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Dinh NTT, de Graaff B, Campbell JA, Jose MD, Burgess J, Saunder T, Kitsos A, Wells C, Palmer AJ. Creating an interactive map visualising the geographic variations of the burden of diabetes to inform policymaking: An example from a cohort study in Tasmania, Australia. Aust N Z J Public Health 2024; 48:100109. [PMID: 38429224 DOI: 10.1016/j.anzjph.2023.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/16/2023] [Accepted: 11/07/2023] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES To visualise the geographic variations of diabetes burden and identify areas where targeted interventions are needed. METHODS Using diagnostic criteria supported by hospital codes, 51,324 people with diabetes were identified from a population-based dataset during 2004-2017 in Tasmania, Australia. An interactive map visualising geographic distribution of diabetes prevalence, mortality rates, and healthcare costs in people with diabetes was generated. The cluster and outlier analysis was performed based on statistical area level 2 (SA2) to identify areas with high (hot spot) and low (cold spot) diabetes burden. RESULTS There were geographic variations in diabetes burden across Tasmania, with highest age-adjusted prevalence (6.1%), excess cost ($2627), and annual costs per person ($5982) in the West and Northwest. Among 98 SA2 areas, 16 hot spots and 25 cold spots for annual costs, and 10 hot spots and 10 cold spots for diabetes prevalence were identified (p<0.05). 15/16 (94%) and 6/10 (60%) hot spots identified were in the West and Northwest. CONCLUSIONS We have developed a method to graphically display important diabetes outcomes for different geographical areas. IMPLICATIONS FOR PUBLIC HEALTH The method presented in our study could be applied to any other diseases, regions, and countries where appropriate data are available to identify areas where interventions are needed to improve diabetes outcomes.
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Affiliation(s)
- Ngan T T Dinh
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia; Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen University, Thai Nguyen, Vietnam. https://twitter.com/@NganDin46229988
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Julie A Campbell
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Matthew D Jose
- School of Medicine, University of Tasmania, Tasmania, Australia; Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australia, Australia
| | - John Burgess
- School of Medicine, University of Tasmania, Tasmania, Australia; Department of Endocrinology, Royal Hobart Hospital, Tasmania, Australia
| | - Timothy Saunder
- School of Medicine, University of Tasmania, Tasmania, Australia
| | - Alex Kitsos
- School of Medicine, University of Tasmania, Tasmania, Australia
| | | | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
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Strings S, Wells C, Bell C, Tomiyama AJ. The association of body mass index and odds of type 2 diabetes mellitus varies by race/ethnicity. Public Health 2023; 215:27-30. [PMID: 36634403 DOI: 10.1016/j.puhe.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to examine the association between body mass index (BMI; weight [kilogram]/height2 [meter]) and type 2 diabetes mellitus (T2DM) among the largest three largest racial/ethnic groups in the United States. METHODS We compiled 10 waves of the continuous National Health and Nutrition Examination Survey from 1999-2000 through 2017-2018. Participants (N = 45,514) were those who had data on BMI, HbA1c, and demographics. We estimated associations between BMI and prediabetes/T2DM odds for Black, Latine, and White participants. RESULTS BMI was associated with 10% higher odds of prediabetes/T2DM vs. having normal HbA1c levels (odds ratio = 1.10, 95% confidence interval = 1.10-1.11) for Latine and White individuals. However, the association between BMI and prediabetes/T2DM was significantly weaker among Black individuals. When focusing on T2DM prevalence, the association with BMI for Black participants was even weaker (odds ratio = 0.97, 95% confidence interval = 0.95-0.98). CONCLUSIONS The unstable associations between BMI and T2DM across race indicate that BMI has received unwarranted focus as a prime predictor of T2DM. Relying on BMI introduces bias in T2DM risk estimations especially in Black individuals. Focusing on BMI places the onus on individuals to change and increases weight stigma, which can worsen health outcomes. Instead, policymakers should focus on social determinants of T2DM and its concomitant racial/ethnic disparities.
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Affiliation(s)
- S Strings
- Department of Sociology, 3151 Social Sciences Plaza A, University of California, Irvine, Irvine CA 92697, USA.
| | - C Wells
- Advanced Research Computing, University of California, Los Angeles, Los Angeles CA, USA
| | - C Bell
- Social, Behavioral, and Population Sciences, School of Public Health & Tropical Medicine, Tulane University, New Orleans LA, USA
| | - A J Tomiyama
- Department of Psychology, University of California, Los Angeles, Los Angeles CA, USA
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Holmes-Truscott E, Baptista S, Ling M, Collins E, Ekinci EII, Furler J, Hagger V, Manski-Nankervis JA, Wells C, Speight J. The impact of structured self-monitoring of blood glucose on clinical, behavioral, and psychosocial outcomes among adults with non-insulin-treated type 2 diabetes: a systematic review and meta-analysis. Front Clin Diabetes Healthc 2023; 4:1177030. [PMID: 37153750 PMCID: PMC10157033 DOI: 10.3389/fcdhc.2023.1177030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
Background Self-monitoring of blood glucose (SMBG) is considered of little clinical benefit for adults with non-insulin-treated type 2 diabetes, but no comprehensive review of a structured approach to SMBG has been published to date. Purpose To conduct a systematic review and meta-analysis of the impact of sSMBG on HbA1c, treatment modifications, behavioral and psychosocial outcomes, and; examine the moderating effects of sSMBG protocol characteristics on HbA1c. Data sources Four databases searched (November 2020; updated: February 2022). Study selection Inclusion criteria: non-randomized and randomized controlled trials (RCTs) and prospective observational studies; reporting effect of sSMBG on stated outcomes; among adults (≥18 years) with non-insulin-treated type 2 diabetes. Studies excluded if involving children or people with insulin-treated or other forms of diabetes. Data extraction and analysis Outcome data extracted, and risk of bias/quality assessed independently by two researchers. Meta-analysis was conducted for RCTs, and moderators explored (HbA1c only). Data synthesis From 2,078 abstracts, k=23 studies were included (N=5,372). Risk of bias was evident and study quality was low. Outcomes assessed included: HbA1c (k=23), treatment modification (k=16), psychosocial/behavioral outcomes (k=12). Meta-analysis revealed a significant mean difference favoring sSMBG in HbA1c (-0·29%, 95% CI: -0·46 to -0·11, k=13) and diabetes self-efficacy (0.17%, 95% CI: 0.01 to 0.33, k=2). Meta-analysis revealed no significant moderating effects by protocol characteristics. Limitations Findings limited by heterogeneity in study designs, intervention characteristics, and psychosocial assessments. Conclusion A small positive effect of sSMBG on HbA1c and diabetes self-efficacy was observed. Narrative synthesis of sSMBG intervention characteristics may guide future implementation. PROSPERO registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020208857, identifier CRD42020208857.
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Affiliation(s)
- Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- *Correspondence: Elizabeth Holmes-Truscott,
| | - Shaira Baptista
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Mathew Ling
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Neami National, Preston, VIC, Australia
| | | | - EIif I. Ekinci
- Department of Medicine, Austin Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- The Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, VIC, Australia
| | - John Furler
- Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia
| | - Virginia Hagger
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Jo-Anne Manski-Nankervis
- The Australian Centre for Accelerating Diabetes Innovations (ACADI), The University of Melbourne, Melbourne, VIC, Australia
- Department of General Practice, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
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Bhoopathi V, Wells C, Ramos-Gomez F, Atchison KA. Difficulty with Oral Health Complications in Adolescents with Developmental Disability and Obesity. JDR Clin Trans Res 2022:23800844221090447. [PMID: 35442123 DOI: 10.1177/23800844221090447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Developmental disabilities (DDs), obesity, and dental caries are highly prevalent health conditions among adolescents. Evidence indicates that a significant proportion of adolescents with DDs are obese, and those with obesity and dental caries share common risk factors. OBJECTIVE In this first-ever US-based cross-sectional national study, we assessed the likelihood of adolescents with DDs and obesity experiencing chronic difficulty with decayed teeth, toothaches, bleeding gums, and eating and swallowing due to a health condition among adolescents with DDs and obesity compared to adolescents with no DDs or obesity. METHODS For this secondary data analysis study, we used data of 68,942 adolescents aged 10 to 17 y from the 2016 through 2019 National Survey of Children's Health. Weighted descriptive and bivariate analyses were conducted. Four multiple logistic regression models predicting chronic difficulty in the past 12 mo with decayed teeth, toothaches, bleeding gums, and eating and swallowing due to a health condition were conducted, controlling for other variables. RESULTS The adjusted odds ratio (aOR) of experiencing chronic difficulty in the past 12 mo for adolescents with no DDs or obesity was significantly lower for decayed teeth (aOR, 0.64; 95% confidence interval [CI], 0.51-0.80; P < 0.0001), toothaches (aOR, 0.43; 95% CI, 0.30-0.60; P < 0.0001), bleeding gums (aOR, 0.48; 95% CI, 0.33-0.70; P < 0.0001), and eating or swallowing due to a health condition (aOR, 0.34; 95% CI, 0.20-0.57; P < 0.0001) compared to adolescents with both DDs and obesity. CONCLUSIONS Results from this study indicate that DD adolescents with obesity have more/greater impending oral health needs than adolescents with no DDs or obesity. KNOWLEDGE TRANSFER STATEMENT Results of this study highlight the high oral health needs and the chronic difficulty adolescents with developmental disabilities and obesity experience compared to adolescents without developmental disabilities and obesity. Targeted oral health policies and interventions that will promote oral health among this high-risk group are recommended.
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Affiliation(s)
- V Bhoopathi
- Section of Public and Population Oral Health, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - C Wells
- Statistical Methods and Data Analytics, University of California at Los Angeles Office of Advanced Research Computing, Los Angeles, CA, USA
| | - F Ramos-Gomez
- Division of Preventative and Restorative Sciences, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - K A Atchison
- Section of Public and Population Oral Health, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
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Varghese A, Ryan A, Wells C, Li G, Baer D, Parker E, Buko A, Kaza V, Banga A, Bollineni S, Mahan L, Mohanka M, Lawrence A, Joerns J, Torres F, Wait M, Iacono A, Verceles A, Terada L, Terrin M, Timofte I. Post-Transplant Metabolomics Profiles in Patients Undergoing Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.115] [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: 12/01/2022] Open
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6
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Holloway Z, Hawkey AB, Pippen E, White H, Katragadda V, Kenou B, Wells C, Murphy SK, Rezvani AH, Levin ED. Corrigendum to "Paternal cannabis extract exposure in rats: Preconception timing effects on neurobehavioral effects in offspring" [Neurotoxicology 81 (2020) 180-188]. Neurotoxicology 2021; 87:258. [PMID: 34483001 DOI: 10.1016/j.neuro.2021.08.009] [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)
| | | | - E Pippen
- Duke University Medical Center, USA
| | - H White
- Duke University Medical Center, USA
| | | | - B Kenou
- Duke University Medical Center, USA
| | - C Wells
- Duke University Medical Center, USA
| | | | | | - E D Levin
- Duke University Medical Center, USA.
