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Faksova K, Walsh D, Jiang Y, Griffin J, Phillips A, Gentile A, Kwong JC, Macartney K, Naus M, Grange Z, Escolano S, Sepulveda G, Shetty A, Pillsbury A, Sullivan C, Naveed Z, Janjua NZ, Giglio N, Perälä J, Nasreen S, Gidding H, Hovi P, Vo T, Cui F, Deng L, Cullen L, Artama M, Lu H, Clothier HJ, Batty K, Paynter J, Petousis-Harris H, Buttery J, Black S, Hviid A. COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals. Vaccine 2024; 42:2200-2211. [PMID: 38350768 DOI: 10.1016/j.vaccine.2024.01.100] [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: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The Global COVID Vaccine Safety (GCoVS) Project, established in 2021 under the multinational Global Vaccine Data Network™ (GVDN®), facilitates comprehensive assessment of vaccine safety. This study aimed to evaluate the risk of adverse events of special interest (AESI) following COVID-19 vaccination from 10 sites across eight countries. METHODS Using a common protocol, this observational cohort study compared observed with expected rates of 13 selected AESI across neurological, haematological, and cardiac outcomes. Expected rates were obtained by participating sites using pre-COVID-19 vaccination healthcare data stratified by age and sex. Observed rates were reported from the same healthcare datasets since COVID-19 vaccination program rollout. AESI occurring up to 42 days following vaccination with mRNA (BNT162b2 and mRNA-1273) and adenovirus-vector (ChAdOx1) vaccines were included in the primary analysis. Risks were assessed using observed versus expected (OE) ratios with 95 % confidence intervals. Prioritised potential safety signals were those with lower bound of the 95 % confidence interval (LBCI) greater than 1.5. RESULTS Participants included 99,068,901 vaccinated individuals. In total, 183,559,462 doses of BNT162b2, 36,178,442 doses of mRNA-1273, and 23,093,399 doses of ChAdOx1 were administered across participating sites in the study period. Risk periods following homologous vaccination schedules contributed 23,168,335 person-years of follow-up. OE ratios with LBCI > 1.5 were observed for Guillain-Barré syndrome (2.49, 95 % CI: 2.15, 2.87) and cerebral venous sinus thrombosis (3.23, 95 % CI: 2.51, 4.09) following the first dose of ChAdOx1 vaccine. Acute disseminated encephalomyelitis showed an OE ratio of 3.78 (95 % CI: 1.52, 7.78) following the first dose of mRNA-1273 vaccine. The OE ratios for myocarditis and pericarditis following BNT162b2, mRNA-1273, and ChAdOx1 were significantly increased with LBCIs > 1.5. CONCLUSION This multi-country analysis confirmed pre-established safety signals for myocarditis, pericarditis, Guillain-Barré syndrome, and cerebral venous sinus thrombosis. Other potential safety signals that require further investigation were identified.
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Affiliation(s)
- K Faksova
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
| | - D Walsh
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - Y Jiang
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - J Griffin
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - A Phillips
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - A Gentile
- Department of Epidemiology, Ricardo Gutierrez Children Hospital, Buenos Aires University, Argentina
| | - J C Kwong
- ICES, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine and the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - K Macartney
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia; The University of Sydney, Australia
| | - M Naus
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Z Grange
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | - S Escolano
- Université Paris-Saclay, UVSQ, Inserm, CESP, High Dimensional Biostatistics for Drug Safety and Genomics, Villejuif, France
| | - G Sepulveda
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - A Shetty
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - A Pillsbury
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - C Sullivan
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | - Z Naveed
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - N Z Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - N Giglio
- Department of Epidemiology, Ricardo Gutierrez Children Hospital, Buenos Aires University, Argentina
| | - J Perälä
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - S Nasreen
- ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - H Gidding
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia; The University of Sydney, Australia
| | - P Hovi
- Department of Public Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - T Vo
- Faculty of Social Sciences, Tampere University, Finland
| | - F Cui
- School of Public Health, Peking University, China
| | - L Deng
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - L Cullen
- Public Health Scotland, Glasgow, Scotland, United Kingdom
| | - M Artama
- Faculty of Social Sciences, Tampere University, Finland
| | - H Lu
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - H J Clothier
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - K Batty
- Auckland UniServices Limited at University of Auckland, New Zealand
| | - J Paynter
- School of Population Health, University of Auckland, New Zealand
| | - H Petousis-Harris
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; School of Population Health, University of Auckland, New Zealand
| | - J Buttery
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia
| | - S Black
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; School of Population Health, University of Auckland, New Zealand
| | - A Hviid
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Kerr S, Bedston S, Cezard G, Sampri A, Murphy S, Bradley DT, Morrison K, Akbari A, Whiteley W, Sullivan C, Patterson L, Khunti K, Denaxas S, Bolton T, Khan S, Keys A, Weatherill D, Mooney K, Davies J, Ritchie L, McMenamin J, Kee F, Wood A, Lyons RA, Sudlow C, Robertson C, Sheikh A. Undervaccination and severe COVID-19 outcomes: meta-analysis of national cohort studies in England, Northern Ireland, Scotland, and Wales. Lancet 2024; 403:554-566. [PMID: 38237625 DOI: 10.1016/s0140-6736(23)02467-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Undervaccination (receiving fewer than the recommended number of SARS-CoV-2 vaccine doses) could be associated with increased risk of severe COVID-19 outcomes-ie, COVID-19 hospitalisation or death-compared with full vaccination (receiving the recommended number of SARS-CoV-2 vaccine doses). We sought to determine the factors associated with undervaccination, and to investigate the risk of severe COVID-19 outcomes in people who were undervaccinated in each UK nation and across the UK. METHODS We used anonymised, harmonised electronic health record data with whole population coverage to carry out cohort studies in England, Northern Ireland, Scotland, and Wales. Participants were required to be at least 5 years of age to be included in the cohorts. We estimated adjusted odds ratios for undervaccination as of June 1, 2022. We also estimated adjusted hazard ratios (aHRs) for severe COVID-19 outcomes during the period June 1 to Sept 30, 2022, with undervaccination as a time-dependent exposure. We combined results from nation-specific analyses in a UK-wide fixed-effect meta-analysis. We estimated the reduction in severe COVID-19 outcomes associated with a counterfactual scenario in which everyone in the UK was fully vaccinated on June 1, 2022. FINDINGS The numbers of people undervaccinated on June 1, 2022 were 26 985 570 (45·8%) of 58 967 360 in England, 938 420 (49·8%) of 1 885 670 in Northern Ireland, 1 709 786 (34·2%) of 4 992 498 in Scotland, and 773 850 (32·8%) of 2 358 740 in Wales. People who were younger, from more deprived backgrounds, of non-White ethnicity, or had a lower number of comorbidities were less likely to be fully vaccinated. There was a total of 40 393 severe COVID-19 outcomes in the cohorts, with 14 156 of these in undervaccinated participants. We estimated the reduction in severe COVID-19 outcomes in the UK over 4 months of follow-up associated with a counterfactual scenario in which everyone was fully vaccinated on June 1, 2022 as 210 (95% CI 94-326) in the 5-15 years age group, 1544 (1399-1689) in those aged 16-74 years, and 5426 (5340-5512) in those aged 75 years or older. aHRs for severe COVID-19 outcomes in the meta-analysis for the age group of 75 years or older were 2·70 (2·61-2·78) for one dose fewer than recommended, 3·13 (2·93-3·34) for two fewer, 3·61 (3·13-4·17) for three fewer, and 3·08 (2·89-3·29) for four fewer. INTERPRETATION Rates of undervaccination against COVID-19 ranged from 32·8% to 49·8% across the four UK nations in summer, 2022. Undervaccination was associated with an elevated risk of severe COVID-19 outcomes. FUNDING UK Research and Innovation National Core Studies: Data and Connectivity.
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Millington T, Morrison K, Jeffrey K, Sullivan C, Kurdi A, Fagbamigbe AF, Swallow B, Shi T, Shah SA, Kerr S, Simpson CR, Ritchie LD, Robertson C, Sheikh A, Rudan I. Caveats in reporting of national vaccine uptake. J Glob Health 2024; 14:03006. [PMID: 38330197 PMCID: PMC10852533 DOI: 10.7189/jogh.14.03006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Affiliation(s)
| | | | - Karen Jeffrey
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Erbil, Iraq
- College of Pharmacy, Al-Kitab University, Kirkuk, Iraq
- School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | | | - Ben Swallow
- School of Mathematics and Statistics, University of St Andrews, UK
| | - Ting Shi
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Colin R Simpson
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, NZ
| | - Lewis D Ritchie
- School of Medicine, Medical Sciences & Nutrition, Academic Primary Care, University of Aberdeen, UK
| | - Chris Robertson
- Public Health Scotland, Glasgow, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Igor Rudan
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Algebra University College, Zagreb, Croatia
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Bedston S, Almaghrabi F, Patterson L, Agrawal U, Woolford L, Anand SN, Joy M, Crawford A, Goudie R, Byford R, Abbasizanjani H, Smith D, Laidlaw L, Akbari A, Sullivan C, Bradley DT, Lyons RA, de Lusignan S, Hobbs FR, Robertson C, Sheikh SA, Shi T. Risk of severe COVID-19 outcomes after autumn 2022 COVID-19 booster vaccinations: a pooled analysis of national prospective cohort studies involving 7.4 million adults in England, Northern Ireland, Scotland and Wales. Lancet Reg Health Eur 2024; 37:100816. [PMID: 38162515 PMCID: PMC10757260 DOI: 10.1016/j.lanepe.2023.100816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Background UK COVID-19 vaccination policy has evolved to offering COVID-19 booster doses to individuals at increased risk of severe Illness from COVID-19. Building on our analyses of vaccine effectiveness of first, second and initial booster doses, we aimed to identify individuals at increased risk of severe outcomes (i.e., COVID-19 related hospitalisation or death) post the autumn 2022 booster dose. Methods We undertook a national population-based cohort analysis across all four UK nations through linked primary care, vaccination, hospitalisation and mortality data. We included individuals who received autumn 2022 booster doses of BNT162b2 (Comirnaty) or mRNA-1273 (Spikevax) during the period September 1, 2022 to December 31, 2022 to investigate the risk of severe COVID-19 outcomes. Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CIs) for the association between demographic and clinical factors and severe COVID-19 outcomes after the autumn booster dose. Analyses were adjusted for age, sex, body mass index (BMI), deprivation, urban/rural areas and comorbidities. Stratified analyses were conducted by vaccine type. We then conducted a fixed-effect meta-analysis to combine results across the four UK nations. Findings Between September 1, 2022 and December 31, 2022, 7,451,890 individuals ≥18 years received an autumn booster dose. 3500 had severe COVID-19 outcomes (2.9 events per 1000 person-years). Being male (male vs female, aHR 1.41 (1.32-1.51)), older adults (≥80 years vs 18-49 years; 10.43 (8.06-13.50)), underweight (BMI <18.5 vs BMI 25.0-29.9; 2.94 (2.51-3.44)), those with comorbidities (≥5 comorbidities vs none; 9.45 (8.15-10.96)) had a higher risk of COVID-19 hospitalisation or death after the autumn booster dose. Those with a larger household size (≥11 people within household vs 2 people; 1.56 (1.23-1.98)) and from more deprived areas (most deprived vs least deprived quintile; 1.35 (1.21-1.51)) had modestly higher risks. We also observed at least a two-fold increase in risk for those with various chronic neurological conditions, including Down's syndrome, immunodeficiency, chronic kidney disease, cancer, chronic respiratory disease, or cardiovascular disease. Interpretation Males, older individuals, underweight individuals, those with an increasing number of comorbidities, from a larger household or more deprived areas, and those with specific underlying health conditions remained at increased risk of COVID-19 hospitalisation and death after the autumn 2022 vaccine booster dose. There is now a need to focus on these risk groups for investigating immunogenicity and efficacy of further booster doses or therapeutics. Funding National Core Studies-Immunity, UK Research and Innovation (Medical Research Council and Economic and Social Research Council), Health Data Research UK, the Scottish Government, and the University of Edinburgh.
