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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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Moore HJ, Lake AA, O’Malley CL, Bradford C, Gray N, Chang M, Mathews C, Townshend TG. The impact of COVID-19 on the hot food takeaway planning regulatory environment: perspectives of local authority professionals in the North East of England. Perspect Public Health 2024; 144:52-60. [PMID: 35929588 PMCID: PMC10757382 DOI: 10.1177/17579139221106343] [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] [Indexed: 11/16/2022]
Abstract
AIMS Planning regulations have been used to prevent the over-proliferation of hot food takeaways, minimising the impact of local obesogenic environments. To help mitigate the effects of lockdown, the UK government introduced temporary changes in March 2020 to Planning Regulations for England, allowing food retailers to open for takeaway services beyond 'ancillary' level without needing to apply for planning permission through permitted development rights (PDR). Businesses are required to notify their local authority (LA) when they implement PDRs. To better understand the impact of regulations on the policy and practice of key professional groups, Public Health England commissioned Teesside University to undertake scoping research in the North East of England. METHODS A focus group and interviews were conducted with 15 professionals from 7 of 12 North East LAs. Professions included Planners, Public Health Leads, Environmental Health Officers and Town Centre Managers. Data were analysed using a codebook thematic analysis approach. An interpretation meeting with some participants was conducted. RESULTS LAs were not aware of most businesses notifying them of new regulation adherence despite taking up PDRs, but were considered low-priority with many lacking formal recording procedures. There were concerns about health consequences of the changes, and consensus relating to ongoing issues with capacity across all professional groups, largely due to the continuing pandemic and absence of a strategy out of temporary measures. Concerns existed around ensuring cessation of restaurants trading as takeaways, and hygiene inspections backlog. Many (personally) saw new takeaways as a lifeline, offering broader menus and preserving local economies. CONCLUSION Lack of information around the number of restaurants/pubs using PDR to trade as takeaway services, ongoing capacity issues of LAs and, at the time, the absence of a strategy post regulation changes, meant there were high levels of uncertainty regarding the impacts of these temporary measures.
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Affiliation(s)
- HJ Moore
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - AA Lake
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - CL O’Malley
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - C Bradford
- Centre for Public Health Research, School of Health & Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - N Gray
- School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - M Chang
- Healthy Places, Public Health England, London, UK WHO Collaborating Centre for Healthy Urban Environments, University of the West of England, Bristol, UK
| | - C Mathews
- Health and Wellbeing, North East, Public Health England, Newcastle upon Tyne, UK
| | - TG Townshend
- School of Architecture, Planning & Landscape, Newcastle University, Newcastle upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Siegfried NL, De Voux A, Jona K, Yun JA, Chetty T, Mabona M, Els F, Mdose H, Kuonza L, Hsiao M, Mathews C. SARS-CoV-2 Transmission Risk in the School Environment: a pilot case-ascertained prospective study to inform future school-based surveillance. S Afr Med J 2023; 113:30-38. [PMID: 37170607 DOI: 10.7196/samj.2023.v113i5.16736] [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] [Received: 03/06/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND There is no current active or passive disease surveillance programme focused on schools in South Africa. As such the country is missing an opportunity to rapidly and effectively flag and address pathogen outbreaks, for example SARS-CoV-2, in a key closed setting. Furthermore, the role of school transmission in the spread of the SARS-CoV-2 virus within communities is uncertain. Objective. This pilot study, conducted during March 2022 in Cape Town, aimed to indicate the feasibility of conducting intense active contact-tracing in a school environment prior to a large national study to compare school versus community SARS-CoV-2 transmission risk. Methods. We conducted a pilot school-level case-ascertained prospective study with a component of enhanced surveillance. Following study initiation, the first learner at a participating school who tested SARS-CoV-2 positive (via Polymerase Chain Reaction (PCR) or a Rapid Antigen Test (RAT)) was invited to join the study as the index case and all their school-based close contacts were followed up telephonically, monitored for symptoms for 14 days, and tested using a PCR if any symptoms were reported. Results. On 8th March 2022, a student with RAT laboratory-confirmed COVID-19 was identified and they and their guardian consented to participate as the index case. Of the 11 eligible close contacts, six provided consent/assent and completed symptom monitoring calls until the end of the 14-day study period. The Secondary Attack Rate (SAR) was 2/11 (18.18%) of all close contacts who were at risk of infection, 2/4 (50.0%) of all those close contacts who developed symptoms, and 2/4 (50.0%) of all those close contacts who developed symptoms and were tested for SARS-CoV-2. During the same period, the school reported that nine of the 926 learner body tested COVID-19 positive (0.97%). Total hours spent conducting monitoring for 6 learners was 27 hours, with each learner requiring approximately 4.5 hours of contact time during the study period. Conclusion. This is the first South African school-based COVID-19 transmission study, the results of which can inform national discussions regarding the role of schools and school-based active and passive surveillance in pathogen prevention and control.
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Affiliation(s)
- N L Siegfried
- Health Systems Research Unit, South African Medical Council, Tygerberg, South Africa. Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - A De Voux
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - K Jona
- Health Systems Research Unit, South African Medical Council, and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J A Yun
- Health Systems Research Unit, South African Medical Council, and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Chetty
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Mabona
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - F Els
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - H Mdose
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - L Kuonza
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Hsiao
- SouthAfricanFieldEpidemiologyTrainingProgramme,DivisionofPublicHealth,SurveillanceandResponse,NationalInstituteforCommunicable Diseases of the National Health Laboratory Service, and Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
| | - C Mathews
- Health Systems Research Unit, South African Medical Council, and Faculty of Health Sciences, University of Cape Town, South Africa.
