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Meredith-Jones KA, Haszard JJ, Graham-DeMello A, Campbell A, Stewart T, Galland BC, Cox A, Kennedy G, Duncan S, Taylor RW. Validation of actigraphy sleep metrics in children aged 8 to 16 years: considerations for device type, placement and algorithms. Int J Behav Nutr Phys Act 2024; 21:40. [PMID: 38627708 PMCID: PMC11020269 DOI: 10.1186/s12966-024-01590-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Actigraphy is often used to measure sleep in pediatric populations, despite little confirmatory evidence of the accuracy of existing sleep/wake algorithms. The aim of this study was to determine the performance of 11 sleep algorithms in relation to overnight polysomnography in children and adolescents. METHODS One hundred thirty-seven participants aged 8-16 years wore two Actigraph wGT3X-BT (wrist, waist) and three Axivity AX3 (wrist, back, thigh) accelerometers over 24-h. Gold standard measures of sleep were obtained using polysomnography (PSG; Embletta MPRPG, ST + Proxy and TX Proxy) in the home environment, overnight. Epoch by epoch comparisons of the Sadeh (two algorithms), Cole-Kripke (three algorithms), Tudor-Locke (four algorithms), Count-Scaled (CS), and HDCZA algorithms were undertaken. Mean differences from PSG values were calculated for various sleep outcomes. RESULTS Overall, sensitivities were high (mean ± SD: 91.8%, ± 5.6%) and specificities moderate (63.8% ± 13.8%), with the HDCZA algorithm performing the best overall in terms of specificity (87.5% ± 1.3%) and accuracy (86.4% ± 0.9%). Sleep outcome measures were more accurately measured by devices worn at the wrist than the hip, thigh or lower back, with the exception of sleep efficiency where the reverse was true. The CS algorithm provided consistently accurate measures of sleep onset: the mean (95%CI) difference at the wrist with Axivity was 2 min (-6; -14,) and the offset was 10 min (5, -19). Several algorithms provided accurate measures of sleep quantity at the wrist, showing differences with PSG of just 1-18 min a night for sleep period time and 5-22 min for total sleep time. Accuracy was generally higher for sleep efficiency than for frequency of night wakings or wake after sleep onset. The CS algorithm was more accurate at assessing sleep period time, with narrower 95% limits of agreement compared to the HDCZA (CS:-165 to 172 min; HDCZA: -212 to 250 min). CONCLUSION Although the performance of existing count-based sleep algorithms varies markedly, wrist-worn devices provide more accurate measures of most sleep measures compared to other sites. Overall, the HDZCA algorithm showed the greatest accuracy, although the most appropriate algorithm depends on the sleep measure of focus.
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Affiliation(s)
- K A Meredith-Jones
- Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand.
| | - J J Haszard
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - A Graham-DeMello
- Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand
| | - A Campbell
- WellSleep Centre, University of Otago, Wellington, New Zealand
| | - T Stewart
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - B C Galland
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - A Cox
- Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand
| | - G Kennedy
- Fuzzy Systems Ltd, Dunedin, New Zealand
| | - S Duncan
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - R W Taylor
- Department of Medicine, University of Otago, PO Box 56, Dunedin, New Zealand
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Margaroli C, Yuan K, Christenson A, Gaggar A, Duncan S. 448 Pathological autoimmune responses in cystic fibrosis exacerbation. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01138-9] [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: 11/07/2022]
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Hobbs M, Stewart T, Marek L, Duncan S, Campbell M, Kingham S. Health-promoting and health-constraining environmental features and physical activity and sedentary behaviour in adolescence: a geospatial cross-sectional study. Health Place 2022; 77:102887. [DOI: 10.1016/j.healthplace.2022.102887] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/04/2022]
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Duncan S, Estrada-Rodriguez G, Stocek J, Dragone M, Vargas PA, Gimperlein H. Efficient quantitative assessment of robot swarms: coverage and targeting Lévy strategies. Bioinspir Biomim 2022; 17:036006. [PMID: 35196266 DOI: 10.1088/1748-3190/ac57f0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Biologically inspiredstrategieshave long been adapted to swarm robotic systems, including biased random walks, reaction to chemotactic cues and long-range coordination. In this paper we applyanalysis toolsdeveloped for modeling biological systems, such as continuum descriptions, to the efficient quantitative characterization of robot swarms. As an illustration, both Brownian and Lévy strategies with a characteristic long-range movement are discussed. As a result we obtain computationally fast methods for the optimization of robot movement laws to achieve a prescribed collective behavior. We show how to compute performance metrics like coverage and hitting times, and illustrate the accuracy and efficiency of our approach for area coverage and search problems. Comparisons between the continuum model and robotic simulations confirm the quantitative agreement and speed up by a factor of over 100 of our approach. Results confirm and quantify the advantage of Lévy strategies over Brownian motion for search and area coverage problems in swarm robotics.
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Affiliation(s)
- S Duncan
- Robotics Lab, Edinburgh Centre for Robotics, School of Mathematical and Computer Sciences School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom
| | - G Estrada-Rodriguez
- Department of Mathematics, Universitat Politecnica de Catalunya, Jordi Girona, 1-3, 08034, Barcelona, Spain
| | - J Stocek
- British Antarctic Survey, High Cross, Madingley Road, Cambridge, CB3 0ET, United Kingdom
| | - M Dragone
- Robotics Lab, Edinburgh Centre for Robotics, School of Mathematical and Computer Sciences School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom
| | - P A Vargas
- Robotics Lab, Edinburgh Centre for Robotics, School of Mathematical and Computer Sciences School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom
| | - H Gimperlein
- Leopold-Franzens-Universität Innsbruck, Engineering Mathematics, 6020, Innsbruck, Austria
