelines for preoperative G&S samples it is difficult to make decisions on the amount of samples needed before SCSS. Single G&S sampling in patients without bleeding risk factors can reduce patient burden, save costs, and reduce environmental footprints left by laboratory tests. Those with risk factors may still benefit from two pre-operative G&S samples to ensure patient safety.
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Affiliation(s)
- M McKenna
- Neuroscience Department, University Hospital of Wales, Cardiff, United Kingdom
| | - T Ye
- Cardiff University, University Hospital of Wales, Cardiff, United Kingdom
| | - R Nannapaneni
- Neuroscience Department, University Hospital of Wales, Cardiff, United Kingdom
| | - C Patel
- Neuroscience Department, University Hospital of Wales, Cardiff, United Kingdom
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9
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Allman M, McKenna M, Leopard D, Backhouse S. 1342 Screening Patients’ Temperature in COVID-era Outpatient Clinics: An Overreliance on Unreliable Devices? Br J Surg 2021. [DOI: 10.1093/bjs/znab259.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
The Covid-19 pandemic continues to impair patient access to hospital clinics. One way of enabling outpatient services to continue safely is to screen for pyrexia by checking patients’ temperature prior to their clinic appointment. Infrared tympanic thermometers (ITT) are commonly used as a surrogate marker of core temperature. Non-contact infrared cutaneous thermometers (NICT) are increasingly favoured as they require no direct contact with patients. The aim was to measure the concordance of temperature readings between ITT and NICT on patients attending ENT outpatient clinic at one hospital.
Method
Body temperature was recorded using ITT and NICT on 63 sequential patients. Agreement was tested using a Bland-Altman plot with 95% confidence interval and paired T-tests.
Results
Mean body temperature was significantly lower (p < 0.05) for the NICT [36.3 °C (95% CI 36.2 °C-36.4 °C)] compared with the ITT [36.6 °C (95% CI 36.5 °C-36.7 °C)]. The NICT measured on average 0.34 °C (95% CI 0.33 °C-0.35 °C) lower than the ITT. The Bland-Altman plot showed moderate agreement of the two methods (SD 0.46 °C; limits -1.25 °c to 0.57 °c); however, disagreement was greater at higher and lower temperature extremes.
Conclusions
Screening patients for pyrexia aims to help prevent spread of COVID-19. False negatives result in a missed opportunity to break the chain of transmission. A significant proportion of false negatives may reverse any intended benefit. NICT are convenient but may be more susceptible to false negatives when assessing for pyrexia and may provide little more than false reassurance when used for pyrexia screening.
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Affiliation(s)
- M Allman
- Princess of Wales Hospital, Bridgend, United Kingdom
| | - M McKenna
- Prince Charles Hospital, Merthyr Tydfil, United Kingdom
| | - D Leopard
- Morriston Hospital, Swansea, United Kingdom
| | - S Backhouse
- Princess of Wales Hospital, Bridgend, United Kingdom
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10
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McKenna M, Shackelford D, Ferreira Pontes H, Ball B, Nance E. Multiple Particle Tracking Detects Changes in Brain Extracellular Matrix and Predicts Neurodevelopmental Age. ACS Nano 2021; 15:8559-8573. [PMID: 33969999 PMCID: PMC8281364 DOI: 10.1021/acsnano.1c00394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Brain extracellular matrix (ECM) structure mediates many aspects of neural development and function. Probing structural changes in brain ECM could thus provide insights into mechanisms of neurodevelopment, the loss of neural function in response to injury, and the detrimental effects of pathological aging and neurological disease. We demonstrate the ability to probe changes in brain ECM microstructure using multiple particle tracking (MPT). We performed MPT of colloidally stable polystyrene nanoparticles in organotypic rat brain slices collected from rats aged 14-70 days old. Our analysis revealed an inverse relationship between nanoparticle diffusive ability in the brain extracellular space and age. Additionally, the distribution of effective ECM pore sizes in the cortex shifted to smaller pores throughout development. We used the raw data and features extracted from nanoparticle trajectories to train a boosted decision tree capable of predicting chronological age with high accuracy. Collectively, this work demonstrates the utility of combining MPT with machine learning for measuring changes in brain ECM structure and predicting associated complex features such as chronological age. This will enable further understanding of the roles brain ECM play in development and aging and the specific mechanisms through which injuries cause aberrant neuronal function. Additionally, this approach has the potential to develop machine learning models capable of detecting the presence of injury or indicating the extent of injury based on changes in the brain microenvironment microstructure.
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Affiliation(s)
- Michael McKenna
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - David Shackelford
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - Hugo Ferreira Pontes
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - Brendan Ball
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - Elizabeth Nance
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
- Department of Radiology, University of Washington, Seattle, Washington 98195, United States
- Center on Human Development and Disability, University of Washington, Seattle, Washington 98195, United States
- eScience Institute, University of Washington, Seattle, Washington 98195, United States
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11
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Scherpereel A, Antonia S, Bautista Y, Grossi F, Kowalski D, Zalcman G, Nowak A, Fujimoto N, Peters S, Tsao A, Mansfield A, Popat S, Sun X, Padilla B, Aanur P, Daumont M, Bennett B, McKenna M, Baas P. LBA1 First-line nivolumab (NIVO) plus ipilimumab (IPI) versus chemotherapy (chemo) for the treatment of unresectable malignant pleural mesothelioma (MPM): Patient-reported outcomes (PROs) from CheckMate 743. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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12
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McKenna M, Abdelaal A. Group & save sampling in lumbar decompression: A review into current practice. J Perioper Pract 2020; 31:15-17. [PMID: 33225836 DOI: 10.1177/1750458920950664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The risks, benefits and technical aspects of surgery require careful consideration. One element of this is the requirement of postoperative blood transfusion. Patients who undergo elective lumbar decompression are at a low risk of requiring a postoperative transfusion yet undergo multiple preoperative group & save tests. For those who are at a low risk of bleeding, a single group & save sample may be adequate. This review analysed the postoperative blood loss and transfusion rate associated with lumbar decompression surgery without fusion in one institution. A subsequent cost analysis and review of the literature was performed. The aim was to assess whether single group & save sampling, within the context of lumbar decompression, was cost effective and amenable to the patient without impacting patient care. Average blood loss was estimated as a drop in Hb of 12.3g/dl. Six patients (14%) had Hb loss of over 20g/dl. No patients underwent a blood transfusion. Through examination of medical records, we found that 65% of patients (35) were suitable for single group & save sampling, estimating a saving of £2415.95 (53%). Selective group & save testing holds economic potential and safeguards patients from undergoing unnecessary testing. The next step after this review would be a prospective multi-centre study.