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Affiliation(s)
- Stuart Bedston
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Fatima Almaghrabi
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Lynsey Patterson
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Public Health Agency, Belfast, UK
| | - Utkarsh Agrawal
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lana Woolford
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Sneha N. Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anna Crawford
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Rosalind Goudie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hoda Abbasizanjani
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Deb Smith
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Lynn Laidlaw
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | | | - Declan T. Bradley
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Public Health Agency, Belfast, UK
| | - Ronan A. Lyons
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - F.D. Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland, UK
- Public Health Scotland, Glasgow, Scotland, UK
| | - Sir Aziz Sheikh
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ting Shi
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
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Scott S, McGowan VJ, Wildman J, Bidmead E, Hartley J, Mathews C, James B, Sullivan C, Bambra C, Sowden S. "I'll meet you at our bench": adaptation, innovation and resilience among VCSE organisations who supported marginalised and minoritised communities during the Covid-19 pandemic in Northern England - a qualitative focus group study. BMC Health Serv Res 2024; 24:7. [PMID: 38172856 PMCID: PMC10765907 DOI: 10.1186/s12913-023-10435-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The Covid-19 pandemic has exacerbated pre-existing inequalities and increased adversity and challenges for vulnerable and marginalised communities worldwide. In the UK, the Voluntary Community and Social Enterprise (VCSE) sector play a vital role in supporting the health and wellbeing of people who are marginalised or experiencing multiple complex needs. However, only a small number of studies have focused on the impact that Covid-19 had on the VCSE sector. METHODS As part of a Health Inequalities Impact Assessment (HIIA), we conducted qualitative focus groups with staff and volunteers from five organisations to examine short, medium and longer-term impacts of Covid-19 upon the VCSE sector in Northern England. Nine online focus groups were conducted between March and July 2021. FINDINGS Focus group transcripts were analysed using Framework Analysis and yielded three central themes: (1) exacerbation of pre-existing inequalities, adversity and challenges for vulnerable and marginalised populations; (2) the 'price' of being flexible, innovative and agile for VCSE staff and volunteers; and (3) the voluntary sector as a 'lifeline' - organisational pride and resilience. CONCLUSIONS While the voluntary sector 'adapted at pace' to provide support during Covid-19 and in its continued aftermath, this resilience has potentially come at the cost of workforce and volunteer wellbeing, compounded by political obstacles and chronic shortage in funding and support. The VCSE sector has a vital role to play in the post-lockdown 'levelling up' agenda. The expertise, capacity and resilience of VCSE organisations, and their ability to respond to Covid-19, should be celebrated, recognised and supported adequately to maintain its resilience. To not do so threatens the sector's sustainability and risks jeopardising attempts to involve the sector in addressing the social determinants of health.
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Affiliation(s)
- S Scott
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
- NIHR Applied Research Collaboration North East and North Cumbria, St Nicholas' Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK.
| | - V J McGowan
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - J Wildman
- ScotCen, Scotiabank House, 6 South Charlotte Street, Edinburgh, EH2 4AW, UK
| | - E Bidmead
- Institute of Health, University of Cumbria, Fusehill Street, Carlisle, CA1 2HH, UK
- NIHR Applied Research Collaboration North East and North Cumbria, St Nicholas' Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - J Hartley
- VONNE, 4th Floor, MEA House, Ellison Place, Newcastle upon Tyne, Tyne and Wear, NE1 8XS, UK
| | - C Mathews
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
| | - B James
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
| | - C Sullivan
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
| | - C Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- NIHR Applied Research Collaboration North East and North Cumbria, St Nicholas' Hospital, Jubilee Road, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - S Sowden
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
- Office for Health Improvement and Disparities, Department of Health and Social Care, Waterfront 4, Goldcrest Way, Newburn Riverside, NE15 8NY, Newcastle upon Tyne, UK
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Jones M, Abendano DG, Turner M, Sullivan C, Reyes MCD. The histologic outcomes of indeterminate thyroid nodules with rat sarcoma mutations: A case series. Diagn Cytopathol 2023; 51:E332-E337. [PMID: 37583345 DOI: 10.1002/dc.25214] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023]
Abstract
Molecular testing is an adjunct test for thyroid fine needle aspirations with indeterminate diagnoses, with certain mutations showing a greater risk of malignancy (ROM). Rat sarcoma (RAS) point mutations are the most common alterations in indeterminate thyroid nodules. While they can have a high ROM, they are also found in benign disease. This study describes the histologic outcomes of indeterminate nodules with RAS mutations. Bethesda III and IV thyroid nodules with ThyroSeq results showing RAS mutations (NRAS, KRAS, and HRAS) were identified between November 1, 2018 and February 28, 2023. Baseline patient characteristics, ThyroSeq results, and surgical diagnoses were collected. We identified 18 nodules with RAS mutations from 17 patients. Fourteen were NRAS (isolated NRAS in 6; NRAS with other abnormalities [NRAS+] in 8); one was isolated KRAS; and three were HRAS with other abnormalities (HRAS+). NRAS Q16R was the most common amino acid change. Twelve cases had follow-up. Two were malignant, a minimally invasive follicular carcinoma (NRAS+) and a papillary thyroid carcinoma, follicular variant (HRAS+). Three were noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), 2 HRAS+ and 1 NRAS+. Four were follicular adenomas, one being atypical (3 NRAS+ and one isolated NRAS). One was an oncocytic adenoma (isolated NRAS). Two were nodular hyperplasias (isolated NRAS and NRAS+, respectively). Twenty-eight percent of our RAS-mutated nodules were malignant or NIFTP. All three HRAS-mutated nodules were malignant or NIFTP. The three isolated RAS mutations with follow up were benign (adenomas or nodular hyperplasia). These findings were in line with the literature.
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Affiliation(s)
- MacKenzie Jones
- Medical University of South Carolina College of Medicine, Charleston, South Carolina, USA
| | - Dorbin G Abendano
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Matthew Turner
- Medical University of South Carolina College of Medicine, Charleston, South Carolina, USA
| | - Christopher Sullivan
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Maria Cecilia D Reyes
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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Pen OV, Kelly B, Sullivan C, Heinzerling JH. Planning Considerations for the Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Radiotherapy for Locally-Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e48-e49. [PMID: 37785520 DOI: 10.1016/j.ijrobp.2023.06.754] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Phase III prospective randomized trial of primary lung tumor stereotactic body radiation therapy followed by concurrent mediastinal chemoradiation for locally-advanced non-small cell lung cancer (NRG LU-008), designed to lower the rates of radiation pneumonitis and improve the progression-free survival, is expected to become active nationally in July 2023. Due to the specific nature of the cases selected for this trial, a new approach to treatment planning had to be developed to satisfy the conditions of the trial. Levice Cancer Institute (Atrium Health, North Carolina) ran the initial Phase II trial and investigated several approaches, providing recommendations for the future dosimetry planning approach. MATERIALS/METHODS A total of 60 patients were selected for the initial trial and treated with a combination of SBRT treatment to the primary tumor (50-54 Gy in 3-5 fractions) and conventional IMRT treatment to 60 Gy to the involved lymph nodes for patients with stage 3 or unresectable stage II NSCLC, combined with chemotherapy. Depending on the location of the primary tumor, all cases could be subdivided into no overlap between the SBRT and IMRT targets, adjacent targets, and overlapping targets. All SBRT plans were done with a 6X-FFF beam, advanced dose calculation algorithm, and 0.1 cm grid size. IMRT targets were primarily treated with VMAT plans, though a minority of cases were planned with the DMLC technique, with a 6X beam, advanced dose calculation algorithm, and 0.25 cm grid size. Various approaches to the planning included target cropping, avoidance via adjusting optimization objectives and utilizing the base dose of the SBRT plan to optimize the dose for the IMRT nodal plan. Various geometries utilized in the plan included a variation in the number of arcs, covered arc angles, and the number of beams. RESULTS A significant reduction in the side effects was achieved throughout the trial, with only three patients experiencing grade 3 or higher pneumonitis, 3 patients experiencing grade 3 or higher cardiotoxicity, and 1 patient experiencing grade 3 esophagitis. For targets with no significant overlap between the primary tumor and nodal target, standard planning techniques proved to be sufficient. For the overlapping targets, the planning approach of utilizing 2 arcs, >180-degree coverage, for the SBRT plan, and using ¼ of the base SBRT dose to plan the IMRT nodal plan provided the best target coverage while achieving sufficient OAR sparing. CONCLUSION Planning the joint SBRT-IMRT plan in the cases of a significant target overlap requires a careful approach, but is feasible with the proposed guideline and should be achievable for any center electing to participate in the NRG LU-008 trial.
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Affiliation(s)
- O V Pen
- Levine Cancer Institute, Atrium Health, Concord, NC
| | - B Kelly
- Levine Cancer Institute, Atrium Health, Concord, NC
| | - C Sullivan
- Levine Cancer Institute, Atrium Health, Concord, NC
| | - J H Heinzerling
- Levine Cancer Institute, Atrium Health and Southeast Radiation Oncology Group, Charlotte, NC
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Morrison K, Cullen L, James AB, Chua V, Sullivan C, Robertson C, Carruthers J, Wood R, Jeffrey K, MacDonald C, Shah SA, Rudan I, Simpson CR, McCowan C, Vittal Katikireddi S, Grange Z, Ritchie L, Sheikh A. Predictors of incomplete COVID-19 vaccine schedule among adults in Scotland: Two retrospective cohort analyses of the primary schedule and third dose. Vaccine 2023; 41:5863-5876. [PMID: 37598025 DOI: 10.1016/j.vaccine.2023.07.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/19/2023] [Accepted: 07/29/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Vaccination continues to be the key public health measure for preventing severe COVID-19 outcomes. Certain groups may be at higher risk of incomplete vaccine schedule, which may leave them vulnerable to COVID-19 hospitalisation and death. AIM To identify the sociodemographic and clinical predictors for not receiving a scheduled COVID-19 vaccine after previously receiving one. METHODS We conducted two retrospective cohort studies with ≥3.7 million adults aged ≥18 years in Scotland. Multivariable logistic regression was used to estimate adjusted odds ratios (aOR) of not receiving a second, and separately a third dose between December 2020 and May 2022. Independent variables included sociodemographic and clinical factors. RESULTS Of 3,826,797 people in the study population who received one dose, 3,732,596 (97.5%) received two doses, and 3,263,153 (86.5%) received all doses available during the study period. The most strongly associated predictors for not receiving the second dose were: being aged 18-29 (reference: 50-59 years; aOR:4.26; 95% confidence interval (CI):4.14-4.37); hospitalisation due to a potential vaccine related adverse event of special interest (AESI) (reference: not having a potential AESI, aOR:3.78; 95%CI: 3.29-4.35); and living in the most deprived quintile (reference: least deprived quintile, aOR:3.24; 95%CI: 3.16-3.32). The most strongly associated predictors for not receiving the third dose were: being 18-29 (reference: 50-59 years aOR:4.44; 95%CI: 4.38-4.49), living in the most deprived quintile (reference: least deprived quintile aOR:2.56; 95%CI: 2.53-2.59), and Black, Caribbean, or African ethnicity (reference: White ethnicity aOR:2.38; 95%CI: 2.30-2.46). Pregnancy, previous vaccination with mRNA-1273, smoking history, individual and household severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, and having an unvaccinated adult in the household were also associated with incomplete vaccine schedule. CONCLUSION We observed several risk factors that predict incomplete COVID-19 vaccination schedule. Vaccination programmes must take immediate action to ensure maximum uptake, particularly for populations vulnerable to severe COVID-19 outcomes.
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Affiliation(s)
| | - Lucy Cullen
- Public Health Scotland, Glasgow, Scotland, UK
| | | | - Vera Chua
- Public Health Scotland, Glasgow, Scotland, UK
| | | | - Chris Robertson
- Public Health Scotland, Glasgow, Scotland, UK; University of Strathclyde, Glasgow, UK
| | | | - Rachael Wood
- Public Health Scotland, Glasgow, Scotland, UK; Usher Institute, University of Edinburgh, Scotland, UK
| | - Karen Jeffrey
- Usher Institute, University of Edinburgh, Scotland, UK
| | | | | | - Igor Rudan
- Usher Institute, University of Edinburgh, Scotland, UK
| | - Colin R Simpson
- Usher Institute, University of Edinburgh, Scotland, UK; School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Srinivasa Vittal Katikireddi
- Public Health Scotland, Glasgow, Scotland, UK; School of Health and Wellbeing, University of Glasgow, Scotland, UK
| | - Zoe Grange
- Public Health Scotland, Glasgow, Scotland, UK
| | - Lewis Ritchie
- School of Medicine, Medical Science & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Scotland, UK
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9
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Kobayashi S, Sullivan C, Bialkowska AB, Saltz JH, Yang VW. Computational immunohistochemical mapping adds immune context to histological phenotypes in mouse models of colitis. Sci Rep 2023; 13:14386. [PMID: 37658187 PMCID: PMC10474139 DOI: 10.1038/s41598-023-41574-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023] Open
Abstract
Inflammatory bowel disease (IBD) is characterized by chronic, dysregulated inflammation in the gastrointestinal tract. The heterogeneity of IBD is reflected through two major subtypes, Crohn's Disease (CD) and Ulcerative Colitis (UC). CD and UC differ across symptomatic presentation, histology, immune responses, and treatment. While colitis mouse models have been influential in deciphering IBD pathogenesis, no single model captures the full heterogeneity of clinical disease. The translational capacity of mouse models may be augmented by shifting to multi-mouse model studies that aggregate analysis across various well-controlled phenotypes. Here, we evaluate the value of histology in multi-mouse model characterizations by building upon a previous pipeline that detects histological disease classes in hematoxylin and eosin (H&E)-stained murine colons. Specifically, we map immune marker positivity across serially-sectioned slides to H&E histological classes across the dextran sodium sulfate (DSS) chemical induction model and the intestinal epithelium-specific, inducible Villin-CreERT2;Klf5fl/fl (Klf5ΔIND) genetic model. In this study, we construct the beginning frameworks to define H&E-patch-based immunophenotypes based on IHC-H&E mappings.
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Affiliation(s)
- Soma Kobayashi
- Department of Biomedical Informatics, Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
| | - Christopher Sullivan
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Agnieszka B Bialkowska
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Joel H Saltz
- Department of Biomedical Informatics, Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
- Department of Pathology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Vincent W Yang
- Department of Biomedical Informatics, Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA.
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
- Department of Physiology and Biophysics, Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA.
