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Glebov VY, Forrest CJ, Kendrick J, Knauer JP, Mannion OM, McClow H, Regan SP, Stoeckl C, Stanley B, Theobald W. A new neutron time-of-flight detector for yield and ion-temperature measurements at the OMEGA Laser Facility. Rev Sci Instrum 2022; 93:093522. [PMID: 36182446 DOI: 10.1063/5.0101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
A new neutron time-of-flight (nTOF) detector for deuterium-deuterium (DD)-fusion yield and ion-temperature measurements was designed, installed, and calibrated for the OMEGA Laser Facility. This detector provides an additional line of sight for DD neutron yield and ion-temperature measurements for yields exceeding 1 × 1010 with higher precision than existing detectors. The nTOF detector consists of a 90-mm-diam, 20-mm-thick BC-422 scintillator and a gated Photek photomultiplier tube (PMT240). The PMT collects scintillating light through the 20-mm side of the scintillator without the use of a light guide. There is no lead shielding from hard x rays in order to allow the x-ray instrument response function of the detector to be measured easily. Instead, hard x-ray signals generated in implosion experiments are gated out by the PMT. The design provides a place for glass neutral-density filters between the scintillator and the PMT to avoid PMT saturation at high yields. The nTOF detector is installed in the OMEGA Target Bay along the P8A sub-port line of sight at a distance of 5.3 m from the target chamber center. In addition to DD measurements, the same detector can be used to measure the neutron yield and ion temperature from deuterium-tritium (DT) implosion targets in the 5 × 1010 to 2 × 1012 yield range. The design details and the calibration results of this nTOF detector for both D2 and DT implosions on OMEGA will be presented.
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Affiliation(s)
- V Yu Glebov
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - C J Forrest
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - J Kendrick
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - J P Knauer
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - O M Mannion
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - H McClow
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - S P Regan
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - C Stoeckl
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - B Stanley
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
| | - W Theobald
- Laboratory for Laser Energetics, University of Rochester, New York, New York 14623-1299, USA
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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3
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Hodgson SE, Sulaeman SJ, Stanley B, Koutsogiannis Z, Braitberg G. Toceranib: Isolated acute liver injury following ingestion of a canine tyrosine kinase inhibitor treated with N-acetylcysteine. Clin Toxicol (Phila) 2021; 60:538-539. [PMID: 34581252 DOI: 10.1080/15563650.2021.1982960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S E Hodgson
- Victorian Poisons Information Centre, Austin Health, Heidelberg, Australia.,Emergency Department, Austin Health, Heidelberg, Australia
| | - S J Sulaeman
- Victorian Poisons Information Centre, Austin Health, Heidelberg, Australia.,Monash Toxicology and Emergency Department, Monash Health, Clayton, Australia
| | - B Stanley
- Victorian Poisons Information Centre, Austin Health, Heidelberg, Australia
| | - Z Koutsogiannis
- Victorian Poisons Information Centre, Austin Health, Heidelberg, Australia.,Emergency Department, Austin Health, Heidelberg, Australia
| | - G Braitberg
- Victorian Poisons Information Centre, Austin Health, Heidelberg, Australia.,Department of Medicine, Royal Melbourne Hospital, Melbourne, Australia
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4
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Ward LM, Stanley B, Greenlaw N, Cooper SA, Pacitti C, Henderson A, Gibson J, Kinnear D. Risk of anticholinergic burden in adults with intellectual disabilities: a Scottish retrospective cohort study of n = 17 220. J Intellect Disabil Res 2021; 65:813-830. [PMID: 34169610 DOI: 10.1111/jir.12861] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Several drugs have anticholinergic side effects that are associated with adverse health outcomes. Anticholinergic burden studies in adults with intellectual disabilities (ID) have focused exclusively on older adults. This study investigates anticholinergic burden and its associations in adults with ID of all ages (17-94 years). METHODS Adults with ID (n = 4 305), each with three general population age-sex-neighbourhood-matched controls (n = 12 915), were linked to their prescribed medications with anticholinergic effects between 2009 and 2017. Analyses were undertaken using logistic regression models. RESULTS Adults with ID were more likely to be prescribed any anticholinergic medicines, odds ratio (OR) = 1.49 (1.38-1.59), especially 'very strong' risk medicines, OR = 2.59 (2.39-2.81); 48.5% had very high total anticholinergic burden (3+) compared with 35.4% of the general population, OR = 1.77 (1.64-1.90). This group difference was greater for males, OR = 2.02 (1.84-2.22), than females, OR = 1.48 (1.33-1.65). Adults with ID had significantly higher odds of having very high total anticholinergic burden up to 75 years old, with the greatest group effect occurring in younger ages, 17-24-year-olds, OR = 3.05 (2.39-3.89), and the extent of the difference decreased as age increased. The main effect of neighbourhood deprivation showed greater group differences with increasing affluence of neighbourhood. Results examining only the ID group showed that very high total anticholinergic burden was greatest for females, OR = 1.21 (1.07-1.37), and those over age 55, and extent of neighbourhood deprivation was not significant. CONCLUSIONS Adults with ID are at higher risk of anticholinergic burden than the general population, especially young adults. Overall anticholinergic burden increased with age, but burden was high across all ages in the ID group. Very high total anticholinergic burden is prevalent across all types of neighbourhoods for the adults with ID, in contrast to the steeper gradient seen in the general population. Adults with ID have increased likelihood of unintended adverse effects, regardless of potential confounds, so clinicians undertaking medication reviews need to consider anticholinergic side effects and cumulative burden across concomitant medications, including in young adults with ID, not just older adults, and particularly women.
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Affiliation(s)
- L M Ward
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - B Stanley
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - N Greenlaw
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - S-A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - C Pacitti
- NHS Greater Glasgow & Clyde, Leverndale Hospital, Glasgow, UK
| | - A Henderson
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - J Gibson
- School of Medicine, Dentistry and Nursing, Glasgow Dental Hospital and School, Glasgow, UK
| | - D Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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5
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Ward LM, Cooper SA, McSkimming P, Greenlaw N, Pacitti C, Gibson J, Henderson A, Stanley B, Pell J, Kinnear D. Dental attendance, restoration and extractions in adults with intellectual disabilities compared with the general population: a record linkage study. J Intellect Disabil Res 2020; 64:980-986. [PMID: 32996662 DOI: 10.1111/jir.12786] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Oral health may be poorer in adults with intellectual disabilities (IDs) who rely on carer support and medications with increased dental risks. METHODS Record linkage study of dental outcomes, and associations with anticholinergic (e.g. antipsychotics) and sugar-containing liquid medication, in adults with IDs compared with age-sex-neighbourhood deprivation-matched general population controls. RESULTS A total of 2933/4305 (68.1%) with IDs and 7761/12 915 (60.1%) without IDs attended dental care: odds ratio (OR) = 1.42 [1.32, 1.53]; 1359 (31.6%) with IDs versus 5233 (40.5%) without IDs had restorations: OR = 0.68 [0.63, 0.73]; and 567 (13.2%) with IDs versus 2048 (15.9%) without IDs had dental extractions: OR = 0.80 [0.73, 0.89]. Group differences for attendance were greatest in younger ages, and restoration/extractions differences were greatest in older ages. Adults with IDs were more likely prescribed with anticholinergics (2493 (57.9%) vs. 6235 (48.3%): OR = 1.49 [1.39, 1.59]) and sugar-containing liquids (1641 (38.1%) vs. 2315 (17.9%): OR = 2.89 [2.67, 3.12]). CONCLUSION Carers support dental appointments, but dentists may be less likely to restore teeth, possibly extracting multiple teeth at individual appointments instead.
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Affiliation(s)
- L M Ward
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - S-A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - P McSkimming
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - N Greenlaw
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - C Pacitti
- Leverndale Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Gibson
- School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital and School, Glasgow, UK
| | - A Henderson
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - B Stanley
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - J Pell
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - D Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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6
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Biscaglia S, Campo G, Fox K, Tardif J, Tendera M, Greenlaw N, Ford I, Stanley B, Ferrari R, Steg P. Prognosis in patients with prior myocardial infarction and PEGASUS-TIMI 54 criteria in the CLARIFY registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The PEGASUS-TIMI 54 trial showed that prolonged treatment with ticagrelor reduces the cumulative occurrence of ischemic adverse events. CLARIFY is the biggest real life registry on chronic coronary syndrome.
