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Simms LA, Davies C, Jayasundara N, Sandhu S, Pintara A, Pretorius A, Nimmo GR, Harper J, Hiskens M, Smith K, Boxall S, Lord A, Giardino R, Farlow D, Ward DM, Huygens F. Performance evaluation of InfectID-BSI: A rapid quantitative PCR assay for detecting sepsis-associated organisms directly from whole blood. J Microbiol Methods 2023:106783. [PMID: 37442279 DOI: 10.1016/j.mimet.2023.106783] [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: 05/27/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Bloodstream infections (BSIs) (presence of pathogenic organism in blood) that progress to sepsis (life-threatening organ dysfunction caused by the body's dysregulated response to an infection) is a major healthcare issue globally with close to 50 million cases annually and 11 million sepsis-related deaths, representing about 20% of all global deaths. A rapid diagnostic assay with accurate pathogen identification has the potential to improve antibiotic stewardship and clinical outcomes. METHODS The InfectID-Bloodstream Infection (InfectID-BSI) test is a real-time quantitative PCR assay, which detects 26 of the most prevalent BSI-causing pathogens (bacteria and yeast) directly from blood (without need for pre-culture). InfectID-BSI identifies pathogens using highly discriminatory single nucleotide polymorphisms located in conserved regions of bacterial and fungal genomes. This report details the findings of a patient study which compared InfectID-BSI with conventional blood culture at two public hospitals in Queensland, Australia, using 375 whole blood samples (from multiple anatomical sites, eg. left arm, right arm, etc.) from 203 patients that have been clinically assessed to have signs and symptoms of suspected BSI, sepsis and septic shock. FINDINGS InfectID-BSI was a more sensitive method for microorganism detection compared with blood culture (BacT/ALERT, bioMerieux) for positivity rate (102 vs 54 detections), detection of fastidious organisms (Streptococcus pneumoniae and Aerococcus viridans) (25 vs 0), detection of low bioburden infections (measured as genome copies/0.35 mL of blood), time to result (<3 h including DNA extraction for InfectID-BSI vs 16 h-48 h for blood culture), and volume of blood required for testing (0.5 mL vs 40-60 mL). InfectID-BSI is an excellent 'rule out' test for BSI, with a negative predictive value of 99.7%. InfectID-BSI's ability to detect 'difficult to culture' microorganisms re-defines the four most prevalent BSI-associated pathogens as E. coli (28.4%), S. pneumoniae (17.6%), S. aureus (13.7%), and S. epidermidis (13.7%). INTERPRETATION InfectID-BSI has the potential to alter the clinical treatment pathway for patients with BSIs that are at risk of progressing to sepsis.
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Affiliation(s)
- Lisa A Simms
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia.
| | - Corey Davies
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia
| | - Nadeesha Jayasundara
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia
| | - Sumeet Sandhu
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia; Queensland Health, Brisbane, Queensland, Australia
| | - Alexander Pintara
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia
| | - Amorette Pretorius
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia
| | - Graeme R Nimmo
- Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland 4029, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Jacqueline Harper
- Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland 4029, Australia
| | - Matthew Hiskens
- Mackay Institute of Research and Innovation, Mackay Hospital and Health Service, Mackay, Queensland 4740, Australia
| | - Karen Smith
- Mackay Institute of Research and Innovation, Mackay Hospital and Health Service, Mackay, Queensland 4740, Australia; Department of Emergency Medicine, Mackay Hospital and Health Service, Mackay, Queensland 4740, Australia
| | - Sarah Boxall
- Department of Emergency Medicine, Mackay Hospital and Health Service, Mackay, Queensland 4740, Australia
| | - Anton Lord
- Spectroscopy and Data Consultants, Brisbane, Queensland, Australia
| | - Raffaella Giardino
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia
| | - David Farlow
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia; Mackay Institute of Research and Innovation, Mackay Hospital and Health Service, Mackay, Queensland 4740, Australia
| | | | - Flavia Huygens
- Microbio Ltd., Translational Research Institute, Brisbane, Queensland 4102, Australia
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Mortlock S, Lord A, Montgomery G, Zakrzewski M, Simms LA, Krishnaprasad K, Hanigan K, Doecke JD, Walsh A, Lawrance IC, Bampton PA, Andrews JM, Mahy G, Connor SJ, Sparrow MP, Bell S, Florin TH, Begun J, Gearry RB, Radford-Smith GL. An Extremes of Phenotype Approach Confirms Significant Genetic Heterogeneity in Patients with Ulcerative Colitis. J Crohns Colitis 2023; 17:277-288. [PMID: 36111848 PMCID: PMC10024548 DOI: 10.1093/ecco-jcc/jjac121] [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: 10/29/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Ulcerative colitis [UC] is a major form of inflammatory bowel disease globally. Phenotypic heterogeneity is defined by several variables including age of onset and disease extent. The genetics of disease severity remains poorly understood. To further investigate this, we performed a genome wide association [GWA] study using an extremes of phenotype strategy. METHODS We conducted GWA analyses in 311 patients with medically refractory UC [MRUC], 287 with non-medically refractory UC [non-MRUC] and 583 controls. Odds ratios [ORs] were calculated for known risk variants comparing MRUC and non-MRUC, and controls. RESULTS MRUC-control analysis had the greatest yield of genome-wide significant single nucleotide polymorphisms [SNPs] [2018], including lead SNP = rs111838972 [OR = 1.82, p = 6.28 × 10-9] near MMEL1 and a locus in the human leukocyte antigen [HLA] region [lead SNP = rs144717024, OR = 12.23, p = 1.7 × 10-19]. ORs for the lead SNPs were significantly higher in MRUC compared to non-MRUC [p < 9.0 × 10-6]. No SNPs reached significance in the non-MRUC-control analysis (top SNP, rs7680780 [OR 2.70, p = 5.56 × 10-8). We replicate findings for rs4151651 in the Complement Factor B [CFB] gene and demonstrate significant changes in CFB gene expression in active UC. Detailed HLA analyses support the strong associations with MHC II genes, particularly HLA-DQA1, HLA-DQB1 and HLA-DRB1 in MRUC. CONCLUSIONS Our MRUC subgroup replicates multiple known UC risk variants in contrast to non-MRUC and demonstrates significant differences in effect sizes compared to those published. Non-MRUC cases demonstrate lower ORs similar to those published. Additional risk and prognostic loci may be identified by targeted recruitment of individuals with severe disease.
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Affiliation(s)
- Sally Mortlock
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Anton Lord
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia
| | - Grant Montgomery
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | | | - Lisa A Simms
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | | | | | - James D Doecke
- Australian eHealth Research Centre, CSIRO, Brisbane, QLD, Australia
| | - Alissa Walsh
- Department of Gastroenterology, John Radcliffe Hospital, Headington, Oxford, UK
| | - Ian C Lawrance
- Centre of Inflammatory Bowel Diseases, Saint John of God Hospital Subiaco, University of Western Australia, WA, Australia
| | | | - Jane M Andrews
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital & University of Adelaide, Adelaide, SA, Australia
| | - Gillian Mahy
- Department of Gastroenterology and Hepatology, Townsville University Hospital, Townsville, QLD, Australia
| | - Susan J Connor
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Miles P Sparrow
- Department of Gastroenterology, Alfred Health, Melbourne, VIC, Australia
| | - Sally Bell
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, VIC, Australia
| | - Timothy H Florin
- Inflammatory Bowel Diseases Group, Translational Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jakob Begun
- Inflammatory Bowel Diseases Group, Translational Research Institute, Brisbane, QLD, Australia
- Inflammatory Disease Biology and Therapeutics Group, Translational Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Richard B Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Graham L Radford-Smith
- Corresponding author: Graham Radford-Smith, Gut Health Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. Tel: +617 3362 0499; Fax: +617 3009 0053;
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Irwin J, Lord A, Ferguson E, Simms LA, Hanigan K, Montoya CA, Radford-Smith G. A Method Using Longitudinal Laboratory Data to Predict Future Intestinal Complication in Patients with Crohn's Disease. Dig Dis Sci 2023; 68:596-607. [PMID: 36125595 PMCID: PMC9905172 DOI: 10.1007/s10620-022-07639-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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/20/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Stenosis, fistulization, and perforation of the bowel are severe outcomes which can occur in patients with Crohn's disease. Accurate prediction of these events may enable clinicians to alter treatment strategies and avoid these outcomes. AIMS To study the correlation between longitudinal laboratory testing and subsequent intestinal complications in patients with Crohn's disease. METHODS An observational cohort of patients with Crohn's disease at a single center were analyzed between 01/01/1994 and 06/30/2016. A complication was defined as the development of an intestinal fistula, stenosis, or perforation. Exploratory analysis using Cox regression was performed to select the best statistical method to represent longitudinal laboratory data. Cox regression was used to identify laboratory variables independently associated with the development of a subsequent complication. A clinical scoring tool was designed. RESULTS In 246 patients observed over a median of 5.72 years, 134 complications occurred. Minimum or maximum value in a preceding window period of one year was most strongly associated with subsequent complication. A Longitudinal Laboratory score of ≥ 2 (maximum albumin level < 39 g/L = 1, maximum mean cell volume < 88 fL = 1, minimum platelet count > 355 × 109/L = 1, minimum C reactive protein > 5 mg/L = 1) was 62% sensitive and 91% specific in identifying patients who develop a subsequent complication. CONCLUSION A consistent reduction in serum albumin and mean cell volume, and a consistent increase in platelet count and C reactive protein were associated with a subsequent complication in patients with Crohn's disease. Longitudinal laboratory tests may be used as described in this paper to provide a rational for earlier escalation of therapy.
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Affiliation(s)
- James Irwin
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.
- Faculty of Medicine, The University of Queensland, Brisbane, Australia.
- Department of Gastroenterology, Palmerston North Hospital, 50 Ruahine Street, Palmerston North, 4442, New Zealand.
| | - Anton Lord
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Emma Ferguson
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Lisa A Simms
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Carlos A Montoya
- Smart Foods Innovation Centre of Excellence, AgResearch Limited, Te Ohu Rangahau Kai Facility, Palmerston North, 4474, New Zealand
- Riddet Institute, Massey University, Te Ohu Rangahau Kai Facility, Palmerston North, 4474, New Zealand
| | - Graham Radford-Smith
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Afrin S, Simms LA, Lord A, Radford‐Smith GL. Nudix hydrolase 15 (NUDT15) loss-of-function variants in an Australian inflammatory bowel disease population. Intern Med J 2022; 52:1971-1977. [PMID: 35289057 PMCID: PMC9796699 DOI: 10.1111/imj.15746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Thiopurine-related adverse events such as leukopenia, liver dysfunction and pancreatitis are associated with variants in the NUDT15 gene. Loss-of-function (low or no enzyme activity) alleles are more common in Asian and Hispanic populations. The prevalence of these variants in the Australian inflammatory bowel disease (IBD) population has not yet been reported. AIM To evaluate the presence of NUDT15 loss-of-function alleles *2,*3,*9 in the Australian IBD population. METHODS The NUDT15 screening cohort included 423 IBD patients from Brisbane, Australia. Study patients were recruited by: (i) retrospective review of clinical charts for thiopurine-related severe adverse events; (ii) pathology data (white blood cell (WBC) and neutrophil counts). NUDT15 genotyping was performed using polymerase chain reaction (PCR)-high-resolution melt (HRM), TaqMan genotyping and Sanger sequencing. RESULTS NUDT15 mutation R139C (allele *3) was identified in 8 of 423 (1.9%) IBD patients. Seven of eight patients were R139C heterozygous (C/T) and one patient was R139C homozygous (T/T). One of the C/T group and the T/T patient developed thiopurine-induced myelosuppression (TIM) within 60 days of dosing. One patient in the C/T group developed TIM after 60 days of thiopurine dosing. The remaining five patients in the C/T group did not show TIM; however, other thiopurine-related events could not be ruled out and therefore careful monitoring over a long period is recommended. CONCLUSIONS This is the first study to report the frequency of NUDT15 haplotypes *2,*3,*9 in an Australian IBD population. The most common variant detected was the R139C mutation. PCR and Sanger sequencing are efficient and cost-effective approaches for NUDT15 genotyping.