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Oaknin A, Pothuri B, Gilbert L, Sabatier R, Brown J, Ghamande S, Mathews C, O'Malley D, Boni V, Gravina A, Banerjee S, Miller R, Pikiel J, Mirza M, Duan T, Han X, Zildjian S, Dewal N, J.Veneris, Tinker A. 547P Efficacy of dostarlimab in endometrial cancer (EC) by molecular subtype: A post hoc analysis of the GARNET study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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5
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DiSilvestro P, Banerjee S, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Oza A, Gonzalez Martin A, Aghajanian C, Bradley W, Mathews C, McNamara J, Lowe E, Moore K. 517O Overall survival (OS) at 7-year (y) follow-up (f/u) in patients (pts) with newly diagnosed advanced ovarian cancer (OC) and a BRCA mutation (BRCAm) who received maintenance olaparib in the SOLO1/GOG-3004 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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6
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Tinker A, Pothuri B, Gilbert L, Sabatier R, Brown J, Ghamande S, Mathews C, O'Malley D, Boni V, Gravina A, Banerjee S, Miller R, Pikiel J, Mirza M, Duan T, Antony G, Zildjian S, Zografos E, Veneris J, Oaknin A. 548P Progression-free survival (PFS) and overall survival (OS) in advanced/recurrent (AR) mismatch repair deficient/microsatellite instability–high or proficient/stable (dMMR/MSI-H or MMRp/MSS) endometrial cancer (EC) treated with dostarlimab in the GARNET study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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7
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Mathews C, Kirby S. P244 The experiences of taking Kaftrio® for cystic fibrosis (CF). J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Mindel EL, Mathews C. P242 Young people’s views on Kaftrio®: a peer research project. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00571-9] [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: 10/18/2022]
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9
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Hamilton E, Goel S, Arend R, Chu C, Richardson D, Corr B, John V, Janku F, Hays J, Michenzie M, Reichmann W, Achour H, Sherman M, Ruiz-Soto R, Mathews C. 728P A phase Ib/II study of rebastinib and paclitaxel in advanced/metastatic platinum-resistant ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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Oaknin A, Gilbert L, Tinker A, Brown J, Mathews C, Press J, Sabatier R, O'Malley D, Samouelian V, Boni V, Duska L, Ghamande S, Ghatage P, Kristeleit R, Leath C, Han X, Kumar S, Duan T, Im E, Pothuri B. 76P Analysis of antitumor activity of dostarlimab by tumor mutational burden (TMB) in patients (pts) with endometrial cancer (EC) in the GARNET trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.356] [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: 10/20/2022] Open
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11
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Hanker LC, Oaknin A, Tinker A, Gilbert L, Samouëlian V, Mathews C, Brown J, Guo W, Danaee H, Im E, Sabatier R. Safety and efficacy of the anti-PD-1 monoclonal antibody dostarlimab in patients with recurrent or advanced dMMR endometrial cancer. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- LC Hanker
- AGO & University Hospital Schleswig-Holstein, Campus Lübeck, Department of Gynecology & Obstetrics
| | | | | | - L Gilbert
- Vall d’Hebron University Hospital, Vall d´Hebron Institute of Oncology (VHIO)
| | - V Samouëlian
- Gynecologic Oncology Service, Centre Hospitalier de l’Université de Montréal, Department of Obstetrics and Gynecology
| | - C Mathews
- Women and Infants Hospital of Rhode Island
| | - J Brown
- Levine Cancer Institute, Carolinas HealthCare System, Division of Gynecologic Oncology
| | | | | | | | - R Sabatier
- Aix-Marseille University, Department of Medical Oncology
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12
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Ray HC, Corliss BA, Bruce AC, Kesting S, Dey P, Mansour J, Seaman SA, Smolko CM, Mathews C, Dey BK, Owens GK, Peirce SM, Yates PA. Myh11+ microvascular mural cells and derived mesenchymal stem cells promote retinal fibrosis. Sci Rep 2020; 10:15808. [PMID: 32978500 PMCID: PMC7519078 DOI: 10.1038/s41598-020-72875-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 08/10/2020] [Indexed: 12/29/2022] Open
Abstract
Retinal diseases are frequently characterized by the accumulation of excessive scar tissue found throughout the neural retina. However, the pathophysiology of retinal fibrosis remains poorly understood, and the cell types that contribute to the fibrotic response are incompletely defined. Here, we show that myofibroblast differentiation of mural cells contributes directly to retinal fibrosis. Using lineage tracing technology, we demonstrate that after chemical ocular injury, Myh11+ mural cells detach from the retinal microvasculature and differentiate into myofibroblasts to form an epiretinal membrane. Inhibition of TGFβR attenuates Myh11+ retinal mural cell myofibroblast differentiation, and diminishes the subsequent formation of scar tissue on the surface of the retina. We demonstrate retinal fibrosis within a murine model of oxygen-induced retinopathy resulting from the intravitreal injection of adipose Myh11-derived mesenchymal stem cells, with ensuing myofibroblast differentiation. In this model, inhibiting TGFβR signaling does not significantly alter myofibroblast differentiation and collagen secretion within the retina. This work shows the complexity of retinal fibrosis, where scar formation is regulated both by TGFβR and non-TGFβR dependent processes involving mural cells and derived mesenchymal stem cells. It also offers a cautionary note on the potential deleterious, pro-fibrotic effects of exogenous MSCs once intravitreally injected into clinical patients.
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Affiliation(s)
- H Clifton Ray
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Bruce A Corliss
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Anthony C Bruce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Sam Kesting
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Paromita Dey
- The RNA Institute, University at Albany, State University of New York, Albany, NY, USA
| | - Jennifer Mansour
- Department of Biology, University of Virginia, Charlottesville, VA, USA
| | - Scott A Seaman
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Christian M Smolko
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Corbin Mathews
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Bijan K Dey
- The RNA Institute, University at Albany, State University of New York, Albany, NY, USA
| | - Gary K Owens
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Molecular Physiology and Biological Physics, University of Virginia, Charlottesville, VA, USA
| | - Shayn M Peirce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Paul A Yates
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
- Department of Ophthalmology, University of Virginia, PO Box 800715, Charlottesville, VA, 22908, USA.
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Corliss BA, Ray HC, Doty RW, Mathews C, Sheybani N, Fitzgerald K, Prince R, Kelly-Goss MR, Murfee WL, Chappell J, Owens GK, Yates PA, Peirce SM. Pericyte Bridges in Homeostasis and Hyperglycemia. Diabetes 2020; 69:1503-1517. [PMID: 32321760 PMCID: PMC7306121 DOI: 10.2337/db19-0471] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 04/17/2020] [Indexed: 12/29/2022]
Abstract
Diabetic retinopathy is a potentially blinding eye disease that threatens the vision of one-ninth of patients with diabetes. Progression of the disease has long been attributed to an initial dropout of pericytes that enwrap the retinal microvasculature. Revealed through retinal vascular digests, a subsequent increase in basement membrane bridges was also observed. Using cell-specific markers, we demonstrate that pericytes rather than endothelial cells colocalize with these bridges. We show that the density of bridges transiently increases with elevation of Ang-2, PDGF-BB, and blood glucose; is rapidly reversed on a timescale of days; and is often associated with a pericyte cell body located off vessel. Cell-specific knockout of KLF4 in pericytes fully replicates this phenotype. In vivo imaging of limbal vessels demonstrates pericyte migration off vessel, with rapid pericyte filopodial-like process formation between adjacent vessels. Accounting for off-vessel and on-vessel pericytes, we observed no pericyte loss relative to nondiabetic control retina. These findings reveal the possibility that pericyte perturbations in location and process formation may play a role in the development of pathological vascular remodeling in diabetic retinopathy.