Purpose
- To evaluate the percentage of patients eligible for long-term ticagrelor therapy in the CLARIFY registry.
– To compare the outcome of this subgroup of patients with those with PEGASUS exclusion criteria or without PEGASUS inclusion criteria.
Methods
Within the CLARIFY population, we selected post MI patients and we excluded those with missing info (post MI evaluable population). Then, we divided patients into 3 groups: excluded (meeting PEGASUS exclusion criteria, namely use of P2Y12 receptor antagonists or chronic oral anticoagulant, any stroke, coronary-artery bypass grafting in the past 5 years); eligible (meeting PEGASUS high-risk inclusion criteria, namely age≥65 years; diabetes; multivessel disease; creatinine clearance <60 ml/min) and ineligible (not meeting PEGASUS high-risk inclusion criteria).
We therefore compared the ischemic (CV death, MI and stroke) and bleeding (major bleeding) outcome of the 3 groups adjusting for age, sex, smoking and geographical region.
Results
Among the 11811 post-MI evaluable patients, 4706 (39.8%) were included in the eligible group, 5715 (48.4%) in the excluded group, and 1390 in the ineligible group (11.8%). Both the ischemic and bleeding endpoints were significantly different among the 3 groups with the excluded patients with the worst and ineligible patients with the best outcome (see table). The same trend was shown for CV death, while the occurrence of MI was not significantly different among the 3 groups. In the eligible group, the ratio between ischemic and bleeding events was 6:1, whereas between CV death and major bleeding was 3.5:1.
Conclusions
Around 40% of CLARIFY post-MI patients could benefit from prolonged ticagrelor therapy. In this group of patients, ischemic risk seems to be higher than the bleeding one.
Ischemic & bleeding risk in the 3 groups
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): CLARIFY registry was funded by Servier
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Affiliation(s)
- S Biscaglia
- Azienda Ospedaliero Universitaria Sant'Anna, Ferrara, Ferrara, Italy
| | - G Campo
- Azienda Ospedaliero Universitaria Sant'Anna, Ferrara, Ferrara, Italy
| | - K Fox
- Imperial College London, NHLI, London, United Kingdom
| | - J.C Tardif
- Montreal Heart Institute, Montreal, Canada
| | - M Tendera
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - N Greenlaw
- University of Glasgow, Glasgow, United Kingdom
| | - I Ford
- University of Glasgow, Glasgow, United Kingdom
| | - B Stanley
- University of Glasgow, Glasgow, United Kingdom
| | - R Ferrari
- University Hospital of Ferrara, Medical Sciences, Ferrara, Italy
| | - P.G Steg
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T, Paris, France
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7
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Mclaren A, Cartwright D, Roxburgh P, Stanley B, Brown J, Lindsay D, Glasspool R. 1848P Managing hypersensitivity reactions in Ovarian malignancy – can we re-challenge successfully? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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Niméus A, Hjalmarsson Ståhlfors F, Sunnqvist C, Stanley B, Träskman-Bendz L. Evaluation of a modified interview version and of a self-rating version of the Suicide Assessment Scale. Eur Psychiatry 2020; 21:471-7. [PMID: 16545548 DOI: 10.1016/j.eurpsy.2006.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AbstractThe Suicide Assessment Scale (SUAS) was constructed to be sensitive to change of suicidality. It was recently found to be predictive of suicide in a group of suicide attempters. The aim of the present study was to evaluate the reliability and validity of a modified interview version of SUAS with defined scores and also a new self-rating version (SUAS-S). The subjects consisted of former inpatients, 42 persons who had been admitted because of a suicide attempt about 12 years ago and 22 control patients. The subjects were rated according to the SUAS, the SUAS-S, as well as the Montgomery Asberg Depression Rating Scale (MADRS). The interrater reliability was found to be high. The SUAS correlated significantly with the MADRS, but the concordance was not consistent, which indicates that the SUAS measures something different from depression. The SUAS-S correlated significantly with the interview-rated SUAS, thus exhibiting good concurrent validity. In summary, both the modified interview version of SUAS and the SUAS-S seem to be valid, reliable and easily used suicide assessment instruments.
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Affiliation(s)
- A Niméus
- Department of Psychiatry, Clinical Sciences, Lund University Hospital, S-22185 Lund, Sweden.
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9
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Pellicori P, Stanley B, Iliodromiti S, Celis-Morales CA, Lyall DM, Anderson J, Gray S, Mackay DF, Nelson SM, Welsh P, Pell JP, Gill JMR, Sattar N, Cleland JGF. P3823Body mass index or waist and hip circumference as predictors of outcome in the UK biobank. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Controversies exist about the relationship between body habitus and mortality, especially for patients with cardiovascular disease.
Purpose
We evaluated the relations between different anthropometric indices and mortality amongst participants with and without cardiovascular (CV) risk factors, or established CV disease (stroke, myocardial infarction and/or heart failure), enrolled in the UK Biobank.
Methods
The UK Biobank is a large prospective study which, between 2006 and 2010, enrolled 502,620 participants aged 38–73 years. Participants filled questionnaires and had a medical history recorded, physical measurements done and biological samples taken. The UK Biobank is routinely linked to national death registries and updated on a quarterly basis. Data on death were coded according to the International Classification of Diseases, 10th Revision (ICD-10). The primary end-point was all-cause mortality (ACM) across three subgroups of men and women: those with, or without, one or more CV risk factors (smoking, diabetes and/or hypertension), and those with CV disease (history of stroke, myocardial infarction and/or heart failure) at recruitment. Presence, or absence, of CV risk factors and diagnoses of CV disease were self-reported by participants at enrolment. Associations between anthropometric indices (body mass index (BMI), waist circumference (WC), waist to hip ratio (WHiR), and waist to height ratio (WHeR)) and the risk of all-cause mortality were analysed using Cox regression models.
Results
After excluding those with history of cancer at baseline (n=45,222), 453,046 participants were included (median age: 58 (interquartile range: 50 - 63) years; 53% women), of whom 150,732 had at least one CV risk factor, and 17,884 established CV disease.
During a median follow-up of 5 years, 6,319 participants died. Baseline BMI had a U-shaped relationship with ACM, with higher nadir-values for those with CV risk factors or CV disease, for both sexes (figure). WC, WHiR and WHeR (measures of central distribution of body fat) had more linear associations with ACM, regardless of CV risk factors, CV disease and sex.
Conclusions
For adults with or without CV risk factors or established CV disease, measures of central distribution of body fat are more strongly and more linearly associated with ACM than BMI. WC, or WHiR, rather than BMI, appear to be more appropriate variables for risk stratification.