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10
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Sullivan C, Presnell SE, Madory JE, Phillips AI. Retrospective Review of Antecustodial Deaths Referred for Medicolegal Autopsy at the Medical University of South Carolina. Am J Forensic Med Pathol 2023; Publish Ahead of Print:00000433-990000000-00078. [PMID: 37235866 DOI: 10.1097/paf.0000000000000838] [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: 05/28/2023]
Abstract
Deaths occurring in police custody have dominated public discourse over recent years. However, deaths occurring after law enforcement have initiated nonphysical contact but before active restraint or containment lie outside the strict definition of "in custody." These "antecustodial" deaths demonstrate a unique population and interaction with law enforcement. A retrospective analysis of medicolegal cases referred to the Medical University of South Carolina from September 1, 2012, to April 28, 2022 was performed. Deaths during nonphysical interaction with or during evasion of law enforcement occurred in 78 cases and were categorized by demographic data, cause of death, manner of death, the presence of drugs and/or alcohol, and circumstances surrounding the interaction. Antecustodial deaths occurred primarily during law enforcement pursuit and deescalation scenarios. Decedents were predominantly male (92.3%) with a Black-to-White ratio of 1.1:1. The average age of male and female decedents was 35.7 and 32.2 years, respectively. The most common causes of death were gunshot wounds and blunt trauma sustained in motor vehicle crashes. The most common manner of death was homicide (43.6%), followed by suicide (28.2%) and accident (28.2%).
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Affiliation(s)
- Christopher Sullivan
- From the Department of Pathology and Laboratory Medicine, Medical University of South Carolina
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11
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Jhaveri VV, Sullivan C, Ward A, Giurini JM, Karchmer AW, Stillman IE, Davis RB, Freed JA, LaSalvia MT, Stead W. More Specialties, Fewer Problems: Using Collaborative Competency Between Infectious Diseases, Podiatry, and Pathology to Improve the Care of Patients with Diabetic Foot Osteomyelitis. J Am Podiatr Med Assoc 2022; 112:461851. [PMID: 33630067 DOI: 10.7547/20-178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/16/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Diabetic foot osteomyelitis is a common infection where treatment involves multiple services, including infectious diseases, podiatry, and pathology. Despite its ubiquity in the hospital, consensus on much of its management is lacking. METHODS Representatives from infectious diseases, podiatry, and pathology interested in quality improvement developed multidisciplinary institutional recommendations culminating in an educational intervention describing optimal diagnostic and therapeutic approaches to diabetic foot osteomyelitis (DFO). Knowledge acquisition was assessed by preintervention and postintervention surveys. Inpatients with forefoot DFO were retrospectively reviewed before and after intervention to assess frequency of recommended diagnostic and therapeutic maneuvers, including appropriate definition of surgical bone margins, definitive histopathology reports, and unnecessary intravenous antibiotics or prolonged antibiotic courses. RESULTS A postintervention survey revealed significant improvements in knowledge of antibiotic treatment duration and the role of oral antibiotics in managing DFO. There were 104 consecutive patients in the preintervention cohort (April 1, 2018, to April 1, 2019) and 32 patients in the postintervention cohort (November 5, 2019, to March 1, 2020), the latter truncated by changes in hospital practice during the coronavirus disease 2019 pandemic. Noncategorizable or equivocal disease reports decreased from before intervention to after intervention (27.0% versus 3.3%, respectively; P = .006). We observed nonsignificant improvement in correct bone margin definition (74.0% versus 87.5%; P = .11), unnecessary peripherally inserted central catheter line placement (18.3% versus 9.4%; P = .23), and unnecessary prolonged antibiotics (21.9% versus 5.0%; P = .10). In addition, by working as an interdisciplinary group, many solvable misunderstandings were identified, and processes were adjusted to improve the quality of care provided to these patients. CONCLUSIONS This quality improvement initiative regarding management of DFO led to improved provider knowledge and collaborative competency between these three departments, improvements in definitive pathology reports, and nonsignificant improvement in several other clinical endpoints. Creating collaborative competency may be an effective local strategy to improve knowledge of diabetic foot infection and may generalize to other common multidisciplinary conditions.
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Affiliation(s)
- Vimal V Jhaveri
- *Division of Infectious Diseases, Department of Medicine, Boston, MA.,¶Harvard Medical School, Boston, MA
| | - Christopher Sullivan
- †Division of Podiatry, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ashley Ward
- ‡Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.,¶Harvard Medical School, Boston, MA
| | - John M Giurini
- †Division of Podiatry, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Adolf W Karchmer
- *Division of Infectious Diseases, Department of Medicine, Boston, MA.,¶Harvard Medical School, Boston, MA
| | - Isaac E Stillman
- ‡Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.,¶Harvard Medical School, Boston, MA
| | - Roger B Davis
- ‖Division of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.,¶Harvard Medical School, Boston, MA
| | - Jason A Freed
- §Division of Hematology and Hematologic Malignancies, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.,¶Harvard Medical School, Boston, MA
| | - Mary T LaSalvia
- *Division of Infectious Diseases, Department of Medicine, Boston, MA.,¶Harvard Medical School, Boston, MA.,#Co-senior author
| | - Wendy Stead
- *Division of Infectious Diseases, Department of Medicine, Boston, MA.,¶Harvard Medical School, Boston, MA.,#Co-senior author
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12
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Kerr S, Robertson C, Hillman S, Grange Z, Sullivan C, Sheikh A. Severity of BA.2 variant and vaccine effectiveness against symptomatic disease in Scotland. Lancet Reg Health Eur 2022; 23:100533. [PMID: 36373099 PMCID: PMC9635838 DOI: 10.1016/j.lanepe.2022.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Steven Kerr
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
| | - Sam Hillman
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Zoe Grange
- Public Health Scotland, Glasgow, United Kingdom
| | | | - Aziz Sheikh
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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13
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Rudan I, Millington T, Antal K, Grange Z, Fenton L, Sullivan C, Buelo A, Wood R, Woolford L, Swann OV, Murray JL, Cullen LA, Moore E, Haider F, Almaghrabi F, McMenamin J, Agrawal U, Shah SA, Kerr S, Simpson CR, Katikireddi SV, Ritchie SLD, Robertson C, Sheikh SA. BNT162b2 COVID-19 vaccination uptake, safety, effectiveness and waning in children and young people aged 12-17 years in Scotland. Lancet Reg Health Eur 2022; 23:100513. [PMID: 36189425 PMCID: PMC9514975 DOI: 10.1016/j.lanepe.2022.100513] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background The two-dose BNT162b2 (Pfizer-BioNTech) vaccine has demonstrated high efficacy against COVID-19 disease in clinical trials of children and young people (CYP). Consequently, we investigated the uptake, safety, effectiveness and waning of the protective effect of the BNT162b2 against symptomatic COVID-19 in CYP aged 12-17 years in Scotland. Methods The analysis of the vaccine uptake was based on information from the Turas Vaccination Management Tool, inclusive of Mar 1, 2022. Vaccine safety was evaluated using national data on hospital admissions and General Practice (GP) consultations, through a self-controlled case series (SCCS) design, investigating 17 health outcomes of interest. Vaccine effectiveness (VE) against symptomatic COVID-19 disease for Delta and Omicron variants was estimated using a test-negative design (TND) and S-gene status in a prospective cohort study using the Scotland-wide Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. The waning of the VE following each dose of BNT162b2 was assessed using a matching process followed by conditional logistic regression. Findings Between Aug 6, 2021 and Mar 1, 2022, 75.9% of the 112,609 CYP aged 16-17 years received the first and 49.0% the second COVID-19 vaccine dose. Among 237,681 CYP aged 12-15 years, the uptake was 64.5% and 37.2%, respectively. For 12-17-year-olds, BNT162b2 showed an excellent safety record, with no increase in hospital stays following vaccination for any of the 17 investigated health outcomes. In the 16-17-year-old group, VE against symptomatic COVID-19 during the Delta period was 64.2% (95% confidence interval [CI] 59.2-68.5) at 2-5 weeks after the first dose and 95.6% (77.0-99.1) at 2-5 weeks after the second dose. The respective VEs against symptomatic COVID-19 in the Omicron period were 22.8% (95% CI -6.4-44.0) and 65.5% (95% CI 56.0-73.0). In children aged 12-15 years, VE against symptomatic COVID-19 during the Delta period was 65.4% (95% CI 61.5-68.8) at 2-5 weeks after the first dose, with no observed cases at 2-5 weeks after the second dose. The corresponding VE against symptomatic COVID-19 during the Omicron period were 30.2% (95% CI 18.4-40.3) and 81.2% (95% CI 77.7-84.2). The waning of the protective effect against the symptomatic disease began after five weeks post-first and post-second dose. Interpretation During the study period, uptake of BNT162b2 in Scotland has covered more than two-thirds of CYP aged 12-17 years with the first dose and about 40% with the second dose. We found no increased likelihood of admission to hospital with a range of health outcomes in the period after vaccination. Vaccination with both doses was associated with a substantial reduction in the risk of COVID-19 symptomatic disease during both the Delta and Omicron periods, but this protection began to wane after five weeks. Funding UK Research and Innovation (Medical Research Council); Research and Innovation Industrial Strategy Challenge Fund; Chief Scientist's Office of the Scottish Government; Health Data Research UK; National Core Studies - Data and Connectivity.
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Affiliation(s)
- Igor Rudan
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | | | - Rachael Wood
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Public Health Scotland, Glasgow, UK
| | - Lana Woolford
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Olivia V. Swann
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Royal Hospital for Sick Children, Paediatric Infectious Diseases, Edinburgh, UK
| | | | | | | | - Fasih Haider
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | | | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | | | - Steven Kerr
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Colin R. Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | | | | | - Chris Robertson
- Public Health Scotland, Glasgow, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
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14
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Robertson A, Makris A, Johnson P, Middleton S, Norman M, Sullivan C, Hennessy A. Delivery outcomes as a result of snoring as determined by standard sleep surveys. Obstet Med 2022; 15:253-259. [PMID: 36523878 PMCID: PMC9745590 DOI: 10.1177/1753495x211064107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2023] Open
Abstract
Background Sleep-disordered breathing (SDB), is an umbrella term that encompasses obstructive sleep apnea (OSA), central sleep apnea (CSA) and hypoventilation. is common but studies in the pregnant population are limited. Data suggests relationships between OSA and preeclampsia, but the relationship between snoring and pregnancy outcomes is unknown. Methods A prospective study of 2224 singleton pregnancies was undertaken. Women were questioned using the Berlin Questionnaire (BQ- 2 or more categories where the score is positive.) and the Epworth Sleepiness Scale (ESS >10/24), the results compared with pregnancy outcomes with regard to hypertension in pregnancy. Results Women having symptoms raising the possibility of OSA defined by the BQ with a score >7 was 45.5%, and using ESS with a score >10, was 36%. The birth and neonatal outcomes for self-reported snoring and increased daytime sleepiness showed increased adverse outcomes notably increased caesarean section rates and low APGAR scores but not birth before 37 weeks of gestation. Conclusion Using questionnaires designed for the general population, the prevalence of possible undiagnosed OSA is high in the pregnant population. The increased adverse delivery and neonatal outcomes for self-reported snoring and increased daytime sleepiness with these tools indicated the need for further investigation of the links between snoring SDB and pregnancy outcomes.
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Affiliation(s)
- A Robertson
- Western Sydney University
NSW, Australia
- Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW,
Australia
| | - A Makris
- Liverpool Hospital, Liverpool, NSW, Australia
| | - P Johnson
- David Reid Laboratory, University of Sydney, NSW, Australia
| | - S Middleton
- Liverpool Hospital, Liverpool, NSW, Australia
| | - M Norman
- David Reid Laboratory, University of Sydney, NSW, Australia
| | - C Sullivan
- David Reid Laboratory, University of Sydney, NSW, Australia
| | - A Hennessy
- Western Sydney University
NSW, Australia
- Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW,
Australia
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15
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Florentino PTV, Millington T, Cerqueira-Silva T, Robertson C, de Araújo Oliveira V, Júnior JBS, Alves FJO, Penna GO, Vital Katikireddi S, Boaventura VS, Werneck GL, Pearce N, McCowan C, Sullivan C, Agrawal U, Grange Z, Ritchie LD, Simpson CR, Sheikh A, Barreto ML, Rudan I, Barral-Netto M, Paixão ES. Vaccine effectiveness of two-dose BNT162b2 against symptomatic and severe COVID-19 among adolescents in Brazil and Scotland over time: a test-negative case-control study. Lancet Infect Dis 2022; 22:1577-1586. [PMID: 35952702 PMCID: PMC9359673 DOI: 10.1016/s1473-3099(22)00451-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Little is known about vaccine effectiveness over time among adolescents, especially against the SARS-CoV-2 omicron (B.1.1.529) variant. This study assessed the associations between time since two-dose vaccination with BNT162b2 and the occurrence of symptomatic SARS-CoV-2 infection and severe COVID-19 among adolescents in Brazil and Scotland. METHODS We did test-negative, case-control studies in adolescents aged 12-17 years with COVID-19-related symptoms in Brazil and Scotland. We linked records of SARS-CoV-2 RT-PCR and antigen tests to national vaccination and clinical records. We excluded tests from individuals who did not have symptoms, were vaccinated before the start of the national vaccination programme, received vaccines other than BNT162b2 or a SARS-CoV-2 booster dose of any kind, or had an interval between their first and second dose of fewer than 21 days. Additionally, we excluded negative SARS-CoV-2 tests recorded within 14 days of a previous negative test, negative tests recorded within 7 days after a positive test, any test done within 90 days after a positive test, and tests with missing sex and location information. Cases (SARS-CoV-2 test-positive adolescents) and controls (test-negative adolescents) were drawn from a sample of individuals in whom tests were collected within 10 days of symptom onset. We estimated the adjusted odds ratio and vaccine effectiveness against symptomatic COVID-19 for both countries and against severe COVID-19 (hospitalisation or death) for Brazil across fortnightly periods. FINDINGS We analysed 503 776 tests from 2 948 538 adolescents in Brazil between Sept 2, 2021, and April 19, 2022, and 127 168 tests from 404 673 adolescents in Scotland between Aug 6, 2021, and April 19, 2022. Vaccine effectiveness peaked at 14-27 days after the second dose in both countries during both waves, and was significantly lower against symptomatic infection during the omicron-dominant period in Brazil (64·7% [95% CI 63·0-66·3]) and in Scotland (82·6% [80·6-84·5]), than it was in the delta-dominant period (80·7% [95% CI 77·8-83·3] in Brazil and 92·8% [85·7-96·4] in Scotland). Vaccine efficacy started to decline from 27 days after the second dose for both countries, reducing to 5·9% (95% CI 2·2-9·4) in Brazil and 50·6% (42·7-57·4) in Scotland at 98 days or more during the omicron-dominant period. In Brazil, protection against severe disease remained above 80% from 28 days after the second dose and was 82·7% (95% CI 68·8-90·4) at 98 days or more after receiving the second dose. INTERPRETATION We found waning vaccine protection of BNT162b2 against symptomatic COVID-19 infection among adolescents in Brazil and Scotland from 27 days after the second dose. However, protection against severe COVID-19 outcomes remained high at 98 days or more after the second dose in the omicron-dominant period. Booster doses for adolescents need to be considered. FUNDING UK Research and Innovation (Medical Research Council), Scottish Government, Health Data Research UK BREATHE Hub, Fiocruz, Fazer o Bem Faz Bem programme, Brazilian National Research Council, and Wellcome Trust. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Pilar T V Florentino
- Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil; Biomedical Science Institute, University of São Paulo, São Paulo, Brazil.
