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Paterson C, Roberts C, Blackburn J, Jojo N, Northam HL, Wallis E, Hind A, Caulfield R, Barratt M, Toohey K, Kavanagh PS, Bacon R, Wilson RL. Understanding the needs and preferences for cancer care among First Nations people: An integrative review. J Adv Nurs 2024; 80:1776-1812. [PMID: 38018290 DOI: 10.1111/jan.15968] [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: 03/21/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
AIM This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people. DESIGN Integrative review. DATA SOURCES An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted. RESULTS Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs. CONCLUSION Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs. PATIENT OR PUBLIC CONTRIBUTION Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work. IMPLICATIONS FOR NURSING PRACTICE Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Blackburn
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - A Hind
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R Caulfield
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - M Barratt
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Justice and Society, University of South Australia, Magill, South Australia, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - R L Wilson
- School of Nursing and Midwifery, University of Newcastle, Gosford, New South Wales, Australia
- School of Nursing, Massey University, Palmerston North, New Zealand
- Descendent of the Wiradjuri Nation (First Nations Person), New South Wales, Australia
- Department of Nursing, RMIT University, Melbourne, Victoria, Australia
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Paterson C, Davis D, Roberts C, Bail K, Wallis E, Northam HL, Frost J, Jojo N, McGrory C, Dombkins A, Kavanagh PS. Sense of coherence moderates job demand-resources and impact on burnout among nurses and midwives in the context of the COVID-19 pandemic: A cross-sectional survey. J Adv Nurs 2024. [PMID: 38426656 DOI: 10.1111/jan.16125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/04/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
AIM This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. DESIGN Cross-sectional quantitative survey. DATA SOURCES The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. RESULTS 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. CONCLUSION It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution in this study, as the focus was on nurses and midwives.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
| | - D Davis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - K Bail
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - E Wallis
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - H L Northam
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - J Frost
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Western Sydney University, Penrith South, New South Wales, Australia
| | - N Jojo
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - C McGrory
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - A Dombkins
- ACT Health Directorate, Canberra, Australian Capital Territory, Australia
| | - P S Kavanagh
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
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Talasaz AH, Sculthorpe R, Pak M, Lipinski M, Roberts C, Markley R, Trankle CR, Canada JM, Wohlford GF, Golino M, Dixon D, Van Tassell BW, Abbate A. Comparison of Safety and Biological Efficacy of Anakinra (Kineret) Dispensed in Polycarbonate Plastic versus Borosilicate Glass Syringes: A Patient-Level Analysis of VCUART2 and VCUART3 Clinical Trials. J Pharmacol Exp Ther 2023; 386:138-142. [PMID: 36868827 PMCID: PMC10353132 DOI: 10.1124/jpet.122.001404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
Anakinra is a recombinant human interleukin-1 receptor antagonist approved for the treatment of inflammatory diseases. Kineret is available as a solution prepared in a borosilicate glass syringe. For implementing a placebo-controlled double-blind randomized clinical trial, anakinra is commonly transferred into plastic syringes. However, there is limited data on anakinra's stability in polycarbonate syringes. We described the results of our previous studies on the use of anakinra in glass (VCUART3) versus plastic syringes (VCUART2) compared with placebo. These studies were conducted in patients with ST-segment elevation myocardial infarction (STEMI), and we assessed the anti-inflammatory effects of anakinra versus placebo by comparing the area under the curve for high-sensitivity cardiac reactive protein (AUC-CRP) levels during the first 14 days of STEMI, its clinical effects on heart failure (HF) hospitalization, cardiovascular death, or new diagnosis of HF as well as adverse events profile between groups. The levels of AUC-CRP were 75 (50-255 mg·day/l) for anakinra in plastic syringes versus 255 (116-592 mg·day/l) in placebo and 60 (24-139 mg·day/l) and 86 (43-123 mg·day/l) for anakinra once and twice daily in glass syringes, respectively, compared with placebo 214 (131-394 mg·day/l). The rate of adverse events was also comparable between groups. There were no differences in the rate of HF hospitalization or cardiovascular death in patients who received anakinra in plastic or glass syringes. Fewer cases of new-onset heart failure occurred in patients receiving anakinra in plastic or glass syringes compared with placebo. Anakinra stored in plastic (polycarbonate) syringes provides comparable biologic and clinical effect to glass (borosilicate) syringes. SIGNIFICANCE STATEMENT: Anakinra (Kineret) 100 mg administered subcutaneously in patients with ST-segment elevation myocardial infarction (STEMI) for a duration of up to 14 days appears to have comparable safety and biological efficacy signals when delivered in prefilled glass or transferred into plastic polycarbonate syringes. This may have important implications for the feasibility of designing clinical trials in STEMI and other clinical conditions.
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Affiliation(s)
- Azita H Talasaz
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Robin Sculthorpe
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Mary Pak
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Michael Lipinski
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Charlotte Roberts
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Roshanak Markley
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Cory R Trankle
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Justin M Canada
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - George F Wohlford
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Michele Golino
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Dave Dixon
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Benjamin W Van Tassell
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
| | - Antonio Abbate
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy (A.H.T.), Investigation Drug Pharmacy Department (R.S., M.P., G.F.W., D.D., B.W.V.T.), and Pauley Heart Center (M.L., C.R., R.M., C.R.T., J.M.C., M.G., D.D., B.W.V.T., A.A.), Virginia Commonwealth University, Richmond, Virginia; and Berne Cardiovascular Research Center and Division of Cardiology, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia (A.A.)
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Paterson C, Roberts C, Li J, Chapman M, Strickland K, Johnston N, Law E, Bacon R, Turner M, Mohanty I, Pranavan G, Toohey K. What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: A qualitative systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01401-5. [PMID: 37256499 DOI: 10.1007/s11764-023-01401-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers. METHODS A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings. RESULTS A total of 33 studies were included which represented a total sample of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 individual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs. CONCLUSION This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with individualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services. IMPLICATIONS FOR CANCER SURVIVORS It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.
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Affiliation(s)
- C Paterson
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia.
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia.
- Canberra Health Services and ACT Health, Garran, Canberra, Australia.
- Robert Gordon University, Aberdeen, Scotland, UK.
| | - C Roberts
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - J Li
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - M Chapman
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- Department of Palliative Care, Canberra Health Services, Garran, Canberra, Australia
- School of Medicine and Psychology, Australian National University, Canberra, Australia
| | - K Strickland
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing & Midwifery, Edith Cowan University, Joondalup, WA, Australia
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, AUT, Auckland, New Zealand
| | - N Johnston
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - E Law
- Icon Cancer Centre, Canberra, Australia
| | - R Bacon
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
| | - I Mohanty
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
| | - G Pranavan
- Canberra Health Services and ACT Health, Garran, Canberra, Australia
| | - K Toohey
- Faculty of Health, University of Canberra, Bruce, Canberra, ACT, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Canberra, ACT, Australia
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Del Buono MG, Damonte JI, Moroni F, Chiabrando JG, Markley R, Turlington J, Trankle C, Kang L, Biondi-Zoccai G, Kontos MC, Roberts C, Van Tassell B, Abbate A. Clinical and Pharmacological Implications of Time to Treatment with Interleukin-1 Blockade in ST-Segment Elevation Myocardial Infarction. J Pharmacol Exp Ther 2023:jpet.123.001601. [PMID: 37037651 PMCID: PMC10353076 DOI: 10.1124/jpet.123.001601] [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: 01/30/2023] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 04/12/2023] Open
Abstract
Interleukin-1 (IL-1) blockade with anakinra given within 12 hours from reperfusion has been shown to reduce the inflammatory response as well as prevent heart failure (HF) events in patients with STEMI.We sought to determine whether time-to-treatment influences the efficacy of anakinra on systemic inflammation and incidence of HF events in patients with STEMI. We divided the cohort in two groups based on the median time from percutaneous coronary intervention (PCI) to investigational drug, and analyzed the effects of anakinra on the area-under-the-curve for C reactive protein (AUC-CRP) and on incidence of the composite endpoint of death or new onset HF. We analyzed data from 139 patients: 84 (60%) treated with anakinra and 55 (40%) with placebo. The median time from PCI to investigational treatment was 271(182-391) minutes. The AUC-CRP was significantly higher in patients receiving placebo versus anakinra both in those with time from PCI to treatment <271 min (222.6[103.9-325.2] vs 78.4[44.3-131.2], p<0.001) and those with time from PCI to treatment {greater than or equal to}271 min (235.2[131.4-603.4] vs 75.5[38.9-171.9], p<0.001) (p>0.05 for interaction). Anakinra significantly reduced the combined endpoint of death or new onset HF in patients with time from PCI to treatment <271 min (5[11%] vs 9[36%], log-rank Chi-square 5.985, p=0.014) as well as in patients with time from PCI to drug {greater than or equal to}271 min (2[5%] vs 7[23%], log-rank Chi-square 3.995, p=0.046) (p>0.05 for interaction). IL-1 blockade with anakinra blunts the acute systemic inflammatory response and prevents HF events independent of time-to-treatment. Significance Statement In patients with ST segment elevation presenting within 12 hours of pain onset and treated within 12 hours of reperfusion, IL-1 blockade with anakinra blunts the acute systemic inflammatory response, a surrogate of IL-1 activity, and prevents HF events independent of time-to-treatment.
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Wright A, Amodie DM, Cernicchiaro N, Lascelles BDX, Pavlock AM, Roberts C, Bartram DJ. Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests. J Small Anim Pract 2022; 63:609-618. [PMID: 35385129 PMCID: PMC9543207 DOI: 10.1111/jsap.13500] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/10/2022] [Accepted: 03/11/2022] [Indexed: 12/14/2022]
Abstract
Objectives To investigate the diagnostic value of an owner‐completed canine osteoarthritis screening checklist to help identify previously undiagnosed osteoarthritis cases, and assess their response to carprofen treatment by monitoring pain and functional mobility. Materials and Methods Dogs (n=500) whose owners reported ≥1 positive response to the osteoarthritis checklist were examined to identify dogs with previously undiagnosed osteoarthritis. Eligible dogs (n=133) were evaluated for pain and video mobility analysis by Helsinki Chronic Pain Index and visual analogue scale scores, respectively, following carprofen treatment, administered for 30 days (n=95) or up to 120 days (n=38). Dogs were filmed at clinics performing activities (walking, jogging, sitting/lying, walking up and down stairs), and scored at days 0, 30 and 120 using visual analogue scale by an independent blinded expert. Results A diagnosis of osteoarthritis was confirmed by a veterinarian in 38% (188 of 500) of dogs. Balance of sensitivity and specificity across the original group of nine screening questions was optimised to approximately 88 and 71%, respectively, after elimination of three questions. Pain measured by Helsinki Chronic Pain Index and functional mobility improved over time in response to treatment with carprofen. Mean ability scores for activities significantly improved between days 0 and 30 for walking, jogging, sitting/lying and walking down stairs, and days 0 and 120 for sitting/lying and walking up stairs. Clinical Significance More osteoarthritis cases were identified in study dogs than previous prevalence estimates, indicating the screening checklist's potential to help identify for further evaluation cases that could otherwise remain undiagnosed. Improvements in function were demonstrated after carprofen treatment.
