1
|
Hammond E, Zhan-Moodie S, Sapkalova V, Rivera D, Agrawal R, Thomas J, Fox E, Lawson A. Establishing Geriatric Opiate Use Patterns in Trauma. Am Surg 2024:31348241256063. [PMID: 38782463 DOI: 10.1177/00031348241256063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Introduction: There is evidence that providers often overprescribe opiates in the postoperative period. Despite an ever-growing geriatric population, there is little research detailing current opiate usage in older patients after trauma. This population presents a unique set of challenges for pain management and prescription drug dependence due to sensitivity, a narrow therapeutic window, and high rates of pre-existing polypharmacy.Objective: Assess the use of narcotics in geriatric trauma patients with various injury patterns to establish a reference point for future intervention for reduction in narcotic dependence.Methods: We created a database of trauma patients' age ≥65 years admitted to a single level 1 trauma center in the Southeastern United States during the 2019 calendar year. Information gathered included patient factors, injury patterns, operative intervention, pain medications prescribed during hospitalization and at discharge, total and average daily morphine milligram equivalents (MME) inpatient and outpatient, and requests/prescriptions for narcotics at follow-up.Results: In 2019, there were 475 patients aged ≥65 admitted to our level 1 trauma center for acute traumatic injuries. 219 of those patients required operative intervention. Average total inpatient MME for this cohort was 169.0 with average daily MME of 22.89. The average total prescribed MME upon discharge was 79.27. There were 29 patients documented to request narcotic prescription refill at time of clinic follow-up, 27 of whom were prescribed a narcotic medication at follow-up.Conclusion: This dataset establishes a reference point for opiate use in geriatric trauma patients to facilitate further research for mitigation of risk in this population.
Collapse
Affiliation(s)
- Emily Hammond
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Samantha Zhan-Moodie
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Viktoriya Sapkalova
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Daniel Rivera
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Rishabh Agrawal
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Jason Thomas
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Elizabeth Fox
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| | - Andrew Lawson
- Department of Surgery, Medical College of Georgiaat Augusta University, Augusta, GA, USA
| |
Collapse
|
2
|
Joel A, Konjengbam A, Viswanath Y, Kourounis G, Hammond E, Frank H, Kuttuva S, Mbarushimana S, Hidayat H, Thulasiraman S. Endoscopic radiofrequency Stretta therapy reduces proton pump inhibitor dependency and the need for anti-reflux surgery for refractory gastroesophageal reflux disease. Clin Endosc 2024; 57:58-64. [PMID: 37157958 PMCID: PMC10834287 DOI: 10.5946/ce.2023.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND/AIMS Radiofrequency treatment of the gastroesophageal junction using the Stretta procedure for treating gastroesophageal reflux disease (GERD) is observed to improve the symptoms and proton pump inhibitor (PPI) dependence and reduce the need for anti-reflux operations. As one of the largest studies in Europe, we evaluated the clinical outcomes of Stretta in patients with medically refractory GERD. METHODS A tertiary UK center evaluated all patients with refractory GERD who underwent Stretta between 2014 and 2022. Patients and primary care professionals were contacted to obtain information regarding the initiation of PPI and reintervention after Stretta. RESULTS Of the 195 patients (median age, 55 years; 116 women [59.5%]) who underwent Stretta, PPI-free period (PFP) data were available for 144 (73.8%) patients. Overall, 66 patients (45.8%) did not receive PPI after a median follow-up of 55 months. Six patients (3.1%) underwent further interventions. The median PFP after Stretta was 41 months. There was a significant negative correlation between PFP and age (p=0.007), with no differences between sexes (p=0.96). Patients younger than 55 years of age had a longer PFP than their older counterparts (p=0.005). Younger males had a significantly longer PFP than older males (p=0.021). However, this was not observed in the female cohort (p=0.09) or between the younger men and women (p=0.66). CONCLUSION Our findings suggest that Stretta is a safe and feasible option for treating refractory GERD, especially in younger patients. It prevents further anti-reflux interventions in most patients and increases the lead-time to surgery in patients with refractory GERD.
Collapse
Affiliation(s)
- Abraham Joel
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Alakh Konjengbam
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Yirupaiahgari Viswanath
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Georgios Kourounis
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Emily Hammond
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Helen Frank
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Shivani Kuttuva
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Simon Mbarushimana
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Hena Hidayat
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| | - Srivishnu Thulasiraman
- Department of General and Upper Gastrointestinal Surgery, James Cook University Hospital, Cleveland, UK
| |
Collapse
|
3
|
Hammond E, Jones-Sayyid C, Langer J, Fox E, Lawson A. Posterior Rectus Sheath Hernia Causing Chronic Abdominal Pain. Am Surg 2023:31348231173989. [PMID: 37140199 DOI: 10.1177/00031348231173989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Posterior rectus sheath hernias are rare hernias that can be difficult to diagnose due to unreliable physical exam characteristics and subtle radiological findings. We present an interesting case of an elderly female found to have a posterior rectus sheath hernia during a diagnostic laparoscopy for chronic abdominal pain. CT evaluation revealed possible appendicitis and laxity of the abdominal wall of the right lower quadrant. Intraoperatively, a 4 cm hernia defect in the right lateral abdominal wall was appreciated. Appendectomy and herniorrhaphy with mesh repair were performed. Postoperative review of CT imaging and intraoperative photographs determined that this hernia defect is a posterior rectus sheath hernia likely caused by trocar placement from previous laparoscopic surgery. This report contributes to the limited body of the literature for this rare type of hernia. Posterior rectus sheath hernias should be considered in differential diagnoses for patients presenting with chronic abdominal pain without clear etiology.
Collapse
Affiliation(s)
- Emily Hammond
- Augusta University, Department of Surgery, Medical College of Georgia, Augusta, GA, USA
| | - Caitlin Jones-Sayyid
- Augusta University, Department of Surgery, Medical College of Georgia, Augusta, GA, USA
| | - Jason Langer
- Phoebe General Surgery of Albany, Albany, GA, USA
| | - Elizabeth Fox
- Augusta University, Department of Surgery, Medical College of Georgia, Augusta, GA, USA
| | - Andrew Lawson
- Augusta University, Department of Surgery, Medical College of Georgia, Augusta, GA, USA
| |
Collapse
|
4
|
Gwilym BL, Pallmann P, Waldron CA, Thomas-Jones E, Milosevic S, Brookes-Howell L, Harris D, Massey I, Burton J, Stewart P, Samuel K, Jones S, Cox D, Clothier A, Edwards A, Twine CP, Bosanquet DC, Benson R, Birmpili P, Blair R, Bosanquet DC, Dattani N, Dovell G, Forsythe R, Gwilym BL, Hitchman L, Machin M, Nandhra S, Onida S, Preece R, Saratzis A, Shalhoub J, Singh A, Forget P, Gannon M, Celnik A, Duguid M, Campbell A, Duncan K, Renwick B, Moore J, Maresch M, Kamal D, Kabis M, Hatem M, Juszczak M, Dattani N, Travers H, Shalan A, Elsabbagh M, Rocha-Neves J, Pereira-Neves A, Teixeira J, Lyons O, Lim E, Hamdulay K, Makar R, Zaki S, Francis CT, Azer A, Ghatwary-Tantawy T, Elsayed K, Mittapalli D, Melvin R, Barakat H, Taylor J, Veal S, Hamid HKS, Baili E, Kastrisios G, Maltezos C, Maltezos K, Anastasiadou C, Pachi A, Skotsimara A, Saratzis A, Vijaynagar B, Lau S, Velineni R, Bright E, Montague-Johnstone E, Stewart K, King W, Karkos C, Mitka M, Papadimitriou C, Smith G, Chan E, Shalhoub J, Machin M, Agbeko AE, Amoako J, Vijay A, Roditis K, Papaioannou V, Antoniou A, Tsiantoula P, Bessias N, Papas T, Dovell G, Goodchild F, Nandhra S, Rammell J, Dawkins C, Lapolla P, Sapienza P, Brachini G, Mingoli A, Hussey K, Meldrum A, Dearie L, Nair M, Duncan A, Webb B, Klimach S, Hardy T, Guest F, Hopkins L, Contractor U, Clothier A, McBride O, Hallatt M, Forsythe R, Pang D, Tan LE, Altaf N, Wong J, Thurston B, Ash O, Popplewell M, Grewal A, Jones S, Wardle B, Twine C, Ambler G, Condie N, Lam K, Heigberg-Gibbons F, Saha P, Hayes T, Patel S, Black S, Musajee M, Choudhry A, Hammond E, Costanza M, Shaw P, Feghali A, Chawla A, Surowiec S, Encalada RZ, Benson R, Cadwallader C, Clayton P, Van Herzeele I, Geenens M, Vermeir L, Moreels N, Geers S, Jawien A, Arentewicz T, Kontopodis N, Lioudaki S, Tavlas E, Nyktari V, Oberhuber A, Ibrahim A, Neu J, Nierhoff T, Moulakakis K, Kakkos S, Nikolakopoulos K, Papadoulas S, D'Oria M, Lepidi S, Lowry D, Ooi S, Patterson B, Williams S, Elrefaey GH, Gaba KA, Williams GF, Rodriguez DU, Khashram M, Gormley S, Hart O, Suthers E, French S. Short-term risk prediction after major lower limb amputation: PERCEIVE study. Br J Surg 2022; 109:1300-1311. [PMID: 36065602 DOI: 10.1093/bjs/znac309] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. METHODS The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. RESULTS Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). CONCLUSION Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.
Collapse
Affiliation(s)
- Brenig L Gwilym
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ian Massey
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Jo Burton
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Phillippa Stewart
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
| | - Sian Jones
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - David Cox
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - Annie Clothier
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Christopher P Twine
- Bristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - David C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Hammond E, Liu Y, Xu F, Liu G, Xi H, Xue L, Bai X, Liao H, Xue S, Zhao S, Zhang A, Kemper J, Afnan M, Mol B, Morbeck D. P–138 When is low quality really low? Should we transfer low-grade blastocysts? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the live birth rate after single, low-grade blastocyst (LGB) transfer?