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Affiliation(s)
- M McKenna
- 97644Royal Gwent Hospital, Newport, UK
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13
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Plaks JG, Brewer JA, Jacobsen NK, McKenna M, Uzarski JR, Lawton TJ, Filocamo SF, Kaar JL. Rosetta-Enabled Structural Prediction of Permissive Loop Insertion Sites in Proteins. Biochemistry 2020; 59:3993-4002. [PMID: 32970423 DOI: 10.1021/acs.biochem.0c00533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While loop motifs frequently play a major role in protein function, our understanding of how to rationally engineer proteins with novel loop domains remains limited. In the absence of rational approaches, the incorporation of loop domains often destabilizes proteins, thereby requiring massive screening and selection to identify sites that can accommodate loop insertion. We developed a computational strategy for rapidly scanning the entire structure of a scaffold protein to determine the impact of loop insertion at all possible amino acid positions. This approach is based on the Rosetta kinematic loop modeling protocol and was demonstrated by identifying sites in lipase that were permissive to insertion of the LAP peptide. Interestingly, the identification of permissive sites was dependent on the contribution of the residues in the near-loop environment on the Rosetta score and did not correlate with conventional structural features (e.g., B-factors). As evidence of this, several insertion sites (e.g., following residues 17, 47-49, and 108), which were predicted and confirmed to be permissive, interrupted helices, while others (e.g., following residues 43, 67, 116, 119, and 121), which are situated in loop regions, were nonpermissive. This approach was further shown to be predictive for β-glucosidase and human phosphatase and tensin homologue (PTEN), and to facilitate the engineering of insertion sites through in silico mutagenesis. By enabling the design of loop-containing protein libraries with high probabilities of soluble expression, this approach has broad implications in many areas of protein engineering, including antibody design, improving enzyme activity, and protein modification.
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Affiliation(s)
- Joseph G Plaks
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Boulder, Colorado 80309, United States
| | - Jeff A Brewer
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Boulder, Colorado 80309, United States
| | - Nicole K Jacobsen
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Boulder, Colorado 80309, United States
| | - Michael McKenna
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Boulder, Colorado 80309, United States
| | - Joshua R Uzarski
- U.S. Army Combat Capabilities Development Command Soldier Center, Natick, Massachusetts 01760, United States
| | - Timothy J Lawton
- U.S. Army Combat Capabilities Development Command Soldier Center, Natick, Massachusetts 01760, United States
| | - Shaun F Filocamo
- U.S. Army Combat Capabilities Development Command Soldier Center, Natick, Massachusetts 01760, United States
| | - Joel L Kaar
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Boulder, Colorado 80309, United States
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14
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Abstract
Neurological diseases account for a significant portion of the global disease burden. While research efforts have identified potential drugs or drug targets for neurological diseases, most therapeutic platforms are still ineffective at reaching the target location selectively and with high yield. Restricted transport, including passage across the blood-brain barrier, through the brain parenchyma, and into specific cells, is a major cause of ineffective therapeutic delivery. However, nanotechnology is a promising, tailorable platform for overcoming these transport barriers and improving therapeutic delivery to the brain. We provide a transport-oriented analysis of nanotechnology's ability to navigate these transport barriers in the brain. We also provide an opinion on the need for technology development for increasing our capacity to characterize and quantify nanoparticle passage through each transport barrier. Finally, we highlight the importance of incorporating the effect of disease, metabolic state, and regional dependencies to better understand transport of nanotherapeutics in the brain.
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Affiliation(s)
- Hawley Helmbrecht
- Department of Chemical Engineering, University of Washington, Seattle WA 98195
| | - Andrea Joseph
- Department of Chemical Engineering, University of Washington, Seattle WA 98195
| | - Michael McKenna
- Department of Chemical Engineering, University of Washington, Seattle WA 98195
| | - Mengying Zhang
- Molecular Engineering and Sciences Institute, University of Washington, Seattle WA 98105
| | - Elizabeth Nance
- Department of Chemical Engineering, University of Washington, Seattle WA 98195.,Molecular Engineering and Sciences Institute, University of Washington, Seattle WA 98105.,Department of Radiology, University of Washington, Seattle WA 98195.,eScience Institute, University of Washington, Seattle WA 98195
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15
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McKenna M, Suárez-Bonnet A, Smith K, Stewart S. Diagnosis and treatment of a caecal mucocoele in a dog. J Small Anim Pract 2020; 62:305-309. [PMID: 32974903 DOI: 10.1111/jsap.13175] [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: 09/30/2018] [Revised: 07/25/2019] [Accepted: 08/09/2019] [Indexed: 11/28/2022]
Abstract
An 11-year-old male intact Staffordshire Bull terrier was referred for diabetic ketoacidosis. Abdominal ultrasonographic examination revealed a 5 cm × 2 cm intraluminal caecal mass-like structure. Exploratory laparotomy and typhlectomy were subsequently performed. Histopathology of the caecal mass-like structure was consistent with a caecal mucocoele, defined as a cystic dilation of the caecal lumen with stasis of mucus. This lesion has been previously described in humans, where it is termed an appendiceal mucocoele. The patient was euthanased 58 days post-operatively due to unrelated diabetic complications.
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Affiliation(s)
- M McKenna
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - A Suárez-Bonnet
- Department of Pathobiology and Population Sciences, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - K Smith
- Department of Pathobiology and Population Sciences, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - S Stewart
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
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16
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Vergalasova I, McKenna M, Yue NJ, Reyhan M. Impact of computed tomography (CT) reconstruction kernels on radiotherapy dose calculation. J Appl Clin Med Phys 2020; 21:178-186. [PMID: 32889789 PMCID: PMC7497921 DOI: 10.1002/acm2.12994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 06/27/2020] [Accepted: 07/11/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To quantitatively evaluate the effect of computed tomography (CT) reconstruction kernels on various dose calculation algorithms with heterogeneity correction. METHODS The gammex electron density (ED) Phantom was scanned with the Siemens PET/CT Biograph20 mCT and reconstructed with twelve different kernel options. Hounsfield unit (HU) vs electron density (ED) curves were generated to compare absolute differences. Scans were repeated under head and pelvis protocols and reconstructed per H40s (head) and B40s (pelvis) kernels. In addition, raw data from a full-body patient scan were also reconstructed using the four B kernels. Per reconstruction, photon (3D and VMAT), electron (18 and 20 MeV) and proton (single field) treatment plans were generated using Varian Eclipse dose calculation algorithms. Photon and electron plans were also simulated to pass through cortical bone vs liver plugs of the phantom for kernel comparison. Treatment field monitor units (MU) and isodose volumes were compared across all scenarios. RESULTS The twelve kernels resulted in minor differences in HU, except at the extreme ends of the density curve with a maximum absolute difference of 55.2 HU. The head and pelvis scans of the phantom resulted in absolute HU differences of up to 49.1 HU for cortical bone and 45.1 HU for lung 300, which is a relative difference of 4.1% and 6.2%, respectively. MU comparisons across photon and proton calculation algorithms for the patient and phantom scans were within 1-2 MU, with a maximum difference of 5.4 MU found for the 20 MeV electron plan. The 20MeV electron plan also displayed maximum differences in isodose volumes of 20.4 cc for V90%. CONCLUSION Clinically insignificant differences were found among the various kernel generated plans for photon and proton plans calculated on patient and phantom scan data. However, differences in isodose volumes found for higher energy electron plans amongst the kernels may have clinical implications for prescribing dose to an isodose level.