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Affiliation(s)
- Bruce A Corliss
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - H Clifton Ray
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Richard W Doty
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Corbin Mathews
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Natasha Sheybani
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Kathleen Fitzgerald
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Remi Prince
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Molly R Kelly-Goss
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Walter L Murfee
- Department of Biomedical Engineering, University of Florida, Gainesville, FL
| | - John Chappell
- Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | - Gary K Owens
- Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA
| | - Paul A Yates
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
- Department of Ophthalmometry, University of Virginia School of Medicine, Charlottesville, VA
| | - Shayn M Peirce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
- Department of Ophthalmometry, University of Virginia School of Medicine, Charlottesville, VA
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14
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Siegfried N, Mathews C. COVID-19 and the school response: Looking back to learn what we can do better. S Afr Med J 2020; 110:727-728. [PMID: 32880297] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023] Open
Affiliation(s)
- N Siegfried
- Independent Public Health Medicine Specialist; Chief Specialist Scientist, South African Medical Research Council, Cape Town, South Africa; Honorary Associate Professor, Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
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Corliss BA, Doty RW, Mathews C, Yates PA, Zhang T, Peirce SM. REAVER: A program for improved analysis of high-resolution vascular network images. Microcirculation 2020; 27:e12618. [PMID: 32173962 PMCID: PMC7507177 DOI: 10.1111/micc.12618] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 12/17/2022]
Abstract
Alterations in vascular networks, including angiogenesis and capillary regression, play key roles in disease, wound healing, and development. The spatial structures of blood vessels can be captured through imaging, but effective characterization of network architecture requires both metrics for quantification and software to carry out the analysis in a high‐throughput and unbiased fashion. We present Rapid Editable Analysis of Vessel Elements Routine (REAVER), an open‐source tool that researchers can use to analyze high‐resolution 2D fluorescent images of blood vessel networks, and assess its performance compared to alternative image analysis programs. Using a dataset of manually analyzed images from a variety of murine tissues as a ground‐truth, REAVER exhibited high accuracy and precision for all vessel architecture metrics quantified, including vessel length density, vessel area fraction, mean vessel diameter, and branchpoint count, along with the highest pixel‐by‐pixel accuracy for the segmentation of the blood vessel network. In instances where REAVER's automated segmentation is inaccurate, we show that combining manual curation with automated analysis improves the accuracy of vessel architecture metrics. REAVER can be used to quantify differences in blood vessel architectures, making it useful in experiments designed to evaluate the effects of different external perturbations (eg, drugs or disease states).
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Affiliation(s)
- Bruce A Corliss
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Richard W Doty
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Corbin Mathews
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Paul A Yates
- Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Tingting Zhang
- Department of Statistics, University of Virginia, Charlottesville, Virginia
| | - Shayn M Peirce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia.,Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, Virginia
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Corliss BA, Ray HC, Mathews C, Fitzgerald K, Doty RW, Smolko CM, Shariff H, Peirce SM, Yates PA. Myh11 Lineage Corneal Endothelial Cells and ASCs Populate Corneal Endothelium. Invest Ophthalmol Vis Sci 2019; 60:5095-5103. [PMID: 31826231 PMCID: PMC6905658 DOI: 10.1167/iovs.19-27276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/24/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose To establish Myh11 as a marker of a subset of corneal endothelial cells (CECs), and to demonstrate the feasibility of restoring the corneal endothelium with Myh11-lineage (Myh11-Lin[+]) adipose-derived stromal cells (ASCs). Methods Intraperitoneal administration of tamoxifen and (Z)-4-hydroxytamoxifen eyedrops were used to trace the lineage of Myh11-expressing cells with the Myh11-Cre-ERT2-flox-tdTomato mouse model. Immunostaining and Western blot characterized marker expression and spatial distribution of Myh11-Lin(+) cells in the cornea, and administration of 5-ethynyl-2'-deoxyuridine labeled proliferating cells. ASCs were isolated from epididymal adipose Myh11+ mural cells and treated with cornea differentiation media to evaluate corneal endothelial differentiation potential. Differentiated ASCs were injected into the anterior chamber to test for incorporation into corneal endothelium following scratch injury. Results A subset of CECs express Myh11, a marker previously thought restricted to only mural cells. Myh11-Lin(+) CECs marked a stable subpopulation of cells in the cornea endothelium. Myh11-Lin(+) ASCs undergo CEC differentiation in vitro and incorporate into injured corneal endothelium. Conclusions Dystrophy and dysfunction of the corneal endothelium accounts for almost half of all corneal transplants, the maintenance of the cornea endothelium is poorly understood, and there are a lack of mouse models to study specific CEC populations. We establish a mouse model that can trace the cell fate of a subpopulation of CECs based on Myh11 expression. A subset of ASCs that share this Myh11 transcriptional lineage are capable of differentiating into CECs that can incorporate into injured corneal endothelium, revealing a potential cell source for creating engineered transplant material.
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Affiliation(s)
- Bruce A. Corliss
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - H. Clifton Ray
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - Corbin Mathews
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - Kathleen Fitzgerald
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - Richard W. Doty
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - Chris M. Smolko
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - Hamzah Shariff
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
| | - Shayn M. Peirce
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
- Department of Ophthalmology, University of Virginia, Charlottesville, Virginia, United States
| | - Paul A. Yates
- Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States
- Department of Ophthalmology, University of Virginia, Charlottesville, Virginia, United States
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Corliss BA, Mathews C, Doty R, Rohde G, Peirce SM. Cover Image. Microcirculation 2019. [DOI: 10.1111/micc.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nessle CN, Ghosal S, Mathews C, Taylor D, Myers J, Raj A, Panigrahi A. Weak correlation of bleeding scores to platelet electron microscopy: A retrospective chart review of pediatric patients with delta-storage pool disorder. Pediatr Blood Cancer 2019; 66:e27505. [PMID: 30345617 DOI: 10.1002/pbc.27505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/11/2018] [Accepted: 09/24/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Delta granule storage pool deficiency (δ-SPD) is a rare platelet disorder in which a deficiency of platelet granules leads to poor aggregation, resulting in varying clinical bleeding phenotypes. Children with δ-SPD have variable laboratory results, making the proper diagnosis and evaluation controversial. OBJECTIVES To describe the demographic and laboratory trends of this population and to assess the value of electron microscopy in diagnostic evaluation and its correlation to bleeding symptoms. METHODS We performed a retrospective review of 109 pediatric patients diagnosed with δ-SPD. We collected demographic information and bleeding scores using a validated bleeding assessment tool. A descriptive and exploratory analysis was performed. RESULTS The majority of patients were female, with an average age at diagnosis of 11.61 years. Females were diagnosed at a significantly older age presenting most often with menorrhagia, while males presented most commonly with epistaxis. The majority showed normal lumiaggregometry, the mean platelet electron microscopy (PEM) value was 2.37, and the mean bleeding score was 6. Bleeding assessment tool and PEM had a significantly weak correlation. CONCLUSIONS Patients with more dense granules per platelet had higher bleeding scores than those with fewer dense granules per platelet. The current body of evidence does not favor the use of PEM in routine clinical practice, and results are difficult to interpret. In patients with severe mucocutaneous bleeding symptoms and normal platelet aggregation studies, consideration should be given to an alternative diagnosis and further evaluation is warranted.