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Franzen-Castle L, Schwarz C, Brison C, Larvick C, Aufdenkamp B, Frecks N, Jones G, Urbanec N, Wells C. Home Food Preservation Virtual Learning Series Increases Knowledge, Understanding, and Confidence for Preserving Food. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Timofte I, Wells C, Hersi K, Ryan A, Varghese A, Vesselinov R, Iacono A, Assadi J, Davis D, Li G, Herr D, Harrington T, Griffith B, Lau C, Krupnick A, Madathil R, Rabin J, Alon G, Parker E, Baer D, Magder L, Terrin M, Verceles A. Nutritional Supplementation and Neuromuscular Electrical Stimulation in Lung Transplant Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1012] [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: 10/21/2022] Open
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9
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Wells C, Dubow J, Fenton M, Patel D, Tyler C, Seiden D. 0747 Study Design of an Open-Label Extension and Switch Study for Once Nightly Sodium Oxybate, FT218, in NT1 and NT2 Patients. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Avadel Pharmaceuticals has developed FT218, a once nightly sodium oxybate (SO) formulation for the treatment of excessive daytime sleepiness (EDS) and cataplexy in narcoleptic patients. REST-ON, a pivotal efficacy/safety study is expected to be completed in the first half of 2020. Previous Phase 1 studies have demonstrated FT218 delivers a pharmacokinetic profile needed for once-nightly dosing. The purpose of this study is to evaluate long-term safety of FT218 in REST-ON completers and dosing strategy when switching from twice-nightly SO to FT218.
Methods
The study will enroll NT1/NT2 patients who completed REST-ON or patients switching from stable dose of twice-nightly SO to FT218. REST-ON completers will initiate FT218 at 4.5 g and increase by 1.5 g to the highest tolerated dose or the dose deemed effective (up to 9 g). Switch patients will initiate FT218 at the equivalent/closest dose to their current twice-nightly SO and titrate in accord with safety/efficacy. The study will enroll approximately 250 patients for a duration of two years.
Results
The primary endpoint for REST-ON completers will be safety and tolerability. Secondary endpoints for REST-ON completers will include changes in ESS, reported cataplexy and other REM associated phenomena as well as changes in clinician and patient global impression. For switch patients, endpoints will include percentage of subjects that stay on the same, higher or lower dose of FT218 compared to twice-nightly SO, as well as the percentage of subjects who report a preference for the once-nightly dosing regimen.
Conclusion
The results of this open label extension/switch study will further elucidate the potential benefits of once-nightly FT218 regarding long term safety/tolerability, nocturnal safety/tolerability and efficacy, and importantly provide dosing and preference data for patients switching from twice-nightly SO to once-nightly FT218.
Support
This work was supported by Avadel Pharmaceuticals.
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Affiliation(s)
- C Wells
- Avadel Pharmaceuticals, Chesterfield, MO
| | - J Dubow
- Avadel Pharmaceuticals, Chesterfield, MO
| | - M Fenton
- Avadel Pharmaceuticals, Chesterfield, MO
| | - D Patel
- Avadel Pharmaceuticals, Chesterfield, MO
| | - C Tyler
- Avadel Pharmaceuticals, Chesterfield, MO
| | - D Seiden
- Avadel Pharmaceuticals, Chesterfield, MO
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Ratnayake CBB, Wells C, Hammond J, French JJ, Windsor JA, Pandanaboyana S. Network meta-analysis comparing techniques and outcomes of stump closure after distal pancreatectomy. Br J Surg 2019; 106:1580-1589. [DOI: 10.1002/bjs.11291] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/27/2019] [Accepted: 05/30/2019] [Indexed: 12/24/2022]
Abstract
Abstract
Background
The incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy remains high, and different pancreatic stump closure techniques have been used to reduce the incidence. A network meta-analysis was undertaken to compare the most frequently performed pancreatic stump closure techniques after distal pancreatectomy and determine the technique associated with the lowest POPF rate.
Methods
A systematic search of the Scopus, PubMed, MEDLINE and Embase databases was conducted to identify eligible RCTs. The primary outcome was the occurrence of clinically relevant POPF. Secondary outcomes were duration of operation, blood loss, intrabdominal collections, postoperative complications and 30-day mortality.
Results
Sixteen RCTs including 1984 patients and eight different pancreatic stump closure techniques were included in the network meta-analysis. Patch coverage of the pancreatic stump (round ligament or seromuscular patch) after stapler or suture closure ranked best, with the lowest rates of clinically relevant POPF, lowest volume of intraoperative blood loss, fewer intra-abdominal abscesses, and lower rates of overall complications and 30-day mortality. Round ligament patch closure outperformed seromuscular patch closure in preventing clinically relevant POPF with a significantly larger cohort for comparative analysis. Pancreaticoenteric anastomotic closure consistently ranked poorly for most reported postoperative outcomes.
Conclusion
Patch coverage after stapler or suture closure has the lowest POPF rate and best outcomes among stump closure techniques after distal pancreatectomy.
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Affiliation(s)
- C B B Ratnayake
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hepatopancreatobiliary Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - C Wells
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hepatopancreatobiliary Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - J Hammond
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - J J French
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - J A Windsor
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hepatopancreatobiliary Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - S Pandanaboyana
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
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Fesenko S, Isamov N, Howard BJ, Sanzharova N, Wells C. Review of Russian language studies on radionuclide behaviour in agricultural animals: Transfer to animal tissues. J Environ Radioact 2018; 192:233-249. [PMID: 29986315 DOI: 10.1016/j.jenvrad.2018.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/18/2018] [Indexed: 06/08/2023]
Abstract
Data on radionuclide transfer to animals from research performed in the former Soviet Union were reviewed to collate transfer coefficient values (Ff) to animal tissues such as liver, kidney and bone, but not muscle which has previously been reported. The derived values were compared with selected data published in the English language literature. The new data are mainly for 90Sr and 137Cs, although some data were also provided for 3H, 54Mn, 59Fe, 60Co, 22Na 65Zn, 131I and U. The Russian language data may provide a basis for better informed evaluation of radiation dose from the consumption of such animal products, which can form important components of the diet in some countries.
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Affiliation(s)
- S Fesenko
- Russian Institute of Radiology and Radioecology, 249020 Obninsk, Russia.
| | - N Isamov
- Russian Institute of Radiology and Radioecology, 249020 Obninsk, Russia
| | - B J Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LAI 4AP, UK
| | - N Sanzharova
- Russian Institute of Radiology and Radioecology, 249020 Obninsk, Russia
| | - C Wells
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LAI 4AP, UK
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Lee H, Stacey A, Klesert T, Wells C, Skalet A, Bloch C, Fung A, Bowen S, Wong T, Shibata D, Halasz L, Rengan R. A Contour-Based Approach for Predicting Corneal Toxicity in Patients with Uveal Melanoma Treated with Proton Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Shell R, Al-Zaidy S, Arnold W, Rodino-Klapac L, Prior T, Kotha K, Paul G, Lowes L, Alfano L, Berry K, Church K, Kissel J, Nagendran S, Ogrinc F, Sproule D, Wells C, Meyer K, Likhite S, Kaspar B, Mendell J. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mendell J, Al-Zaidy S, Shell R, Arnold W, Rodino-Klapac L, Prior T, Lowes L, Alfano L, Berry K, Church K, Kissel J, Nagendran S, Italien J, Sproule D, Wells C, Burghes A, Foust K, Meyer K, Likhite S, Kaspar B. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Day J, Feltner D, Ogrinc F, Macek T, Wells C, Muehring L, Italien J, Sproule D, Nagendran S, Kaspar B, Mendell J. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Alfano L, Lowes L, Al-Zaidy S, Shell R, Arnold W, Rodino-Klapac L, Prior T, Berry K, Church K, Kissel J, Nagendran S, Italien J, Sproule D, Wells C, Burghes A, Foust K, Meyer K, Likhite S, Kaspar B, Mendell J. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Scholten W, Simon O, Maremmani I, Wells C, Kelly J, Hämmig R, Radbruch L. Re: Letter to the editor of public health in response to ‘Access to treatment with controlled medicines rationale and recommendations for neutral, respectful, and precise language’. Public Health 2018; 160:157-158. [DOI: 10.1016/j.puhe.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 02/05/2018] [Indexed: 12/01/2022]
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18
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Lisberg A, Cummings A, Goldman JW, Bornazyan K, Reese N, Wang T, Coluzzi P, Ledezma B, Mendenhall M, Hunt J, Wolf B, Jones B, Madrigal J, Horton J, Spiegel M, Carroll J, Gukasyan J, Williams T, Sauer L, Wells C, Hardy A, Linares P, Lim C, Ma L, Adame C, Garon EB. A Phase II Study of Pembrolizumab in EGFR-Mutant, PD-L1+, Tyrosine Kinase Inhibitor Naïve Patients With Advanced NSCLC. J Thorac Oncol 2018; 13:1138-1145. [PMID: 29874546 DOI: 10.1016/j.jtho.2018.03.035] [Citation(s) in RCA: 369] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/25/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite the significant antitumor activity of pembrolizumab in NSCLC, clinical benefit has been less frequently observed in patients whose tumors harbor EGFR mutations compared to EGFR wild-type patients. Our single-center experience on the KEYNOTE-001 trial suggested that pembrolizumab-treated EGFR-mutant patients, who were tyrosine kinase inhibitor (TKI) naïve, had superior clinical outcomes to those previously treated with a TKI. As TKI naïve EGFR-mutants have generally been excluded from pembrolizumab studies, data to guide treatment decisions in this patient population is lacking, particularly in patients with programmed death ligand 1 (PD-L1) expression ≥50%. METHODS We conducted a phase II trial (NCT02879994) of pembrolizumab in TKI naive patients with EGFR mutation-positive, advanced NSCLC and PD-L1-positive (≥1%, 22C3 antibody) tumors. Pembrolizumab was administered 200 mg every 3 weeks. The primary endpoint was objective response rate. Secondary endpoints included safety of pembrolizumab, additional pembrolizumab efficacy endpoints, and efficacy and safety of an EGFR TKI after pembrolizumab. RESULTS Enrollment was ceased due to lack of efficacy after 11 of 25 planned patients were treated. Eighty-two percent of trial patients were treatment naïve, 64% had sensitizing EGFR mutations, and 73% had PD-L1 expression ≥50%. Only 1 patient had an objective response (9%), but repeat analysis of this patient's tumor definitively showed the original report of an EGFR mutation to be erroneous. Observed treatment-related adverse events were similar to prior experience with pembrolizumab, but two deaths within 6 months of enrollment, including one attributed to pneumonitis, were of concern. CONCLUSIONS Pembrolizumab's lack of efficacy in TKI naïve, PD-L1+, EGFR-mutant patients with advanced NSCLC, including those with PD-L1 expression ≥50%, suggests that it is not an appropriate therapeutic choice in this setting.