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Affiliation(s)
- A Wright
- Outcomes Research, Zoetis Inc., Parsippany, New Jersey, 07054, USA
| | - D M Amodie
- Outcomes Research, Zoetis Inc., Parsippany, New Jersey, 07054, USA
| | - N Cernicchiaro
- Center for Outcomes Research and Epidemiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, 66506, USA
| | - B D X Lascelles
- Comparative Pain Research and Education Centre & Translational Research in Pain Program, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, 27606, USA
| | - A M Pavlock
- AMP Research Solutions, Parker Ford, Pennsylvania, 19457, USA
| | - C Roberts
- vHive, School of Veterinary Medicine, University of Surrey, Guildford, GU2 7AL, UK
| | - D J Bartram
- Outcomes Research, Zoetis Inc., Parsippany, New Jersey, 07054, USA
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Hunjan MK, Roberts C, Karim S, Hague J. Pityriasis rubra pilaris-like eruption following administration of the BNT163b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine. Clin Exp Dermatol 2022; 47:188-190. [PMID: 34379821 PMCID: PMC8444918 DOI: 10.1111/ced.14878] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
We describe a case of a pityriasis rubra pilaris (PRP)-like eruption occurring following administration of the Pfizer-Biontech mRNA COVID-19 vaccine, with worsening of the condition following the second dose. To our knowledge, this is the first reported case of a PRP-like eruption as a cutaneous adverse event of the Pfizer-Biontech mRNA COVID-19 vaccine.
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Affiliation(s)
- M. K. Hunjan
- Department of DermatologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
| | - C. Roberts
- Department of HistopathologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
| | - S. Karim
- Department of HistopathologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
| | - J. Hague
- Department of DermatologySolihull HospitalUniversity Hospitals Birmingham Foundation NHS TrustBirminghamUK
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8
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Abbate A, Gavin J, Madanchi N, Kim C, Shah PR, Klein K, Boatman J, Roberts C, Patel S, Danielides S. Fulminant myocarditis and systemic hyperinflammation temporally associated with BNT162b2 mRNA COVID-19 vaccination in two patients. Int J Cardiol 2021; 340:119-121. [PMID: 34416319 PMCID: PMC8372420 DOI: 10.1016/j.ijcard.2021.08.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 01/06/2023]
Abstract
Immune-mediated myocardial injury following Severe Acute Respiratory Syndrome Coronavirys-2 (SARS-CoV2) infection has been described in adults and children. Cases of myocarditis following immunization for SARS-CoV2 have recently been documented, mostly associated with mild severity and spontaneous recovery. We herein report two cases of fulminant myocarditis following BNT162b2 mRNA Covid-19 vaccination associated with systemic hyperinflammatory syndrome and refractory shock requiring support with veno-arterial extracorporeal membrane oxygenation.
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Affiliation(s)
- Antonio Abbate
- Division of Cardiology, Virginia Commonwealth University, Richmond, VA, United States of America.
| | - Josh Gavin
- Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Nima Madanchi
- Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Christin Kim
- Anesthesiology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Pranav R Shah
- Anesthesiology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Katherine Klein
- Cardiothoracic Surgery, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Julie Boatman
- Infectious Disease - Virginia Commonwealth University, Richmond, VA, United States of America
| | - Charlotte Roberts
- Division of Cardiology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Seema Patel
- Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Stamatina Danielides
- Allergy, Immunology and Rheumatology, Virginia Commonwealth University, Richmond, VA, United States of America.
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9
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Bange EM, Han NA, Wileyto P, Kim JY, Gouma S, Robinson J, Greenplate AR, Hwee MA, Porterfield F, Owoyemi O, Naik K, Zheng C, Galantino M, Weisman AR, Ittner CAG, Kugler EM, Baxter AE, Oniyide O, Agyekum RS, Dunn TG, Jones TK, Giannini HM, Weirick ME, McAllister CM, Babady NE, Kumar A, Widman AJ, DeWolf S, Boutemine SR, Roberts C, Budzik KR, Tollett S, Wright C, Perloff T, Sun L, Mathew D, Giles JR, Oldridge DA, Wu JE, Alanio C, Adamski S, Garfall AL, Vella LA, Kerr SJ, Cohen JV, Oyer RA, Massa R, Maillard IP, Maxwell KN, Reilly JP, Maslak PG, Vonderheide RH, Wolchok JD, Hensley SE, Wherry EJ, Meyer NJ, DeMichele AM, Vardhana SA, Mamtani R, Huang AC. CD8 + T cells contribute to survival in patients with COVID-19 and hematologic cancer. Nat Med 2021; 27:1280-1289. [PMID: 34017137 PMCID: PMC8291091 DOI: 10.1038/s41591-021-01386-7] [Citation(s) in RCA: 305] [Impact Index Per Article: 101.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023]
Abstract
Patients with cancer have high mortality from coronavirus disease 2019 (COVID-19), and the immune parameters that dictate clinical outcomes remain unknown. In a cohort of 100 patients with cancer who were hospitalized for COVID-19, patients with hematologic cancer had higher mortality relative to patients with solid cancer. In two additional cohorts, flow cytometric and serologic analyses demonstrated that patients with solid cancer and patients without cancer had a similar immune phenotype during acute COVID-19, whereas patients with hematologic cancer had impairment of B cells and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody responses. Despite the impaired humoral immunity and high mortality in patients with hematologic cancer who also have COVID-19, those with a greater number of CD8 T cells had improved survival, including those treated with anti-CD20 therapy. Furthermore, 77% of patients with hematologic cancer had detectable SARS-CoV-2-specific T cell responses. Thus, CD8 T cells might influence recovery from COVID-19 when humoral immunity is deficient. These observations suggest that CD8 T cell responses to vaccination might provide protection in patients with hematologic cancer even in the setting of limited humoral responses.
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Affiliation(s)
- Erin M Bange
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Nicholas A Han
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paul Wileyto
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Justin Y Kim
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sigrid Gouma
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James Robinson
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Allison R Greenplate
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Madeline A Hwee
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Florence Porterfield
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Olutosin Owoyemi
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karan Naik
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Cathy Zheng
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Galantino
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Ariel R Weisman
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Caroline A G Ittner
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily M Kugler
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy E Baxter
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Olutwatosin Oniyide
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Presbyterian Hospital, Philadelphia, PA, USA
| | - Roseline S Agyekum
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Presbyterian Hospital, Philadelphia, PA, USA
| | - Thomas G Dunn
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Presbyterian Hospital, Philadelphia, PA, USA
| | - Tiffanie K Jones
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Presbyterian Hospital, Philadelphia, PA, USA
| | - Heather M Giannini
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Madison E Weirick
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher M McAllister
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - N Esther Babady
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anita Kumar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Adam J Widman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susan DeWolf
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sawsan R Boutemine
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charlotte Roberts
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Krista R Budzik
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan Tollett
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Carla Wright
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Tara Perloff
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Pennsylvania Hospital, Philadelphia, NY, USA
| | - Lova Sun
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Divij Mathew
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Josephine R Giles
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA
| | - Derek A Oldridge
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer E Wu
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA
| | - Cécile Alanio
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA
| | - Sharon Adamski
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alfred L Garfall
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura A Vella
- Department of Pediatrics, Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Samuel J Kerr
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology/Oncology, Department of Medicine, Lancaster General Hospital, Philadelphia, PA, USA
| | - Justine V Cohen
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Pennsylvania Hospital, Philadelphia, NY, USA
| | - Randall A Oyer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology/Oncology, Department of Medicine, Lancaster General Hospital, Philadelphia, PA, USA
| | - Ryan Massa
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Presbyterian Hospital, Philadelphia, PA, USA
| | - Ivan P Maillard
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Kara N Maxwell
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - John P Reilly
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter G Maslak
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert H Vonderheide
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA
| | - Jedd D Wolchok
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA
| | - Scott E Hensley
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - E John Wherry
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA
| | - Nuala J Meyer
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Angela M DeMichele
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Santosha A Vardhana
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA.
| | - Ronac Mamtani
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
| | - Alexander C Huang
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Parker Institute for Cancer Immunotherapy, Philadelphia, PA, USA.
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10
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Azeez N, Roberts C, Bradbury H. Stakeholders (trainees & tutors) views on the introduction of a workplace-based assessment tool within the pre-registration pharmacy training programme in a large teaching hospital: A qualitative triangulation study. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Pre-registration pharmacy training in the UK is a competency-based programme1. Workplace-based assessment (WBA) tools are valid and reliable tools in assessing competency in the workplace,2 however no recognised WBA tools are used within pre-registration pharmacy training. Historically WBA have been used within healthcare training, including postgraduate pharmacy. A WBA tool was designed by amalgamating three recognised tools from postgraduate pharmacy training (case-based discussion, mini clinical examination and direct observed patient consultation), then piloted within the 2018/19 pre-registration pharmacy training year in a large teaching hospital.
Aim
To gather the views of pre-registration pharmacist trainees and tutors of their experiences of using the WBA tool in practice. From the views, to determine if the purposes of the tool had been met: allowing tutors to work directly with their trainee in the workplace and meet the GPhC performance standards1 that are more easily met through observation.
Methods
This research was carried out in a large teaching hospital in the North of England. The WBA tool which included a six-point Likert scale and comments boxes for feedback, was introduced to the stakeholders at the start of the 2018/19 training year in a training session. Data was collected 6 months after using the tool in practice. A triangulation method was used; a semi-structured interview with the pre-registration pharmacist manager and two focus groups were conducted, one with trainees (n=7) and one with tutors (n=5). Participants were recruited through an invitation email sent via a gatekeeper. The focus groups moderator set ground rules to ensure a safe space for discussion to reduce conflict. They also reduced possible bias by ensuring they were not a current tutor. Responses from the interview were used to support the design of the topic guide for the focus groups. Data was transcribed and thematic analysis was undertaken.
Results
Following thematic analysis, three global themes emerged: clarity of purpose of the tool, feedback to trainees and the WBA tool as an assessment. Overall, trainees found the WBA tool was the most valuable part of their training owing to the benefit of instant feedback. Tutors agreed the tool was valuable when directly observing their trainee in practice, supporting the initial aim of the tool. There were conflicting views on why the tool was introduced, therefore highlighting the importance of a good implementation strategy when making changes. Interestingly, the WBA tool was not perceived as an assessment by the majority of trainees, and the inclusion of the Likert scale on the tool was questioned, leading to possible changes being made for future use.
Conclusion
This is the first study that gathers stakeholders’ experiences of using a WBA tool within pre-registration pharmacy training within the UK. Overall, the WBA tool received positive responses from both trainees and tutors. With upcoming changes in foundation pharmacy training proposed, this study supports the use of a WBA tool as it allows for focused feedback which trainees’ value. Limitations include a small sample size and the WBA tool being piloted in one hospital.
References
1. GPhC. 2020. Pre-registration trainee. [Online]. Available from: https://www.pharmacyregulation.org/i-am-pre-registration-trainee
2. Norcini, J. and Burch, V. 2007. Workplace-based assessment as an educational tool: AMEE Guide No.31. Medical Teacher.29, pp. 855–871.
