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Dosis A, Husnoo N, Roney S, Hendry C, Bonner C, Kronberga M, Moran E, Ninh V, Jha A, Grey T, Saha AK. A census of general surgery consultants in England and Wales: implications for the current and future surgical workforce. Ann R Coll Surg Engl 2024; 106:150-159. [PMID: 37489525 PMCID: PMC10830335 DOI: 10.1308/rcsann.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION This study aimed to describe the composition of the current general surgical consultant body in England and Wales and quantify levels of inequality within it as well as describe future workforce challenges. METHODS This is an observational study of all general surgical departments in England and Wales. Consultant general surgeons were identified and data regarding their gender, country of undergraduate medical education, subspecialty and private practice were recorded. RESULTS Of the 2,682 consultant general surgeons in England and Wales identified for this study, just 17% are women, with gender inequality most marked in university teaching hospitals and among certain subspecialties. Almost 40% of consultants did not obtain their primary undergraduate degree in the United Kingdom and there are considerably fewer surgeons who studied abroad in university teaching hospitals. Over 40% of current general surgical consultants have been qualified for more than three decades and there is no equivalent sized group of younger consultants. CONCLUSIONS There remains considerable gender and racial inequality in the consultant general surgical workforce, with pockets of a lack of diversity within university or teaching hospital surgical departments and some subspecialties. The proportion of surgeons in their fourth decade of clinical practice represents the largest group of current practising consultants, which points towards an impending workforce crisis should senior clinicians seek to reduce activity or consider taking early retirement.
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Affiliation(s)
- A Dosis
- Yorkshire and the Humber Deanery, UK
| | - N Husnoo
- University of Sheffield & Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - S Roney
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | | | - C Bonner
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - M Kronberga
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - E Moran
- Yorkshire and the Humber Deanery, UK
| | - V Ninh
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - A Jha
- South Tees Hospitals NHS Foundation Trust, UK
| | - T Grey
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - AK Saha
- Calderdale and Huddersfield NHS Foundation Trust, UK
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Calzada D, Bartra J, Serrano CD, Riggioni S, Moran E, Maselli JP, Silva DL, Ramirez LF, Pascal M, Carnés J, Valero A. Differences in molecular sensitization profiles between a Spanish and Latin American mite allergic patients. J Investig Allergol Clin Immunol 2024; 35:0. [PMID: 38174976 DOI: 10.18176/jiaci.0968] [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: 01/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE To analyze the sensitization pattern to Dermatophagoides pteronyssinus and to associate the diagnostic findings and clinical severity in 218 allergic patients from two different continents. METHODS Mite allergic patients were recruited by the Allergology departments from Latin America (n=88: Colombia, Costa Rica and Guatemala) and Spain (N=130). All patients had allergic rhinitis with or without asthma and positive skin prick test results to D. pteronyssinus. Specific IgE levels to D. pteronyssinus, D. farinae, Der p 1, Der p 2, and Der p 23 were quantified by ImmunoCAP system (ThermoFisher Scientific). Allergenic profile was also determined by western blot. Comparative Statistical analysis was performed by GraphPad software. RESULTS Patients recognized most frequently Der p 2 (79%) followed by Der p 1 (73%), and Der p 23 (69%) allergens. The percentage of asthmatic patients increases with the number of sensitizations however none statistically significant differences were found. Interestingly, asthmatic patients presented the highest median levels of total IgE and specific IgE levels of D. pteronyssinus and molecular allergens, mainly Der p 2. Analysing the two different populations, Spanish patients were predominantly sensitized to Der p 2 (88.46%) and Der p 1 (83.84%), whereas Latin American population were more sensitized to Der p 23. CONCLUSION Our data support the relevance of Der p 2 in mite allergy as the major allergen, with the high number of patients sensitized to it and its importance in the development of asthma. Sensitization to Der p 23 was more important in Latin America.
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Affiliation(s)
- D Calzada
- Unidad I+D. LETI Pharma. S.L.u. Madrid, España
| | - J Bartra
- Servicio de Alergología, Hospital Clínic, IDIBAPS Barcelona, RICORS, España
| | - C D Serrano
- Unidad de Alergia, Fundación Valle del Lili. Cali, Colombia
| | - S Riggioni
- Centro Diagnóstico y Tratamiento de Alergia. San José, Costa Rica
| | - E Moran
- Universidad Rafael Landivar, Facultad de Medicina, Catedra de Inmunología, Guatemala City, Guatemala
| | - J P Maselli
- Universidad Rafael Landivar, Facultad de Medicina, Catedra de Inmunología, Guatemala City, Guatemala
| | - D L Silva
- Unidad de Alergia, Fundación Valle del Lili. Cali, Colombia
| | - L F Ramirez
- Unidad de Alergia, Fundación Valle del Lili. Cali, Colombia
| | - M Pascal
- Servicio de Inmunología, CDB, Hospital Clínic, IDIBAPS Barcelona, RICORS, España
| | - J Carnés
- Unidad I+D. LETI Pharma. S.L.u. Madrid, España
| | - A Valero
- Servicio de Alergología, Hospital Clínic, IDIBAPS Barcelona, CIBERES, España
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3
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Qiu T, Aravena MC, Ascoli D, Bergeron Y, Bogdziewicz M, Boivin T, Bonal R, Caignard T, Cailleret M, Calama R, Calderon SD, Camarero JJ, Chang-Yang CH, Chave J, Chianucci F, Courbaud B, Cutini A, Das AJ, Delpierre N, Delzon S, Dietze M, Dormont L, Espelta JM, Fahey TJ, Farfan-Rios W, Franklin JF, Gehring CA, Gilbert GS, Gratzer G, Greenberg CH, Guignabert A, Guo Q, Hacket-Pain A, Hampe A, Han Q, Holik J, Hoshizaki K, Ibanez I, Johnstone JF, Journé V, Kitzberger T, Knops JMH, Kunstler G, Kurokawa H, Lageard JGA, LaMontagne JM, Lefevre F, Leininger T, Limousin JM, Lutz JA, Macias D, Marell A, McIntire EJB, Moore CM, Moran E, Motta R, Myers JA, Nagel TA, Naoe S, Noguchi M, Oguro M, Parmenter R, Pearse IS, Perez-Ramos IM, Piechnik L, Podgorski T, Poulsen J, Redmond MD, Reid CD, Rodman KC, Rodriguez-Sanchez F, Samonil P, Sanguinetti JD, Scher CL, Seget B, Sharma S, Shibata M, Silman M, Steele MA, Stephenson NL, Straub JN, Sutton S, Swenson JJ, Swift M, Thomas PA, Uriarte M, Vacchiano G, Whipple AV, Whitham TG, Wion AP, Wright SJ, Zhu K, Zimmerman JK, Zywiec M, Clark JS. Masting is uncommon in trees that depend on mutualist dispersers in the context of global climate and fertility gradients. Nat Plants 2023:10.1038/s41477-023-01446-5. [PMID: 37386149 DOI: 10.1038/s41477-023-01446-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 05/17/2023] [Indexed: 07/01/2023]
Abstract
The benefits of masting (volatile, quasi-synchronous seed production at lagged intervals) include satiation of seed predators, but these benefits come with a cost to mutualist pollen and seed dispersers. If the evolution of masting represents a balance between these benefits and costs, we expect mast avoidance in species that are heavily reliant on mutualist dispersers. These effects play out in the context of variable climate and site fertility among species that vary widely in nutrient demand. Meta-analyses of published data have focused on variation at the population scale, thus omitting periodicity within trees and synchronicity between trees. From raw data on 12 million tree-years worldwide, we quantified three components of masting that have not previously been analysed together: (i) volatility, defined as the frequency-weighted year-to-year variation; (ii) periodicity, representing the lag between high-seed years; and (iii) synchronicity, indicating the tree-to-tree correlation. Results show that mast avoidance (low volatility and low synchronicity) by species dependent on mutualist dispersers explains more variation than any other effect. Nutrient-demanding species have low volatility, and species that are most common on nutrient-rich and warm/wet sites exhibit short periods. The prevalence of masting in cold/dry sites coincides with climatic conditions where dependence on vertebrate dispersers is less common than in the wet tropics. Mutualist dispersers neutralize the benefits of masting for predator satiation, further balancing the effects of climate, site fertility and nutrient demands.