Summary answer
The live birth rate for LGBs is 28%, ranging between 15–31% for the different inner cell mass (ICM) and trophectoderm (TE) subgroups of LGBs.
What is known already
Live birth rates following LGB transfer are varied and have been reported to be in the range of 5–39%. However, these estimates are inaccurate as studies investigating live birth rates following LGB transfer are inherently limited by sample size (n = 10–440 for LGB transfers) due to LGBs being ranked last for transfer. Further, these studies are heterogenous with varied LGB definitions and design. Collating LGB live birth data from multiple clinics is warranted to obtain sufficient numbers of LGB transfers to establish reliable live birth rates, and to allow for delineation of different LGB subgroups, including blastocyst age and female age.
Study design, size, duration
We performed a multicentre, multinational retrospective cohort study in 9 IVF centres in China and New Zealand from 2012 to 2019. We studied the outcome of 6966 single blastocyst transfer cycles on days 5–7 (fresh and frozen) according to blastocyst grade, including 875 transfers from LGBs (<3bb, this being the threshold typically applied to LGB studies). Blastocysts with expansion stage 1 or 2 (early blastocysts) were excluded.
Participants/materials, setting, methods
The main outcome measured was live birth rate. Blastocysts were grouped according to quality grade: good-grade blastocysts (GGBs; n = 3849, aa, ab and ba), moderate-grade blastocysts (MGBs; n = 2242, bb) and LGBs (n = 875, ac, ca, bc, cb and cc) and live birth rates compared using the Pearson Chi-squared test. A logistic regression analysis explored the relationship between blastocyst grade and live birth after adjustment for the confounders: clinic, female age, expansion stage, and blastocyst age.
Main results and the role of chance
The live birth rates for GGBs, MGBs and LGBs were 45%, 36% and 28% respectively (p < 0.0001). Within the LGB group, the highest live birth rates were for grade c TE (30%) and the lowest were for grade c ICM (19%). The lowest combined grade (cc) maintained a 15% live birth rate (n = 7/48). After accounting for confounding factors, including female age and blastocyst characteristics, the odds of live birth were 2.33 (95% CI = 1.88–2.89) for GGBs compared to LGBs and 1.56 (95% CI = 1.28–1.92) for MGBs compared to LGBs following fresh and frozen blastocyst transfers (p < 0.0001, odds ratios confirmed in exclusively frozen blastocyst transfer cycles). When stratified by individual ICM and TE grade, the odds of live birth according to ICM grade were 1.31 (a versus b; 95% CI = 1.15–1.48), 2.82 (a versus c; 95% CI = 1.91–4.18) and 2.16 (b versus c; 95% CI = 1.48–3.16; all p < 0.0001). The odds of live birth according to TE grade were 1.33 (a versus b; 95% CI = 1.17–1.50, p < 0.0001), 1.85 (a versus c; 95% CI = 1.45–2.34, p < 0.0001) and 1.39 (b versus c; 95% CI = 1.12–1.73, p = 0.0024).
Limitations, reasons for caution
Despite the large multicentre design of the study, analyses of transfers occurring within the smallest subsets of the LGB group were limited by sample size. The study was not randomised and had a retrospective character.
Wider implications of the findings: LGBs maintain satisfactory live birth rates (averaging 28%) in the general IVF population. Even those in the lowest grading tier maintain modest live birth rates (15%; cc). It is recommended that LGBs not be universally discarded, and instead considered for subsequent frozen embryo transfer to maximize cumulative live birth rates.
Trial registration number
Not applicable
Collapse
Affiliation(s)
- E Hammond
- Fertility Associates, Embryology, Auckland, New Zealand
| | - Y Liu
- Monash IVF Group- Southport- Australia, Embryology, Queensland, Australia
| | - F Xu
- Tianjin First Central Hospital, Reproductive Medicine Center, Tianjin, China
| | - G Liu
- Tianjin Aiwei Hospital, Reproductive Center, Tianjin, China
| | - H Xi
- The second affiliated hospital of WenZhou Medical University, Department of Obstetrics and Gynecology, Wenzhou, China
| | - L Xue
- People’s Hospital of Guangxi Zhuang Autonomous Region, Reproductive Medical and Genetic Center, Nanning, China
| | - X Bai
- General Hospital of Tianjin Medical University, Department of Obstetrics and Gynecology, Tianjin, China
| | - H Liao
- The second affiliated hospital of South China University, Reproductive Medicine Center, Hengyang, China
| | - S Xue
- Shanghai East Hospital, Department of Assisted Reproduction, Shanghai, China
| | - S Zhao
- Zaozhuang Maternal and Child Health Care, Reproductive Center, Zaozhuang, China
| | - A Zhang
- Reproductive Medical Center of Ruijin Hospital- School of Medicine- Shanghai Jiao Tong University, Reproductive Medical Center, Shanghai, China
| | - J Kemper
- Monash Women’s- Monash Health- Clayton- Australia, Department of obstetrics and gynaecology, Melbourne, Australia
| | - M Afnan
- Qingdao United Family Hospital- Qingdao- China, Obstetrics and Gynecology, Qingdao, China
| | - B Mol
- Monash Women’s- Monash Health- Clayton- Australia, Obstetrics & Gynaecology Monash Health, Melbourne, Australia
| | - D Morbeck
- Fertility Associates, Embryology, Auckland, New Zealand
| |
Collapse
|
6
|
Morbeck D, Hammond E, Kit AMF, Curchoe C. P–167 Assuring quality in embryology decision making: blastocyst grading agreement assessed via a smartphone application. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.166] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Given the subjectivity of blastocyst grading and the challenge of performing routine competency assessments, how consistently do embryologists grade blastocysts when using an easily accessible phone application?
Summary answer
Grading agreement was fair to moderate for inner cell mass (ICM) and trophectoderm (TE), evidence that a mobile application can be used for quality assurance.
What is known already
Embryologists routinely perform external quality assessments (EQA), though the utility of EQA for quality improvement is limited, and more active, user-friendly tools are needed to improve quality assurance in embryology. Blastocyst grading is one of the most important and subjective tasks in clinical embryology, important for both blastocyst ranking and decision to freeze. Inter-user agreement is only fair for ICM (kappa 0.349) and TE grade (kappa 0.397; Storr et al., 2017). Fair agreement has also been reported for decision to freeze for a cohort of blastocysts that exhibited borderline morphology (kappa 0.301; Hammond et al., 2020).
Study design, size, duration
A prospective study of blastocyst grading consistency using ARTCompass, a mobile phone application designed to assess clinical decision making of laboratory staff for andrology and embryology competency. Two assessments, each with 100 images of expanded blastocysts in three planes, were performed by 42 embryologists from 9 clinics in 2 countries between April to July 2020. Survey 1 assessed ICM grading and survey 2 assessed TE grading using the same set of images for consistency.
Participants/materials, setting, methods
Blastocysts were of proportionally mixed grades (ranging from grade A to X) using a modified Gardner system that included “X” for non-viable ICM/TE. Embryologists were advised to complete the tests individually in one sitting. The Fleiss kappa coefficient (k) measured inter-rater agreement among embryologists when assigning blastocyst grade. Kappa value interpretation is as follows <0.20: poor; 0.21–0.40: fair; 0.41–0.60: moderate; 0.61–0.80: good and 0.81–1.00: very good.
Main results and the role of chance
Overall, agreement for ICM and TE grades was moderate among embryologists (kappa 0.47, 0.52, respectively). ICM grade B and C had the lowest agreement (0.37, 0.39), while ICM grade X (no, or degenerate ICM), and TE grade A showed the highest agreement (0.68, 0.62). These results illustrate that embryologists had difficultly classifying ICM grade when it was of moderate to poor quality (grade b or c), likely due to subjectivity in grading size and compaction level, but were good at classifying ICM grade when there was no apparent ICM (grade x). For TE grade, embryologists consistently identified a top-quality TE (grade a), which is reassuring as TE grade is the primary morphological feature used for blastocyst ranking. In general, this QA platform offers ease of use and shows agreement values for ICM and TE that are similar to other studies, suggesting that blastocyst grading with a mobile phone application is a viable option for quality assurance.
Limitations, reasons for caution
Only blastocyst grading was assessed, therefore additional competency assessments using a mobile device should be assessed for accuracy. Further studies are needed to determine if mobile applications can improve competency.
Wider implications of the findings: Ease of use by 42 embryologists indicates mobile applications may provide a user-friendly and accessible platform for QA. Since effective and efficient assessment of competency and KPIs is an ongoing challenge for laboratories, a mobile application is a novel and effective tool to monitor QA parameters in the IVF laboratory
Trial registration number
Not applicable
Collapse
Affiliation(s)
- D Morbeck
- Fertility Associates, Embryology, Auckland, New Zealand
| | - E Hammond
- Fertility Associates, Embryology, Auckland, New Zealand
| | - A M F Kit
- Sunfert International Fertility Centre, Embryology, Bangsar South, Malaysia
| | - C Curchoe
- Fertility Guidance Technologies, Development, San Francisco, USA
| |
Collapse
|
7
|
Hitchcock C, Smith AJ, Elliott R, O'Leary C, Gormley S, Parker J, Patel SD, Esteves CV, Rodrigues E, Hammond E, Watson P, Werner-Seidler A, Dalgleish T. A randomized, controlled proof-of-concept trial evaluating durable effects of memory flexibility training (MemFlex) on autobiographical memory distortions and on relapse of recurrent major depressive disorder over 12 months. Behav Res Ther 2021; 140:103835. [PMID: 33691266 PMCID: PMC8047774 DOI: 10.1016/j.brat.2021.103835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/24/2021] [Accepted: 02/21/2021] [Indexed: 12/12/2022]
Abstract
Low-intensity psychological interventions that target cognitive risk factors for depressive relapse may improve access to relapse prevention programs and thereby reduce subsequent risk. This study provides the first evaluation of an autobiographical memory-based intervention for relapse prevention, to establish whether memory-training programs that are efficacious for acute depression may also aid those currently in remission. We also provide the longest follow-up to-date of the effects of autobiographical memory training on autobiographical memory processes themselves. This pre-registered randomized-controlled proof-of-concept trial (N = 74) compared an autobiographical Memory Flexibility (MemFlex) intervention to Psychoeducation about cognitive-behavioral mechanisms which maintain depression. Both interventions were primarily self-guided, and delivered via paper workbooks completed over four weeks. The key cognitive outcome was ability to retrieve and alternate between specific and general autobiographical memories. Co-primary clinical outcomes were time until depressive relapse and depression-free days in the twelve-months following intervention. Results indicated a small-moderate effect size (d = 0.35) in favor of MemFlex for the cognitive outcome. A small Hazard Ratio (1.08) was observed for time until depressive relapse, along with a negligible effect size for depression-free days (d = 0.11). Although MemFlex produced long-term improvement in memory retrieval skills, there was little support for MemFlex as a relapse prevention program for depression.