| | | | - Thiago Cerqueira-Silva
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Brazil; Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | | | - Vinicius de Araújo Oliveira
- Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Juracy B S Júnior
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Flávia J O Alves
- Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Gerson O Penna
- Tropical Medicine Centre, University of Brasília, Fiocruz School of Government Brasília, Brasília, Brazil
| | | | - Viviane S Boaventura
- LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Brazil; Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Guilherme L Werneck
- Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; Institute of Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Neil Pearce
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | | | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - Zoe Grange
- Public Health Scotland, Glasgow, Scotland, UK
| | - Lewis D Ritchie
- Academic Primary Care, University of Aberdeen, Aberdeen, Scotland, UK
| | - Colin R Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mauricio L Barreto
- Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Igor Rudan
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Manoel Barral-Netto
- Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil; LIB and LEITV Laboratories, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixão
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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16
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Hameed SS, Hall E, Grange Z, Sullivan C, Kennedy S, Ritchie LD, Agrawal U, Simpson CR, Shah SA, Rudan I, McCowan C, Murray JLK, Robertson C, Sheikh A. Characterising adults in Scotland who are not vaccinated against COVID-19. Lancet 2022; 400:993-995. [PMID: 36154687 PMCID: PMC9499389 DOI: 10.1016/s0140-6736(22)01653-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022]
Affiliation(s)
| | | | | | | | | | - Lewis D Ritchie
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Colin R Simpson
- Usher Institute, School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Syed Ahmar Shah
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Igor Rudan
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | | | - Chris Robertson
- Public Health Scotland, Glasgow, UK; Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK.
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Rutsch F, O'brien K, Nitschke Y, Sullivan C, Howe J, Lynch A, Schrier D, Thompson D, Sabbagh Y. INZ-701, a recombinant ENPP1-Fc protein, effectively treats and prevents neointimal proliferation in WT and ENPP1 Deficient mice. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.235] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Inozyme Pharma
Inactivating mutations in ENPP1, which encodes the ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), underlie the rare inherited disorder, generalized arterial calcification of infancy (GACI)/autosomal recessive hypophosphatemic rickets type 2 (ARHR2) also known as ENPP1 Deficiency. ENPP1 Deficiency is characterized by calcification of large and medium sized arteries and marked neointimal proliferation of arteries, leading to arterial stenosis and severe cardiovascular and skeletal complications. ENPP1 Deficiency is associated with a 50% mortality rate in the first six months of life, and there are no approved treatments.
Previous research demonstrated that INZ-701 protein prevented arterial calcification in an ENPP1 deficient mouse model (Enpp1 asj/asj). This study was designed to determine whether INZ-701 can prevent neointimal proliferation in WT and an ENPP1 deficient mouse model (ttw/ttw). Carotid ligation was performed to induce intimal proliferation in the mice.
In the preventive arm of the study, INZ-701 (10mg/kg) or vehicle was administered subcutaneously every other day starting in 6-week-old ttw/ttw-mice. Carotid ligation was performed in these mice at the age of 7 weeks and dosing continued for another 2 weeks. Carotid intimal and medial area caudal from the ligation were analyzed by histomorphometry 14 days and 21 days after carotid ligation. In the therapeutic arm of the study, INZ-701 (10 mg/kg) or vehicle was administered subcutaneously every other day starting 7 days after carotid ligation, when intimal proliferation had already developed, in 8-week-old ttw/ttw-mice. After one week of treatment, histomorphometry was performed.
Fourteen days after carotid ligation, ttw/ttw-mice preventatively treated with INZ-701 showed a significantly reduced intimal area (p<0.001) and intimal/medial (I/M) ratio (p<0.001) compared to those treated with vehicle. This effect was also observed in mice treated with INZ-701, which were treated for 28 days and were subsequently dissected 21 days after carotid ligation. Interestingly, similar effects of INZ-701 were found in WT mice in the preventative study. In the therapeutic arm of the study, subcutaneous injection of INZ-701 beginning at 7 days post carotid ligation also led to a significant reduction in the I/M ratio (p<0.001) in the INZ-701 treated group compared to vehicle treated ttw/ttw-mice.
These findings demonstrate that INZ-701 prevents neointimal proliferation after carotid injury in a murine model of ENPP1 Deficiency. INZ-701 is hypothesized to restore circulating levels of AMP and adenosine, both potent inhibitors of intimal hyperplasia. Neointimal proliferation is a key feature in the pathophysiology of ENPP1 Deficiency and our results build on prior evidence to support the potential of INZ-701 to treat this rare and life-threatening disease.
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Affiliation(s)
- F Rutsch
- Münster University Children’s Hospital , Münster , Germany
| | - K O'brien
- Inozyme Pharma , Boston , United States of America
| | - Y Nitschke
- Münster University Children’s Hospital , Münster , Germany
| | - C Sullivan
- Inozyme Pharma , Boston , United States of America
| | - J Howe
- Inozyme Pharma , Boston , United States of America
| | - A Lynch
- Inozyme Pharma , Boston , United States of America
| | - D Schrier
- Inozyme Pharma , Boston , United States of America
| | - D Thompson
- Inozyme Pharma , Boston , United States of America
| | - Y Sabbagh
- Inozyme Pharma , Boston , United States of America
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Shah SA, Robertson C, Rudan I, Murray JL, McCowan C, Grange Z, Buelo A, Sullivan C, Simpson CR, Ritchie LD, Sheikh A. BNT162b2 and ChAdOx1 nCoV-19 vaccinations, incidence of SARS-CoV-2 infections and COVID-19 hospitalisations in Scotland in the Delta era. J Glob Health 2022; 12:05008. [PMID: 35356660 PMCID: PMC8942298 DOI: 10.7189/jogh.12.05008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The emergence of the B.1.617.2 Delta variant of concern was associated with increasing numbers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and COVID-19 hospital admissions. We aim to study national population level SARS-CoV-2 infections and COVID-19 associated hospitalisations by vaccination status to provide insight into the association of vaccination on temporal trends during the time in which the SARS-CoV-2 Delta variant became dominant in Scotland. Methods We used the Scotland-wide Early Pandemic Evaluation and Enhanced Surveillance (EAVE II) platform, covering the period when Delta was pervasive (May 01 to October 23, 2021). We performed a cohort analysis of every vaccine-eligible individual aged 20 or over from across Scotland. We determined the vaccination coverage, SARS-CoV-2 incidence rate and COVID-19 associated hospitalisations incidence rate. We then stratified those rates by age group, vaccination status (defined as "unvaccinated", "partially vaccinated" (1 dose), or "fully vaccinated" (2 doses)), vaccine type (BNT162b2 or ChAdOx1 nCoV-19), and coexisting conditions known to be associated with severe COVID-19 outcomes. Results During the follow-up of 4 183 022 individuals, there were 407 405 SARS-CoV-2 positive cases with 10 441 (2.6%) associated with a hospital admission. Those vaccinated with two doses (defined as fully vaccinated in the current study) of either vaccine had lower incidence rates of SARS-CoV-2 infections and much lower incidence rates of COVID-19 associated hospitalisations than those unvaccinated in the Delta era in Scotland. Younger age groups were substantially more likely to get infected. In contrast, older age groups were much more likely to be hospitalised. The incidence rates stratified by coexisting conditions were broadly comparable with the overall age group patterns. Conclusions This study suggests that national population level vaccination was associated with a reduction in SARS-CoV-2 infections and COVID-19 associated hospitalisation in Scotland throughout the Delta era.
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Affiliation(s)
| | | | - Igor Rudan
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Zoe Grange
- Public Health Scotland, Glasgow, Edinburgh, UK
| | | | | | - Colin R Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | | | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
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19
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Strong J, Drummond S, Hanson J, Pole JD, Engstrom T, Copeland K, Lipman B, Sullivan C. Outcomes of rapid digital transformation of large-scale communications during the COVID-19 pandemic. AUST HEALTH REV 2021; 45:696-703. [PMID: 34856118 DOI: 10.1071/ah21125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022]
Abstract
Objective This study examined the content and impact of a new digital communication medium, called a VIDCAST, implemented at a large hospital and health service when the COVID-19 pandemic was announced, and the key concerns held by staff at the time when the health service was preparing for the COVID-19 pandemic to arrive in this health service. Methods A mixed-methods approach was used. Thematic analysis of 20 transcripts of daily VIDCASTS broadcast between 30 March and 24 April 2020 was undertaken, in addition to descriptive analysis of feedback from an anonymous online survey. Results Survey feedback from 322 staff indicated almost universal satisfaction with this new communication method. The VIDCASTS provided a new COVID-safe method for the Executive to connect to staff at a time of uncertainty. Thematic analysis of the content of the VIDCASTS revealed three themes: 'Accurate Information', 'Reassurance and Support' and 'Innovation'. The Executive was able to reassure staff about what the organisation was doing to safeguard the health and wellbeing of all, and enabled an effective response to the pandemic. Conclusions The digital communication channel of VIDCASTS, rapidly operationalised at a major Australian hospital and health service in March 2020, provided important information and support for staff as it prepared for the anticipated COVID-19 surge. What is known about the topic? When the COVID-19 pandemic began, traditional face-to-face staff meetings were disrupted and many hospitals and their staff were left scrambling for information, and for reassurance about their safety, as they prepared to receive increasing numbers of COVID-19 patients. What does this paper add? The implementation of a digital communication tool was able to address many of the concerns raised by hospital staff in other geographic locations dealing with surging COVID-19 cases and underpinned a globally leading COVID-19 response. What are the implications for practitioners? New digitised communication methods provided an effective vehicle to inform and support staff in the early stages of pandemic preparation.
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Affiliation(s)
- J Strong
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ; ; and School of Health and Rehabilitation Sciences, The University of Queensland, 84a Services Road, St Lucia, Qld 4067, Australia; and Corresponding author.
| | - S Drummond
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - J Hanson
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - J D Pole
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia. ;
| | - T Engstrom
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia. ;
| | - K Copeland
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - B Lipman
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - C Sullivan
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ; ; and Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia. ;
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20
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Grange Z, Buelo A, Sullivan C, Moore E, Agrawal U, Boukhari K, McLaughlan I, Stockton D, McCowan C, Robertson C, Sheikh A, Murray JLK. Characteristics and risk of COVID-19-related death in fully vaccinated people in Scotland. Lancet 2021; 398:1799-1800. [PMID: 34756204 PMCID: PMC8553268 DOI: 10.1016/s0140-6736(21)02316-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 01/19/2023]
Affiliation(s)
| | | | | | | | - Utkarsh Agrawal
- School of Medicine, University of St Andrews, St Andrews, UK
| | | | | | | | - Colin McCowan
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Chris Robertson
- University of Strathclyde and Public Health Scotland, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh EH8 9AG, UK.
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21
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Hansen R, Lewis A, Sullivan C, Hirsig L. Juvenile granulosa cell tumor diagnosed in 6-month-old infant with precocious puberty. Radiol Case Rep 2021; 16:2609-2613. [PMID: 34285730 PMCID: PMC8278142 DOI: 10.1016/j.radcr.2021.06.006] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022] Open
Abstract
Juvenile granulosa cell tumor is a rare tumor diagnosed in children, which can present with precocious puberty. We have reported a case of a 6-month-old female patient who presented with precocious puberty. Abdominopelvic imaging revealed a large mixed cystic and solid mass, with internal solid enhancement, and restricted diffusion. At surgery, mass was confirmed to arise from the left ovary, and histopathology confirmed juvenile granulosa cell tumor. We provide a literature review of juvenile granulosa cell tumor and discuss imaging characteristics of this diagnosis.