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Affiliation(s)
- P Pellicori
- University of Glasgow, Glasgow, United Kingdom
| | - B Stanley
- University of Glasgow, Glasgow, United Kingdom
| | | | | | - D M Lyall
- University of Glasgow, Glasgow, United Kingdom
| | - J Anderson
- University of Glasgow, Glasgow, United Kingdom
| | - S Gray
- University of Glasgow, Glasgow, United Kingdom
| | - D F Mackay
- University of Glasgow, Glasgow, United Kingdom
| | - S M Nelson
- University of Glasgow, Glasgow, United Kingdom
| | - P Welsh
- University of Glasgow, Glasgow, United Kingdom
| | - J P Pell
- University of Glasgow, Glasgow, United Kingdom
| | - J M R Gill
- University of Glasgow, Glasgow, United Kingdom
| | - N Sattar
- University of Glasgow, Glasgow, United Kingdom
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10
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Cacciottolo TM, Perikari A, van der Klaauw A, Henning E, Stadler LKJ, Keogh J, Farooqi IS, Tenin G, Keavney B, Ryan E, Budd R, Bewley M, Coelho P, Rumsey W, Sanchez Y, McCafferty J, Dockrell D, Walmsley S, Whyte M, Liu Y, Choy MK, Tenin G, Abraham S, Black G, Keavney B, Ford T, Stanley B, Good R, Rocchiccioli P, McEntegart M, Watkins S, Eteiba H, Shaukat A, Lindsay M, Robertson K, Hood S, McGeoch R, McDade R, Sidik N, McCartney P, Corcoran D, Collison D, Rush C, McConnachie A, Touyz R, Oldroyd K, Berry C, Gazdagh G, Diver L, Marshall J, McGowan R, Ahmed F, Tobias E, Curtis E, Parsons C, Maslin K, D'Angelo S, Moon R, Crozier S, Gossiel F, Bishop N, Kennedy S, Papageorghiou A, Fraser R, Gandhi S, Prentice A, Inskip H, Godfrey K, Schoenmakers I, Javaid MK, Eastell R, Cooper C, Harvey N, Watt ER, Howden A, Mirchandani A, Coelho P, Hukelmann JL, Sadiku P, Plant TM, Cantrell DA, Whyte MKB, Walmsley SR, Mordi I, Forteath C, Wong A, Mohan M, Palmer C, Doney A, Rena G, Lang C, Gray EH, Azarian S, Riva A, Edwards H, McPhail MJW, Williams R, Chokshi S, Patel VC, Edwards LA, Page D, Miossec M, Williams S, Monaghan R, Fotiou E, Santibanez-Koref M, Keavney B, Badat M, Mettananda S, Hua P, Schwessinger R, Hughes J, Higgs D, Davies J. Scientific Business Abstracts of the 113th Annual Meeting of the Association of Physicians of Great Britain and Ireland. QJM 2019; 112:724-729. [PMID: 31505685 DOI: 10.1093/qjmed/hcz175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Perikari
- University of Cambridge Metabolic Research Laboratories
| | | | - E Henning
- University of Cambridge Metabolic Research Laboratories
| | - L K J Stadler
- University of Cambridge Metabolic Research Laboratories
| | - J Keogh
- University of Cambridge Metabolic Research Laboratories
| | - I S Farooqi
- University of Cambridge Metabolic Research Laboratories
| | - G Tenin
- From University of Manchester
| | | | - E Ryan
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - R Budd
- Department of Infection Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield
| | - M Bewley
- Department of Infection Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield
| | - P Coelho
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - W Rumsey
- Stress and Repair Discovery Performance Unit, Respiratory Therapy Area
| | - Y Sanchez
- Stress and Repair Discovery Performance Unit, Respiratory Therapy Area
| | - J McCafferty
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - D Dockrell
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - S Walmsley
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - M Whyte
- Department of Respiratory Medicine, Centre for Inflammation Research, University of Edinburgh
| | - Y Liu
- From the University of Manchester
| | - M-K Choy
- From the University of Manchester
| | - G Tenin
- From the University of Manchester
| | | | - G Black
- From the University of Manchester
| | | | - T Ford
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - R Good
- Golden Jubilee National Hospital
| | - P Rocchiccioli
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - M McEntegart
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - H Eteiba
- Golden Jubilee National Hospital
| | | | | | | | - S Hood
- Golden Jubilee National Hospital
| | | | - R McDade
- Golden Jubilee National Hospital
| | - N Sidik
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - P McCartney
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - D Corcoran
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - D Collison
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - C Rush
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | | | - R Touyz
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
| | - K Oldroyd
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - Colin Berry
- BHF Centre of Excellence in Vascular Science and Medicine, University of Glasgow
- Golden Jubilee National Hospital
| | - G Gazdagh
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - L Diver
- West of Scotland Regional Genetics Service, Laboratory Medicine Building, Queen Elizabeth University Hospital
| | - J Marshall
- Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow
| | - R McGowan
- West of Scotland Regional Genetics Service, Laboratory Medicine Building, Queen Elizabeth University Hospital
| | - F Ahmed
- Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow
| | - E Tobias
- Academic Unit of Medical Genetics and Clinical Pathology, Laboratory Medicine Building, Queen Elizabeth University Hospital, University of Glasgow
| | - E Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - C Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - K Maslin
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - R Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - S Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - F Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield
| | - N Bishop
- Academic Unit of Child Health, University of Sheffield
| | - S Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford
| | - A Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford
| | - R Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield
| | - S Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals NHS Trust, University of Sheffield
| | | | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - K Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - I Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia
| | - M K Javaid
- NIHR Oxford Biomedical Research Centre, University of Oxford
| | - R Eastell
- Academic Unit of Bone Metabolism, University of Sheffield
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton
| | | | - A Howden
- School of Life Sciences, University of Dundee
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E H Gray
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - S Azarian
- Institute of Hepatology, Foundation for Liver Research
| | - A Riva
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - H Edwards
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - M J W McPhail
- School of Immunology and Microbial Sciences, King's College London
- Institute of Liver Studies & Transplantation, King's College Hospital
| | - R Williams
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - S Chokshi
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - V C Patel
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
- Institute of Liver Studies & Transplantation, King's College Hospital
| | - L A Edwards
- Institute of Hepatology, Foundation for Liver Research
- School of Immunology and Microbial Sciences, King's College London
| | - D Page
- University of Manchester
- Manchester Metropolitan University
| | - M Miossec
- Manchester Metropolitan University
- University of Newcastle
| | | | | | | | | | | | - M Badat
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - S Mettananda
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya
| | - P Hua
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - R Schwessinger
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - J Hughes
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - D Higgs
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
| | - J Davies
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital
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Mattila J, Curtis S, Webb-Vargas Y, Wilson E, Galperina O, Roush D, Tobler S, Stanley B, Clark M, Weaver J, Pike J, Yu D, Li X, Flicker A, Kindermann J, Schuelke N, Whitcombe R, Bennett L. Retrospective Evaluation of Cycled Resin in Viral Clearance Studies-A Multiple Company Collaboration. PDA J Pharm Sci Technol 2019; 73:470-486. [PMID: 31101706 DOI: 10.5731/pdajpst.2018.009605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The BioPhorum Development Group Viral Clearance Workstream performed a collaborative retrospective analysis to evaluate packed bed chromatographic resin performance after repeated cycling for two commonly used chromatography steps in biopharmaceutical manufacturing: protein A and anion exchange. Key variables evaluated in the assessment included virus type, resin type, number of reuse cycles, and virus challenge. In this retrospective analysis of viral clearance data on naïve versus cycled resin, powered by the availability of a decade's worth of accumulated industry data, clearance capability was not negatively impacted by resin cycling. This finding is consistent with publications showing that surrogates for viral clearance capabilities could be employed in lieu of testing the viral clearance of cycled resins for protein A and anion exchange chromatography. The rigorous analysis of the retrospective data supports the view that viral clearance studies for cycled resins are not necessary provided that appropriate cleaning methods are applied during repeated use of the chromatography columns.LAY ABSTRACT: The manufacturing processes for biopharmaceutical products often include reusable chromatographic resins that remove process- and product-related impurities as well as potential contaminating viruses. Typically, chromatography resin is "cycled" through repeated steps of resin conditioning, product purification, and resin cleaning. The cycling approach has been evaluated in both small- and full-scale studies that show the performance parameters are maintained. The ability to remove virus is demonstrated separately in a focused small-scale virus-spiking study that is resource-intensive and costly. This paper is a retrospective review of industry data comparing virus removal by naïve and repeatedly cycled resins that summarizes the viral clearance impact of re-using protein A and anion exchange chromatography resins. The key variables evaluated in the assessment included virus type, resin type, number of cycles, and virus challenge. In this retrospective analysis, it was found that the viral clearance capability is not negatively impacted by resin cycling. This finding is consistent with other publications and supports the view that viral clearance studies for cycled resins are not necessary if appropriate cleaning methods are applied during the repeated use of the chromatography columns.Abbreviations: AAV-2, Adeno-associated virus; A-MuLV, Amphotropic murine leukemia virus; AEX, Anion-exchange chromatography; B/E, Bind and elute; BVDV, Bovine viral diarrhea virus; C.P.G., Controlled pore glass; DEAE, Diethylaminoethanol; EMCV, Encephalomyocarditis virus; FT, Flow through; HAV, Hepatitis A virus; HSV-1, Herpes simplex virus type 1; LOD, Limit of detection; LOQ, Limit of quantification; LRF, Log10 reduction factor; mAb, Monoclonal antibody; MVM, Minute virus of mice; NaOH, Sodium hydroxide; PA, Protein A; PPV, Porcine parvovirus; QA, Quaternary amine; QP, Quaternized polyethyleneimine; qPCR, Quantitative polymerase chain reaction; Reo3, Reovirus type 3; SuHV-1, Suid herpesvirus; SV40, Simian virus 40; X-MuLV, Xenotropic murine leukemia virus.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mike Clark