Collapse
Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK.
| | - Alicia J Smith
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Rachel Elliott
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Cliodhna O'Leary
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Jenna Parker
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Shivam D Patel
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Carlos V Esteves
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; University of Exeter, UK
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
| |
Collapse
|
8
|
Werner-Seidler A, Hitchcock C, Hammond E, Hill E, Golden AM, Breakwell L, Ramana R, Moore R, Dalgleish T. Emotional complexity across the life story: Elevated negative emodiversity and diminished positive emodiversity in sufferers of recurrent depression. J Affect Disord 2020; 273:106-112. [PMID: 32421590 PMCID: PMC7116332 DOI: 10.1016/j.jad.2020.04.060] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/23/2020] [Accepted: 04/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Greater diversity in the experience of negative and positive emotions - emodiversity - is associated with better mental health outcomes in the general population (Quoidbach et al. 2014). However, conceptual accounts of depression suggest this might differ in clinical depression. In this study, the diversity of negative and positive emotion experiences as remembered by a recurrently depressed sample and a never-depressed control group were compared. METHODS Emodiversity was assessed using a life structure card sort task which allowed for the assessment of memory for emotional experience over the life course. Depressed (n=34) and non-depressed (n=34) participants completed the card sort task, from which emodiversity metrics were calculated for negative and positive emotion experience. RESULTS Depressed individuals showed recollections of enhanced emodiversity across negative emotion but reduced emodiversity across positive emotion, relative to never-depressed individuals. LIMITATIONS This study involved a relatively small sample size. DISCUSSION This study indicates that greater diversity of negative emotion experience, which has been interpreted as a protective factor against depressed mood in community samples (Quoidbach et al., 2014), instead characterises the remembered experience of recurrent clinical depression. The finding that positive emodiversity is adaptive in depression suggests that therapeutic outcomes may be improved by facilitating exposure to a diverse range of positive emotions. These findings indicate that the relationship between emotion diversity and mental health is more complex than hitherto assumed.
Collapse
Affiliation(s)
- Aliza Werner-Seidler
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Black Dog Institute, UNSW Sydney, Australia
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Emma Hill
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Ann-Marie Golden
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Lauren Breakwell
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Rajini Ramana
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Richard Moore
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK.
| |
Collapse
|
9
|
Seneschal J, Lacour JP, Bewley A, Faurby M, Paul C, Pellacani G, De Simone C, Horne L, Sohrt A, Augustin M, Hammond E, Reich K. A multinational, prospective, observational study to estimate complete skin clearance in patients with moderate-to-severe plaque PSOriasis treated with BIOlogics in a REAL world setting (PSO-BIO-REAL). J Eur Acad Dermatol Venereol 2020; 34:2566-2573. [PMID: 32364296 PMCID: PMC7818467 DOI: 10.1111/jdv.16568] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Background Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis. Objective The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months. Methods PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%) and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at months 6 and 12. Results At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both months 6 and 12) compared with biologic‐naïve patients (25% at month 6, 30% at month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased. Conclusion Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis.
Collapse
Affiliation(s)
- J Seneschal
- Department of Dermatology and Paediatric Dermatology, National Reference Centre for Rare Skin Diseases, Saint-André Hospital, University of Bordeaux, Bordeaux, France
| | - J-P Lacour
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - A Bewley
- Department of Dermatology, Barts Health NHS Trust London, London, UK
| | - M Faurby
- LEO Pharma A/S, Ballerup, Denmark
| | - C Paul
- Toulouse University and Larrey Hospital, Toulouse, France
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - L Horne
- AstraZeneca, Gaithersburg, MD, USA
| | - A Sohrt
- LEO Pharma A/S, Ballerup, Denmark
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
| |
Collapse
|
10
|
Uthoff J, Larson J, Sato TS, Hammond E, Schroeder KE, Rohret F, Rogers CS, Quelle DE, Darbro BW, Khanna R, Weimer JM, Meyerholz DK, Sieren JC. Longitudinal phenotype development in a minipig model of neurofibromatosis type 1. Sci Rep 2020; 10:5046. [PMID: 32193437 PMCID: PMC7081358 DOI: 10.1038/s41598-020-61251-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 10/16/2019] [Accepted: 02/17/2020] [Indexed: 12/24/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is a rare, autosomal dominant disease with variable clinical presentations. Large animal models are useful to help dissect molecular mechanisms, determine relevant biomarkers, and develop effective therapeutics. Here, we studied a NF1 minipig model (NF1+/ex42del) for the first 12 months of life to evaluate phenotype development, track disease progression, and provide a comparison to human subjects. Through systematic evaluation, we have shown that compared to littermate controls, the NF1 model develops phenotypic characteristics of human NF1: [1] café-au-lait macules, [2] axillary/inguinal freckling, [3] shortened stature, [4] tibial bone curvature, and [5] neurofibroma. At 4 months, full body computed tomography imaging detected significantly smaller long bones in NF1+/ex42del minipigs compared to controls, indicative of shorter stature. We found quantitative evidence of tibial bowing in a subpopulation of NF1 minipigs. By 8 months, an NF1+/ex42del boar developed a large diffuse shoulder neurofibroma, visualized on magnetic resonance imaging, which subsequently grew in size and depth as the animal aged up to 20 months. The NF1+/ex42del minipig model progressively demonstrates signature attributes that parallel clinical manifestations seen in humans and provides a viable tool for future translational NF1 research.
Collapse
Affiliation(s)
- Johanna Uthoff
- Department of Radiology, University of Iowa, Iowa City, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Jared Larson
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Takashi S Sato
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Emily Hammond
- Department of Radiology, University of Iowa, Iowa City, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | | | | | | | - Dawn E Quelle
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
- Department of Pharmacology, University of Iowa, Iowa City, IA, USA
| | - Benjamin W Darbro
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Rajesh Khanna
- Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Jill M Weimer
- Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, SD, USA
| | | | - Jessica C Sieren
- Department of Radiology, University of Iowa, Iowa City, IA, USA.
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA.
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA.
| |
Collapse
|
11
|
Uthoff J, Koehn N, Larson J, Dilger SKN, Hammond E, Schwartz A, Mullan B, Sanchez R, Hoffman RM, Sieren JC. Post-imaging pulmonary nodule mathematical prediction models: are they clinically relevant? Eur Radiol 2019; 29:5367-5377. [PMID: 30937590 DOI: 10.1007/s00330-019-06168-x] [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] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/06/2019] [Accepted: 03/14/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Post-imaging mathematical prediction models (MPMs) provide guidance for the management of solid pulmonary nodules by providing a lung cancer risk score from demographic and radiologists-indicated imaging characteristics. We hypothesized calibrating the MPM risk score threshold to a local study cohort would result in improved performance over the original recommended MPM thresholds. We compared the pre- and post-calibration performance of four MPM models and determined if improvement in MPM prediction occurs as nodules are imaged longitudinally. MATERIALS AND METHODS A common cohort of 317 individuals with computed tomography-detected, solid nodules (80 malignant, 237 benign) were used to evaluate the MPM performance. We created a web-based application for this study that allows others to easily calibrate thresholds and analyze the performance of MPMs on their local cohort. Thirty patients with repeated imaging were tested for improved performance longitudinally. RESULTS Using calibrated thresholds, Mayo Clinic and Brock University (BU) MPMs performed the best (AUC = 0.63, 0.61) compared to the Veteran's Affairs (0.51) and Peking University (0.55). Only BU had consensus with the original MPM threshold; the other calibrated thresholds improved MPM accuracy. No significant improvements in accuracy were found longitudinally between time points. CONCLUSIONS Calibration to a common cohort can select the best-performing MPM for your institution. Without calibration, BU has the most stable performance in solid nodules ≥ 8 mm but has only moderate potential to refine subjects into appropriate workup. Application of MPM is recommended only at initial evaluation as no increase in accuracy was achieved over time. KEY POINTS • Post-imaging lung cancer risk mathematical predication models (MPMs) perform poorly on local populations without calibration. • An application is provided to facilitate calibration to new study cohorts: the Mayo Clinic model, the U.S. Department of Veteran's Affairs model, the Brock University model, and the Peking University model. • No significant improvement in risk prediction occurred in nodules with repeated imaging sessions, indicating the potential value of risk prediction application is limited to the initial evaluation.