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Affiliation(s)
- Sadia Afrin
- Gut Health Research GroupQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Lisa A. Simms
- Gut Health Research GroupQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Anton Lord
- Gut Health Research GroupQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Graham L. Radford‐Smith
- Gut Health Research GroupQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
- Department of Gastroenterology and HepatologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
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Sapkota S, Molitor J, Evans M, Kofoed B, Lord A, Robinson L, Crosson J. AB1384 CLINICAL SIGNIFICANCE OF DENSE FINE SPECKLED PATTERN ANA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe clinical significance of Dense Fine Speckled (DFS) pattern Anti-nuclear antibodies (ANA) by indirect immunofluorescence method (IIF) is unclear and has been inversely associated with rheumatic disease 12.ObjectivesOur purpose was to determine associations between DFS pattern ANA and the disease categories of inflammatory arthritis, ANA associated rheumatic diseases (AARD), fibromyalgia/chronic pain syndrome/chronic fatigue syndrome and atopic disorder.MethodsThis retrospective study used data from patients tested for ANA by IIF between August 2017 to August 2019 at the University of Minnesota Medical Center. Comparisons between the diagnostic categories listed in objectives were made for patients with negative ANA, positive ANA (any pattern) and DFS pattern. Individual disease diagnoses belonging to the above categories were also analyzed. The inflammatory arthritis category included seropositive rheumatoid arthritis (RA), seronegative RA, RA with unknown serology, ankylosing spondylitis, and psoriatic arthritis. The disease category of AARD included systemic lupus erythematosus (SLE), systemic sclerosis, mixed connective tissue disease, idiopathic inflammatory myopathies, Sjogren’s syndrome (SS), and undifferentiated connective tissue disorder (UCTD). Atopic disorders included atopic dermatitis, allergic rhinitis, urticaria, and asthma. Frequency of Raynaud’s phenomenon (RP) was also calculated.Results13,845 patients with an ANA during the study period were identified. 9106 (65.8%) had negative ANA and 4739 (34.2%) had positive ANA by IIF (including all patterns). 640 (4.6%) had ANA positive DFS patterns. Relative risk (RR) was calculated for diagnostic categories and individual diseases. For patients with positive ANA and DFS pattern, the RR for diagnostic codes of inflammatory arthritis categories [1.35 (1.07- 1.71), p=0.02] was higher when compared to the frequency of codes in ANA negative. RR for AARD among patients with DFS pattern was also higher [1.78 (1.44- 2.2), p <0.001]. There was no significant difference in the frequency of diagnostic codes of chronic pain/fibromyalgia/chronic fatigue syndrome [1.02 (0.9- 1.2), p=0.84] atopic disorder [0.68 (0.4- 1.15), p=0.16] for DFS+ compared to the ANA group. The frequency of AARD diagnostic codes was lower for patients with DFS pattern [0.64 (0.52- 0.79), p<0.001] compared to ANA positive patients with all other patterns, consistent with published data. There was no significant difference of frequency of diagnostic codes for the rest of the disease categories when comparison was made between ANA positive DFS pattern and ANA positive with other patterns.Individual disease diagnostic codes of RA were higher among DFS+ patients when compared to ANA- patients. The frequency of diagnostic codes of SLE, SS, UCTD, fibromyalgia, Raynaud’s phenomenon, and autoimmune thyroid disease was also higher among patients with DFS pattern compared to ANA- patients. The frequency of diagnostic codes of seropositive RA was lower among patients with DFS pattern compared to ANA+ with all other patterns. The frequency of diagnostic codes of SLE, SSc, UCTD, and chronic pain was also lower among DFS+ patients, compared to those with ANA of all other patterns, consistent with prior reports.ConclusionThe frequency of diagnostic codes of RA, SS and Raynaud’s was higher among DFS pattern ANA compared to ANA negative group but was not significantly different from ANA positive with other patterns. This suggests that the presence of a DFS pattern should not be used to indiscriminately exclude the presence of a rheumatic disease.References[1]Mariz HA, Sato EI, Barbosa SH, Rodrigues SH, Dellavance A, Andrade LEC. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis Rheum. 2011;63(1):191-200. doi:10.1002/art.30084[2]Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 Antibodies in 597 Healthy Hospital Workers. ARTHRITIS Rheum. 2004;50(3):892-900. doi:10.1002/art.20096Disclosure of InterestsNone declared
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Croft A, Lord A, Radford-Smith G. Markers of Systemic Inflammation in Acute Attacks of Ulcerative Colitis: What Level of C-reactive Protein Constitutes Severe Colitis? J Crohns Colitis 2022; 16:1089-1096. [PMID: 35147694 PMCID: PMC9351978 DOI: 10.1093/ecco-jcc/jjac014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/12/2022] [Accepted: 02/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS The erythrocyte sedimentation rate [ESR] as a component of the Truelove and Witts Criteria [TWC] is the traditional inflammatory marker used for the assessment of ulcerative colitis [UC] activity. However, the C-reactive protein [CRP] is preferentially used in contemporary clinical practice. We aimed to determine the equivalent CRP cut-off for an ESR of >30 mm/h in patients presenting with acute severe UC. METHODS Clinical and pathological data were prospectively collected from 163 presentations of severe UC. A CRP cut-off corresponding to an ESR of >30 mm/h was determined using confusion matrices. A validation cohort of 128 presentations was prospectively collected and analysed. RESULTS A CRP cut-off of ≥12 mg/L generated an 85% positive predictive value [PPV] with a sensitivity of 95% and an accuracy of 82% for having a paired ESR of >30 mm/h. There were no statistically significant differences between groups determined by the traditional ESR versus the new CRP-based criterion in the presenting faecal calprotectin, Mayo endoscopic subscore, or the rates of intravenous corticosteroid therapy failure and colectomy-by-discharge. Applying the CRP ≥12 mg/L criterion to a validation cohort of 128 presentations generated a PPV of 83% and a sensitivity of 94%. CONCLUSIONS The proposed CRP ≥12 mg/L cut-off is an inclusive, sensitive, and very practical alternative to ESR as part of the TWC for defining UC presentation severity. It demonstrated similar performance characteristics to the classical ESR criterion when used for the assessment of acute UC disease activity. These findings were confirmed in a validation cohort.
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Affiliation(s)
- Anthony Croft
- Corresponding author: Anthony Croft, Department of Gastroenterology & Hepatology, Royal Brisbane and Women’s Hospital Butterfield Street, Herston, QLD 4029, Australia. Tel.: +61 7 3646 8111;
| | - Anton Lord
- QIMR-Berghofer Medical Research Institute, Brisbane, Australia,Centre for Health Services Research, University of Queensland, Brisbane, Australia
| | - Graham Radford-Smith
- Department of Gastroenterology & Hepatology, Royal Brisbane and Women’s Hospital, Brisbane, Australia,QIMR-Berghofer Medical Research Institute, Brisbane, Australia,Faculty of Medicine, University of Queensland, Brisbane, Australia
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Marsh A, Radford-Smith G, Banks M, Lord A, Chachay V. Dietary intake of patients with inflammatory bowel disease aligns poorly with traditional Mediterranean diet principles. Nutr Diet 2021; 79:229-237. [PMID: 34806269 DOI: 10.1111/1747-0080.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 12/19/2022]
Abstract
AIM Previous research has shown that individuals with inflammatory bowel disease avoid specific food items, such as fibre rich foods, in order to manage symptoms. Dietary fibre and the traditional Mediterranean diet are both associated with reduced mucosal and systemic inflammation, gut barrier integrity, and microbiota diversity. There is limited data on the diet composition of individuals with inflammatory bowel disease. The aim of this study was to evaluate how it compares to the traditional Mediterranean diet and national dietary guidelines. METHODS Outpatients with inflammatory bowel disease were recruited to the study between February and August 2019. Demographic and medical information was obtained for consenting participants. All participants completed a dietary assessment of usual intake (24-h diet recall and 17-point ready reckoner) from which a Mediterranean diet adherence score was calculated. Dietary intake of core food groups was compared to the recommended number of serves outlined in the Australian Guide to Healthy Eating. RESULTS 100 participants were recruited. The mean Mediterranean diet adherence score was 5.1 ± 1.3 (maximum 14 points), 4% of participants scored ≥9 (commonly agreed criteria for Mediterranean diet adherence). Participants also consumed considerably less grains and vegetables than national dietary guidelines recommendations. CONCLUSIONS The diet of outpatients with inflammatory bowel disease did not align with Mediterranean diet characteristics. Participants consumed significantly less grains and vegetables than national guidelines, suggesting a low fibre intake. These findings suggest that dietary interventions focusing on improving the diet of individuals with inflammatory bowel disease to align with Mediterranean diet characteristics are warranted.
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Affiliation(s)
- Abigail Marsh
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Graham Radford-Smith
- Gut Health Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Merrilyn Banks
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Anton Lord
- Gut Health Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Veronique Chachay
- The School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
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Hajelssedig OE, Zorron Cheng Tao Pu L, Thompson JY, Lord A, El Sayed I, Meyer C, Shaukat Ali F, Abdulazeem HM, Kheir AO, Siepmann T, Singh R. Diagnostic accuracy of narrow-band imaging endoscopy with targeted biopsies compared with standard endoscopy with random biopsies in patients with Barrett's esophagus: A systematic review and meta-analysis. J Gastroenterol Hepatol 2021; 36:2659-2671. [PMID: 34121232 DOI: 10.1111/jgh.15577] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 01/09/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Endoscopic surveillance for dysplasia in Barrett's esophagus (BE) with random biopsies is the primary diagnostic tool for monitoring clinical progression into esophageal adenocarcinoma. As an alternative, narrow-band imaging (NBI) endoscopy offers targeted biopsies that can improve dysplasia detection. This study aimed to evaluate NBI-guided targeted biopsies' diagnostic accuracy for detecting dysplasia in patients undergoing endoscopic BE surveillance compared with the widely used Seattle protocol. METHODS Cochrane DTA Register, MEDLINE/PubMed, EMBASE, OpenGrey, and bibliographies of identified papers were searched until 2018. Two independent investigators resolved discrepancies by consensus, study selection, data extraction, and quality assessment. Data on sensitivity, specificity, and predictive values were pooled and analyzed using a random-effects model. RESULTS Of 9528 identified articles, six studies comprising 493 participants were eligible for quantitative synthesis. NBI-targeted biopsy showed high diagnostic accuracy in detection of dysplasia in BE with a sensitivity of 76% (95% confidence interval [CI]: 0.61-0.91), specificity of 99% (95% CI: 0.99-1.00), positive predictive value of 97% (95% CI: 0.96-0.99), and negative predictive value of 84% (95% CI: 0.69-0.99) for detection of all grades of dysplasia. The receiver-operating characteristic curve for NBI model performance was 0.8550 for detecting all dysplasia. CONCLUSION Narrow-band imaging-guided biopsy demonstrated high diagnostic accuracy and might constitute a valid substitute for random biopsies during endoscopic surveillance for dysplasia in BE.