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Affiliation(s)
- N Azeez
- Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, UK
| | - C Roberts
- Medicines Management & Pharmacy Services, Leeds Teaching Hospitals NHS Trust, UK
| | - H Bradbury
- School of Healthcare, University of Leeds, UK
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Dardenne E, Padilla F, Rasmussen S, Yang S, Mentes A, Ogawa L, Fiorenza R, Trombino A, Smith S, Romashko D, Ishiyama N, Chevtsova M, Thakur S, Rosfjord E, Buck E, Roberts C, Lucas M, Lin TA. 35MO Discovery and characterization of selective, FGFR1-sparing, inhibitors of FGFR2/3 oncogenic mutations for the treatment of cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.050] [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: 10/22/2022] Open
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Roberts C, Wheatley-Price P, Asmis T, Barton G, Greene T. P39.03 Developing A Collaborative Northern Roadmap for Lung Cancer Care. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.803] [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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13
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Han YC, Ng P, Schulz R, Yang S, Lelo A, Ogawa L, O'Connor M, Ishiyama N, Jewett I, Romashko D, Salomatov A, Thakur S, Smith S, Buck E, Roberts C, Lucas M, Lin TA. 43P Pre-clinical evaluation of potent and orally bioavailable next-generation inhibitors targeting the family of mutants that drive oncogenic BRAF dimer formation. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Marques C, Roberts C, Matos VMJ, Buikstra JE. Cancers as rare diseases: Terminological, theoretical, and methodological biases. Int J Paleopathol 2021; 32:111-122. [PMID: 33524843 DOI: 10.1016/j.ijpp.2020.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/10/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Was cancer a rare disease in the past? Our objective is to consider the various terminological, theoretical, and methodological biases that may affect perceptions of the rarity of cancer in the past. MATERIALS AND METHODS We discuss relevant malignant neoplastic biomedical and paleopathological literature and evaluate skeletal data. We selected 108 archaeological sites (n = 151 cancer cases) with published malignant neoplasms and that were amenable to calculating cancer crude prevalence. Furthermore, datasets from four medieval/postmedieval Portuguese and 12 postmedieval UK sites were used to compare age-adjusted rates for metastatic bone disease and tuberculosis. RESULTS In the literature review, mean cancer crude prevalence (1.2 %; 95 % CI = 0.96-1.4) exceeded the threshold for a rare disease (RD). Age-standardized rates of MBD and TB were not markedly different in the sites surveyed. CONCLUSIONS Methodological, theoretical and historical factors contribute to assumptions that cancers were rare diseases. The assumption that cancers are extremely rare in the paleopathological literature was not fully supported. Cancer is a heterogeneous concept, and it is important to view it as such. If a disease is considered rare, we may fail to recognize it or dismiss it as unimportant in the past. SIGNIFICANCE We present a re-evaluation of the idea that cancer is a rare disease. We present a more nuanced way of comparing rates of pathological conditions in archaeological contexts. LIMITATIONS Variation in the amount of useable information in published literature on malignant neoplasms. SUGGESTIONS FOR FURTHER RESEARCH More large-scale studies of cancer in the past alongside comparative studies of cancer prevalence with other assumed rare diseases.
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Affiliation(s)
- Carina Marques
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Portugal.
| | - Charlotte Roberts
- Department of Archaeology, Durham University, South Road, Durham, DL8 5NP, Durham University, UK.
| | - Vitor M J Matos
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Portugal.
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Roberts C, Kaplow J, Giroux M, Krause S, Kanekiyo M. Amyloid and APOE Status of Screened Subjects in the Elenbecestat MissionAD Phase 3 Program. J Prev Alzheimers Dis 2021; 8:218-223. [PMID: 33569570 DOI: 10.14283/jpad.2021.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/OBJECTIVES Elenbecestat, an oral BACE-1 inhibitor that has been shown to reduce Aβ levels in cerebrospinal fluid, was investigated in two global phase 3 studies in early AD. Here we report on differences observed in characteristics of APOE ε4 and amyloid positive subjects in the large screening cohort. DESIGN Screening was performed in 5 sequential tiers over a maximum of 80 days, as part of placebo controlled, double blind phase 3 studies. SETTING Subjects were evaluated at sites in 7 regions (29 countries). PARTICIPANTS Overall, 9758 subjects were screened. INTERVENTION All screened subjects that were eligible received either placebo or 50 mg QID elenbecestat post randomisation. MEASUREMENTS Gender, disease staging, APOE ε4 status, amyloid status, amyloid positron emission tomography (PET) standard uptake value ratio (SUVr) and amyloid PET Centiloid (CL) values were determined for screened subjects; by country and region. RESULTS In this program, 44% of subjects were APOE ε4 positive. Frequency of females was similar in both APOE ε4 positive and negative groups. However, early mild AD subjects were slightly higher in the APOE ε4 positive group compared with the APOE ε4 negative group. 56% of subjects were amyloid positive. The mean age in the amyloid positive group was slightly higher than the amyloid negative group. The gender distribution was similar between amyloid groups. A lower number of mild cognitive impairment was observed in the amyloid positive group along with a higher number of early mild AD. APOE ε4 positive subjects were higher in amyloid positive group compared to the amyloid negative group. China had the lowest APOE ε4 and amyloid positivity rates with Western Europe and Oceania performing best. Subjects received florbetapir, florbetaben or flutemetamol amyloid PET tracer. Amyloid negative and positive subjects CL values were normally distributed around their respective means of 1.5 CL and 83 CL. However, there was an appreciable overlap in the 20-40 CL range. CONCLUSIONS In this large cohort of cognitively impaired subjects, subject demographics characteristics were comparable regardless of APOE genotype or amyloid positivity. APOE ε4 positivity and amyloid positivity varied by country and by geographical region.
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Affiliation(s)
- C Roberts
- Claire Roberts, Eisai Ltd., Hatfield, UK, , Phone: +44 8456 761 590
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Bange EM, Han NA, Wileyto P, Kim JY, Gouma S, Robinson J, Greenplate AR, Porterfield F, Owoyemi O, Naik K, Zheng C, Galantino M, Weisman AR, Ittner CA, Kugler EM, Baxter AE, Oniyide O, Agyekum RS, Dunn TG, Jones TK, Giannini HM, Weirick ME, McAllister CM, Babady NE, Kumar A, Widman AJ, DeWolf S, Boutemine SR, Roberts C, Budzik KR, Tollett S, Wright C, Perloff T, Sun L, Mathew D, Giles JR, Oldridge DA, Wu JE, Alanio C, Adamski S, Garfall AL, Vella L, Kerr SJ, Cohen JV, Oyer RA, Massa R, Maillard IP, Maxwell KN, Reilly JP, Maslak PG, Vonderheide RH, Wolchok JD, Hensley SE, Wherry EJ, Meyer N, DeMichele AM, Vardhana SA, Mamtani R, Huang AC. CD8 T cells compensate for impaired humoral immunity in COVID-19 patients with hematologic cancer. Res Sq 2021:rs.3.rs-162289. [PMID: 33564756 PMCID: PMC7872363 DOI: 10.21203/rs.3.rs-162289/v1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cancer patients have increased morbidity and mortality from Coronavirus Disease 2019 (COVID-19), but the underlying immune mechanisms are unknown. In a cohort of 100 cancer patients hospitalized for COVID-19 at the University of Pennsylvania Health System, we found that patients with hematologic cancers had a significantly higher mortality relative to patients with solid cancers after accounting for confounders including ECOG performance status and active cancer status. We performed flow cytometric and serologic analyses of 106 cancer patients and 113 non-cancer controls from two additional cohorts at Penn and Memorial Sloan Kettering Cancer Center. Patients with solid cancers exhibited an immune phenotype similar to non-cancer patients during acute COVID-19 whereas patients with hematologic cancers had significant impairment of B cells and SARS-CoV-2-specific antibody responses. High dimensional analysis of flow cytometric data revealed 5 distinct immune phenotypes. An immune phenotype characterized by CD8 T cell depletion was associated with a high viral load and the highest mortality of 71%, among all cancer patients. In contrast, despite impaired B cell responses, patients with hematologic cancers and preserved CD8 T cells had a lower viral load and mortality. These data highlight the importance of CD8 T cells in acute COVID-19, particularly in the setting of impaired humoral immunity. Further, depletion of B cells with anti-CD20 therapy resulted in almost complete abrogation of SARS-CoV-2-specific IgG and IgM antibodies, but was not associated with increased mortality compared to other hematologic cancers, when adequate CD8 T cells were present. Finally, higher CD8 T cell counts were associated with improved overall survival in patients with hematologic cancers. Thus, CD8 T cells likely compensate for deficient humoral immunity and influence clinical recovery of COVID-19. These observations have important implications for cancer and COVID-19-directed treatments, immunosuppressive therapies, and for understanding the role of B and T cells in acute COVID-19.
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Affiliation(s)
- Erin M. Bange
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - Nicholas A. Han
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
| | - Paul Wileyto
- Abramson Cancer Center, University of Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania
| | - Justin Y. Kim
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
| | - Sigrid Gouma
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania
| | | | - Allison R. Greenplate
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
| | - Florence Porterfield
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Olutosin Owoyemi
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Karan Naik
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Cathy Zheng
- Abramson Cancer Center, University of Pennsylvania
| | | | - Ariel R. Weisman
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Caroline A.G. Ittner
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Emily M. Kugler
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Amy E. Baxter
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
| | - Olutwatosin Oniyide
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Roseline S. Agyekum
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Thomas G. Dunn
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Tiffanie K. Jones
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Heather M. Giannini
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Madison E. Weirick
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania
| | | | - N. Esther Babady
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center
| | - Anita Kumar
- Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Adam J Widman
- Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Susan DeWolf
- Department of Medicine, Memorial Sloan Kettering Cancer Center
| | | | | | | | | | - Carla Wright
- Abramson Cancer Center, University of Pennsylvania
| | - Tara Perloff
- Abramson Cancer Center, University of Pennsylvania
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Pennsylvania Hospital
| | - Lova Sun
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - Divij Mathew
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
| | - Josephine R. Giles
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
- Parker Institute for Cancer Immunotherapy
| | - Derek A. Oldridge
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Jennifer E. Wu
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
- Parker Institute for Cancer Immunotherapy
| | - Cécile Alanio
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
- Parker Institute for Cancer Immunotherapy
| | - Sharon Adamski
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
| | - Alfred L. Garfall
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - Laura Vella
- Department of Pediatrics, Perelman School of Medicine, Children’s Hospital of Philadelphia
| | - Samuel J. Kerr
- Abramson Cancer Center, University of Pennsylvania
- Division of Hematology/Oncology, Department of Medicine, Lancaster General Hospital
| | - Justine V. Cohen
- Abramson Cancer Center, University of Pennsylvania
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Pennsylvania Hospital
| | - Randall A. Oyer
- Abramson Cancer Center, University of Pennsylvania
- Division of Hematology/Oncology, Department of Medicine, Lancaster General Hospital
| | - Ryan Massa
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, Presbyterian Hospital
| | - Ivan P. Maillard
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | | | - Kara N. Maxwell
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - John P. Reilly
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Peter G. Maslak
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center
| | - Robert H. Vonderheide
- Abramson Cancer Center, University of Pennsylvania
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Parker Institute for Cancer Immunotherapy
| | - Jedd D. Wolchok
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Scott E. Hensley
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania
| | - E. John Wherry
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania
- Parker Institute for Cancer Immunotherapy
| | - Nuala Meyer
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Division of Pulmonary and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
| | - Angela M. DeMichele
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - Santosha A. Vardhana
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Parker Institute for Cancer Immunotherapy
| | - Ronac Mamtani
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - Alexander C. Huang
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania
- Parker Institute for Cancer Immunotherapy
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17
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Triant DA, Le Tourneau JJ, Diesh CM, Unni DR, Shamimuzzaman M, Walsh AT, Gardiner J, Goldkamp AK, Li Y, Nguyen HN, Roberts C, Zhao Z, Alexander LJ, Decker JE, Schnabel RD, Schroeder SG, Sonstegard TS, Taylor JF, Rivera RM, Hagen DE, Elsik CG. Using online tools at the Bovine Genome Database to manually annotate genes in the new reference genome. Anim Genet 2020; 51:675-682. [PMID: 32537769 PMCID: PMC7540445 DOI: 10.1111/age.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/16/2022]
Abstract
With the availability of a new highly contiguous Bos taurus reference genome assembly (ARS-UCD1.2), it is the opportune time to upgrade the bovine gene set by seeking input from researchers. Furthermore, advances in graphical genome annotation tools now make it possible for researchers to leverage sequence data generated with the latest technologies to collaboratively curate genes. For many years the Bovine Genome Database (BGD) has provided tools such as the Apollo genome annotation editor to support manual bovine gene curation. The goal of this paper is to explain the reasoning behind the decisions made in the manual gene curation process while providing examples using the existing BGD tools. We will describe the sources of gene annotation evidence provided at the BGD, including RNA-seq and Iso-Seq data. We will also explain how to interpret various data visualizations when curating gene models, and will demonstrate the value of manual gene annotation. The process described here can be applied to manual gene curation for other species with similar tools. With a better understanding of manual gene annotation, researchers will be encouraged to edit gene models and contribute to the enhancement of livestock gene sets.