Collapse
Affiliation(s)
- Johanna Uthoff
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 5601 Seamans Center, Iowa City, IA, 52242, USA
| | - Nicholas Koehn
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA
| | - Jared Larson
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA
| | - Samantha K N Dilger
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 5601 Seamans Center, Iowa City, IA, 52242, USA
| | - Emily Hammond
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 5601 Seamans Center, Iowa City, IA, 52242, USA
| | - Ann Schwartz
- Karmanos Cancer Institute, Wayne State University, 4100 John R St, Detroit, MI, 48201, USA
| | - Brian Mullan
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA
| | - Rolando Sanchez
- Department of Internal Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Richard M Hoffman
- Department of Internal Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Jessica C Sieren
- Department of Radiology, University of Iowa, 200 Hawkins Drive cc704 GH, Iowa City, IA, 52242, USA. .,Department of Biomedical Engineering, University of Iowa, 5601 Seamans Center, Iowa City, IA, 52242, USA.
| | | |
Collapse
|
12
|
Hitchcock C, Gormley S, Rees C, Rodrigues E, Gillard J, Panesar I, Wright IM, Hammond E, Watson P, Werner-Seidler A, Dalgleish T. A randomised controlled trial of memory flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with major depressive disorder. Behav Res Ther 2018; 110:22-30. [PMID: 30199738 PMCID: PMC6173798 DOI: 10.1016/j.brat.2018.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
Abstract
Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval can thereby have a detrimental impact on mental health. This randomised controlled phase II exploratory trial (N = 60) evaluated the potential of a novel intervention drawn from basic science - an autobiographical Memory Flexibility (MemFlex) training programme - which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and diagnostic status at three-month follow-up. These effect sizes could subsequently be used to estimate sample size for a fully-powered trial. Results demonstrated small-moderate, though as expected statistically non-significant, effect sizes in favour of MemFlex for memory flexibility (d = 0.34, p = .20), and loss of diagnosis (OR = 0.65, p = .48), along with the secondary outcome of depression-free days (d = 0.36, p = .18). A smaller effect size was observed for between-group difference in self-reported depressive symptoms (d = 0.24, p = .35). Effect sizes in favour of MemFlex in this early-stage trial suggest that fully-powered evaluation of MemFlex may be warranted as an avenue to improving low-intensity treatment of depression. TRIAL REGISTRATION ClinicalTrials.gov, Identifier NCT02371291.
Collapse
Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom.
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Julia Gillard
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Inderpal Panesar
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Isobel M Wright
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| |
Collapse
|
13
|
White KA, Swier VJ, Cain JT, Kohlmeyer JL, Meyerholz DK, Tanas MR, Uthoff J, Hammond E, Li H, Rohret FA, Goeken A, Chan CH, Leidinger MR, Umesalma S, Wallace MR, Dodd RD, Panzer K, Tang AH, Darbro BW, Moutal A, Cai S, Li W, Bellampalli SS, Khanna R, Rogers CS, Sieren JC, Quelle DE, Weimer JM. A porcine model of neurofibromatosis type 1 that mimics the human disease. JCI Insight 2018; 3:120402. [PMID: 29925695 DOI: 10.1172/jci.insight.120402] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/17/2018] [Indexed: 12/11/2022] Open
Abstract
Loss of the NF1 tumor suppressor gene causes the autosomal dominant condition, neurofibromatosis type 1 (NF1). Children and adults with NF1 suffer from pathologies including benign and malignant tumors to cognitive deficits, seizures, growth abnormalities, and peripheral neuropathies. NF1 encodes neurofibromin, a Ras-GTPase activating protein, and NF1 mutations result in hyperactivated Ras signaling in patients. Existing NF1 mutant mice mimic individual aspects of NF1, but none comprehensively models the disease. We describe a potentially novel Yucatan miniswine model bearing a heterozygotic mutation in NF1 (exon 42 deletion) orthologous to a mutation found in NF1 patients. NF1+/ex42del miniswine phenocopy the wide range of manifestations seen in NF1 patients, including café au lait spots, neurofibromas, axillary freckling, and neurological defects in learning and memory. Molecular analyses verified reduced neurofibromin expression in swine NF1+/ex42del fibroblasts, as well as hyperactivation of Ras, as measured by increased expression of its downstream effectors, phosphorylated ERK1/2, SIAH, and the checkpoint regulators p53 and p21. Consistent with altered pain signaling in NF1, dysregulation of calcium and sodium channels was observed in dorsal root ganglia expressing mutant NF1. Thus, these NF1+/ex42del miniswine recapitulate the disease and provide a unique, much-needed tool to advance the study and treatment of NF1.
Collapse
Affiliation(s)
- Katherine A White
- Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Vicki J Swier
- Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Jacob T Cain
- Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, South Dakota, USA
| | | | | | | | - Johanna Uthoff
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.,Department of Biomedical Engineering at the University of Iowa, Iowa City, Iowa, USA
| | - Emily Hammond
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.,Department of Biomedical Engineering at the University of Iowa, Iowa City, Iowa, USA
| | - Hua Li
- Department of Molecular Genetics and Microbiology and.,University of Florida Health Cancer Center, University of Florida, Gainesville, Florida, USA
| | | | | | - Chun-Hung Chan
- Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, South Dakota, USA
| | | | | | - Margaret R Wallace
- Department of Molecular Genetics and Microbiology and.,University of Florida Health Cancer Center, University of Florida, Gainesville, Florida, USA
| | - Rebecca D Dodd
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA
| | - Karin Panzer
- Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Amy H Tang
- Department of Microbiology and Molecular Cell Biology, Leroy T. Canoles Jr. Cancer Research Center, Eastern Virginia Medical School, Norfolk, Virginia
| | - Benjamin W Darbro
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA.,Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Aubin Moutal
- Department of Pharmacology, University of Arizona, Tucson, Arizona, USA
| | - Song Cai
- Department of Pharmacology, University of Arizona, Tucson, Arizona, USA
| | - Wennan Li
- Department of Pharmacology, University of Arizona, Tucson, Arizona, USA
| | | | - Rajesh Khanna
- Department of Pharmacology, University of Arizona, Tucson, Arizona, USA
| | | | - Jessica C Sieren
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.,Department of Biomedical Engineering at the University of Iowa, Iowa City, Iowa, USA.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA
| | - Dawn E Quelle
- Molecular Medicine Program.,Department of Pathology, and.,Department of Pharmacology and.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa, USA
| | - Jill M Weimer
- Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, South Dakota, USA.,Department of Pediatrics, Sanford School of Medicine at the University of South Dakota, Sioux Falls, South Dakota, USA
| |
Collapse
|
14
|
Hammond E, Chan KS, Ames JC, Stoyles N, Sloan CM, Guo J, Newell JD, Hoffman EA, Sieren JC. Impact of advanced detector technology and iterative reconstruction on low-dose quantitative assessment of lung computed tomography density in a biological lung model. Med Phys 2018; 45:10.1002/mp.13057. [PMID: 29926932 PMCID: PMC6309498 DOI: 10.1002/mp.13057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Quantitative computed tomography (QCT)-derived measures of lung density are valued methods for objectively characterizing lung parenchymal and peripheral airways disease and are being used in a growing number of lung disease focused trials. Detector and reconstruction improvements in CT technology have allowed for significant radiation dose reduction in image acquisition with comparable qualitative image quality. We report the impact of detector type and reconstruction type on QCT lung density measures in relation to decreasing dose indices. METHODS Two sets of studies were completed in an in vivo pig model with a SOMATOM Definition Flash CT system: (a) prior to system upgrade with conventional detectors (UFC) and filtered back projection (FBP), and (b) post system upgrade with integrated electronic detectors (STELLAR) and iterative reconstruction (SAFIRE). CT data were acquired across estimated CT volume dose indices (CTDIvol ) ranging from 0.75 to 15 mGy at both inspiratory and expiratory breath holds. Semiautomated lung segmentations allowed calculation of histogram median, kurtosis, and 15th percentile. Percentage of voxels below -910 HU and -950 HU (inspiratory), and -856 HU (expiratory) were also examined. The changes in these QCT metrics from dose reduction (15 mGy down to 0.75 mGy) were calculated relative to paired reference values (15 mGy). Results were compared based on detector and reconstruction type. RESULTS In this study, STELLAR detectors improved concordance with 15 mGy values down to 3 mGy for inspiratory scans and 6 mGy for expiratory scans. The addition of SAFIRE reconstruction in all acquired measurements resulted in minimal deviation from reference values at 0.75 mGy. CONCLUSION The use of STELLAR integrated electronic detectors and SAFIRE iterative reconstruction may allow for comparable lung density measures with CT dose indices down to 0.75 mGy.
Collapse
Affiliation(s)
- E. Hammond
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - K. S. Chan
- Statistics and Actuarial Science, University of Iowa, Iowa City, IA, 52242, USA
| | - J. C. Ames
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
| | - N. Stoyles
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
| | - C. M. Sloan
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
| | - J. Guo
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - J. D. Newell
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - E. A. Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| | - J. C. Sieren
- Department of Radiology, University of Iowa, Iowa City, IA, 52242, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242, USA
| |
Collapse
|
15
|
Thomson L, Barker M, Kaylor-Hughes C, Garland A, Ramana R, Morriss R, Hammond E, Hopkins G, Simpson S. How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience. BMC Psychiatry 2018; 18:194. [PMID: 29902995 PMCID: PMC6003097 DOI: 10.1186/s12888-018-1708-9] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants. METHODS Qualitative audiotaped and transcribed semi-structured interviews were conducted 12-18 months after baseline with 21 service users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using a grounded approach contrasted the experiences of SDS with TAU participants. RESULTS Four themes emerged in relation to service user experience: 1. Specific treatment components of the SDS: which included sub-themes of the management of medication change, explaining and developing treatment strategies, setting realistic expectations, and person-centred and holistic approach; 2. Individual qualities of SDS clinicians; 3. Collaborative team context in SDS: which included sub-themes of communication between healthcare professionals, and continuity of team members; 4. Accessibility to SDS: which included sub-themes of flexibility of locations, frequent consultation as reinforcement, gradual pace of treatment, and challenges of returning to usual care. CONCLUSIONS The study uncovered important mechanisms and contextual factors in the SDS that service users experience as different from TAU, and which may explain the greater effectiveness of the SDS: the technical expertise of the healthcare professionals, personal qualities of clinicians, teamwork, gradual pace of care, accessibility and managing service transitions. Usual care in other specialist mental health services may share many of the features from the SDS. TRIAL REGISTRATION "Trial of the Clinical and Cost Effectiveness of a Specialist Expert Mood Disorder Team for Refractory Unipolar Depressive Disorder" was registered in www.ClinicalTrials.gov ( NCT01047124 ) on 12-01-2010 and the ISRCTN registry was registered in www.isrctn.com ( ISRCTN10963342 ) on 25-11-2015 (retrospectively registered).