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Affiliation(s)
- Omer Eljyli Hajelssedig
- Master Program of Clinical Research, Dresden International University, Dresden, Germany.,DRESDEN INTERNATIONAL UNIVERSITAET (Freiberger Str. 37, 01067 Dresden, Germany)
| | | | | | - Anton Lord
- Gut Health Lab, Immunology Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Iman El Sayed
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Chase Meyer
- Department of Internal Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Faisal Shaukat Ali
- Department of Internal Medicine, Saint Joseph Hospital, Chicago, Illinois, USA
| | | | - Ammar O Kheir
- Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Timo Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University, Dresden, Germany
| | - Rajvinder Singh
- Department of Gastroenterology, The Lyell McEwin Hospital, Adelaide, South Australia, Australia.,The University of Adelaide, Adelaide, South Australia, Australia
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Santos LMB, Mutsaers M, Garcia GA, David MR, Pavan MG, Petersen MT, Corrêa-Antônio J, Couto-Lima D, Maes L, Dowell F, Lord A, Sikulu-Lord M, Maciel-de-Freitas R. High throughput estimates of Wolbachia, Zika and chikungunya infection in Aedes aegypti by near-infrared spectroscopy to improve arbovirus surveillance. Commun Biol 2021; 4:67. [PMID: 33452445 PMCID: PMC7810739 DOI: 10.1038/s42003-020-01601-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
Deployment of Wolbachia to mitigate dengue (DENV), Zika (ZIKV) and chikungunya (CHIKV) transmission is ongoing in 12 countries. One way to assess the efficacy of Wolbachia releases is to determine invasion rates within the wild population of Aedes aegypti following their release. Herein we evaluated the accuracy, sensitivity and specificity of the Near Infrared Spectroscopy (NIRS) in estimating the time post death, ZIKV-, CHIKV-, and Wolbachia-infection in trapped dead female Ae. aegypti mosquitoes over a period of 7 days. Regardless of the infection type, time post-death of mosquitoes was accurately predicted into four categories (fresh, 1 day old, 2–4 days old and 5–7 days old). Overall accuracies of 93.2, 97 and 90.3% were observed when NIRS was used to detect ZIKV, CHIKV and Wolbachia in dead Ae. aegypti female mosquitoes indicating NIRS could be potentially applied as a rapid and cost-effective arbovirus surveillance tool. However, field data is required to demonstrate the full capacity of NIRS for detecting these infections under field conditions. Santos et al. demonstrate that the Near Infrared Spectroscopy (NIRS) can accurately estimate the death time of trapped female Aedes aegypti and vector infection with Zika virus, Chikungunya virus, or Wolbachia in a 7-day trapping period. This study suggests that NIRS may provide an accurate and inexpensive tool that improves arbovirus surveillance systems.
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Affiliation(s)
- Lilha M B Santos
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Mathijs Mutsaers
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil.,Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, 2000, Antwerp, Belgium
| | - Gabriela A Garcia
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Mariana R David
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Márcio G Pavan
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil.,Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular (INCT-EM), Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Martha T Petersen
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Jessica Corrêa-Antônio
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Dinair Couto-Lima
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Louis Maes
- Laboratory for Microbiology, Parasitology and Hygiene (LMPH), University of Antwerp, 2000, Antwerp, Belgium
| | - Floyd Dowell
- USDA-ARS, Center for Grain and Animal Health Research, Manhattan, KS, 66502, USA
| | - Anton Lord
- The School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia.,QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia
| | - Maggy Sikulu-Lord
- The School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
| | - Rafael Maciel-de-Freitas
- Laboratório de Transmissores de Hematozoários, IOC, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil. .,Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular (INCT-EM), Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brazil.
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10
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Lord A, Radford-Smith G. Letter: hidden costs in healthcare use for incident and prevalent Crohn's disease and ulcerative colitis. Aliment Pharmacol Ther 2021; 53:368-369. [PMID: 33368510 DOI: 10.1111/apt.16169] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Anton Lord
- Department of Immunology, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Graham Radford-Smith
- Department of Immunology, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
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11
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White LS, Campbell C, Lee A, Lord A, Radford-Smith G. Intestinal ultrasound as first-line investigation in low-risk gastrointestinal symptoms: a new model of care. Intern Med J 2020; 52:95-99. [PMID: 33197118 DOI: 10.1111/imj.15133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Functional gut disorders (FGD) are common. Diagnosis is symptom based, although symptoms may be indistinguishable from inflammatory bowel disease. As a result of this, investigations are common, diagnostic yield is low. A streamlined novel model of care may reduce costly investigations. AIM To compare a new model of care for patients with low-risk gastrointestinal symptoms to a matched historical cohort. METHODS Data were prospectively collected over 12 months. General practitioner referrals for low-risk abdominal symptoms were triaged to a new multidisciplinary clinic structure utilising intestinal ultrasound. Outcomes were compared to the historical model in the preceding 12 months. Duration of care (time from referral to discharge), number of contact episodes and investigations ordered were reviewed. RESULTS Thirty-seven patients meeting strict inclusion criteria completed their care. Compared with the historical cohort, colonoscopies reduced from 0.7 to 0.05 per patient (P < 0.0001). Gastroenterology consults reduced from 1.5 to 1.2 (P = 0.303) and dietitian review increased from 0.8 to 1.5 (P < 0.0001). Total contact episodes reduced from 3.2 to 1.8 (P < 0.0001). Duration of care reduced from a median of 252 days to 130 days (interquartile ranges (IQR) 287 and 69, respectively; P < 0.0001). Time from first consultation to discharge reduced from 125 to 42 days (IQR 188 and 63; P < 0.0001). CONCLUSION This multidisciplinary approach to care of low-risk abdominal symptoms significantly reduced contact episodes, time in care and invasive investigations. It decreased costly gastroenterology consultation and increased allied health exposure. It demonstrates improved health service outcomes.
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Affiliation(s)
- Lauren S White
- Department of Gastroenterology and Hepatology, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia.,Department of Gastroenterology and Hepatology, Royal Brisbane Womens Hospital, Brisbane, Queensland, Australia.,Gut Health Group, QIMR Berghofer, Brisbane, Queensland, Australia
| | - Caitlin Campbell
- Department of Gastroenterology and Hepatology, Royal Brisbane Womens Hospital, Brisbane, Queensland, Australia
| | - Andrew Lee
- Department of Gastroenterology and Hepatology, Royal Brisbane Womens Hospital, Brisbane, Queensland, Australia
| | - Anton Lord
- Department of Gastroenterology and Hepatology, Royal Brisbane Womens Hospital, Brisbane, Queensland, Australia.,Gut Health Group, QIMR Berghofer, Brisbane, Queensland, Australia
| | - Graham Radford-Smith
- Department of Gastroenterology and Hepatology, Royal Brisbane Womens Hospital, Brisbane, Queensland, Australia.,Gut Health Group, QIMR Berghofer, Brisbane, Queensland, Australia
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12
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Lord A, Pan W, Li G, Chen H, Peng K, Song L, Chu N, Liou T, Liou Y, Wang Y. Policy infrastructure and mechanism to Promote “Health by All” Movement for Overturning Obesity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity is a pressing pandemic. However, major policies have targeted individual responsibility and focused on “losing weight or lowering calories”. Such approach has limited effect and overlooks the hidden obesity.
Methods
Under auspices of NHRI Forum, Taiwan; the WAKE.TAIWAN Research Team analyzed the global trends of policies, strategies, and literatures to formulate guiding principles for a total solution. 1. Defining obesity should go beyond body weight and emphasize more on healthy body composition and muscle mass, etc. 2. Effective obesity control strategy should facilitate building healthy living environments, lifestyle, and culture for natural flow of healthy behaviors. 3. All sectorial leaders should be involved in engaging and promoting healthy lifestyle culture and environment.
Results
”Guidelines for Establishing a lifestyle and Culture of Healthy Body Build” has been published as a blueprint for policy reform and strategies development, which consists of three parts. Part I emphasizes the active roles, social responsibilities, influence, and opportunities confronted the leaders and experts in all sectors and how government may facilitate these societal engagements, “Healthy by All”. The crucial sectors should include academia, NGO/NPO, industry/business, workplaces, healthcare systems, educational sectors, media and press, etc. Part II details on community spatial planning and architectural designs for healthy lifestyles. Part III proposes governmental “Health in All” infrastructure and mechanism.
Conclusions
We anticipate that the Guideline may draw out expertise and volunteering in all sectors of the society and help guide the public to take initiative in building such a culture of healthy-body-build and achieving this goal in all aspects of daily life.
Key messages
Emphasize on healthy body composition rather than body weight. Propagate 'Health by all' movement to foster building 'healthy physique' culture.
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Affiliation(s)
- A Lord
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - W Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - G Li
- Department of Athletic Sports, National Chung Cheng University, Chiayi, Taiwan
| | - H Chen
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - K Peng
- Department of Architecture, College of Design, National Taipei University of Technology, Taipei, Taiwan
| | - L Song
- Department of Architecture, College of Design, National Taipei University of Technology, Taipei, Taiwan
| | - N Chu
- Endocrinology and Metabolism Division, The Tri-Service General Hospital, Taipei, Taiwan
| | - T Liou
- Department of Physical Medicine and Rehabilitation, Taipei Medical University, Taipei, Taiwan
| | - Y Liou
- School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Y Wang
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
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13
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Chand T, Li M, Jamalabadi H, Wagner G, Lord A, Alizadeh S, Danyeli LV, Herrmann L, Walter M, Sen ZD. Heart Rate Variability as an Index of Differential Brain Dynamics at Rest and After Acute Stress Induction. Front Neurosci 2020; 14:645. [PMID: 32714132 PMCID: PMC7344021 DOI: 10.3389/fnins.2020.00645] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/25/2020] [Indexed: 11/17/2022] Open
Abstract
The brain continuously receives input from the internal and external environment. Using this information, the brain exerts its influence on both itself and the body to facilitate an appropriate response. The dynamic interplay between the brain and the heart and how external conditions modulate this relationship deserves attention. In high-stress situations, synchrony between various brain regions such as the prefrontal cortex and the heart may alter. This flexibility is believed to facilitate transitions between functional states related to cognitive, emotional, and especially autonomic activity. This study examined the dynamic temporal functional association of heart rate variability (HRV) with the interaction between three main canonical brain networks in 38 healthy male subjects at rest and directly after a psychosocial stress task. A sliding window approach was used to estimate the functional connectivity (FC) among the salience network (SN), central executive network (CEN), and default mode network (DMN) in 60-s windows on time series of blood-oxygen-level dependent (BOLD) signal. FC between brain networks was calculated by Pearson correlation. A multilevel linear mixed model was conducted to examine the window-by-window association between the root mean square of successive differences between normal heartbeats (RMSSD) and FC of network-pairs across sessions. Our findings showed that the minute-by-minute correlation between the FC and RMSSD was significantly stronger between DMN and CEN than for SN and CEN in the baseline session [b = 4.36, t(5025) = 3.20, p = 0.006]. Additionally, this differential relationship between network pairs and RMSSD disappeared after the stress task; FC between DMN and CEN showed a weaker correlation with RMSSD in comparison to baseline [b = −3.35, t(5025) = −3.47, p = 0.006]. These results suggest a dynamic functional interplay between HRV and the functional association between brain networks that varies depending on the needs created by changing conditions.