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Affiliation(s)
- A Lisberg
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - A Cummings
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J W Goldman
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - K Bornazyan
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - N Reese
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - T Wang
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - P Coluzzi
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - B Ledezma
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - M Mendenhall
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Hunt
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - B Wolf
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - B Jones
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Madrigal
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Horton
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - M Spiegel
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Carroll
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Gukasyan
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - T Williams
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - L Sauer
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - C Wells
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - A Hardy
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - P Linares
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - C Lim
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - L Ma
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - C Adame
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - Edward B Garon
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California.
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Wells C, Dellheim V, Goverman J, Ryan CM, Schneider JC. 492 Development of a Decision Tree to Assist with Treatment of Burn-Related Ankle Contractures. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- C Wells
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - V Dellheim
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - J Goverman
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - C M Ryan
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - J C Schneider
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
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20
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Matossian M, Burks H, Bowles A, Sabol R, Hoang V, Elliott S, Bunnell B, Zuercher W, Drewry D, Wells C, Alfortish A, Lee S, Hartono A, Jones S, Moroz K, Zea A, Burow M, Collins-Burow B. Abstract P5-05-05: Patient-derived triple negative breast cancer xenografts as a translational model to screen for novel kinase pathways. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-05-05] [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
Overall, triple negative breast cancers (TNBCs) constitute 12% of all breast cancers, and is approximately twice more prevalent in African-American populations. Louisiana has a high proportion of African-American residents (32.5% in 2015), and thus hosts a higher population of TNBC patients. TNBCs have an aggressive phenotype that is elusive to the targeted therapeutics used to treat other breast cancer subtypes. Certain kinase families have been extensively studied as regulators of epithelial-mesenchymal transition (EMT), a process involved in the initiation of cancer metastasis. Discovery of novel kinase targets within the subset of uncharacterized kinases could provide important insight into future targeted therapies. However, current models utilized in target discovery research are limited by the inability to accurately recapitulate the complex stromal architecture and heterogenous genetic and molecular composition of breast cancer. Furthermore, immortalized cell lines are limited to a 2D environment and over time acquire mutations that may not reflect the primary tumor. Recently, our laboratory has successfully established two TNBC patient-derived xenograft (PDX) models derived from African-American patients, and generated cell lines (TU-BCx-2K1, TU-BCx-2O0) and mammospheres. One of these models, 2O0, presents tumor architecture, cellular composition, genomic (qRT-PCR) and protein (western blot) expressions that are concordant with a claudin-low subtype, which has higher rates of metastasis and recurrence. Furthermore, we show that both TNBC models metastasize to the lungs, and exhibit molecular characteristics consistent with mesenchymal phenotypes. We utilized these translational PDX models to screen a library of small molecule inhibitors that represent a variety of kinase pathways to identify novel therapeutic targets and/or pathways that are specific to TNBC subtypes. We found in a preliminary cell morphology screen using three TNBC cell lines (MDA-MB-231, BT549, MDA-MB-157), two small molecule inhibitors that increased epithelial marker (CDH1) gene expression, suppressed mesenchymal (VIM, c-FOS, SNAI1, ZEB1) expression and/or suppressed cellular motility in transwell migration assays. We observed after ex vivo treatments with our PDX tumors the two compounds increase the epithelial marker CDH1 expression, and suppress mesenchymal markers (VIM, MMP2, c-FOS, SNAI1, ZEB1) expressions. We confirm these findings in the TU-BCx-2K1 cell line. Kinase array data revealed candidate kinases responsible for the observed EMT changes in the two compounds of interest (NEK5, NEK9, NEK1 potentially affect cell motility; SRC-family kinases, TAOK2, STK10 potentially affect EMT gene changes); we plan to utilize the PDX cell lines to characterize these kinases in EMT. We aim to ultimately discover novel therapeutic targets specific to different TNBC molecular subtypes.
Citation Format: Matossian M, Burks H, Bowles A, Sabol R, Hoang V, Elliott S, Bunnell B, Zuercher W, Drewry D, Wells C, Alfortish A, Lee S, Hartono A, Jones S, Moroz K, Zea A, Burow M, Collins-Burow B. Patient-derived triple negative breast cancer xenografts as a translational model to screen for novel kinase pathways [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-05-05.
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Affiliation(s)
- M Matossian
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - H Burks
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Bowles
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - R Sabol
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - V Hoang
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - S Elliott
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - B Bunnell
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - W Zuercher
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - D Drewry
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - C Wells
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Alfortish
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - S Lee
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Hartono
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - S Jones
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - K Moroz
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Zea
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - M Burow
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - B Collins-Burow
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
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Arendt‐Nielsen L, Morlion B, Perrot S, Dahan A, Dickenson A, Kress H, Wells C, Bouhassira D, Drewes AM. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain 2018; 22:216-241. [DOI: 10.1002/ejp.1140] [Citation(s) in RCA: 360] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
AbstractDifferent neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation.SignificanceCentral sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.
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Affiliation(s)
| | - B. Morlion
- The Leuven Centre for Algology University Hospitals Leuven University of Leuven Belgium
| | - S. Perrot
- INSERM U987 Pain Center Cochin Hospital Paris Descartes University Paris France
| | - A. Dahan
- Department of Anesthesiology Leiden University Medical Center Leiden The Netherlands
| | - A. Dickenson
- Neuroscience Physiology & Pharmacology University College London UK
| | - H.G. Kress
- Department of Special Anaesthesia and Pain Therapy Medizinische Universität/AKH Wien Vienna Austria
| | | | - D. Bouhassira
- INSERM U987 Centre d'Evaluation et de Traitement de la Douleur Hôpital Ambroise Paré Boulogne Billancourt France
| | - A. Mohr Drewes
- Mech‐Sense Department of Gastroenterology and Hepatology Clinical Institute Aalborg University Hospital Aalborg Denmark
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22
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Scholten W, Simon O, Maremmani I, Wells C, Kelly J, Hämmig R, Radbruch L. Access to treatment with controlled medicines rationale and recommendations for neutral, precise, and respectful language. Public Health 2017; 153:147-153. [DOI: 10.1016/j.puhe.2017.08.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 08/24/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
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23
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Krcevski-Skvarc N, Wells C, Häuser W. Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation. Eur J Pain 2017; 22:440-454. [PMID: 29134767 DOI: 10.1002/ejp.1147] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is considerable public and political interest in the use of cannabis products for medical purposes. METHODS The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care. RESULTS Thirty-one out of 37 contacted councillors responded. Plant-derived tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray is approved for spasticity in multiple sclerosis refractory to conventional treatment in 21 EFIC chapters. Plant-derived THC (dronabinol) is approved for some palliative care conditions in four EFIC chapters. Synthetic THC analogue (nabilone) is approved for chemotherapy-associated nausea and vomiting refractory to conventional treatment in four EFIC chapters'. Eight EFIC chapters' countries have an exceptional and six chapters an expanded access programme for medical cannabis. German and Israeli pain societies recommend the use of cannabis-based medicines as third-line drug therapies for chronic pain within a multicomponent approach. Conversely, the German medical association and a team of finish experts and officials do not recommend the prescription of medical cannabis due to the lack of high-quality evidence of efficacy and the potential harms. CONCLUSIONS There are marked differences between the countries represented in EFIC in the approval and availability of cannabis-based products for medical use. EFIC countries are encouraged to collaborate with the European Medicines Agency to publish a common document on cannabis-based medicines. SIGNIFICANCE There are striking differences between European countries in the availability of plant-derived and synthetic cannabinoids and of medical cannabis for pain management and for symptom control in palliative care and in the covering of costs by health insurance companies or state social security systems.
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Affiliation(s)
- N Krcevski-Skvarc
- Department of Anesthesiology, Intensive Care and Pain Treatment, University Medical Center Maribor, Slovenia.,Faculty of Medicine of University Maribor, Institute for Palliative Medicine and Care, Slovenia
| | - C Wells
- Pain Medicine, Pain Matters Ltd, Liverpool, UK
| | - W Häuser
- Department Internal Medicine 1, Klinikum Saarbrücken gGmbH, Germany.,Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, Germany
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24
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Shell R, Al-Zaidy S, Arnold W, Rodino-Klapac L, Prior T, Lowes L, Alfano L, Berry K, Church K, Kissel J, Nagendran S, L'Italien J, Sproule D, Wells C, Burghes A, Foust K, Meyer K, Likhite S, Kaspar B, Mendell J. AVXS-101 phase 1 gene therapy clinical trial in SMA Type 1: decreased need of ventilatory and nutritional support at End-of-Study. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Braso Maristany F, Quist J, Wells C, Grigoriadis A, Marra P, Tutt A. PIM1 kinase promotes cell migration via SHP2 in triple-negative breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx361.009] [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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26
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Keane C, Wells C, O'Grady G, Bissett IP. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis 2017; 19:713-722. [PMID: 28612460 DOI: 10.1111/codi.13767] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/29/2017] [Indexed: 12/13/2022]
Abstract
AIM There is increasing awareness of the poor functional outcome suffered by many patients after sphincter-preserving rectal resection, termed 'low anterior resection syndrome' (LARS). There is no consensus definition of LARS and varying instruments have been employed to measure functional outcome, complicating research into prevalence, contributing factors and potential therapies. We therefore aimed to describe the instruments and outcome measures used in studies of bowel dysfunction after low anterior resection and identify major themes used in the assessment of LARS. METHOD A systematic review of the literature was performed for studies published between 1986 and 2016. The instruments and outcome measures used to report bowel function after low anterior resection were extracted and their frequency of use calculated. RESULTS The search revealed 128 eligible studies. These employed 18 instruments, over 30 symptoms, and follow-up time periods from 4 weeks to 14.6 years. The most frequent follow-up period was 12 months (48%). The most frequently reported outcomes were incontinence (97%), stool frequency (80%), urgency (67%), evacuatory dysfunction (47%), gas-stool discrimination (34%) and a measure of quality of life (80%). Faecal incontinence scoring systems were used frequently. The LARS score and the Bowel Function Instrument (BFI) were used in only nine studies. CONCLUSION LARS is common, but there is substantial variation in the reporting of functional outcomes after low anterior resection. Most studies have focused on incontinence, omitting other symptoms that correlate with patients' quality of life. To improve and standardize research into LARS, a consensus definition should be developed, and these findings should inform this goal.