- AbbVie Bioresearch Center, Worcester, MA
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Ford TJ, Layland J, Stanley B, Carberry J, May VTY, Eteiba H, Lindsay MM, Petrie MC, Watkins S, Shaukat A, Oldroyd KG, Curzen N, McConnachie A, McEntegart M, Berry C. P6432Overlooked prognostic markers in NSTEMI: insights from the BHF FAMOUS-NSTEMI trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6432] [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: 11/13/2022] Open
Affiliation(s)
- T J Ford
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - J Layland
- St Vincent's Hospital, Melbourne, Australia
| | - B Stanley
- University of Glasgow, Glasgow, United Kingdom
| | - J Carberry
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - V T Y May
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - H Eteiba
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - M M Lindsay
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - M C Petrie
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - S Watkins
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - A Shaukat
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - K G Oldroyd
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - N Curzen
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - M McEntegart
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
| | - C Berry
- Golden Jubilee National Hospital, Interventional Cardiology, Glasgow, United Kingdom
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Steiner E, Campos D, Keall P, Makhija K, Stanley B, Yamamoto T, Daly M, Rong Y. EP-2037: First clinical use of a new surface tracking/biofeedback system: DIBH reproducibility and stability. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32346-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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14
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Stanley B, Hollis R, Towler J, Yan X, Nunes H, Rye T, Herrington S, Churchman M, MacKean M, Nussey F, Gourley C. A retrospective study of endocrine therapy in high grade serous ovarian carcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.022] [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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15
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Callahan DJ, Stanley B, Li Y. Control of protein particle formation during ultrafiltration/diafiltration through interfacial protection. J Pharm Sci 2014; 103:862-9. [PMID: 24449131 PMCID: PMC4284022 DOI: 10.1002/jps.23861] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/23/2013] [Accepted: 01/03/2014] [Indexed: 12/14/2022]
Abstract
This study investigates the mechanism of protein particle formation during ultrafiltration/diafiltration (UF/DF), finding that agitation drives particle formation by promoting protein-interface adsorption and desorption. Low conductivity and the presence of surfactant reduced the level of particle formation in small-scale stirring studies, and the same trends were observed in pumping and UF/DF. Polysorbate 80 (PS80) and hydroxypropyl-β-cyclodextrin (HPβCD) reduced particle formation in UF/DF by factors of 15 and 4, respectively. Measurements of conformational stability, colloidal stability, and surface tension demonstrated that PS80 protects against particle formation by preventing protein-interface adsorption, low conductivity improves the colloidal stability of the protein, and the mechanism of action of HPβCD remains unclear. This work demonstrates that interfacial adsorption–desorption of the protein during UF/DF is the principal cause of particle formation, that the level of surfactant-free particle formation depends on the colloidal stability of the protein, and that the inclusion of surfactant greatly reduces in-process particle formation during UF/DF.
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Affiliation(s)
- Daniel J Callahan
- Department of Purification Process Sciences, MedImmune, Gaithersburg, Maryland, 20878
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Tørmoen AJ, Grøholt B, Haga E, Brager-Larsen A, Miller A, Walby F, Stanley B, Mehlum L. Feasibility of dialectical behavior therapy with suicidal and self-harming adolescents with multi-problems: training, adherence, and retention. Arch Suicide Res 2014; 18:432-44. [PMID: 24842553 DOI: 10.1080/13811118.2013.826156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We evaluated the feasibility of DBT training, adherence, and retention preparing for a randomized controlled trial of Dialectical Behavior Therapy (DBT) adapted for Norwegian adolescents engaging in self-harming behavior and diagnosed with features of borderline personality disorder. Therapists were intensively trained and evaluated for adherence. Adherence scores, treatment retention, and present and previous self-harm were assessed. Twenty-seven patients were included (mean age 15.7 years), all of them with recent self-harming behaviors and at least 3 features of Borderline Personality Disorder. Therapists were adherent and 21 (78%) patients completed the whole treatment. Three subjects reported self-harm at the end of treatment, and urges to self-harm decreased. At follow up, 7 of 10 subjects reported no self-harm. DBT was found to be well accepted and feasible. Randomized controlled trials are required to test the effectiveness of DBT for adolescents.
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Affiliation(s)
- A J Tørmoen
- a National Centre for Suicide Research and Prevention , University of Oslo , Norway
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Stanley B, Gibson S. Audit of receptionists' records of symptoms and concurrence with clinician consultation: data collected for the Department of Health. Int J STD AIDS 2011; 22:684-5. [PMID: 22096058 DOI: 10.1258/ijsa.2009.009444] [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: 11/18/2022]
Abstract
Audit of reliability of data collected by genitourinary (GU) medicine reception staff in north Cumbria for Department of Health mandatory returns suggests that receptionist-logged presence or absence of symptoms does not concur well with subsequent symptom disclosure to clinicians during consultations, even after the use of patient-completed symptom-specific questionnaires. Triage or fast-tracking based upon symptoms in order to select those at risk of sexually transmitted infection (STI) is likely to fail for a significant proportion of patients. Department of Health symptoms data need to be interpreted with caution.
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Affiliation(s)
- B Stanley
- Department of Genitourinary Medicine, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK.
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Abstract
OBJECTIVE Prior studies examining the relationship between social adjustment and suicidal ideation or behaviour have not examined attachment. This study examines the effect of attachment on the association between current social adjustment and suicide attempt risk. METHOD Attachment, social adjustment, and history of suicide attempt were assessed in patients participating in research on major depressive disorder (N = 524). Suicide attempters and non-attempters were compared with attachment style and social adjustment using hierarchical logistic regression models. The two factor scoring method of the Adult Attachment Scale (secure vs. avoidant) was utilized as each measures unique aspects of attachment. RESULTS Anxious attachment (OR = 1.33; 95% CI = 1.016-1.728; P = 0.038) but not overall social adjustment (P = 0.14) was associated with a history of a past suicide attempt when both attachment and social adjustment were assessed in the same model. Among subtypes of social adjustment, work adjustment was associated with past history of suicide attempt (OR = 1.25; 95%CI = 1.019-1.540; P = 0.033). As impairment in work adjustment increased by 1 unit, the likelihood of reporting a suicide attempt increased by approximately 25%. There was no interaction between anxious attachment and work adjustment (P = 0.81). CONCLUSION Anxious attachment and work adjustment warrant further study as potential treatment targets in depressed suicidal patients.
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Affiliation(s)
- D Lizardi
- School of Social Work, Columbia University, New York, NY, USA.
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Ierano C, Polgar O, Tamaki A, Stanley B, Ward Y, Xia D, Tarasova N, Robey RW, Bates SE. Abstract 3528: Mutational analysis of threonine 402 adjacent to the GXXXG dimerization motif in TM1 of ABCG2. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-3528] [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: 11/16/2022]
Abstract
Abstract
ABCG2 is an ATP-binding cassette half-transporter important in normal tissue protection, drug distribution and excretion. ABCG2 requires homodimerization for function, though the mechanism for dimerization has not been worked out. We carried out mutational analysis of threonine 402, three residues away from the GXXXG motif in TM1, to study its potential role in ABCG2 dimerization (TXXXGXXXG). Single mutations to leucine (T402L) or arginine (T402R) did not have significant impact on the ABCG2 protein. On the other hand, combining the T402 mutations with the GXXXG glycine to leucine mutations (T402L/G406L/G410L and T402R/G406L/G410L) resulted in substantially reduced expression, altered glycosylation, degradation by a proteosome independent pathway and partial retention in the endoplasmic reticulum as suggested by immunostaining, Endoglycosidase H sensitivity and MG132 and bafilomycin failed effect. The T402L/G406L/G410L mutant when incubated with the ABCG2-substrate mitoxantrone showed a shift on immunoblot analysis to the band representing the fully matured glycoprotein. The T402R/G406L/G410L mutant carrying the more drastic substitution failed to shift to the surface with mitoxantrone. The same set of mutations also displayed impaired dimerization in the TOXCAT assay for TM1 compared to the wild type. Homology modeling of ABCG2 places the TXXXGXXXG motif at the dimer interface. These studies are consistent with a role for the extended TXXXGXXXG motif in ABCG2 folding, processing, and/or dimerization.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3528.