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Affiliation(s)
- Tara Chand
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Anton Lord
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Sarah Alizadeh
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Lena V Danyeli
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Luisa Herrmann
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Zumrut D Sen
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
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14
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Miller Renfrew L, Rafferty D, Lord A, Hunter R, Paul L. Determining validity of the PALite and ODFS PACE activity logger for measuring step count in healthy adults. Gait Posture 2020; 80:315-317. [PMID: 32593100 DOI: 10.1016/j.gaitpost.2020.06.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/03/2020] [Accepted: 06/16/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Determining adherence with orthoses is important for clinicians prescribing devices. Measuring orthotic use often relies on patient recall which has poor agreement with objective measures. Measuring step count whilst wearing an orthosis could help objectively quantifying adherence. The Odstock Drop Foot Stimulator (ODFS) Pace, used in foot drop, has an integral activity logger which provides data on step count. The PALite, an accelerometer, measures step count and can be fixed to an ankle foot orthoses (AFO). Both have the potential to provide objective measures of adherence; however, their validity for this purpose has not been determined. RESEARCH QUESTION To determine the validity of the PALite and ODFS Pace activity logger in measuring total step count, by exploring their level of agreement. METHODS A convenience sample of sixteen healthy volunteers, aged 18-65, were recruited from Glasgow Caledonian University (GCU). Participants walked continuously for 5 min on a treadmill at three walking speeds; normal (1.3ms-1), slow (0.4 ms-1) and fast (1.7-2.0 ms-1), wearing both the PALite and ODFS Pace. All walks were video recorded, viewed by 2 raters, and observed step count was determined by a click counter. Step count from both devices was validated against observed step count using video recording. The level of agreement between the three methods was established. RESULTS There was no significant difference between the 3 methods of measuring step count at any walking speed (normal, p = 0.913; slow, p = 0.938; fast, p = 0.566). Good levels of agreement for both devices with observed step count at all 3 walking speeds, with mean percentage differences being between -1.2 and 2.1 % (maximum upper and lower levels of agreement = 19.5 and -18.8 %) was detected. SIGNIFICANCE Clinicians could consider both devices to objectively measure step count with people who are prescribed foot drop orthoses, thus quantifying orthotic use.
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Affiliation(s)
| | - D Rafferty
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - A Lord
- MS Service, NHS Ayrshire and Arran, Scotland, UK
| | - R Hunter
- MS Service, NHS Ayrshire and Arran, Scotland, UK
| | - L Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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15
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Denzel D, Colic L, Demenescu LR, von Düring F, Ristow I, Nießen H, Hermann L, Kaufmann J, Dannlowski U, Frommer J, Vogel M, Li M, Lord A, Walter M. Local glutamate in cingulate cortex subregions differentially correlates with affective network activations during face perception. Eur J Neurosci 2020; 52:3047-3060. [PMID: 32239708 DOI: 10.1111/ejn.14733] [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: 10/25/2019] [Revised: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 12/01/2022]
Abstract
The cingulate cortex is involved in emotion recognition/perception and regulation. Rostral and caudal subregions belong to different brain networks with distinct roles in affective perception. Despite recent accounts of the relevance of cingulate cortex glutamate (Glu) on blood-oxygen-level-dependent (BOLD) responses, the specificity of the subregional Glu levels during emotional tasks remains unclear. Seventy-two healthy participants (age = 27.33 ± 6.67, 32 women) performed an affective face-matching task and underwent magnetic resonance spectroscopy (MRS) at 7 Tesla. Correlations between the BOLD response during emotion perception and Glu concentration in the pregenual anterior cingulate cortex (pgACC) and anterior midcingulate cortex (aMCC) were compared on a whole-brain level. Post hoc specificity of the association with an affect was assessed. Lower Glu in the pgACC correlated with stronger activation differences between negative and positive faces in the left inferior and superior frontal gyrus (L IFG and L SFG). In contrast, lower Glu in the aMCC correlated with BOLD contrasts in the posterior cingulate cortex (PCC). Furthermore, negative face detection was associated with prolonged response time (RT). Our results demonstrate a subregion-specific involvement of cingulate cortex Glu in interindividual differences during viewing of affective facial expressions. Glu levels in the pgACC were correlated with frontal area brain activations, whereas Glu in the salience network component aMCC modulated responses in the PCC-precuneus. We show that region-specific metabolite mapping enables specific activation of different BOLD signals in the brain underlying emotional perception.
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Affiliation(s)
- Dominik Denzel
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
| | - Lejla Colic
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany.,Department Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | | | - Felicia von Düring
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany.,Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Inka Ristow
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany.,Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Nießen
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
| | - Luisa Hermann
- Department of Psychiatry and Psychotherapy, Eberhard-Karls-University, Tübingen, Germany
| | - Jörn Kaufmann
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Jörg Frommer
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Matthias Vogel
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany.,Max Planck Institute for Biological Cybernetics Tübingen, Tübingen, Germany
| | - Anton Lord
- Immunology Department, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia.,School of Public Health, The University of Queensland, Herston, Qld, Australia
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany.,Department Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Eberhard-Karls-University, Tübingen, Germany.,Max Planck Institute for Biological Cybernetics Tübingen, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University, Jena, Germany
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16
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Shen EX, Lord A, Doecke JD, Hanigan K, Irwin J, Cheng RKY, Radford-Smith G. A validated risk stratification tool for detecting high-risk small bowel Crohn's disease. Aliment Pharmacol Ther 2020; 51:281-290. [PMID: 31769537 DOI: 10.1111/apt.15550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 02/16/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Delays in Crohn's disease (CD) diagnosis are positively associated with ileal location and an increased risk of complications. AIM To develop a simple risk assessment tool to enable primary care physicians to recognise potential ileal CD earlier, shortening the delay to specialist investigation METHODS: Three cohorts were acquired for this study. Cohort 1 included 61 patients retrospectively identified with ileal CD between 2000 and 2010 and 78 matched controls drawn from a cohort referred for investigation of abdominal symptoms. Cohort 2 included 42 individuals diagnosed with ileal CD and 57 controls identified prospectively. Cohort 3 included an additional 84 individuals with ileal CD and 495 without CD referred for colonoscopy. Clinical symptoms and serological biomarkers were acquired and used to develop a risk prediction algorithm. The algorithm was trained independently on each of the three cohorts and tested on the latter two cohorts. RESULTS Altered bowel habit with abdominal pain combined with derangements in white cell count (WCC), albumin and platelet counts were important features in predicting ileal CD (AUC = 0.92, 95% CI = 0.89-0.92). This was validated in cohorts 2 (AUC = 0.96, 95% CI = 0.95-0.98) and 3 (AUC = 0.94, 95% CI = 0.92-0.96). C-reactive protein was independently associated with ileal CD but non-signficant in a multivariate model. CONCLUSION A web-based risk stratification tool for ileal CD has been developed from objective and symptom-based criteria. This tool enables primary care physicians to more confidently request urgent specialist assessment for patients identified as at high risk for ileal CD.
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Affiliation(s)
- Eddie X Shen
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
| | - Anton Lord
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - James D Doecke
- CSIRO Health and Biosecurity/Australian e-Health Research Centre, Brisbane, Qld, Australia
| | | | - James Irwin
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - Richard K Y Cheng
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - Graham Radford-Smith
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia.,Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
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17
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Marsh A, Kinneally J, Robertson T, Lord A, Young A, Radford –Smith G. Food avoidance in outpatients with Inflammatory Bowel Disease – Who, what and why. Clin Nutr ESPEN 2019; 31:10-16. [DOI: 10.1016/j.clnesp.2019.03.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/08/2019] [Accepted: 03/26/2019] [Indexed: 01/18/2023]
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18
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Elliott TM, Lord A, Simms LA, Radford-Smith G, Valery PC, Gordon LG. Evaluating a risk assessment tool to improve triaging of patients to colonoscopies. Intern Med J 2019; 49:1292-1299. [PMID: 30816603 DOI: 10.1111/imj.14267] [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: 08/19/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Colonoscopy is the gold standard in the diagnosis of significant bowel disease (SBD), including colorectal cancer, high-risk adenoma and inflammatory bowel disease. As the demand for colonoscopy services is placing significant pressure on hospital resources, new solutions are needed to manage patients more efficiently and effectively. AIM We investigated the impact of using a risk assessment tool (RAT) to improve selection of patients for colonoscopy procedures to detect SBD. METHODS A hybrid simulation model was constructed to replicate the current patient triage bookings and waiting times in a large metropolitan hospital. The model used data on 327 patients who were retrospectively assessed for risk of SBD. Risk assessment incorporated blood and faecal immunochemical test results, gender and age in addition to patient symptoms. The model was calibrated over 12 months to current outcomes and was compared with the RAT and a third scenario where low-risk patients did not proceed to a colonoscopy. One-way sensitivity analyses were undertaken. RESULTS Using the RAT was expected to shorten waiting times by 153 days for moderately-urgent patients and 138 days for non-urgent patients. If low-risk patients did not proceed to colonoscopy, waiting times were expected to reduce for patients with SBD by 17 days producing cost-savings of AU$373 824 through avoided colonoscopies. CONCLUSIONS A hybrid model that combines patient-level characteristics with hospital-level resource constraints can demonstrate improved efficiency in a hospital clinic. Further research on risk assessment is required to improve quality patient care and reduce low-value service delivery.
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Affiliation(s)
- Thomas M Elliott
- QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia
| | - Anton Lord
- QIMR Berghofer Medical Research Institute, Inflammatory Bowel Diseases, Brisbane, Queensland, Australia
| | - Lisa A Simms
- QIMR Berghofer Medical Research Institute, Inflammatory Bowel Diseases, Brisbane, Queensland, Australia
| | - Graham Radford-Smith
- QIMR Berghofer Medical Research Institute, Inflammatory Bowel Diseases, Brisbane, Queensland, Australia.,Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,The University of Queensland, School of Medicine, Brisbane, Queensland, Australia
| | - Patricia C Valery
- QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia
| | - Louisa G Gordon
- QIMR Berghofer Medical Research Institute, Population Health Department, Brisbane, Queensland, Australia.,The University of Queensland, School of Medicine, Brisbane, Queensland, Australia.,Queensland University of Technology, School of Nursing, Brisbane, Queensland, Australia
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D'Souza N, Balyasnikova S, Tudyka V, Lord A, Shaw A, Abulafi M, Tekkis P, Brown G. Variation in landmarks for the rectum: an MRI study. Colorectal Dis 2018; 20:O304-O309. [PMID: 30176118 DOI: 10.1111/codi.14398] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 07/30/2018] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to assess the reliability of measurements and bony landmarks for the rectosigmoid junction on MRI. METHOD The staging MRI scans for 100 patients were reviewed. The junction of the mesorectum and mesocolon was used to identify the rectum and sigmoid. The performance of current metric measurements or bony landmarks was then compared against the actual anatomical bowel segment. RESULTS The mean distance of the sigmoid take-off from the anal verge was 12.6 cm (SD 1.8 cm, range 9.4-19.0 cm). At a cutoff of 12 cm, the anatomical bowel segment was found to be sigmoid colon rather than rectum in 35% of patients. At 15 and 16 cm the bowel segment was sigmoid in 84% and 96% of patients, respectively. At the sacral promontory and the third sacral segment, the bowel segment was sigmoid in 28% and 100% of patients, respectively. CONCLUSION Current definitions of the rectum that rely on arbitrary measurements or bony landmarks will not locate the correct point of transition between the rectum and sigmoid in the majority of patients. The sigmoid take-off offers an alternative, anatomically bespoke, landmark.