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Affiliation(s)
- Irina Vergalasova
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Michael McKenna
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Ning Jeff Yue
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - Meral Reyhan
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
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17
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Joseph A, Liao R, Zhang M, Helmbrecht H, McKenna M, Filteau JR, Nance E. Nanoparticle-microglial interaction in the ischemic brain is modulated by injury duration and treatment. Bioeng Transl Med 2020; 5:e10175. [PMID: 33005740 PMCID: PMC7510458 DOI: 10.1002/btm2.10175] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 12/15/2022] Open
Abstract
Cerebral ischemia is a major cause of death in both neonates and adults, and currently has no cure. Nanotechnology represents one promising area of therapeutic development for cerebral ischemia due to the ability of nanoparticles to overcome biological barriers in the brain. ex vivo injury models have emerged as a high-throughput alternative that can recapitulate disease processes and enable nanoscale probing of the brain microenvironment. In this study, we used oxygen-glucose deprivation (OGD) to model ischemic injury and studied nanoparticle interaction with microglia, resident immune cells in the brain that are of increasing interest for therapeutic delivery. By measuring cell death and glutathione production, we evaluated the effect of OGD exposure time and treatment with azithromycin (AZ) on slice health. We found a robust injury response with 0.5 hr of OGD exposure and effective treatment after immediate application of AZ. We observed an OGD-induced shift in microglial morphology toward increased heterogeneity and circularity, and a decrease in microglial number, which was reversed after treatment. OGD enhanced diffusion of polystyrene-poly(ethylene glycol) (PS-PEG) nanoparticles, improving transport and ability to reach target cells. While microglial uptake of dendrimers or quantum dots (QDs) was not enhanced after injury, internalization of PS-PEG was significantly increased. For PS-PEG, AZ treatment restored microglial uptake to normal control levels. Our results suggest that different nanoparticle platforms should be carefully screened before application and upon doing so; disease-mediated changes in the brain microenvironment can be leveraged by nanoscale drug delivery devices for enhanced cell interaction.
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Affiliation(s)
- Andrea Joseph
- Department of Chemical EngineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Rick Liao
- Department of Chemical EngineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Mengying Zhang
- Molecular Engineering and Sciences InstituteUniversity of WashingtonSeattleWashingtonUSA
| | - Hawley Helmbrecht
- Department of Chemical EngineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Michael McKenna
- Department of Chemical EngineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Jeremy R. Filteau
- Department of Chemical EngineeringUniversity of WashingtonSeattleWashingtonUSA
| | - Elizabeth Nance
- Department of Chemical EngineeringUniversity of WashingtonSeattleWashingtonUSA
- Molecular Engineering and Sciences InstituteUniversity of WashingtonSeattleWashingtonUSA
- Department of RadiologyUniversity of WashingtonSeattleWashingtonUSA
- eScience InstituteUniversity of WashingtonSeattleWashingtonUSA
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18
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Waser N, Adam A, Schweikert B, Vo L, McKenna M, Breckenridge M, Penrod J, Goring S. 1243P Pathologic response as early endpoint for survival following neoadjuvant therapy (NEO-AT) in resectable non-small cell lung cancer (rNSCLC): Systematic literature review and meta-analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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19
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Núñez ES, Myrtle A, McKenna D, Brown L, Fauset-Jones J, McKenna M. WS02.4 Developing an enhanced transition pathway for young people with additional needs at the Manchester Adult Cystic Fibrosis Centre (MACFC). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30174-0] [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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20
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Millik SC, Dostie AM, Karis DG, Smith PT, McKenna M, Chan N, Curtis CD, Nance E, Theberge AB, Nelson A. 3D printed coaxial nozzles for the extrusion of hydrogel tubes toward modeling vascular endothelium. Biofabrication 2019; 11:045009. [PMID: 31220824 PMCID: PMC7350911 DOI: 10.1088/1758-5090/ab2b4d] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Engineered tubular constructs made from soft biomaterials are employed in a myriad of applications in biomedical science. Potential uses of these constructs range from vascular grafts to conduits for enabling perfusion of engineered tissues and organs. The fabrication of standalone tubes or complex perfusable constructs from biofunctional materials, including hydrogels, via rapid and readily accessible routes is desirable. Here we report a methodology in which customized coaxial nozzles are 3D printed using commercially available stereolithography (SLA) 3D printers. These nozzles can be used for the fabrication of hydrogel tubes via coextrusion of two shear-thinning hydrogels: an unmodified Pluronic® F-127 (F127) hydrogel and an F127-bisurethane methacrylate (F127-BUM) hydrogel. We demonstrate that different nozzle geometries can be modeled via computer-aided design and 3D printed in order to generate tubes or coaxial filaments with different cross-sectional geometries. We were able to fabricate tubes with luminal diameters or wall thicknesses as small as ∼150 μm. Finally, we show that these tubes can be functionalized with collagen I to enable cell adhesion, and human umbilical vein endothelial cells can be cultured on the luminal surfaces of these tubes to yield tubular endothelial monolayers. Our approach could enable the rapid fabrication of biofunctional hydrogel conduits which can ultimately be utilized for engineering in vitro models of tubular biological structures.
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Affiliation(s)
- S Cem Millik
- Department of Chemistry, University of Washington, Seattle, WA, United States of America
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21
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Rouce R, Thakkar A, Sharma S, Shah N, Reyna A, Ramos C, Lapteva N, Zhang H, Mehta B, Perconti S, McKenna M, Gee A, Lulla P, Castello J, Brenner M, Heslop H, Rooney C. Use of highly characterized EBV-Specific T Cells outside of the immediate Post-Transplant setting. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.010] [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: 10/26/2022]
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22
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Weiand D, McKenna M. Describing the End of Life Experience of Patients Supported with a Life-Sustaining Left Ventricular Assist Device (LVAD) as Bridge to Transplantation in a UK Centre. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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23
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Yang L, McAlarnen L, McKenna M. 11: Laparoscopic techniques for Essure device removal. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Merritt SM, Ako-Brew A, Bryant WJ, Staley A, McKenna M, Leone A, Shirase L. Automation-Induced Complacency Potential: Development and Validation of a New Scale. Front Psychol 2019; 10:225. [PMID: 30837913 PMCID: PMC6389673 DOI: 10.3389/fpsyg.2019.00225] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 08/03/2018] [Accepted: 01/22/2019] [Indexed: 11/13/2022] Open
Abstract
Complacency, or sub-optimal monitoring of automation performance, has been cited as a contributing factor in numerous major transportation and medical incidents. Researchers are working to identify individual differences that correlate with complacency as one strategy for preventing complacency-related accidents. Automation-induced complacency potential is an individual difference reflecting a general tendency to be complacent across a wide variety of situations which is similar to, but distinct from trust. Accurately assessing complacency potential may improve our ability to predict and prevent complacency in safety-critical occupations. Much past research has employed an existing measure of complacency potential. However, in the 25 years since that scale was published, our conceptual understanding of complacency itself has evolved, and we propose that an updated scale of complacency potential is needed. The goal of the present study was to develop, and provide initial validation evidence for, a new measure of automation-induced complacency potential that parallels the current conceptualization of complacency. In a sample of 475 online respondents, we tested 10 new items and found that they clustered into two separate scales: Alleviating Workload (which focuses on attitudes about the use of automation to ease workloads) and Monitoring (which focuses on attitudes toward monitoring of automation). Alleviating workload correlated moderately with the existing complacency potential rating scale, while monitoring did not. Further, both the alleviating workload and monitoring scales showed discriminant validity from the previous complacency potential scale and from similar constructs, such as propensity to trust. In an initial examination of criterion-related validity, only the monitoring-focused scale had a significant relationship with hypothetical complacency (r = -0.42, p < 0.01), and it had significant incremental validity over and above all other individual difference measures in the study. These results suggest that our new monitoring-related items have potential for use as a measure of automation-induced complacency potential and, compared with similar scales, this new measure may have unique value.