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Affiliation(s)
- Tong Qiu
- Department of Ecosystem Science and Management, Pennsylvania State University, University Park, PA, USA.
| | - Marie-Claire Aravena
- Facultad de Ciencias Forestales y de la Conservacion de la Naturaleza (FCFCN), Universidad de Chile, La Pintana, Santiago, Chile
| | - Davide Ascoli
- Department of Agriculture, Forest and Food Sciences, University of Torino, Grugliasco, Torino, Italy
| | - Yves Bergeron
- Forest Research Institute, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, Quebec, Canada
| | - Michal Bogdziewicz
- Department of Systematic Zoology, Faculty of Biology, Adam Mickiewicz University, Poznan, Poland
| | - Thomas Boivin
- Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Ecologie des Forets Mediterranennes, Avignon, France
| | - Raul Bonal
- Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - Thomas Caignard
- Universite Bordeaux, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Biodiversity, Genes, and Communities (BIOGECO), Pessac, France
| | - Maxime Cailleret
- NRAE, Aix-Marseille University, UMR RECOVER, Aix-en-Provence, France
| | - Rafael Calama
- Centro de Investigacion Forestal (INIA-CSIC), Madrid, Spain
| | - Sergio Donoso Calderon
- Facultad de Ciencias Forestales y de la Conservacion de la Naturaleza (FCFCN), Universidad de Chile, La Pintana, Santiago, Chile
| | - J Julio Camarero
- Instituto Pirenaico de Ecologla, Consejo Superior de Investigaciones Cientificas (IPE-CSIC), Zaragoza, Spain
| | - Chia-Hao Chang-Yang
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Jerome Chave
- Laboratoire Evolution et Diversite Biologique, Toulouse, France
| | | | - Benoit Courbaud
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
| | - Andrea Cutini
- Research Centre for Forestry and Wood, Arezzo, Italy
| | - Adrian J Das
- U.S. Geological Survey Western Ecological Research Center, Three Rivers, CA, USA
| | - Nicolas Delpierre
- Universite Paris-Saclay, Centre national de la recherche scientifique, AgroParisTech, Ecologie Systematique et Evolution, Orsay, France
| | - Sylvain Delzon
- Universite Bordeaux, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Biodiversity, Genes, and Communities (BIOGECO), Pessac, France
| | - Michael Dietze
- Earth and Environment, Boston University, Boston, MA, USA
| | - Laurent Dormont
- Centre d'Ecologie Fonctionnelle et Evolutive (CEFE), Centre National de la Recherche Scientifique (CNRS), Montpellier, France
| | - Josep Maria Espelta
- Centre de Recerca Ecologica i Aplicacions Forestals (CREAF), Bellaterra, Catalunya, Spain
| | | | - William Farfan-Rios
- Washington University in Saint Louis, Center for Conservation and Sustainable Development, Missouri Botanical Garden, St Louis, MO, USA
| | | | - Catherine A Gehring
- Department of Biological Sciences and Center for Adaptive Western Landscapes, Flagstaff, AZ, USA
| | - Gregory S Gilbert
- Department of Environmental Studies, University of California, Santa Cruz, CA, USA
| | - Georg Gratzer
- Institute of Forest Ecology, Department of Forest and Soil Sciences, University of Natural Resources and Life Sciences, Wien, Austria
| | | | | | - Qinfeng Guo
- Eastern Forest Environmental Threat Assessment Center, USDA Forest Service, Southern Research Station, Research Triangle Park, NC, USA
| | - Andrew Hacket-Pain
- Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - Arndt Hampe
- Universite Bordeaux, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Biodiversity, Genes, and Communities (BIOGECO), Pessac, France
| | - Qingmin Han
- Department of Plant Ecology Forestry and Forest Products Research Institute (FFPRI), Tsukuba, Ibaraki, Japan
| | - Jan Holik
- Department of Forest Ecology, Silva Tarouca Research Institute, Brno, Czech Republic
| | - Kazuhiko Hoshizaki
- Department of Biological Environment, Akita Prefectural University, Akita, Japan
| | - Ines Ibanez
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
| | - Jill F Johnstone
- Institute of Arctic Biology, University of Alaska, Fairbanks, AK, USA
| | - Valentin Journé
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
| | - Thomas Kitzberger
- Department of Ecology, Instituto de Investigaciones en Biodiversidad y Medioambiente (Consejo Nacional de Investigaciones Cientificas y Tecnicas - Universidad Nacional del Comahue), Bariloche, Argentina
| | - Johannes M H Knops
- Health and Environmental Sciences Department, Xian Jiaotong-Liverpool University, Suzhou, China
| | - Georges Kunstler
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
| | - Hiroko Kurokawa
- Department of Forest Vegetation, Forestry and Forest Products Research Institute, Tsukuba, Japan, Ibaraki
| | - Jonathan G A Lageard
- Department of Natural Sciences, Manchester Metropolitan University, Manchester, UK
| | | | - Francois Lefevre
- Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Ecologie des Forets Mediterranennes, Avignon, France
| | - Theodor Leininger
- USDA, Forest Service, Southern Research Station, Stoneville, MS, USA
| | | | - James A Lutz
- Department of Wildland Resources, and the Ecology Center, Utah State University, Logan, UT, USA
| | - Diana Macias
- Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | | | | | | | - Emily Moran
- School of Natural Sciences, UC Merced, Merced, CA, USA
| | - Renzo Motta
- Department of Agriculture, Forest and Food Sciences, University of Torino, Grugliasco, Torino, Italy
| | - Jonathan A Myers
- Department of Biology, Washington University in St Louis, St Louis, MO, USA
| | - Thomas A Nagel
- Department of Forestry and Renewable Forest Resources, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Shoji Naoe
- Tohoku Research Center, Forestry and Forest Products Research Institute, Morioka, Iwate, Japan
| | - Mahoko Noguchi
- Tohoku Research Center, Forestry and Forest Products Research Institute, Morioka, Iwate, Japan
| | - Michio Oguro
- Department of Forest Vegetation, Forestry and Forest Products Research Institute, Tsukuba, Japan, Ibaraki
| | - Robert Parmenter
- Valles Caldera National Preserve, National Park Service, Jemez Springs, NM, USA
| | - Ian S Pearse
- U.S. Geological Survey Fort Collins Science Center, Fort Collins, CO, USA
| | - Ignacio M Perez-Ramos
- Instituto de Recursos Naturales y Agrobiologia de Sevilla, Consejo Superior de Investigaciones Cientificas (IRNAS-CSIC), Seville, Andalucia, Spain
| | - Lukasz Piechnik
- W. Szafer Institute of Botany, Polish Academy of Sciences, Krakow, Poland
| | - Tomasz Podgorski