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Affiliation(s)
- N D'Souza
- Royal Marsden Hospital, Sutton, UK.,Croydon University Hospital, Croydon, UK.,Imperial College, London, UK
| | - S Balyasnikova
- Royal Marsden Hospital, Sutton, UK.,Imperial College, London, UK.,N. N. Petrov Research Institute of Oncology, Saint Petersburg, Russia
| | | | - A Lord
- Royal Marsden Hospital, Sutton, UK.,Croydon University Hospital, Croydon, UK.,Imperial College, London, UK
| | - A Shaw
- Royal Marsden Hospital, Sutton, UK.,Croydon University Hospital, Croydon, UK.,Imperial College, London, UK
| | - M Abulafi
- Croydon University Hospital, Croydon, UK
| | - P Tekkis
- Royal Marsden Hospital, Sutton, UK.,Imperial College, London, UK
| | - G Brown
- Royal Marsden Hospital, Sutton, UK.,Imperial College, London, UK
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20
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Roberts G, Perry A, Lord A, Frankland A, Leung V, Holmes-Preston E, Levy F, Lenroot RK, Mitchell PB, Breakspear M. Structural dysconnectivity of key cognitive and emotional hubs in young people at high genetic risk for bipolar disorder. Mol Psychiatry 2018; 23:413-421. [PMID: 27994220 PMCID: PMC5794888 DOI: 10.1038/mp.2016.216] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 01/01/2023]
Abstract
Emerging evidence suggests that psychiatric disorders are associated with disturbances in structural brain networks. Little is known, however, about brain networks in those at high risk (HR) of bipolar disorder (BD), with such disturbances carrying substantial predictive and etiological value. Whole-brain tractography was performed on diffusion-weighted images acquired from 84 unaffected HR individuals with at least one first-degree relative with BD, 38 young patients with BD and 96 matched controls (CNs) with no family history of mental illness. We studied structural connectivity differences between these groups, with a focus on highly connected hubs and networks involving emotional centres. HR participants showed lower structural connectivity in two lateralised sub-networks centred on bilateral inferior frontal gyri and left insular cortex, as well as increased connectivity in a right lateralised limbic sub-network compared with CN subjects. BD was associated with weaker connectivity in a small right-sided sub-network involving connections between fronto-temporal and temporal areas. Although these sub-networks preferentially involved structural hubs, the integrity of the highly connected structural backbone was preserved in both groups. Weaker structural brain networks involving key emotional centres occur in young people at genetic risk of BD and those with established BD. In contrast to other psychiatric disorders such as schizophrenia, the structural core of the brain remains intact, despite the local involvement of network hubs. These results add to our understanding of the neurobiological correlates of BD and provide predictions for outcomes in young people at high genetic risk for BD.
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Affiliation(s)
- G Roberts
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - A Perry
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,Metro North Mental Health Service, Brisbane, QLD, Australia,Centre for Healthy Brain Ageing, Randwick, NSW, Australia
| | - A Lord
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - A Frankland
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - V Leung
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - E Holmes-Preston
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - F Levy
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Prince of Wales Hospital, Randwick, NSW, Australia
| | - R K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia
| | - P B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia,Prince of Wales Hospital, Randwick, NSW, Australia
| | - M Breakspear
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,Metro North Mental Health Service, Brisbane, QLD, Australia,Systems Neuroscience Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, QLD, Australia. E-mail:
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21
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Lord A, Ten Hove R, Clifford K, Palma S. Physiotherapy in primary care: making the economic case. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Liebe T, Li S, Lord A, Colic L, Krause AL, Batra A, Kretzschmar MA, Sweeney-Reed CM, Behnisch G, Schott BH, Walter M. Factors Influencing the Cardiovascular Response to Subanesthetic Ketamine: A Randomized, Placebo-Controlled Trial. Int J Neuropsychopharmacol 2017; 20:909-918. [PMID: 29099972 PMCID: PMC5737852 DOI: 10.1093/ijnp/pyx055] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/28/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The increasing use of ketamine as a potential rapid-onset antidepressant necessitates a better understanding of its effects on blood pressure and heart rate, well-known side effects at higher doses. For the subanesthetic dose used for depression, potential predictors of these cardiovascular effects are important factors influencing clinical decisions. Since ketamine influences the sympathetic nervous system, we investigated the impact of autonomic nervous system-related factors on the cardiovascular response: a genetic polymorphism in the norepinephrine transporter and gender effects. METHODS Blood pressure and heart rate were monitored during and following administration of a subanesthetic dose of ketamine or placebo in 68 healthy participants (mean age 26.04 ±5.562 years) in a double-blind, randomized, controlled, parallel-design trial. The influences of baseline blood pressure/heart rate, gender, and of a polymorphism in the norepinephrine transporter gene (NET SLC6A2, rs28386840 [A-3081T]) on blood pressure and heart rate changes were investigated. To quantify changes in blood pressure and heart rate, we calculated the maximum change from baseline (ΔMAX) and the time until maximum change (TΔMAX). RESULTS Systolic and diastolic blood pressure as well as heart rate increased significantly upon ketamine administration, but without reaching hypertensive levels. During administration, the systolic blood pressure at baseline (TP0Sys) correlated negatively with the time to achieve maximal systolic blood pressure (TΔMAXSys, P<.001). Furthermore, women showed higher maximal diastolic blood pressure change (ΔMAXDia, P<.001) and reached this peak earlier than men (TΔMAXDia, P=.017) at administration. NET rs28386840 [T] carriers reached their maximal systolic blood pressure during ketamine administration significantly earlier than [A] homozygous (TΔMAXSys, P=.030). In a combined regression model, both genetic polymorphism and TP0Sys were significant predictors of TΔMAXSys (P<.0005). CONCLUSIONS Subanesthetic ketamine increased both blood pressure and heart rate without causing hypertensive events. Furthermore, we identified gender and NET rs28386840 genotype as factors that predict increased cardiovascular sequelae of ketamine administration in our young, healthy study population providing a potential basis for establishing monitoring guidelines.
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Affiliation(s)
- Thomas Liebe
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter).,Correspondence: Martin Walter, MD, Head, Translational Psychiatry, General Psychiatry and Psychotherapy, Eberhard-Karls-University, Tübingen, Calwer Str. 14, 72076 Tübingen, Germany ()
| | - Shijia Li
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Anton Lord
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Lejla Colic
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Anna Linda Krause
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Anil Batra
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Moritz A Kretzschmar
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Catherine M Sweeney-Reed
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Gusalija Behnisch
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Björn H Schott
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Magdeburg, Germany (Dr Liebe, Ms Colic, and Dr Krause); School of Psychology and Cognitive Science, East China Normal University, Shanghai, China (Dr Li); Department of Immunology, Queensland Institute of Medical Research, Herston, Queensland, Australia (Dr Lord); Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany (Dr Batra); Department of Anesthesiology and Intensive Care Medicine (Dr Kretzschmar) and Neurocybernetics and Rehabilitation (Dr Sweeney-Reed), University Hospital, Magdeburg, Germany; Behavioural Neuroscience, Leibniz Institute for Neurobiology, Magdeburg, Germany (Ms Behnisch and Dr Schott); Translational Psychiatry Tübingen, University Hospital Tübingen, Tübingen, Germany (Drs Liebe and Walter)
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Rossoni M, Cho R, Smith J, Lord A, Popel J, Cory E, Shouldice M, Shwartz S. UTILIZATION OF A CLINICAL TOOL FOR THE ASSESSMENT OF BRUISES CONCERNING FOR CHILD MALTREATMENT. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.006] [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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Roberts G, Lord A, Frankland A, Wright A, Lau P, Levy F, Lenroot RK, Mitchell PB, Breakspear M. Functional Dysconnection of the Inferior Frontal Gyrus in Young People With Bipolar Disorder or at Genetic High Risk. Biol Psychiatry 2017; 81:718-727. [PMID: 28031150 DOI: 10.1016/j.biopsych.2016.08.018] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 07/20/2016] [Accepted: 08/04/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by a dysregulation of affect and impaired integration of emotion with cognition. These traits are also expressed in probands at high genetic risk of BD. The inferior frontal gyrus (IFG) is a key cortical hub in the circuits of emotion and cognitive control, and it has been frequently associated with BD. Here, we studied resting-state functional connectivity of the left IFG in participants with BD and in those at increased genetic risk. METHODS Using resting-state functional magnetic resonance imaging we compared 49 young BD participants, 71 individuals with at least one first-degree relative with BD (at-risk), and 80 control subjects. We performed between-group analyses of the functional connectivity of the left IFG and used graph theory to study its local functional network topology. We also used machine learning to study classification based solely on the functional connectivity of the IFG. RESULTS In BD, the left IFG was functionally dysconnected from a network of regions, including bilateral insulae, ventrolateral prefrontal gyri, superior temporal gyri, and the putamen (p < .001). A small network incorporating neighboring insular regions and the anterior cingulate cortex showed weaker functional connectivity in at-risk than control participants (p < .006). These constellations of regions overlapped with frontolimbic regions that a machine learning classifier selected as predicting group membership with an accuracy significantly greater than chance. CONCLUSIONS Functional dysconnectivity of the IFG from regions involved in emotional regulation may represent a trait abnormality for BD and could potentially aid clinical diagnosis.
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Affiliation(s)
- Gloria Roberts
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales
| | - Anton Lord
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Andrew Frankland
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales
| | - Adam Wright
- Black Dog Institute, Randwick, New South Wales
| | - Phoebe Lau
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales
| | - Florence Levy
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Department of •••, Prince of Wales Hospital, Randwick, New South Wales
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Neuroscience Research Australia, Randwick, New South Wales
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales; Department of •••, Prince of Wales Hospital, Randwick, New South Wales
| | - Michael Breakspear
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Metro North Mental Health Service, Brisbane, Queensland, Australia.
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Lord A, Ehrlich S, Borchardt V, Geisler D, Seidel M, Huber S, Murr J, Walter M. Brain parcellation choice affects disease-related topology differences increasingly from global to local network levels. Psychiatry Res Neuroimaging 2016; 249:12-19. [PMID: 27000302 DOI: 10.1016/j.pscychresns.2016.02.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 01/15/2016] [Accepted: 02/04/2016] [Indexed: 11/17/2022]
Abstract
Network-based analyses of deviant brain function have become extremely popular in psychiatric neuroimaging. Underpinning brain network analyses is the selection of appropriate regions of interest (ROIs). Although ROI selection is fundamental in network analysis, its impact on detecting disease effects remains unclear. We investigated the impact of parcellation choice when comparing results from different studies. We investigated the effects of anatomical (AAL) and literature-based (Dosenbach) parcellation schemes on comparability of group differences in 35 female patients with anorexia nervosa and 35 age- and sex-matched healthy controls. Global and local network properties, including network-based statistics (NBS), were assessed on resting state functional magnetic resonance imaging data obtained at 3T. Parcellation schemes were comparably consistent on global network properties, while NBS and local metrics differed in location, but not metric type. Location of local metric alterations varied for AAL (parietal and cingulate cortices) versus Dosenbach (insula, thalamus) parcellation approaches. However, consistency was observed for the occipital cortex. Patient-specific global network properties can be robustly observed using different parcellation schemes, while graph metrics characterizing impairments of individual nodes vary considerably. Therefore, the impact of parcellation choice on specific group differences varies depending on the level of network organization.