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Affiliation(s)
- C Keane
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - C Wells
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - G O'Grady
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - I P Bissett
- Department of Surgery, University of Auckland, Auckland, New Zealand.,Department of Surgery, Auckland City Hospital, Auckland, New Zealand
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Verceles A, Serra M, Wells C, Davis D, Sorkin J, Terrin M, Alon G, Goldberg A. EXERCISE, PROTEIN, AND ELECTRIC STIMULATION REDUCES ICU ASSOCIATED SARCOPENIA IN OLDER PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.463] [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: 11/13/2022] Open
Affiliation(s)
- A.C. Verceles
- University of Maryland School of Medicine, Baltimore, Maryland,
- University of Maryland Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland
| | - M.C. Serra
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - C. Wells
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - D. Davis
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - J. Sorkin
- University of Maryland School of Medicine, Baltimore, Maryland,
- University of Maryland Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland
| | - M.L. Terrin
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - G. Alon
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - A.P. Goldberg
- University of Maryland School of Medicine, Baltimore, Maryland,
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28
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Howard BJ, Wells C, Barnett CL, Howard DC. Improving the quantity, quality and transparency of data used to derive radionuclide transfer parameters for animal products. 2. Cow milk. J Environ Radioact 2017; 167:254-268. [PMID: 28011111 DOI: 10.1016/j.jenvrad.2016.10.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/26/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 06/06/2023]
Abstract
Under the International Atomic Energy Agency (IAEA) MODARIA (Modelling and Data for Radiological Impact Assessments) Programme, there has been an initiative to improve the derivation, provenance and transparency of transfer parameter values for radionuclides from feed to animal products that are for human consumption. A description of the revised MODARIA 2016 cow milk dataset is described in this paper. As previously reported for the MODARIA goat milk dataset, quality control has led to the discounting of some references used in IAEA's Technical Report Series (TRS) report 472 (IAEA, 2010). The number of Concentration Ratio (CR) values has been considerably increased by (i) the inclusion of more literature from agricultural studies which particularly enhanced the stable isotope data of both CR and Fm and (ii) by estimating dry matter intake from assumed liveweight. In TRS 472, the data for cow milk were 714 transfer coefficient (Fm) values and 254 CR values describing 31 elements and 26 elements respectively. In the MODARIA 2016 cow milk dataset, Fm and CR values are now reported for 43 elements based upon 825 data values for Fm and 824 for CR. The MODARIA 2016 cow milk dataset Fm values are within an order of magnitude of those reported in TRS 472. Slightly bigger changes are seen in the CR values, but the increase in size of the dataset creates greater confidence in them. Data gaps that still remain are identified for elements with isotopes relevant to radiation protection.
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Affiliation(s)
- B J Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK.
| | - C Wells
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK
| | - C L Barnett
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK
| | - D C Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK
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Furin J, Alirol E, Allen E, Fielding K, Merle C, Abubakar I, Andersen J, Davies G, Dheda K, Diacon A, Dooley KE, Dravnice G, Eisenach K, Everitt D, Ferstenberg D, Goolam-Mahomed A, Grobusch MP, Gupta R, Harausz E, Harrington M, Horsburgh CR, Lienhardt C, McNeeley D, Mitnick CD, Nachman S, Nahid P, Nunn AJ, Phillips P, Rodriguez C, Shah S, Wells C, Thomas-Nyang'wa B, du Cros P. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults. Int J Tuberc Lung Dis 2017; 20:290-4. [PMID: 27046707 DOI: 10.5588/ijtld.15.0490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.
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Affiliation(s)
- J Furin
- TB Research Unit, Case Western Reserve University School of Medicine, Room E-202, 2210 Circle Dr, Cleveland, OH 44149, USA.
| | - E Alirol
- Manson Unit Médicins Sans Frontières, London, UK
| | - E Allen
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - K Fielding
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - C Merle
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - I Abubakar
- Department of Infection and Population Health, University College of London, London, UK
| | - J Andersen
- Statistical and Data Analysis Center, Harvard School of Public Health, Boston, Massachusetts, USA
| | - G Davies
- Institutes of Infection and Global Health and of Translational Medicine, University of Liverpool, Liverpool, UK
| | - K Dheda
- Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - A Diacon
- Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | - K E Dooley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - G Dravnice
- Tuberculosis Foundation, KNCV, Amsterdam, The Netherlands
| | - K Eisenach
- Pathology and Microbiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - D Everitt
- Global Alliance for TB Drug Development, New York, New York, USA
| | | | | | - M P Grobusch
- Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Gupta
- Otsuka USA, Rockville, Maryland, USA
| | - E Harausz
- TB Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - M Harrington
- Treatment Action Group, New York City, New York, USA
| | - C R Horsburgh
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - C Lienhardt
- Stop TB Partnership & Stop TB Department, World Health Organization, Geneva, Switzerland
| | - D McNeeley
- Medical Service Corp International, Arlington, Virginia, USA
| | - C D Mitnick
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - S Nachman
- Department of Pediatrics, Stony Brook School of Medicine, Stony Brook, New York, USA
| | - P Nahid
- Curry International Tuberculosis Center, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - A J Nunn
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - P Phillips
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - C Rodriguez
- Department of Respiratory Medicine, P D Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - S Shah
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - C Wells
- Otsuka USA, Rockville, Maryland, USA
| | | | - P du Cros
- Manson Unit Médicins Sans Frontières, London, UK
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Wanaski S, Shieh P, Kuntz N, Ciafaloni E, Butterfield R, Brantley S, Grasfeder L, Dubow J, Beers B, Kernbauer E, Wells C, Cunniff T, Griggs R. Pharmacokinetics of 21-desacetyldeflazacort and the safety of deflazacort after oral administration to children and adolescents with Duchenne muscular dystrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.343] [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: 10/21/2022]
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31
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Huque S, Hepgul N, Verne J, Wells C, Higginson IJ, Gao W. OP94 Causes of death in long-term neurological conditions: a population-based study in England, 2012–2014. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.94] [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]
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Mitchell M, Wells C, Zhang X, Hughes J, White J, Nash R, Haas DW. Patient willingness to undergo efavirenz dose reduction based on pharmacogenetic testing. Per Med 2016; 13:241-247. [PMID: 29767607 DOI: 10.2217/pme-2015-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM Among HIV-infected adults receiving efavirenz fixed-dose combination tablets, genotyping could guide efavirenz dose reduction but would require more pills. METHODS We assessed willingness to dose reduce among 129 patients at an HIV primary care clinic in the southeastern USA. RESULTS When told that switching from one pill to two or three pills "might make you feel a little better", 47% expressed definite or possible willingness. This decreased to 9% if there was "a small chance it might not control your HIV as well". Clinical variables were not associated with willingness. CONCLUSION Many patients receiving a fixed-dose combination tablet may be willing to take more pills in order to dose reduce, guided by genetic testing, but only if virologic control is not compromised.
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Affiliation(s)
| | - Caroline Wells
- Lipscomb University College of Pharmacy, Nashville, TN, USA
| | - Xuechao Zhang
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | | | - Robertson Nash
- Vanderbilt University School of Nursing, Nashville, TN, USA.,Vanderbilt Comprehensive Care Clinic, Nashville, TN, USA
| | - David W Haas
- Vanderbilt University School of Medicine, Nashville, TN, USA.,Meharry Medical College, Nashville, TN, USA
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Howard BJ, Wells C, Barnett CL. Improving the quantity, quality and transparency of data used to derive radionuclide transfer parameters for animal products. 1. Goat milk. J Environ Radioact 2016; 154:34-42. [PMID: 26845198 DOI: 10.1016/j.jenvrad.2016.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/05/2015] [Revised: 01/14/2016] [Accepted: 01/16/2016] [Indexed: 06/05/2023]
Abstract
Under the MODARIA (Modelling and Data for Radiological Impact Assessments Programme of the International Atomic Energy Agency), there has been an initiative to improve the derivation, provenance and transparency of transfer parameter values for radionuclides. The approach taken for animal products is outlined here and the first revised table for goat milk is provided. Data from some references used in TRS 472 were removed and reasons given for removal. Particular efforts were made to improve the number of CR (concentration ratio) values which have some advantages over transfer coefficients. There is little difference in most of the new CR and Fm (transfer coefficient) values for goat milk compared with those in TRS 472. In TRS 472, 21 CR values were reported for goat milk. In the 2015 dataset for goat milk CR values for a further 14 elements are now included. The CR and Fm values for only one element (Co) were removed.
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Affiliation(s)
- B J Howard
- NERC Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, UK.
| | - C Wells
- NERC Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, UK
| | - C L Barnett
- NERC Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, UK
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Mitchell M, Wells C, Zhang X, Hughes J, White J, Nash R, Haas D. Patient Willingness to Reduce Efavirenz Dose Based on Genetic Testing. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.789] [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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35
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Beresford NA, Beaugelin-Seiller K, Burgos J, Cujic M, Fesenko S, Kryshev A, Pachal N, Real A, Su BS, Tagami K, Vives i Batlle J, Vives-Lynch S, Wells C, Wood MD. Radionuclide biological half-life values for terrestrial and aquatic wildlife. J Environ Radioact 2015; 150:270-276. [PMID: 26378959 DOI: 10.1016/j.jenvrad.2015.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 05/11/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Abstract
The equilibrium concentration ratio is typically the parameter used to estimate organism activity concentrations within wildlife dose assessment tools. Whilst this is assumed to be fit for purpose, there are scenarios such as accidental or irregular, fluctuating, releases from licensed facilities when this might not be the case. In such circumstances, the concentration ratio approach may under- or over-estimate radiation exposure depending upon the time since the release. To carrying out assessments for such releases, a dynamic approach is needed. The simplest and most practical option is representing the uptake and turnover processes by first-order kinetics, for which organism- and element-specific biological half-life data are required. In this paper we describe the development of a freely available international database of radionuclide biological half-life values. The database includes 1907 entries for terrestrial, freshwater, riparian and marine organisms. Biological half-life values are reported for 52 elements across a range of wildlife groups (marine = 9, freshwater = 10, terrestrial = 7 and riparian = 3 groups). Potential applications and limitations of the database are discussed.