Collapse
Affiliation(s)
- Louise Thomson
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, Yang Fujia Building, Nottingham, NG8 1BB, UK.
| | - Marcus Barker
- 0000 0004 1936 8868grid.4563.4CLAHRC-EM, School of Medicine, University of Nottingham, Nottingham, UK
| | - Catherine Kaylor-Hughes
- 0000 0004 1936 8868grid.4563.4CLAHRC-EM, School of Medicine, University of Nottingham, Nottingham, UK
| | - Anne Garland
- Adult Mental Health Directorate, Nottinghamshire Healthcare Trust, Nottingham, UK
| | - Rajini Ramana
- Cambridge and Peterborough Partnership NHS Foundation Trust, Cambridge, UK
| | - Richard Morriss
- 0000 0004 1936 8868grid.4563.4CLAHRC-EM, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emily Hammond
- Cambridge and Peterborough Partnership NHS Foundation Trust, Cambridge, UK
| | - Gail Hopkins
- 0000 0004 1936 8868grid.4563.4Faculty of Science, University of Nottingham, Nottingham, UK
| | - Sandra Simpson
- Clinical Research Network, Nottinghamshire Healthcare Trust, Nottingham, UK
| |
Collapse
|
16
|
Watson NL, Prosperi C, Driscoll AJ, Higdon MM, Park DE, Sanza M, DeLuca AN, Awori JO, Goswami D, Hammond E, Hossain L, Johnson C, Kamau A, Kuwanda L, Moore DP, Neyzari O, Onwuchekwa U, Parker D, Sapchookul P, Seidenberg P, Shamsul A, Siazeele K, Srisaengchai P, Sylla M, Levine OS, Murdoch DR, O'Brien KL, Wolff M, Deloria Knoll M. Data Management and Data Quality in PERCH, a Large International Case-Control Study of Severe Childhood Pneumonia. Clin Infect Dis 2018; 64:S238-S244. [PMID: 28575357 PMCID: PMC5447839 DOI: 10.1093/cid/cix080] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The Pneumonia Etiology Research for Child Health (PERCH) study is the largest multicountry etiology study of pediatric pneumonia undertaken in the past 3 decades. The study enrolled 4232 hospitalized cases and 5325 controls over 2 years across 9 research sites in 7 countries in Africa and Asia. The volume and complexity of data collection in PERCH presented considerable logistical and technical challenges. The project chose an internet-based data entry system to allow real-time access to the data, enabling the project to monitor and clean incoming data and perform preliminary analyses throughout the study. To ensure high-quality data, the project developed comprehensive quality indicator, data query, and monitoring reports. Among the approximately 9000 cases and controls, analyzable laboratory results were available for ≥96% of core specimens collected. Selected approaches to data management in PERCH may be extended to the planning and organization of international studies of similar scope and complexity.
Collapse
Affiliation(s)
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amanda J Driscoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Melissa M Higdon
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel E Park
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, District of Columbia
| | | | - Andrea N DeLuca
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Juliet O Awori
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi
| | - Doli Goswami
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab
| | | | - Lokman Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab
| | | | - Alice Kamau
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi
| | - Locadiah Kuwanda
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, and
| | - David P Moore
- Medical Research Council, Respiratory and Meningeal Pathogens Research Unit.,Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, and.,Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesberg, South Africa
| | | | - Uma Onwuchekwa
- Centre pour le Développement des Vaccins (CVD-Mali), Bamako
| | - David Parker
- Medical Research Council Unit, Basse, The Gambia
| | - Patranuch Sapchookul
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi
| | - Phil Seidenberg
- Center for Global Health and Development, Boston University School of Public Health, Massachusetts.,Department of Emergency Medicine, University of New Mexico, Albuquerque
| | | | | | - Prasong Srisaengchai
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi
| | - Mamadou Sylla
- Centre pour le Développement des Vaccins (CVD-Mali), Bamako
| | - Orin S Levine
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Bill & Melinda Gates Foundation, Seattle, Washington
| | - David R Murdoch
- Department of Pathology, University of Otago, and.,Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Katherine L O'Brien
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Maria Deloria Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
17
|
Hitchcock C, Gormley S, O’Leary C, Rodrigues E, Wright I, Griffiths K, Gillard J, Watson P, Hammond E, Werner-Seidler A, Dalgleish T. Study protocol for a randomised, controlled platform trial estimating the effect of autobiographical Memory Flexibility training (MemFlex) on relapse of recurrent major depressive disorder. BMJ Open 2018; 8:e018194. [PMID: 29382674 PMCID: PMC5829844 DOI: 10.1136/bmjopen-2017-018194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 11/04/2022] Open
Abstract
INTRODUCTION Major depressive disorder (MDD) is a chronic condition. Although current treatment approaches are effective in reducing acute depressive symptoms, rates of relapse are high. Chronic and inflexible retrieval of autobiographical memories, and in particular a bias towards negative and overgeneral memories, is a reliable predictor of relapse. This randomised controlled single-blind trial will determine whether a therapist-guided self-help intervention to ameliorate autobiographical memory biases using Memory Flexibility training (MemFlex) will increase the experience of depression-free days, relative to a psychoeducation control condition, in the 12 months following intervention. METHODS AND ANALYSIS Individuals (aged 18 and above) with a diagnosis of recurrent MDD will be recruited when remitted from a major depressive episode. Participants will be randomly allocated to complete 4 weeks of a workbook providing either MemFlex training, or psychoeducation on factors that increase risk of relapse. Assessment of diagnostic status, self-report depressive symptoms, depression-free days and cognitive risk factors for depression will be completed post-intervention, and at 6 and 12 months follow-up. The cognitive target of MemFlex will be change in memory flexibility on the Autobiographical Memory Test- Alternating Instructions. The primary clinical endpoints will be the number of depression-free days in the 12 months following workbook completion, and time to depressive relapse. ETHICS AND DISSEMINATION Ethics approval has been granted by the NHS National Research Ethics Committee (East of England, 11/H0305/1). Results from this study will provide a point-estimate of the effect of MemFlex on depressive relapse, which will be used to inform a fully powered trial evaluating the potential of MemFlex as an effective, low-cost and low-intensity option for reducing relapse of MDD. TRIAL REGISTRATION NUMBER NCT02614326.
Collapse
Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Cliodhna O’Leary
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Isobel Wright
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Kirsty Griffiths
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Julia Gillard
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Psychology, University of Exeter, Exeter, UK
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
18
|
Tittlemier SA, Drul D, Lake B, Zirdum T, Hammond E, Sobering D, Lin WJ, Tran M, Roscoe M. Evaluation of a Commercially Available Enzyme-Linked Immunosorbent Assay and a Liquid Chromatography–Tandem Mass Spectrometric Method for the Analysis of Glyphosate in Wheat, Oats, Barley, Malt, and Lentils. Cereal Chem 2017. [DOI: 10.1094/cchem-01-17-0021-r] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Dainna Drul
- Grain Research Laboratory, Canadian Grain Commission, Winnipeg, MB, Canada
| | - Benjamin Lake
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Tanya Zirdum
- Industry Services, Canadian Grain Commission, Winnipeg, MB, Canada
| | - Emily Hammond
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Debbie Sobering
- Industry Services, Canadian Grain Commission, Winnipeg, MB, Canada
| | - Wen Jing Lin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Michael Tran
- Grain Research Laboratory, Canadian Grain Commission, Winnipeg, MB, Canada
| | - Mike Roscoe
- Grain Research Laboratory, Canadian Grain Commission, Winnipeg, MB, Canada
| |
Collapse
|
19
|
Cheng W, Choudhry H, Leszczynska K, Roberts D, Hammond E, West C, Harris A, Buffa F. Extensive global alternative splicing induced by hypoxia across four major cancer types. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx513] [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
|
20
|
Hammond E, Sloan C, Newell JD, Sieren JP, Saylor M, Vidal C, Hogue S, De Stefano F, Sieren A, Hoffman EA, Sieren JC. Comparison of low- and ultralow-dose computed tomography protocols for quantitative lung and airway assessment. Med Phys 2017; 44:4747-4757. [PMID: 28657201 DOI: 10.1002/mp.12436] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Quantitative computed tomography (CT) measures are increasingly being developed and used to characterize lung disease. With recent advances in CT technologies, we sought to evaluate the quantitative accuracy of lung imaging at low- and ultralow-radiation doses with the use of iterative reconstruction (IR), tube current modulation (TCM), and spectral shaping. METHODS We investigated the effect of five independent CT protocols reconstructed with IR on quantitative airway measures and global lung measures using an in vivo large animal model as a human subject surrogate. A control protocol was chosen (NIH-SPIROMICS + TCM) and five independent protocols investigating TCM, low- and ultralow-radiation dose, and spectral shaping. For all scans, quantitative global parenchymal measurements (mean, median and standard deviation of the parenchymal HU, along with measures of emphysema) and global airway measurements (number of segmented airways and pi10) were generated. In addition, selected individual airway measurements (minor and major inner diameter, wall thickness, inner and outer area, inner and outer perimeter, wall area fraction, and inner equivalent circle diameter) were evaluated. Comparisons were made between control and target protocols using difference and repeatability measures. RESULTS Estimated CT volume dose index (CTDIvol) across all protocols ranged from 7.32 mGy to 0.32 mGy. Low- and ultralow-dose protocols required more manual editing and resolved fewer airway branches; yet, comparable pi10 whole lung measures were observed across all protocols. Similar trends in acquired parenchymal and airway measurements were observed across all protocols, with increased measurement differences using the ultralow-dose protocols. However, for small airways (1.9 ± 0.2 mm) and medium airways (5.7 ± 0.4 mm), the measurement differences across all protocols were comparable to the control protocol repeatability across breath holds. Diameters, wall thickness, wall area fraction, and equivalent diameter had smaller measurement differences than area and perimeter measurements. CONCLUSIONS In conclusion, the use of IR with low- and ultralow-dose CT protocols with CT volume dose indices down to 0.32 mGy maintains selected quantitative parenchymal and airway measurements relevant to pulmonary disease characterization.