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Affiliation(s)
- Anton Lord
- Leibniz Institute for Neurobiology, Magdeburg, Saxony-Anhalt, Germany; Clinical Affective Neuroimaging Laboratory, Magdeburg, Saxony-Anhalt, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Eating Disorder Research and Treatment Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States; Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - Viola Borchardt
- Leibniz Institute for Neurobiology, Magdeburg, Saxony-Anhalt, Germany; Clinical Affective Neuroimaging Laboratory, Magdeburg, Saxony-Anhalt, Germany
| | - Daniel Geisler
- Department of Child and Adolescent Psychiatry, Eating Disorder Research and Treatment Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - Maria Seidel
- Department of Child and Adolescent Psychiatry, Eating Disorder Research and Treatment Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - Stefanie Huber
- Department of Child and Adolescent Psychiatry, Eating Disorder Research and Treatment Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - Julia Murr
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - Martin Walter
- Leibniz Institute for Neurobiology, Magdeburg, Saxony-Anhalt, Germany; Clinical Affective Neuroimaging Laboratory, Magdeburg, Saxony-Anhalt, Germany; Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Magdeburg, Saxony-Anhalt, Germany; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany.
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Tozzi L, Carballedo A, Lavelle G, Doolin K, Doyle M, Amico F, McCarthy H, Gormley J, Lord A, O'Keane V, Frodl T. Longitudinal functional connectivity changes correlate with mood improvement after regular exercise in a dose-dependent fashion. Eur J Neurosci 2016; 43:1089-96. [PMID: 26929085 DOI: 10.1111/ejn.13222] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 02/18/2016] [Accepted: 02/23/2016] [Indexed: 01/18/2023]
Abstract
Exercise increases wellbeing and improves mood. It is however unclear how these mood changes relate to brain function. We conducted a randomized controlled trial investigating resting-state modifications in healthy adults after an extended period of aerobic physical exercise and their relationship with mood improvements. We aimed to identify novel functional networks whose activity could provide a physiological counterpart to the mood-related benefits of exercise. Thirty-eight healthy sedentary volunteers were randomised to either the aerobic exercise group of the study or a control group. Participants in the exercise group attended aerobic sessions with a physiotherapist twice a week for 16 weeks. Resting-state modifications using magnetic resonance imaging were assessed before and after the programme and related to mood changes. An unbiased approach using graph metrics and network-based statistics was adopted. Exercise reduced mood disturbance and improved emotional wellbeing. It also induced a decrease in local efficiency in the parahippocampal lobe through strengthening of the functional connections from this structure to the supramarginal gyrus, precentral area, superior temporal gyrus and temporal pole. Changes in mood disturbance following exercise were correlated with those in connectivity between parahippocampal gyrus and superior temporal gyrus as well as with the amount of training. No changes were detected in the control group. In conclusion, connectivity from the parahippocampal gyrus to motor, sensory integration and mood regulation areas was strengthened through exercise. These functional changes might be related to the benefits of regular physical activity on mood.
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Affiliation(s)
- Leonardo Tozzi
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Angela Carballedo
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Grace Lavelle
- Department of Physiotherapy, St. James's Hospital, James's Street, Dublin 8, Ireland
| | - Kelly Doolin
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Myles Doyle
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Francesco Amico
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Hazel McCarthy
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - John Gormley
- Department of Physiotherapy, St. James's Hospital, James's Street, Dublin 8, Ireland
| | - Anton Lord
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Veronica O'Keane
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Thomas Frodl
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland.,Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Cheng X, Zheng L, Li L, Guo X, Wang Q, Lord A, Hu Z, Yang G. Power to Punish Norm Violations Affects the Neural Processes of Fairness-Related Decision Making. Front Behav Neurosci 2015; 9:344. [PMID: 26696858 PMCID: PMC4678221 DOI: 10.3389/fnbeh.2015.00344] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/23/2015] [Indexed: 11/13/2022] Open
Abstract
Punishing norm violations is considered an important motive during rejection of unfair offers in the ultimatum game (UG). The present study investigates the impact of the power to punish norm violations on people's responses to unfairness and associated neural correlates. In the UG condition participants had the power to punish norm violations, while an alternate condition, the impunity game (IG), was presented where participants had no power to punish norm violations since rejection only reduced the responder's income to zero. Results showed that unfair offers were rejected more often in UG compared to IG. At the neural level, anterior insula and dorsal anterior cingulate cortex were more active when participants received and rejected unfair offers in both UG and IG. Moreover, greater dorsolateral prefrontal cortex activity was observed when participants rejected than accepted unfair offers in UG but not in IG. Ventromedial prefrontal cortex activation was higher in UG than IG when unfair offers were accepted as well as when rejecting unfair offers in IG as opposed to UG. Taken together, our results demonstrate that the power to punish norm violations affects not only people's behavioral responses to unfairness but also the neural correlates of the fairness-related social decision-making process.
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Affiliation(s)
- Xuemei Cheng
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, East China Normal University Shanghai, China
| | - Li Zheng
- Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, School of Psychology and Cognitive Science, East China Normal University Shanghai, China
| | - Lin Li
- School of Psychology and Cognitive Science, East China Normal University Shanghai, China
| | - Xiuyan Guo
- Shanghai Key Laboratory of Magnetic Resonance and Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, School of Psychology and Cognitive Science, East China Normal University Shanghai, China
| | - Qianfeng Wang
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, East China Normal University Shanghai, China
| | - Anton Lord
- Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology Magdeburg, Germany
| | - Zengxi Hu
- School of Finance and Statistics, East China Normal University Shanghai, China
| | - Guang Yang
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, East China Normal University Shanghai, China
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Dinica K, Demenescu LR, Lord A, Krause AL, Kaiser R, Horn D, Metzger CD, Walter M. Self-directedness and the susceptibility to distraction by saliency. Cogn Emot 2015; 30:1461-1469. [PMID: 26301698 DOI: 10.1080/02699931.2015.1070792] [Citation(s) in RCA: 6] [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] [Indexed: 10/23/2022]
Abstract
People with low Self-directedness (SD) tend to explain their behaviour as being significantly influenced by events in the external environment. One important dimension of external cues is their level of salience: highly salient external stimuli are more likely to capture attention, even when such stimuli are not relevant to goals. We examined whether adults reporting low SD would exhibit greater susceptibility to distraction by highly salient external stimuli. Fifty-four (42 males) subjects completed the Attention Modulation by Salience Task (AMST) measuring reaction times to early- or late-onset auditory stimuli in the presence of high- or low-salience visual distractors. SD was assessed via self-report, and analyses tested the relationship between SD and performance on the AMST. Results showed a slowed early response to auditory cues during high salience compared to low salience. Indeed, individuals reporting low SD showed stronger salience interference, suggesting that external causality attribution is accompanied by a subconscious perceptual deficit.
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Affiliation(s)
- Katharina Dinica
- a Clinical Affective Neuroimaging Laboratory , Magdeburg , Germany.,b Department of Psychiatry and Psychotherapy , Otto von Guericke University , Magdeburg , Germany
| | - Liliana Ramona Demenescu
- a Clinical Affective Neuroimaging Laboratory , Magdeburg , Germany.,c Department of Neurology , Otto von Guericke University , Magdeburg , Germany.,d Leibniz Institute for Neurobiology , Magdeburg , Germany
| | - Anton Lord
- a Clinical Affective Neuroimaging Laboratory , Magdeburg , Germany.,b Department of Psychiatry and Psychotherapy , Otto von Guericke University , Magdeburg , Germany
| | - Anna Linda Krause
- a Clinical Affective Neuroimaging Laboratory , Magdeburg , Germany.,b Department of Psychiatry and Psychotherapy , Otto von Guericke University , Magdeburg , Germany
| | - Roselinde Kaiser
- e Department of Psychiatry , Harvard Medical School, and Center for Depression, Anxiety and Stress Research, McLean Hospital , Belmont , MA , USA
| | - Dorothea Horn
- a Clinical Affective Neuroimaging Laboratory , Magdeburg , Germany.,b Department of Psychiatry and Psychotherapy , Otto von Guericke University , Magdeburg , Germany
| | - Coraline Danielle Metzger
- b Department of Psychiatry and Psychotherapy , Otto von Guericke University , Magdeburg , Germany.,d Leibniz Institute for Neurobiology , Magdeburg , Germany.,f Centre for Behavioral Brain Sciences (CBBS) , Magdeburg , Germany.,g Institute for Cognitive Neurology and Dementia Research (IKND) , Magdeburg , Germany.,h German Center for Neurodegenerative Diseases (DZNE) , Magdeburg , Germany
| | - Martin Walter
- a Clinical Affective Neuroimaging Laboratory , Magdeburg , Germany.,b Department of Psychiatry and Psychotherapy , Otto von Guericke University , Magdeburg , Germany.,d Leibniz Institute for Neurobiology , Magdeburg , Germany.,f Centre for Behavioral Brain Sciences (CBBS) , Magdeburg , Germany
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Perry A, Wen W, Lord A, Thalamuthu A, Roberts G, Mitchell PB, Sachdev PS, Breakspear M. The organisation of the elderly connectome. Neuroimage 2015; 114:414-26. [DOI: 10.1016/j.neuroimage.2015.04.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/23/2015] [Accepted: 04/03/2015] [Indexed: 12/13/2022] Open
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Lord A, Hompes R, Arnold S, Venkatasubramaniam A. Ultra-low anterior resection with coloanal anastomosis for recurrent rectal prolapse in a young woman with colitis cystica profunda. Ann R Coll Surg Engl 2015; 97:e32-3. [PMID: 25723681 DOI: 10.1308/003588414x14055925061351] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This case demonstrates the successful treatment of a young female patient with colitis cystica profunda causing rectal prolapse, after primary treatment with a Delorme procedure had failed. An ultra-low anterior resection with a temporary defunctioning ileostomy was carried out with good postoperative results. This case illustrates the possibility of carrying out sphincter preserving surgery rather than an abdominoperineal resection in the treatment of this condition, which may be preferable for patients.
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Affiliation(s)
- A Lord
- Hampshire Hospitals NHS Foundation Trust, UK
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Cocchi L, Sale MV, Lord A, Zalesky A, Breakspear M, Mattingley JB. Dissociable effects of local inhibitory and excitatory theta-burst stimulation on large-scale brain dynamics. J Neurophysiol 2015; 113:3375-85. [PMID: 25717162 DOI: 10.1152/jn.00850.2014] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 10/27/2014] [Accepted: 02/21/2015] [Indexed: 12/12/2022] Open
Abstract
Normal brain function depends on a dynamic balance between local specialization and large-scale integration. It remains unclear, however, how local changes in functionally specialized areas can influence integrated activity across larger brain networks. By combining transcranial magnetic stimulation with resting-state functional magnetic resonance imaging, we tested for changes in large-scale integration following the application of excitatory or inhibitory stimulation on the human motor cortex. After local inhibitory stimulation, regions encompassing the sensorimotor module concurrently increased their internal integration and decreased their communication with other modules of the brain. There were no such changes in modular dynamics following excitatory stimulation of the same area of motor cortex nor were there changes in the configuration and interactions between core brain hubs after excitatory or inhibitory stimulation of the same area. These results suggest the existence of selective mechanisms that integrate local changes in neural activity, while preserving ongoing communication between brain hubs.