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Traweek R, Keung E, Ajami N, Duncan S, Burton E, Tate T, Callahan K, Ingram D, Wani K, Lazar A, Wang WL, Guadagnolo B, Bishop A, Wargo J, Somaiah N, Roland C, Nassif E. 191P Fecal microbiome in soft-tissue sarcoma (STS) patients treated with neoadjuvant immune checkpoint blockade (ICB). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Karabayas M, Brock J, Rutherford M, Fordyce G, Fluck N, Kardash S, Moran L, Richmond R, Tan A, Sznajd J, Lambie S, Khalid M, Else S, Davies CA, Duncan M, Mclaren J, Duncan S, Murphy5 S, Hasan F, Basu N. O30 Variation in immunosuppressant impact on severe COVID-19 outcome: preliminary results from the COVID-19 Scottish Registry of Autoimmune Rheumatic Diseases (SCAR-19). Rheumatology (Oxford) 2021. [PMCID: PMC8135447 DOI: 10.1093/rheumatology/keab246.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background/Aims The novel infectious disease COVID-19 is associated with a wide spectrum of clinical severity amongst the general population. Patients with autoimmune rheumatic diseases (ARD) are more likely to experience serious COVID-19 related events, although risk factors for such outcomes have yet to be established. In particular, the risk profiles of specific ARD therapies are unknown. Methods A Scottish wide registry was rapidly developed in March 2020. Clinical characteristics and outcomes of infected cases were collated across all Scottish health boards, leveraging the Scottish Systemic Vasculitis Network and Scottish Society for Rheumatology. Eligible patients included any adult ARD patients with a confirmed (clinically or PCR) diagnosis of COVID-19. Simple descriptive statistics were employed to evaluate associations between ARD therapies and a serious COVID-19 disease outcome, as defined by a requirement of invasive or non-invasive ventilation, and/or death. Results A total of 69 patients (59% female; mean age 65.6, SD15.5) were recruited to the registry ,92% of which required hospitalisation. Cases were most commonly diagnosed with rheumatoid arthritis (n = 32, 46.4%) followed by spondyloarthritis (n = 19, 27.5%) and systemic vasculitis (n = 9, 13.0%). Anti-TNF therapy (n = 8, 11.6%) and methotrexate (n = 31, 44.9%) were the commonest biologic and conventional disease modifying drug (bDMARD and csDMARD) used respectively. N = 20 (29%) received background corticosteroid therapy (15.9% prednisolone >5mg, 13% prednisolone ≤5mg). A severe outcome was observed in n = 25(31.9%); n = 11 required assisted ventilation and n = 19 died. With the exception of Leflunomide, conventional and biologic DMARDs did not appear to confer a higher risk for severe outcome (table 1). Of note, anti-TNF therapy was associated with a non-serious outcome (p = 0.04) and prednisolone>5mg with a serious outcome (p = 0.08). Conclusion Preliminary data from this Scotland-wide ARD COVID-19 registry evidences variation in the impact of standard ARD therapies on the severity of COVID-19 outcome. In general, background csDMARD and bDMARD use does not appear to be a risk factor for severe outcomes. However, anti-TNF therapy may confer a favourable outcome, while leflunomide and corticosteroids may have the opposite effect. Rheumatologists should be aware of these possible risk factors and continue to contribute to registries to help establish whether these putative signals are clinically relevant. Disclosure M. Karabayas: None. J. Brock: None. M. Rutherford: None. G. Fordyce: None. N. Fluck: None. S. Kardash: None. L. Moran: None. R. Richmond: None. A. Tan: None. J. Sznajd: None. S. Lambie: None. M. Khalid: None. S. Else: None. C.A. Davies: None. M. Duncan: None. J. Mclaren: None. S. Duncan: None. S. Murphy5: None. F. Hasan: None. N. Basu: None.
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Affiliation(s)
- Maira Karabayas
- Aberdeen Centre for Arthritis & Musculoskeletal Health, University of Aberdeen, Aberdeen, UNITED KINGDOM
- Department of Rheumatology, NHS Grampian, Aberdeen, UNITED KINGDOM
| | - James Brock
- Department of Rheumatology, NHS Greater Glasgow & Clyde, Glasgow, UNITED KINGDOM
| | - Matthew Rutherford
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Gillian Fordyce
- Department of Rheumatology, NHS Grampian, Aberdeen, UNITED KINGDOM
| | - Nick Fluck
- Renal Unit, NHS Grampian, Aberdeen, UNITED KINGDOM
| | - Sally Kardash
- Department of Rheumatology, NHS Lanarkshire, Lanarkshire, UNITED KINGDOM
| | - Lucy Moran
- Department of Rheumatology, NHS Dumfries and Galloway, Dumfries and Gal, UNITED KINGDOM
| | - Ruth Richmond
- Department of Rheumatology, NHS Borders, Borders, UNITED KINGDOM
| | - Adrian Tan
- Department of Rheumatology, NHS Borders, Borders, UNITED KINGDOM
| | - Jan Sznajd
- Department of Rheumatology, NHS Highlands, Inverness, UNITED KINGDOM
| | - Stewart Lambie
- Department of Rheumatology, NHS Highlands, Inverness, UNITED KINGDOM
| | - Mohmmed Khalid
- Department of Rheumatology, NHS Lothian, Edinburgh, UNITED KINGDOM
| | - Sara Else
- Department of Rheumatology, NHS Forth Valley, Forth Valley, UNITED KINGDOM
| | - Carol A Davies
- Department of Rheumatology, NHS Forth Valley, Forth Valley, UNITED KINGDOM
| | - Margaret Duncan
- Department of Rheumatology, NHS Ayrshire and Arran, Ayrshire, UNITED KINGDOM
| | - John Mclaren
- Department of Rheumatology, NHS Fife, Fife, UNITED KINGDOM
| | - Sean Duncan
- Department of Rheumatology, NHS Fife, Fife, UNITED KINGDOM
| | - Sean Murphy5
- Department of Rheumatology, NHS Tayside, Dundee, UNITED KINGDOM
| | - Fuad Hasan
- Department of Rheumatology, NHS Tayside, Dundee, UNITED KINGDOM
| | - Neil Basu
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UNITED KINGDOM
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Disher N, Robertson T, Duncan S, Grainger S, Ahn K, Hay C, Leighs T, Palmer J, Lim J, White T, Pemberton J, Iosua E, Hancox B, Coffey S. A061 Exercise Stress Echocardiography as Predictor for Major Adverse Cardiac Events: A Single Centre Retrospective Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.05.066] [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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Ruiz S, Koebernick N, Duncan S, Fletcher DM, Scotson C, Boghi A, Marin M, Bengough AG, George TS, Brown LK, Hallett PD, Roose T. Significance of root hairs at the field scale - modelling root water and phosphorus uptake under different field conditions. Plant Soil 2019; 447:281-304. [PMID: 32214504 PMCID: PMC7062663 DOI: 10.1007/s11104-019-04308-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/13/2019] [Indexed: 05/22/2023]
Abstract
ABSTRACT BACKGROUND AND AIMS Root hairs play a significant role in phosphorus (P) extraction at the pore scale. However, their importance at the field scale remains poorly understood. METHODS This study uses a continuum model to explore the impact of root hairs on the large-scale uptake of P, comparing root hair influence under different agricultural scenarios. High vs low and constant vs decaying P concentrations down the soil profile are considered, along with early vs late precipitation scenarios. RESULTS Simulation results suggest root hairs accounted for 50% of total P uptake by plants. Furthermore, a delayed initiation time of precipitation potentially limits the P uptake rate by over 50% depending on the growth period. Despite the large differences in the uptake rate, changes in the soil P concentration in the domain due to root solute uptake remains marginal when considering a single growth season. However, over the duration of 6 years, simulation results showed that noticeable differences arise over time. CONCLUSION Root hairs are critical to P capture, with uptake efficiency potentially enhanced by coordinating irrigation with P application during earlier growth stages of crops.