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Affiliation(s)
- N A Beresford
- NERC Centre for Ecology & Hydrology, Bailrigg, Lancaster LA1 4AP, UK; School of Environment & Life Sciences, University of Salford, Manchester M4 4WT, UK.
| | - K Beaugelin-Seiller
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-ENV, LM2E, Cadarache, France
| | | | - M Cujic
- Institute for the Application of Nuclear Energy, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - S Fesenko
- International Atomic Energy Agency, A-2444 Seibersdorf, Austria
| | | | - N Pachal
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, L8S 4K1, Canada
| | - A Real
- Centro de Investigaciones Energéticas Medio Ambientales y Tecnológicas, Av. Complutense 40, Madrid 28040, Spain
| | - B S Su
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, L8S 4K1, Canada
| | - K Tagami
- National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, 263-8555 Chiba, Japan
| | - J Vives i Batlle
- Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| | | | - C Wells
- NERC Centre for Ecology & Hydrology, Bailrigg, Lancaster LA1 4AP, UK
| | - M D Wood
- School of Environment & Life Sciences, University of Salford, Manchester M4 4WT, UK
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De Benedetti F, Ruperto N, Brunner H, Keane C, Wells C, Wang J, Calvo I, Cuttica R, Ravelli A, Schneider R, Eleftheriou D, Wouters C, Xavier R, Zemel L, Baildam E, Burgos-Vargas R, Dolezalova P, Garay S, Joos R, Grom A, Wulffraat N, Zuber Z, Zulian F, Martini A, Lovell D. THU0508 Safety and Efficacy of Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis: 5-Year Data from Tender, A Phase 3 Clinical Trial. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gunnell D, Coope C, Fearn V, Wells C, Chang SS, Hawton K, Kapur N. Suicide by gases in England and Wales 2001-2011: evidence of the emergence of new methods of suicide. J Affect Disord 2015; 170:190-5. [PMID: 25254616 DOI: 10.1016/j.jad.2014.08.055] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/29/2014] [Accepted: 08/31/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Increases in suicide deaths by gassing, particularly carbon monoxide poisoning from burning barbecue charcoal, have occurred in many parts of East Asia and resulted in rises in overall suicide rates in some countries. Recent trends in gas poisoning suicides outside Asia have received little attention. METHODS We analysed suicides by gassing in England and Wales (2001-2011) using national suicide mortality data enhanced by free text searching of information sent by coroners to the Office for National Statistics (ONS). We conducted specific searches for suicides involving barbecue charcoal gas, helium, and hydrogen sulphide. We analysed coroners' records of eight people who used helium as a method of suicide, identified from systematic searches of the records of four coroners. RESULTS Gassing accounted for 5.2% of suicide deaths in England and Wales during 2001-2011. The number of gas suicides declined from 368 in 2001 to 174 by 2011 (a 53% reduction). The fall was due to a decline in deaths involving car exhaust and other sources of carbon monoxide. There was a rapid rise in deaths due to helium inhalation over the period, from five deaths in the two year period 2001-2002 to 89 in 2010-2011 (a 17-fold increase). There were small rises in deaths involving hydrogen sulphide (0 cases in 2001-2002 versus 14 cases in 2010-2011) and barbecue charcoal gas (1 case in 2001-2002 versus 11 cases in 2010-2011). Compared to individuals using other methods, those suicides adopting new types of gas for suicide were generally younger and from more affluent socioeconomic groups. The corones' records of four of the eight individuals dying by helium inhalation whose records were reviewed showed evidence of Internet involvement in their choice of method. LIMITATIONS We were not able to identify the source of carbon monoxide (car exhaust or barbecue charcoal) for over 50% of cases. CONCLUSION Increases in helium inhalation as a method of suicide have partially offset recent decreases in suicide by the use of car exhaust. Public health measures are urgently needed to prevent a potential epidemic rise in the use of helium similar to the recent rises in charcoal burning suicides in East Asia.
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Affiliation(s)
- D Gunnell
- School of Social and Community Medicine, Canynge Hall, 39 Whatley Road, University of Bristol, Bristol BS8 2PS, United Kingdom.
| | - C Coope
- School of Social and Community Medicine, Canynge Hall, 39 Whatley Road, University of Bristol, Bristol BS8 2PS, United Kingdom
| | - V Fearn
- Office for National Statistics, Newport, Wales NP10 8XG, United Kingdom
| | - C Wells
- Office for National Statistics, Newport, Wales NP10 8XG, United Kingdom
| | - S-S Chang
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China; Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - K Hawton
- Centre for Suicide Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, United Kingdom
| | - N Kapur
- Centre for Suicide Prevention, University of Manchester, Manchester M13 9PL, United Kingdom
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Templeton A, Knox J, Mitchell N, Broom R, Choueiri T, McDermott D, Fay A, Rini B, Alvarez A, Bjarnason G, Smoragiewicz M, Kollmannsberger C, Kanesvaran R, North S, Alimohamed N, Hermanns T, Wells C, Amir E, Heng D. Prognostic Impact of Change in Neutrophil to Lymphocyte Ratio (Nlr) in Response to Targeted Therapy for Metastatic Renal Cell Carcinoma (Mrcc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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39
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Barnett CL, Beresford NA, Walker LA, Baxter M, Wells C, Copplestone D. Transfer parameters for ICRP reference animals and plants collected from a forest ecosystem. Radiat Environ Biophys 2014; 53:125-149. [PMID: 24173444 DOI: 10.1007/s00411-013-0493-6] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/15/2013] [Indexed: 06/02/2023]
Abstract
The International Commission on Radiological Protection (ICRP) have suggested the identification of a series of terrestrial, marine and freshwater sites from which samples of each Reference animal and plant (RAP) could be systematically collected and analysed. We describe the first such study in which six of the eight terrestrial RAPs, and associated soil samples, were collected from a site located in a managed coniferous forestry plantation in north-west England. Adult life stages of species representing six of the terrestrial RAPs (Wild grass, Pine tree, Deer, Rat, Earthworm and Bee) were sampled and analysed to determine concentrations of 60 elements and gamma-emitting radionuclides. The resultant data have been used to derive concentration ratios (CR(wo-soil)) relating element/radionuclide concentrations in the RAPs to those in soil. This paper presents the first-reported transfer parameters for a number of the RAP-element combinations. Where possible, the derived CR(wo-soil) values are compared with the ICRPs-recommended values and any appreciable differences discussed.
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Affiliation(s)
- C L Barnett
- NERC Centre for Ecology & Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster, LA1 4AP, UK,
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He BJ, Nolte G, Nagata K, Takano D, Yamazaki T, Fujimaki Y, Maeda T, Satoh Y, Heckers S, George MS, Lopes da Silva F, de Munck JC, Van Houdt PJ, Verdaasdonk RM, Ossenblok P, Mullinger K, Bowtell R, Bagshaw AP, Keeser D, Karch S, Segmiller F, Hantschk I, Berman A, Padberg F, Pogarell O, Scharnowski F, Karch S, Hümmer S, Keeser D, Paolini M, Kirsch V, Koller G, Rauchmann B, Kupka M, Blautzik J, Pogarell O, Razavi N, Jann K, Koenig T, Kottlow M, Hauf M, Strik W, Dierks T, Gotman J, Vulliemoz S, Lu Y, Zhang H, Yang L, Worrell G, He B, Gruber O, Piguet C, Hubl D, Homan P, Kindler J, Dierks T, Kim K, Steinhoff U, Wakai R, Koenig T, Kottlow M, Melie-García L, Mucci A, Volpe U, Prinster A, Salvatore M, Galderisi S, Linden DEJ, Brandeis D, Schroeder CE, Kayser C, Panzeri S, Kleinschmidt A, Ritter P, Walther S, Haueisen J, Lau S, Flemming L, Sonntag H, Maess B, Knösche TR, Lanfer B, Dannhauer M, Wolters CH, Stenroos M, Haueisen J, Wolters C, Aydin U, Lanfer B, Lew S, Lucka F, Ruthotto L, Vorwerk J, Wagner S, Ramon C, Guan C, Ang KK, Chua SG, Kuah WK, Phua KS, Chew E, Zhou H, Chuang KH, Ang BT, Wang C, Zhang H, Yang H, Chin ZY, Yu H, Pan Y, Collins L, Mainsah B, Colwell K, Morton K, Ryan D, Sellers E, Caves K, Throckmorton S, Kübler A, Holz EM, Zickler C, Sellers E, Ryan D, Brown K, Colwell K, Mainsah B, Caves K, Throckmorton S, Collins L, Wennberg R, Ahlfors SP, Grova C, Chowdhury R, Hedrich T, Heers M, Zelmann R, Hall JA, Lina JM, Kobayashi E, Oostendorp T, van Dam P, Oosterhof P, Linnenbank A, Coronel R, van Dessel P, de Bakker J, Rossion B, Jacques C, Witthoft N, Weiner KS, Foster BL, Miller KJ, Hermes D, Parvizi J, Grill-Spector K, Recanzone GH, Murray MM, Haynes JD, Richiardi J, Greicius M, De Lucia M, Müller KR, Formisano E, Smieskova R, Schmidt A, Bendfeldt K, Walter A, Riecher-Rössler