Collapse
Affiliation(s)
- Emily Hammond
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, IA, 52242, USA
| | - Chelsea Sloan
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - John D Newell
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, IA, 52242, USA
| | - Jered P Sieren
- Department of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Melissa Saylor
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Craig Vidal
- Department of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Shayna Hogue
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Frank De Stefano
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Alexa Sieren
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Eric A Hoffman
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, IA, 52242, USA.,Imaging services, VIDA Diagnostics, Inc., 2500 Crosspark Road, W250 BioVentures Center, Coralville, IA, 52241, USA
| | - Jessica C Sieren
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.,Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, IA, 52242, USA
| |
Collapse
|
21
|
Ahmed SU, Carruthers R, Biasoli D, Gomez-Roman N, Gilmour L, Strathdee K, Hedley A, Kalna G, Hammond E, Chalmers AJ. P08.36 Radioresistance of glioblastoma stem-like cells is associated with DNA replication stress, which is a promising therapeutic target. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
22
|
Hitchcock C, Mueller V, Hammond E, Rees C, Werner-Seidler A, Dalgleish T. The effects of autobiographical memory flexibility (MemFlex) training: An uncontrolled trial in individuals in remission from depression. J Behav Ther Exp Psychiatry 2016; 52:92-98. [PMID: 27058165 DOI: 10.1016/j.jbtep.2016.03.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 02/11/2016] [Accepted: 03/22/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Impaired cognitive processing is a key feature of depression. Biases in autobiographical memory retrieval (in favour of negative and over-general memories) directly impact depression symptoms, but also influence downstream cognitive factors implicated in the onset and maintenance of the disorder. We introduce a novel cognitive intervention, MemFlex, which aims to correct these biases in memory retrieval and thereby modify key downstream cognitive risk and maintenance factors: rumination, impaired problem solving, and cognitive avoidance. METHOD Thirty eight adults with remitted Major Depressive Disorder completed MemFlex in an uncontrolled clinical trial. This involved an orientation session, followed by self-guided completion of six workbook-based sessions over one-month. Assessments of cognitive performance and depression symptoms were completed at pre- and post-intervention. RESULTS Results demonstrated medium-sized effects of MemFlex in improving memory specificity and problem solving, and decreasing rumination, and a small effect in reducing cognitive avoidance. No significant change was observed in residual symptoms of depression. LIMITATIONS This study was an uncontrolled trial, and has provided initial evidence to support a larger-scale, randomized controlled trial. CONCLUSIONS These findings provide promising evidence for MemFlex as a cost-effective, low-intensity option for reducing cognitive risk associated with depression.
Collapse
Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom; The Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
| | - Viola Mueller
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
| | - Aliza Werner-Seidler
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom; The Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom; The Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
| |
Collapse
|
23
|
Hammond E, Newell JD, Dilger SKN, Stoyles N, Morgan J, Sieren JP, Thedens DR, Hoffman EA, Meyerholz DK, Sieren JC. Computed Tomography and Magnetic Resonance Imaging for Longitudinal Characterization of Lung Structure Changes in a Yucatan Miniature Pig Silicosis Model. Toxicol Pathol 2016; 44:373-81. [PMID: 26839326 DOI: 10.1177/0192623315622303] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Medical imaging is a rapidly advancing field enabling the repeated, noninvasive assessment of physiological structure and function. These beneficial characteristics can supplement studies in swine by mirroring the clinical functions of detection, diagnosis, and monitoring in humans. In addition, swine may serve as a human surrogate, facilitating the development and comparison of new imaging protocols for translation to humans. This study presents methods for pulmonary imaging developed for monitoring pulmonary disease initiation and progression in a pig exposure model with computed tomography and magnetic resonance imaging. In particular, a focus was placed on systematic processes, including positioning, image acquisition, and structured reporting to monitor longitudinal change. The image-based monitoring procedure was applied to 6 Yucatan miniature pigs. A subset of animals (n= 3) were injected with crystalline silica into the apical bronchial tree to induce silicosis. The methodology provided longitudinal monitoring and evidence of progressive lung disease while simultaneously allowing for a cross-modality comparative study highlighting the practical application of medical image data collection in swine. The integration of multimodality imaging with structured reporting allows for cross comparison of modalities, refinement of CT and MRI protocols, and consistently monitors potential areas of interest for guided biopsy and/or necropsy.
Collapse
Affiliation(s)
- Emily Hammond
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - John D Newell
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Samantha K N Dilger
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Nicholas Stoyles
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA
| | - John Morgan
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA
| | - Jered P Sieren
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA
| | - Daniel R Thedens
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| | | | - Jessica C Sieren
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
24
|
Hitchcock C, Hammond E, Rees C, Panesar I, Watson P, Werner-Seidler A, Dalgleish T. Memory Flexibility training (MemFlex) to reduce depressive symptomatology in individuals with major depressive disorder: study protocol for a randomised controlled trial. Trials 2015; 16:494. [PMID: 26531124 PMCID: PMC4632349 DOI: 10.1186/s13063-015-1029-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/22/2015] [Indexed: 11/10/2022] Open
Abstract
Background Major depressive disorder (MDD) is associated with chronic biases in the allocation of attention and recollection of personal memories. Impaired flexibility in attention and autobiographical memory retrieval is seen to both maintain current symptoms and predict future depression. Development of innovative interventions to reduce maladaptive cognitive patterns and improve cognitive flexibility in the domain of memory may therefore advance current treatment approaches for depression. Memory specificity training and cognitive bias modification techniques have both shown some promise in improving cognitive flexibility. Here we outline plans for a trial of an innovative memory flexibility training programme, MemFlex, which advances current training techniques with the aim of improving flexibility of autobiographical memory retrieval. This trial seeks to estimate the efficacy of MemFlex, provide data on feasibility, and begin to explore mechanisms of change. Methods/design We plan a single-blind, randomised, controlled, patient-level trial in which 50 individuals with MDD will complete either psychoeducation (n = 25) or MemFlex (n = 25). After completing pre-treatment measures and an orientation session, participants complete eight workbook-based sessions at home. Participants will then be assessed at post-treatment and at 3 month follow-up. The co-primary outcomes are depressive symptoms and diagnostic status at 3 month follow-up. The secondary outcomes are memory flexibility at post-treatment and number of depression free days at 3 month follow-up. Other process outcomes and mediators of any treatment effects will also be explored. Discussion This trial will establish the efficacy of MemFlex in improving memory flexibility, and reducing depressive symptoms. Any effects on process measures related to relapse may also indicate whether MemFlex may be helpful in reducing vulnerability to future depressive episodes. The low-intensity and workbook-based format of the programme may improve access to psychological therapies, and, if encouraging, the results of this study will provide a platform for later-phase trials. Trial registration NCT02371291 (ClinicalTrials.gov), registered 9 February 2015.
Collapse
Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK. .,Cambridgeshire and Peterborough National Health Service Foundation Trust (CPFT), Cambridge, UK.
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK. .,University of Exeter, Exeter, Devon, UK.
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
| | - Inderpal Panesar
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK. .,Cambridgeshire and Peterborough National Health Service Foundation Trust (CPFT), Cambridge, UK.
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
| | - Aliza Werner-Seidler
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK. .,The Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia.
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK. .,Cambridgeshire and Peterborough National Health Service Foundation Trust (CPFT), Cambridge, UK.
| |
Collapse
|
25
|
Dilger SKN, Uthoff J, Judisch A, Hammond E, Mott SL, Smith BJ, Newell JD, Hoffman EA, Sieren JC. Improved pulmonary nodule classification utilizing quantitative lung parenchyma features. J Med Imaging (Bellingham) 2015; 2:041004. [PMID: 26870744 DOI: 10.1117/1.jmi.2.4.041004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 04/01/2015] [Accepted: 07/09/2015] [Indexed: 11/14/2022] Open
Abstract
Current computer-aided diagnosis (CAD) models for determining pulmonary nodule malignancy characterize nodule shape, density, and border in computed tomography (CT) data. Analyzing the lung parenchyma surrounding the nodule has been minimally explored. We hypothesize that improved nodule classification is achievable by including features quantified from the surrounding lung tissue. To explore this hypothesis, we have developed expanded quantitative CT feature extraction techniques, including volumetric Laws texture energy measures for the parenchyma and nodule, border descriptors using ray-casting and rubber-band straightening, histogram features characterizing densities, and global lung measurements. Using stepwise forward selection and leave-one-case-out cross-validation, a neural network was used for classification. When applied to 50 nodules (22 malignant and 28 benign) from high-resolution CT scans, 52 features (8 nodule, 39 parenchymal, and 5 global) were statistically significant. Nodule-only features yielded an area under the ROC curve of 0.918 (including nodule size) and 0.872 (excluding nodule size). Performance was improved through inclusion of parenchymal (0.938) and global features (0.932). These results show a trend toward increased performance when the parenchyma is included, coupled with the large number of significant parenchymal features that support our hypothesis: the pulmonary parenchyma is influenced differentially by malignant versus benign nodules, assisting CAD-based nodule characterizations.