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Affiliation(s)
- S Ruiz
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
| | - N Koebernick
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
- 5Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Universitaetplatz 10, 06108 Halle (Saale), Germany
| | - S Duncan
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
| | - D McKay Fletcher
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
| | - C Scotson
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
| | - A Boghi
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
| | - M Marin
- 2School of Biological Sciences, University of Aberdeen, Aberdeen, AB24 3UU UK
| | - A G Bengough
- 3Ecological Sciences Group, The James Hutton Institute, Invergowrie, Dundee, DD2 5DA UK
- 4School of Science and Engineering, University of Dundee, Dundee, DD1 4HN UK
| | - T S George
- 3Ecological Sciences Group, The James Hutton Institute, Invergowrie, Dundee, DD2 5DA UK
| | - L K Brown
- 3Ecological Sciences Group, The James Hutton Institute, Invergowrie, Dundee, DD2 5DA UK
| | - P D Hallett
- 2School of Biological Sciences, University of Aberdeen, Aberdeen, AB24 3UU UK
| | - T Roose
- 1Bioengineering Science Research Group, Department of Mechanical Engineering, School of Engineering, Faculty of Engineering and Physical Science, University of Southampton, Southampton, SO17 1BJ UK
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Vakharia N, Xiao F, O’Keeffe A, Sparks R, McEvoy W, Miserocchi A, Ourselin S, Duncan S. P30 A PRISMA systematic review and meta-analysis of open and novel ‘minimally invasive’ techniques for mesial temporal lobe epilepsy (MTLE). J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesOne third of patients with focal epilepsy fail to achieve seizure freedom despite best medical therapy. Surgery may provide seizure freedom if the epileptogenic zone can be safely remove. We compare the outcomes following open surgery, laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and radiosurgery (RS).DesignPRISMA systematic review and meta-analysis.SubjectsMTLEMethodsStructured searchs of PubMed, Embase and Cochrane databases. Random effects meta-analysis to calculate effects sizes and a pooled estimate of the probability of remaining seizure free at one year following intervention.ResultsFrom 1212 screened publications, 57 articles were included in the quantitative analysis. Open surgery included anterior temporal lobectomy as well as transcortical, subtemporal and transsylvian selective amygdalohippocampectomy. The probability of remaining seizure free at one year was 0.89 (95% CI 0.83–0.93) with open surgery based on Level 1 and 2 evidence. RS resulted in 0.88 (95% CI 0.84–0.90) probability and a single RCT revealed RS was less efficacious than open surgery. Follow up duration and study sizes were limited with LITT and RFA providing a probability of remaining seizure free at one year of 0.71 (95% CI 0.65–0.76) and 0.86 (95% CI 0.76–0.92) respectively.ConclusionsThere is no evidence supporting novel ‘minimally invasive’ approaches as being as efficacious as open surgery. Secondary outcome measures such as neuropsychological outcome and intervention morbidity are poorly reported.
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Vakharia N, Manchini M, Vos B, Li K, McEvoy A, Sparks R, Ourselin S, Duncan S. TP3-4 Changes in whole brain connectomes with simulated laser interstitial thermal therapy (LITT) using seizure free and non-seizure free ablation cavities in mesial temporal sclerosis: a graph theory approach. J Neurol Neurosurg Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesLITT is a novel means of focal lesioning. Improved seizure free outcome has been associated with the extent to which the mesial hippocampal head is ablated, but not overall ablation volume. We question whether specific changes in structural network connectivity exist in patients that achieve seizure freedom.DesignRetrospectiveSubjects25 MTS patients after LITT with 2 year outcome.MethodsAblation cavities from 11 seizure free and 14 non-seizure free patients were combined to generate group masks. In 12 separate pre-operative patients with MTS (6 right), weighted normalized connectomes were generated with 1 × 10^7 streamlines. To simulate ablations the group cavity masks were excluded from the connectomes prior to normalization. Differences in connectomes were assessed by graph theory metrics.ResultsGreater node strength (str) in non-seizure free patients were present in the ipsilateral basal temporo-occipital cortices in both right and left MTS. Str and local efficiency were relatively maintained in the ipsilateral thalamus of seizure free cavities. Betweenness centrality in non-seizure free cavities were greater in ipsilateral temporal poles in right and left MTS.ConclusionsDifferences in network connectivity are present following simulated LITT for MTS between seizure free and non-seizure free ablation cavities. LiTT ablation cavities may be pre-operatively modelled to ensure the ablation cavity includes important structures and non-essential or inhibitory connectivity is spared. Prospective validation is required.
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Pattullo GG, Duncan S, Tang C. Management of Severe Factor XI Deficiency with Factor XI Concentrate to Facilitate Prolonged Use of a Thoracic Epidural Catheter. Pain Med 2019; 20:198-199. [PMID: 29917113 DOI: 10.1093/pm/pny126] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Sean Duncan
- Department of Anaesthesia and Pain Management
| | - Catherine Tang
- Department of Haematology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia
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Clohisy JC, Pascual-Garrido C, Duncan S, Pashos G, Schoenecker PL. Concurrent femoral head reduction and periacetabular osteotomies for the treatment of severe femoral head deformities. Bone Joint J 2018; 100-B:1551-1558. [PMID: 30499318 DOI: 10.1302/0301-620x.100b12.bjj-2018-0030.r3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aims of this study were to review the surgical technique for a combined femoral head reduction osteotomy (FHRO) and periacetabular osteotomy (PAO), and to report the short-term clinical and radiological results of a combined FHRO/PAO for the treatment of selected severe femoral head deformities. PATIENTS AND METHODS Between 2011 and 2016, six female patients were treated with a combined FHRO and PAO. The mean patient age was 13.6 years (12.6 to 15.7). Clinical data, including patient demographics and patient-reported outcome scores, were collected prospectively. Radiologicalally, hip morphology was assessed evaluating the Tönnis angle, the lateral centre to edge angle, the medial offset distance, the extrusion index, and the alpha angle. RESULTS The mean follow-up was 3.3 years (2 to 4.6). The modified Harris Hip Score improved by 33.0 points from 53.5 preoperatively to 83.4 postoperatively (p = 0.03). The Western Ontario McMasters University Osteoarthritic Index score improved by 30 points from 62 preoperatively to 90 postoperatively (p = 0.029). All radiological parameters showed significant improvement. There were no long-term disabilities and none of the hips required early conversion to total hip arthroplasty. CONCLUSION FHRO combined with a PAO resulted in clinical and radiological improvement at short-term follow-up, suggesting it may serve as an appropriate salvage treatment option for selected young patients with severe symptomatic hip deformities.