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Affiliation(s)
- D. A. Triant
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | | | - C. M. Diesh
- Department of BioengineeringUniversity of California, BerkeleyBerkeleyCA94720USA
| | - D. R. Unni
- Division of Environmental Genomics and Systems BiologyLawrence Berkeley National LaboratoryBerkeleyCA94608USA
| | - M. Shamimuzzaman
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - A. T. Walsh
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - J. Gardiner
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - A. K. Goldkamp
- Department of Animal and Food SciencesOklahoma State UniversityStillwaterOK74078USA
| | - Y. Li
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - H. N. Nguyen
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
| | - C. Roberts
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - Z. Zhao
- Division of Plant SciencesUniversity of MissouriColumbiaMO65211USA
| | - L. J. Alexander
- USDA‐ARS‐PA‐Livestock & Range Research LabMiles CityMT59301USA
| | - J. E. Decker
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
| | - R. D. Schnabel
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
| | - S. G. Schroeder
- USDA‐ARS Animal Genomics and Improvement LabBeltsvilleMD20705USA
| | | | - J. F. Taylor
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - R. M. Rivera
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
| | - D. E. Hagen
- Department of Animal and Food SciencesOklahoma State UniversityStillwaterOK74078USA
| | - C. G. Elsik
- Division of Animal SciencesUniversity of MissouriColumbiaMO65211USA
- MU Institute for Data Science and InformaticsUniversity of MissouriColumbiaMO65211USA
- Division of Plant SciencesUniversity of MissouriColumbiaMO65211USA
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18
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Paterson C, Roberts C, Toohey K, McKie A. Prostate Cancer Prehabilitation and the Importance of Multimodal Interventions for Person-centred Care and Recovery. Semin Oncol Nurs 2020; 36:151048. [PMID: 32709485 DOI: 10.1016/j.soncn.2020.151048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Prostate cancer is the second most commonly diagnosed cancer globally. Cancer prehabilitation is defined as a process on the continuum of care that occurs between the time of a cancer diagnosis and the beginning of acute treatment. This article will discuss the importance of prostate cancer prehabilitation interventions in optimising physical and psychological recovery to enhance person-centred care. DATA SOURCES Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, professional websites, and grey literature were searched using Google Scholar. CONCLUSION Prehabilitation in cancer care aims to enhance perioperative care and recovery. An emerging field of research suggests that the preoperative period may be physically and psychologically salient to introduce modifiable self-management behaviours to optimise overall recovery. IMPLICATIONS FOR NURSING PRACTICE Prostate cancer specialist nurses provide the hub of person-centred care across the entire cancer care continuum embedded within the multidisciplinary team. Individually tailored interventions such as exercise and pelvic floor muscle training programmes, nutritional advice, anxiety and depression reduction, and sexual well-being interventions should be considered in the prehabilitation phase of the cancer care continuum.
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Affiliation(s)
- C Paterson
- School of Nursing, Midwifery, and Public Health, University of Canberra, Canberra, ACT, Australia; ACT Health and the Canberra Health Services, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia.
| | - C Roberts
- School of Nursing, Midwifery, and Public Health, University of Canberra, Canberra, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia
| | - K Toohey
- ACT Health and the Canberra Health Services, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - A McKie
- School of Nursing, Midwifery, and Public Health, University of Canberra, Canberra, ACT, Australia; School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
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19
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Paterson C, Kozlovskaia M, Turner M, Strickland K, Roberts C, Ogilvie R, Pranavan G, Craft P. Identifying the supportive care needs of men and women affected by chemotherapy-induced alopecia? A systematic review. J Cancer Surviv 2020; 15:14-28. [PMID: 32683651 DOI: 10.1007/s11764-020-00907-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/11/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically evaluate evidence regarding the unmet supportive care needs of men and women affected by chemotherapy-induced alopecia (CIA) to inform clinical practice guidelines. METHODS We performed a review of CINAHL, MEDLINE, PsychINFO, Scopus, the Cochrane Library (CCRT and CDSR) controlled trial databases and clinicaltrials.gov from January 1990 to June 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Twenty-seven publications were selected for inclusion in this analysis. RESULTS Included reports used qualitative (ten) and quantitative (17) studies. Across these studies men and women reported the major impact that CIA had on their psychological well-being, quality of life and body image. Hair loss had a negative impact irrespective of gender, which resulted in feelings of vulnerability and visibility of being a "cancer patient". Men and women described negative feelings, often similar, related to CIA with a range of unmet supportive care needs. CONCLUSIONS Some patients are not well-prepared for alopecia due to a lack of information and resources to reduce the psychological burden associated with CIA. Hair loss will affect each patient and their family differently, therefore, intervention and support must be tailored at an individual level of need to optimise psychological and physical well-being and recovery. IMPLICATIONS FOR CANCER SURVIVORS People affected by CIA may experience a range of unmet supportive care needs, and oncology doctors and nurses are urged to use these findings in their everyday consultations to ensure effective, person-centred care and timely intervention to minimise the sequalae associated with CIA.
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Affiliation(s)
- C Paterson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia.
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia.
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia.
- Robert Gordon University, Aberdeen, Scotland.
| | - M Kozlovskaia
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - M Turner
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
| | - K Strickland
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - C Roberts
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia
| | - R Ogilvie
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra ACT, Canberra, 2601, Australia
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- SYNERGY Nursing & Midwifery, Research Centre, ACT Health Directorate, Canberra Hospital, Canberra, Australia
| | - G Pranavan
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
| | - P Craft
- Australian Capital Territory (ACT) Health & Canberra Health Services, Canberra, Australia
- Australian National University, Canberra, Australia
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20
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Roberts C, Paterson C. An Exploration of the Rs of Radiobiology in Prostate Cancer. Semin Oncol Nurs 2020; 36:151054. [PMID: 32669231 DOI: 10.1016/j.soncn.2020.151054] [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: 11/29/2022]
Abstract
OBJECTIVES To explore the four Rs of radiobiology (Repair, Reoxygenation, Reassortment, and Repopulation) as a means to understand the effects of ionising radiation on biological tissue and subsequently as the basis for conventional fractionated treatment schedules. These radiobiological principles will form a rationale for combined regimens in prostate cancer treatment involving androgen deprivation therapy and radiation therapy and the associated toxicities of this approach will be discussed. DATA SOURCES Electronic databases including CINAHL, MEDLINE, Scopus, professional websites, books and grey literature were searched using Google Scholar. CONCLUSION It is important for nurses to understand the four Rs of radiobiology to grasp the effects of ionising radiation on biological tissue as the basis for conventional fractionated treatment schedules in prostate cancer. Men can experience a sequalae of physical and psychological side effects of treatment that can negatively impact quality of life. IMPLICATIONS FOR NURSING PRACTICE Men can experience a range of unmet supportive care needs particularly related to informational, sexual, and psychological needs. For men affected by prostate cancer opting for radiation therapy (+/-) androgen deprivation therapy, nurses should ask targeted questions based on the Common Terminology Criteria for Adverse Events related to urinary and bowel function, potency and fatigue, and sexual health. We also recommend the use of holistic needs assessments to tailor self-management care plans. Evidence-based self-management advice should be provided in response to each man's unique needs.
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Affiliation(s)
- C Roberts
- Faculty of Health, University of Canberra, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, ACT, Australia.
| | - C Paterson
- Faculty of Health, University of Canberra, Canberra ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia; School of Nursing, Midwifery and Public Health, University of Canberra, ACT, Australia; ACT Synergy Nursing and Midwifery Research Centre, Canberra Hospital, ACT, Australia
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21
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Abbate A, Trankle CR, Lipinski MJ, Kadariya D, Canada JM, Carbone S, Buckley LF, Appleton D, Wohlford GF, Medina De Chazal H, Chiabrando JG, Roberts C, Turlington JS, Abouzaki NA, Van Tassell B. 5233Interleukin-1 blockade with Anakinra in ST-segment elevation acute myocardial infarction: Results from the VCUART3 study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
ST-segment elevation myocardial infarction (STEMI) is associated with an intense inflammatory response that predicts an increased risk of death and heart failure (HF). In the current study we tested whether anakinra, a recombinant Interleukin-1 (IL-1) receptor antagonist, given once daily (standard dose) or twice daily reduced systemic inflammation in patients with STEMI.
Methods
We enrolled patients with STEMI within 12 hours of presentation at 3 sites. After revascularization, patients were randomly assigned to receive anakinra 100 mg twice daily, anakinra 100 mg once daily alternating with placebo once daily every 12 hours, or placebo twice daily, for 14 days in a 1:1:1 ratio. The primary efficacy outcome was the area under the curve for C-reactive protein levels (CRP-AUC) using a high-sensitivity assay at 14 days comparing anakinra (both arms) versus placebo followed by a comparison between each of the anakinra arms with placebo. Two pre-specified exploratory clinical efficacy endpoints, adjudicated by a blinded event committee, were assessed: a composite endpoint of all-cause death for any reason or incidence of HF (defined as new-onset HF requiring hospitalization or a new prescription of a loop diuretic, D+HF) and a composite endpoint of death and HF hospitalization (D+HHF) at 1 year. Data are expressed as median and interquartile range or number and percentage. Kaplan-Meyer survival curves were compared using Log-rank test (Mantel-Cox). (ClinicalTrials.gov number, NCT01950299)
Results
Of 311 patients screened, 99 subjects (80 [81%] males, 57 [58%] Caucasians, 55 [49–62] years of age) were randomly assigned to anakinra twice daily (N=31), anakinra once daily (N=33) or placebo (N=35). There were no significant imbalances in the demographic characteristics between groups (all P>0.05). The CRP-AUC was significantly lower in the anakinra group than in the placebo group (67 [39–120] versus 214 [131–394] mg/dl, P<0.001; and P<0.001 for each anakinra arm versus placebo separately, without significant differences between the two anakinra arms, P=0.41). Treatment with anakinra was associated with a significant reduction versus placebo in the incidence of D+HF (6/64 [9.4%] versus 9/35 [25.7%], P=0.046), and of D+HHF (0/64 [0] versus 4/35 [11.4%], P=0.011), without any significant difference between the two anakinra arms. Anakinra was not associated with any treatment-related serious adverse events, nor with excess infections compared with placebo (14.1% vs 14.3%, P=0.87).
Conclusions
Among patients with STEMI, IL-1 blockade significantly reduced the systemic inflammatory response compared with placebo, without any significant difference between standard or high dose regimens. Prespecified exploratory analyses on clinical endpoints demonstrate reduced incidence of HF and reduced HF hospitalizations, supporting the concept of beneficial effects with IL-1 blockade in patients with acute myocardial infarction.