- Mammal Research Institute, Polish Academy of Sciences, Bialowieza, Poland
| | - John Poulsen
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Miranda D Redmond
- Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO, USA
| | - Chantal D Reid
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Kyle C Rodman
- Ecological Restoration Institute, Northern Arizona University, Flagstaff, AZ, USA
| | | | - Pavel Samonil
- Department of Forest Ecology, Silva Tarouca Research Institute, Brno, Czech Republic
| | - Javier D Sanguinetti
- Bilogo Dpto. Conservacin y Manejo, Parque Nacional Lanin Elordi y Perito Moreno, San Marten de los Andes, Neuqun, Argentina
| | - C Lane Scher
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Barbara Seget
- W. Szafer Institute of Botany, Polish Academy of Sciences, Krakow, Poland
| | - Shubhi Sharma
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Mitsue Shibata
- Department of Forest Vegetation, Forestry and Forest Products Research Institute, Tsukuba, Japan, Ibaraki
| | - Miles Silman
- Department of Biology, Wake Forest University, Winston-Salem, NC, USA
| | | | - Nathan L Stephenson
- U.S. Geological Survey Western Ecological Research Center, Three Rivers, CA, USA
| | - Jacob N Straub
- Department of Environmental Science and Ecology, State University of New York-Brockport, Brockport, NY, USA
| | - Samantha Sutton
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | - Margaret Swift
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Peter A Thomas
- School of Life Sciences, Keele University, Staffordshire, UK
| | - Maria Uriarte
- Department of Ecology, Evolution and Environmental Biology, Columbia University, New York, NY, USA
| | - Giorgio Vacchiano
- Department of Agricultural and Environmental Sciences - Production, Territory, Agroenergy (DISAA), University of Milan, Milano, Italy
| | - Amy V Whipple
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Thomas G Whitham
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Andreas P Wion
- Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO, USA
| | - S Joseph Wright
- Smithsonian Tropical Research Institute, Balboa, Republic of Panama
| | - Kai Zhu
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
| | - Jess K Zimmerman
- Department of Environmental Sciences, University of Puerto Rico, Rio Piedras, PR, USA
| | - Magdalena Zywiec
- W. Szafer Institute of Botany, Polish Academy of Sciences, Krakow, Poland
| | - James S Clark
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
- Nicholas School of the Environment, Duke University, Durham, NC, USA
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Kosti A, Borakati A, Varma A, Gupta A, Mustafa A, Hakeem A, Quddus A, Sahl AB, Beniwal A, Adesuyi A, Krzak AM, Brooks A, Frampton A, Gadhvi A, Talbot A, Elnogoomi A, Mahgoub A, Naqvi A, Pervez A, Bodla AS, Taha A, Tawfik A, Prabhu A, Puri A, Belgaumkar A, Gupta A, McCrorie A, Findlay A, Healey A, De Prendergast A, Farrugia A, Dosis A, Adiamah A, Sallam A, Wong A, Bradley A, Martin A, Collins A, Awan A, Bond A, Koh A, Kourdouli A, Patel AG, Dhannoon A, Khalil A, Banerjee A, Khan A, Elserafy A, Alamassi A, Owen A, Benjafield A, Zuccarrelli A, Luhmann A, Jones A, Kennedy-Dalby A, Smith AM, Kaul A, Kumar A, White A, Baker A, Minicozzi A, Bardoli A, Golpe AL, Manzelli A, Sivakumar A, Saha A, Shajpal A, Lango A, Cotton A, Nair A, Brown A, Menon A, Tandon A, Afza A, Hassan A, Shamali A, Khalid A, Regan A, Piramanayagam B, Oyewole B, Ibrahim B, Murphy B, Clayton B, Jenkins B, Kumar B, Rybinski B, Khor BY, Davidson BR, Lees B, Blacklock C, Johnstone C, Salinas CH, Boven C, Wolstenholme C, Chin C, Gilmore C, Sharp C, Walker C, Harris C, Khanna C, Ferguson C, Kyriakides C, Bee C, Currow C, Parmar C, Collins C, Halloran C, Smart CJ, Neophytou C, Delaney C, Anele C, Heugh C, Choh CTP, Kenington C, Wyatt C, Borg CM, Mole D, Arumugam D, Gunia D, Porter D, Berry D, Griffith D, Hou D, Longbotham D, Mitton D, Strachan D, Di Mauro D, Worku D, Heaphy D, Dunne D, Yeung D, Arambepola D, Leswas DA, Pournaras DJ, Damaskos D, Saleh D, Osilli D, Pearman D, Whitelaw D, Haq EU, Mack E, Spurring E, Jamieson E, Lenzi E, Gemmill E, Gammeri E, Bota E, Britton E, Farrow E, Lloyd E, Moran E, Itobi E, Craig E, Tanaka E, Chohda E, Muhammad FU, Youssef F, Roslan F, Amir F, Froghi F, Di Franco F, Abbadessa F, DiMaggio F, Gurung G, Faulkner G, Choa G, Kerans G, Davis GN, Galanopoulos G, Karagiannidis G, McCabe G, Mohammadi-Zaniani G, Nawaz G, Van Boxel G, Bond-Smith G, Tierney GM, Muthukumarasamy G, Grey G, Wong G, Finch G, Khan H, Bourne H, Javanmard-Emamghissi H, Murray H, Rottenburg H, Wright H, Khalil H, Spiers HVM, Bashiti H, Shanti H, Ebied H, Ng HJ, Hamid HKS, Kim H, Wilson I, Rajendran I, Gerogiannis I, Patel I, El-Abbassy I, Burridge I, Caldwll J, Jackman J, Clark J, Duncan J, Milburn J, O’Kelly J, Olivier J, Rink J, Royle J, Rai J, Latif J, Ahmad J, Maliyil J, Carr J, Coles J, McGarry J, Apollos J, Lim J, Gray J, Thomas J, Bennett J, Findlay J, Spearman J, Young J, Lund JN, Meilak J, Alfred J, Welsh J, Chan JH, Martin J, Patel K, Ko KYK, Isand K, Razi K, Sarathy K, Powezka K, Foster K, Peleki K, Bevan K, Fox K, Edwards K, Larsen K, Spellar K, Oh KE, Kong K, Brown K, Roberts KJ, Seymour K, Beatson K, Etherson K, Willis K, Mann K, Nizami K, Rajput K, Lavery L, Sawdon L, Nip L, Al-Hamed L, Fagan L, Watton L, Saint-Grant AL, Convie L, Girard LP, Huppler L, Marsh L, Seretny L, Newton L, Buksh M, Sallam M, Mathew M, Prasanth MN, Nayar M, Wijeyaratne M, Hollyman M, Ransome M, Popa M, Galea M, Taylor M, Gismondi M, Michel M, Wadley M, Al-Azzawi M, Claxton M, Kuzman M, Bonomaully M, Newman M, Bhandari M, Courtney M, Jones M, Rarity M, Wilson M, Ebraheem M, Elnaghi M, Mohamed MSN, Al-Hijaji M, Al-Rashedy M, Qayum MK, Zourob M, Gaber M, Rao M, Islam MA, Rashid MU, Zafar M, Naqvi M, Ahmad MN, Telfah M, Merali N, Hanbali N, Gulnaz N, Kumar N, Husain N, Angamuthu N, Murali N, Kirmani N, Assaf N, Doshi N, Shah NS, Basra N, Menezes N, Dai N, Schuijtvlot N, Kansal N, Chidumije N, Yassin N, Babalola O, Oyende O, Williams O, Pawlik O, O'Connor O, Jalil OA, Ryska O, Vaz O, Sarmah P, Jayawardena P, Patel P, Hart P, Cromwell P, Manby P, Marriott P, Needham P, Ghaneh P, Rao PKD, Eves P, Coe PO, May-Miller P, Szatmary P, Ireland P, Seta P, Ravi P, Janardhanan P, Patil P, Mistry P, Heer P, Patel P, Nunes Q, Ain Q, Clifford R, Brindle R, Lee RXN, Lim RQH, Rahman R, Kumar RM, Lunevicius R, Mukherjee R, Lahiri R, Behmida R, Rajebhosale R, Levy R, Chhabra R, Oliphant R, Freeman R, Jones