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Affiliation(s)
- J C Clohisy
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - C Pascual-Garrido
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - S Duncan
- Department of Orthopedic Surgery, St. Louis Shriner's Hospital for Children, St Louis, Missouri, USA
| | - G Pashos
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - P L Schoenecker
- Department of Orthopedic Surgery, University of Kentucky, Lexington, Kentucky, USA
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Glitza I, Rohlfs M, Iqbal M, Richard J, Burton E, Duncan S, Brown C, Anderson J, Hwu P, Hwu WJ, Wong M, Yee C, Patel S, Woodman S, Amaria R, Diab A, Tawbi H, Davies M. A phase I/Ib study of concurrent intravenous (IV) and intrathecal (IT) nivolumab (Nivo) for melanoma patients (pts) with leptomeningeal disease (LMD). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Leggett G, Butler A, Massey D, Middleton S, Russell N, Woodward J, Green J, Bond D, Duncan S, Woolner L, Sharkey L. A summary of 10 years of transplant activity and outcomes from a UK centre for intestinal and multivisceral transplantation. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2063] [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: 10/28/2022]
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Keyes SD, Cooper L, Duncan S, Koebernick N, McKay Fletcher DM, Scotson CP, van Veelen A, Sinclair I, Roose T. Measurement of micro-scale soil deformation around roots using four-dimensional synchrotron tomography and image correlation. J R Soc Interface 2018; 14:rsif.2017.0560. [PMID: 29118113 DOI: 10.1098/rsif.2017.0560] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 07/31/2017] [Accepted: 10/13/2017] [Indexed: 01/19/2023] Open
Abstract
This study applied time lapse (four-dimensional) synchrotron X-ray computed tomography to observe micro-scale interactions between plant roots and soil. Functionally contrasting maize root tips were repeatedly imaged during ingress into soil columns of varying water content and compaction. This yielded sequences of three-dimensional densiometric data, representing time-resolved geometric soil and root configurations at the micronmetre scale. These data were used as inputs for two full-field kinematic quantification methods, which enabled the analysis of three-dimensional soil deformation around elongating roots. Discrete object tracking was used to track rigid mineral grains, while continuum digital volume correlation was used to track grey-level patterns within local sub-volumes. These techniques both allowed full-field soil displacements to be quantified at an intra-rhizosphere spatial sampling scale of less than 300 µm. Significant differences in deformation mechanisms were identified around different phenotypes under different soil conditions. A uniquely strong contrast was observed between intact and de-capped roots grown in dry, compacted soil. This provides evidence that functional traits of the root cap significantly reduce the amount of soil disturbance per unit of root elongation, with this effect being particularly significant in drier soil.
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Affiliation(s)
- S D Keyes
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - L Cooper
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - S Duncan
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - N Koebernick
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - D M McKay Fletcher
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - C P Scotson
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - A van Veelen
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - I Sinclair
- Materials Engineering Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - T Roose
- Bioengineering Sciences Research Group, Department of Mechanical Engineering, Faculty of Engineering and Environment, University of Southampton, University Road, Southampton SO17 1BJ, UK
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Bhagey A, Foster K, Ralph S, Wardropper A, White C, Wholey V, Duncan S. High prevalence of anti-hepatitis A IgG in a cohort of UK HIV-negative men who have sex with men: implications for local hepatitis A vaccine policy. Int J STD AIDS 2018; 29:1007-1010. [DOI: 10.1177/0956462418770008] [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: 12/20/2022]
Abstract
BASHH guidelines recommend that ‘the hepatitis A virus total antibody test can be offered to at-risk patients whose immune status is unknown … depending on local funding arrangements’. We sought to measure the local prevalence of anti-hepatitis A (HAV) IgG in HIV-negative men who have sex with men (MSM), to inform the utility of pre-vaccination screening. We assessed the prevalence of anti-HAV IgG in HIV-negative MSM who attended sexual health services in County Durham and Darlington, UK, from March to August 2017. Data were extracted from electronic patient records and analysed in Excel. Our study was granted local Caldicott approval. Seventy four per cent of 244 HIV-negative MSM who attended for review were screened. Anti-HAV IgG was detected in 42% who did not report definite previous infection or vaccination; not detected in 57.4%; and was equivocal in 0.6%. Vaccine was administered to 48% of eligible patients. The estimated financial costs of universal vaccination of MSM (£4235.40) and pre-vaccination screening with vaccination of susceptible patients (£4188.13) are similar. Pre-vaccination screening and vaccination of susceptible patients does not save resources compared to a policy of universal vaccination of MSM in our setting. Universal vaccination of MSM attending genitourinary medicine clinics may improve vaccine uptake.
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Affiliation(s)
- A Bhagey
- County Durham and Darlington NHS Foundation Trust (CDDFT), Darlington, UK
| | - K Foster
- Public Health England North East, Newcastle-upon-Tyne, UK
| | - S Ralph
- County Durham and Darlington NHS Foundation Trust (CDDFT), Darlington, UK
| | - A Wardropper
- County Durham and Darlington NHS Foundation Trust (CDDFT), Darlington, UK
| | - C White
- County Durham and Darlington NHS Foundation Trust (CDDFT), Darlington, UK
| | - V Wholey
- County Durham and Darlington NHS Foundation Trust (CDDFT), Darlington, UK
| | - S Duncan
- County Durham and Darlington NHS Foundation Trust (CDDFT), Darlington, UK
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Duncan S, Annunziato RA, Dunphy C, LaPointe Rudow D, Shneider BL, Shemesh E. A systematic review of immunosuppressant adherence interventions in transplant recipients: Decoding the streetlight effect. Pediatr Transplant 2018; 22:10.1111/petr.13086. [PMID: 29218760 PMCID: PMC5811374 DOI: 10.1111/petr.13086] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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] [Accepted: 10/23/2017] [Indexed: 12/23/2022]
Abstract
Non-adherence to immunosuppressant medications is an important risk factor for graft dysfunction. To evaluate the effectiveness of adherence-enhancing interventions, we reviewed adherence intervention studies in solid organ transplant recipients (all ages). Using the following databases: PsycINFO, PubMed, Scopus, and ScienceDirect, we identified 41 eligible studies. Only three non-randomized trials showed a possible positive effect on objective indicators of transplant outcomes (such as rejection, liver enzyme levels, kidney function). None of the 21 RCTs showed an improvement in transplant outcomes. Three studies showed a higher rate of adverse events in the intervention group as compared with controls, although this may be related to ascertainment bias. Improvement in adherence as measured indirectly (eg, with electronic monitoring devices) was not aligned with effects on transplant outcomes. We conclude that adherence interventions, to date, have largely been ineffective in improving transplant outcomes. To improve this track record, intervention efforts may wish to concentrate on non-adherent patients (rather than use convenience sampling, which excludes many of the patients who need the intervention), use direct measures of adherence to guide the interventions, and employ strategies that are intensive and yet engaging enough to ensure that non-adherent patients are able to participate.