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Affiliation(s)
- C N Nessle
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - S Ghosal
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - C Mathews
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - D Taylor
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - J Myers
- Department of Pediatrics, University of Louisville, Louisville, Kentucky.,Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - A Raj
- Department of Pediatrics, University of Louisville, Louisville, Kentucky.,Department of Pediatric Hematology Oncology, University of Louisville, Louisville, Kentucky
| | - A Panigrahi
- Department of Pediatric Hematology Oncology, University of California-Davis, Davis, California
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Corliss BA, Mathews C, Doty R, Rohde G, Peirce SM. Methods to label, image, and analyze the complex structural architectures of microvascular networks. Microcirculation 2019; 26:e12520. [PMID: 30548558 PMCID: PMC6561846 DOI: 10.1111/micc.12520] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/31/2018] [Accepted: 11/26/2018] [Indexed: 12/30/2022]
Abstract
Microvascular networks play key roles in oxygen transport and nutrient delivery to meet the varied and dynamic metabolic needs of different tissues throughout the body, and their spatial architectures of interconnected blood vessel segments are highly complex. Moreover, functional adaptations of the microcirculation enabled by structural adaptations in microvascular network architecture are required for development, wound healing, and often invoked in disease conditions, including the top eight causes of death in the Unites States. Effective characterization of microvascular network architectures is not only limited by the available techniques to visualize microvessels but also reliant on the available quantitative metrics that accurately delineate between spatial patterns in altered networks. In this review, we survey models used for studying the microvasculature, methods to label and image microvessels, and the metrics and software packages used to quantify microvascular networks. These programs have provided researchers with invaluable tools, yet we estimate that they have collectively attained low adoption rates, possibly due to limitations with basic validation, segmentation performance, and nonstandard sets of quantification metrics. To address these existing constraints, we discuss opportunities to improve effectiveness, rigor, and reproducibility of microvascular network quantification to better serve the current and future needs of microvascular research.
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Affiliation(s)
- Bruce A Corliss
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Corbin Mathews
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Richard Doty
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Gustavo Rohde
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Shayn M Peirce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
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de Vries PJ, Davids EL, Mathews C, Aarø LE. Measuring adolescent mental health around the globe: psychometric properties of the self-report Strengths and Difficulties Questionnaire in South Africa, and comparison with UK, Australian and Chinese data. Epidemiol Psychiatr Sci 2018; 27:369-380. [PMID: 28112065 PMCID: PMC6998978 DOI: 10.1017/s2045796016001207] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/15/2016] [Indexed: 11/06/2022] Open
Abstract
AIMS This study evaluated the psychometric properties of the Strengths and Difficulties Questionnaire Self-Report (SDQ-S) in South African adolescents, and compared findings with data from the UK, Australia and China. METHODS A sample of 3451 South African adolescents in grade 8, the first year of secondary school (Mage = 13.7 years), completed the SDQ-S in Afrikaans, English or isiXhosa. Means, group differences and internal consistency were analysed using SPSS V22, and confirmatory factor analyses were conducted using MPlus V7. RESULTS In the South African sample, significant gender differences were found for four of the five sub-scale means and for total difficulties, but gender differences of alpha scores were negligible. The internal consistency for the total difficulties, prosocial behaviour and emotional symptoms sub-scales were fair. UK cut-off values for caseness (set to identify the top 10% of scores in a UK sample) led to a higher proportion of South African adolescents classified in the 'abnormal' range on emotional and peer difficulties and a lower proportion classified in the 'abnormal' range for hyperactivity. South African cut-offs were therefore generated. The cross-country comparison with UK, Australian and Chinese data showed that South African adolescent boys and girls had the highest mean scores on total difficulties as well as on the subscales of emotional symptoms and conduct problems. In contrast, South African boys and girls had the lowest mean scores for hyperactivity/inattention. The UK boys and girls had the highest mean scores for hyperactivity/inattention, while the Australian sample had the highest scores for prosocial behaviours. The Chinese boys had the highest peer problem mean scores and Chinese boys and girls had the lowest means on prosocial behaviours. Confirmatory factor analyses showed significant item loadings with loadings higher than 0.40 for the emotional and prosocial behaviour sub-scales on the five-factor model, but not for all relevant items on the other three domains. CONCLUSIONS Findings support the potential usefulness of the SDQ-S in a South African setting, but suggest that the SDQ-S should not be used with UK cut-off values, and indicate the need for further validation and standardisation work in South African adolescents. We recommend that in-country cut-offs for 'caseness' should be used for clinical purposes in South Africa, that cross-country comparisons should be made with caution, and that further examination of naturalistic clusters and factors of the SDQ should be performed in culturally and contextually diverse settings.