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Polgar O, Ierano C, Tamaki A, Stanley B, Ward Y, Xia D, Tarasova N, Robey RW, Bates SE. Mutational analysis of threonine 402 adjacent to the GXXXG dimerization motif in transmembrane segment 1 of ABCG2. Biochemistry 2010; 49:2235-45. [PMID: 20088606 DOI: 10.1021/bi902085q] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ABCG2 is an ATP-binding cassette half-transporter important in normal tissue protection, drug distribution, and excretion. ABCG2 requires homodimerization for function, though the mechanism for dimerization has not been elucidated. We conducted mutational analysis of threonine 402, three residues from the GXXXG motif in TM1, to study its potential role in ABCG2 dimerization (TXXXGXXXG). Single mutations to leucine (T402L) or arginine (T402R) did not have a significant impact on the ABCG2 protein. On the other hand, combining the T402 mutations with the GXXXG glycine to leucine mutations (T402L/G406L/G410L and T402R/G406L/G410L) resulted in a substantially reduced level of expression, altered glycosylation, degradation by a proteosome-independent pathway, and partial retention in the endoplasmic reticulum as suggested by immunostaining, Endo H sensitivity, and MG132 and bafilomycin failed effect. The T402L/G406L/G410L mutant when incubated with the ABCG2 substrate MX showed a shift on immunoblot analysis to the band representing the fully mature glycoprotein. The T402R/G406L/G410L mutant carrying the more drastic substitution was found to primarily localize intracellularly. The same set of mutations also displayed impaired dimerization in the TOXCAT assay for TM1 compared to that of the wild type. Homology modeling of ABCG2 places the TXXXGXXXG motif at the dimer interface. These studies are consistent with a role for the extended TXXXGXXXG motif in ABCG2 folding, processing, and/or dimerization.
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Affiliation(s)
- Orsolya Polgar
- Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Room 13N240, Bethesda, Maryland 20892, USA
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Fertuck EA, Jekal A, Song I, Wyman B, Morris MC, Wilson ST, Brodsky BS, Stanley B. Enhanced 'Reading the Mind in the Eyes' in borderline personality disorder compared to healthy controls. Psychol Med 2009; 39:1979-1988. [PMID: 19460187 PMCID: PMC3427787 DOI: 10.1017/s003329170900600x] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is partly characterized by chronic instability in interpersonal relationships, which exacerbates other symptom dimensions of the disorder and can interfere with treatment engagement. Facial emotion recognition paradigms have been used to investigate the bases of interpersonal impairments in BPD, yielding mixed results. We sought to clarify and extend past findings by using the Reading the Mind in the Eyes Test (RMET), a measure of the capacity to discriminate the mental state of others from expressions in the eye region of the face. METHOD Thirty individuals diagnosed with BPD were compared to 25 healthy controls (HCs) on RMET performance. Participants were also assessed for depression severity, emotional state at the time of assessment, history of childhood abuse, and other Axis I and personality disorders (PDs). RESULTS The BPD group performed significantly better than the HC group on the RMET, particularly for the Total Score and Neutral emotional valences. Effect sizes were in the large range for the Total Score and for Neutral RMET performance. The results could not be accounted for by demographics, co-occurring Axis I or II conditions, medication status, abuse history, or emotional state. However, depression severity partially mediated the relationship between RMET and BPD status. CONCLUSIONS Mental state discrimination based on the eye region of the face is enhanced in BPD. An enhanced sensitivity to the mental states of others may be a basis for the social impairments in BPD.
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Affiliation(s)
- E A Fertuck
- Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY 10032, USA.
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Lizardi D, Sher L, Sullivan GM, Stanley B, Burke A, Oquendo MA. Association between familial suicidal behavior and frequency of attempts among depressed suicide attempters. Acta Psychiatr Scand 2009; 119:406-10. [PMID: 19367777 PMCID: PMC3804892 DOI: 10.1111/j.1600-0447.2009.01365.x] [Citation(s) in RCA: 22] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Only a few studies have examined whether a family history of suicide influences the severity of suicidal acts and the results have been inconsistent. The current study aimed to examine whether a family history of suicidal acts predicts severity of suicide attempts. METHOD 190 suicide attempters aged 18-75 years with a lifetime history of major depression were assessed for first-degree family history of suicidality and severity of suicide attempts (number and lethality of prior suicide attempts and age at first attempt). RESULTS Regression analyses indicate that a positive family history of suicidal behaviors predicts a greater number of suicide attempts. Reasons for living predict number and lethality of prior attempts. CONCLUSION It is critical to assess for family history of suicidal behavior when treating depressed suicide attempters as it may serve as an indicator of the risk of repeat suicide attempt and as a guide for treatment.
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Affiliation(s)
- D. Lizardi
- School of Social Work, Columbia University, New York, NY, USA
| | - L. Sher
- Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - G. M. Sullivan
- Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - B. Stanley
- Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - A. Burke
- Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - M. A. Oquendo
- Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
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Stanley B, Engelman D. Isolation and Identification of Membrane Protein Oligomers from the E. coli Inner Membrane. FASEB J 2006. [DOI: 10.1096/fasebj.20.5.lb76-d] [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: 11/11/2022]
Affiliation(s)
- Bradford Stanley
- Department of Molecular Biophysics and BiochemistryYale UniversityP.O. BOX 208114New HavenCT06520
| | - Donald Engelman
- Department of Molecular Biophysics and BiochemistryYale UniversityP.O. BOX 208114New HavenCT06520
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Stanley B, Todd A. Testing for Neisseria gonorrhoeae by nucleic acid amplification testing of chlamydia samples using Roche Cobas Amplicor in a rural area in the north of England does not find more gonorrhoea in primary care. Sex Transm Infect 2005; 81:518. [PMID: 16326859 PMCID: PMC1745058 DOI: 10.1136/sti.2004.013722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
We conducted a retrospective database search of the Hospital Morbidity Data System at the Health Department of Western Australia to determine the number of anaesthetics given to children aged 16 years or less in Western Australia over a twelve-month period. Information was also collected to assess the types of surgery for which anaesthesia was being provided, and the categories of hospital in which children were being anaesthetized. We found that 28,522 anaesthetics were given to 24,981 children, and 2,462 (9.9%) children had more than one anaesthetic. Five and a half percent of the children in Western Australia had an anaesthetic during the twelve months studied. The most common types of surgery were ear nose and throat (28% of anaesthetics), general (21%), dental/oral procedures (17%) and orthopaedic (15%). There was a bimodal distribution in the incidence of anaesthesia versus age, with peaks at 4 years and at 16 years. The most common category of hospital that children were anaesthetized in was private metropolitan (40%) followed by tertiary (38%), rural (14%) and public metropolitan (8%). One thousand, seven hundred and seven children aged less than one year were given an anaesthetic. These anaesthetics were most frequently given to children in tertiary hospitals (62%) followed by private metropolitan (30%), public metropolitan (6%) and rural hospitals (2%).
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Affiliation(s)
- C Sims
- Department of Anaesthesia, Princess Margaret Hospital for Children and Health Information Centre, Department of Health and Institute for Child Health Research, Perth, Western Australia
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Stanley B. Sexually Transmitted Infections and HIV. Sex Transm Infect 2005. [DOI: 10.1136/sti.2005.015313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Malik R, Shaw SE, Griffin C, Stanley B, Burrows AK, Bryden SL, Titmarsh J, Stutsel MJ, Carter SA, Warner A, Martin P, Wigney DI, Gilpin C. Infections of the subcutis and skin of dogs caused by rapidly growing mycobacteria. J Small Anim Pract 2004; 45:485-94. [PMID: 15517689 DOI: 10.1111/j.1748-5827.2004.tb00193.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nine dogs with panniculitis due to rapidly growing mycobacteria (RGM) were examined over 17 years. Dogs were two to 15 years; five were male, four were female. All were obese or in good condition. Antecedent injury, typically a dog bite or vehicular trauma, could be identified in some patients, while one bitch had hyperadrenocorticism. Infections involved different locations, although the cervicothoracic region, dorsum or flank were most often affected. Patients were systemically well, apart from one dog with pyrexia and two with pain or lameness. Cytology demonstrated pyogranulomatous inflammation, but in only one case was it possible to see acid-fast bacilli (AFB) in smears. Histology demonstrated chronic active pyogranulomatous panniculitis and dermatitis; AFB could be detected in only four specimens. Culture of aspirates or resected tissues demonstrated RGM in all cases, comprising six Mycobacterium smegmatis group and three Mycobacterium fortuitum group isolates. Resection of infected tissues, perioperative injectable antimicrobials and long courses of oral antimicrobials chosen according to susceptibility data generally effected a cure, although some cases recurred.