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Affiliation(s)
- S Duncan
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - R A Annunziato
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - C Dunphy
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - D LaPointe Rudow
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
| | - B L Shneider
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - E Shemesh
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA
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Clausen J, Martinsen L, Wilson B, Duncan S, Andersen J. SUN-P147: Organization of the Dietetic Service in a Hospital – Local in the Department or Centralized? Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30480-6] [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: 10/18/2022]
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Leach JP, Smith PE, Craig J, Bagary M, Cavanagh D, Duncan S, Kelso ARC, Marson AG, McCorry D, Nashef L, Nelson-Piercy C, Northridge R, Sieradzan K, Thangaratinam S, Walker M, Winterbottom J, Reuber M. Epilepsy and Pregnancy: For healthy pregnancies and happy outcomes. Suggestions for service improvements from the Multispecialty UK Epilepsy Mortality Group. Seizure 2017. [PMID: 28641176 DOI: 10.1016/j.seizure.2017.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Between 2009 and 2012 there were 26 epilepsy-related deaths in the UK of women who were pregnant or in the first post-partum year. The number of pregnancy-related deaths in women with epilepsy (WWE) has been increasing. Expert assessment suggests that most epilepsy-related deaths in pregnancy were preventable and attributable to poor seizure control. While prevention of seizures during pregnancy is important, a balance must be struck between seizure control and the teratogenic potential of antiepileptic drugs (AEDs). A range of professional guidance on the management of epilepsy in pregnancy has previously been issued, but little attention has been paid to how optimal care can be delivered to WWE by a range of healthcare professionals. We summarise the findings of a multidisciplinary meeting with representation from a wide group of professional bodies. This focussed on the implementation of optimal pregnancy epilepsy care aiming to reduce mortality of epilepsy in mothers and reduce morbidity in babies exposed to AEDs in utero. We identify in particular -What stage to intervene - Golden Moments of opportunities for improving outcomes -Which Key Groups have a role in making change -When - 2020 vision of what these improvements aim to achieve. -How to monitor the success in this field We believe that the service improvement ideas developed for the UK may provide a template for similar initiatives in other countries.
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Affiliation(s)
- J P Leach
- School of Medicine, University of Glasgow, G12 8QQ, United Kingdom.
| | - P E Smith
- The Alan Richens Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, CF14 4XW, United Kingdom.
| | - J Craig
- Department of Neurology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, United Kingdom.
| | - M Bagary
- Regional Complex Epilepsy Service, The Barberry, 25 Vincent Drive, Birmingham, B15 2FG, United Kingdom.
| | - D Cavanagh
- Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, S2 1JF, United Kingdom
| | - S Duncan
- Department of Clinical Neurosciences, Western General Hospital Edinburgh, EH42XU, United Kingdom.
| | - A R C Kelso
- Royal London Hospital,Whitechapel Road, London, E1 1BB, United Kingdom.
| | - A G Marson
- Department of Neurology, Liverpool University, Walton Centre for Neurology and Neurosurgery, Liverpool L9 7LJ, United Kingdom.
| | - D McCorry
- University Hospital Birmingham, The new Queen Elizabeth Hospital Birmingham, Birmingham, B15 2WB, United Kingdom.
| | - L Nashef
- Department of Neurology, King's College Hospital, London, United Kingdom.
| | - C Nelson-Piercy
- Women's health directorate, St Thomas hospital, London, SE17EH, United Kingdom.
| | - R Northridge
- Ninewells Hospital, Dundee DD1 9SY, United Kingdom.
| | - K Sieradzan
- Department of Neurology, Brunel Building, Level 2, Gate 3, Southmead Hospital, Bristol, BS10 5NB, United Kingdom.
| | - S Thangaratinam
- Maternal and Perinatal Health Women's Health Research Unit, The Blizard Institute Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom.
| | - M Walker
- UCL Institute of Neurology, Queen Square, WC1N 3BG, United Kingdom.
| | - J Winterbottom
- The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, United Kingdom.
| | - M Reuber
- Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, S2 1JF, United Kingdom.
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Harada S, Zhou Y, Duncan S, Armstead AR, Coshatt GM, Dillon C, Brott BC, Willig J, Alsip JA, Hillegass WB, Limdi NA. Precision Medicine at the University of Alabama at Birmingham: Laying the Foundational Processes Through Implementation of Genotype-Guided Antiplatelet Therapy. Clin Pharmacol Ther 2017; 102:493-501. [PMID: 28124392 DOI: 10.1002/cpt.631] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/04/2017] [Accepted: 01/15/2017] [Indexed: 12/14/2022]
Abstract
Precision medicine entails tailoring treatment based on patients' unique characteristics. As drug therapy constitutes the cornerstone of treatment for most chronic diseases, pharmacogenomics (PGx), the study of genetic variation influencing individual response to drugs, is an important component of precision medicine. Over the past decade investigations have identified genes and single-nucleotide polymorphisms (SNPs) and quantified their effect on drug response. Parallel development of point-of-care (POC) genotyping platforms has enabled the interrogation of the genes/SNPs within a timeline conducive to the provision of care. Despite these advances, the pace of integration of genotype-guided drug therapy (GGTx) into practice has faced significant challenges. These include difficulty in identifying SNPs with sufficiently robust evidence to guide clinical decision making, lack of clinician training on how to order and use genotype data, lack of clinical decision support (CDS) to guide treatment, and limited reimbursement. The University of Alabama at Birmingham's (UAB) efforts in precision medicine were initiated to address these challenges and improve the health of the racially diverse patients we treat.
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Affiliation(s)
- S Harada
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Y Zhou
- Department of Pathology, University of Oklahoma Health Sciences Center, Norman, Oklahoma, USA
| | - S Duncan
- University of Alabama at Birmingham Health System, Birmingham, Alabama, USA
| | - A R Armstead
- University of Alabama at Birmingham Health System, Birmingham, Alabama, USA
| | - G M Coshatt
- University of Alabama at Birmingham Health System, Birmingham, Alabama, USA
| | - C Dillon
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - B C Brott
- Department of Medicine, Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J Willig
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J A Alsip
- University of Alabama at Birmingham Health System, Birmingham, Alabama, USA
| | | | - N A Limdi
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Ambrose T, Sharkey LM, Louis-Auguste J, Rutter CS, Duncan S, English S, Gkrania-Klotsas E, Carmichael A, Woodward JM, Russell N, Massey D, Butler A, Middleton S. Cytomegalovirus Infection and Rates of Antiviral Resistance Following Intestinal and Multivisceral Transplantation. Transplant Proc 2017; 48:492-6. [PMID: 27109985 DOI: 10.1016/j.transproceed.2015.09.070] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/03/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) disease is a common and clinically significant complication following intestinal or multivisceral transplantation. CMV disease is more common in cases of serologic mismatch between donor and recipient. Though in some cases it may be asymptomatic, in the immunosuppressed population it often manifests with evidence of systemic infection or end-organ disease. METHODS We conducted a retrospective review of all patients undergoing intestinal or multivisceral transplantation over 8 years at our institution. RESULTS Forty-eight transplantations were performed, with 40% of the patients (19/48) having ≥1 episode of CMV viremia, which rose to 90% in the "donor-positive, recipient-negative" (DPRN) serologic mismatch group. The median time to 1st episode following transplantation was 22.3 weeks (range, 1-78) and median duration of each episode was 4.9 weeks (range, 1.6-37.4). Six of the 19 viremic patients (31.6%) developed virologic resistance with 4 of these occurring in the DPRN group. Four of the 6 patients with drug-resistant CMV died with CMV viremia. All patients with drug resistance acquired ganciclovir resistance; these patients were more challenging to manage with second-line toxicity-limited treatments, including foscarnet, cidofovir, and leflunomide. CMV immunoglobulin has been used and we briefly discuss the use of CMV-specific adoptive T-lymphocyte transfer in the management of 1 case. CONCLUSIONS Post-transplantation CMV disease continues to be challenging to manage, and there is little consensus on optimal management strategies in this patient group, with a significant requirement for novel therapies; these may be pharmacologic or cell based. Extensive multidisciplinary discussion is important for most cases, but particularly for those patients who acquire virologic resistance.