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Affiliation(s)
- Luca Cocchi
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia;
| | - Martin V Sale
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Anton Lord
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre and Melbourne School of Engineering, The University of Melbourne, Melbourne, Australia; and
| | | | - Jason B Mattingley
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia; School of Psychology, The University of Queensland, Brisbane, Australia
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Affiliation(s)
- Martin Walter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany
- Corresponding author at: Clinical Affective Neuroimaging Laboratory Otto v. Guericke University Magdeburg & Leibniz Institute for Neurobiology Leipziger Strasse 44 39120 Magdeburg, Germany.
| | - Anton Lord
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
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Li M, Metzger CD, Li W, Safron A, van Tol MJ, Lord A, Krause AL, Borchardt V, Dou W, Genz A, Heinze HJ, He H, Walter M. Dissociation of glutamate and cortical thickness is restricted to regions subserving trait but not state markers in major depressive disorder. J Affect Disord 2014; 169:91-100. [PMID: 25173431 DOI: 10.1016/j.jad.2014.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 06/08/2014] [Accepted: 08/03/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND The anterior cingulate cortex (ACC) plays an important role in the neuropathology of major depressive disorder (MDD). So far, the effect of local cortical alteration on metabolites in multiple subdivisions of ACC has not been studied. We aimed to investigate structural and biochemical changes and their relationship in the pregenual ACC (pgACC), dorsal ACC (dACC) in MDD. METHODS We obtained magnetic resonance spectroscopy (MRS) in two investigated regions for 24 depressed patients and matched controls. In each region, cortical thickness (CTh) was calculated within a template mask based on its MRS voxel. We investigated neurotransmitter concentrations of Glx, N-acetyl aspartate (NAA), and myo-inositol (m-Ins) in two investigated regions, as well as their relationships with CTh in depressed individuals and healthy controls. RESULTS Patients showed significantly lower cortical thickness in dACC compared to controls. Glx in dACC significantly correlated with CTh in healthy controls but not MDD patients, while NAA and CTh in dACC significantly correlated in both groups. A marginal decrease of Glx in pgACC was found in the subgroup of more severely depressive patients, compared to the mildly depressed patients. LIMITATIONS Modest sample size and lack of episodes of depression may limit the generalizability of our findings. CONCLUSION Our results indicate an abolished CTh-MRS relation in dACC-associated with structural decline-but not in pgACC, where acute MRS alterations prevailed. Our study provides the first evidence of a neurochemical basis explaining some of the inter-individual variability in CTh in MDD.
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Affiliation(s)
- Meng Li
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
| | - Coraline D Metzger
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany; Center of Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany
| | - Wenjing Li
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China; College of Electronic and Control Engineering, Beijing University of Technology, Beijing, China
| | - Adam Safron
- Department of Psychology, Northwestern University, United States
| | - Marie-José van Tol
- Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anton Lord
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Anna Linda Krause
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | | | - Weiqiang Dou
- Biomedical Magnetic Resonance, Otto-von-Guericke University, Magdeburg, Germany
| | - Axel Genz
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - Hans-Jochen Heinze
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany
| | - Huiguang He
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
| | - Martin Walter
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany; Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China; Leibniz Institute for Neurobiology, Magdeburg, Germany; Center of Behavioral Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany.
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Bhardwaj N, Kanhere H, Lord A, Maddern G. Handheld modification of the laparoscopic hook using the Trewavis(©) arthroscopic lateral release hook. Ann R Coll Surg Engl 2014; 96:318-9. [PMID: 24780034 DOI: 10.1308/rcsann.2014.96.4.318] [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: 11/22/2022] Open
Affiliation(s)
- N Bhardwaj
- Queen Elizabeth Hospital, Woodville, SA, Australia
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Lord A, Horn D, Breakspear M, Walter M. Changes in community structure of resting state functional connectivity in unipolar depression. PLoS One 2012; 7:e41282. [PMID: 22916105 PMCID: PMC3423402 DOI: 10.1371/journal.pone.0041282] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 06/19/2012] [Indexed: 11/28/2022] Open
Abstract
Major depression is a prevalent disorder that imposes a significant burden on society, yet objective laboratory-style tests to assist in diagnosis are lacking. We employed network-based analyses of “resting state” functional neuroimaging data to ascertain group differences in the endogenous cortical activity between healthy and depressed subjects. We additionally sought to use machine learning techniques to explore the ability of these network-based measures of resting state activity to provide diagnostic information for depression. Resting state fMRI data were acquired from twenty two depressed outpatients and twenty two healthy subjects matched for age and gender. These data were anatomically parcellated and functional connectivity matrices were then derived using the linear correlations between the BOLD signal fluctuations of all pairs of cortical and subcortical regions. We characterised the hierarchical organization of these matrices using network-based matrics, with an emphasis on their mid-scale “modularity” arrangement. Whilst whole brain measures of organization did not differ between groups, a significant rearrangement of their community structure was observed. Furthermore we were able to classify individuals with a high level of accuracy using a support vector machine, primarily through the use of a modularity-based metric known as the participation index. In conclusion, the application of machine learning techniques to features of resting state fMRI network activity shows promising potential to assist in the diagnosis of major depression, now suggesting the need for validation in independent data sets.
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Affiliation(s)
- Anton Lord
- Division of Mental Health Research, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
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Amaya N, Irfan M, Zervas G, Banias K, Garrich M, Henning I, Simeonidou D, Zhou YR, Lord A, Smith K, Rancano VJF, Liu S, Petropoulos P, Richardson DJ. Gridless optical networking field trial: flexible spectrum switching, defragmentation and transport of 10G/40G/100G/555G over 620-km field fiber. Opt Express 2011; 19:B277-B282. [PMID: 22274030 DOI: 10.1364/oe.19.00b277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We present results from the first gridless networking field trial with flexible spectrum switching nodes and 620 km of installed fibre links. Signals at 10G, 12.25G, 42.7G, DP-QPSK 40G, DP-QPSK 100G and 555G are generated, successfully transported and switched using flexible, custom spectrum allocation per channel. Spectrum defragmentation is demonstrated using integrated SOA-MZI wavelength converters. Results show error-free end-to-end performance (BER<1e-9) for the OOK channels and good pre-FEC BER performance with sufficient margin to FEC limit for the 40G and 100G coherent channels as well as for the 555G super-channel.
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Affiliation(s)
- N Amaya
- School of Computer Science and Electronic Engineering, University of Essex, Colchester CO4 3SQ, UK.
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Amaya N, Zervas GS, Irfan M, Zhou YR, Lord A, Simeonidou D. Experimental demonstration of gridless spectrum and time optical switching. Opt Express 2011; 19:11182-11188. [PMID: 21716346 DOI: 10.1364/oe.19.011182] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An experimental demonstration of gridless spectrum and time switching is presented. We propose and demonstrate a bit-rate and modulation-format independent optical cross-connect architecture, based on gridless spectrum selective switch, 20-ms 3D-MEMS and 10-ns PLZT optical switches, that supports arbitrary spectrum allocation and transparent time multiplexing. The architecture is implemented in a four-node field-fiber-linked testbed to transport continuous RZ and NRZ data channels at 12.5, 42.7 and 170.8 Gb/s, and selectively groom sub-wavelength RZ channels at 42.7 Gb/s. We also showed that the architecture is dynamic and can be reconfigured to meet the routing requirements of the network traffic. Results show error-free operation with an end-to-end power penalty between 0.8 dB and 5 dB for all continuous and sub-wavelength channels.
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Affiliation(s)
- N Amaya
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK.
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Nakao J, Egan D, Newman D, Sharp V, He X, Tsao D, Skalak T, Lord A, Nollen C, Wiener D. 131: Falling Through the Cracks? Missed Opportunities for Earlier Diagnosis of HIV Infection. Ann Emerg Med 2010. [DOI: 10.1016/j.annemergmed.2010.06.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Affiliation(s)
- H Iswariah
- Department of Surgery, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
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Abstract
PURPOSE This paper investigates the impact of the Asthma Foundation of Victoria's educational camp program on children's knowledge of asthma and its management, their feelings about asthma, and their attitudes toward physical and social activities. Parents' observations of changes in their child's behaviour and attitudes are also reported. DESIGN AND METHODS This research was descriptive and applied. It used questionnaires atfour stages (directly pre- and post-camp, three-four months and ten-15 months post-camp) of an asthma education camp program to assess child asthma knowledge levels. At three months post-camp, parental observations of children's attitudes and behaviours were assessed using a questionnaire. Children's feelings toward asthma were also assessed using a questionnaire pre- and post-camp. RESULTS The children surveyed displayed a better knowledge of asthma and how to manage their condition immediately after the camp. This knowledge tended to return to pre-camp levels after ten months. The children also reported less anxiety and fear about their illness, a greater sense of wellbeing, and more confidence in participating in a whole range of physical and social activities. Many parents also noted positive changes in their children in terms of activities and asthma management at three months post-camp. CLINICAL IMPLICATIONS Although there were limitations to sustaining knowledge gained in the asthma camping program, the camping experience provided a benefit for children in terms of promoting their mental and social wellbeing. When readers consider modernising asthma education (e.g. shorter camps, education in everyday social settings such as schools), they need to consider retaining the key ingredients of the more traditional camping program that supports good asthma management, wellbeing and social participation.
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Affiliation(s)
- A Lord
- Asthma Foundation of Victoria, North Melbourne, Victoria
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Lord A, Bailey AS, Klapper PE, Snowden N, Khoo SH. Impaired humoral responses to subgenus D adenovirusenovirus infections in HIV-positive patients. J Med Virol 2000; 62:405-9. [PMID: 11074466] [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: 02/18/2023]
Abstract
HIV-positive patients are at increased risk of developing adenovirus infection, particularly of the gastrointestinal tract and with unusual subgenus D strains. To investigate humoral immunity to these strains of adenoviruses, the humoral immune response was examined in longitudinal samples of serum against isolates collected from a prospective study of HIV-positive patients with subgenus D adenovirus infection. Of 10 HIV-positive patients developing adenovirus infection, 3 had chronic infection (8->27 months) with one serotype, 3 had chronic infection (>/=10 months) with changing serotypes and 4 had acute and self-limiting adenovirus infection (<1 month). Fifty-one sera were tested, and samples collected before adenovirus infection were available in 8 patients. Neutralising assays were performed against the patient's own isolate (adenoviruses 9, 17, 19, 19/23, 19/37, 23, 26, 23/26, 43 and 46) and common circulating strains of adenovirus 1-5. Indirect immunofluorescence tests were carried out against the autologous isolate and complement-fixation tests were undertaken using a standard assay. Immunofluorescence test antibodies were detected (titre >/=160) in all patients, and present to high titre (>/=320) in 8/10 patients. Complement-fixing antibodies were not detected in significant titre. Of particular note, there was no significant neutralising antibody response to the patient's own isolate after acute infection. Neutralising antibody to adenovirus 3 (titre 20) was transiently detected in two patients. In the remaining patients neutralising antibody directed against adenoviruses 1-5 was not detected. Persistent carriage of subgenus D adenoviruses in HIV-positive patients is probably the result of failure of cell-mediated immune responses to clear primary infection. Nevertheless, there is marked impairment of B cell responses resulting in poor neutralising and complement-fixing antibody production even though immunofluorescence test determined antibodies are produced in high titre. These possibly reflect impairment of effective B cell priming mechanisms within the germinal centres of lymph nodes, or the polyclonal activation of B cells driven by HIV infection.