Acknowledgement/Funding
Funded by NHLBI 1R34HL121402; Drug supply from Swedish Orphan Biovitrum
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Affiliation(s)
- A Abbate
- Virginia Commonwealth University, Richmond, United States of America
| | - C R Trankle
- Virginia Commonwealth University, Richmond, United States of America
| | - M J Lipinski
- Medstar Research Institute, Washington, United States of America
| | - D Kadariya
- Medstar Research Institute, Washington, United States of America
| | - J M Canada
- Medstar Research Institute, Washington, United States of America
| | - S Carbone
- Medstar Research Institute, Washington, United States of America
| | - L F Buckley
- Brigham and Womens Hospital, Boston, United States of America
| | - D Appleton
- Virginia Cardiovascular Specialists, Richmond, United States of America
| | - G F Wohlford
- Virginia Commonwealth University, Richmond, United States of America
| | | | - J G Chiabrando
- Virginia Commonwealth University, Richmond, United States of America
| | - C Roberts
- Virginia Commonwealth University, Richmond, United States of America
| | - J S Turlington
- Virginia Commonwealth University, Richmond, United States of America
| | - N A Abouzaki
- Virginia Commonwealth University, Richmond, United States of America
| | - B Van Tassell
- Virginia Commonwealth University, Richmond, United States of America
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Roberts C, Bornais C, Wheatley-Price P, Asmis T, Nicholas G, Barton G. MA22.07 A Culturally Safe Advocacy Model of Care for Inuit Cancer Patients and Their Families. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bornais C, Roberts C, Wheatley-Price P, Asmis T, Dennie C, Maziak D, Nicholas G, Barton G, Alie E, Greene T. EP1.11-01 Lung Cancer Screening and Canada’s Inuit: A Missed Opportunity. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Crespo F, White J, Roberts C. Revisiting the tuberculosis and leprosy cross-immunity hypothesis: Expanding the dialogue between immunology and paleopathology. Int J Paleopathol 2019; 26:37-47. [PMID: 31185376 DOI: 10.1016/j.ijpp.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 05/08/2019] [Accepted: 05/26/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Our primary objective is to re-visit the tuberculosis and leprosy cross-immunity. hypothesis through the careful integration of immunology and paleopathology. METHODS Using an integrated theoretical analysis that evaluates clinical literature on human innate immunological responses, paleomicrobiology, bioarchaeology, and paleopathology, we develop a multifactorial model. RESULTS Past populations do not represent homogeneous immunological landscapes, and therefore it is likely that leprosy in Medieval Europe did not uniformly decline due to cross-immunity. CONCLUSIONS We recommend that bioarchaeological reconstructions of past disease experience take into consideration models that include variation in immune function based on past environments and social contexts. This provides a unique opportunity to conduct comprehensive analyses on complex immunological processes. SIGNIFICANCE Extrapolating results from experimental immunology to larger populations elucidates complexities of disease cross-immunity and highlights the importance of synthesizing archaeological, social, paleopathological and biological data as a means of understanding disease in the past. LIMITATIONS All extrapolations from data produced from in vitro studies to past populations, using living donors, pose significant limitations where, among other factors, the full reconstruction of past environmental and social contexts can frequently be sparse or incomplete. SUGGESTIONS FOR FUTURE RESEARCH To reduce the limitations of integrating experimental immunology with bioarchaeological reconstructions (i.e. how to use skeletal samples to reconstruct inflammatory phenotypes), we propose that osteoimmunology, or the study of the interplay between immune cells and bone cells, should be considered a vital discipline and perhaps the foundation for the expansion of paleoimmunology.
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Affiliation(s)
- Fabian Crespo
- Department of Anthropology, University of Louisville, Louisville, KY, 40292, USA.
| | - Jacob White
- Department of Anthropology, University of Louisville, Louisville, KY, 40292, USA
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Roberts C. Author Prop: Assisting the Creative Process with an Automated Intelligent Cognitive Prop for Writers. EAI Endorsed Transactions on Creative Technologies 2019. [DOI: 10.4108/eai.30-7-2019.162945] [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: 11/05/2022] Open
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Kumar J, Chudasama D, Roberts C, Kubista M, Sjöback R, Chatterjee J, Anikin V, Karteris E, Hall M. Detection of Abundant Non-Haematopoietic Circulating Cancer-Related Cells in Patients with Advanced Epithelial Ovarian Cancer. Cells 2019; 8:cells8070732. [PMID: 31319587 PMCID: PMC6678489 DOI: 10.3390/cells8070732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/05/2019] [Accepted: 07/15/2019] [Indexed: 12/17/2022] Open
Abstract
: Background: Current diagnosis and staging of advanced epithelial ovarian cancer (aEOC) has important limitations and better biomarkers are needed. We investigate the performance of non-haematopoietic circulating cells (CCs) at the time of disease presentation and relapse. Methods: Venous blood was collected prospectively from 37 aEOC patients and 39 volunteers. CCs were evaluated using ImageStream TechnologyTM and specific antibodies to differentiate epithelial cells from haematopoetic cells. qRT-PCR from whole blood of relapsed aEOC patients was carried out for biomarker discovery. Results: Significant numbers of CCs (CK+/WT1+/CD45-) were identified, quantified and characterised from aEOC patients compared to volunteers. CCs are abundant in women with newly diagnosed aEOC, prior to any treatment. Evaluation of RNA from the CCs in relapsed aEOC patients (n = 5) against a 79-gene panel revealed several differentially expressed genes compared to volunteers (n = 14). Size differentiation of CCs versus CD45+ haematopoietic cells was not reliable. Conclusion: CCs of non-haematopoetic origin are prevalent, particularly in patients with newly diagnosed aEOC. Exploiting a CC-rich population in aEOC patients offers insights into a part of the circulating microenvironment.
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Affiliation(s)
- Juhi Kumar
- Department Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
| | - Dimple Chudasama
- Department Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
| | | | - Mikael Kubista
- TATAA Biocenter, 411 03 Göteborg, Sweden
- Laboratory of Gene Expression, Institute of Biotechnology CAS, v.v.i., 252 50 Vestec, Czech Republic
| | | | - Jayanta Chatterjee
- Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Vladimir Anikin
- Department Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Division of Thoracic Surgery, The Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, London UB9 6JH, UK
- Department of Oncology and Reconstructive Surgery, Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Emmanouil Karteris
- Department Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK.
| | - Marcia Hall
- Department Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK.
- Mount Vernon Cancer Centre, Middlesex HA6 2RN, UK.
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Brierley CK, Staves J, Roberts C, Johnson H, Vyas P, Goodnough LT, Murphy MF. The effects of monoclonal anti-CD47 on RBCs, compatibility testing, and transfusion requirements in refractory acute myeloid leukemia. Transfusion 2019; 59:2248-2254. [PMID: 31183877 DOI: 10.1111/trf.15397] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND CD47 is a novel therapeutic target in the treatment of solid-organ and hematologic malignancies. CD47 is also expressed on RBCs. Here, we report our experience of the RBC effects and the impact on blood bank testing and transfusion management in a Phase 1 trial of the humanized anti-CD47 monoclonal antibody Hu5F9-G4 in relapsed or primary refractory acute myeloid leukemia (AML) (NCT02678338). STUDY DESIGN AND METHODS Nineteen patients with relapsed or primary refractory AML treated across five UK centers were included for analysis. Patients received escalating doses of Hu5F9-G4. Serial laboratory data were collected to evaluate impact on hemoglobin (Hb), markers of hemolysis (bilirubin, lactate dehydrogenase, reticulocyte count), transfusion requirements, and blood compatibility testing. RESULTS A decline in Hb was observed with drug administration (median Hb change, -1.0 g/dL; range, 0.4-1.6) with associated increase in transfusion requirements. Patients responded to transfusion with a median Hb increment per unit of 1.0 g/dL. RBC agglutination was seen in all cases without associated change in Hb, lactate dehydrogenase, bilirubin, or reticulocyte count. Nine of 19 (47%) patients developed a newly positive antibody screen with a pan-agglutinin identified in plasma. Invalid ABO blood grouping occurred in 4 of 12 (33%) non-group O patients due to anomalous reactivity in the reverse ABO-type results. CONCLUSIONS Treatment with Hu5F9-G4 in patients with AML resulted in an Hb decline and increased transfusion requirements. Problems with ABO blood typing and compatibility testing were widely observed and should be expected by centers treating recipients of Hu5F9-G4.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Anemia/chemically induced
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/pharmacology
- Blood Grouping and Crossmatching
- Blood Transfusion
- CD47 Antigen/antagonists & inhibitors
- Diagnostic Errors/prevention & control
- Erythrocytes/drug effects
- Humans
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/therapy
- Middle Aged
- Neoplasm Recurrence, Local/therapy
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Affiliation(s)
- C K Brierley
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- MRC Molecular Haematology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - J Staves
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - C Roberts
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - H Johnson
- Oncology Clinical Trials Office (OCTO), Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - P Vyas
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- MRC Molecular Haematology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - L T Goodnough
- Departments of Pathology and Medicine, Stanford University, Stanford, California
| | - M F Murphy
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
- National Health Service Blood and Transplant, Oxford, United Kingdom
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de Wit M, Cooper C, Tugwell P, Bere N, Kirwan J, Conaghan PG, Roberts C, Aujoulat I, Al-Daghri N, Araujo de Carvalho I, Barker M, Bedlington N, Brandi ML, Bruyère O, Burlet N, Halbout P, Hiligsmann M, Jiwa F, Kanis JA, Laslop A, Lawrence W, Pinto D, Prieto Yerro C, Rabenda V, Rizzoli R, Scholte-Voshaar M, Vlaskovska M, Reginster JY. Practical guidance for engaging patients in health research, treatment guidelines and regulatory processes: results of an expert group meeting organized by the World Health Organization (WHO) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res 2019; 31:905-915. [PMID: 30993659 PMCID: PMC6589151 DOI: 10.1007/s40520-019-01193-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/03/2019] [Indexed: 12/27/2022]
Abstract
There is increasing emphasis on patient-centred research to support the development, approval and reimbursement of health interventions that best meet patients' needs. However, there is currently little guidance on how meaningful patient engagement may be achieved. An expert working group, representing a wide range of stakeholders and disciplines, was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the World Health Organization (WHO). Through a structured, collaborative process the group generated practical guidance to facilitate optimal patient engagement in clinical development and regulatory decisions. Patient engagement is a relational process. The principles outlined in this report were based on lessons learned through applied experience and on an extensive dialogue among the expert participants. This practice guidance forms a starting point from which tailoring of the approach to suit different chronic diseases may be undertaken.
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Affiliation(s)
- Maarten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Nathalie Bere
- Public Engagement Department, European Medicines Agency, 30 Churchill Place, Canary Wharf, London, E14 5EU, UK
| | - John Kirwan
- Emeritus Professor of Rheumatic Diseases, University of Bristol, Bristol, UK
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Charlotte Roberts
- International Consortium for Health Outcomes Measurement, Hamilton House, 4 Mabledon Place, Bloomsbury, London, WC1H 9BB, UK
| | - Isabelle Aujoulat
- Université Catholique de Louvain, Institute of Health & Society, Brussels, Belgium
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Islene Araujo de Carvalho
- Department of Ageing and Life Course, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Nicola Bedlington
- European Patients' Forum, Chaussée d'Etterbeek 180, Etterbeek, 1040, Brussels, Belgium
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
- Fondazione F.I.R.M.O., Florence, Italy
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - Nansa Burlet
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
| | - Philippe Halbout
- International Osteoporosis Foundation, 9 Rue Juste-Olivier, 1260, Nyon, Switzerland
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | | | - John A Kanis
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Daniel Pinto
- Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, USA
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Concepción Prieto Yerro
- Spanish Agency for Drugs and Medical Devices, Calle Campezo 1, Building 8, 28022, Madrid, Spain
| | - Véronique Rabenda
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - René Rizzoli
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Marieke Scholte-Voshaar
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology, Medical University Sofia, 2, Zdrave Str, 1431, Sofia, Bulgaria
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium.
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia.
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium.