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Affiliation(s)
- T Ambrose
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - L M Sharkey
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Louis-Auguste
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - C S Rutter
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Duncan
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S English
- Department of Clinical Virology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - E Gkrania-Klotsas
- Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Carmichael
- Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J M Woodward
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - N Russell
- Department of Transplant Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Massey
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Butler
- Department of Transplant Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Middleton
- Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, United Kingdom.
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Potts H, Duncan S, Johnson ML, O'Keefe SF, Marcy JE, Mallikarjunan K. 0712 Oxygen barrier and light interference packaging properties for controlling light-induced oxidation in milk. J Anim Sci 2016. [DOI: 10.2527/jam2016-0712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Duncan S, Potts H, Amin KN. 0532 Comparing fluorescent and light-emitting diode (LED) retail lighting effects on consumer acceptability of fluid milk. J Anim Sci 2016. [DOI: 10.2527/jam2016-0532] [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: 11/13/2022] Open
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24
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Amin KN, Johnson ML, Phillips JB, Duncan S, Potts H, O'Keefe SF, Marcy JE, Mallikarjunan K. 0706 Differences in high-density polyethylene milk packaging performance under light-emitting diode and fluorescent retail storage. J Anim Sci 2016. [DOI: 10.2527/jam2016-0706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Leonard N, Korenko M, Larson C, Blood K, Venstrom L, Nudehi S, Duncan S, Diver R, Simko F, Priscak J, Schoer J, Kissinger P, Palumbo R. The thermal electrolytic production of Mg from MgO: A discussion of the electrochemical reaction kinetics and requisite mass transport processes. Chem Eng Sci 2016. [DOI: 10.1016/j.ces.2016.03.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Duncan S, McCann M, Qiang G, Gil V, Whang Kong H, Liew C. ID: 87: TRANSCRIPTION FACTOR CREB3L3 IS A NOVEL REGULATOR FOR ADIPOCYTE BIOLOGY AND METABOLISM. J Investig Med 2016. [DOI: 10.1136/jim-2016-000120.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The presence of differential metabolic risks between the metabolically-protective subcutaneous adipose tissue (SAT) and the disease-associated visceral adipose tissue (VAT) is well established, but the mechanisms that cause these differences are not well understood. Cyclic AMP responsive element binding protein 3-like 3 (CREB3L3), a previously characterized liver-specific ER-bound transcription factor, was found to be expressed in murine SAT and VAT. In obese human subjects and an obese mouse model, we found that CREB3L3 is downregulated in SAT, but not in VAT. To examine the role of CREB3L3 in adipocyte biology and metabolism, we created a fat-specific CREB3L3 knockout (KO) mouse using the AdipoQ-Cre mouse. To establish a potential role for CREB3L3 in adipocytes, we examined in vitro differentiated adipocytes from isolated WT and KO primary stromal vascular fraction. We observed that ablation of CREB3L3 in SAT adipocytes significantly upregulated expression of both lipogenic and lipolytic markers. At the same time, we also observed significantly increased expression of thermogenic markers like PGC1α and Cox8b. Taken together our data suggest potential upregulation of the fat futile cycle in SAT upon deletion of CREB3L3. Surprisingly, we found that CREB3L3 KO tends to downregulate expression of markers of both lipogenesis and lipolysis in VAT adipocytes. This observation could potentially be contributed by the tendency of CREB3l3 KO VAT to have inhibited differentiation. To investigate the in vivo function of CREB3L3, we challenged WT and KO mice with high fat diet with weekly body weight assessment. We observed that CREB3L3 ablation in adipose tissues promotes significant weight gain in mice on HFD. Unexpectedly, despite being heavier, the KO mice are not more glucose intolerant or insulin resistant. These data together suggest that ablation of CREB3L3 could potentially promote fat storage in adipose tissues to prevent metabolic diseases caused by ectopic fat deposition.
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Gao R, Kratzing C, Pither C, Sharkey L, West S, Butler A, Woodward J, Duncan S, Green J, Chukualim B, Gabe S, Jamieson N, Middleton S. Nutritional outcomes following small bowel transplantation – The first year post-operative nutritional nadir. Clin Nutr ESPEN 2015; 10:e190-e191. [DOI: 10.1016/j.clnesp.2015.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Duncan S. David Gavin Millar. Assoc Med J 2015. [DOI: 10.1136/bmj.h1010] [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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Bennett A, Wainwright E, Lord E, Oduru M, Chen F, Desmond N, Sherrard J, Duncan S. The impact of the 2011 UK post-exposure prophylaxis for HIV following sexual exposure guidelines: a regional retrospective audit. Int J STD AIDS 2014; 26:746-8. [PMID: 25332226 DOI: 10.1177/0956462414556329] [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: 06/19/2014] [Accepted: 09/23/2014] [Indexed: 11/16/2022]
Abstract
A re-audit of prescribing of post-exposure prophylaxis for HIV following sexual exposure in the Thames Valley demonstrated that an updated proforma has led to significant improvements in clinician-led outcomes, but had no impact on completion or follow-up rates.
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Affiliation(s)
- A Bennett
- The Garden Clinic, Upton Hospital, Slough, Berkshire, UK
| | - E Wainwright
- The Churchill Hospital, Old Road, Headington, Oxford, UK
| | - E Lord
- The Churchill Hospital, Old Road, Headington, Oxford, UK
| | - M Oduru
- The Florey Unit, Royal Berkshire Hospital, Reading, UK
| | - F Chen
- The Florey Unit, Royal Berkshire Hospital, Reading, UK
| | - N Desmond
- The Garden Clinic, Upton Hospital, Slough, Berkshire, UK
| | - J Sherrard
- The Churchill Hospital, Old Road, Headington, Oxford, UK
| | - S Duncan
- Darlington Memorial Hospital, Hundens Lane, Darlington, UK
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Middleton S, Pither C, Gao R, Duncan S, Green J, Sharkey L, Chukualim B, Kratzing C, Woodward J, Gabe S, Jamieson N, Butler A. Adult Small Intestinal and Multivisceral Transplantation: Lessons Through the “Retrospecto-scope” at a Single UK Centre From 1991 to 2013. Transplant Proc 2014; 46:2114-8. [DOI: 10.1016/j.transproceed.2014.06.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Hypophosphataemia with tenofovir (TDF) treatment has been well described. The role of HIV infection and of other antiretroviral (ART) agents in hypophosphataemia has received less attention. The aim of this study was to determine the prevalence of hypophosphataemia in HIV-positive adults. We measured the fasting plasma phosphate level and estimated glomerular filtration rate (eGFR) in 123 HIV-positive patients. A total of 26% had hypophosphataemia and 11% had hypophosphataemia of grades 2-4 (0.65 mmol/L or less). Hypophosphataemia of any grade was more frequent in those who were ART-treated than ART-naive (35% versus 10%; P = 0.0001). Multiple linear regression analysis showed no significant association between phosphate level and gender, TDF status, duration of ART, duration of HIV infection and eGFR. Increasing age was significantly associated with a very small rise in phosphate level. Isolated hypophosphataemia was significantly more frequent in HIV-positive subjects receiving ART than ART-naive individuals, irrespective of the drug regimen.