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Affiliation(s)
- A Lord
- Clinical Virology, Manchester Royal Infirmary, Manchester, United Kingdom
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Lord A. "The Great Arcana of the Deity": menstruation and menstrual disorders in eighteenth-century British medical thought. Bull Hist Med 1999; 73:38-63. [PMID: 10189727 DOI: 10.1353/bhm.1999.0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- A Lord
- State University of New York at New Paltz 12561, USA.
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Abstract
The O-antigen of most Shigella flexneri serotypes contains an identical tetrasaccharide repeating unit. Apart from serotype Y, the O-antigen is modified by addition of a glucosyl and/or O-acetyl residue to a specific position in the O-unit. In this study the glucosyl transferase gene from a serotype 1 a has been cloned and identified. The bacteriophage SfV integrase (int) gene was used to probe a S. flexneri Y53 (serotype 1 a) cosmid library and 18 unique clones were identified. Southern hybridisation of these clones indicated two unlinked regions of the chromosome contained the int homologue. When expressed in a live candidate vaccine strain of S. flexneri serotype Y (SFL124), clones with one region produced type I antigen, whereas clones containing the other region produced mainly type Y antigen. One of the cosmid clones positive for type I antigen by agglutination and Western blotting was selected for further study. Genes involved in O-antigen glucosyl modification were mapped on a 5.8 kb fragment and subclones were produced which fully or partially expressed the type I antigen, depending on the extent of the clone. Fully and partially expressing clones may be useful vaccine candidate strains for protection against disease caused by two serotypes of S. flexneri.
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Affiliation(s)
- D A Bastin
- Division of Biochemistry and Molecular Biology, School of Life Sciences, Faculty of Science, Australian National University, Canberra, Australia
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44
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Jones TR, Labelle M, Belley M, Champion E, Charette L, Evans J, Ford-Hutchinson AW, Gauthier JY, Lord A, Masson P, McAuliffe M, McFarlane CS, Metters KM, Pickett C, Piechuta H, Rochette C, Rodger IW, Sawyer N, Young RN, Zamboni R, Abraham WM. Erratum: Pharmacology of montelukast sodium (Singulair™), a potent and selective leukotriene D4 receptor antagonist. Can J Physiol Pharmacol 1995. [DOI: 10.1139/y95-098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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45
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Jones TR, Labelle M, Belley M, Champion E, Charette L, Evans J, Ford-Hutchinson AW, Gauthier JY, Lord A, Masson P. Pharmacology of montelukast sodium (Singulair), a potent and selective leukotriene D4 receptor antagonist. Can J Physiol Pharmacol 1995; 73:191-201. [PMID: 7621356 DOI: 10.1139/y95-028] [Citation(s) in RCA: 193] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Montelukast sodium (Singulair), also known as MK-0476 (1-(((1(R)-(3-(2-(7-chloro-2-quinolinyl)-(E)-ethenyl)phenyl)(3-2-(1- hydroxy-1-methylethyl)phenyl)propyl)thio)methyl)cyclopropane) acetic acid sodium salt, is a potent and selective inhibitor of [3H]leukotriene D4 specific binding in guinea pig lung (Ki 0.18 +/- 0.03 nM), sheep lung (Ki 4 nM), and dimethylsulfoxide-differentiated U937 cell plasma membrane preparations (Ki 0.52 +/- 0.23 nM), but it was essentially inactive versus [3H]leukotriene C4 specific binding in dimethylsulfoxide-differentiated U937 cell membranes (IC50 10 microM) and [3H]leukotriene B4 specific binding in THP-1 cell membranes (IC50 40 microM). Montelukast also inhibited specific binding of [3H]leukotriene D4 to guinea pig lung in the presence of human serum albumin, human plasma, and squirrel monkey plasma with Ki values of 0.21 +/- 0.08, 0.19 +/- 0.02, and 0.26 +/- 0.02 nM, respectively. Functionally, montelukast antagonized contractions of guinea pig trachea induced by leukotriene D4 (pA2 value 9.3; slope 0.8). In contrast, montelukast (16 microM) failed to antagonize contractions of guinea pig trachea induced by leukotriene C4 (45 mM serine-borate), serotonin, acetylcholine, histamine, prostaglandin D2, or U-44069. Intravenous montelukast antagonized bronchoconstriction induced in anesthetized guinea pigs by i.v. leukotriene D4 but did not block bronchoconstriction to arachidonic acid, histamine, serotonin, or acetylcholine. Oral administration of montelukast blocked leukotriene D4 induced bronchoconstriction in conscious squirrel monkeys, ovalbumin-induced bronchoconstriction in conscious sensitized rats (ED50 0.03 +/- 0.001 mg/kg; 4 h pretreatment), and also ascaris-induced early and late phase bronchoconstriction in conscious squirrel monkeys (0.03-0.1 mg/kg; 4 h pretreatment). A continuous i.v. infusion of montelukast (8 micrograms.kg-1.min-1) resulted in a 70% decrease in the peak early response and a 75% reduction of the late response to ascaris aerosol in allergic conscious sheep. Montelukast, a potent and selective leukotriene D4 receptor antagonist with excellent in vivo activity is currently in clinical development for the treatment of asthma and related diseases.
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Affiliation(s)
- T R Jones
- Department of Pharmacology, Merck Frosst Canada Inc., Pointe Claire-Dorval, QC
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Metters KM, Gareau Y, Lord A, Rochette C, Sawyer N. Characterization of specific binding sites for cysteinyl leukotrienes in sheep lung. J Pharmacol Exp Ther 1994; 270:399-406. [PMID: 8035338] [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: 01/28/2023] Open
Abstract
Specific binding sites for [3H]leukotriene (LT)D4 and [3H]LTC4 have been identified in sheep lung parenchymal membranes. [3H] LTD4 specific binding was of high affinity (KD = 0.56 nM), saturable (Bmax = 43 fmol/mg of protein), stimulated by divalent cations and inhibited by nonhydrolyzable GTP analogs. LTs and LTD4-receptor antagonists competed for [3H]LTD4 specific binding with the rank order of potency predicted for the LTD4 receptor: LTD4 > ONO-1078 > ICI 204,219 > MK-571 > LTE4 > LTC4 > BAY u9773 >> LTB4. In contrast, [3H]LTC4 specific binding was of lower affinity (KD = 27 nM), abundant (Bmax = 87 pmol/mg of protein) and although stimulated by divalent cations was unaffected by GTP analogs. LTs and LTC4 analogs competed for [3H]LTC4 specific binding with the following rank order of potency: LTC2 > LTC3 > LTC4 > LTC5 >> N-methyl-LTC4 >> LTD4 approximately LTB4 approximately LTB4. [3H]LTD4 specific binding to sheep lung membranes has, therefore, the characteristics of being to a G-protein-coupled LTD4 receptor, whereas the profile of [3H]LTC4 specific binding strongly suggests that these sites are not LT-receptor related. Photolabeling of sheep lung membranes using [125I]azido-LTC4, a photoactivable LTC4 analog, resulted in the selective photolabeling of two polypeptides migrating at 30 kDa and 19 kDa. The selective photolabeling of the 19 kDa polypeptide could be modulated in an identical manner to [3H]LTC4 specific binding. This protein is, therefore, a candidate for being the principal [3H]LTC4 specific site in sheep lung membranes and has a comparable molecular mass to microsomal glutathione S-transferase, recently shown to be the predominant LTC4 binding protein in cellular membranes.
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Affiliation(s)
- K M Metters
- Department of Biochemistry, Merck Frosst Centre for Therapeutic Research, Pointe-Claire, Dorval, Quebec, Canada
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Abstract
The concept that elderly patients with urinary incontinence due to detrusor hyperreflexia can be divided into two groups with differing natural histories on the basis of the detrusor contractility found on cystometry is reassessed. Thirty patients shown to have hyperreflexia on urodynamic study for persistent urinary incontinence following a recent neurological lesion had their contractility measured by the suggested criteria of the residual urine following a hyperreflexic contraction and the rate of increase of detrusor pressure. The consistency of contractility on cystometry was also measured by repeating this three times on the same occasion. A spectrum of values for the post-contraction volumes and the rate of increase of detrusor pressure was found. On repetitive cystometry 11 out of 30 patients showed a variable post-contraction residual volume. While impaired contractility is common in detrusor hyperreflexia, the concept of two subgroups is not supported by these results. In some patients cystometric measures of contractility vary considerably on repeating the study on the same occasion.
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Affiliation(s)
- A Lord
- Department of Medicine for the Elderly, Southampton General Hospital
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48
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Abstract
This prospective randomized trial examines the effect of a "reflush" with preservation solution immediately prior to renal allograft implantation, using hyperosmolar citrate (HOC, n = 10) or phosphate-buffered sucrose (PBS140, n = 10) versus no reflush (n = 10). All kidneys had been stored in HOC. The HOC reflush did not alter the postpreservation intra- or extracellular electrolyte milieu, whereas the PBS140 reflush resulted in an apparent overall loss of both sodium and potassium from the kidney (P < 0.0005). A small amount of calcium was released into the venous effluent in both reflush groups. A similar amount of lactic acid was released into the venous effluent of the two reflush groups, reflected by a lower pH (P < 0.0005), and there was a similar loss of lactate dehydrogenase and creatine phosphokinase. An analysis of procoagulant activity in the first urine produced was performed as a marker of reperfusion injury. The median value was higher in the No Reflush group at 457.5 units, compared with 263.0 and 209.0 units for the PBS140 and HOC Reflush groups, respectively (P = 0.06). Reflushing the kidneys reduced the postoperative dialysis requirement (from 40% to 15%), but by the end of the first posttransplant week there was no significant difference between the renal functional analyses of the three groups, and there was no difference at one year. The proposed mechanism for the early renal functional improvement is a reduction in the calcium paradox and free radical formation, by release of calcium and ATP breakdown products into the venous effluent prior to implantation.
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Affiliation(s)
- J P Lodge
- University Department of Surgery, St. James's University Hospital, Leeds, United Kingdom
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Abstract
There is a paucity of data on which to base estimates of the energy requirements of the elderly. In general, ageing appears to be associated with a reduction in energy requirement arising from a reduction in physical activity and loss of fat-free mass. The aim of the present study was to measure the total energy expenditure (TEE), basal metabolic rate (BMR), and energy expended on physical activity (calculated as TEE-BMR) in a group of healthy elderly women living in the community in Southampton. Mean rates of TEE (9.21 (SD 1.48) MJ/d) and energy expended on physical activity (4.12 (SD 1.19) MJ/d) were higher than those observed in some studies of younger adults in the UK, and higher than the factors used to estimate the average energy requirement for the elderly. The results suggest that an age-related reduction in energy requirement is not inevitable and support the hypothesis that the effects of ageing on physical activity, body composition, and hence energy requirements, are variable.
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Affiliation(s)
- J J Reilly
- University Geriatric Medicine Group, Southampton General Hospital
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50
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Labelle M, Prasit P, Belley M, Blouin M, Champion E, Charette L, DeLuca J, Dufresne C, Frenette R, Gauthier J, Grimm E, Grossman S, Guay D, Herold E, Jones T, Lau C, Leblanc Y, Léger S, Lord A, McAuliffe M, McFarlane C, Masson P, Metters K, Ouimet N, Patrick D, Perrier H, Pickett C, Piechuta H, Roy P, Williams H, Wang Z, Xiang Y, Zamboni R, Ford-Hutchinson A, Young R. The discovery of a new structural class of potent orally active leukotriene D4 antagonists. Bioorg Med Chem Lett 1992. [DOI: 10.1016/s0960-894x(00)80635-6] [Citation(s) in RCA: 26] [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: 12/01/2022]
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