RM, Elkalbash R, Brignall R, Bell R, Byrom R, Laing RW, Patel R, Buhain R, Clark R, Sutton R, Presa R, Lawther R, Patel R, Zakeri R, Mashar R, Wei R, Baron R, Tasleem S, Kadambot SS, Azam S, Wajed S, Ali S, Body S, Saeed S, Bandyopadhyay S, Mohamed S, Pandanaboyana S, Hassasing S, Dyer S, Small S, Seeralakandapalan S, Arumugam S, Chakravartty S, Ong SL, Ooi SZY, Nazir S, Zafar S, Shirazi S, Bharucha S, Majid S, Ahmed S, Rajamanickam SK, Albalkiny S, Ng S, Chowdhury S, Yahia S, Handa S, Fallis S, Fisher S, Jones S, Phillips S, Mitra S, Aroori S, Thanki S, Rozwadowski S, Tucker S, Conroy S, Barman S, Bhat S, McCallion S, Knight SR, Tezas S, van Laarhoven S, Cowie S, Rao S, Sellahewa S, Bhatti S, Kaistha S, Moug SJ, Argyropoulos S, Virupaksha S, Difford T, Shikh-Bahaei T, Saafan T, Lo T, Magro T, Gala T, Katbeh T, Athwal T, Lo T, Fraser T, Anyomih T, Chase TJG, Walker T, Ward T, Gallagher TK, Richardson T, Wiggins T, Ali U, Patnam V, Kanakala V, Beynon V, Hudson VE, Morrison-Jones V, Korwar V, Massella V, Parekh V, Ng V, Toh WH, Toh W, Hawkins W, Cambridge W, Harrison W, Tan YY, Aal YA, Malam Y, Toumi Z, Khaddar ZA, Bleything Z. PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK. BJS Open 2023; 7:zrad008. [PMID: 37161673 PMCID: PMC10170253 DOI: 10.1093/bjsopen/zrad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. METHODS All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. RESULTS A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. CONCLUSION Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions.
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Hammett F, Saha A, Hurley A, Fifer H, Moran E, Patel B. EP-235 Improving working conditions of junior surgeons. Br J Surg 2022. [DOI: 10.1093/bjs/znac245.060] [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: 11/07/2022]
Abstract
Abstract
Aims
Significant exception reporting is reflective of difficult working conditions though well-recognised barriers exist to reporting which may reflect the culture within a unit. This study used exception reporting data to understand and improve the working conditions of juniors.
Methods
Junior surgeons were surveyed in December 2019 to evaluate additional hours worked, reasons for this work and whether exception reports were completed; where they were not, doctors were asked why.
After data analysis, rota structures and surgical teams were changed and formal education about exception reporting given at departmental induction. The main changes involved greater opportunities to take leave and enhanced staffing on evenings and weekends.
Surgical juniors were re-surveyed in September 2021.
Results
In December 2019, 49.2 additional hours were worked between 18 juniors. No exception reports were completed with the main reasons being a personal decision to stay late (for training opportunities), lack of understanding on how to report and cultural issues that made juniors unsure about how exception reports would be viewed.
In September 2021, only 30 additional hours were worked between 17 respondents. Again, no exception reports were completed with over 95% of respondents citing a personal decision to stay late. Cultural issues within the department were no longer cited and knowledge of how to exception report was greatly increased.
Conclusions
A positive and open culture, where consultants and surgical leaders engage with juniors about rotas and working conditions can lead to a reduction in additional hours and improve the understanding of exception reporting.
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Affiliation(s)
| | - Arin Saha
- Calderdale and Huddersfield NHS Foundation Trust
| | - Anna Hurley
- Calderdale and Huddersfield NHS Foundation Trust
| | - Helen Fifer
- Calderdale and Huddersfield NHS Foundation Trust
| | - Emily Moran
- Calderdale and Huddersfield NHS Foundation Trust
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Qiu T, Andrus R, Aravena MC, Ascoli D, Bergeron Y, Berretti R, Berveiller D, Bogdziewicz M, Boivin T, Bonal R, Bragg DC, Caignard T, Calama R, Camarero JJ, Chang-Yang CH, Cleavitt NL, Courbaud B, Courbet F, Curt T, Das AJ, Daskalakou E, Davi H, Delpierre N, Delzon S, Dietze M, Calderon SD, Dormont L, Espelta J, Fahey TJ, Farfan-Rios W, Gehring CA, Gilbert GS, Gratzer G, Greenberg CH, Guo Q, Hacket-Pain A, Hampe A, Han Q, Hille Ris Lambers J, Hoshizaki K, Ibanez I, Johnstone JF, Journé V, Kabeya D, Kilner CL, Kitzberger T, Knops JMH, Kobe RK, Kunstler G, Lageard JGA, LaMontagne JM, Ledwon M, Lefevre F, Leininger T, Limousin JM, Lutz JA, Macias D, McIntire EJB, Moore CM, Moran E, Motta R, Myers JA, Nagel TA, Noguchi K, Ourcival JM, Parmenter R, Pearse IS, Perez-Ramos IM, Piechnik L, Poulsen J, Poulton-Kamakura R, Redmond MD, Reid CD, Rodman KC, Rodriguez-Sanchez F, Sanguinetti JD, Scher CL, Schlesinger WH, Schmidt Van Marle H, Seget B, Sharma S, Silman M, Steele MA, Stephenson NL, Straub JN, Sun IF, Sutton S, Swenson JJ, Swift M, Thomas PA, Uriarte M, Vacchiano G, Veblen TT, Whipple AV, Whitham TG, Wion AP, Wright B, Wright SJ, Zhu K, Zimmerman JK, Zlotin R, Zywiec M, Clark JS. Limits to reproduction and seed size-number trade-offs that shape forest dominance and future recovery. Nat Commun 2022; 13:2381. [PMID: 35501313 PMCID: PMC9061860 DOI: 10.1038/s41467-022-30037-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractThe relationships that control seed production in trees are fundamental to understanding the evolution of forest species and their capacity to recover from increasing losses to drought, fire, and harvest. A synthesis of fecundity data from 714 species worldwide allowed us to examine hypotheses that are central to quantifying reproduction, a foundation for assessing fitness in forest trees. Four major findings emerged. First, seed production is not constrained by a strict trade-off between seed size and numbers. Instead, seed numbers vary over ten orders of magnitude, with species that invest in large seeds producing more seeds than expected from the 1:1 trade-off. Second, gymnosperms have lower seed production than angiosperms, potentially due to their extra investments in protective woody cones. Third, nutrient-demanding species, indicated by high foliar phosphorus concentrations, have low seed production. Finally, sensitivity of individual species to soil fertility varies widely, limiting the response of community seed production to fertility gradients. In combination, these findings can inform models of forest response that need to incorporate reproductive potential.