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Affiliation(s)
- P. J. de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Adolescent Health Research Unit, University of Cape Town, South Africa
| | - E. L. Davids
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Adolescent Health Research Unit, University of Cape Town, South Africa
| | - C. Mathews
- Adolescent Health Research Unit, University of Cape Town, South Africa
- Health Systems Research Unit, Medical Research Council; & School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - L. E. Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
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Finer S, Iqbal MS, Lowe R, Ogunkolade BW, Pervin S, Mathews C, Smart M, Alam DS, Hitman GA. Is famine exposure during developmental life in rural Bangladesh associated with a metabolic and epigenetic signature in young adulthood? A historical cohort study. BMJ Open 2016; 6:e011768. [PMID: 27881521 PMCID: PMC5168545 DOI: 10.1136/bmjopen-2016-011768] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Famine exposure in utero can 'programme' an individual towards type 2 diabetes and obesity in later life. We sought to identify, (1) whether Bangladeshis exposed to famine during developmental life are programmed towards diabetes and obesity, (2) whether this programming was specific to gestational or postnatal exposure windows and (3) whether epigenetic differences were associated with famine exposure. DESIGN A historical cohort study was performed as part of a wider cross-sectional survey. Exposure to famine was defined through birth date and historical records and participants were selected according to: (A) exposure to famine in postnatal life, (B) exposure to famine during gestation and (C) unexposed. SETTING Matlab, a rural area in the Chittagong division of Bangladesh. PARTICIPANTS Young adult men and women (n=190) recruited to a historical cohort study with a randomised subsample included in an epigenetic study (n=143). OUTCOME MEASURES Primary outcome measures of weight, body mass index and oral glucose tolerance tests (0 and 120 min glucose). Secondary outcome measures included DNA methylation using genome-wide and targeted analysis of metastable epialleles sensitive to maternal nutrition. RESULTS More young adults exposed to famine in gestation were underweight than those postnatally exposed or unexposed. In contrast, more young adults exposed to famine postnatally were overweight compared to those gestationally exposed or unexposed. Underweight adults exposed to famine in gestation in utero were hyperglycaemic following a glucose tolerance test, and those exposed postnatally had elevated fasting glucose, compared to those unexposed. Significant differences in DNA methylation at seven metastable epialleles (VTRNA2-1, PAX8, PRDM-9, near ZFP57, near BOLA, EXD3) known to vary with gestational famine exposure were identified. CONCLUSIONS Famine exposure in developmental life programmed Bangladeshi offspring towards diabetes and obesity in adulthood but gestational and postnatal windows of exposure had variable effects on phenotype. DNA methylation differences were replicated at previously identified metastable epialleles sensitive to periconceptual famine exposure.
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Affiliation(s)
- S Finer
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - M S Iqbal
- Center for Control and Chronic disease' to Initiative for Non-Communicable Diseases (INCD), Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - R Lowe
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - B W Ogunkolade
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - S Pervin
- Center for Control and Chronic disease' to Initiative for Non-Communicable Diseases (INCD), Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - C Mathews
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - M Smart
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
| | - D S Alam
- Center for Control and Chronic disease' to Initiative for Non-Communicable Diseases (INCD), Health System and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - G A Hitman
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, London, UK
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Miyazaki D, Mathews C, Sherif El Haraki A. 13: Validation of an educational simulation model for vaginal hysterectomy (VH) training design: Prospective cohort study. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND There is currently no national screening programme for prostate cancer in England, but eligible men can request a prostate-specific antigen (PSA) test from their general practitioner (GP). There are no routinely available data to monitor the extent of PSA testing and referral. AIM The aim of this study was to investigate the rate of PSA testing in general practice and subsequent patterns of referral. DESIGN AND SETTING Data obtained from the Clinical Practice Research Datalink (CPRD) for men aged 45-84 years who had a PSA test during 2010-2011, registered in practices in England with linked Hospital Episode Statistics (HES) data. METHOD Patient data were linked to previous tests and consultations. Rates of PSA testing and proportions of men retested and referred to secondary care were calculated. RESULTS Overall, 8.74 (95% CI 8.67-8.82) of men per 100 person-years were tested at least once in 2010, and 9.45 (95% CI 9.37-9.53) in 2011. Rates increased with age and decreased with increasing level of deprivation. Of the 53,069 men tested in 2010, 11,289 (21.3%) had a previous PSA test within the past 12 months. Of men with raised PSA according to age specific guidelines, 22.4% (2113/9425) were referred to secondary care within 14 days, with 36% of the remainder retested within 6 months. CONCLUSIONS Rates of PSA testing have increased compared with earlier studies; the data suggest that many GPs are retesting men with raised PSA rather than referring immediately. More routine data on PSA testing, including reasons for testing, and subsequent management and outcomes, are required.
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Affiliation(s)
- S Moss
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - J Melia
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - J Sutton
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - C Mathews
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - M Kirby
- Faculty of Health and Human Sciences, University of Hertfordshire and the Prostate Centre, London, UK
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Murphy K, Steyn K, Mathews C. The midwife's role in providing smoking cessation interventions for pregnant women: The views of midwives working with high risk, disadvantaged women in public sector antenatal services in South Africa. Int J Nurs Stud 2015; 53:228-37. [PMID: 26302658 DOI: 10.1016/j.ijnurstu.2015.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 08/04/2015] [Accepted: 08/04/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the knowledge, attitudes, beliefs and current practices of South Africa midwives in relation to providing smoking cessation education or counselling to pregnant women. This was with a view to involving them in a potential smoking cessation intervention, targeting a sub-group of South African women who are at particularly high risk of the adverse pregnancy outcomes associated with smoking. DESIGN A cross-sectional survey of midwives, supplemented by individual, in depth, qualitative interviews. SETTING Public sector antenatal clinics serving this particular community of women in five of the major urban centres of South Africa. PARTICIPANTS A total of 102 midwives were surveyed across 29 antenatal clinics and 24 were interviewed. MEASUREMENTS Self-administered survey and semi-structured, individual interviews describing constructs from the Theory of Planned Behaviour with respect to the provision of smoking cessation education/counselling, including: knowledge, attitudes, subjective norms and perceived behavioural control. FINDINGS The majority of midwives accepted that providing smoking cessation advice was a part of their remit, perceived prevailing social norms to be supportive and were, overall, positively predisposed to participating in a smoking cessation intervention in antenatal clinics. However, the study identified a number of constraints to midwives fulfilling this role, which affected their perceived behavioural control. These included stressful working conditions, too little time, a dearth of educational resources and a lack of knowledge of best practice intervention methods and counselling skills. Perceived patient resistance to quitting was a further obstacle. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE For the intervention to be accepted and adopted by midwives, it would need to offer them an opportunity to enhance their professional knowledge and expertise, provide them with attractive educational aids and take into account the very limited time they have for smoking education. Patient-centred, best practice methods for cessation counselling may help midwives overcome the problem of patient resistance and to engage smokers in constructive discussions about smoking with a greater prospect of success.