A, Borgwardt S, Fusar-Poli P, Eliez S, Schmidt A, Sekihara K, Nagarajan SS, Schoffelen JM, Guggisberg AG, Nolte G, Balazs S, Kermanshahi K, Kiesenhofer W, Binder H, Rattay F, Antal A, Chaieb L, Paulus W, Bodis-Wollner I, Maurer K, Fein G, Camchong J, Johnstone J, Cardenas-Nicolson V, Fiederer LDJ, Lucka F, Yang S, Vorwerk J, Dümpelmann M, Cosandier-Rimélé D, Schulze-Bonhage A, Aertsen A, Speck O, Wolters CH, Ball T, Fuchs M, Wagner M, Kastner J, Tech R, Dinh C, Haueisen J, Baumgarten D, Hämäläinen MS, Lau S, Vogrin SJ, D'Souza W, Haueisen J, Cook MJ, Custo A, Van De Ville D, Vulliemoz S, Grouiller F, Michel CM, Malmivuo J, Aydin U, Vorwerk J, Küpper P, Heers M, Kugel H, Wellmer J, Kellinghaus C, Scherg M, Rampp S, Wolters C, Storti SF, Boscolo Galazzo I, Del Felice A, Pizzini FB, Arcaro C, Formaggio E, Mai R, Manganotti P, Koessler L, Vignal J, Cecchin T, Colnat-Coulbois S, Vespignani H, Ramantani G, Maillard L, Rektor I, Kuba R, Brázdil M, Chrastina J, Rektorova I, van Mierlo P, Carrette E, Strobbe G, Montes-Restrepo V, Vonck K, Vandenberghe S, Ahmed B, Brodely C, Carlson C, Kuzniecky R, Devinsky O, French J, Thesen T, Bénis D, David O, Lachaux JP, Seigneuret E, Krack P, Fraix V, Chabardès S, Bastin J, Jann K, Gee D, Kilroy E, Cannon T, Wang DJ, Hale JR, Mayhew SD, Przezdzik I, Arvanitis TN, Bagshaw AP, Plomp G, Quairiaux C, Astolfi L, Michel CM, Mayhew SD, Mullinger KJ, Bagshaw AP, Bowtell R, Francis ST, Schouten AC, Campfens SF, van der Kooij H, Koles Z, Lind J, Flor-Henry P, Wirth M, Haase CM, Villeneuve S, Vogel J, Jagust WJ, Kambeitz-Ilankovic L, Simon-Vermot L, Gesierich B, Duering M, Ewers M, Rektorova I, Krajcovicova L, Marecek R, Mikl M, Bracht T, Horn H, Strik W, Federspiel A, Schnell S, Höfle O, Stegmayer K, Wiest R, Dierks T, Müller TJ, Walther S, Surmeli T, Ertem A, Eralp E, Kos IH, Skrandies W, Flüggen S, Klein A, Britz J, Díaz Hernàndez L, Ro T, Michel CM, Lenartowicz A, Lau E, Rodriguez C, Cohen MS, Loo SK, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, La Porta P, Verardo AR, Niolu C, Fernandez I, Siracusano A, Flor-Henry P, Lind J, Koles Z, Bollmann S, Ghisleni C, O'Gorman R, Poil SS, Klaver P, Michels L, Martin E, Ball J, Eich-Höchli D, Brandeis D, Salisbury DF, Murphy TK, Butera CD, Mathalon DH, Fryer SL, Kiehl KA, Calhoun VC, Pearlson GD, Roach BJ, Ford JM, McGlashan TH, Woods SW, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Gonzalez Andino S, Grave de Peralta Menendez R, Grave de Peralta Menendez R, Sanchez Vives M, Rebollo B, Gonzalez Andino S, Frølich L, Andersen TS, Mørup M, Belfiore P, Gargiulo P, Ramon C, Vanhatalo S, Cho JH, Vorwerk J, Wolters CH, Knösche TR, Watanabe T, Kawabata Y, Ukegawa D, Kawabata S, Adachi Y, Sekihara K, Sekihara K, Nagarajan SS, Wagner S, Aydin U, Vorwerk J, Herrmann C, Burger M, Wolters C, Lucka F, Aydin U, Vorwerk J, Burger M, Wolters C, Bauer M, Trahms L, Sander T, Faber PL, Lehmann D, Gianotti LRR, Pascual-Marqui RD, Milz P, Kochi K, Kaneko S, Yamashita S, Yana K, Kalogianni K, Vardy AN, Schouten AC, van der Helm FCT, Sorrentino A, Luria G, Aramini R, Hunold A, Funke M, Eichardt R, Haueisen J, Gómez-Aguilar F, Vázquez-Olvera S, Cordova-Fraga T, Castro-López J, Hernández-Gonzalez MA, Solorio-Meza S, Sosa-Aquino M, Bernal-Alvarado JJ, Vargas-Luna M, Vorwerk J, Magyari L, Ludewig J, Oostenveld R, Wolters CH, Vorwerk J, Engwer C, Ludewig J, Wolters C, Sato K, Nishibe T, Furuya M, Yamashiro K, Yana K, Ono T, Puthanmadam Subramaniyam N, Hyttinen J, Lau S, Güllmar D, Flemming L, Haueisen J, Sonntag H, Vorwerk J, Wolters CH, Grasedyck L, Haueisen J, Maeß B, Freitag S, Graichen U, Fiedler P, Strohmeier D, Haueisen J, Stenroos M, Hauk O, Grigutsch M, Felber M, Maess B, Herrmann B, Strobbe G, van Mierlo P, Vandenberghe S, Strobbe G, Cárdenas-Peña D, Montes-Restrepo V, van Mierlo P, Castellanos-Dominguez G, Vandenberghe S, Lanfer B, Paul-Jordanov I, Scherg M, Wolters CH, Ito Y, Sato D, Kamada K, Kobayashi T, Dalal SS, Rampp S, Willomitzer F, Arold O, Fouladi-Movahed S, Häusler G, Stefan H, Ettl S, Zhang S, Zhang Y, Li H, Kong X, Montes-Restrepo V, Strobbe G, van Mierlo P, Vandenberghe S, Wong DDE, Bidet-Caulet A, Knight RT, Crone NE, Dalal SS, Birot G, Spinelli L, Vulliémoz S, Seeck M, Michel CM, Emory H, Wells C, Mizrahi N, Vogrin SJ, Lau S, Cook MJ, Karahanoglu FI, Grouiller F, Caballero-Gaudes C, Seeck M, Vulliemoz S, Van De Ville D, Spinelli L, Megevand P, Genetti M, Schaller K, Michel C, Vulliemoz S, Seeck M, Genetti M, Tyrand R, Grouiller F, Vulliemoz S, Spinelli L, Seeck M, Schaller K, Michel CM, Grouiller F, Heinzer S, Delattre B, Lazeyras F, Spinelli L, Pittau F, Seeck M, Ratib O, Vargas M, Garibotto V, Vulliemoz S, Vogrin SJ, Bailey CA, Kean M, Warren AE, Davidson A, Seal M, Harvey AS, Archer JS, Papadopoulou M, Leite M, van Mierlo P, Vonck K, Boon P, Friston K, Marinazzo D, Ramon C, Holmes M, Koessler L, Rikir E, Gavaret M, Bartolomei F, Vignal JP, Vespignani H, Maillard L, Centeno M, Perani S, Pier K, Lemieux L, Clayden J, Clark C, Pressler R, Cross H, Carmichael DW, Spring A, Bessemer R, Pittman D, Aghakhani Y, Federico P, Pittau F, Grouiller F, Vulliémoz S, Gotman J, Badier JM, Bénar CG, Bartolomei F, Cruto C, Chauvel P, Gavaret M, Brodbeck V, van Leeuwen T, Tagliazzuchi E, Melloni L, Laufs H, Griskova-Bulanova I, Dapsys K, Klein C, Hänggi J, Jäncke L, Ehinger BV, Fischer P, Gert AL, Kaufhold L, Weber F, Marchante Fernandez M, Pipa G, König P, Sekihara K, Hiyama E, Koga R, Iannilli E, Michel CM, Bartmuss AL, Gupta N, Hummel T, Boecker R, Holz N, Buchmann AF, Blomeyer D, Plichta MM, Wolf I, Baumeister S, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M, Natahara S, Ueno M, Kobayashi T, Kottlow M, Bänninger A, Koenig T, Schwab S, Koenig T, Federspiel A, Dierks T, Jann K, Natsukawa H, Kobayashi T, Tüshaus L, Koenig T, Kottlow M, Achermann P, Wilson RS, Mayhew SD, Assecondi S, Arvanitis TN, Bagshaw AP, Darque A, Rihs TA, Grouiller F, Lazeyras F, Ha-Vinh Leuchter R, Caballero C, Michel CM, Hüppi PS, Hauser TU, Hunt LT, Iannaccone R, Stämpfli P, Brandeis D, Dolan RJ, Walitza S, Brem S, Graichen U, Eichardt R, Fiedler P, Strohmeier D, Freitag S, Zanow F, Haueisen J, Lordier L, Grouiller F, Van de Ville D, Sancho Rossignol A, Cordero I, Lazeyras F, Ansermet F, Hüppi P, Schläpfer A, Rubia K, Brandeis D, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Giannoudas I, Verardo AR, La Porta P, Niolu C, Fernandez I, Siracusano A, Tamura K, Karube C, Mizuba T, Matsufuji M, Takashima S, Iramina K, Assecondi S, Ostwald D, Bagshaw AP, Marecek R, Brazdil M, Lamos M, Slavícek T, Marecek R, Jan J, Meier NM, Perrig W, Koenig T, Minami T, Noritake Y, Nakauchi S, Azuma K, Minami T, Nakauchi S, Rodriguez C, Lenartowicz A, Cohen MS, Rodriguez C, Lenartowicz A, Cohen MS, Iramina K, Kinoshita H, Tamura K, Karube C, Kaneko M, Ide J, Noguchi Y, Cohen MS, Douglas PK, Rodriguez CM, Xia HJ, Zimmerman EM, Konopka CJ, Epstein PS, Konopka LM, Giezendanner S, Fisler M, Soravia L, Andreotti J, Wiest R, Dierks T, Federspiel A, Razavi N, Federspiel A, Dierks T, Hauf M, Jann K, Kamada K, Sato D, Ito Y, Okano K, Mizutani N, Kobayashi T, Thelen A, Murray M, Pastena L, Formaggio E, Storti SF, Faralli F, Melucci M, Gagliardi R, Ricciardi L, Ruffino G, Coito A, Macku P, Tyrand R, Astolfi L, He B, Wiest R, Seeck M, Michel C, Plomp G, Vulliemoz S, Fischmeister FPS, Glaser J, Schöpf V, Bauer H, Beisteiner R, Deligianni F, Centeno M, Carmichael DW, Clayden J, Mingoia G, Langbein K, Dietzek M, Wagner G, Smesny S, Scherpiet S, Maitra R, Gaser C, Sauer H, Nenadic I, Dürschmid S, Zaehle T, Pannek H, Chang HF, Voges J, Rieger J, Knight RT, Heinze HJ, Hinrichs H, Tsatsishvili V, Cong F, Puoliväli T, Alluri V, Toiviainen P, Nandi AK, Brattico E, Ristaniemi T, Grieder M, Crinelli RM, Jann K, Federspiel A, Wirth M, Koenig T, Stein M, Wahlund LO, Dierks T, Atsumori H, Yamaguchi R, Okano Y, Sato H, Funane T, Sakamoto K, Kiguchi M, Tränkner A, Schindler S, Schmidt F, Strauß M, Trampel R, Hegerl U, Turner R, Geyer S, Schönknecht P, Kebets V, van Assche M, Goldstein R, van der Meulen M, Vuilleumier P, Richiardi J, Van De Ville D, Assal F, Wozniak-Kwasniewska A, Szekely D, Harquel S, Bougerol T, David O, Bracht T, Jones DK, Horn H, Müller TJ, Walther S, Sos P, Klirova M, Novak T, Brunovsky M, Horacek J, Bares M, Hoschl C C, Fellhauer I, Zöllner FG, Schröder J, Kong L, Essig M, Schad LR, Arrubla J, Neuner I, Hahn D, Boers F, Shah NJ, Neuner I, Arrubla J, Hahn D, Boers F, Jon Shah N, Suriya Prakash M, Sharma R, Kawaguchi H, Kobayashi T, Fiedler P, Griebel S, Biller S, Fonseca C, Vaz F, Zentner L, Zanow F, Haueisen J, Rochas V, Rihs T, Thut G, Rosenberg N, Landis T, Michel C, Moliadze V, Schmanke T, Lyzhko E, Bassüner S, Freitag C, Siniatchkin M, Thézé R, Guggisberg AG, Nahum L, Schnider A, Meier L, Friedrich H, Jann K, Landis B, Wiest R, Federspiel A, Strik W, Dierks T, Witte M, Kober SE, Neuper C, Wood G, König R, Matysiak A, Kordecki W, Sieluzycki C, Zacharias N, Heil P, Wyss C, Boers F, Arrubla J, Dammers J, Kawohl W, Neuner I, Shah NJ, Braboszcz C, Cahn RB, Levy J, Fernandez M, Delorme A, Rosas-Martinez L, Milne E, Zheng Y, Urakami Y, Kawamura K, Washizawa Y, Hiyoshi K, Cichocki A, Giroud N, Dellwo V, Meyer M, Rufener KS, Liem F, Dellwo V, Meyer