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Affiliation(s)
- Rebecca Hansen
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - Austin Lewis
- The College of Medicine at Medical University of South Carolina, Charleston, SC, USA
| | - Christopher Sullivan
- Department of Pathology, Medical University of South Carolina, Charleston, SC, USA
| | - Leslie Hirsig
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
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22
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Yang R, Lee E, Willcox S, Kim J, Sullivan C, Zhao J, Griffith J, Wang R. 109 Characterization of Polyomavirus encoded-circular RNAs in Merkel Cell Carcinoma. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.112] [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: 10/24/2022]
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23
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Sullivan C, Mulholland D, Chapman L, Sheehy N. Electronic Vetting of Imaging Requests: Increasing Productivity and Patient Safety. Ir Med J 2020; 113:28. [PMID: 32407013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- C Sullivan
- Department of Radiology, St. James's Hospital, Dublin
| | - D Mulholland
- Department of Radiology, St. James's Hospital, Dublin
| | - L Chapman
- Department of Health Informatics, St. James's Hospital, Dublin
| | - N Sheehy
- Department of Radiology, St. James's Hospital, Dublin
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24
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Aczel B, Szaszi B, Sarafoglou A, Kekecs Z, Kucharský Š, Benjamin D, Chambers CD, Fisher A, Gelman A, Gernsbacher MA, Ioannidis JP, Johnson E, Jonas K, Kousta S, Lilienfeld SO, Lindsay DS, Morey CC, Munafò M, Newell BR, Pashler H, Shanks DR, Simons DJ, Wicherts JM, Albarracin D, Anderson ND, Antonakis J, Arkes HR, Back MD, Banks GC, Beevers C, Bennett AA, Bleidorn W, Boyer TW, Cacciari C, Carter AS, Cesario J, Clifton C, Conroy RM, Cortese M, Cosci F, Cowan N, Crawford J, Crone EA, Curtin J, Engle R, Farrell S, Fearon P, Fichman M, Frankenhuis W, Freund AM, Gaskell MG, Giner-Sorolla R, Green DP, Greene RL, Harlow LL, de la Guardia FH, Isaacowitz D, Kolodner J, Lieberman D, Logan GD, Mendes WB, Moersdorf L, Nyhan B, Pollack J, Sullivan C, Vazire S, Wagenmakers EJ. A consensus-based transparency checklist. Nat Hum Behav 2020; 4:4-6. [PMID: 31792401 PMCID: PMC8324470 DOI: 10.1038/s41562-019-0772-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [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] [Indexed: 11/30/2022]
Abstract
We present a consensus-based checklist to improve and document the transparency of research reports in social and behavioural research. An accompanying online application allows users to complete the form and generate a report that they can submit with their manuscript or post to a public repository.
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Affiliation(s)
- Balazs Aczel
- ELTE, Eotvos Lorand University, Budapest, Hungary.
| | | | | | | | | | | | | | | | | | | | | | | | - Kai Jonas
- Maastricht University, Maastricht, Netherlands
| | | | - Scott O Lilienfeld
- Emory University, Atlanta, GA, USA.,University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - George C Banks
- University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | | | | | - Ty W Boyer
- Georgia Southern University, Statesboro, GA, USA
| | | | | | | | | | | | | | | | | | | | | | - John Curtin
- University of Wisconsin-Madison, Madison, WI, USA
| | | | - Simon Farrell
- University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Wendy B Mendes
- University of California, San Francisco, San Francisco, CA, USA
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25
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Saddi V, Teng A, Pithers S, Allen H, Thambipillay G, Sullivan C. Nasal mask average volume-assured pressure support versus conventional bilevel respiratory support in a 10-month-old infant with congenital central hypoventilation syndrome: a case report. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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26
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Cypher LR, Sullivan C, Jones R, Phillips A. Clostridium Perfringens Bacteremia with Acute Hemolytic Anemia in the Setting of Endometrial Malignancy. Acad Forensic Pathol 2019; 9:127-133. [PMID: 34394798 DOI: 10.1177/1925362119851240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/10/2019] [Indexed: 11/17/2022]
Abstract
Acute intravascular hemolysis is a rare and often lethal complication of Clostridium perfringens septicemia.Clostridium perfringens is an anaerobic, gram-positive spore-forming rod which is commonly implicated in cases of food poisoning, gas gangrene, and severe hemolytic anemia in humans via the alpha-toxin (phospholipase C). We report an interesting and rare case of a 72-year-old woman who developed massive intravascular hemolysis secondary to C perfringens bacteremia in the setting of poorly differentiated high-grade endometrial malignancy.
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27
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Vignet C, Frank RA, Yang C, Wang Z, Shires K, Bree M, Sullivan C, Norwood WP, Hewitt LM, McMaster ME, Parrott JL. Long-term effects of an early-life exposure of fathead minnows to sediments containing bitumen. Part I: Survival, deformities, and growth. Environ Pollut 2019; 251:246-256. [PMID: 31082609 DOI: 10.1016/j.envpol.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/11/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to investigate the long-term effects of a short exposure to natural sediments within the Athabasca oil sand formation to critical stages of embryo-larval development in fathead minnows (Pimephales promelas). Three different sediments were used: Ref sediment from the upper Steepbank River tested at 3 g/L (containing 12.2 ng/g ∑PAHs), and two bitumen-rich sediments tested at 1 and 3 g/L; one from the Ells River (Ells downstream, 6480 ng/g ∑PAHs) and one from the Steepbank River (Stp downstream, 4660 ng/g ∑PAHs). Eggs and larvae were exposed to sediments for 21 days, then transferred to clean water for a 5-month grow-out and recovery period. Larval fish had significantly decreased survival after exposure to 3 g/L sediment from Stp downstream, and decreased growth (length and weight at 16 days post hatch) in Ells and Stp downstream sediments at both 1 and 3 g/L. Decreased tail length was a sensitive endpoint in larval fish exposed to Ells and Stp downstream sediments for 21 days compared to Ref sediment. After the grow-out in clean water, all growth effects from the bitumen-containing sediments recovered, but adult fish from Stp downstream 3 g/L sediment had significant increases in jaw deformities. The study shows the potential for fish to recover from the decreased growth effects caused by sediments containing oil sands-related compounds, but that some effects of the early-life sediment exposure occur later on in adult fish.
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Affiliation(s)
- C Vignet
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - R A Frank
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - C Yang
- Environment and Climate Change Canada, 335 River Road, Ottawa, ON, Canada
| | - Z Wang
- Environment and Climate Change Canada, 335 River Road, Ottawa, ON, Canada
| | - K Shires
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - M Bree
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - C Sullivan
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - W P Norwood
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - L M Hewitt
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - M E McMaster
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada
| | - J L Parrott
- Environment and Climate Change Canada, 867 Lakeshore Rd., Burlington, ON, L7S 1A1, Canada.
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28
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Wolf C, Langer C, Montes F, Pereira J, Ong WJ, Poxon-Pearson T, Ahn S, Ayoub S, Baumann T, Bazin D, Bender PC, Brown BA, Browne J, Crawford H, Cyburt RH, Deleeuw E, Elman B, Fiebiger S, Gade A, Gastis P, Lipschutz S, Longfellow B, Meisel Z, Nunes FM, Perdikakis G, Reifarth R, Richter WA, Schatz H, Schmidt K, Schmitt J, Sullivan C, Titus R, Weisshaar D, Woods PJ, Zamora JC, Zegers RGT. Constraining the Neutron Star Compactness: Extraction of the ^{23}Al(p,γ) Reaction Rate for the rp Process. Phys Rev Lett 2019; 122:232701. [PMID: 31298878 DOI: 10.1103/physrevlett.122.232701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/10/2019] [Indexed: 06/10/2023]
Abstract
The ^{23}Al(p,γ)^{24}Si reaction is among the most important reactions driving the energy generation in type-I x-ray bursts. However, the present reaction-rate uncertainty limits constraints on neutron star properties that can be achieved with burst model-observation comparisons. Here, we present a novel technique for constraining this important reaction by combining the GRETINA array with the neutron detector LENDA coupled to the S800 spectrograph at the National Superconducting Cyclotron Laboratory. The ^{23}Al(d,n) reaction was used to populate the astrophysically important states in ^{24}Si. This enables a measurement in complete kinematics for extracting all relevant inputs necessary to calculate the reaction rate. For the first time, a predicted close-lying doublet of a 2_{2}^{+} and (4_{1}^{+},0_{2}^{+}) state in ^{24}Si was disentangled, finally resolving conflicting results from two previous measurements. Moreover, it was possible to extract spectroscopic factors using GRETINA and LENDA simultaneously. This new technique may be used to constrain other important reaction rates for various astrophysical scenarios.
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Affiliation(s)
- C Wolf
- Institute for Applied Physics, Goethe University, 60438 Frankfurt am Main, Germany
| | - C Langer
- Institute for Applied Physics, Goethe University, 60438 Frankfurt am Main, Germany
| | - F Montes
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Pereira
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
| | - W-J Ong
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Poxon-Pearson
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Ahn
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Ayoub
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Baumann
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - P C Bender
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Browne
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Crawford
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R H Cyburt
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Deleeuw
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Elman
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Fiebiger
- Institute for Applied Physics, Goethe University, 60438 Frankfurt am Main, Germany
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - P Gastis
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - S Lipschutz
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Longfellow
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - Z Meisel
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Institute of Nuclear & Particle Physics, Department of Physics & Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - F M Nunes
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Perdikakis
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - R Reifarth
- Institute for Applied Physics, Goethe University, 60438 Frankfurt am Main, Germany
| | - W A Richter
- Department of Physics, University of Stellenbosch, Matieland 7602, South Africa
- iThemba LABS, P.O. Box 722, Somerset West 7129, South Africa
| | - H Schatz
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Schmidt
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Schmitt
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Sullivan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Titus
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - P J Woods
- University of Edinburgh, Edinburgh EH9 3JZ, United Kingdom
| | - J C Zamora
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R G T Zegers
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- JINA Center for the Evolution of the Elements, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
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Sullivan C, Dolata J, Barnswell KV, Greenway K, Kamps CM, Marbury Q, Pencak JA, Wilson D, Perzynski AT, Sehgal AR, Huml AM. Experiences of Kidney Transplant Recipients as Patient Navigators. Transplant Proc 2019; 50:3346-3350. [PMID: 30577205 DOI: 10.1016/j.transproceed.2018.02.090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/17/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE The use of trained kidney transplant recipients as patient navigators resulted in increased completion of the steps in the transplant process by dialysis patients. We sought to understand the experiences of these patient navigators. SETTING AND PARTICIPANTS Six kidney transplant recipients were hired and employed by transplant centers in Ohio, Kentucky, and Indiana. The transplant navigators received formal training as peer educators, met with dialysis patients on a regular basis, and provided tailored education and assistance about transplantation to each patient. They worked closely with the pretransplant coordinators and social workers to learn the details of each patient's transplant work-up. METHODOLOGY We queried navigators using open-ended questions to learn about their experiences. Navigator responses were coded and common themes identified. A thematic auditor reviewed and refined the coding. RESULTS Two primary categories of themes emerged about the navigator experience: 1. practical comments that supported programmatic or implementation observations of the navigators, and 2. affective comments that reflected a shared experience among the navigators and patients. The navigators were able to fill voids in the transplant process that were not fulfilled by other caregivers. This was accomplished by a natural bond based upon a shared experience (of dialysis and kidney failure) between the navigator and the patient. The patient and navigator became experiential partners. CONCLUSION Kidney transplant recipients trained as patient navigators fill the role of a nontraditional medical provider, offer support during the transplant process, and provide an added benefit to complement routine dialysis and nephrology care.
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Affiliation(s)
- C Sullivan
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH
| | - J Dolata
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH
| | - K V Barnswell
- Division of Transplantation, Department of Surgery, University of Louisville, Louisville, KY
| | - K Greenway
- Division of Transplantation, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - C M Kamps
- Division of Transplantation, Department of Surgery, University of Kentucky, Lexington, KY
| | - Q Marbury
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH
| | - J A Pencak
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH
| | - D Wilson
- Kidney Transplant Center, The Lutheran Hospital of Indiana, Fort Wayne, IN
| | - A T Perzynski
- Center for Health Care Research and Policy, MetroHealth Medical Center Campus of Case Western Reserve University, Cleveland, OH
| | - A R Sehgal
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH; Division of Nephrology, Department of Medicine, MetroHealth Medical Center, Cleveland, OH; Department of Population and Health Sciences, Case Western Reserve University, Cleveland, OH
| | - A M Huml
- Center for Reducing Health Disparities, Case Western Reserve University, Cleveland, OH; Division of Nephrology, Department of Medicine, MetroHealth Medical Center, Cleveland, OH; Division of Nephrology, Department of Medicine, University Hospitals, Cleveland, OH.