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Affiliation(s)
- K Murphy
- Chronic Diseases of Lifestyle Unit, Medical Research Council, South Africa; Chronic Disease Initiative for Africa, University of Cape Town, South Africa.
| | - K Steyn
- Chronic Diseases of Lifestyle Unit, Medical Research Council, South Africa; Chronic Disease Initiative for Africa, University of Cape Town, South Africa
| | - C Mathews
- Department of Public Health and Family Medicine, University of Cape Town, South Africa
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Lokich E, Palisoul M, Romano N, Stuckey A, Robison K, DiSilvestro P, Mathews C, Miller M, Granai C, Moore R. ROMA guided conservative management for women diagnosed with an ovarian cyst or pelvic mass. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.049] [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: 11/24/2022]
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Cachay E, Agmas W, Mathews C. Five-year cumulative incidence of invasive anal cancer among HIV-infected patients according to baseline anal cytology results: an inception cohort analysis. HIV Med 2014; 16:191-5. [PMID: 25197003 DOI: 10.1111/hiv.12190] [Citation(s) in RCA: 27] [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] [Accepted: 07/09/2014] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The aim of the study was to estimate the cumulative incidence of, and rates of progression to, invasive anal cancer (IAC) according to baseline anal cytology screening category in an unselected HIV clinical care cohort in the antiretroviral era. METHODS A retrospective cohort analysis of HIV-infected patients under care at the University of California at San Diego Owen Clinic was carried out. Patients were eligible for this analysis if they had at least two anal cytohistological results available for longitudinal analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of IAC over time according to baseline cytology category [less than high-grade intraepithelial lesion (HSIL) versus HSIL]. Cox regression analysis was used to adjust for the following covariates: antiretroviral use, level of HIV viraemia, smoking status and infrared photocoagulation (IRC) ablation therapy. RESULTS Between 2000 and 2012, we followed 2804 HIV-infected patients for a median of 4 years under a clinic protocol requiring baseline anal cytology screening. Incident IAC was diagnosed in 23 patients. Patients with a baseline HSIL anal cytology had an estimated 5-year probability of progression to IAC of 1.7% and an estimated annual progression risk of 1 in 263. None of the examined covariates was significantly associated with IAC incidence when examined in separate unadjusted Cox models. CONCLUSIONS HIV-infected patients with a baseline HSIL anal cytology had a 5-year cumulative incidence of IAC of 1.65%, with an upper 95% confidence bound of 4.5%. This population-based study provides quantitative risk estimates that may be used for counselling patients regarding management options for abnormal cytology results.
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Affiliation(s)
- E Cachay
- Department of Medicine, University of California at San Diego, San Diego, CA, USA
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Mathews C, Aarø LE, Grimsrud A, Flisher AJ, Kaaya S, Onya H, Schaalma H, Wubs A, Mukoma W, Klepp KI. Effects of the SATZ teacher-led school HIV prevention programmes on adolescent sexual behaviour: cluster randomised controlled trials in three sub-Saharan African sites. Int Health 2013; 4:111-22. [PMID: 24029149 DOI: 10.1016/j.inhe.2012.02.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
In this study, the effects on young adolescent sexual risk behaviour of teacher-led school HIV prevention programmes were examined in two sites in South Africa (Cape Town and Mankweng) and one site in Tanzania (Dar es Salaam). In Cape Town, Dar es Salaam and Mankweng, 26, 24 and 30 schools, respectively, were randomly allocated to intervention or comparison groups. Primary outcomes were delayed sexual debut and condom use among adolescents aged 12-14 years (grade 8 in South Africa and grades 5 and 6 in Tanzania). In total, 5352, 4197 and 2590 students participated at baseline in 2004 in Cape Town, Dar es Salaam and Mankweng, respectively, and 73% (n = 3926), 88% (n = 3693) and 83% (n = 2142) were retained 12-15 months later. At baseline, 13% (n = 224), 5% (n = 100) and 17% (n = 164) had had their sexual debut, and 44% (n = 122), 20% (n = 17) and 37% (n = 57) of these used a condom at last sex, respectively. In Dar es Salaam, students in the intervention were less likely to have their sexual debut during the study (OR 0.65, 95% CI 0.48-0.87). In Cape Town and Mankweng, the intervention had no impact. The current interventions were effective at delaying sexual debut in Dar es Salaam but not in South Africa, where they need to be supplemented with programmes to change the environment in which adolescents make decisions about sexual behaviour.
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Affiliation(s)
- C Mathews
- Health System Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
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Thomas E, Nugent E, McMeekin D, Walker J, Landrum L, Moxley K, Bishop E, Mathews C, Moore K. Effectiveness of cyanoacrylate microbial sealant (CMS) in the reduction of surgical site infection in gynecologic oncology procedures: A single-center randomized study: Interim analysis. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.200] [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: 10/26/2022]
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Bastien S, Mason-Jones AJ, De Koker P, Mmbaga EJ, Ross DA, Mathews C. Herpes simplex virus type 2 infection as a biomarker for sexual debut among young people in sub-Saharan Africa: a literature review. Int J STD AIDS 2013; 23:761-6. [PMID: 23155093 DOI: 10.1258/ijsa.2012.011433] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Biological markers are needed in order to provide objective measures to validate self-reported sexual behaviour and interpret prevention trial data. In this review, we evaluated herpes simplex type 2 virus (HSV-2), one of the most prevalent sexually transmitted infections in sub-Saharan Africa as a biological marker of sexual debut. Based on our findings, we do not recommend using HSV-2 as a biomarker for sexual debut due to its low transmission probabilities and the fact that HSV-2 prevalence is not 100% among potential sexual partners. We recommend that the validation of alternative biological measures should be prioritized, and included in future studies and trials of interventions to reduce sexual health risk.
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Affiliation(s)
- S Bastien
- Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, Domus Medica, Sognsvannsveien 9, 0372 Oslo, Norway.
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Dewing S, Mathews C, Schaay N, Cloete A, Louw J, Simbayi L. "It's important to take your medication everyday okay?" An evaluation of counselling by lay counsellors for ARV adherence support in the Western Cape, South Africa. AIDS Behav 2013; 17:203-12. [PMID: 22610373 DOI: 10.1007/s10461-012-0211-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
There is growing interest in standard care programmes for antiretroviral (ARV) adherence support. In South Africa, individual counselling following ARV initiation is a main strategy for supporting adherence in the public sector. Egan's client-centred "Skilled Helper" counselling model is the predominant model used in HIV counselling in this context. This study evaluated counselling delivered by lay ARV adherence counsellors in Cape Town in terms of adherence to Egan's model. Thirty-eight transcripts of counselling sessions with non-adherent patients were analysed based on the methods of content analysis. These sessions were conducted by 30 counsellors. Generally counsellors' practice adhered neither to Egan's model nor a client-centred approach. Inconsistent with evidence-based approaches to counselling for ARV adherence support, counsellors mainly used information-giving and advice as strategies for addressing clients' non-adherence. Recommendations for improving practice are made. The question as to how appropriate strategies from developed countries are for this setting is also raised.