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Old GH, Naden PS, Harman M, Bowes MJ, Roberts C, Scarlett PM, Nicholls DJE, Armstrong LK, Wickham HD, Read DS. Using dissolved organic matter fluorescence to identify the provenance of nutrients in a lowland catchment; the River Thames, England. Sci Total Environ 2019; 653:1240-1252. [PMID: 30759564 DOI: 10.1016/j.scitotenv.2018.10.421] [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] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/20/2018] [Accepted: 10/30/2018] [Indexed: 06/09/2023]
Abstract
Catchment based solutions are being sought to mitigate water quality pressures and achieve multiple benefits but their success depends on a sound understanding of catchment functioning. Novel approaches to monitoring and data analysis are urgently needed. In this paper we explore the potential of river water fluorescence at the catchment scale in understanding nutrient concentrations, sources and pathways. Data were collected from across the River Thames basin from January 2012 to March 2015. Analysing emission excitation matrices (EEMs) using both PARAFAC and optimal area averaging produced consistent results for humic-like component 1 and tryptophan-like component 4 in the absence of a subset of samples that exhibited an unusual peak; illustrating the importance of inspecting the entire EEM before using peak averaging methods. Strong relationships between fluorescence components and dissolved organic carbon (DOC), soluble reactive phosphorus (SRP), and ammonium clearly demonstrated its potential, in this study basin, as a field based surrogate for nutrients. Analysing relationships between fluorescence, catchment characteristics and boron from across the basin enabled new insights into the provenance of nutrients. These include evidence for diffuse sources of DOC from near surface hydrological pathways (i.e. soil horizons); point source inputs of nutrients from sewage effluent discharges; and diffuse contributions of nutrients from agriculture and/or sewage (e.g. septic tanks). The information gained by broad scale catchment wide monitoring of fluorescence could support catchment managers in (a) prioritising subcatchments for nutrient mitigation; (b) providing information on relative nutrient source contributions; and (c) providing evidence of the effectiveness of investment in pollution mitigation measures. The collection of high resolution fluorescence data at the catchment scale and, in particular, over shorter event timescales would complement broad scale assessments by enhancing our hydro-biogeochemical process understanding.
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Affiliation(s)
- G H Old
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK.
| | - P S Naden
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - M Harman
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - M J Bowes
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - C Roberts
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - P M Scarlett
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - D J E Nicholls
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - L K Armstrong
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - H D Wickham
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
| | - D S Read
- Centre for Ecology & Hydrology, Benson Lane, Crowmarsh Gifford, Wallingford, Oxfordshire OX10 8BB, UK
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Bedient C, Rodriguez D, Sidell N, Roberts C, Schutte S. Alterations in the invasive properties of peripheral blood monocytes from patients with endometriosis. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4333.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Walker VA, Tranquille CA, Harris P, Roberts C, McEwen J, Murray RC. Do back kinematics of elite horses change over consecutive days of jumping the same course? PFERDEHEILKUNDE 2019. [DOI: 10.21836/pem20190306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Sparacello VS, Rossi S, Pettitt P, Roberts C, Riel-Salvatore J, Formicola V. New insights on Final Epigravettian funerary behavior at Arene Candide Cave (Western Liguria, Italy). J Anthropol Sci 2018; 96:161-184. [PMID: 30036182 DOI: 10.4436/jass.96003] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We gained new insights on Epigravettian funerary behavior at the Arene Candide cave through the osteological and spatial analysis of the burials and human bone accumulations found in the cave during past excavations. Archaeothanathological information on the human skeletal remains was recovered from diaries, field pictures and notes, and data from recent excavations was integrated. The secondary deposits have traditionally been interpreted as older burials that were disturbed to make space for new inhumations. Our results suggest that those disturbances were not casual: older burials were intentionally displaced to bury younger inhumations. Subsequently, some skeletal elements, especially crania, were arranged around the new burial; these were often placed within stone niches. Based on the composition of some clusters, which contain the bones of two individuals displaced together, it is possible that a double burial composed of two adults was originally present at the site. This would be a burial type that had not been recognized at Arene Candide until now. Strikingly, this potential double burial contained an individual showing pathological bowing of the limbs, a finding which is not infrequent in skeletons from Gravettian and Epigravettian multiple burials. In addition, the crania and other skeletal elements derived from this burial were intentionally placed around a new inhumation, whose skeleton possibly shows a milder form of the same disease (possibly hereditary rickets). This and other observations suggest that the five individuals belonging to the second phase of this "cemetery" (AMS dates spanning 12,030 -11,180 cal BP) might have been buried over a relatively brief time span. Our study demonstrated similar behaviors in the first phase of mortuary use of the cave (12,820-12,420 cal BP), indicating a remarkable persistence in Final Epigravettian funerary models despite their archaeologically apparent rarity and intermittent nature.
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Affiliation(s)
- Vitale Stefano Sparacello
- Univ. Bordeaux, CNRS, PACEA, UMR 5199, Batiment B8, Allée Geoffroy Saint Hilaire, CS 50023, 33615 Pessac cedex; Department of Archaeology, Durham University, Durham DH1 3LE, United Kingdom,
| | - Stefano Rossi
- Soprintendenza Archeologia Belle Arti e Paesaggio per la cittá metropolitana di Genova e le province di Imperia, La Spezia e Savona, Via Balbi, 10, 16126 Genova, Italy; DISTAV, Universitá di Genova, Corso Europa, 26, 16132 Genova, Italy
| | - Paul Pettitt
- Department of Archaeology, Durham University, Durham DH1 3LE, United Kingdom
| | - Charlotte Roberts
- Department of Archaeology, Durham University, Durham DH1 3LE, United Kingdom
| | - Julien Riel-Salvatore
- Département d'Anthropologie, Université de Montréal, Pavillon Lionel-Groulx, 3150 rue Jean-Brillant, H3T 1N8 Montréal (QC), Canada
| | - Vincenzo Formicola
- Department of Biology, Universitá di Pisa, Via Derna 1, 56126 Pisa, Italy
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Verberne WR, Das-Gupta Z, Allegretti AS, Bart HAJ, van Biesen W, García-García G, Gibbons E, Parra E, Hemmelder MH, Jager KJ, Ketteler M, Roberts C, Al Rohani M, Salt MJ, Stopper A, Terkivatan T, Tuttle KR, Yang CW, Wheeler DC, Bos WJW. Development of an International Standard Set of Value-Based Outcome Measures for Patients With Chronic Kidney Disease: A Report of the International Consortium for Health Outcomes Measurement (ICHOM) CKD Working Group. Am J Kidney Dis 2018; 73:372-384. [PMID: 30579710 DOI: 10.1053/j.ajkd.2018.10.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/14/2018] [Indexed: 12/14/2022]
Abstract
Value-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients relative to the cost of obtaining those outcomes. To support the shift toward value-based health care in chronic kidney disease (CKD), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international working group of health professionals and patient representatives to develop a standardized minimum set of patient-centered outcomes targeted for clinical use. The considered outcomes and patient-reported outcome measures were generated from systematic literature reviews. Feedback was sought from patients and health professionals. Patients with very high-risk CKD (stages G3a/A3 and G3b/A2-G5, including dialysis, kidney transplantation, and conservative care) were selected as the target population. Using an online modified Delphi process, outcomes important to all patients were selected, such as survival and hospitalization, and to treatment-specific subgroups, such as vascular access survival and kidney allograft survival. Patient-reported outcome measures were included to capture domains of health-related quality of life, which were rated as the most important outcomes by patients. Demographic and clinical variables were identified to be used as case-mix adjusters. Use of these consensus recommendations could enable institutions to monitor, compare, and improve the quality of their CKD care.
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Affiliation(s)
| | - Zofia Das-Gupta
- International Consortium for Health Outcomes Measurement, London, United Kingdom
| | | | - Hans A J Bart
- patient representative, Dutch Kidney Patients Association (NVN), Bussum, the Netherlands
| | - Wim van Biesen
- Renal Division, Ghent University Hospital, Ghent, Belgium
| | - Guillermo García-García
- University of Guadalajara Health Sciences Center, Hospital Civil de Guadalajara "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico
| | - Elizabeth Gibbons
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (EG)
| | - Eduardo Parra
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Marc H Hemmelder
- Dutch Renal Registry (Renine), Nefrovisie, Utrecht; Medical Center Leeuwarden, Leeuwarden
| | - Kitty J Jager
- ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Markus Ketteler
- Klinikum Coburg, Coburg, Germany; University of Split School of Medicine, Split, Croatia
| | - Charlotte Roberts
- International Consortium for Health Outcomes Measurement, London, United Kingdom
| | | | - Matthew J Salt
- International Consortium for Health Outcomes Measurement, London, United Kingdom
| | - Andrea Stopper
- European Renal Care Providers Association, Brussels, Belgium
| | | | - Katherine R Tuttle
- Providence Medical Research Center, Providence Health Care Kidney Research Institute, Nephrology Division and Institute for Translational Health Sciences, University of Washington, Spokane, WA
| | - Chih-Wei Yang
- Chang Gung Memorial Hospital, Linkou; Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - David C Wheeler
- Centre for Nephrology, University College London, London, United Kingdom
| | - Willem Jan W Bos
- St Antonius Hospital, Nieuwegein; Leiden University Medical Center, Leiden, the Netherlands
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Murray JK, Casey RA, Gale E, Buffington CAT, Roberts C, Kinsman RH, Gruffydd-Jones TJ. Cohort Profile: The 'Bristol Cats Study' (BCS)-a birth cohort of kittens owned by UK households. Int J Epidemiol 2018. [PMID: 28645213 DOI: 10.1093/ije/dyx066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- J K Murray
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - R A Casey
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK.,The Royal Veterinary College, Hawkshead Lane, North Mymms, Herts, AL9 7TA, UK
| | - E Gale
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK.,Ceva Animal Health Ltd, Unit 3 Anglo Office Park, White Lion Road, Amersham, Bucks, HP7 9FB, UK
| | | | - C Roberts
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - R H Kinsman
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK.,The Royal Veterinary College, Hawkshead Lane, North Mymms, Herts, AL9 7TA, UK
| | - T J Gruffydd-Jones
- School of Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
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Abbas M, de Kraker MEA, Aghayev E, Astagneau P, Aupee M, Behnke M, Bull A, Choi HJ, de Greeff SC, Elgohari S, Gastmeier P, Harrison W, Koek MBG, Lamagni T, Limon E, Løwer HL, Lyytikäinen O, Marimuthu K, Marquess J, McCann R, Prantner I, Presterl E, Pujol M, Reilly J, Roberts C, Segagni Lusignani L, Si D, Szilágyi E, Tanguy J, Tempone S, Troillet N, Worth LJ, Pittet D, Harbarth S. Impact of participation in a surgical site infection surveillance network: results from a large international cohort study. J Hosp Infect 2018; 102:267-276. [PMID: 30529703 DOI: 10.1016/j.jhin.2018.12.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Surveillance of surgical site infections (SSIs) is a core component of effective infection control practices, though its impact has not been quantified on a large scale. AIM To determine the time-trend of SSI rates in surveillance networks. METHODS SSI surveillance networks provided procedure-specific data on numbers of SSIs and operations, stratified by hospitals' year of participation in the surveillance, to capture length of participation as an exposure. Pooled and procedure-specific random-effects Poisson regression was performed to obtain yearly rate ratios (RRs) with 95% confidence intervals (CIs), and including surveillance network as random intercept. FINDINGS Of 36 invited networks, 17 networks from 15 high-income countries across Asia, Australia and Europe participated in the study. Aggregated data on 17 surgical procedures (cardiovascular, digestive, gynaecological-obstetrical, neurosurgical, and orthopaedic) were collected, resulting in data concerning 5,831,737 operations and 113,166 SSIs. There was a significant decrease in overall SSI rates over surveillance time, resulting in a 35% reduction at the ninth (final) included year of surveillance (RR: 0.65; 95% CI: 0.63-0.67). There were large variations across procedure-specific trends, but strong consistent decreases were observed for colorectal surgery, herniorrhaphy, caesarean section, hip prosthesis, and knee prosthesis. CONCLUSION In this large, international cohort study, pooled SSI rates were associated with a stable and sustainable decrease after joining an SSI surveillance network; a causal relationship is possible, although unproven. There was heterogeneity in procedure-specific trends. These findings support the pivotal role of surveillance in reducing infection rates and call for widespread implementation of hospital-based SSI surveillance in high-income countries.