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Affiliation(s)
- E Wainwright
- Oxford Genitourinary Medicine, Oxford OX3 9DS, UK.
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Duncan S, Sherrard J. P3.442 Experience of Screening For Hepatitis C in an Oxfordshire Prison. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0892] [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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Feng X, Knowlton KF, Dietrich AD, Duncan S. Effect of abomasal ferrous lactate infusion on phosphorus absorption in lactating dairy cows. J Dairy Sci 2013; 96:4586-91. [PMID: 23660146 DOI: 10.3168/jds.2013-6602] [Citation(s) in RCA: 6] [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] [Received: 01/21/2013] [Accepted: 03/17/2013] [Indexed: 11/19/2022]
Abstract
The objective of this study was to evaluate the effect of ferrous lactate infusion on postruminal P absorption in lactating dairy cows. Four ruminally cannulated lactating cows were used in a 4×4 Latin square design with 14 d per period. Cows were fed a basal diet containing 0.39% P, providing 100% of the calculated P requirement. On d 8 to 14 of each period, each cow was infused with 0, 200, 500, or 1,250mg of Fe/d in the form of ferrous lactate solution (ferrous lactate in 1L of double-distilled water) into the abomasum. Infusate was formulated to approximate 0, 2, 5, or 12.5mg of Fe/L in drinking water with 100L of water intake/d. Total fecal collection was conducted in the last 4 d of each period to measure nutrient digestion and excretion. Dry matter intake, milk yield, and milk composition were not affected by treatment. Digestibility of DM, NDF, and nitrogen decreased linearly with increasing ferrous lactate infusion. Infusion of ferrous lactate did not affect intake and digestibility of total P, inorganic P, or phytate P. In lactating cows, P absorption was not negatively influenced by abomasally infused ferrous lactate up to 1,250mg of Fe/d.
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Affiliation(s)
- X Feng
- Department of Dairy Science, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
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Williden M, Badland H, Schofield L, Schofield G, Duncan S. Assessing the relationship between the workplace environment and employee physical activity and nutrition behaviours. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.247] [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: 10/27/2022]
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Madsen T, Christiansen L, Nielsen T, Troelsen J, Schipperijn J, Duncan S. Associations between a walkability index and bicycle use in Denmark. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.657] [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: 10/27/2022]
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Toftager M, Duncan S, Oliver M, Kristensen P, Christiansen L, Troelsen J. Physical activity in adolescents–Accelerometer data reduction criteria: Number of valid days, minimum daily wear time, and non-wear time. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.159] [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: 10/27/2022]
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Duncan S, Kunkel J, White K, McPhee J, Schofield G, Meredith-Jones K, Johnston M, Taylor R. Is physical activity and body composition associated with neurocognitive function in children? J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.835] [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: 10/27/2022]
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Duncan S, Jones R, McIntyre M, Pilsniak A, Trott J, Desmond N. Managing HIV in pregnancy in a community-based sexual health clinic: a decade in review. Int J STD AIDS 2012; 23:806-9. [DOI: 10.1258/ijsa.2012.011466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The management of HIV in pregnancy has evolved significantly over the past 10 years as our experience of combination antiretroviral therapy (ART) has grown. We reviewed 109 pregnancies which were managed at our community-based integrated HIV and sexual health clinic to investigate preconception and antenatal care, and trends in ART over time. We document an increasing proportion of pregnancies in which the mother was aware of her HIV status pre-conception and conception on ART. Pre-conception care was sought in a minority of cases, and many women did not present for first antenatal review until the end of the second trimester. Of 108 live births, there was one case of vertical transmission (0.93%). While our study demonstrates the efficacy of current strategies to prevent mother to child transmission of HIV infection, more could be done to encourage HIV-positive women to seek preconception advice and to attend for early review in the first trimester.
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Affiliation(s)
- S Duncan
- The Garden Clinic, Upton Hospital, Albert Street, Slough SL1 2BJ
| | - R Jones
- Wexham Park Hospital, Slough, UK
| | | | | | - J Trott
- Wexham Park Hospital, Slough, UK
| | - N Desmond
- The Garden Clinic, Upton Hospital, Albert Street, Slough SL1 2BJ
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Grinton M, Leavy Y, Ahern D, Hughes F, Duncan S. Epilepsy health consumer groups and charities; how representative of patients are they? The results of a pilot study. Seizure 2012; 22:472-5. [PMID: 23102834 DOI: 10.1016/j.seizure.2012.09.016] [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: 06/11/2012] [Revised: 09/23/2012] [Accepted: 09/25/2012] [Indexed: 11/16/2022] Open
Abstract
PURPOSE In the United Kingdom all health care providers are encouraged to consult with user groups. The submissions of charities and patient advocacy groups to NICE and SIGN are considered reflective of the patient groups they purport to represent, yet little is known about how representative they are. This pilot study was designed to ascertain how many patients attending a hospital based epilepsy clinic were members of such advocacy groups. METHODS Patients were asked to complete a brief 9-question questionnaire before they left the clinic. RESULTS One hundred and twenty-five questionnaires were distributed, of which 101 were returned. Seventeen percent of patients were members of advocacy groups, with several being members of more than one charity/group. Only seven percent of the respondents had ever been contacted by an advocacy group to canvass their opinions. Seventy percent of patients questioned stated they thought a frank discussion with their physician, or specialist nurse was more likely to influence patient services. Patients with long duration of disease and taking multiple anti-epileptic drugs were more likely to be members of charity/advocacy groups. CONCLUSIONS As patient charities in the U.K. are often in receipt of public funds, and actively seek to influence public policy this raises the question of whether they should be required to consult more widely with the people they claim to represent.
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Affiliation(s)
- M Grinton
- Edinburgh and South East Scotland Epilepsy Service, Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, UK
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Affiliation(s)
- S Duncan
- Specialty Registrar Genitourinary Medicine, The Garden Clinic, Upton Hospital, Slough, UK.
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Abstract
The Timeline Followback (TLFB) interview has been used extensively in the assessment of alcohol and other substance use. While this methodology has been validated in multiple formats for multiple behaviors, to date no systematic comparisons have been conducted between the traditional interview format and online versions. The present research employed a randomized within-subjects design to compare interview versus online-based TLFB assessments of alcohol and marijuana use among 102 college students. Participants were randomly assigned to receive either the online version first or the in-person interview format first. Participants subsequently completed the second format within 3 days. While we expected few overall differences between formats, we hypothesized that differences might emerge to the extent that participants are more comfortable and willing to answer honestly in an online format, which provides a degree of anonymity. Results were consistent with expectations in suggesting relatively few differences between the online version and the in-person version. Participants did report feeling more comfortable in completing the online version. Moreover, greater discomfort during the in-person assessment was associated with reporting more past-month marijuana use on the online assessment, but reported discomfort did not moderate differences between formats in reported alcohol consumption.