Collapse
Affiliation(s)
- Samantha K N Dilger
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States; University of Iowa, Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Johanna Uthoff
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States; University of Iowa, Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Alexandra Judisch
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Emily Hammond
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States; University of Iowa, Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Sarah L Mott
- University of Iowa , Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Brian J Smith
- University of Iowa, Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242, United States; University of Iowa, Department of Biostatistics, 145 North Riverside Drive, Iowa City, Iowa 52242, United States
| | - John D Newell
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Eric A Hoffman
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| | - Jessica C Sieren
- University of Iowa, Department of Biomedical Engineering, 3100 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242, United States; University of Iowa, Department of Radiology, 200 Hawkins Drive, Iowa City, Iowa 52242, United States; University of Iowa, Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242, United States
| |
Collapse
|
26
|
Bonawitz RE, Duncan J, Hammond E, Hamomba L, Nambule J, Sambambi K, Musonda V, Calise A, Knapp A, Mwale J, McCauley J, Thea D, Herlihy JM. Assessment of the impact of rapid syphilis tests on syphilis screening and treatment of pregnant women in Zambia. Int J Gynaecol Obstet 2015; 130 Suppl 1:S58-62. [PMID: 25968492 PMCID: PMC8991823 DOI: 10.1016/j.ijgo.2015.04.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the impact of rapid syphilis tests (RSTs) on syphilis testing and treatment in pregnant women in Kalomo District, Zambia. METHODS In March 2012, health workers at all 35 health facilities in Kalomo Distract were trained in RST use and penicillin treatment. In March 2013, data were retrospectively abstracted from 18 randomly selected health facilities and stratified into three time intervals: baseline (6months prior to RST introduction), midline (0-6 months after RST introduction), and endline (7-12 months after RST introduction). RESULTS Data collected on 4154 pregnant women showed a syphilis-reactive seroprevalence of 2.7%. The proportion of women screened improved from baseline (140/1365, 10.6%) to midline (976/1446, 67.5%), finally decreasing at endline (752/1337, 56.3%) (P<0.001). There was no significant difference in the proportion of syphilis-seroreactive pregnant women who received 1 dose of penicillin before (1/2, 50%) or after (5/48, 10.4%; P=0.199) RST introduction with low treatment rates throughout. CONCLUSION With RST scale-up in Zambia and other resource-limited settings, same-day test and treatment with penicillin should be prioritized to achieve the goal of eliminating congenital syphilis.
Collapse
Affiliation(s)
- Rachael E Bonawitz
- Center for Global Health and Development, Boston University, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA.
| | - Julie Duncan
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Emily Hammond
- Center for Global Health and Development, Boston University, Boston, MA, USA
| | - Leoda Hamomba
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Jane Nambule
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Kennedy Sambambi
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Victor Musonda
- Zambia Center for Applied Health Research and Development, Lusaka, Zambia
| | - Alana Calise
- Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Anna Knapp
- Center for Global Health and Development, Boston University, Boston, MA, USA
| | - Jonas Mwale
- US Centers for Disease Control and Prevention, Lusaka, Zambia
| | - James McCauley
- US Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Donald Thea
- Center for Global Health and Development, Boston University, Boston, MA, USA; Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Julie M Herlihy
- Center for Global Health and Development, Boston University, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA; Global Health, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
27
|
Kfoury A, Miller D, Snow G, Afshar K, Stehlik J, Budge D, Caine W, McKellar S, Everitt M, Alharethi R, Fang J, Drakos S, Gilbert E, Hammond E. Mixed Cellular and Antibody-Mediated Rejection in Heart Transplantation: A Distinct Entity or Simply the Sum of Two? J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.263] [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: 10/23/2022] Open
|
28
|
Ward DJ, Hammond E, Linden-Phillips L, Stevens A. Trends In Clinical Drug Development Timeframes, 1981-2013 - An Example From Virology. Value Health 2014; 17:A408. [PMID: 27200996 DOI: 10.1016/j.jval.2014.08.956] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D J Ward
- NIHR Horizon Scanning Centre, Birmingham, UK
| | - E Hammond
- University of Birmingham, Birmingham, UK
| | | | - A Stevens
- University of Birmingham, Birmingham, UK
| |
Collapse
|
29
|
Sieren JC, Wang XJ, Davis B, Newell JD, Hammond E, Rohret J, Rohret F, Struzynski J, Goeken A, Naumann P, Leidinger M, Hagen J, Rheeden RV, Darbro BW, Quelle DE, Meyerholz DK, Rogers CS. Abstract LB-162: Translational imaging of tumorigenesis in a TP53 porcine cancer model. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-lb-162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cancer remains the second deadliest disease in the United States, necessitating improvements in tumor diagnosis and treatment. Current model systems of cancer have been informative but also present challenges to translating promising imaging approaches and therapies to the clinic. The lack of a large animal model that accurately mimics human cancer has been a major barrier to the development of effective diagnostic tools and interventions (surgical and therapeutic). This study sought to 1) develop a genetically-modified porcine model of cancer expressing a TP53 mutation commonly found in humans (R175H in people, R167H in pigs), 2) validate the cellular p53 mutation and 3) evaluate tumor development in the animals using medical imaging, histopathology and molecular approaches. TP53R167H/R167H mutant pigs primarily developed lymphomas and osteogenic tumors, mimicking the tumor types observed in mice and humans expressing the orthologous TP53 mutant allele. CT and MRI imaging data effectively detected developing tumors, which were validated by histopathologic evaluation following necropsy. Molecular genetic analyses confirmed mutant p53 expression and characteristic chromosomal instability within the tumors. In conclusion, TP53R167H/R167H pigs provide a novel large animal tumor model that replicates the human condition and is uniquely suited to developing clinically-relevant, non-invasive imaging approaches to facilitate earlier detection, diagnosis and treatment of human cancers.
Citation Format: Jessica C. Sieren, Xiao-Jun Wang, Bryan Davis, John D. Newell, Emily Hammond, Judy Rohret, Frank Rohret, Jason Struzynski, Adam Goeken, Paul Naumann, Mariah Leidinger, Jussara Hagen, Richard Van Rheeden, Benjamin W. Darbro, Dawn E. Quelle, David K. Meyerholz, Christopher S. Rogers. Translational imaging of tumorigenesis in a TP53 porcine cancer model. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-162. doi:10.1158/1538-7445.AM2014-LB-162
Collapse
Affiliation(s)
| | | | | | | | - Emily Hammond
- 1University of Iowa College of Medicine, Iowa City, IA
| | | | | | | | - Adam Goeken
- 1University of Iowa College of Medicine, Iowa City, IA
| | - Paul Naumann
- 1University of Iowa College of Medicine, Iowa City, IA
| | | | - Jussara Hagen
- 1University of Iowa College of Medicine, Iowa City, IA
| | | | | | | | | | | |
Collapse
|
30
|
Seidenberg P, Cerwensky K, Brown RO, Hammond E, Mofu Y, Lungu J, Mulla Y, Biemba G, Mowafi H. Epidemiology of injuries, outcomes, and hospital resource utilisation at a tertiary teaching hospital in Lusaka, Zambia. Afr J Emerg Med 2014. [DOI: 10.1016/j.afjem.2014.01.006] [Citation(s) in RCA: 6] [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: 10/25/2022] Open
|
31
|
Sieren JC, Meyerholz DK, Wang XJ, Davis BT, Newell JD, Hammond E, Rohret JA, Rohret FA, Struzynski JT, Goeken JA, Naumann PW, Leidinger MR, Taghiyev A, Van Rheeden R, Hagen J, Darbro BW, Quelle DE, Rogers CS. Development and translational imaging of a TP53 porcine tumorigenesis model. J Clin Invest 2014; 124:4052-66. [PMID: 25105366 DOI: 10.1172/jci75447] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 06/19/2014] [Indexed: 01/03/2023] Open
Abstract
Cancer is the second deadliest disease in the United States, necessitating improvements in tumor diagnosis and treatment. Current model systems of cancer are informative, but translating promising imaging approaches and therapies to clinical practice has been challenging. In particular, the lack of a large-animal model that accurately mimics human cancer has been a major barrier to the development of effective diagnostic tools along with surgical and therapeutic interventions. Here, we developed a genetically modified porcine model of cancer in which animals express a mutation in TP53 (which encodes p53) that is orthologous to one commonly found in humans (R175H in people, R167H in pigs). TP53(R167H/R167H) mutant pigs primarily developed lymphomas and osteogenic tumors, recapitulating the tumor types observed in mice and humans expressing orthologous TP53 mutant alleles. CT and MRI imaging data effectively detected developing tumors, which were validated by histopathological evaluation after necropsy. Molecular genetic analyses confirmed that these animals expressed the R167H mutant p53, and evaluation of tumors revealed characteristic chromosomal instability. Together, these results demonstrated that TP53(R167H/R167H) pigs represent a large-animal tumor model that replicates the human condition. Our data further suggest that this model will be uniquely suited for developing clinically relevant, noninvasive imaging approaches to facilitate earlier detection, diagnosis, and treatment of human cancers.
Collapse
|
32
|
Ware A, Snow G, Hammond E, Miller D, Stehlik J, Kfoury A, Eckhauser A, Eckels D, Everitt M. How Does Donor Specific Antibody Relate to Biopsy-diagnosed Antibody-mediated Rejection after Pediatric Heart Transplantation? J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.875] [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: 10/25/2022] Open
|
33
|
Hammond E. SP-0210: Targeting resistant hypoxic cells by exploiting the DNA damage response. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30315-7] [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]
|
34
|
Yen CG, Diakos N, Stehlik J, Selzman C, Koufry A, Reid B, Everitt M, Wever-Pinzon O, Myrick C, Salama M, Hammond E, Symons J, Li D, Drakos S. Continuous-Flow Ventricular Assist Devices Impact on Failing Heart’s Vasculature. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.598] [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: 10/27/2022] Open
|
35
|
Hamilton-Craig I, Watts G, Hammond E, Sullivan D, George P, Clifton P, Nicholls S, van Bockxmeer F, Bishop W, O’Brien R, Bell D. Establishing an Australian and New Zealand Registry for Patients with Familial Hypercholesterolaemia. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.543] [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]
|
36
|
Fargason R, Gamble K, Preston T, Hammond E, Mrs May. Treatment of attention deficit hyperactivity disorder insomnia with blue wavelength light-blocking glasses. ACTA ACUST UNITED AC 2013. [DOI: 10.2147/cpt.s37985] [Citation(s) in RCA: 6] [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: 11/23/2022]
|
37
|
Abstract
OBJECTIVE Vitamin D deficiency (VDD) is prevalent in HIV, and following antiretroviral therapy (ART), increased rates of lipoatrophy and metabolic abnormalities are described. We investigated the relationships between 25-hydroxyvitamin D [25(OH)D] and other metabolic parameters in a group of HIV patients with and without lipoatrophy to examine whether lipoatrophy could explain the high prevalence of VDD and metabolic abnormalities. BACKGROUND Vitamin D receptors are expressed in adipose tissue implicating vitamin D, through paracrine/autocrine mechanism, in exerting effects on fat metabolism. HIV patients frequently suffer from VDD, and those treated with thymidine analogues frequently suffer from lipoatrophy so we investigated whether lipoatrophy could explain these associations. DESIGN AND PATIENTS Cross-sectional study of HIV-infected male patients (n = 107; 39 with lipoatrophy) from the West Australian cohort with measurements of 25(OH)D, adiponectin, insulin, lipids and leg fat as a percentage of mass. RESULTS Reduced 25(OH)D levels were common and significantly associated with higher serum insulin in the entire cohort (P = 0·006), but there was no difference in 25(OH)D between untreated and antiretroviral-treated patients with or without lipoatrophy. Treated patients with lipoatrophy were more likely to take thymidine analogue therapy, were older and on therapy longer than treated patients without lipoatrophy. Adiponectin levels did not correlate with 25(OH)D, but lipoatrophic-treated patients had lower levels of adiponectin compared with nonlipoatrophic-treated patients. CONCLUSIONS Lower 25(OH)D is associated with higher serum insulin but not lipoatrophy or hypoadiponectinemia in HIV-infected patients. The association between VDD and insulin resistance is likely to be mediated by independent mechanisms.