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Affiliation(s)
- M Abbas
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - M E A de Kraker
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - E Aghayev
- Swiss RDL, Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland; Schulthess Klinik, Zürich, Switzerland
| | - P Astagneau
- Reference Centre for Prevention and Control of Healthcare-associated Infections, APHP University Hospital, Paris, France
| | - M Aupee
- Coordination Center for Prevention and Control of Nosocomial Infections (CClin) Ouest, Rennes, France
| | - M Behnke
- Institute of Hygiene and Environmental Medicine, National Reference Centre for the Surveillance of Nosocomial Infections, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Bull
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Victoria, Australia
| | - H J Choi
- Division of Infectious Diseases, Office of Infection Control, Ewha Woman's University Medical Center, Seoul, Republic of Korea
| | - S C de Greeff
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Control (CIb), Epidemiology and Surveillance (EPI), Bilthoven, the Netherlands
| | - S Elgohari
- National Infection Service, Public Health England, London, UK
| | - P Gastmeier
- Institute of Hygiene and Environmental Medicine, National Reference Centre for the Surveillance of Nosocomial Infections, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - W Harrison
- Welsh Healthcare Associated Infection Programme (WHAIP), Public Health Wales, Cardiff, UK
| | - M B G Koek
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Diseases Control (CIb), Epidemiology and Surveillance (EPI), Bilthoven, the Netherlands
| | - T Lamagni
- National Infection Service, Public Health England, London, UK
| | - E Limon
- VINCat Coordinator Center, Catalan Health Department, University of Barcelona, Barcelona, Spain
| | - H L Løwer
- Norwegian Institute of Public Health, Department of Infectious Disease Epidemiology, Oslo, Norway
| | - O Lyytikäinen
- Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - K Marimuthu
- Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J Marquess
- Epidemiology and Research Unit, Communicable Diseases Branch, Department of Health, Queensland, Australia
| | - R McCann
- Healthcare Associated Infection Unit, Communicable Diseases Control Directorate, Department of Health Western Australia, Australia
| | - I Prantner
- National Center for Epidemiology, Budapest, Hungary
| | - E Presterl
- Medical University of Vienna, Department of Infection Control and Hospital Epidemiology, Vienna, Austria
| | - M Pujol
- VINCat Coordinator Center, Catalan Health Department, University of Barcelona, Barcelona, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - J Reilly
- Healthcare Associated Infection, Antimicrobial Resistance, Decontamination and Infection Control Group, Health Protection Scotland, NHS National Services Scotland, Glasgow, UK; Safeguarding Health Through Infection Prevention (SHIP) Research Group, Glasgow Caledonian University, Glasgow, UK
| | - C Roberts
- Welsh Healthcare Associated Infection Programme (WHAIP), Public Health Wales, Cardiff, UK
| | | | - D Si
- Epidemiology and Research Unit, Communicable Diseases Branch, Department of Health, Queensland, Australia
| | - E Szilágyi
- National Public Health and Medical Officer Service, Budapest, Hungary
| | - J Tanguy
- Coordination Center for Prevention and Control of Nosocomial Infections (CClin) Ouest, Rennes, France
| | - S Tempone
- Healthcare Associated Infection Unit, Communicable Diseases Control Directorate, Department of Health Western Australia, Australia
| | - N Troillet
- Swissnoso, National Center for Infection Prevention, Bern, Switzerland; Service of Infectious Diseases, Central Institute of the Valais Hospital, Sion, Switzerland
| | - L J Worth
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Victoria, Australia; Department of Medicine, University of Melbourne, Victoria, Australia
| | - D Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - S Harbarth
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Patterson F, Roberts C, Hanson MD, Hampe W, Eva K, Ponnamperuma G, Magzoub M, Tekian A, Cleland J. 2018 Ottawa consensus statement: Selection and recruitment to the healthcare professions. Med Teach 2018; 40:1091-1101. [PMID: 30251906 DOI: 10.1080/0142159x.2018.1498589] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Selection and recruitment into healthcare education and practice is a key area of interest for educators with significant developments in research, policy, and practice in recent years. This updated consensus statement, developed through a multi-stage process, examines future opportunities and challenges in selection and recruitment. There is both a gap in the literature around and a compelling case for further theoretical and empirical literature to underpin the development of overall selection philosophes and policies and their enactment. More consistent evidence has emerged regarding the quality of different selection methods. Approaches to selection are context-dependent, requiring the consideration of an institution's philosophy regarding what they are trying to achieve, the communities it purports to serve, along with the system within which they are used. Diversity and globalization issues continue to be critically important topics. Further research is required to explore differential attainment and explain why there are substantial differences in culturally acceptable ways of approaching diversity and widening access. More sophisticated evaluation approaches using multi-disciplinary theoretical frameworks are required to address the issues. Following a discussion of these areas, 10 recommendations are presented to guide future research and practice and to encourage debate between colleagues across the globe.
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Affiliation(s)
- F Patterson
- a Work Psychology Group, Derby United Kingdom of Great Britain and Northern Ireland, UK
| | - C Roberts
- b Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - M D Hanson
- c Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - W Hampe
- d Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Eva
- e Centre for Health Education Scholarship and Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - G Ponnamperuma
- f Centre for Medical Education, Yong Loo Lin School of Medicine, Singapore
| | - M Magzoub
- g Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A Tekian
- h Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois, USA
| | - J Cleland
- i Centre for Healthcare Research and Innovation (CHERI), University of Aberdeen, UK
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Morgan K, Hawkins J, Hallingberg B, Roberts C, Murphy S, Moore G. Energy drink use and health complaints: findings from the 2013/14 HBSC study in Wales. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | - G Moore
- Cardiff University, Cardiff, UK
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Andonian N, Lee CC, Blanchard E, Roberts C, Singh S, Russell M, Bojalian M, Castle SC. GEROFIT PREHABILITATION TO IMPROVE POST-OPERATIVE OUTCOMES IN AN OLDER/AT-RISK POPULATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Andonian
- UCLA, Los Angeles, California, United States
| | - C C Lee
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
| | - E Blanchard
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
| | - C Roberts
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
| | - S Singh
- UCLA Department of Anesthesiology and Perioperative Medicine, Los Angeles, CA, USA; Greater Los Angeles VA Health System, Los Angeles, CA, USA
| | - M Russell
- Greater Los Angeles VA Health System, Los Angeles, CA, USA
| | - M Bojalian
- Greater Los Angeles VA Health System, Los Angeles, CA, USA
| | - S C Castle
- Geriatric Medicine UCLA/Veterans Affairs, Los Angeles, CA, USA
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Walker V, Tranquille C, Harris P, Roberts C, McEwen J, Murray R. Back kinematics at take-off in elite showjumping horses over an upright and parallel-spread fence forming part of a three-fence combination. Comparative Exercise Physiology 2018. [DOI: 10.3920/cep180005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study was to evaluate head, neck and back kinematics during take-off in elite level horses jumping, and to compare these over an upright and parallel spread fence. Ten mixed-breed elite-level showjumping horses were opportunistically evaluated jumping the same 15-fence course (1.35 m) during a British Equestrian Federation World Class Performance three-day training session. Two fences were evaluated using high-speed motion-capture (250 Hz). Head, neck and back kinematics of the horse were determined at take-off, at vertical orientation of leading and trailing third metacarpus/tarsus and as the trailing hindlimb left the floor. Very consistent patterns between all horses over both upright and spread fences were observed in neck-trunk (NT) angle, lumbosacral (LS) angle, the angle of the thoracolumbar (TL) to horizontal and of LS to horizontal. Head-neck (HN), TL angle and distance to fence showed moderate variation between horses. There were no significant differences between fence-type in HN, NT, TL, LS angle or distance to the fence, but TL to the horizontal angle was greater over the spread for all stride phases. LS to the horizontal angle was greater over the upright when the leading forelimb was vertical at take-off and when the trailing hindlimb was vertical at take-off. These findings suggest that elite horses may use some similar strategies to achieve a successful jump. Further understanding regions which are most influenced by velocity, rider, and horse stability could enable us to modify jumping patterns for the performance and welfare of jumping horses.
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Affiliation(s)
- V.A. Walker
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, CB8 7UU, United Kingdom
| | - C.A. Tranquille
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, CB8 7UU, United Kingdom
| | - P. Harris
- Equine Studies Group, WALTHAM Centre for Pet Nutrition, Freeby Lane, Waltham-on-the-Wolds, Leicestershire LE14 4RT, United Kingdom
| | - C. Roberts
- Sidney Sussex College, Cambridge University, Sidney Street, Cambridge, Cambridgeshire CB2 3HU,United Kingdom
| | - J. McEwen
- British Equestrian Federation, Abbey Park, Stareton, Kenilworth, Warwickshire CV8 2RH, United Kingdom
| | - R.C. Murray
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, CB8 7UU, United Kingdom
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Kumar K, Roberts C, Bartle E, Eley DS. Correction to: Testing for medical school selection: What are prospective doctors' experiences and perceptions of the GAMSAT and what are the consequences of testing? Adv Health Sci Educ Theory Pract 2018; 23:547. [PMID: 29435698 DOI: 10.1007/s10459-018-9813-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The wrong acknowledgement and funding information were provided in the original publication.
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Affiliation(s)
- K Kumar
- Prideaux Centre for Research in Health Professions Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - C Roberts
- Sydney Medical School - Northern, The University of Sydney, Sydney, Australia
| | - E Bartle
- School of Dentistry, University of Queensland, Brisbane, Australia
| | - D S Eley
- Office of Medical Education, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Kumar K, Roberts C, Bartle E, Eley DS. Testing for medical school selection: What are prospective doctors' experiences and perceptions of the GAMSAT and what are the consequences of testing? Adv Health Sci Educ Theory Pract 2018; 23:533-546. [PMID: 29388087 DOI: 10.1007/s10459-018-9811-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 01/22/2018] [Indexed: 06/07/2023]
Abstract
Written tests for selection into medicine have demonstrated reliability and there is accumulating evidence regarding their validity, but we know little about the broader impacts or consequences of medical school selection tests from the perspectives of key stakeholders. In this first Australian study of its kind, we use consequential validity as a theoretical lens to examine how medical school students and applicants view and experience the Graduate Medical Schools Admission Test (GAMSAT), and the consequences of testing. Participants (n = 447) were recruited from five graduate-entry medical schools across Australia and a publicly available online test preparation forum. An online survey was used to gather demographic information, and quantitative and qualitative data. Quantitative data were analysed via descriptive statistics and qualitative data were thematically analysed. The findings showed there was a considerable financial burden associated with preparing for and sitting the GAMSAT and moderate agreement regarding the GAMSAT as a fair selection method. The main unintended consequences of using the GAMSAT as a selection tool included barriers related to test affordability and language, and socialisation into the hidden curriculum of medicine. Selection tools such as the GAMSAT have some limitations when the goals are to support equitable participation in medicine and professional identity development. Our study highlights the value interpretive and theoretically-informed research in contributing to the evidence base on medical school selection.