M, Jones-Rounds JD, Raizada R, Staljanssens W, Strobbe G, van Mierlo P, Van Holen R, Vandenberghe S, Pefkou M, Becker R, Michel C, Hervais-Adelman A, He W, Brock J, Johnson B, Ohla K, Hitz K, Heekeren K, Obermann C, Huber T, Juckel G, Kawohl W, Gabriel D, Comte A, Henriques J, Magnin E, Grigoryeva L, Ortega JP, Haffen E, Moulin T, Pazart L, Aubry R, Kukleta M, Baris Turak B, Louvel J, Crespo-Garcia M, Cantero JL, Atienza M, Connell S, Kilborn K, Damborská A, Brázdil M, Rektor I, Kukleta M, Koberda JL, Bienkiewicz A, Koberda I, Koberda P, Moses A, Tomescu M, Rihs T, Britz J, Custo A, Grouiller F, Schneider M, Debbané M, Eliez S, Michel C, Wang GY, Kydd R, Wouldes TA, Jensen M, Russell BR, Dissanayaka N, Au T, Angwin A, O'Sullivan J, Byrne G, Silburn P, Marsh R, Mellic G, Copland D, Bänninger A, Kottlow M, Díaz Hernàndez L, Koenig T, Díaz Hernàndez L, Bänninger A, Koenig T, Hauser TU, Iannaccone R, Mathys C, Ball J, Drechsler R, Brandeis D, Walitza S, Brem S, Boeijinga PH, Pang EW, Valica T, Macdonald MJ, Oh A, Lerch JP, Anagnostou E, Di Lorenzo G, Pagani M, Monaco L, Daverio A, Verardo AR, Giannoudas I, La Porta P, Niolu C, Fernandez I, Siracusano A, Shimada T, Matsuda Y, Monkawa A, Monkawa T, Hashimoto R, Watanabe K, Kawasaki Y, Matsuda Y, Shimada T, Monkawa T, Monkawa A, Watanabe K, Kawasaki Y, Stegmayer K, Horn H, Federspiel A, Razavi N, Bracht T, Laimböck K, Strik W, Dierks T, Wiest R, Müller TJ, Walther S, Koorenhof LJ, Swithenby SJ, Martins-Mourao A, Rihs TA, Tomescu M, Song KW, Custo A, Knebel JF, Murray M, Eliez S, Michel CM, Volpe U, Merlotti E, Vignapiano A, Montefusco V, Plescia GM, Gallo O, Romano P, Mucci A, Galderisi S, Laimboeck K, Jann K, Walther S, Federspiel A, Wiest R, Strik W, Horn H. Abstracts of Presentations at the International Conference on Basic and Clinical Multimodal Imaging (BaCI), a Joint Conference of the International Society for Neuroimaging in Psychiatry (ISNIP), the International Society for Functional Source Imaging (ISFSI), the International Society for Bioelectromagnetism (ISBEM), the International Society for Brain Electromagnetic Topography (ISBET), and the EEG and Clinical Neuroscience Society (ECNS), in Geneva, Switzerland, September 5-8, 2013. Clin EEG Neurosci 2013; 44:1550059413507209. [PMID: 24368763 DOI: 10.1177/1550059413507209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/17/2022]
Affiliation(s)
- B J He
- National Institutes of Health, Bethesda, MD, USA
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Wisner DJ, Feig S, Joe B, Hargreaves J, Ojeda-Fournier H, Bassett L, Aminololama-Shakeri S, DeGuzman JQ, Flowers CI, Campbell JE, Elson S, Retallack H, Wells C. Abstract P2-01-06: How much agreement can we expect on BI-RADS mammographic findings? Observer agreement among 10 expert mammographers. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-01-06] [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
Purpose: To determine the agreement between expert readers on mammographic findings and calcification patterns.
Materials and Methods: Ten academic radiologists from 5 centers reviewed 250 de-identified mammographic cases without prior exams which were previously assessed as BI-RADS 4 or 5 with subsequent pathologic diagnosis by percutaneous or surgical biopsy. For benign cases diagnosed by percutaneous biopsy, 1 year of benign or negative imaging follow-up was required. Using standardized forms, each radiologist assessed the presence of any suspicious mammographic findings (microcalcifications, asymmetry (1-vew), focal asymmetry (2-view), architectural distortion), and the morphology (none, round/punctate, amorphous, coarse heterogeneous, fine pleomorphic, fine linear branching) and distribution (none, diffuse, regional, grouped, linear, segmental) of any identified microcalcifications. Agreement between radiologists for presence/absence of findings, morphology, and distribution of calcifications was determined by calculating the Kappa (k) coefficient with 95% confidence interval (95% CI). The kappa coefficient proposed strength of agreement is ≤0 = poor, .01-.20 = slight, .21-.40 = fair, .41-.60 = moderate, .61-.80 = substantial, and .81-1 = almost perfect, as established by Landis and Koch.1
Results: Of the 250 lesions, 156 (62%) were benign and 94 (38%) malignant. Agreement among the 10 expert readers was strongest for recognizing the presence/absence of calcifications (k = 0.82, 95% CI: 0.80-84), “almost perfect”). There was substantial agreement among the readers for the identification of a mass (k = 0.67, 95% CI: 0.66-69), whereas agreement was fair for the presence of a focal (2-view) asymmetry (k = 0.21, 95% CI: 0.1900.23) or architectural distortion (k = 0.28, 95%CI: 0.26-0.30). Agreement for asymmetries (1-view) was slight (k = 0.09, 95%CI: 0.08-0.11). Among the 6 categories of microcalcification distribution and morphology, reader agreement was moderate (distribution k = 0.60, 95%CI:0.59-0.61; morphology k = 0.51, 95%CI: 0.50-0.52).
Conclusion: When asked to characterize suspicious mammographic findings, this sampling of 10 expert academic breast imagers across 5 centers revealed varying strength of agreement for different findings, ranging from slight to almost perfect. Strongest agreement (“almost perfect”) was found for identifying the presence or absence of microcalcifications, although agreement drops to moderate when readers are asked to specify microcalcification morphology and distribution.
1 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics.1977;33:159-174.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-01-06.
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Affiliation(s)
- DJ Wisner
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - S Feig
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - B Joe
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - J Hargreaves
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - H Ojeda-Fournier
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - L Bassett
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - S Aminololama-Shakeri
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - JQ DeGuzman
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - CI Flowers
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - JE Campbell
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - S Elson
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - H Retallack
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
| | - C Wells
- University of California, San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; University of California, Davis, Davis, CA; University of California, San Diego, San Diego, CA; University of California, Los Angeles, Los Angeles, CA; Cancer Imaging Advisors, Tampa, FL
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Howard BJ, Wells C, Beresford NA, Copplestone D. Exploring methods to prioritise concentration ratios when estimating weighted absorbed dose rates to terrestrial Reference Animals and Plants. J Environ Radioact 2013; 126:326-337. [PMID: 23866262 DOI: 10.1016/j.jenvrad.2013.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/13/2013] [Accepted: 05/13/2013] [Indexed: 06/02/2023]
Abstract
The ICRP and IAEA have recently reported Concentration Ratio values (CRwo-media--equilibrium radionuclide activity concentration in whole organism divided by that in media) for Reference Animals and Plants (RAPs) and a wide range of organism groups, respectively, based on a common online database. Given the large number of data gaps in both publications, there is a need to develop methods for identifying the relative importance of improving currently available CR(wo-media) values. A simple, transparent approach involving the derivation and comparison of predicted internal and external weighted absorbed dose rates for radionuclides considered by ICRP (2009) for terrestrial RAPs is presented. Using the approach of applying a reference value of CR(wo-soil) = 1 or using the maximum reported values where CR(wo-soil) >1, we provisionally identify terrestrial radionuclide RAP combinations which could be considered low priority, notably: Ca, Cr and Ni consistently; Mn for all RAPs except Deer and Pine Tree; and Tc for all RAPs but Wild Grass. Equally, we can systematically identify high priority elements and radioisotopes, which largely, but not exclusively, consist of alpha-emitters (especially isotopes of Ra and Th, but also consistently Am, Cf, Cm, Np, Pa, Po, Pu, U). The analysis highlights the importance of the radiation weighting factor default assumption of 10 for alpha-emitters in the ERICA Tool when comparing the magnitude of the internal dose and trying to identify high priority RAP-isotope combinations. If the unweighted Dose Conversion Coefficient (DCC) values are considered, those for alpha-emitters are often one order of magnitude higher than those due to some beta-gamma emitters for terrestrial RAPs, whereas with the radiation weighting factor applied they are two orders of magnitude higher.
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Affiliation(s)
- B J Howard
- NERC Centre for Ecology & Hydrology, Lancaster Environment Centre, Library Av., Bailrigg, Lancaster LA1 4AP, United Kingdom.