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Affiliation(s)
- R Malik
- Post Graduate Foundation in Veterinary Science, Conference Center, Building B22, The University of Sydney, Australia
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Pearson JL, Stanley B, King CA, Fisher CB. Intervention research with persons at high risk for suicidality: safety and ethical considerations. J Clin Psychiatry 2002; 62 Suppl 25:17-26. [PMID: 11765091] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
There is a critical need for studies designed to reduce suicidality. Individuals at high risk for suicidality deserve safe and effective treatments, just as do other individuals with mental disorders who do not experience suicidality. Points for consideration regarding safety and monitoring procedures are offered to help researchers who conduct treatment trials with individuals who have mental disorders and investigators specifically interested in developing treatments to reduce suicidality. Issues such as study design, increased monitoring and supervision, research clinician competencies, and liability concerns are addressed. Points to consider in planning an intervention trial, a checklist of informed consent issues, and a list of relevant active federal regulations are provided.
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Affiliation(s)
- J L Pearson
- National Institute of Mental Health, Rockville, MD, USA
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Abstract
Personality disorders are usually treated with either psychodynamic or supportive psychotherapy, with psychotropic medication often used as an adjunctive treatment. However, patients with personality disorders pose special treatment issues, because their problems are pervasive and long-standing and they have entrenched deficits in many areas of functioning. In this article, the authors consider the role of skills training in the treatment of personality disorders. They describe a two-pronged approach to the treatment of personality disorders based on a model of deficit compensation. Because skills training has only been investigated in a very limited way in personality disorders, the authors first review research on the use of skills training in Axis I disorders as background for a discussion of ways in which skills training may be applicable to the treatment of Axis II disorders. They describe a number of skills training approaches (social skills training, anger management, and conversational skills) that can be used for a variety of different Axis I disorders. Skills training approaches that are targeted to specific types of disorders (substance use disorders, schizophrenia, anxiety disorders, adolescent problems) are also described. The authors then review what is known about the use of skills training in borderline personality disorder and avoidant personality disorder, and propose skills training approaches that may be useful for patients with paranoid personality disorder and antisocial personality disorder. Case examples are provided to demonstrate how skills training for personality disorders can be applied in clinical practice.
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Affiliation(s)
- B Stanley
- New York State Psychiatric Institute, Columbia University College of Physicians & Surgeons, USA
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Abstract
Goal planning is an integral part of the role of the key worker in services for people with intellectual disability. The present study investigated the effect of the Weiner stability-expectancy principle on unexpected outcomes in goal planning. Four hundred and twenty-two actual goal attainment scales were constructed, with each scale describing the key workers' expected levels of outcome. Two hundred and twenty-six (54%) unexpected outcomes, both successful and unsuccessful, were then rated by key workers to provide a causal explanation for each outcome. These explanations were then grouped according to whether the attributions represented stable or variable causes. Finally, key workers were asked to provide a new expectancy rating to forecast future goal attainment. Two predictions from Weiner's model were confirmed by statistical analysis: (1) that success attributed to stable factors would lead to higher revised forecasts of goal attainment than success attributed to variable factors; and (2) that failure attributed to stable factors would lead to lower revised forecasts of goal attainment than failure attributed to variable factors. The results of the present study confirm that stability attributions do alter key workers' revised forecasts of goal attainment. The results are discussed in terms of the possible consequences for key worker behaviour, such as goal abandonment, differential treatment of service users and the need for a knowledgeable approach to performance appraisal by managers.
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Affiliation(s)
- B Stanley
- Bradford Community Health Trust, Bradford, UK; University of Nottingham, Nottingham, UK.
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Abstract
OBJECTIVE Individuals who mutilate themselves are at greater risk for suicidal behavior. Clinically, however, there is a perception that the suicide attempts of self-mutilators are motivated by the desire for attention rather than by a genuine wish to die. The purpose of this study was to determine differences between suicide attempters with and without a history of self-mutilation. METHOD The authors examined demographic characteristics, psychopathology, objective and perceived lethality of suicide attempts, and perceptions of their suicidal behavior in 30 suicide attempters with cluster B personality disorders who had a history of self-mutilation and a matched group of 23 suicide attempters with cluster B personality disorders who had no history of self-mutilation. RESULTS The two groups did not differ in the objective lethality of their attempts, but their perceptions of the attempts differed. Self-mutilators perceived their suicide attempts as less lethal, with a greater likelihood of rescue and with less certainty of death. In addition, suicide attempters with a history of self-mutilation had significantly higher levels of depression, hopelessness, aggression, anxiety, impulsivity, and suicide ideation. They exhibited more behaviors consistent with borderline personality disorder and were more likely to have a history of childhood abuse. Self-mutilators had more persistent suicide ideation, and their pattern for suicide was similar to their pattern for self-mutilation, which was characterized by chronic urges to injure themselves. CONCLUSIONS Suicide attempters with cluster B personality disorders who have a history of self-mutilation tend to be more depressed, anxious, and impulsive, and they also tend to underestimate the lethality of their suicide attempts. Therefore, clinicians may be unintentionally misled in assessing the suicide risk of self-mutilators as less serious than it is.
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Affiliation(s)
- B Stanley
- Mental Health Clinical Research Center for the Study of Suicidal Behavior, Department of Neuroscience, New York State Psychiatric Institute, NY 10032, USA.
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Stanley B. Proposal 2: How do we enhance the consumer-provider partnership? The consumer-provider partnership. N Z Dent J 2000; 96:106-8. [PMID: 11051754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Abstract
OBJECTIVES The purpose of this study was to apply Weiner's (1986) attributional model of helping to the care of clients presenting with challenging behaviour. A number of predictions were tested: (a) that aggressive, destructive, and self-injurious behaviours would differentially affect carers' ratings of attributional dimensions; (b) that carers' propensity to help would be mediated by positive affect rather than optimism; (c) that optimism would be reduced by a perceived stable cause, such as client's level of dependency. DESIGN AND METHOD The participants were 50 care staff working in challenging behaviour day services, who were presented with six case studies to rate. A two-factor repeated measures design was employed to examine the effects of challenging behaviour and dependency on carers' ratings of attributional dimensions, affects, optimism and helping. Correlational analysis was employed to examine the relative effects of positive affect, negative affect and optimism on carers' propensity to help. RESULTS All three predictions were confirmed. The more independent and outer directed the challenging behaviour, the greater the carers' attributions of control and negative affect, and the less the propensity to help. The more self-directed and dependent the client's challenging behaviour, the greater the carers' attribution of stability, positive affect and propensity to help. CONCLUSIONS The results are discussed in relation to the concept of helping and the experience of carers coping with challenging behaviours.