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Affiliation(s)
- K Kumar
- Prideaux Centre for Research in Health Professions Education, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - C Roberts
- Sydney Medical School - Northern, The University of Sydney, Sydney, Australia
| | - E Bartle
- School of Dentistry, University of Queensland, Brisbane, Australia
| | - D S Eley
- Office of Medical Education, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Hughes M, Moore T, Manning J, Wilkinson J, Watson S, Samraj P, Dinsdale G, Roberts C, Rhodes LE, Herrick AL, Murray A. A feasibility study of a novel low-level light therapy for digital ulcers in systemic sclerosis. J DERMATOL TREAT 2018; 30:251-257. [PMID: 29862855 PMCID: PMC6484448 DOI: 10.1080/09546634.2018.1484875] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Locally acting, well-tolerated treatments for systemic sclerosis (SSc) digital ulcers (DUs) are needed. Objectives: Our primary aim was to investigate the safety, feasibility, and tolerability of a novel low-level light therapy (LTTT). A secondary aim was to tentatively assess efficacy. Methods: A custom-built device comprising infrared (850 nm), red (660 nm), and violet (405 nm) LEDs was utilized. DUs were irradiated with 10 J/cm2 twice weekly for 3 weeks, with follow-up at weeks 4 and 8. Any safety concerns were documented. Patient opinion on time to deliver, feasibility, and pain visual analogue score (VAS; 0–100, 100 most severe) was collected. Patient and clinician DU global assessment VAS were documented. DUs were evaluated by laser Doppler perfusion imaging pre- and post-irradiation. Results: In all, 14 DUs in eight patients received a total of 46 light exposures, with no safety concerns. All patients considered LTTT ‘took just the right amount of time’ and was ‘feasible’, with a low associated mean pain VAS of 1.6 (SD: 5.2). Patient and clinician global DC VAS improved during the study (mean change: –7.1 and –5.2, respectively, both p < .001). DU perfusion significantly increased post-irradiation. Conclusions: LTTT for DUs is safe, feasible, and well tolerated. There was an early tentative suggestion of treatment efficacy.
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Affiliation(s)
- M Hughes
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK
| | - T Moore
- b Department of Rheumatology , Salford Royal NHS Foundation Trust , Salford , UK
| | - J Manning
- b Department of Rheumatology , Salford Royal NHS Foundation Trust , Salford , UK
| | - J Wilkinson
- c Research and Development , Salford Royal NHS Foundation Trust , Salford , UK
| | - S Watson
- d Medical Physics Department and University of Manchester , Manchester Academic Health Science Centre , Salford Royal NHS Foundation Trust , UK
| | - P Samraj
- e Medical Physics Department , Salford Royal NHS Foundation Trust , UK
| | - G Dinsdale
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK
| | - C Roberts
- f Centre for Biostatistics , Institute of Population Health, School of Medicine, The University of Manchester , Manchester , UK
| | - L E Rhodes
- g Photobiology Unit, Dermatology Centre, Division of Musculoskeletal and Dermatological Sciences , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK
| | - A L Herrick
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.,h NIHR Manchester Musculoskeletal Biomedical Research Centre , Central Manchester NHS Foundation Trust , Manchester Academic Health Science Centre , UK
| | - A Murray
- a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.,i Photon Science Institute , The University of Manchester , UK
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Thompson A, Roberts C, Edwards A, Morgan J. Outpatient removal of ureteric stents in renal transplant patients improves patient outcomes. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.517] [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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Wreglesworth N, Roberts C, Innominato P. A retrospective review of neutrophil-lymphocyte ratio as a predictive prognostic marker in upper gastrointestinal cancers in three UK hospitals over a nine year period. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hunt KJ, Roberts C, Kirkpatrick C. Taking stock: A systematic review of archaeological evidence of cancers in human and early hominin remains. Int J Paleopathol 2018; 21:12-26. [PMID: 29773338 DOI: 10.1016/j.ijpp.2018.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
This study summarizes data from 154 paleopathological studies documenting 272 archaeologically recovered individuals exhibiting skeletal or soft tissue evidence of cancer (malignant neoplastic disease) between 1.8 million years ago and 1900 CE. The paper reviews and summarizes the temporal, spatial and demographic distribution of the evidence and the methods used to provide the cancer diagnoses. Metastasis to bone is the most widely reported evidence (n = 161), followed by multiple myeloma (n = 55). In the dataset, males were represented more than females (M = 127, F = 94), and middle-adults (35-49) and old-adults (50+) were represented most among age groups (MA = 77, OA = 66). The majority of the evidence comes from Northern Europe (n = 51) and Northern Africa (n = 46). The data are summarized in the Cancer Research in Ancient Bodies (CRAB) Database, a growing online resource for future paleo-oncological research. This systematic review contributes to broader studies of malignant neoplastic disease in antiquity; it provides an overview of paleo-oncological data, discusses the many practical and methodological challenges of paleo-oncological research, and dispels presumptions about cancer's rarity in the past.
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Affiliation(s)
- Kathryn J Hunt
- Paleo-Oncology Research Organization; 106 Group, United States.
| | | | - Casey Kirkpatrick
- Western Ontario University, Canada; Paleo-Oncology Research Organization, United States
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Hall M, Chudasama D, Roberts C, Stone N, Vardaki M, Urnowitz H, Schuetz E, Beck J, Karteris E. Applications of liquid biopsies as prognostic markers in patients (pts) with advanced ovarian cancer (AOC) on metronomic cyclophosphamide (MCy) with or without nintedanib (N) (Trans METRO-BIBF). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e24065] [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: 11/20/2022] Open
Affiliation(s)
- Marcia Hall
- Mount Vernon Cancer Centre, Middlesex, United Kingdom
| | | | | | - Nick Stone
- The University of Exeter Mail Room,, Exeter, United Kingdom
| | - Martha Vardaki
- The University of Exeter Mail Room,, Exeter, United Kingdom
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Moorhouse HL, Read DS, McGowan S, Wagner M, Roberts C, Armstrong LK, Nicholls DJE, Wickham HD, Hutchins MG, Bowes MJ. Characterisation of a major phytoplankton bloom in the River Thames (UK) using flow cytometry and high performance liquid chromatography. Sci Total Environ 2018; 624:366-376. [PMID: 29258037 DOI: 10.1016/j.scitotenv.2017.12.128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
Recent river studies have observed rapid phytoplankton dynamics, driven by diurnal cycling and short-term responses to storm events, highlighting the need to adopt new high-frequency characterisation methods to understand these complex ecological systems. This study utilised two such analytical methods; pigment analysis by high performance liquid chromatography (HPLC) and cell counting by flow cytometry (FCM), alongside traditional chlorophyll spectrophotometry and light microscopy screening, to characterise the major phytoplankton bloom of 2015 in the River Thames, UK. All analytical techniques observed a rapid increase in chlorophyll a concentration and cell abundances from March to early June, caused primarily by a diatom bloom. Light microscopy identified a shift from pennate to centric diatoms during this period. The initial diatom bloom coincided with increased HPLC peridinin concentrations, indicating the presence of dinoflagellates which were likely to be consuming the diatom population. The diatom bloom declined rapidly in early June, coinciding with a storm event. There were low chlorophyll a concentrations (by both HPLC and spectrophotometric methods) throughout July and August, implying low biomass and phytoplankton activity. However, FCM revealed high abundances of pico-chlorophytes and cyanobacteria through July and August, showing that phytoplankton communities remain active and abundant throughout the summer period. In combination, these techniques are able to simultaneously characterise a wider range of phytoplankton groups, with greater certainty, and provide improved understanding of phytoplankton functioning (e.g. production of UV inhibiting pigments by cyanobacteria in response to high light levels) and ecological status (through examination of pigment degradation products). Combined HPLC and FCM analyses offer rapid and cost-effective characterisation of phytoplankton communities at appropriate timescales. This will allow a more-targeted use of light microscopy to capture phytoplankton peaks or to investigate periods of rapid community succession. This will lead to greater system understanding of phytoplankton succession in response to biogeochemical drivers.
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Affiliation(s)
- H L Moorhouse
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom; Lancaster Environment Centre, Library Avenue, Lancaster University, Lancaster LA1 4YQ, United Kingdom
| | - D S Read
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - S McGowan
- School of Geography, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - M Wagner
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - C Roberts
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - L K Armstrong
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - D J E Nicholls
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - H D Wickham
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - M G Hutchins
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom
| | - M J Bowes
- Centre for Ecology & Hydrology, Wallingford, Oxon OX10 8BB, United Kingdom.
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Merola J, Wager C, Hamann S, Zhang X, Thai A, Roberts C, Lam C, Musselli C, Marsh G, Rabah D, Barbey C, Franchimont N, Reynolds T. 1096 Non-invasive tape sampling reveals a type I interferon RNA signature in cutaneous lupus erythematosus that distinguishes affected from unaffected and healthy volunteer skin. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim AH, Roberts C, Feagan BG, Banerjee R, Bemelman W, Bodger K, Derieppe M, Dignass A, Driscoll R, Fitzpatrick R, Gaarentstroom-Lunt J, Higgins PD, Kotze PG, Meissner J, O'Connor M, Ran ZH, Siegel CA, Terry H, van Deen WK, van der Woude CJ, Weaver A, Yang SK, Sands BE, Vermeire S, Travis SP. Developing a Standard Set of Patient-Centred Outcomes for Inflammatory Bowel Disease-an International, Cross-disciplinary Consensus. J Crohns Colitis 2018; 12:408-418. [PMID: 29216349 DOI: 10.1093/ecco-jcc/jjx161] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 11/23/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Success in delivering value-based healthcare involves measuring outcomes that matter most to patients. Our aim was to develop a minimum Standard Set of patient-centred outcome measures for inflammatory bowel disease [IBD], for use in different healthcare settings. METHODS An international working group [n = 25] representing patients, patient associations, gastroenterologists, surgeons, specialist nurses, IBD registries and patient-reported outcome measure [PROM] methodologists participated in a series of teleconferences incorporating a modified Delphi process. Systematic review of existing literature, registry data, patient focus groups and open review periods were used to reach consensus on a minimum set of standard outcome measures and risk adjustment variables. Similar methodology has been used in 21 other disease areas [www.ichom.org]. RESULTS A minimum Standard Set of outcomes was developed for patients [aged ≥16] with IBD. Outcome domains included survival and disease control [survival, disease activity/remission, colorectal cancer, anaemia], disutility of care [treatment-related complications], healthcare utilization [IBD-related admissions, emergency room visits] and patient-reported outcomes [including quality of life, nutritional status and impact of fistulae] measured at baseline and at 6 or 12 month intervals. A single PROM [IBD-Control questionnaire] was recommended in the Standard Set and minimum risk adjustment data collected at baseline and annually were included: demographics, basic clinical information and treatment factors. CONCLUSIONS A Standard Set of outcome measures for IBD has been developed based on evidence, patient input and specialist consensus. It provides an international template for meaningful, comparable and easy-to-interpret measures as a step towards achieving value-based healthcare in IBD.
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Affiliation(s)
- Andrew H Kim
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Charlotte Roberts
- International Consortium for Health Outcomes Measurement, London, UK
| | - Brian G Feagan
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Rupa Banerjee
- Asian Institute of Gastroenterology, Hyderabad, India
| | - Willem Bemelman
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Keith Bodger
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Digestive Diseases Unit, Aintree University Hospital, Liverpool, UK
| | | | - Axel Dignass
- Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, Frankfurt am Main, Germany
| | | | | | - Janette Gaarentstroom-Lunt
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter D Higgins
- Department of Internal Medicine, University of Michigan Medical School, Michigan, Ann Arbor, MI, USA
| | | | | | - Marian O'Connor
- St Mark's Hospital, London Northwest Healthcare NHS Trust, UK
| | - Zhi-Hua Ran
- Key Laboratory of Gastroenterology & Hepatology Ministry of Health, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai Inflammatory Bowel Disease Research Center, Shanghai, China
| | - Corey A Siegel
- Department of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Helen Terry
- Crohn's and Colitis UK, St Albans, Hertfordshire, UK
| | - Welmoed K van Deen
- UCLA Center for Inflammatory Bowel Diseases, Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,USC Gehr Family Center for Implementation Science, Los Angeles, CA, USA
| | | | | | - Suk-Kyun Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Bruce E Sands
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Séverine Vermeire
- Department of Gastroenterology & Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Simon Pl Travis
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
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