Collapse
Affiliation(s)
- E Hammond
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | | | | | | | | | | |
Collapse
|
38
|
Hammond E. Helen Margaret Connell. West J Med 2011. [DOI: 10.1136/bmj.d5902] [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]
|
39
|
Dredge K, Hammond E, Handley P, Gonda TJ, Smith MT, Vincent C, Brandt R, Ferro V, Bytheway I. PG545, a dual heparanase and angiogenesis inhibitor, induces potent anti-tumour and anti-metastatic efficacy in preclinical models. Br J Cancer 2011; 104:635-42. [PMID: 21285983 PMCID: PMC3049593 DOI: 10.1038/bjc.2011.11] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [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: 01/04/2023] Open
Abstract
Background: PG545 is a heparan sulfate (HS) mimetic that inhibits tumour angiogenesis by sequestering angiogenic growth factors in the extracellular matrix (ECM), thus limiting subsequent binding to receptors. Importantly, PG545 also inhibits heparanase, the only endoglycosidase which cleaves HS chains in the ECM. The aim of the study was to assess PG545 in various solid tumour and metastasis models. Methods: The anti-angiogenic, anti-tumour and anti-metastatic properties of PG545 were assessed using in vivo angiogenesis, solid tumour and metastasis models. Pharmacokinetic (PK) data were also generated in tumour-bearing mice to gain an understanding of optimal dosing schedules and regimens. Results: PG545 was shown to inhibit angiogenesis in vivo and induce anti-tumour or anti-metastatic effects in murine models of breast, prostate, liver, lung, colon, head and neck cancers and melanoma. Enhanced anti-tumour activity was also noted when used in combination with sorafenib in a liver cancer model. PK data revealed that the half-life of PG545 was relatively long, with pharmacologically relevant concentrations of radiolabeled PG545 observed in liver tumours. Conclusion: PG545 is a new anti-angiogenic clinical candidate for cancer therapy. The anti-metastatic property of PG545, likely due to the inhibition of heparanase, may prove to be a critical attribute as the compound enters phase I clinical trials.
Collapse
Affiliation(s)
- K Dredge
- Progen Pharmaceuticals Ltd, 16 Benson Street, Toowong, Brisbane, QLD 4066, Australia.
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Drakos S, Hammond E, Clayson S, Revelo M, Stoker S, McCormick A, Smith H, Selzman C, Verma D, Budge D. 243: Impact of Mechanical Unloading on Myocardial Endothelium and Microvasculature. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.254] [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: 10/19/2022] Open
|
41
|
Drakos S, Hammond E, Reid B, Stoker S, Revelo M, Rasmusson B, Selzman C, Alharethi R, McCormick A, Gilbert E. 244: Effect of Mechanical Unloading on Fibrosis and Hypertrophy during Cardiac Remodeling in Humans. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.255] [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: 10/19/2022] Open
|
42
|
Bell LJ, Oliver L, Vial P, Eade TN, Rinks M, Hammond E, Morgan GW, Back M, Wiltshire KL. Implementation of an image-guided radiation therapy program: Lessons learnt and future challenges. J Med Imaging Radiat Oncol 2010; 54:82-9. [DOI: 10.1111/j.1754-9485.2010.02142.x] [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: 11/30/2022]
|
43
|
Hammond E, Lucas A, Lucas M, Phillips E, Gaudieri S. Vaniprevir. DRUG FUTURE 2010. [DOI: 10.1358/dof.2010.035.010.1527293] [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]
|
44
|
Hammond E, Fetzer J, Belnap T, Rowley B, Hall C, Nkoy F. Impact of Recording of Pre-Analytical Specimen Handling Conditions for ER and PR Testing in Women with Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-4154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Hormone receptor testing is important in the management of women with breast cancer. We previously reported potential adverse effects of variable specimen and prolonged specimen handling conditions on ER (estrogen receptor) test results (2005 SABCS, abstract#5107).Objective: To compare prevalence of ER and PR (progesterone receptor) negative test results following standardization of pre-analytical specimen handling conditions at Intermountain facilities.Methods: Prospective, quasi-experimental study design of 6 Intermountain facilities. Facilities were separated into 2 categories: experimental (2 facilities) and control (4 facilities) groups. Pre-analytical specimen handling conditions (including recording of time to fixative and duration of fixation in neutral buffered formalin) were standardized at experimental facilities but not at control facilities. Standardization consisted of educating operating and grossing room staff about appropriate specimen handling and the value of recording time to fixation and fixative duration as a way to improve pre-analytic standardization. OR staff was called in any cases where times were not recorded. Study population includes women undergoing breast cancer surgery and who were tested for ER/PR status between January 2008 and January 2009. Specimen handling conditions and ER/PR test results were collected manually. Covariates were retrieved from cancer registry and included age, grade, positive lymph nodes, specimen type, and tumor stage. Multivariate logistic regression was used to compare prevalence of ER and PR negativity between experimental and control facilities after controlling for covariates.Results: 1054 women with breast cancer were tested for ER/PR status during the study period. The average age was 60.2 years (59.2 years for control cases and 61.1 years for the experimental group). The overall prevalence of ER and PR negative tests was respectively 18.5% and 27.3%. Average time to fixative at experimental facilities was 18.4 minutes (SE=3.1; 95% CI, 12.2-25.6) and average time in fixative was 18.0 hours (SE=0.4; 95% CI, 17.2-18.8). Compared to experimental facilities, both the prevalence of ER and PR negativity was higher (16.9% vs 19.7%) and (23.9% vs 30.0%) at control facilities. After controlling for covariates there was no difference in prevalence of ER negativity (p=0.13) between the two groups. However, the prevalence of PR negativity remains significantly higher (p<0.01) at control facilities compared to experimental facilities even after controlling for covariates.Conclusions: The prevalence of ER and PR negative results was lower following staff education and recording of pre-analytical specimen handling conditions. Our data suggest that staff education and recording of pre-analytical specimen handling conditions has the potential to optimize hormone receptor test results. It also shows the feasibility of fixing tissue routinely after less than an hour interval between time of breast cancer tissue removal and fixation and underscores the value of standardization of pre-analytic handling as a method to improve ER and PR testing on breast cancer specimens.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4154.
Collapse
Affiliation(s)
| | | | | | | | - C. Hall
- 1Intermountain Healthcare, UT,
| | | |
Collapse
|
45
|
Chinnaiyan P, Wang M, Rojiani A, Tofilon P, Chakravarti A, Ang K, Zhang H, Hammond E, Curran W, Mehta M. The Prognostic Value of Nestin Expression in Newly Diagnosed GBM: Report from the RTOG. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
46
|
Abstract
Inheritance of HLA-B*5701 is a strong predictor of a hypersensitivity reaction to the anti-HIV drug abacavir. The identification of susceptible individuals prior to the institution of abacavir therapy is therefore of clinical importance and has generated demand for a simple and rapid diagnostic test for carriage of HLA-B*5701. In this study, we describe the development of such a method based on allele-specific polymerase chain reaction (AS-PCR) and melting curve analysis. Ninety-six patient samples including 36 HLA-B*5701-positive samples and 60 HLA-B*5701-negative samples were analysed. Compared with sequence-based typing, this method had 100% sensitivity and specificity for the HLA-B*5701 allele. In conclusion, the AS-PCR/melting curve approach minimises post-polymerase chain reaction handling processing and provides an attractive alternative to currently described AS-PCR methods.
Collapse
Affiliation(s)
- E Hammond
- Centre for Clinical Immunology and Biomedical Statistics, Royal Perth Hospital and Murdoch University, Wellington Street, Western Australia 6000, Australia.
| | | | | | | |
Collapse
|
47
|
Hammond E, Shaw K, Herrmann R. “The JAK2 V617F mutation is detectable in granulocyte populations at greater than two copies per cell among individuals with myeloproliferative disorders”, by El Housni et al. Leukemia 2007. [DOI: 10.1038/sj.leu.2404569] [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: 11/09/2022]
|
48
|
Hammond E, Shaw K, Herrmann R. The JAK2 V617F mutation is detectable in granulocyte populations at greater than two copies per cell among individuals with myeloproliferative disorders. Leukemia 2007; 21:815-6; discussion 816-8. [PMID: 17268517 DOI: 10.1038/sj.leu.2404567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
49
|
Zhang M, Ho A, Hammond E, Sause W, Pilepich M, Shipley W, Sandler H, Khor L, Pollack A, Chakravarti A. 2210. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.616] [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]
|
50
|
Zhai G, Ho A, Hammond E, Fontanesi J, Rotman M, Pilepich M, Shipley W, Sandler H, Pollack A, Zhang M, Chakravarti A. Phospho-AKT Expression and Prognosis of Locally Advanced Prostate Cancer: A Study Based on RTOG 8610. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.546] [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: 10/25/2022]
|