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Sehgal NKR, Sullivan C, Figueroa M, Pencak JA, Einstadter D, Thornton JD. A Standardized Donor Designation Ratio to Assess the Performance of Driver's License Agencies. Transplant Proc 2018; 49:1211-1214. [PMID: 28735982 DOI: 10.1016/j.transproceed.2017.01.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
Abstract
Evaluating Department of Motor Vehicles (DMV) locations based on the percent of patrons who register as donors does not account for individual characteristics that may influence willingness to donate. We reviewed the driver's licenses of 2997 randomly selected patients at an urban medical system to obtain donor designation, age, gender, and DMV location and linked patient addresses with census tract data on race, ethnicity, income, and education. We then developed a Standardized Donor Designation Ratio (SDDR) (ie, the observed number of donors at each DMV divided by the expected number of donors based on patient demographic characteristics). Overall, 1355 (45%) patients were designated as donors. Donor designation was independently associated with younger age, female gender, nonblack race, and higher income. Across 18 DMVs, the proportion of patients who were donors ranged from 30% to 68% and SDDRs ranged from 0.82 to 1.17. Among the 6 facilities in the lowest tertile by SDDR, 3 were in the lowest tertile by percent donation. In conclusion, there is a great deal of variation across DMVs in rates of organ donor designation. SDDRs that adjust for DMV patron characteristics are distinct measures that may more accurately describe the performance of DMVs in promoting organ donation.
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Affiliation(s)
| | - C Sullivan
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA
| | - M Figueroa
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA
| | - J A Pencak
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA
| | - D Einstadter
- Center for Health Care Research and Policy, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA; Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Department of Internal Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA
| | - J D Thornton
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA; Department of Internal Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA.
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Abstract
INTRODUCTION Acute traumatic or surgical wounds that cannot be primarily closed often cause substantial morbidity and mortality. This often leads to increased costs from higher material expenses, more involved nursing care, and longer hospital stays. Advancements in soft tissue expansion has made it a popular alternative to facilitate early closure without the need for more complicated plastic surgical procedures. AREAS COVERED In this review, we briefly elaborate on the history and biomechanics of tissue expansion and provide comprehensive descriptions of traditional internal tissue expanders and a variety of contemporary external tissue expanders. We describe their uses, advantages, disadvantages, and clinical outcomes. The majority of articles reviewed include case series with level IV evidence. Outcome data was collected for studies after 1990 using PubMed database. EXPERT COMMENTARY An overall reduction in cost, time-to-wound closure, hospital length-of-stay, and infection rate may be expected with most tissue expanders. However, further studies comparing outcomes and cost-effectiveness of various expanders may be beneficial. Surgeons should be aware of the wide array of tissue expanders that are commercially available to individualize treatment based on thorough understanding of their advantages and disadvantages to optimize outcomes. We predict the use of external expanders to increase in the future and the need for more invasive procedures such as flaps to decrease.
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Affiliation(s)
- Abdul R Arain
- a Resident, Division of Orthopaedic Surgery , Albany Medical Center , Albany , NY, USA
| | - Keegan Cole
- a Resident, Division of Orthopaedic Surgery , Albany Medical Center , Albany , NY, USA
| | - Christopher Sullivan
- b Medical Student , Albany Medical College, Albany Medical Center , Albany , NY, USA
| | - Samik Banerjee
- a Resident, Division of Orthopaedic Surgery , Albany Medical Center , Albany , NY, USA
| | - Jillian Kazley
- a Resident, Division of Orthopaedic Surgery , Albany Medical Center , Albany , NY, USA
| | - Richard L Uhl
- c Chairman, Division of Orthopaedic Surgery , Albany Medical Center , Albany , NY, USA
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Filichkin SA, Hamilton M, Dharmawardhana PD, Singh SK, Sullivan C, Ben-Hur A, Reddy ASN, Jaiswal P. Abiotic Stresses Modulate Landscape of Poplar Transcriptome via Alternative Splicing, Differential Intron Retention, and Isoform Ratio Switching. Front Plant Sci 2018; 9:5. [PMID: 29483921 PMCID: PMC5816337 DOI: 10.3389/fpls.2018.00005] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/03/2018] [Indexed: 05/19/2023]
Abstract
Abiotic stresses affect plant physiology, development, growth, and alter pre-mRNA splicing. Western poplar is a model woody tree and a potential bioenergy feedstock. To investigate the extent of stress-regulated alternative splicing (AS), we conducted an in-depth survey of leaf, root, and stem xylem transcriptomes under drought, salt, or temperature stress. Analysis of approximately one billion of genome-aligned RNA-Seq reads from tissue- or stress-specific libraries revealed over fifteen millions of novel splice junctions. Transcript models supported by both RNA-Seq and single molecule isoform sequencing (Iso-Seq) data revealed a broad array of novel stress- and/or tissue-specific isoforms. Analysis of Iso-Seq data also resulted in the discovery of 15,087 novel transcribed regions of which 164 show AS. Our findings demonstrate that abiotic stresses profoundly perturb transcript isoform profiles and trigger widespread intron retention (IR) events. Stress treatments often increased or decreased retention of specific introns - a phenomenon described here as differential intron retention (DIR). Many differentially retained introns were regulated in a stress- and/or tissue-specific manner. A subset of transcripts harboring super stress-responsive DIR events showed persisting fluctuations in the degree of IR across all treatments and tissue types. To investigate coordinated dynamics of intron-containing transcripts in the study we quantified absolute copy number of isoforms of two conserved transcription factors (TFs) using Droplet Digital PCR. This case study suggests that stress treatments can be associated with coordinated switches in relative ratios between fully spliced and intron-retaining isoforms and may play a role in adjusting transcriptome to abiotic stresses.
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Affiliation(s)
- Sergei A. Filichkin
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR, United States
| | - Michael Hamilton
- Department of Computer Science, Colorado State University, Fort Collins, CO, United States
| | | | - Sunil K. Singh
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR, United States
| | - Christopher Sullivan
- Center for Genome Research and Biocomputing, Oregon State University, Corvallis, OR, United States
| | - Asa Ben-Hur
- Department of Computer Science, Colorado State University, Fort Collins, CO, United States
| | - Anireddy S. N. Reddy
- Department of Biology and Program in Cell and Molecular Biology, Colorado State University, Fort Collins, CO, United States
| | - Pankaj Jaiswal
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR, United States
- *Correspondence: Pankaj Jaiswal,
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Sullivan C, Martin N, White C, Newbury-Birch D. Assessing the delivery of alcohol screening and brief intervention in sexual health clinics in the north east of England. BMC Public Health 2017; 17:884. [PMID: 29149878 PMCID: PMC5693529 DOI: 10.1186/s12889-017-4878-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/26/2017] [Indexed: 11/10/2022] Open
Abstract
Background Risky drinking is associated with risky sexual experiences, however the relationship between alcohol and sex is complex. The aim of the study was to assess the feasibility of delivering alcohol screening and brief interventions in genitourinary medicine (GUM) clinics. The objectives were to; understand the levels of alcohol use amongst patients; report on the number of alcohol interventions delivered; and to analyse the relationship between alcohol use with demographic data as well as diagnosed sexually transmitted infections (STIs) to see if there were any associations. Methods All new patients attending GUM between April 2012 and March 2013 self-completed the Alcohol Use Disorder Identification Test (AUDIT) prior to their clinical consultation. Where appropriate (scoring 8+ on AUDIT) the clinician would deliver up to 2–3 min of alcohol brief intervention. Descriptive statistics, t-tests, ANOVA and logistic regression were carried out as appropriate. Results AUDIT scores were available for 90% of all new patients (3058/3390) with an average mean score of 7.75. Of those who drank alcohol, 44% were categorised as being AUDIT positive, including 2% who had a score indicative of probable alcohol dependence (20+). 55 % (n = 638) of patients who screened positive on the AUDIT received a brief intervention whilst 24% (n = 674) of drinkers were diagnosed with a STI. Logistic regression modelling revealed that males, younger age groups and those of ‘white’ ethnicity were more likely to score positive on AUDIT. Patients classified as non-students, living in deprivation quintiles one to four and categorised as probable alcohol dependence on the AUDIT were more likely to be diagnosed with an STI. Conclusion It is possible to embed alcohol screening into routine practice within sexual health services however further work is required to embed brief interventions particularly amongst increasing risk drinkers. If resources are limited, services may consider more targeted rather than universal alcohol screening to specific population groups. The study was undertaken in one GUM service in the North East of England and therefore findings may not be generalizable. The study did not assess efficacy of alcohol brief intervention in this setting.
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Affiliation(s)
- C Sullivan
- Public Health England, North East Centre, Newcastle upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - N Martin
- Balance, North East Alcohol Office, Durham, UK
| | - C White
- County Durham and Darlington NHS Foundation Trust, County Durham, UK
| | - D Newbury-Birch
- School of Health and Social Care, Teesside University, Constantine Building, Middlesbrough, TS1 3BA, UK.
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Bonomi MR, Ado S, Kooshki M, Ahmed T, Sullivan C, Waltonen J, Triozzi P. Immune-related saliva micro-RNA’s to predict clinical response to a combination of cetuximab and low-dose chemotherapy in head and neck cancer (HNSCC) patients (pts) with poor performance status (PS). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e17548] [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: 11/20/2022] Open
Abstract
e17548 Background: Recurrent/Metastatic HNSCC is an immunosuppressive disease, especially in the group of patients with poor performance status. Recent studies have shown that low dose chemotherapy, which is much better tolerated than full dose cytotoxic chemotherapy, can increase the anti-tumor immune response and cause tumor regression. In this study we assessed the immune-effects of weekly cetuximab in combination with low dose weekly chemotherapy in HNSCC pts with poor PS by measuring saliva and plasma immune modulatory micro RNAs (miRs). Methods: Patients with recurrent/metastatic HNC with an ECOG PS of 2 or 3 were treated with low-dose weekly carboplatin (AUC 1) and paclitaxel (25 mg/m2) along with weekly cetuximab (400mg/m2 followed by 250 mg/m2). Seven immune modulatory miRs (146a, 155, 181, 20a, 223, 335, 125b) were measured in the saliva and plasma by quantitative PCR prior to treatment and at week 5. Results: Between 4/2016 and 1/2017, 30 patients were enrolled in this study. 24 patients were evaluable for response. Mean age was 69 years (range 51-89), Male/Female: 14/8. ECOG PS 2/3: 13/9. Site of disease: oral cavity 7, pharynx 9, larynx 4, para-nasal 2, unknown 2. Treatment was well tolerated. The most common dose limiting toxicity was skin rash in 10/24 pts (41.5%). Response: partial response 12 (50%); stable disease 4 (16.5%); progressive disease 8 (33.5%). Reduction in miR levels by week 5 were associated with clinical response. Reduction in saliva levels of miRs 146a and 181 correlated with clinical benefit (PR+SD). Pre-treatment saliva levels of miR 146a also showed to be a predictor of tumor response to therapy. Plasma levels of the immune modulatory miRs tested were not associated with response to therapy. Conclusions: The combination of cetuximab and low-dose chemotherapy is active and well tolerated in HNSCC patients with poor PS. Reduction in saliva levels of immune modulatory miRs 146a and 181 were associated with clinical benefit to therapy.
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Affiliation(s)
| | - Safoa Ado
- Wake Forest Baptist School of Medicine, Winston-Salem, NC
| | - Mitra Kooshki
- Comprehensive Cancer Center Wake Forest University, Winston-Salem, NC
| | - Tamjeed Ahmed
- Wake Forest Baptist School of Medicine, Winston-Salem, NC
| | | | | | - Pierre Triozzi
- Comprehensive Cancer Center Wake Forest University, Winston-Salem, NC
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Castro Codesal ML, Dehaan K, Featherstone R, Bedi P, Martinez Carrasco C, Katz SL, Chan EY, Bendiak GN, Almeida F, Olmstead D, Young R, Waters K, Sullivan C, Hartlin L, MacLean JE. 0886 LONG-TERM NON-INVASIVE VENTILATION THERAPIES IN CHILDREN: A SCOPING REVIEW. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Scott M, Zegers RGT, Almus R, Austin SM, Bazin D, Brown BA, Campbell C, Gade A, Bowry M, Galès S, Garg U, Harakeh MN, Kwan E, Langer C, Loelius C, Lipschutz S, Litvinova E, Lunderberg E, Morse C, Noji S, Perdikakis G, Redpath T, Robin C, Sakai H, Sasamoto Y, Sasano M, Sullivan C, Tostevin JA, Uesaka T, Weisshaar D. Observation of the Isovector Giant Monopole Resonance via the ^{28}Si(^{10}Be,^{10}B^{*}[1.74 MeV]) Reaction at 100 AMeV. Phys Rev Lett 2017; 118:172501. [PMID: 28498679 DOI: 10.1103/physrevlett.118.172501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Indexed: 06/07/2023]
Abstract
The (^{10}Be,^{10}B^{*}[1.74 MeV]) charge-exchange reaction at 100 AMeV is presented as a new probe for isolating the isovector (ΔT=1) nonspin-transfer (ΔS=0) response of nuclei, with ^{28}Si being the first nucleus studied. By using a secondary ^{10}Be beam produced by fast fragmentation of ^{18}O nuclei at the NSCL Coupled Cyclotron Facility, applying the dispersion-matching technique with the S800 magnetic spectrometer to determine the excitation energy in ^{28}Al, and performing high-resolution γ-ray tracking with the Gamma-Ray Energy Tracking In-beam Nuclear Array (GRETINA) to identify the 1022-keV γ ray associated with the decay from the 1.74-MeV T=1 isobaric analog state in ^{10}B, a ΔS=0 excitation-energy spectrum in ^{28}Al was extracted. Monopole and dipole contributions were determined through a multipole-decomposition analysis, and the isovector giant dipole resonance and isovector giant monopole resonance (IVGMR) were identified. The results show that this probe is a powerful tool for studying the elusive IVGMR, which is of interest for performing stringent tests of modern density functional theories at high excitation energies and for constraining the bulk properties of nuclei and nuclear matter. The extracted distributions were compared with theoretical calculations based on the normal-modes formalism and the proton-neutron relativistic time-blocking approximation. Calculated cross sections based on these strengths underestimate the data by about a factor of 2, which likely indicates deficiencies in the reaction calculations based on the distorted wave Born approximation.