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Bishop E, Nugent E, Mathews C, Farrell R, Landrum L, McMeekin D. Prognostic factors in stage 2B–3B cervical cancer in an era of chemoradiation. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nugent E, Long A, Mathews C, Bishop E, Moxley K, Benbrook D, Wild R, McMeekin D. Biomarkers associated with metabolic syndrome, endometrioid adenocarcinoma (EC) of the uterus, and disease prognosis. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.021] [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: 11/29/2022]
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Farrell R, Nugent E, Mathews C, Bishop E, Perry L, Landrum L, Lee S, Kim Y, Nam J, Kim Y, McMeekin D. Outcomes and disease progression after cervical excisional procedures (EPS), loop electroexcisional procedure (LEEP) or cone biopsy specimens (CKC), and radical hysterectomy (RH) for early stage invasive cervical cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nugent E, Bishop E, Mathews C, Perry L, Farrell R, Landrum L, Moxley K. The prognostic impact of isolated pelvic lymph node metastasis in a contemporary population of early stage and loco-regionally advanced carcinoma of the uterine cervix. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Perry L, Mathews C, Nugent E, Farrell R, Moore K. Para-aortic nodal metastases in the modern era: still a dismal prognosis. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2012.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dewing S, Mathews C, Schaay N, Cloete A, Louw J, Simbayi L. Behaviour change counselling for ARV adherence support within primary health care facilities in the Western Cape, South Africa. AIDS Behav 2012; 16:1286-94. [PMID: 21983698 DOI: 10.1007/s10461-011-0059-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Health care systems have been described as ideal settings for behaviour change counselling interventions. There is little research evaluating the feasibility of implementing such interventions in routine practice in primary care facilities. We implemented an intervention called Options for Health within routine adherence counselling practice in 20 antiretroviral facilities in Cape Town, South Africa. Lay counsellors were trained to use Options to help clients to optimise ARV adherence and reduce sexual risk behaviour. Counsellors delivered the intervention to 9% of eligible patients over 12 months. Interviews with counsellors revealed barriers to implementation including a lack of counselling space, time pressure and patient resistance to counselling. Counsellors felt that Options was not appropriate for use with all patients and adherence problems, and used parts of the intervention as it suited their needs. Findings revealed weaknesses in the current adherence counselling system that have implications for the feasibility of behaviour change counselling within this context.
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Scharf J, Yu D, Mathews C, Neale B, Stewart E, Fagerness J, Evans P, Gamazon E, Service S, Osiecki L, Illmann C, Cath D, King R, Dion Y, Sandor P, Barr C, Budman C, Lyon G, Grados M, Singer H, Jankovic J, Gilbert D, Hoekstra P, Heiman G, Tischfield J, State M, Robertson M, Kurlan R, Ophoff R, Gibbs JR, Cookson M, Hardy J, Singleton A, Ruiz-Linares A, Rouleau G, Heutink P, Oostra B, McMahon W, Freimer N, COX N, Pauls D. Genome-Wide Association Study of Gilles de la Tourette Syndrome (IN10-1.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in10-1.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Scharf J, Yu D, Mathews C, Neale B, Stewart E, Fagerness J, Evans P, Gamazon E, Service S, Osiecki L, Illmann C, Cath D, King R, Dion Y, Sandor P, Barr C, Budman C, Lyon G, Grados M, Singer H, Jankovic J, Gilbert D, Hoekstra P, Heiman G, Tischfield J, State M, Robertson M, Kurlan R, Ophoff R, Gibbs JR, Cookson M, Hardy J, Singleton A, Ruiz-Linares A, Rouleau G, Heutink P, Oostra B, McMahon W, Freimer N, COX N, Pauls D. Genome-Wide Association Study of Gilles de la Tourette Syndrome (S32.006). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s32.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mathews C, Lee S, Nugent E, Landrum L, Bishop E, Kim Y, Nam J, Kim Y, McMeekin D. A re-evaluation of contemporary risk models for early stage cervical cancer. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Farrell R, Mathews C, Walker J, Landrum L. Cervical adenocarcinoma in the elderly. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mathews C, Nugent E, Moxley K, Bishop E, McMeekin D. Endometrial cancer risk stratification criteria applied in a unique population. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wasserfall C, Nead K, Mathews C, Atkinson MA. The threshold hypothesis: solving the equation of nurture vs nature in type 1 diabetes. Diabetologia 2011; 54:2232-6. [PMID: 21773685 PMCID: PMC7296551 DOI: 10.1007/s00125-011-2244-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 06/20/2011] [Indexed: 02/06/2023]
Abstract
For more than 40 years, the contributions of nurture (i.e. the environment) and nature (i.e. genetics) have been touted for their aetiological importance in type 1 diabetes. Disappointingly, knowledge gains in these areas, while individually successful, have to a large extent occurred in isolation from each other. One reason underlying this divide is the lack of a testable model that simultaneously considers the contributions of genetic and environmental determinants in the formation of this and potentially other disorders that are subject to these variables. To address this void, we have designed a model based on the hypothesis that the aetiological influences of genetics and environment, when evaluated as intersecting and reciprocal trend lines based on odds ratios, result in a method of concurrently evaluating both facets and defining the attributable risk of clinical onset of type 1 diabetes. The model, which we have elected to term the 'threshold hypothesis', also provides a novel means of conceptualising the complex interactions of nurture with nature in type 1 diabetes across various geographical populations.