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Journé V, Andrus R, Aravena MC, Ascoli D, Berretti R, Berveiller D, Bogdziewicz M, Boivin T, Bonal R, Caignard T, Calama R, Camarero JJ, Chang-Yang CH, Courbaud B, Courbet F, Curt T, Das AJ, Daskalakou E, Davi H, Delpierre N, Delzon S, Dietze M, Donoso Calderon S, Dormont L, Maria Espelta J, Fahey TJ, Farfan-Rios W, Gehring CA, Gilbert GS, Gratzer G, Greenberg CH, Guo Q, Hacket-Pain A, Hampe A, Han Q, Lambers JHR, Hoshizaki K, Ibanez I, Johnstone JF, Kabeya D, Kays R, Kitzberger T, Knops JMH, Kobe RK, Kunstler G, Lageard JGA, LaMontagne JM, Leininger T, Limousin JM, Lutz JA, Macias D, McIntire EJB, Moore CM, Moran E, Motta R, Myers JA, Nagel TA, Noguchi K, Ourcival JM, Parmenter R, Pearse IS, Perez-Ramos IM, Piechnik L, Poulsen J, Poulton-Kamakura R, Qiu T, Redmond MD, Reid CD, Rodman KC, Rodriguez-Sanchez F, Sanguinetti JD, Scher CL, Marle HSV, Seget B, Sharma S, Silman M, Steele MA, Stephenson NL, Straub JN, Swenson JJ, Swift M, Thomas PA, Uriarte M, Vacchiano G, Veblen TT, Whipple AV, Whitham TG, Wright B, Wright SJ, Zhu K, Zimmerman JK, Zlotin R, Zywiec M, Clark JS. Globally, tree fecundity exceeds productivity gradients. Ecol Lett 2022; 25:1471-1482. [PMID: 35460530 DOI: 10.1111/ele.14012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
Lack of tree fecundity data across climatic gradients precludes the analysis of how seed supply contributes to global variation in forest regeneration and biotic interactions responsible for biodiversity. A global synthesis of raw seedproduction data shows a 250-fold increase in seed abundance from cold-dry to warm-wet climates, driven primarily by a 100-fold increase in seed production for a given tree size. The modest (threefold) increase in forest productivity across the same climate gradient cannot explain the magnitudes of these trends. The increase in seeds per tree can arise from adaptive evolution driven by intense species interactions or from the direct effects of a warm, moist climate on tree fecundity. Either way, the massive differences in seed supply ramify through food webs potentially explaining a disproportionate role for species interactions in the wet tropics.
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Affiliation(s)
- Valentin Journé
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
| | - Robert Andrus
- Department of Geography, University of Colorado Boulder, Boulder, Colorado, USA
| | - Marie-Claire Aravena
- Universidad de Chile, Facultad de Ciencias Forestales y de la Conservacion de la Naturaleza (FCFCN), Santiago, Chile
| | - Davide Ascoli
- Department of Agriculture, Forest and Food Sciences, University of Torino, Grugliasco, TO, Italy
| | - Roberta Berretti
- Department of Agriculture, Forest and Food Sciences, University of Torino, Grugliasco, TO, Italy
| | - Daniel Berveiller
- Universite Paris-Saclay, Centre national de la recherche scientifique, AgroParisTech, Ecologie Systematique et Evolution, Orsay, France
| | - Michal Bogdziewicz
- Department of Systematic Zoology, Faculty of Biology, Adam Mickiewicz University, Poznan, Poland
| | - Thomas Boivin
- Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Ecologie des Forets Mediterranennes, Avignon, France
| | - Raul Bonal
- Department of Biodiversity, Ecology and Evolution, Complutense University of Madrid, Madrid, Spain
| | - Thomas Caignard
- Universite Bordeaux, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Biodiversity, Genes, and Communities (BIOGECO), Pessac, France
| | - Rafael Calama
- Centro de Investigacion Forestal (INIA-CSIC), Madrid, Spain
| | - Jesús Julio Camarero
- Instituto Pirenaico de Ecologla, Consejo Superior de Investigaciones Cientificas (IPE-CSIC), Zaragoza, Spain
| | - Chia-Hao Chang-Yang
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Benoit Courbaud
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
| | - Francois Courbet
- Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Ecologie des Forets Mediterranennes, Avignon, France
| | - Thomas Curt
- Aix Marseille universite, Institut National de Recherche pour Agriculture, Alimentation et Environnement (IN-RAE), Aix-en-Provence, France
| | - Adrian J Das
- USGS Western Ecological Research Center, Three Rivers, California, USA
| | - Evangelia Daskalakou
- Institute of Mediterranean and Forest Ecosystems, HellenicAgricultural Organization ¨ DEMETER¨, Athens, Greece
| | - Hendrik Davi
- Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Ecologie des Forets Mediterranennes, Avignon, France
| | - Nicolas Delpierre
- Universite Paris-Saclay, Centre national de la recherche scientifique, AgroParisTech, Ecologie Systematique et Evolution, Orsay, France
| | - Sylvain Delzon
- Universite Bordeaux, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Biodiversity, Genes, and Communities (BIOGECO), Pessac, France
| | - Michael Dietze
- Earth and Environment, Boston University, Boston, Massachusetts, USA
| | - Sergio Donoso Calderon
- Universidad de Chile, Facultad de Ciencias Forestales y de la Conservacion de la Naturaleza (FCFCN), Santiago, Chile
| | - Laurent Dormont
- Centre d'Ecologie Fonctionnelle et Evolutive (CEFE), Centre National de la Recherche Scientifique (CNRS), Montpellier, France
| | - Josep Maria Espelta
- Centre de Recerca Ecologica i Aplicacions Forestals (CREAF), Bellaterra, Catalunya, Spain
| | - Timothy J Fahey
- Natural Resources, Cornell University, Ithaca, New York, USA
| | - William Farfan-Rios
- Center for Conservation and Sustainable Development, Washington University in Saint Louis, Missouri Botanical Garden, St. Louis, Missouri, USA
| | - Catherine A Gehring
- Department of Biological Sciences and Center for Adaptive Western Landscapes, University of Northern Arizona, Flagstaff, Arizona, USA
| | - Gregory S Gilbert
- Department of Environmental Studies, University of California, Santa Cruz, California, USA
| | - Georg Gratzer
- University of Natural Resources and Life Sciences and Institute of Forest Ecology, Wien, Austria
| | - Cathryn H Greenberg
- Bent Creek Experimental Forest, USDA Forest Service, Asheville, North Carolina, USA
| | - Qinfeng Guo
- Eastern Forest Environmental Threat Assessment Center, USDA Forest Service, Southern Research Station, Asheville, North Carolina, USA
| | - Andrew Hacket-Pain
- Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - Arndt Hampe
- Universite Bordeaux, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Biodiversity, Genes, and Communities (BIOGECO), Pessac, France
| | - Qingmin Han
- Department of Plant Ecology Forestry and Forest Products Research Institute (FFPRI), Tsukuba, Ibaraki, Japan
| | | | - Kazuhiko Hoshizaki
- Department of Biological Environment, Akita Prefectural University, Akita, Japan
| | - Ines Ibanez
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, USA
| | - Jill F Johnstone
- Institute of Arctic Biology, University of Alaska, Fairbanks, Alaska, USA
| | - Daisuke Kabeya
- Department of Plant Ecology Forestry and Forest Products Research Institute (FFPRI), Tsukuba, Ibaraki, Japan
| | - Roland Kays
- Department of Forestry and Environmental Resources, NC State University, Raleigh, North Carolina, USA
| | - Thomas Kitzberger
- Department of Ecology, Instituto de Investigaciones en Biodiversidad y Medioambiente (Consejo Nacional de Investigaciones Cientificas y Tecnicas - Universidad Nacional del Comahue), Bariloche, Argentina
| | - Johannes M H Knops
- Health and Environmental Sciences Department, Xian Jiaotong-Liverpool University, Suzhou, China
| | - Richard K Kobe
- Department of Plant Biology, Program in Ecology, Evolutionary Biology, and Behavior, Michigan State University, East Lansing, Michigan, USA
| | - Georges Kunstler
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France
| | - Jonathan G A Lageard
- Department of Natural Sciences, Manchester Metropolitan University, Manchester, UK
| | - Jalene M LaMontagne
- Department of Biological Sciences, DePaul University, Chicago, Illinois, USA
| | - Theodor Leininger
- USDA, Forest Service, Southern Research Station, Stoneville, Mississippi, USA
| | | | - James A Lutz