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Affiliation(s)
- Eric R Pedersen
- Department of Psychology, University of Washington, Seattle, WA 98195, USA.
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Lesser GJ, Case LD, Mirlohi S, Harmon M, Chan M, Duncan S, Dietrich A. Taste and smell abnormalities (TSA) in patients with newly diagnosed malignant gliomas (MG) treated with combined modality therapy (CMT). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19646] [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: 11/20/2022] Open
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Chamouton J, Hansmannel F, Bonzo JA, Clémencet MC, Chevillard G, Battle M, Martin P, Pineau T, Duncan S, Gonzalez FJ, Latruffe N, Mandard S, Nicolas-Francès V. The Peroxisomal 3-keto-acyl-CoA thiolase B Gene Expression Is under the Dual Control of PPARα and HNF4α in the Liver. PPAR Res 2011; 2010:352957. [PMID: 21437216 PMCID: PMC3061263 DOI: 10.1155/2010/352957] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 12/01/2010] [Accepted: 12/09/2010] [Indexed: 01/10/2023] Open
Abstract
PPARα and HNF4α are nuclear receptors that control gene transcription by direct binding to specific nucleotide sequences. Using transgenic mice deficient for either PPARα or HNF4α, we show that the expression of the peroxisomal 3-keto-acyl-CoA thiolase B (Thb) is under the dependence of these two transcription factors. Transactivation and gel shift experiments identified a novel PPAR response element within intron 3 of the Thb gene, by which PPARα but not HNF4α transactivates. Intriguingly, we found that HNF4α enhanced PPARα/RXRα transactivation from TB PPRE3 in a DNA-binding independent manner. Coimmunoprecipitation assays supported the hypothesis that HNF4α was physically interacting with RXRα. RT-PCR performed with RNA from liver-specific HNF4α-null mice confirmed the involvement of HNF4α in the PPARα-regulated induction of Thb by Wy14,643. Overall, we conclude that HNF4α enhances the PPARα-mediated activation of Thb gene expression in part through interaction with the obligate PPARα partner, RXRα.
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Affiliation(s)
- J. Chamouton
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
| | - F. Hansmannel
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
- INSERM U744, Laboratoire d'Épidémiologie et Santé Publique, Institut Pasteur de Lille, 1 Rue du Professeur Calmette, BP 245, 59019 Lille Cedex, France
| | - J. A. Bonzo
- Laboratory of Metabolism, Division of Basic Sciences, National Cancer Institute, Bethesda, MD 20892, USA
| | - M. C. Clémencet
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
| | - G. Chevillard
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
- Lady Davis Institute for Medical Research, McGill University, 3755 Côte Ste. Catherine Road, Montreal, QC, Canada H3T 1E2
| | - M. Battle
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA
| | - P. Martin
- Laboratoire de Pharmacologie et Toxicologie, UR66, INRA, 31931, Toulouse, France
| | - T. Pineau
- Laboratoire de Pharmacologie et Toxicologie, UR66, INRA, 31931, Toulouse, France
| | - S. Duncan
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA
| | - F. J. Gonzalez
- Laboratory of Metabolism, Division of Basic Sciences, National Cancer Institute, Bethesda, MD 20892, USA
| | - N. Latruffe
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
| | - S. Mandard
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
| | - V. Nicolas-Francès
- Centre de Recherche, INSERM U866, LBMN 6, Boulevard Gabriel, 21000 Dijon, France
- Laboratoire de Biochimie Métabolique et Nutritionnelle (LBMN), Faculté des Sciences Gabriel, Université de Bourgogne, 21000 Dijon, France
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McPhee J, Duncan S, Schofield G, Zinn C. Healthy homework pilot study: Qualitative findings from a physical activity and nutrition intervention for primary-aged children. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2010.10.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Quilter CR, Karcanias AC, Bagga MR, Duncan S, Murray A, Conway GS, Sargent CA, Affara NA. Reply: Array comparative genomic hybridization for the detection of submicroscopic copy number variations of the X chromosome in women with premature ovarian failure. Hum Reprod 2010. [DOI: 10.1093/humrep/deq285] [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: 11/12/2022] Open
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Quilter CR, Karcanias AC, Bagga MR, Duncan S, Murray A, Conway GS, Sargent CA, Affara NA. Analysis of X chromosome genomic DNA sequence copy number variation associated with premature ovarian failure (POF). Hum Reprod 2010; 25:2139-50. [PMID: 20570974 DOI: 10.1093/humrep/deq158] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Premature ovarian failure (POF) is a heterogeneous disease defined as amenorrhoea for >6 months before age 40, with an FSH serum level >40 mIU/ml (menopausal levels). While there is a strong genetic association with POF, familial studies have also indicated that idiopathic POF may also be genetically linked. Conventional cytogenetic analyses have identified regions of the X chromosome that are strongly associated with ovarian function, as well as several POF candidate genes. Cryptic chromosome abnormalities that have been missed might be detected by array comparative genomic hybridization. METHODS In this study, samples from 42 idiopathic POF patients were subjected to a complete end-to-end X/Y chromosome tiling path array to achieve a detailed copy number variation (CNV) analysis of X chromosome involvement in POF. The arrays also contained a 1 Mb autosomal tiling path as a reference control. Quantitative PCR for selected genes contained within the CNVs was used to confirm the majority of the changes detected. The expression pattern of some of these genes in human tissue RNA was examined by reverse transcription (RT)-PCR. RESULTS A number of CNVs were identified on both Xp and Xq, with several being shared among the POF cases. Some CNVs fall within known polymorphic CNV regions, and others span previously identified POF candidate regions and genes. CONCLUSIONS The new data reported in this study reveal further discrete X chromosome intervals not previously associated with the disease and therefore implicate new clusters of candidate genes. Further studies will be required to elucidate their involvement in POF.
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Affiliation(s)
- C R Quilter
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK
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Abstract
BACKGROUND The National Institute for Clinical Excellence in the UK has issued guidelines stating all individuals with epilepsy be given information about sudden unexpected death in epilepsy (SUDEP). METHODS We conducted a survey of current practice among UK neurologists, using a questionnaire sent to all practising neurologists in the UK listed on the Association of British Neurologists database, asking under what circumstances they told patients about SUDEP. RESULTS Of the validated respondents, 5% discussed SUDEP with all patients, 26% with a majority, 61% with a few, and 7.5% with none. The commonest reasons for SUDEP to be discussed were the patient asking about it and the neurologist counselling people with known risk factors for SUDEP. CONCLUSIONS The variation we found, although not necessarily in tune with the guidelines, reflects the variation in patients' need for knowledge about their condition.
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Affiliation(s)
- B Morton
- Department of Neurology, Greater Manchester Neurosciences Centre, Hope Hospital, Stott Lane, Salford, Manchester M6 8 HD, UK
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