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Affiliation(s)
- Stephanie M. Merritt
- Department of Psychological Sciences, University of Missouri–St. Louis, St. Louis, MO, United States
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25
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McMenamin M, McKenna M, McDowell A. Clinical Utility of CINtec PLUS Triage in Equivocal Cervical Cytology and Human Papillomavirus Primary Screening. Am J Clin Pathol 2018; 150:512-521. [PMID: 30169728 DOI: 10.1093/ajcp/aqy073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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
OBJECTIVES While cervical cytology is accepted triage for human papillomavirus (HPV)-positive women, the efficiency of cervical screening could be improved by exploiting disease markers with higher specificity. METHODS CINtec PLUS triage alone and combined with HPV 16/18 genotyping was performed on ThinPrep samples from HPV-positive women. Clinical performance and the potential to reduce or expedite colposcopy referrals were evaluated. RESULTS The 2-year sensitivity and specificity for cervical intraepithelial neoplasia grade 3 or worse (CIN3+) were 90% and 42%, respectively. Specificity was improved over HPV testing in equivocal cytology and could cut the referral rate by about 40%. When combined with HPV 16/18 genotyping, CINtec PLUS triage of the 12 other high-risk HPV genotypes generally demonstrated better sensitivity for CIN3+ than separate triage of non-type-specific HPV-positive women. This strategy could reduce colposcopy referrals by 31%. CONCLUSIONS These findings highlight the potential of CINtec PLUS to improve management pathways in HPV-positive women. CINtec PLUS cytology represents a sensitive and efficient triage in HPV-positive women. The clinical performance of the dual-stain was most notable in women younger than 25 years and could potentially improve management pathways.
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Affiliation(s)
- Mary McMenamin
- Cytopathology Department, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, Northern Ireland
| | - Michael McKenna
- Cytopathology Department, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, Northern Ireland
| | - Andrew McDowell
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, Londonderry, Northern Ireland
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26
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McKenna M, McGarrigle S, Pidgeon GP. The next generation of PI3K-Akt-mTOR pathway inhibitors in breast cancer cohorts. Biochim Biophys Acta Rev Cancer 2018; 1870:185-197. [PMID: 30318472 DOI: 10.1016/j.bbcan.2018.08.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/09/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022]
Abstract
The PI3K/Akt/mTOR pathway plays a role in various oncogenic processes in breast cancer and key pathway aberrations have been identified which drive the different molecular subtypes. Early drugs developed targeting this pathway produced some clinical success but were hampered by pharmacokinetics, tolerability and efficacy problems. This created a need for new PI3K pathway-inhibiting drugs, which would produce more robust results allowing incorporation into treatment regimens for breast cancer patients. In this review, the most promising candidates from the new generation of PI3K-pathway inhibitors is explored, presenting evidence from preclinical and early clinical research, as well as ongoing trials utilising these drugs in breast cancer cohorts. The problems hindering the development of drugs targeting the PI3K pathway are examined, which have created problems for their use as monotherapies. PI3K pathway inhibitor combinations therefore remains a dynamic research area, and their role in combination with immunotherapies and epigenetic therapies is also inspected.
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Affiliation(s)
- Michael McKenna
- Department of Surgery, Trinity Translational Medicine Institute, St. James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Sarah McGarrigle
- Department of Surgery, Trinity Translational Medicine Institute, St. James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Graham P Pidgeon
- Department of Surgery, Trinity Translational Medicine Institute, St. James's Hospital, Trinity College Dublin, Dublin, Ireland.
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27
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Fitzpatrick D, McKenna M, Duncan EAS, Laird C, Lyon R, Corfield A. Critcomms: a national cross-sectional questionnaire based study to investigate prehospital handover practices between ambulance clinicians and specialist prehospital teams in Scotland. Scand J Trauma Resusc Emerg Med 2018; 26:45. [PMID: 29859121 PMCID: PMC5984735 DOI: 10.1186/s13049-018-0512-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor communication during patient handover is recognised internationally as a root cause of a significant proportion of preventable deaths. Improving the accuracy and quality of handover may reduce associated mortality and morbidity. Although the practice of handover between Ambulance and Emergency Department clinicians has received some attention over recent years there is little evidence to support handover best practice within the prehospital domain. Further research is therefore urgently required to understand the most appropriate way to deliver clinical information exchange in the pre-hospital environment. We aimed to investigate current clinical information exchange practices, perceived challenges and the preferred handover mnemonic for use during transfer of high acuity patients between ambulance clinicians and specialist prehospital teams. METHODS A national, cross-sectional questionnaire study. Participants were road based ambulance clinicians (RBAC) or active members of specialist prehospital teams (SPHT) based in Scotland. RESULTS Over a three month study period there were 247 prehospital incidents involving specialist teams. One hundred ninety individuals completed the questionnaire; 61% [n = 116] RBAC and 39% [n = 74] SPHT. Median length of prehospital experience was 10 years (IQR 5-18). Overall current prehospital handover practices were perceived as being effective (Mdn 4.00; IQR 3-4 [1 = very ineffective - 5 = very effective]) although SPHT clinicians rated handover effectiveness slightly lower than RBAC's (Mdn 3.00 vs 4.00, U = 1842.5, p = .03). 'ATMIST' (Age, Time of onset, Medical complaint/injury, Investigation, Signs and Treatment) was deemed the mnemonic of choice. The clinical variables perceived as essential for handover are not explicitly identified within the SBAR mnemonic. The most frequently reported method of recording and transferring information during handover was via memory (n = 112 and n = 120 respectively) and 'interruptions' were perceived as the most significant barrier to effective handover. CONCLUSION While, overall, current prehospital handover practice is perceived as effective this study has identified a number of areas for improvement. These include the development of a shared mental model through system standardisation, innovations to support information recording and delivery, and the clear identification at incidents of a handover lead. Mnemonics must be carefully selected to ensure they explicitly contain the perceived essential clinical variables required for prehospital handover; the mnemonic ATMIST meets these requirements. New theoretically informed, evidence-based interventions, must be developed and tested within existing systems of care to minimise information loss and risk to patients.