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Affiliation(s)
- M Scott
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R G T Zegers
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Almus
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - Sam M Austin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Campbell
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Bowry
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Galès
- IPN Orsay, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
- Horia Hulubei National Institute of Physics and Nuclear Engineering, P.O. Box MG6, Bucharest, Romania
| | - U Garg
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - M N Harakeh
- Kernfysisch Versneller Instituut-Center for Advanced Radiation Technology, University of Groningen, Groningen, 9747 AA, Netherlands
| | - E Kwan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Langer
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Lipschutz
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Litvinova
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008-5252, USA
| | - E Lunderberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Morse
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Noji
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Perdikakis
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - T Redpath
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - C Robin
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008-5252, USA
| | - H Sakai
- RIKEN, Nishina Center, Wako, 351-0198, Japan
| | - Y Sasamoto
- RIKEN, Nishina Center, Wako, 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN Campus, Wako, Saitama 351-0198, Japan
| | - M Sasano
- RIKEN, Nishina Center, Wako, 351-0198, Japan
| | - C Sullivan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - J A Tostevin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, University of Surrey, Guilford, Surrey GU2 7XH, United Kingdom
| | - T Uesaka
- RIKEN, Nishina Center, Wako, 351-0198, Japan
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
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Sehgal NKR, Sullivan C, Scallan C, Figueroa M, Pencak JA, Kirkland J, Scott K, Thornton JD. Is Signature Size Associated With Organ Donor Designation on Driver's Licenses? Transplant Proc 2017; 48:1911-5. [PMID: 27569921 DOI: 10.1016/j.transproceed.2016.02.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/16/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Previous studies suggest that large signature size is associated with narcissistic characteristics. By contrast, organ donation is an indicator of altruism. Because altruism and narcissism may be viewed as opposites, we sought to determine if smaller signature size is associated with willingness to be an organ donor. METHODS Using a cross-sectional study design, we reviewed the health records of 571 randomly selected primary care patients at a large urban safety-net medical system to obtain their demographic and medical characteristics. We also examined driver's licenses that were scanned into electronic health records as part of the patient registration process. We measured signature sizes and obtained the organ donor designation from these driver's licenses. RESULTS Overall, 256 (45%) patients were designated as donors on their driver's licenses. Signature size averaged 113.3 mm(2) but varied greatly across patients (10th percentile 49.1 mm(2), 90th percentile 226.1 mm(2)). On multivariate analysis, donor designation was positively associated with age 18-34 years, non-black race, having private insurance, and not having any comorbid conditions. However, signature size was not associated with organ donor designation. CONCLUSIONS Signature size is not associated with verified organ donor designation. Further work is needed to understand the relationship between personality types and willingness to be an organ donor.
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Affiliation(s)
- N K R Sehgal
- University School, Chagrin Falls, Ohio, United States
| | - C Sullivan
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States
| | - C Scallan
- Department of Internal Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States
| | - M Figueroa
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States
| | - J A Pencak
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States
| | - J Kirkland
- Case Western Reserve University, Cleveland, Ohio, United States
| | - K Scott
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States
| | - J D Thornton
- Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States; Department of Internal Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States; Division of Pulmonary, Critical Care, and Sleep Medicine, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, United States.
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Tix JA, Hasler CT, Sullivan C, Jeffrey JD, Suski CD. Elevated carbon dioxide has limited acute effects on Lepomis macrochirus behaviour. J Fish Biol 2017; 90:751-772. [PMID: 27781274 DOI: 10.1111/jfb.13188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 09/20/2016] [Indexed: 06/06/2023]
Abstract
The current study investigated the behavioural response of Lepomis macrochirus following exposures to elevated carbon dioxide (CO2 ). For this, L. macrochirus were held at ambient pCO2 (160 μatm pCO2 ) for 7 days, then exposed to elevated pCO2 (8300 μatm pCO2 ) for 5 days, and then returned to ambient conditions for a further 5 days to recover. At the end of each exposure period, several behavioural metrics were quantified (boldness, lateralization and activity). Data showed no change in lateralization and most metrics associated with performance and boldness. During the boldness test, however, average velocity, velocity in the thigmotaxis (outer) zone and proportion of activity in the thigmotaxis zone increased with pCO2 exposure. During post-exposure, average velocity of L. macrochirus decreased. In addition, individual rank was repeatable during the pre-exposure and post-exposure period in three of the 17 metrics investigated (average velocity in the middle zone, average velocity near object and total shuttles to the object zone), but not during the CO2 exposure period, suggesting that elevated pCO2 disrupted some behavioural performances. Overall, this study found elevated pCO2 caused disruption to behaviours of freshwater fishes such as L. macrochirus and effects do not appear to be as serious as has been shown for marine fishes.
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Affiliation(s)
- J A Tix
- Department of Natural Resources and Environmental Sciences, University of Illinois Urbana-Champaign, W-503 Turner Hall, 1102 South Goodwin Ave, Urbana, IL, 61801, U.S.A
| | - C T Hasler
- Department of Natural Resources and Environmental Sciences, University of Illinois Urbana-Champaign, W-503 Turner Hall, 1102 South Goodwin Ave, Urbana, IL, 61801, U.S.A
| | - C Sullivan
- Department of Natural Resources and Environmental Sciences, University of Illinois Urbana-Champaign, W-503 Turner Hall, 1102 South Goodwin Ave, Urbana, IL, 61801, U.S.A
| | - J D Jeffrey
- Department of Natural Resources and Environmental Sciences, University of Illinois Urbana-Champaign, W-503 Turner Hall, 1102 South Goodwin Ave, Urbana, IL, 61801, U.S.A
| | - C D Suski
- Department of Natural Resources and Environmental Sciences, University of Illinois Urbana-Champaign, W-503 Turner Hall, 1102 South Goodwin Ave, Urbana, IL, 61801, U.S.A
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Bonomi M, Ahmed T, Warner D, Waltonen J, Sullivan C, Porosnicu M, Batt K, Ruiz J, Cappellari J. Human papillomavirus-related small cell carcinoma of the oropharynx: a case report and literature review. Cancers Head Neck 2017; 2:3. [PMID: 31093350 PMCID: PMC6460677 DOI: 10.1186/s41199-017-0022-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 01/23/2017] [Indexed: 12/02/2022]
Abstract
Background Small cell carcinoma (SCC) is a rare variant of head and neck cancer characterized by a high-grade neuroendocrine cancer with similar features to small cell lung carcinoma (SCLC). Human papillomavirus (HPV) is an increasingly recognized cause of head and neck cancer but usually associated squamous cell carcinoma of the oropharynx. In this report, we present the clinical presentation, diagnosis, and management of a patient with HPV-related SCC of the oropharynx that responded favorably to chemotherapy with cisplatin plus etoposide and concomitant radiation therapy, a regimen typically used in SCLC. Case presentation We present a rare case of a 56-year-old man who presented with a three-month history of an enlarging left-sided neck mass. Imaging was consistent with a soft tissue density at the left tongue base, left level IIB nodal conglomerate, and multiple bilateral cervical lymph nodes, without evidence of distant metastasis. The patient underwent a core biopsy of the left neck level II node which read as a poorly differentiated neuroendocrine carcinoma consistent with small cell carcinoma. Polymerase chain reaction revealed that the tumor was positive for HPV16. The tumor was staged T1N2cM0 (stage IVA). He went on to receive four cycles of cisplatin and etoposide. On cycle two, he started radiotherapy to the oropharynx and involved neck nodes. He received a dose of 70 Gray (2 Gy/fraction) over a seven week-period. During the concomitant phase of chemo-radiation, the patient experienced grade IV mucositis, grade II nausea, and dehydration for which he received additional outpatient fluid and electrolyte replacement. Three months after completion of therapy, a PET/CT showed complete resolution of the tumor and metastatic lymph nodes along with no evidence of distant metastasis. Conclusion Patients with HPV-related cancer of the oropharynx require identification of the small cell variant to optimize therapy and improve outcomes.
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Affiliation(s)
- Marcelo Bonomi
- 1Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Tamjeed Ahmed
- 1Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - David Warner
- 2Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Joshua Waltonen
- 3Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Christopher Sullivan
- 3Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Mercedes Porosnicu
- 1Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Katharine Batt
- 1Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - Jimmy Ruiz
- 1Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
| | - James Cappellari
- 4Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157 USA
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Sullivan C, Curtis S, Mouzakes J. Therapeutic use of the HPV vaccine in Recurrent Respiratory Papillomatosis: A case report. Int J Pediatr Otorhinolaryngol 2017; 93:103-106. [PMID: 28109479 DOI: 10.1016/j.ijporl.2016.12.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/22/2016] [Accepted: 12/24/2016] [Indexed: 11/30/2022]
Abstract
Recurrent Respiratory Papillomatosis (RRP) is a condition characterized by recurring squamous papillomas in the aerodigestive tract due to Human Papilloma Virus (HPV) infection. Treatment includes surgical debridement of the lesions often with adjuvant therapy. A newer adjuvant agent being tested is the HPV vaccine. The case report includes a child with RRP who underwent 10 surgeries in a year with an average inter-surgical interval (ISI) of 46 days. The patient then received the scheduled regimen of 3 doses of 9 valent HPV vaccine. Since beginning the vaccination, her average ISI increased to 113 days and as of writing of this paper only 1 surgery in the last 340 days. It is theorized that the increase in humoral response to the virus can slow the course of the disease, lengthen the ISI, and decrease morbidity. The results of this case report lends evidence to the use of the HPV vaccine as a therapeutic adjuvant therapy for RRP.
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Affiliation(s)
| | - Stuart Curtis
- Division of Otolaryngology and Head-Neck Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA
| | - Jason Mouzakes
- Division of Otolaryngology and Head-Neck Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA
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Datta M, Shaw EG, Lesser GJ, Case LD, Vitolins MZ, Schneider C, Frizzell B, Sullivan C, Lively M, Franzmann E, Hu JJ. A Randomized Double-Blind Placebo-Controlled Trial of Fruit and Vegetable Concentrates on Intermediate Biomarkers in Head and Neck Cancer. Integr Cancer Ther 2017; 17:115-123. [PMID: 28102098 PMCID: PMC5501769 DOI: 10.1177/1534735416684947] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background. Head and neck cancer (HNC) patients are at an
increased risk for developing second primary tumors (SPTs). Diets rich in fruits
and vegetables (FVs) may lower HNC risk. FV concentrates may offer a potential
alternative to increasing FV intake. Methods. We conducted a
randomized, double-blind, placebo-controlled trial to evaluate whether Juice
PLUS+ (JP; a commercial product with multiple FV concentrates) has an effect on
p27 and Ki-67, biomarkers associated with the risk of SPTs. During 2004-2008, we
randomized 134 HNC patients to 12 weeks of JP (n = 72) or placebo (n = 62). Oral
cavity mucosal biopsies and whole blood were obtained at baseline and after 12
weeks. All participants were given the opportunity to receive JP for 5 years
following the end of the intervention period, and they were followed yearly for
the development of SPTs. Results. After 12 weeks, patients on
JP had significantly higher serum α-carotene (P = .009),
β-carotene (P < .0001), and lutein (P =
.003) but did not differ significantly in p27 (P = .23) or
Ki-67 (P = .95). JP use following the initial 12-week trial was
not significantly associated with SPT prevention. Conclusions.
Despite increased serum micronutrient levels, our results do not suggest a
clinical benefit of JP in HNC patients. Future studies should focus on longer
intervention periods and/or modified supplement formulations with demonstrated
chemopreventive properties.
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Affiliation(s)
| | - Edward G Shaw
- 2 Wake Forest Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Glenn J Lesser
- 3 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - L Douglas Case
- 3 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | | | - Bart Frizzell
- 3 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Mark Lively
- 3 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Jennifer J Hu
- 5 University of Miami School of Medicine, Miami, FL, USA
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Sterba KR, Garrett-Mayer E, Carpenter MJ, Tooze JA, Hatcher JL, Sullivan C, Tetrick LA, Warren GW, Day TA, Alberg AJ, Weaver KE. Smoking status and symptom burden in surgical head and neck cancer patients. Laryngoscope 2017; 127:127-133. [PMID: 27392821 PMCID: PMC5177454 DOI: 10.1002/lary.26159] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/15/2016] [Accepted: 05/26/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVES/HYPOTHESIS Head and neck squamous cell carcinoma (HNSCC) patients who smoke are at risk for poor treatment outcomes. This study evaluated symptom burden and clinical, sociodemographic, and psychosocial factors associated with smoking in surgical patients to identify potential targets for supportive care services. STUDY DESIGN Cross-sectional survey. METHODS Individuals with HNSCC of the oral cavity, larynx, or pharynx were recruited from two cancer centers and completed questionnaires assessing smoking status (never, former, current/recent), patient characteristics, and symptoms before surgery. RESULTS Of the 103 patients enrolled, 73% were male, 52% were stage IV, 41% reported current/recent smoking, and 37% reported former smoking. Current/recent smokers were less likely than former smokers to have adequate finances (53% vs. 89%, P = .001) and be married/partnered (55% vs. 79%, P = .03). Current/recent smokers were also more likely than both former and never smokers to be unemployed (49% vs. 40% and 13%, respectively, all P = .02) and lack health insurance (17% vs. 5% and 13%, respectively, all P ≤.04). Fatalistic beliefs (P = .03) and lower religiosity (P =.04) were more common in current/recent than never smokers. In models adjusted for sociodemographic/clinical factors, current/recent smokers reported more problems than former and never smokers with swallowing, speech, and cough (P ≤.04). Current/recent smokers also reported more problems than never smokers with social contact, feeling ill, and weight loss (P ≤ .02). CONCLUSIONS HNSCC patients reporting current/recent smoking before surgery have high-risk clinical and sociodemographic features that may predispose them to poor postoperative outcomes. Unique symptoms in HNSCC smokers may be useful targets for patient-centered clinical monitoring and intervention. LEVEL OF EVIDENCE 4 Laryngoscope, 127:127-133, 2017.