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Gunnell D, Bennewith O, Simkin S, Cooper J, Klineberg E, Rodway C, Sutton L, Steeg S, Wells C, Hawton K, Kapur N. Time trends in coroners' use of different verdicts for possible suicides and their impact on officially reported incidence of suicide in England: 1990-2005. Psychol Med 2013; 43:1415-1422. [PMID: 23113986 DOI: 10.1017/s0033291712002401] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [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: 11/06/2022]
Abstract
BACKGROUND Official suicide statistics for England are based on deaths given suicide verdicts and most cases given an open verdict following a coroner's inquest. Previous research indicates that some deaths given accidental verdicts are considered to be suicides by clinicians. Changes in coroners' use of different verdicts may bias suicide trend estimates. We investigated whether suicide trends may be over- or underestimated when they are based on deaths given suicide and open verdicts. Method Possible suicides assessed by 12 English coroners in 1990/91, 1998 and 2005 and assigned open, accident/misadventure or narrative verdicts were rated by three experienced suicide researchers according to the likelihood that they were suicides. Details of all suicide verdicts given by these coroners were also recorded. RESULTS In 1990/91, 72.0% of researcher-defined suicides received a suicide verdict from the coroner, this decreased to 65.4% in 2005 (p trend < 0.01); equivalent figures for combined suicide and open verdicts were 95.4% (1990/91) and 86.7% (2005). Researcher-defined suicides with a verdict of accident/misadventure doubled over that period, from 4.6% to 9.1% (p < 0.01). Narrative verdict cases rose from zero in 1990/91 to 25 in 2005 (4.2% of researcher-defined suicides that year). In 1998 and 2005, 50.0% of the medicine poisoning deaths given accidental/misadventure verdicts were rated as suicide by the researchers. CONCLUSIONS Between 1990/91 and 2005, the proportion of researcher-defined suicides given a suicide verdict by coroners decreased, largely due to an increased use of accident/misadventure verdicts, particularly for deaths involving poisoning. Consideration should be given to the inclusion of 'accidental' deaths by poisoning with medicines in the statistics available for monitoring suicides rates.
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Affiliation(s)
- D Gunnell
- School of Social and Community Medicine, University of Bristol, UK.
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Howard BJ, Beresford NA, Copplestone D, Telleria D, Proehl G, Fesenko S, Jeffree RA, Yankovich TL, Brown JE, Higley K, Johansen MP, Mulye H, Vandenhove H, Gashchak S, Wood MD, Takata H, Andersson P, Dale P, Ryan J, Bollhöfer A, Doering C, Barnett CL, Wells C. The IAEA handbook on radionuclide transfer to wildlife. J Environ Radioact 2013; 121:55-74. [PMID: 22513215 DOI: 10.1016/j.jenvrad.2012.01.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 05/31/2023]
Abstract
An IAEA handbook presenting transfer parameter values for wildlife has recently been produced. Concentration ratios (CRwo-media) between the whole organism (fresh weight) and either soil (dry weight) or water were collated for a range of wildlife groups (classified taxonomically and by feeding strategy) in terrestrial, freshwater, marine and brackish generic ecosystems. The data have been compiled in an on line database, which will continue to be updated in the future providing the basis for subsequent revision of the Wildlife TRS values. An overview of the compilation and analysis, and discussion of the extent and limitations of the data is presented. Example comparisons of the CRwo-media values are given for polonium across all wildlife groups and ecosystems and for molluscs for all radionuclides. The CRwo-media values have also been compared with those currently used in the ERICA Tool which represented the most complete published database for wildlife transfer values prior to this work. The use of CRwo-media values is a pragmatic approach to predicting radionuclide activity concentrations in wildlife and is similar to that used for screening assessments for the human food chain. The CRwo-media values are most suitable for a screening application where there are several conservative assumptions built into the models which will, to varying extents, compensate for the variable data quality and quantity, and associated uncertainty.
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Affiliation(s)
- B J Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue Bailrigg, Lancaster LA1 4AP, UK.
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Tokin CA, Ojeda H, Mayadev JS, Hylton NM, Fowble BL, Rugo HS, Hwang S, Hurvitz S, Wells C, Blair SL. Abstract P4-01-13: Practice patterns of MRI utilization for breast cancer treatment within the University of California system as part of the Athena initiative. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p4-01-13] [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
Background: The appropriate utilization of Breast MRI in breast cancer care remains controversial. As part of a quality improvement initiative for breast cancer screening and treatment, we sent out a survey to physicians who treat breast cancer patients. All respondents are participants in the ATHENA initiative, a program which unites physicians, researchers, and patients at the five University of California medical centers.
Objective: To use the ATHENA infrastructure to perform a qualitative analysis of variations in breast cancer care.
Methods: Surveys were sent to 50 physicians in the ATHENA network whose practices are focused on breast cancer. Respondents were presented with clinical scenarios, and asked whether they would recommend MRI always/usually or sometimes/never. Differences were compared by Chi square.
Results: 39 physicians completed the survey (78% response rate). Of these physicians 29% were surgeons, 26% radiation oncologists and 45% medical oncologists. Athena physicians were more likely to order MRI for high risk screening of mutation carriers than not (85% yes vs. 15% no, p < 0.003) but not based on breast density alone or previous history of breast cancer. They were also more likely to order it for monitoring neo-adjuvant chemotherapy (70% yes vs. 30% no, p < 0.03). Although the majority answered that they would order a Breast MRI for new breast cancer the difference between responses was not significantly different (56% yes vs. 44%, p = 0.07).
Conclusion: Athena physicians follow established published guidelines which demonstrate a benefit for Breast MRI screening for BRCA mutation carriers but not based on density or previous history of breast cancer. The Athena network allows a forum for new practice guidelines to be implemented as data becomes available to improve patient outcomes and utilize the best evidence for patient care, where both the patterns of MRI use as well as the outcomes of practice patterns will be evaluated prospectively.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-01-13.
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Affiliation(s)
- CA Tokin
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - H Ojeda
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - JS Mayadev
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - NM Hylton
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - BL Fowble
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - HS Rugo
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - S Hwang
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - S Hurvitz
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - C Wells
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
| | - SL Blair
- University of California, San Diego; University of California, Davis; University of California, San Francisco; Duke University; University of California, Los Angeles
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Beresford NA, Barnett CL, Howard BJ, Howard DC, Wells C, Tyler AN, Bradley S, Copplestone D. Observations of Fukushima fallout in Great Britain. J Environ Radioact 2012; 114:48-53. [PMID: 22206699 DOI: 10.1016/j.jenvrad.2011.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 12/07/2011] [Accepted: 12/09/2011] [Indexed: 05/31/2023]
Abstract
Following the Fukushima accident in March 2011, grass samples were collected from 42 sites around Great Britain during April 2011. Iodine-131 was measurable in grass samples across the country with activity concentrations ranging from 10 to 55 Bq kg(-1) dry matter. Concentrations were similar to those reported in other European countries. Rainwater and some foodstuffs were also analysed from a limited number of sites. Of these, (131)I was only detectable in sheep's milk (c. 2 Bq kg(-1)). Caesium-134, which can be attributed to releases from the Fukushima reactors, was detectable in six of the grass samples (4-8 Bq kg(-1) dry matter); (137)Cs was detected in a larger number of grass samples although previous release sources (atmospheric weapons test and the 1986 Chernobyl and 1957 Windscale accidents) are likely to have contributed to this.
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Affiliation(s)
- N A Beresford
- Centre for Ecology & Hydrology, Lancaster Environment Centre, Library Av., Bailrigg, Lancaster LA1 4AP, United Kingdom.
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Shah NS, Cavanaugh JS, Pratt R, Cain KP, Wells C, Laserson K, Nelson L. Epidemiology of smear-negative pulmonary tuberculosis in the United States, 1993-2008. Int J Tuberc Lung Dis 2012; 16:1234-40. [PMID: 22748057 DOI: 10.5588/ijtld.11.0794] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smear-negative tuberculosis (TB) is difficult to diagnose and has been associated with poor treatment outcomes and excessive mortality, particularly in high human immunodeficiency virus (HIV) prevalent settings. However, few studies have used mycobacterial culture to rigorously confirm all smear-negative TB cases in a population-based cohort. DESIGN We included all culture-confirmed, pulmonary TB cases reported to the US National TB Surveillance System from 1993 to 2008. We analyzed smear-negative TB risk factors and survival, as compared to smear-positive TB. We calculated prevalence ratios (PRs) and adjusted for confounders (aPR). RESULTS From 1993 to 2008, 159,121 cases of culture-confirmed pulmonary TB were reported in the United States, of which 58,786 (37%) were sputum smear-negative. Smear-negative TB cases were more likely to be foreign-born (aPR 1.10, 95%CI 1.08-1.12), incarcerated (aPR 1.52, 95%CI 1.48-1.56) or HIV-infected (aPR 1.27, 95%CI 1.24-1.30). Hispanics and non-Hispanic Blacks were less likely to have smear-negative TB (respectively aPR 0.87, 95%CI 0.85-0.89 and aPR 0.90, 95%CI 0.89-0.92). Smear-negative TB cases had lower mortality (aRR 0.78, 95%CI 0.74-0.81), independent of HIV status. CONCLUSION Smear-negative TB represents a large proportion of TB cases in the United States, and occurs more often among persons in groups more likely to undergo TB screening. The lower mortality may indicate earlier TB detection, and underscores the need for continued vigilance in screening of high-risk persons.
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Affiliation(s)
- N S Shah
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Hauser S, Kappos L, Li D, Calabresi P, O'Connor P, Bar-Or A, Barkhof F, Wells C, Leppert D, Glanzman R, Tinbergen J. Long-Term Efficacy and Safety of Ocrelizumab in Patients with Relapsing-Remitting Multiple Sclerosis (RRMS): Week 96 Results of a Phase II, Randomized, Multicenter Trial (S30.006). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s30.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Because of their critical role in modulating cellular cyclic nucleotide levels, phosphodiesterases (PDEs) are involved in many disease-related signaling pathways. The PDE family is large and diverse, with members having different tissue distribution, sub-cellular localizations, and substrate specificities. Because of these characteristics, the PDEs represent a broad group of potential drug targets. Described in the present unit are the assay development and validation procedures needed to establish a high-throughput screening system for these important enzymes. The assays provide a structured approach for determining the kinetic parameters of related enzyme families to facilitate the characterization of PDE inhibitors.
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Affiliation(s)
- S J MacKenzie
- Scottish Biomedical, Glasgow, Scotland, United Kingdom
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