- Department of Wildland Resources, and the Ecology Center, Utah State University, Logan, Utah, USA
| | - Diana Macias
- Department of Biology, University of New Mexico, Albuquerque, New Mexico, USA
| | | | | | - Emily Moran
- School of Natural Sciences, UC Merced, Merced, California, USA
| | - Renzo Motta
- Department of Agriculture, Forest and Food Sciences, University of Torino, Grugliasco, TO, Italy
| | - Jonathan A Myers
- Department of Biology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Thomas A Nagel
- Department of forestry and renewable forest resources, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Kyotaro Noguchi
- Tohoku Research Center, Forestry and Forest Products Research Institute, Morioka, Iwate, Japan
| | | | - Robert Parmenter
- Valles Caldera National Preserve, National Park Service, Jemez Springs, New Mexico, USA
| | - Ian S Pearse
- Fort Collins Science Center, Fort Collins, Colorado, USA
| | - Ignacio M Perez-Ramos
- Inst. de Recursos Naturales y Agrobiologia de Sevilla, Consejo Superior de Investigaciones Cientificas (IRNAS-CSIC), Seville, Andalucia, Spain
| | - Lukasz Piechnik
- W. Szafer Institute of Botany, Polish Academy of Sciences, Krakow, Poland
| | - John Poulsen
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | | | - Tong Qiu
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Miranda D Redmond
- Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, Colorado, USA
| | - Chantal D Reid
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Kyle C Rodman
- Department of Forest and Wildlife Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Javier D Sanguinetti
- Bilogo Dpto. Conservacin y Manejo Parque Nacional Lanin Elordi y Perito Moreno 8370, San Marten de los Andes, Argentina
| | - C Lane Scher
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Harald Schmidt Van Marle
- Universidad de Chile, Facultad de Ciencias Forestales y de la Conservacion de la Naturaleza (FCFCN), Santiago, Chile
| | - Barbara Seget
- W. Szafer Institute of Botany, Polish Academy of Sciences, Krakow, Poland
| | - Shubhi Sharma
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Miles Silman
- Department of Biology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Michael A Steele
- Department of Biology, Wilkes University, Wilkes-Barre, Pennsylvania, USA
| | | | - Jacob N Straub
- Department of Environmental Science and Ecology, State University of New York-Brockport, Brockport, New York, USA
| | - Jennifer J Swenson
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Margaret Swift
- Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
| | - Peter A Thomas
- School of Life Sciences, Keele University, Staffordshire, UK
| | - Maria Uriarte
- Department of Ecology, Evolution and Environmental Biology, Columbia University, New York, New York, USA
| | - Giorgio Vacchiano
- Department of Agricultural and Environmental Sciences - Production, Territory, Agroenergy (DISAA), University of Milan, Milano, Italy
| | - Thomas T Veblen
- Department of Geography, University of Colorado Boulder, Boulder, Colorado, USA
| | - Amy V Whipple
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Thomas G Whitham
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - Boyd Wright
- Botany, School of Environmental and Rural Science, University of New England, Armidale, New South Wales, Australia
| | - S Joseph Wright
- Smithsonian Tropical Research Institute, Balboa, Republic of Panama
| | - Kai Zhu
- Department of Environmental Studies, University of California, Santa Cruz, California, USA
| | - Jess K Zimmerman
- Department of Environmental Sciences, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| | - Roman Zlotin
- Geography Department and Russian and East European Institute, Bloomington, Indiana, USA
| | - Magdalena Zywiec
- W. Szafer Institute of Botany, Polish Academy of Sciences, Krakow, Poland
| | - James S Clark
- Universite Grenoble Alpes, Institut National de Recherche pour Agriculture, Alimentation et Environnement (INRAE), Laboratoire EcoSystemes et Societes En Montagne (LESSEM), St. Martin-d'Heres, France.,Nicholas School of the Environment, Duke University, Durham, North Carolina, USA
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Moran E. 132 Improving the Long Term Follow Up of Bisphosphonates in the Community. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Bisphosphonates are generally first line treatment for osteoporosis in primary care. However, long term bisphosphonate use has been associated with atypical femoral fractures. Therefore, it is recommended that bisphosphonates are reviewed every 3–5 years. This study set out to assess and improve the long term follow up of bisphosphonates in a GP practice in Leeds.
Method
System One was searched to identify patients prescribed alendronic acid or risedronate in January and February of 2021 from Aire Valley Surgery, a GP practice in Leeds. These patient’s notes were then used to see if they had planned bisphosphate follow up and if this was via a script note, scheduled task, or recall. In March of 2021 a teaching session on osteoporosis and bisphosphonates was delivered to GPs working at the practice. GPs were also asked to make sure that they planned follow up when prescribing bisphosphonates via a script note. System One was searched again to identify patients prescribed alendronic acid or risedronate in April and May of 2021.
Results
Prior to the teaching session 47.9% of patients had planned follow up with 56.4% via script note, 16.4% via scheduled task and 27.3% via recall. Following the teaching session 48.4% of patients had planned follow up with 73.1% via script note, 13.5% via scheduled task and 13.5% via recall.
Conclusions
This study has identified a group of patients who are taking oral bisphosphonates in the community without planned follow up and are therefore more likely to sustain an atypical femoral fracture.
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Affiliation(s)
- E. Moran
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
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Michel M, Fifer H, Moran E, Hammett F, Kronberga M, Khawgali M, Bonner C, Saab A, Balbola M, Saha A. P-EGS20 Safe emergency laparoscopic cholecystectomy in the first 12 months of the Covid-19 pandemic. Br J Surg 2021. [PMCID: PMC9383090 DOI: 10.1093/bjs/znab430.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
The World Health Organisation declared a global pandemic on the 11th March 2020 regarding the COVID-19 infection. This has had a dramatic impact on both acute and elective hospital services that will take a considerable time to recover from. Initial emergency intercollegiate surgical guidance released in March 2020 raised concern regarding laparoscopic surgery and advised to pursue alternative non-surgical or radiological treatment options for the safety of patients and theatre teams. The aim of this study was to assess the safety of emergency laparoscopic cholecystectomy (ELC) for patients presenting to our centre with acute gallstone pathology during the pandemic.
Methods
Retrospective analysis of all cholecystectomies undertaken in the department during the first year of the pandemic from 11th March 2020 to 11th March 2021. This period encapsulated two recognised peaks of the pandemic in the United Kingdom. Demographic data, elective/emergency, operative time, postop ITU admissions due to COVID and COVID related mortality was collected. Operative numbers and times were compared with historical data (HD) from the previous five years over the same time frame.
Results
399 laparoscopic cholecystectomies were performed during the first year of the pandemic which was less than the previous five-year average of 570 cholecystectomies per annum (30% reduction). 247 (61.9%) were performed as an emergency on patients presenting with acute gallstone pathology compared to 35% (HD) performed acutely on average historically. Average age was 56 yrs (16-88 range). Average operative time for ELC during the pandemic was 69 minutes compared to 78 minutes HD (NS). No patients were admitted to ITU with post-operative Covid infections and there were no 30 day post-operative deaths.