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Affiliation(s)
- B Stanley
- Department of Clinical Psychology, Bradford Community NHS Trust, UK
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Stanley B, Molcho A, Stanley M, Winchel R, Gameroff MJ, Parsons B, Mann JJ. Association of aggressive behavior with altered serotonergic function in patients who are not suicidal. Am J Psychiatry 2000; 157:609-14. [PMID: 10739421 DOI: 10.1176/appi.ajp.157.4.609] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether aggression and serotonergic dysfunction are related in the absence of a history of suicidal behavior. Although serotonergic dysfunction has been implicated in aggressive and impulsive behavior, most studies of such behavior have included individuals with a history of suicide attempts. Low concentrations of CSF 5-hydroxyindoleacetic acid (5-HIAA) have been consistently associated with suicidal behavior, presenting a potential confound in the link between aggression and serotonergic dysfunction. METHOD The authors examined the association between aggression and CSF 5-HIAA concentrations in a group of 64 patients who had different DSM-III-R axis I diagnoses and no past suicidal behavior. Aggressive (N=35) and nonaggressive (N=29) groups were defined by a median split on a six-item history of adulthood aggressive behavior. RESULTS The aggressive group had significantly lower CSF 5-HIAA concentrations than the nonaggressive group. Aggressive individuals also scored significantly higher on self-report measures of hostility, impulsiveness, and sensation seeking. CSF 5-HIAA concentrations, however, did not correlate with self-reported hostility and impulsivity. CONCLUSIONS There is an association between aggressive behavior and serotonergic dysfunction independent of suicidal behavior in patients with axis I disorders who exhibit relatively milder forms of aggressive behavior. Analogous to findings with suicidal behavior, a low concentration of CSF 5-HIAA is related to aggressive behavior but does not show the same relationship to the continuum of aggressive feelings and thoughts.
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Affiliation(s)
- B Stanley
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA
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Yeaman T, Stanley B. Can you keep a secret? IHRIM 1999; 40:11-4. [PMID: 10620998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Stanley B. Oral sex and the transmission of non-viral STIs. Sex Transm Infect 1999; 75:77. [PMID: 10448356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
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Dodd AC, Clarke NM, Coopersmith J, Griffiths RJ, Pearce KI, Stanley B, Cook J. The importance of the tensor interaction in the (7Li,7Be) reaction. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0305-4616/11/9/012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mann JJ, Malone KM, Sweeney JA, Brown RP, Linnoila M, Stanley B, Stanley M. Attempted suicide characteristics and cerebrospinal fluid amine metabolites in depressed inpatients. Neuropsychopharmacology 1996; 15:576-86. [PMID: 8946432 DOI: 10.1016/s0893-133x(96)00102-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Serotonin abnormalities have been reported in the brain of suicide victims. Evidence of a serotonin deficiency in suicide attempters is less consistent. We hypothesized that a serotonin deficiency may be present in suicide attempters whose attempt behavior more closely approximates completed suicide. METHOD Sixty-seven (67) drug-free depressed inpatients (46 suicide attempters, 21 nonattempters) underwent research clinical assessments and a lumbar puncture. Cerebrospinal fluid (CSF) monoamine metabolites were assayed. Degree of medical damage and intent of the most recent suicide attempt were rated. RESULTS CSF amine metabolites did not differentiate suicide attempters as a group from nonattempters. However, reduced serotonergic activity, as indicated by lower levels of CSF-5-hydroxyindoleacetic acid (5-HIAA) was associated with a history of planned suicide attempts and with suicide attempts that resulted in greater medical damage. Other monoamine metabolites did not correlate with seriousness of suicidal behavior, except for low CSF homovanillic acid and higher medical damage. No correlation was found with violent method. CONCLUSIONS Planned and more medically damaging suicide attempts appear to be associated specifically with low serotonergic activity and, therefore, resemble completed suicide both behaviorally and biochemically. It remains to be determined whether low levels of CSF 5-HIAA can predict greater medical damage in future suicide attempts.
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Affiliation(s)
- J J Mann
- MHCRC for the Study of Suicidal Behavior, College of Physicians and Surgeons, Columbia University, New York, USA
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Stanley B, Teague B, Raptis S, Taylor DJ, Berce M. Efficacy of balloon angioplasty of the superficial femoral artery and popliteal artery in the relief of leg ischemia. J Vasc Surg 1996; 23:679-85. [PMID: 8627905 DOI: 10.1016/s0741-5214(96)80049-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [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: 02/01/2023]
Abstract
PURPOSE To assess the efficacy of balloon angioplasty in the superficial femoral artery (SFA) and popliteal artery for relief of lower-limb claudication and critical ischemia. METHODS All patients who underwent SFA or popliteal balloon angioplasty at the Royal Adelaide Hospital between January 1989 and September 1994 were reviewed. Risk factors, indications, angiographic variables, and complications were assessed. Outcome was expressed in life-table form as patency, limb survival, and patient survival rates. RESULTS One hundred seventy-six patients (96 men, 80 women) who underwent 200 balloon angioplasty procedures were monitored for a mean of 25 months. Seventy-four percent of procedures were for claudication relief and 26% for critical ischemia. The cumulative patency rate at 24 months for all cases was 46%. The limb salvage rate was 95%, and the patient survival rate was 91% at 24 months. CONCLUSION Percutaneous transluminal angioplasty of the SFA and popliteal arteries is commonly used to treat claudication and critical ischemia but is associated with a high initial failure rate and poor patency at 24 months. Balloon angioplasty is not recommended to treat claudication.
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Affiliation(s)
- B Stanley
- Department of Vascular Surgery and Radiology, University of Adelaide, Royal Adelaide Hospital, South Australia
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Stanley B. Presidential address. Unprecedented legislation and political activity and a profusion of controversial public and consumer issues. N Z Dent J 1995; 91:122-3. [PMID: 8602284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
A gastrostomy was fashioned laparoscopically in a 15 year old patient with a severe head injury. A preceding attempt at percutaneous endoscopic gastrostomy had failed. The gastrostomy tube was inserted into the stomach under vision and the stomach attached to the anterior abdominal wall by sutures.
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Affiliation(s)
- J R Bessell
- Department of Surgery, Queen Elizabeth Hospital, Woodville, Australia
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Devlin NJ, Stanley B. The economics of dental practice in New Zealand, 1974-1993. N Z Dent J 1994; 90:4-8. [PMID: 8190387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
New Zealand Dental Association survey data were used to explore trends in the principal indicators of dental practice economics over the last two decades. Gross income in the most recent financial year, 1992, was the highest during this period. However, the costs of dental practice have also risen, and now absorb close to 60 percent of revenue compared with around 50 percent in the early 1970s. As a result, real net income has yet to return to the "peak" levels achieved in the mid-1970s. Nevertheless, average real net incomes earned in 1992 (in 1988 dollar terms) of $85,701 is around 8 percent higher than the average real net income between 1974 and 1992 of $79,243. Furthermore, the lower income tax rates applying in the post-1990 period have produced post-1990 after-tax incomes which are higher in real terms than those in the pre-1990 period. The trends in real net dental income earned by dentists between 1982 and 1992 are shown to correspond closely to the trends in the average incomes of higher-income consumers. The rate of increase in the fees charged by dentists between 1978 and 1993 has, for most services, exceeded the rate of increase in consumer prices generally. A notable exception is the fee charged for complete dentures, which displayed much more modest increases. It is possible that this is attributable to the presence of competing suppliers (dental technicians) for this service.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- N J Devlin
- Economics Department, University of Otago, Dunedin
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Ali A, Ceretti G, Barbato L, Marchese G, D'Andrea F, Stanley B. Attraction of Chironomus salinarius (Diptera: Chironomidae) to artificial light on an island in the saltwater lagoon of Venice, Italy. J Am Mosq Control Assoc 1994; 10:35-41. [PMID: 8014626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The attraction of adult Chironomus salinarius to incandescent 3-W lamps of 7 different colors used in CDC traps was studied on a small island in the lagoon of Venice, Italy. An ANOVA indicated that the lamp type was a highly significant (P < 0.01) factor associated with differences in light trap catch (28% of total variation), as well as catch per lux (18% of total variation). The white lamp attracted higher numbers of adults than the other 6 color lamps. Yellow was the second most preferred, and red was the least attractive. There was a strong linear relationship (r = 0.93) between the catch and light intensity, which suggested that intensity was the primary factor influencing catch. However, catch per unit brightness (lux) tended to be inversely proportional to the peak wavelength associated with the lamp color (e.g., the violet lamp had the highest catch/lux, and the red lamp had the lowest). The corresponding regression model, Catch = 49 + [(48,013/lambda) - 63] . L, in which the slope associated with light intensity in lux (L) is inversely proportional to the peak wavelength in nm (lambda) explained 97% of the variation among lamp catch means. Manipulating light intensity and color could be useful to divert adult C. salinarius populations from midge-affected areas for control purposes.