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Affiliation(s)
- C Wasserfall
- Department of Pathology, University of Florida, College of Medicine, 1600 SW Archer Road, Gainesville, FL 32610-0275, USA
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Mathews C, Goodrich S, Farrell R, DeSimone C, Seamon L, Landrum L. Adenocarcinoma as an independent risk factor for early-stage intermediate-risk cervical carcinoma. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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45
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Siegfried N, Mathews C. Commentary: All is not what it seems: a systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI-associated behaviours in low- and middle-income countries. Int J Epidemiol 2010; 39:1556-7. [DOI: 10.1093/ije/dyq198] [Citation(s) in RCA: 7] [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: 11/14/2022] Open
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46
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Wolpaw BJ, Mathews C, Chopra M, Hardie D, Lurie MN, Jennings K. Diagnosis and counselling of patients with acute HIV infection in South Africa. Sex Transm Infect 2010; 87:71-2. [DOI: 10.1136/sti.2009.041475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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47
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Jaspan HB, Soka NF, Mathews C, Flisher AJ, Mark D, Middelkoop K, Wood R, Bekker LG. A qualitative assessment of perspectives on the inclusion of adolescents in HIV vaccine trials in South Africa. Int J STD AIDS 2010; 21:172-6. [PMID: 20215620 DOI: 10.1258/ijsa.2009.008484] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Adolescents are at high risk for HIV acquisition, and thus need to be included in HIV vaccine trials. In preparation for inclusion of adolescents in HIV vaccine trials in an urban community in Cape Town with a high antenatal HIV prevalence, the study assessed the attitudes towards the inclusion of adolescents in HIV vaccine trials. A total of 18 focus group discussions were conducted using a semistructured interview guide. The participants (n = 200) were adolescents, young adults, parents and other key informants. Participants from all groups welcomed the inclusion of adolescents in HIV vaccine trials due to their high-risk status. There were, however, concerns about sexual disinhibition, fear of side-effects, fear of HIV testing and disclosure of HIV status, mistrust of nurses and clinics. The study highlighted a number of ethical and social issues that need to be addressed before the trials.
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Affiliation(s)
- H B Jaspan
- Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
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Jasinska A, Service S, Jawaheer D, DeYoung J, Levinson M, Zhang Z, Kremeyer B, Muller H, Aldana I, Garcia J, Restrepo G, Lopez C, Palacio C, Duque C, Parra M, Vega J, Ortiz D, Bedoya G, Mathews C, Davanzo P, Fournier E, Bejarano J, Ramirez M, Ortiz CA, Araya X, Molina J, Sabatti C, Reus V, Ospina J, Macaya G, Ruiz-Linares A, Freimer N. A narrow and highly significant linkage signal for severe bipolar disorder in the chromosome 5q33 region in Latin American pedigrees. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:998-1006. [PMID: 19319892 PMCID: PMC4815924 DOI: 10.1002/ajmg.b.30956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We previously reported linkage of bipolar disorder to 5q33-q34 in families from two closely related population isolates, the Central Valley of Costa Rica (CVCR) and Antioquia, Colombia (CO). Here we present follow up results from fine-scale mapping in large CVCR and CO families segregating severe bipolar disorder, BP-I, and in 343 population trios/duos from CVCR and CO. Employing densely spaced SNPs to fine map the prior linkage peak region increases linkage evidence and clarifies the position of the putative BP-I locus. We performed two-point linkage analysis with 1134 SNPs in an approximately 9 Mb region between markers D5S410 and D5S422. Combining pedigrees from CVCR and CO yields a LOD score of 4.9 at SNP rs10035961. Two other SNPs (rs7721142 and rs1422795) within the same 94 kb region also displayed LOD scores greater than 4. This linkage peak coincides with our prior microsatellite results and suggests a narrowed BP-I susceptibility regions in these families. To investigate if the locus implicated in the familial form of BP-I also contributes to disease risk in the population, we followed up the family results with association analysis in duo and trio samples, obtaining signals within 2 Mb of the peak linkage signal in the pedigrees; rs12523547 and rs267015 (P = 0.00004 and 0.00016, respectively) in the CO sample and rs244960 in the CVCR sample and the combined sample, with P = 0.00032 and 0.00016, respectively. It remains unclear whether these association results reflect the same locus contributing to BP susceptibility within the extended pedigrees.
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Affiliation(s)
- A.J. Jasinska
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - S. Service
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - D. Jawaheer
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - J. DeYoung
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - M. Levinson
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - Z. Zhang
- Department of Statistics, University of California, Los Angeles, California
| | - B. Kremeyer
- Galton Laboratory, Department of Biology, University College London, London, United Kingdom
| | - H. Muller
- Galton Laboratory, Department of Biology, University College London, London, United Kingdom
| | - I. Aldana
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - J. Garcia
- Departamento de Psiquiatria, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - G. Restrepo
- Departamento de Psiquiatria, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - C. Lopez
- Departamento de Psiquiatria, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - C. Palacio
- Departamento de Psiquiatria, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - C. Duque
- Laboratorio de Genetica Molecular, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - M. Parra
- Laboratorio de Genetica Molecular, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - J. Vega
- Laboratorio de Genetica Molecular, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - D. Ortiz
- Laboratorio de Genetica Molecular, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - G. Bedoya
- Laboratorio de Genetica Molecular, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - C. Mathews
- Department of Psychiatry, University of California, San Francisco, California
| | - P. Davanzo
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Los Angeles, California
| | - E. Fournier
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica
| | - J. Bejarano
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica
| | - M. Ramirez
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica
| | - C. Araya Ortiz
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica
| | - X. Araya
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica
| | - J. Molina
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California
| | - C. Sabatti
- Department of Statistics, University of California, Los Angeles, California,Department of Statistics and Department of Human Genetics, University of California, Los Angeles, California
| | - V. Reus
- Department of Psychiatry, University of California, San Francisco, California
| | - J. Ospina
- Departamento de Psiquiatria, Universidad de Antioquia, Medellin, Colombia, South Carolina
| | - G. Macaya
- Cell and Molecular Biology Research Center, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica
| | - A. Ruiz-Linares
- Galton Laboratory, Department of Biology, University College London, London, United Kingdom
| | - N.B. Freimer
- Center for Neurobehavioral Genetics, University of California, Los Angeles, California,Correspondence to: N.B. Freimer, UCLA Center for Neurobehavioral Genetics, Gonda Center, Rm. 3506, 695 Charles E. Young Dr S., Box 951761, Los Angeles, CA 90095.
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Abstract
Cold haemagglutinin disease (CHAD) is an uncommon condition frequently associated with B-cell lymphoproliferative disorders and is refractory to conventional treatments used in autoimmune haemolytic anaemia. Rituximab has been used in this condition with favourable and lasting responses. Cost has been a major limitation to its use in such indication. We present cost-effectiveness analysis of the use of rituximab in two patients with CHAD. Rituximab successfully controlled haemolysis in both cases of CHAD and was found to be cost-effective through reducing transfusion needs.
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Affiliation(s)
- U Panwar
- Department of Haematology, Salisbury District Hospital, Salisbury, UK
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Coakley G, Mathews C, Field M, Jones A, Kingsley G, Walker D, Phillips M, Bradish C, McLachlan A, Weston V. Comment on: Guidelines for the management of the hot swollen joint in adults: reply. Rheumatology (Oxford) 2008. [DOI: 10.1093/rheumatology/kem189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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