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Affiliation(s)
- David Fitzpatrick
- Faculty of Health Sciences and Sport, University of Stirling, FK9 4LA Stirling, Scotland
| | - Michael McKenna
- Scottish Ambulance Service, Glebe Cottage, Strath, Gairloch, Ross-shire IV212BT Scotland
| | - Edward A. S. Duncan
- Nursing, Midwifery & Allied Health Professions Research Unit, University of Stirling, FK9 4NF Scion House, Scotland, UK
| | - Colville Laird
- Basics Scotland, Aberuthven Enterpise Park, Sandpiper House, Aberuthven, Auchterarder Scotland
| | - Richard Lyon
- Pre-Hospital Emergency Care, School of Health Sciences, University of Surrey, Guildford, UK
| | - Alasdair Corfield
- Emergency Medical Retrieval Service, School of Medicine, Dentistry and Nursing, University of Glasgow, Wolfson Medical School Building, G12 8QQ Glasgow, Scotland
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Ramos IR, Meade AD, Ibrahim O, Byrne HJ, McMenamin M, McKenna M, Malkin A, Lyng FM. Raman spectroscopy for cytopathology of exfoliated cervical cells. Faraday Discuss 2018; 187:187-98. [PMID: 27032537 DOI: 10.1039/c5fd00197h] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cervical cancer is the fourth most common cancer affecting women worldwide but mortality can be decreased by early detection of pre-malignant lesions. The Pap smear test is the most commonly used method in cervical cancer screening programmes. Although specificity is high for this test, it is widely acknowledged that sensitivity can be poor mainly due to the subjective nature of the test. There is a need for new objective tests for the early detection of pre-malignant cervical lesions. Over the past two decades, Raman spectroscopy has emerged as a promising new technology for cancer screening and diagnosis. The aim of this study was to evaluate the potential of Raman spectroscopy for cervical cancer screening using both Cervical Intraepithelial Neoplasia (CIN) and Squamous Intraepithelial Lesion (SIL) classification terminology. ThinPrep® Pap samples were recruited from a cervical screening population. Raman spectra were recorded from single cell nuclei and subjected to multivariate statistical analysis. Normal and abnormal ThinPrep® samples were discriminated based on the biochemical fingerprint of the cells using Principal Component Analysis (PCA). Principal Component Analysis - Linear Discriminant Analysis (PCA-LDA) was employed to build classification models based on either CIN or SIL terminology. This study has shown that Raman spectroscopy can be successfully applied to the study of routine cervical cytology samples from a cervical screening programme and that the use of CIN terminology resulted in improved sensitivity for high grade cases.
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Affiliation(s)
- I R Ramos
- DIT Centre for Radiation and Environmental Science, FOCAS Research Institute, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland. and School of Physics, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland
| | - A D Meade
- School of Physics, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland
| | - O Ibrahim
- DIT Centre for Radiation and Environmental Science, FOCAS Research Institute, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland. and School of Physics, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland
| | - H J Byrne
- FOCAS Research Institute, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland
| | - M McMenamin
- Cytopathology Department, Altnagelvin Hospital, Western Health and Social Care Trust, Derry, Northern Ireland, UK
| | - M McKenna
- Cytopathology Department, Altnagelvin Hospital, Western Health and Social Care Trust, Derry, Northern Ireland, UK
| | - A Malkin
- School of Biological Sciences, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland
| | - F M Lyng
- DIT Centre for Radiation and Environmental Science, FOCAS Research Institute, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland. and School of Physics, Dublin Institute of Technology, Kevin St, Dublin 8, Ireland
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Casson J, McKenna M, Haßdenteufel S, Aviram N, Zimmerman R, High S. Multiple pathways facilitate the biogenesis of mammalian tail-anchored proteins. J Cell Sci 2017; 130:3851-3861. [PMID: 29021347 PMCID: PMC5702047 DOI: 10.1242/jcs.207829] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 07/03/2017] [Accepted: 09/17/2017] [Indexed: 12/24/2022] Open
Abstract
Tail-anchored (TA) proteins are transmembrane proteins with a single C-terminal transmembrane domain, which functions as both their subcellular targeting signal and membrane anchor. We show that knockout of TRC40 in cultured human cells has a relatively minor effect on endogenous TA proteins, despite their apparent reliance on this pathway in vitro. These findings support recent evidence that the canonical TRC40 pathway is not essential for TA protein biogenesis in vivo. We therefore investigated the possibility that other ER-targeting routes can complement the TRC40 pathway and identified roles for both the SRP pathway and the recently described mammalian SND pathway in TA protein biogenesis. We conclude that, although TRC40 normally plays an important role in TA protein biogenesis, it is not essential, and speculate that alternative pathways for TA protein biogenesis, including those identified in this study, contribute to the redundancy of the TRC40 pathway. Summary: In addition to the canonical TRC40-targeting pathway, mammalian tail-anchored proteins can also utilise the SRP and SND pathways to facilitate their insertion into the ER membrane.
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Affiliation(s)
- Joseph Casson
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Michael Smith Building, Manchester, M13 9PT, UK
| | - Michael McKenna
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Michael Smith Building, Manchester, M13 9PT, UK
| | - Sarah Haßdenteufel
- Department of Medical Biochemistry and Molecular Biology, Saarland University, 66421 Homburg, Germany
| | - Naama Aviram
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Richard Zimmerman
- Department of Medical Biochemistry and Molecular Biology, Saarland University, 66421 Homburg, Germany
| | - Stephen High
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Michael Smith Building, Manchester, M13 9PT, UK
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McMenamin M, McKenna M, McDowell A, Dawson C, McKenna R. Intra- and inter-observer reproducibility of CINtec ® PLUS in ThinPrep ® cytology preparations. Cytopathology 2017; 28:284-290. [PMID: 28685883 DOI: 10.1111/cyt.12426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study evaluated the intra- and inter-observer reproducibility of the dual-stain biomarker, CINtec® PLUS cytology in ThinPrep® specimens, for improved specificity in the detection of cervical disease in women testing human papillomavirus (HPV) positive. METHODS A total of 972 cases of HPV-positive women from a triage and primary HPV screening population were selected from an ongoing study evaluating the clinical performance of CINtec® PLUS cytology. For reproducibility analyses, three cytotechnologists rescreened sets of slides which they had previously reported themselves and which were previously reported by each of the other cytotechnologists. The original results of slides previously screened by each of the three cytotechnologists were also compared with the results of an expert reference evaluator. RESULTS Intra- and inter-observer agreement for paired evaluations between reviewers ranged from 82.8% to 94.9% (kappa 0.65-0.91) and 89.2% to 93% (kappa 0.83-0.88), respectively. Reproducibility analyses between the cytotechnologists and the reference evaluator revealed agreements ranging from 95.5% to 98% (kappa 0.89-0.96). CONCLUSION Evaluation of the dual-stain biomarker showed a high level of agreement across all evaluators suggesting that CINtec® PLUS cytology will perform well in the hands of cytotechnologists and pathologist reviewers and could be introduced into cellular pathology laboratories that employ ThinPrep® LBC with a minimum effort.