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Affiliation(s)
- Katherine R. Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth Garrett-Mayer
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Janet A. Tooze
- Department of Biostatistical Sciences and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeanne L. Hatcher
- Department of Otolaryngology-Head and Neck Surgery and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Christopher Sullivan
- Department of Otolaryngology-Head and Neck Surgery and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lee Anne Tetrick
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Graham W. Warren
- Department of Radiation Oncology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Terrence A. Day
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Anthony J. Alberg
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Kathryn E. Weaver
- Department of Social Sciences and Health Policy and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Abstract
In recent years, the zebrafish (Danio rerio) has developed as an important alternative to mammalian models for the study of hostpathogen interactions. Because they lack a functional adaptive immune response during the first 4-6weeks of development, zebrafish rely upon innate immune responses to protect against injuries and infections. During this early period of development, it is possible to isolate and study mechanisms of infection and inflammation arising from the innate immune response without the complications presented by the adaptive immune response. Zebrafish possess several inherent characteristics that make them an attractive option to study hostpathogen interactions, including extensive sequence and functional conservation with the human genome, optical clarity in larvae that facilitates the high-resolution visualization of host cell-microbe interactions, a fully sequenced and annotated genome, robust forward and reverse genetic tools and techniques (e.g., CRISPR-Cas9 and TALENs), and amenability to chemical studies and screens. Here, we describe methods for studying hostpathogen interactions both through systemic infections and through localized infections that allow analysis of host cell response, migration patterns, and behavior. Each of the methods described can be modified for use in downstream applications that include ecotoxicant studies and chemical screens.
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Affiliation(s)
- C Sullivan
- University of Maine, Orono, ME, United States
| | - M A Matty
- Duke University School of Medicine, Durham, NC, United States
| | | | - K A Gabor
- National Institute of Environmental Health Sciences, Durham, NC, United States
| | - P J Millard
- University of Maine, Orono, ME, United States
| | - D M Tobin
- Duke University School of Medicine, Durham, NC, United States
| | - C H Kim
- University of Maine, Orono, ME, United States
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Ball KT, Miller L, Sullivan C, Wells A, Best O, Cavanaugh B, Copus T, Corrigan N, Hawkins S, Kobbe K, Schoener A, Steiger J, Vieweg L. Effects of repeated yohimbine administration on reinstatement of palatable food seeking: involvement of dopamine D 1 -like receptors and food-associated cues. Addict Biol 2016. [PMID: 26223161 DOI: 10.1111/adb.12287] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Acute exposure to the pharmacological stressor yohimbine induces relapse to both food and drug seeking in a rat model. However, no systematic studies on the effects of chronic stress on relapse have been conducted. Because chronic stress causes changes in dopamine D1 -like receptor-mediated transmission in prefrontal cortex (a relapse node), we tested the hypothesis that chronic exposure to stress increases vulnerability to relapse via dopamine-mediated mechanisms. Additionally, to determine the role of food-conditioned cues in reinstatement of food seeking, we made discrete food-paired cues either available (CS Present) or not available (CS Absent) during extinction and reinstatement testing. Rats responded for palatable food reinforcers in daily 3-hour sessions, and the behavior was extinguished. To model chronic stress, rats were injected daily with yohimbine (0.0, 2.5, or 5.0 mg/kg; i.p.) during the first 7 days of extinction. Injections were combined with SCH-23390 (0.0, 5.0, or 10.0 µg/kg; i.p.), a D1 -like receptor antagonist. Rats were then tested for reinstatement of food seeking triggered by acute yohimbine (0.0, 1.0, or 2.0 mg/kg; i.p.) and pellet priming. Rats treated previously with chronic yohimbine displayed increased responding following acute yohimbine priming relative to non-chronically stressed rats, but in the CS Absent condition only. Conversely, the lower dose of chronic yohimbine caused an increase in pellet-primed reinstatement, but this effect was more pronounced in the CS Present condition. Importantly, SCH-23390 combined with repeated yohimbine injections attenuated these effects. Thus, chronic stress may increase vulnerability to relapse under specific circumstances via a dopamine D1 -like receptor-mediated mechanism.
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Affiliation(s)
- Kevin T. Ball
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Leah Miller
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Christopher Sullivan
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Ashleigh Wells
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Olivia Best
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Brittany Cavanaugh
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Taylor Copus
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Nathan Corrigan
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Shaina Hawkins
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Krista Kobbe
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Ashley Schoener
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Johnathan Steiger
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Lauren Vieweg
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
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Knowles B, Silveira CB, Bailey BA, Barott K, Cantu VA, Cobián-Güemes AG, Coutinho FH, Dinsdale EA, Felts B, Furby KA, George EE, Green KT, Gregoracci GB, Haas AF, Haggerty JM, Hester ER, Hisakawa N, Kelly LW, Lim YW, Little M, Luque A, McDole-Somera T, McNair K, de Oliveira LS, Quistad SD, Robinett NL, Sala E, Salamon P, Sanchez SE, Sandin S, Silva GGZ, Smith J, Sullivan C, Thompson C, Vermeij MJA, Youle M, Young C, Zgliczynski B, Brainard R, Edwards RA, Nulton J, Thompson F, Rohwer F. Erratum: Corrigendum: Lytic to temperate switching of viral communities. Nature 2016; 539:123. [DOI: 10.1038/nature19335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Fitzgerald G, Lundon D, Gallagher P, O'Rourke K, Sheehy C, Sullivan C, Silke C, Stafford F, Haroon M, Mullan R, FitzGerald O, O Shea F. FRI0417 Prevalence of Osteoporosis in An Ankylosing Spondylitis Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
When patients who are thin present with knee pain, it can be easy to overlook the possibility of slipped capital femoral epiphysis (SCFE). Although 80% of patients with a "slip" are obese, thin children are not immune to this problem. Endocrinopathies, especially hypothyroidism, can be associated with SCFE. This article describes guidelines for evaluating patients for a slip and highlights some important considerations for the atypical SCFE. Patients with open growth plates with thigh or knee pain should routinely have a hip examination as part of the evaluation. Plain radiographs, with an emphasis on obtaining a frog lateral image, are usually sufficient to make the diagnosis of SCFE. Patients diagnosed with SCFE should be immediately referred to an orthopedic surgeon because treatment for this condition is always surgical.
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O'Connor JK, Zheng XT, Sullivan C, Chuong CM, Wang XL, Li A, Wang Y, Zhang XM, Zhou ZH. Evolution and functional significance of derived sternal ossification patterns in ornithothoracine birds. J Evol Biol 2015; 28:1550-67. [PMID: 26079847 DOI: 10.1111/jeb.12675] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 06/09/2015] [Accepted: 06/12/2015] [Indexed: 12/24/2022]
Abstract
The midline pattern of sternal ossification characteristic of the Cretaceous enantiornithine birds is unique among the Ornithodira, the group containing birds, nonavian dinosaurs and pterosaurs. This has been suggested to indicate that Enantiornithes is not the sister group of Ornithuromorpha, the clade that includes living birds and their close relatives, which would imply rampant convergence in many nonsternal features between enantiornithines and ornithuromorphs. However, detailed comparisons reveal greater similarity between neornithine (i.e. crown group bird) and enantiornithine modes of sternal ossification than previously recognized. Furthermore, a new subadult enantiornithine specimen demonstrates that sternal ossification followed a more typically ornithodiran pattern in basal members of the clade. This new specimen, referable to the Pengornithidae, indicates that the unique ossification pattern observed in other juvenile enantiornithines is derived within Enantiornithes. A similar but clearly distinct pattern appears to have evolved in parallel in the ornithuromorph lineage. The atypical mode of sternal ossification in some derived enantiornithines should be regarded as an autapomorphic condition rather than an indication that enantiornithines are not close relatives of ornithuromorphs. Based on what is known about molecular mechanisms for morphogenesis and the possible selective advantages, the parallel shifts to midline ossification that took place in derived enantiornithines and living neognathous birds appear to have been related to the development of a large ventral keel, which is only present in ornithuromorphs and enantiornithines. Midline ossification can serve to medially reinforce the sternum at a relatively early ontogenetic stage, which would have been especially beneficial during the protracted development of the superprecocial Cretaceous enantiornithines.
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Affiliation(s)
- J K O'Connor
- Key Laboratory of Vertebrate Evolution and Human Origins of the Chinese Academy of Sciences, Institute of Vertebrate Paleontology and Paleoanthropology, Chinese Academy of Sciences, Beijing, China
| | - X-T Zheng
- Institute of Geology and Paleontology, Linyi University, Linyi, Shandong, China.,Tianyu Natural History Museum of Shandong, Pingyi, Shandong, China
| | - C Sullivan
- Key Laboratory of Vertebrate Evolution and Human Origins of the Chinese Academy of Sciences, Institute of Vertebrate Paleontology and Paleoanthropology, Chinese Academy of Sciences, Beijing, China
| | - C-M Chuong
- Department of Pathology, University of Southern California, Los Angeles, CA, USA
| | - X-L Wang
- Institute of Geology and Paleontology, Linyi University, Linyi, Shandong, China.,Tianyu Natural History Museum of Shandong, Pingyi, Shandong, China
| | - A Li
- Department of Pathology, University of Southern California, Los Angeles, CA, USA
| | - Y Wang
- Institute of Geology and Paleontology, Linyi University, Linyi, Shandong, China.,Tianyu Natural History Museum of Shandong, Pingyi, Shandong, China
| | - X-M Zhang
- Tianyu Natural History Museum of Shandong, Pingyi, Shandong, China
| | - Z-H Zhou
- Key Laboratory of Vertebrate Evolution and Human Origins of the Chinese Academy of Sciences, Institute of Vertebrate Paleontology and Paleoanthropology, Chinese Academy of Sciences, Beijing, China
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Reed AN, Putman T, Sullivan C, Jin L. Application of a nanoflare probe specific to a latency associated transcript for isolation of KHV latently infected cells. Virus Res 2015; 208:129-35. [PMID: 26087404 DOI: 10.1016/j.virusres.2015.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/18/2022]
Abstract
One of the unique features of herpesvirus infection is latent infection following an initial exposure, which is characterized by viral genome persistence in a small fraction of cells within the latently infected tissue. Investigation of the mechanisms of herpesvirus latency has been very challenging in tissues with only a small fraction of cells that are latently infected. Cyprinid herpesvirus 3, also known as koi herpesvirus (KHV), is an important and deadly pathogen of koi and common carp, Cyprinus carpio. Acute infection can cause up to 100% mortality in exposed fish, and fish that survive the infection become latently infected. KHV becomes latent in a small percentage of B lymphocytes and can reactivate under stressful conditions. During latency, KHV ORF6 transcript is expressed in the latently infected B lymphocytes. In order to study KHV latent infection in cells that are only latently infected, a nanoflare probe specific to ORF6 RNA was used to separate KHV latently infected cells from total peripheral white blood cells (WBC). Using the ORF6 nanoflare probe, less than 1% of peripheral WBC was isolated from KHV latently infected koi. When this enriched population of WBC was examined by real-time PCR specific for KHV, it was estimated that about 1-2 copies of viral genome persists in the sorted cells. In addition, KHV ORF6 transcript was shown to be the major transcript expressed during latency by RNA-seq analysis. This study demonstrated that an RNA nanoflare probe could be used to enrich latently infected cells, which can subsequently be used to investigate the molecular mechanisms of KHV latency.
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Affiliation(s)
- Aimee N Reed
- Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, United States; Department of Microbiology, College of Science, Oregon State University, Corvallis, OR 97331, United States
| | - Timothy Putman
- Department of Microbiology, College of Science, Oregon State University, Corvallis, OR 97331, United States
| | - Christopher Sullivan
- Center for Genome Research and Biocomputing, Oregon State University, Corvallis, OR 97331, United States
| | - Ling Jin
- Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, United States; Department of Microbiology, College of Science, Oregon State University, Corvallis, OR 97331, United States.
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O'Shea F, Gallagher P, Sullivan C, Sheehy C, Silke C, O'Rourke K, Stafford F, Haroon M, Mullan R, FitzGerald O. FRI0211 High Body Mass Index in Ankylosing Spondylitis is Associated with Greater Disease Activity and More Functional Impairmairment:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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