Conclusions
We performed more ELC’s in the first year of the pandemic compared to the previous five-year average as we were conscious of the inevitable long waiting lists, we would certainly be faced with in the coming months. The Covid-19 pandemic was a global healthcare crisis and one the NHS had never encountered before. At the time there was no high-quality evidence on the safety of laparoscopy on patients presenting acutely. This study adds to the growing body of evidence that with consistent preoperative testing, PPE and appropriate patient flow pathways that emergency laparoscopic cholecystectomies are safe to perform in the current climate.
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Affiliation(s)
- Martin Michel
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Helen Fifer
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Emily Moran
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Felix Hammett
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | | | - Clare Bonner
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Ala Saab
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | - Arin Saha
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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Michel M, Saab A, Kronberga M, Bonner C, Fifer H, Moran E, Hammett F, Saha A. P-O09 Development of a non face-to-face pre-operative assessment pathway for laparoscopic cholecystectomy. Br J Surg 2021. [PMCID: PMC9383085 DOI: 10.1093/bjs/znab430.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background The Covid-19 pandemic has led to markedly reduced capacity in almost all areas of normal face-to-face activity in our hospitals. Prior to the pandemic, the standard pre-operative pathway for all patients included an initial appointment in the outpatients clinic and formal examination before recommending surgery. With the reality of limited clinic capacity, our unit developed a non face-to-face assessment pathway alongside a parallel green operating area in our local Independent Sector (IS) hospitals for laparoscopic cholecystectomy. This study describes and methodology and outcomes of this approach Methods A non face-to-face (telephone) proforma for all new referrals for consideration of laparoscopic cholecystectomy was prepared in April 2020 with the first operations carried out in June 2020. All consultations were carried out by consultant surgeons and included thorough history, careful documentation of previous surgery and duration of symptoms and, where appropriate, patients were told to send images of their abdominal wall if they were unable to describe their scars. The first stage of the consent process was completed at initial appointment and all patients were sent written information about surgery. Patients who had BMI<40, uncomplicated biliary disease (biliary colic, mild cholecystitis, ERCP for CBD stones) and ASA of 1/2 were deemed suitable for surgery in the IS and sent across accordingly. A telephone pre-assessment was completed by the hospital and patients were sent blood tests forms in the post, as well as a Covid test to be completed at home followed by a period of self isolation before surgery. All patients were examined on the day of surgery by the operating surgeon and formal consent taken on the day. Primary outcomes that were recorded were cancellation on the day, transfer to the NHS hospital after surgery and complications. Results From June 2020 to December 2020, when the contract with the IS changed, 218 patients attended the IS hospitals for planned elective laparoscopic cholecystectomy. Four patients (2%) did not have surgery (one cancelled as inappropriate for the Independent Sector, two patients whose Covid swab result was not complete and one patient who no longer wished to have surgery). Three patients required transfer to the NHS hospital for post-operative care (drains inserted after unanticipated difficult surgery). All patients were given details of the surgical SDEC unit at the NHS hospital to allow ease of admission in the event of any problems or complications. 28 patients (13%) attended SDEC within 30 days after surgery; most had blood tests and clinical assessment alone. One patient (<1%) required re-laparoscopy for abdominal pain three days after their initial surgery (washout alone) and 5 patients developed umbilical wound infections after surgery (antibiotics alone). Two patients were found to have CBD stones on MRCP. The waiting time from initial assessment to surgery for patients on this pathway was less than 18 weeks for 168 patients though patients who were not suitable for the Independent Sector have had waiting times that are considerably longer. Conclusions These results demonstrate that it is possible to plan surgery for laparoscopic cholecystectomy without a face-to-face appointment at all which has considerable implications for resource allocation in the future; indeed, this approach has been continued within our unit even as clinic capacity has increased and been rolled out to patients with inguinal or para-umbilical hernia. Use of a green site away from the acute NHS hospital allowed elective surgery for non-urgent pathology to continue with acceptable waiting times even during the worst of the Covid-19 pandemic though patients who were not suitable have had markedly worse experiences and waiting times.
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Affiliation(s)
- Martin Michel
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Ala Saab
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | - Clare Bonner
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Helen Fifer
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Emily Moran
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Felix Hammett
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Arin Saha
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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11
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Michel M, Fifer H, Moran E, Hammett F, Bonner C, Kronberga M, Khawgali M, Balbola M, Saha A. O-BN09 The impact of the Covid-19 pandemic on benign upper GI surgery: The first 12 months at a single centre. Br J Surg 2021. [PMCID: PMC9383084 DOI: 10.1093/bjs/znab429.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background The road to recovery from the Covid-19 pandemic has started but no-one knows when it will end. 18 months on from the World Health Organisation declaring a global pandemic on the 11th March 2020 this has had a dramatic impact on both acute and elective hospital services. Whilst, quite rightly, the focus has been on prioritising cancer resections during the pandemic, many patients awaiting benign operations are facing lengthy waiting times. The aim of this study was to quantify the impact of the COVID-19 pandemic on benign upper GI surgery at a single centre compared to previous operating activity levels. Methods Retrospective analysis of computerised theatre records for the first 12 months of the pandemic (11th March 2020-11th March 2021) were compared to average historical data (HD) over the last five years (2015-2019) over the same time frame. Benign upper Gi operations included were cholecystectomy, anti-reflux/hiatus hernia repairs, cardiomyotomies and bariatric procedures. Results Conclusions The Covid-19 pandemic has dramatically affected benign upper GI surgery at our unit. Overall total operation numbers were down by 31% when compared to HD (440 vs 641). The largest deficit was in bariatrics where no bariatric surgery was performed during the first 12 months of the pandemic, which has restarted as of July 2021. There was also a 30% reduction in the number of cholecystectomies performed likely due to initial guidance recommending non-operative management at the start of the pandemic. Hiatal work numbers remained consistent. This quantitative study can direct future service delivery and help guide the post-pandemic recovery.