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Affiliation(s)
- M McMenamin
- Cytopathology Department, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, UK
| | - M McKenna
- Cytopathology Department, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, UK
| | - A McDowell
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Institute, AltnagelvinHospital, University of Ulster, Londonderry, UK
| | - C Dawson
- Cytopathology Department, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, UK
| | - R McKenna
- Cytopathology Department, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, UK
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McKenna M, Simmonds RE, High S. Mycolactone reveals the substrate-driven complexity of Sec61-dependent transmembrane protein biogenesis. J Cell Sci 2017; 130:1307-1320. [PMID: 28219954 PMCID: PMC5399781 DOI: 10.1242/jcs.198655] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 11/04/2016] [Accepted: 02/02/2017] [Indexed: 12/22/2022] Open
Abstract
Mycolactone is the exotoxin virulence factor produced by Mycobacterium ulcerans, the pathogen responsible for Buruli ulcer. The skin lesions and immunosuppression that are characteristic of this disease result from the action of mycolactone, which targets the Sec61 complex and inhibits the co-translational translocation of secretory proteins into the endoplasmic reticulum. In this study, we investigate the effect of mycolactone on the Sec61-dependent biogenesis of different classes of transmembrane protein (TMP). Our data suggest that the effect of mycolactone on TMP biogenesis depends on how the nascent chain initially engages the Sec61 complex. For example, the translocation of TMP lumenal domains driven by an N-terminal cleavable signal sequence is efficiently inhibited by mycolactone. In contrast, the effect of mycolactone on protein translocation that is driven solely by a non-cleavable signal anchor/transmembrane domain depends on which flanking region is translocated. For example, while translocation of the region N-terminal to a signal anchor/transmembrane domain is refractive to mycolactone, C-terminal translocation is efficiently inhibited. Our findings highlight the diversity of Sec61-dependent translocation and provide a molecular basis for understanding the effect of mycolactone on the biogenesis of different TMPs. Highlighted Article: The exotoxin mycolactone interferes with the biogenesis of the majority of transmembrane proteins and its actions highlight differences in how distinct classes of these proteins initially engage the Sec61 translocon.
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Affiliation(s)
- Michael McKenna
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Michael Smith Building, Manchester M13 9PT, UK
| | - Rachel E Simmonds
- Department of Microbial Sciences, School of Bioscience and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Stephen High
- Division of Molecular and Cellular Function, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Michael Smith Building, Manchester M13 9PT, UK
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Boyce S, Davies O, McKenna M, White A, Dixon M, Elliott N. INDIVIDUAL PHYSICAL MONITORING FOR ELITE WOMEN'S INTERNATIONAL SOCCER PLAYERS: AN EDUCATIONAL PROGRAMME. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.44] [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: 11/04/2022]
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Boyce S, McKenna M, White A, Davies O, Dixon M, Elliott N. SUBJECTIVE SLEEP QUALITY IN ELITE WOMENS INTERNATIONAL SOCCER PLAYERS PRIOR TO AN INTERNATIONAL MATCH. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.46] [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: 11/04/2022]
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Boyce S, White A, McKenna M, Dixon M, Davies O, Elliott N. USING MOBILE DEVICES TO MONITOR HEALTH AND WELLBEING, IN AND OUT OF COMPETITION, IN ELITE INTERNATIONAL WOMENS SOCCER. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.47] [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: 11/04/2022]
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35
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Boyce S, Davies O, McKenna M, White A, Dixon M, Elliott N. A MULTIDISCIPLINARY SPORTS MEDICINE PERFORMANCE MODEL IN ELITE WOMENS INTERNATIONAL SOCCER. Br J Sports Med 2017. [DOI: 10.1136/bjsports-2016-097372.45] [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: 11/04/2022]
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36
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Farr T, Petersen A, McKenna M. Effects of an acute oral dose of digoxin on plasma K+ regulation, muscle performance and excitability during and following high-intensity cycling. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2016.12.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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37
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Flynn SP, Monaghan R, Bogan J, McKenna M, Cowley A, Daniels S, Hughes G, Kelleher SM. Controlling wettability of PECVD-deposited dual organosilicon/carboxylic acid films to influence DNA hybridisation assay efficiency. J Mater Chem B 2017; 5:8378-8388. [DOI: 10.1039/c7tb01925d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Plasma oxidation of Zeonor and deposition of TEOS/AA thin film showing dual layer effect on the surface.
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Affiliation(s)
- S. P. Flynn
- National Centre for Plasma Science and Technology
- Glasnevin
- Dublin 9
- Ireland
- School of Chemistry
| | - R. Monaghan
- National Centre for Plasma Science and Technology
- Glasnevin
- Dublin 9
- Ireland
- Biomedical Diagnostic Institute
| | - J. Bogan
- School of Physical Sciences
- Dublin City University
- Dublin 9
- Ireland
| | - M. McKenna
- National Centre for Plasma Science and Technology
- Glasnevin
- Dublin 9
- Ireland
- Biomedical Diagnostic Institute
| | - A. Cowley
- National Centre for Plasma Science and Technology
- Glasnevin
- Dublin 9
- Ireland
| | - S. Daniels
- National Centre for Plasma Science and Technology
- Glasnevin
- Dublin 9
- Ireland
- Biomedical Diagnostic Institute
| | - G. Hughes
- School of Physical Sciences
- Dublin City University
- Dublin 9
- Ireland
| | - S. M. Kelleher
- National Centre for Plasma Science and Technology
- Glasnevin
- Dublin 9
- Ireland
- School of Chemistry
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Chehab H, McKenna M. Evaluation of Influenza Vaccination Rates and Use of Parent Reminder Cards in Three-Year-Old Children With Annual Well-Child Visits Outside the Influenza Season in an Outpatient Pediatric Center. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.627] [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: 11/14/2022] Open
Affiliation(s)
- Hiba Chehab
- Pediatrics, Ryan White Center for Pediatric Infectious Disease/Indiana University School of Medicine, Indianapolis, Indiana
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Murray K, Sommerville A, McKenna M, Edgar G, Murray A. Normobaric hyperoxia training in elite female hockey players. J Sports Med Phys Fitness 2016; 56:1488-1493. [PMID: 26506152] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Supplemental oxygen use may offer recovery benefits to team sport athletes both in training and match play. A blinded independent measures study was used to investigate the effect of supplementary oxygen use during recovery from high-intensity exercise on performance. METHODS Fifteen female international hockey players underwent a 6 week running based training program with a 2:1 work to rest ratio. The subjects were split into 3 groups; normobaric hyperoxia (HXA), normoxia (NXA) and control (CTR). In between exercise sets HXA received 100% oxygen for 1 minute whilst NXA received a placebo in the same manner. CTR received no treatment and were not supervised. Maximal aerobic speed (MAS) was measured pre and post. Distance covered was measured along with peak heart rate (HRpeak), peak blood lactate concentration ([La-]peak) and rate of perceived exertion (RPE). RESULTS MAS improved in HXA, NXA and CTR. However, distance ran in training was not different between groups. There was a likely positive effect on HRpeak in HXA (lower in HXA). RPE and [La-]peak response was not different between groups. CONCLUSIONS Inhaling supplementary oxygen during recovery between high-intensity intervals did not improve physiological performance of high-level team sport players. The normobaric hyperoxia treatment had no effect on maximal aerobic (distance covered), metabolic ([La-]peak), and perception (RPE) parameters. It is not recommended as an ergogenic aid to training at sea level.