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Affiliation(s)
- A Ali
- University of Florida, Central Florida Research and Education Center, Sanford 32771-9608
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Abstract
The aim of this study was to determine the value of positive, negative and depressive symptoms, and of the dexamethasone suppression test (DST), in differentiating schizophrenics with and without a history of suicide. Fifty-seven hospitalized patients with schizophrenia were assessed at the end of a neuroleptic free interval with the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scale for Depression (HRSD), and with a dexamethasone challenge. Suicide attempters were significantly more likely to meet criteria for major depression than nonattempters. Scores on the HRSD differentiated the two groups whereas the sums of positive and negative symptom items from the BPRS did not. DST a.m. and p.m. cortisol values differentiated suicide attempters from nonattempters and HRSD scores correlated significantly with cortisol levels. This study confirms the importance of depressive symptoms in schizophrenic patients with a history of suicide. Assessment of the hypothalamic-pituitary-adrenal axis in schizophrenia may also provide useful information.
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Affiliation(s)
- J S Jones
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
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Stanley B. Some current factors restricting the potential of private general practice. N Z Dent J 1992; 88:125-8. [PMID: 1484640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This background paper focuses on two or three aspects which, in the writer's opinion, are crucial to the healthy development of general dental practice, although the rapidly progressing health reforms have already altered the relevance of some comments made. The first aspect is equitable access, especially for the financially disadvantaged in this time of economic recession. The ability and inclination of providers to treat the financially disadvantaged has not currently been matched by the political will of funders, even though an effective system could simply be organised. Access problems also apply to the elderly. A smooth transitional system of oral health care should exist for every aging patient, whether economically, physically, and mentally healthy, or in a state of total dependence, and this should be an integral part of general dental practice management. Generally it is not. Secondly, the fragmentation of the New Zealand dental workforce, and the lack of a real team approach have hindered the logical development of oral health services and prevented many possible options from being offered. Dialogue to reduce the fragmentation must continue, hopefully to a successful conclusion. Perhaps the catalyst for meaningful change may be contained in the current health reforms. Certainly opportunities for change have been clearly signalled.
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Winchel RM, Jones JS, Stanley B, Molcho A, Stanley M. Clinical characteristics of trichotillomania and its response to fluoxetine. J Clin Psychiatry 1992; 53:304-8. [PMID: 1517191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND In general, effective treatments for trichotillomania have been elusive. Although behavioral therapies and hypnosis have provided benefits to some, adult patients with chronic hair pulling have often proved refractory to treatment. Medication has generally been unhelpful until the recent introduction of serotonin reuptake inhibitors for the treatment of this condition. Furthermore, there has been little systematic study of the clinical characteristics of these patients. METHOD Twenty individuals with trichotillomania were interviewed and were characterized on the basis of hair-pulling patterns, comorbidity, obsessionality, and the presence of symptoms of depression and anxiety. Twelve patients participated in an open 16-week trial of fluoxetine (up to 80 mg/day). RESULTS Compared with baseline scores derived from a scale of trichotillomania severity, severity scores at endpoint decreased (improved) by 34% (p less than .025). Among the 8 responders, the mean decrease in severity scores was 60%. Fifty-five percent (11 of 20) had current or past additional DSM-III-R Axis I diagnoses (disorders of mood, anxiety, and psychoactive substance use). CONCLUSION We conclude that in an open 16-week trial, patients treated with fluoxetine improved significantly. Data are presented on comorbid conditions, depressive symptoms, and anxiety. Baseline behavioral assessments of patients with trichotillomania suggest that substantial differences exist between this syndrome and obsessive compulsive disorder.
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Affiliation(s)
- R M Winchel
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York
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Abstract
OBJECTIVE The goal of this study was to determine whether self-mutilators with personality disorders differ from nonmutilators with personality disorders in impulsivity, aggression, and other psychopathology and whether serotonergic dysfunction contributes to self-mutilation. METHOD Twenty-six self-mutilators with personality disorders were matched to 26 control subjects with personality disorders for gender, age, education, axis I diagnosis of affective disorder, and axis II diagnosis of personality disorder. Numerous indexes of psychopathology as well as CSF 5-hydroxyindoleacetic acid (5-HIAA) levels and platelet imipramine binding sites (Bmax) and affinity (Kd) were determined. RESULTS Self-mutilators had significantly more severe character pathology, had greater lifetime aggression, and were more antisocial than the control subjects. The self-mutilators scored higher on the Hamilton Rating Scale for Depression but not on the Beck Depression Inventory or the Beck Hopelessness Scale. The two groups did not differ on the Buss-Durkee Hostility and Guilt Inventory or on the Sensation Seeking Scale. The degree of self-mutilation was significantly correlated with impulsivity, chronic anger, and somatic anxiety. Both self-mutilation and impulsivity showed significant negative correlations with Bmax, although the two groups did not differ in CSF 5-HIAA levels or in platelet imipramine binding. CONCLUSIONS The results demonstrate the contribution of severe character pathology, aggression, impulsivity, anxiety, and anger to self-mutilation and provide preliminary support for the hypothesis of underlying serotonergic dysfunction facilitating self-mutilation.
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Affiliation(s)
- D Simeon
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York
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Abstract
OBJECTIVE The purpose of the study was to examine the course of involuntarily administered medication in a state hospital population. METHOD The authors retrospectively examined the records of all 51 involuntarily medicated patients in six state hospitals in New York City in a single calendar year. Clinical course was recorded for the period of involuntary medication and for 12 months thereafter. These patients were compared to 51 patients on the same wards who accepted medication. RESULTS Clinicians assessed involuntarily medicated patients as more dangerous to themselves or others and less delusional after treatment than the comparison patients. Long-acting intramuscular antipsychotics were prescribed more frequently for involuntarily medicated patients. No differences were observed in rates of discharge, outpatient cooperation, or rehospitalization. Half of the patients in both groups remained continuously institutionalized, and of those who left the hospital, only 30% of the involuntarily medicated group and 40% of the comparison group took medication as outpatients. CONCLUSIONS For these chronically severely ill patients, involuntary medication did not appear to enhance insight or cooperation or result in rapid return to the community. Involuntary medication is often a necessary short-term, in-hospital management strategy, but it does not replace the need to develop comprehensive, long-term inpatient and community-based approaches to the management of treatment refusal.
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Affiliation(s)
- F Cournos
- New York State Psychiatric Institute, New York 10032
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Vyakarnam A, Matear P, Meager A, Kelly G, Stanley B, Weller I, Beverley P. Altered production of tumour necrosis factors alpha and beta and interferon gamma by HIV-infected individuals. Clin Exp Immunol 1991; 84:109-15. [PMID: 1901776 PMCID: PMC1535370 DOI: 10.1111/j.1365-2249.1991.tb08132.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.7] [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: 12/29/2022] Open
Abstract
In vitro studies shows that recombinant tumour necrosis factor (TNF) alpha and beta, and interferon-gamma (IFN-gamma) can enhance HIV replication, and peripheral blood mononuclear cells (PBMC) infected with HIV in vitro secrete high levels of the same cytokines. As T cells secrete all three mediators, the capacity of T cell activation signals to trigger cytokine production in PBMC from HIV-infected individuals was investigated as such patients may be immunocompromised. We demonstrate that asymptomatic seropositives in CDC group II/III as well as patients who have progressed to CDC group IV of the disease proliferate efficiently to anti-CD3 antibody, recombinant interleukin-2 (rIL-2), phytohaemagglutinin (PHA), PHA plus phorbol 12,13 dibutyrate (PMA) but secrete significantly (P less than 0.05) higher amounts of TNF-alpha, TNF-beta and IFN-gamma compared with controls in response to the same stimulants. We also show a difference between group II/III and group IV patients with the latter secreting more TNF-alpha and IFN-gamma. The kinetics of TNF-alpha and -beta, and IFN-gamma production was stimulus dependent with overall levels varying in time for each stimulus. Furthermore, the kinetics of the response to all three stimulants were altered in seropositives; CDC group II/III and group IV patients secreted higher levels of cytokines over several time points compared to controls. The altered production of these mediators by HIV-infected patients may contribute to disease progression and to the pathogenesis of AIDS.
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Affiliation(s)
- A Vyakarnam
- Academic Department of Genito Urinary Medicine, University College, London, UK
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