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Affiliation(s)
| | | | | | - Gemma Edgar
- Sportscotland Institute of Sport, Stirling, Scotland, UK
| | - Andrew Murray
- Sportscotland Institute of Sport, Stirling, Scotland, UK
- Aspire Academy, Doha, Qatar
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Ward HJT, Baird D, McKenna M, Mooney A, Lee A. Understanding high resource users across health and social care in Scotland using linked data. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw171.058] [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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41
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Ellison WT, Racca R, Clark CW, Streever B, Frankel AS, Fleishman E, Angliss R, Berger J, Ketten D, Guerra M, Leu M, McKenna M, Sformo T, Southall B, Suydam R, Thomas L. Modeling the aggregated exposure and responses of bowhead whales Balaena mysticetus to multiple sources of anthropogenic underwater sound. ENDANGER SPECIES RES 2016. [DOI: 10.3354/esr00727] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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42
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Faunce T, McKenna M, Rayner J, Hawes J. REGULATION OF AUSTRALIAN MEDICAL PROFESSIONALS AND NATIONAL SECURITY: LESSONS FROM THREE CASE STUDIES. J Law Med 2016; 23:544-556. [PMID: 27323633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In recent times, Australia's national security concerns have had controversial impacts on regulation of Australian medical practitioners in areas related to immigration detention. This column explores three recent case studies relevant to this issue. The first involves the enactment of the Australian Border Force Act 2015 (Cth), which has a significant impact on the regulation of medical professionals who work with people in immigration detention. The second involves the decision of the High Court of Australia in Plaintiff M68/2015 v Minister for Immigration and Border Protection [2016] HCA 1 that an amendment to Australian federal legislation justified sending children back to immigration detention centres in Papua New Guinea and Nauru. This legislation was previously heavily criticised by the Australian Human Rights Commissioner. The third concerns the deregistration of Tareq Kamleh, an Australian doctor of German-Palestinian heritage who came to public attention on ANZAC Day 2015 with his appearance online in a propaganda video for the Islamic State terrorist organisation al-Dawla al-Islamyia fil Iraq wa'al Sham, also known as Islamic State of Iraq and Syria (ISIS) or Daesh. Australia's professional regulatory system should presumptively respect professional virtues, such as loyalty to the relief of individual patient suffering, when dealing with doctors (whether in Australia or ISIS-occupied Syria) working under regimes whose principles appear inconsistent with those of ethics and human rights.
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McKenna M, McMenamin M, McDowell A. HPV16 and HPV18 genotyping triage in young women with borderline cytology or mild dyskaryosis: effect of age on genotype-specific risk of high-grade CIN. Cytopathology 2016; 27:261-8. [PMID: 26873051 DOI: 10.1111/cyt.12316] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Human papillomavirus (HPV) triage of borderline cytology or mild dyskaryosis is limited by the higher prevalence of HPV in women with these findings relative to those with high-grade cervical intraepithelial neoplasia (≥CIN2). This is particularly relevant in young women in whom HPV prevalence is discernible. In a previous analysis of HPV triage and colposcopy outcomes in Northern Ireland, we revealed a substantial amount of prevalent high-grade disease in women below 30 years of age. We explored the role of genotyping for HPV16/HPV18 in this population by assessing the risk of high-grade lesions associated with these genotypes and the effect of age on type-specific risk. METHODS Of the 866 women eligible for HPV triage, those who tested positive for HPV were referred to colposcopy. The relative risk of ≥CIN2 for HPV16, HPV18 and non-HPV16/18 high-risk genotype positivity was determined for cobas(®) HPV Test-positive results. RESULTS The relative risk of high-grade CIN was significantly greater in women infected with HPV16 and/or HPV18 compared with non-HPV16/18 infections, regardless of age (2.23 and 0.45, respectively). In women under 30 years of age, HPV16-associated risk of ≥CIN2 was significantly greater than that of HPV18 and the non-HPV16/18 genotypes (1.74 versus 1.03 and 0.58, respectively). In women aged ≥30 years, HPV18 infection presented the greatest risk of ≥CIN2 (3.03). The relative risk of ≥CIN2 associated with non-HPV16/18 genotypes was lower (range, 0.32-0.58) for both age groups. CONCLUSION This analysis demonstrates the value of genotyping for HPV16/HPV18 and age stratification to improve the specificity of HPV triage and to tailor management relative to the risk of high-grade CIN and cancer.
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Affiliation(s)
- M McKenna
- Cytopathology Department, Altnagelvin Hospital, Londonderry, UK
| | - M McMenamin
- Cytopathology Department, Altnagelvin Hospital, Londonderry, UK
| | - A McDowell
- Northern Ireland Centre for Stratified Medicine, Ulster University, Londonderry, UK
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McKenna M, Simmonds RE, High S. Mechanistic insights into the inhibition of Sec61-dependent co- and post-translational translocation by mycolactone. J Cell Sci 2016; 129:1404-15. [PMID: 26869228 PMCID: PMC4852723 DOI: 10.1242/jcs.182352] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [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: 10/28/2015] [Accepted: 02/03/2016] [Indexed: 12/17/2022] Open
Abstract
The virulence factor mycolactone is responsible for the immunosuppression and tissue necrosis that characterise Buruli ulcer, a disease caused by infection with Mycobacterium ulcerans In this study, we confirm that Sec61, the protein-conducting channel that coordinates entry of secretory proteins into the endoplasmic reticulum, is a primary target of mycolactone, and characterise the nature of its inhibitory effect. We conclude that mycolactone constrains the ribosome-nascent-chain-Sec61 complex, consistent with its broad-ranging perturbation of the co-translational translocation of classical secretory proteins. In contrast, the effect of mycolactone on the post-translational ribosome-independent translocation of short secretory proteins through the Sec61 complex is dependent on both signal sequence hydrophobicity and the translocation competence of the mature domain. Changes to protease sensitivity strongly suggest that mycolactone acts by inducing a conformational change in the pore-forming Sec61α subunit. These findings establish that mycolactone inhibits Sec61-mediated protein translocation and highlight differences between the co- and post-translational routes that the Sec61 complex mediates. We propose that mycolactone also provides a useful tool for further delineating the molecular mechanisms of Sec61-dependent protein translocation.
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Affiliation(s)
- Michael McKenna
- Faculty of Life Sciences, University of Manchester, Michael Smith Building, Manchester M13 9PT, UK
| | - Rachel E Simmonds
- Department of Microbial Sciences, School of Bioscience and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Stephen High
- Faculty of Life Sciences, University of Manchester, Michael Smith Building, Manchester M13 9PT, UK
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Brennan BJ, Lemenuel-Diot A, Snoeck E, McKenna M, Solsky J, Wat C, Mallalieu NL. Use of an integrated modelling and simulation approach to develop a simplified peginterferon alfa-2a dosing regimen for children with hepatitis C. Br J Clin Pharmacol 2016; 81:658-66. [PMID: 26529640 DOI: 10.1111/bcp.12816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 10/23/2015] [Accepted: 11/01/2015] [Indexed: 12/20/2022] Open
Abstract
AIM The aim of the study was to simplify the dosing regimen of peginterferon alfa-2a in paediatric patients with chronic hepatitis C. METHODS A population pharmacokinetic (PK) model was developed using PK data from 14 children aged 2-8 years and 402 adults. Simulations were produced to identify a simplified dosing regimen that would provide exposures similar to those observed in the paediatric clinical trials and in the range known to be safe/efficacious in adults. Model predictions were evaluated against observed adult and paediatric data to reinforce confidence of the proposed dosing regimen. RESULTS The final model was a two compartment model with a zero order resorption process. Covariates included a linear influence of body surface area (BSA) on apparent oral clearance (CL/F) and a linear influence of body weight on apparent volume of distribution of the central compartment (V1 /F). A simplified dosing regimen was developed which is expected to provide exposures in children aged ≥5 years similar to the dosing formula used in the paediatric clinical trial and within the range that is safe/efficacious in adults. This simplified regimen is approved in the EU and in other countries for the treatment of chronic hepatitis C in treatment-naive children/adolescents aged ≥5 years in combination with ribavirin. CONCLUSION Pre-existing adult PK data were combined with relatively limited paediatric PK data to develop a PK model able to predict exposure in both populations adequately. This provided increased confidence in characterizing PK in children and helped in the development of a simplified dosing regimen of peginterferon alfa-2a in paediatric patients.
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46
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Farr, Petersen A, McKenna M. Effects of contracting muscle mass on arterial and venous [K+) and muscular fatigue during intense intermittent cycling. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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47
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Zou W, Fisher T, Zhang M, Kim L, Chen T, Narra V, Swann B, Singh R, Siderit R, Yin L, Teo BKK, McKenna M, McDonough J, Ning YJ. Potential of 3D printing technologies for fabrication of electron bolus and proton compensators. J Appl Clin Med Phys 2015; 16:4959. [PMID: 26103473 PMCID: PMC5690113 DOI: 10.1120/jacmp.v16i3.4959] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 01/12/2015] [Accepted: 12/17/2014] [Indexed: 11/29/2022] Open
Abstract
In electron and proton radiotherapy, applications of patient-specific electron bolus or proton compensators during radiation treatments are often necessary to accommodate patient body surface irregularities, tissue inhomogeneity, and variations in PTV depths to achieve desired dose distributions. Emerging 3D printing technologies provide alternative fabrication methods for these bolus and compensators. This study investigated the potential of utilizing 3D printing technologies for the fabrication of the electron bolus and proton compensators. Two printing technologies, fused deposition modeling (FDM) and selective laser sintering (SLS), and two printing materials, PLA and polyamide, were investigated. Samples were printed and characterized with CT scan and under electron and proton beams. In addition, a software package was developed to convert electron bolus and proton compensator designs to printable Standard Tessellation Language file format. A phantom scalp electron bolus was printed with FDM technology with PLA material. The HU of the printed electron bolus was 106.5 ± 15.2. A prostate patient proton compensator was printed with SLS technology and polyamide material with -70.1 ± 8.1 HU. The profiles of the electron bolus and proton compensator were compared with the original designs. The average over all the CT slices of the largest Euclidean distance between the design and the fabricated bolus on each CT slice was found to be 0.84 ± 0.45 mm and for the compensator to be 0.40 ± 0.42 mm. It is recommended that the properties of specific 3D printed objects are understood before being applied to radiotherapy treatments.
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Affiliation(s)
- Wei Zou
- Rutgers Cancer Institute of New Jersey.
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Coventry E, Ball K, Parrington L, Aughey R, McKenna M. Kinematic effects of a short-term fatigue protocol on punt-kicking performance. J Sports Sci 2015; 33:1596-605. [DOI: 10.1080/02640414.2014.1003582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Evan Coventry
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Kevin Ball
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Lucy Parrington
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Robert Aughey
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Michael McKenna
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
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Affiliation(s)
- M. McKenna
- Royal Liverpool and Broadgreen University Hospitals NHS Trust Liverpool UK
| | - M. Davies
- Royal Liverpool and Broadgreen University Hospitals NHS Trust Liverpool UK
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McKenna M, McMenamin MM. Human papillomavirus testing in young women: clinical outcomes of human papillomavirus triage in a UK cervical screening program. Cancer Cytopathol 2014; 122:702-10. [PMID: 24888573 DOI: 10.1002/cncy.21444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/19/2014] [Accepted: 04/23/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND In the United Kingdom, human papillomavirus (HPV) testing is used to triage women with borderline cytology or mild dyskaryosis; however, in young women, the value of triage is limited by the high HPV prevalence rate. The current study examined the impact of HPV triage on colposcopy referral, colposcopy procedures, and patient outcome in a cervical screening population that included women aged < 25 years. METHODS Women aged 18 to 65 years attending for cervical screening in Northern Ireland were tested for HPV if their cytology result demonstrated borderline cytology or mild dyskaryosis. Of the 866 women eligible for HPV triage, those who tested negative for HPV were returned to routine screening and women who tested positive were referred to colposcopy. RESULTS HPV prevalence was 82.07% in women aged < 25 years and 54.69% in women aged ≥ 25 years. Colposcopy referrals increased by 42.67%. The odds of undergoing a large loop excision of the transformation zone (LLETZ) compared with punch biopsy increased by 0.056 per year above the age of 31 years. LLETZ performed in women aged ≥ 25 years and those aged < 25 years yielded rates of cervical intraepithelial neoplasia of type 2 or higher (≥ CIN2) of 57.04% and 80.00%, respectively. The positive predictive value of HPV triage for detecting ≥ CIN2 was 29.92% in women aged < 25 years and 27.51% in the older age group. CONCLUSIONS HPV triage substantially increased colposcopy referrals. The positive predictive value of a positive HPV test to detect ≥ CIN2 was not affected by age. LLETZ performed in women aged < 25 years yielded higher rates of ≥ CIN2 compared with the older age group.
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Affiliation(s)
- Michael McKenna
- Cytopathology Department, Altnagelvin Area Hospital, Western Health and Social Care Trust, Derry, Northern Ireland
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