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Affiliation(s)
- Martin Michel
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Helen Fifer
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Emily Moran
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Felix Hammett
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Clare Bonner
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | | | | | - Arin Saha
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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12
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Michel M, Fifer H, Moran E, Saab A, Hammett F, Kronberga M, Bonner C, Saha A, Salih T, Peter M. P-B04 Restarting bariatric surgery after the Covid-19 pandemic: a template for safe practice. Br J Surg 2021. [PMCID: PMC9383061 DOI: 10.1093/bjs/znab430.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Bariatric surgery virtually ceased with the advent of the Covid-19 pandemic and has been amongst the last sector of operative practice to restart. There have been understandable concerns about restarting bariatric surgery including the risks to patients of contracting Covid infection in the peri-operative period, potential de-skilling of surgeons and theatre teams and the appropriateness of directing scarce and limited resources to bariatric surgery when every surgical specialty is experiencing rapidly rising waiting times and ever lengthening waiting lists. This study describes the restart programme at our NHS bariatric unit and offers a template for safe commencement of complex benign surgeries in the current era. Methods In the months after the pandemic started, our Bariatric MDT reviewed every case on the waiting list and contacted each patient to explain the current waiting times and the importance of not gaining weight to be eligible for surgery when surgical practice resumed. Group education and Support Group sessions were moved from face-to-face appointments to online classrooms and regular input was sought from specialist dieticians, nurses and psychologists. The expected waiting times for patients was pro-actively submitted to the Executive Board of the Trust with details about >104-week waiting patients being clearly articulated. Once approval was given to restart bariatric surgery, every patient was assessed and prioritised in terms of waiting time and clinical need. A bariatric theatre team was brought together and engaged in pre-operative training and a local refresher course on equipment and the planned surgeries. There was engagement with industry to provide on-the-ground support for the first lists to ensure proper and safe use of energy and stapling devices. Each list had two consultant surgeons assigned to it and just two cases per day were planned and patients were managed on an entirely green pathway within the NHS hospital . Results The bariatric restart programme commenced in May 2021; between May 2021 and August 2021, there have been 27 operations carried out (25 Roux-en-Y gastric bypass, 2 sleeve gastrectomy) and two cancellations on the day (both due to patient choice). Each operating list finished between two and three hours before the planned finish time. Formal debrief sessions after each list identified no problems with the operations of the equipment and none of the patients had any post-operative complications. Length of stay was between 1 to 2 days for the entire cohort. Since the restart programme commenced, the requirement for dual consultant operating has ceased and the last 5 cases have been entirely training cases for the operating registrar, again without complication. Each list is now planned to increase to pre-pandemic levels of activity with four cases per list. Conclusions Restarting complex benign surgical practice is complicated and requires engagement with management, theatre and nursing colleagues to ensure that cases are not ‘left behind'. It is important to reduce the risk of complications and of peri-operative covid-19 infection in bariatric patients and development of a pathway that all members of the theatre team have input in to meant that there were few problems or issues with either the planning of the lists or the running of the lists. Such an approach could be considered for restarting any high volume, complex benign surgical practice.
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Affiliation(s)
- Martin Michel
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Helen Fifer
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Emily Moran
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Ala Saab
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Felix Hammett
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | - Clare Bonner
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Arin Saha
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Tamir Salih
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Mark Peter
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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13
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Michel M, Fifer H, Moran E, Bonner C, Hammett F, Khawgali M, Kronberga M, Saab A, Balbola M, Saha A. P-O15 “Knife to Skin” time: The invariable variable. Br J Surg 2021. [PMCID: PMC9383075 DOI: 10.1093/bjs/znab430.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
The Covid-19 pandemic has affected all aspects of healthcare globally. Theatre utilisation assumes a substantial proportion of hospital resources, creating a streamlined pathway increases efficiency and productivity. With concerns regarding aerosol generating procedures, viral transmission to health care workers in theatre and patient pathways through the hospitals the covid-19 pandemic has added another dimension to the theatre pathway. The aim of this study was to quantify the impact of Covid-19 on the “knife to skin” (KTS) time and compare it to previous historical data (HD).
Methods
Retrospective analysis of real time theatre data was analysed for the first 12 months of the pandemic from 11th March 2020 to 11th March 2021. To try and minimise variability between different specialities and operations we picked one operation to study: Laparoscopic cholecystectomy (LC). Historical data was also gathered from the same time frame over the last 5 years (2015-2020) for comparison. Data collected included emergency or elective, time sent for patient, anaesthetic start time, knife to skin time and duration of operation. Comparison of means were analysed by One-way ANOVA tests and Student’s T-Test.
Results
399 laparoscopic cholecystectomies were performed during the first year of the pandemic. KTS time was calculated as operation start time minus time sent for patient. Average time during the pandemic for emergency LC KTS was 56 minutes and 35 minutes for elective LC. Comparison of these times to HD revealed no statistical difference (Emergency LC 56 mins vs 58 mins p > 0.05, Elective LC 35 mins vs 35 mins p > 0.05). The anaesthetic time for emergency LC during the pandemic vs HD was 10 mins vs 14 mins (p < 0.05), no statistical difference was found in the elective group, 16mins vs 14mins (p > 0.05)
Conclusions
The Covid-19 pandemic has had no detectable effect on Knife to skin time as compared to our previous historical data. It seems the extra Covid 19 precautions involving PPE, pathways etc. have not affected theatre efficiency or utilisation. In fact, there was very little variance in KTS time over the six years studied (2015-2021) with very consistent levels for both elective and emergency procedures. The shorter anaesthetic time for emergency LC during the pandemic needs to be further investigated but one hypothesis is the unconscious or conscious decision to decrease the amount of preoxygenation to minimise aerosolisation.
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Affiliation(s)
- Martin Michel
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Helen Fifer
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Emily Moran
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Clare Bonner
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | - Felix Hammett
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | | | - Ala Saab
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| | | | - Arin Saha
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
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14
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Moran E. 149 Non-Pharmacological Treatment of Bone Health in Fallers. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
1 in 2 women and 1 in 5 men will suffer a fragility fracture. Research into calcium and vitamin D supplements has found no consistent evidence to suggest that they reduce the risk of osteoporotic fractures. There has been little research to suggest that dietary calcium is effective at reducing the risk osteoporotic fractures, but supplements have been linked to increased risk of cardiovascular disease and urinary stones. Bisphosphonates have been shown to reduce the risk of osteoporotic fractures and are usually taken in combination with calcium and vitamin D supplements given that deficiencies must be corrected prior to starting. This study set out to assess the dietary calcium intake of patients who attend the falls clinic and explore their attitudes towards dietary change, as an alternative or adjunct to a calcium and vitamin D tablet.
Methods
Data was collected during private interviews conducted with patients who attended the falls clinic. The Edinburgh University Centre for Genomic and Experimental research (CGEM) food frequency calculator was used to calculate dietary calcium intake. Microsoft Excel was used to collate and analyse the data.
Results
No association was found between dietary calcium intake, age and sex. We did find that mean dietary calcium intake was significantly less than the recommended daily amount for adults with osteoporosis, with 80% not getting their recommended daily intake (p < 0.05). We identified patients who don’t receive a calcium and vitamin D supplement as an at-risk group who would benefit from advice on sources of dietary calcium and 83% of patients said that they would be interested in a leaflet on sources of dietary calcium.
Conclusion
This study has identified a group of patients who will hopefully benefit from a leaflet on sources of dietary calcium and as result improve their bone health.
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Affiliation(s)
- E Moran
- Huddersfield Royal Infirmary
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15
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Clark JS, Andrus R, Aubry-Kientz M, Bergeron Y, Bogdziewicz M, Bragg DC, Brockway D, Cleavitt NL, Cohen S, Courbaud B, Daley R, Das AJ, Dietze M, Fahey TJ, Fer I, Franklin JF, Gehring CA, Gilbert GS, Greenberg CH, Guo Q, HilleRisLambers J, Ibanez I, Johnstone J, Kilner CL, Knops J, Koenig WD, Kunstler G, LaMontagne JM, Legg KL, Luongo J, Lutz JA, Macias D, McIntire EJB, Messaoud Y, Moore CM, Moran E, Myers JA, Myers OB, Nunez C, Parmenter R, Pearse S, Pearson S, Poulton-Kamakura R, Ready E, Redmond MD, Reid CD, Rodman KC, Scher CL, Schlesinger WH, Schwantes AM, Shanahan E, Sharma S, Steele MA, Stephenson NL, Sutton S, Swenson JJ, Swift M, Veblen TT, Whipple AV, Whitham TG, Wion AP, Zhu K, Zlotin R. Author Correction: Continent-wide tree fecundity driven by indirect climate effects. Nat Commun 2021; 12:1664. [PMID: 33686080 PMCID: PMC7940415 DOI: 10.1038/s41467-021-22025-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A Correction to this paper has been published: https://doi.org/10.1038/s41467-021-22025-2
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Affiliation(s)
- James S Clark
- Nicholas School of the Environment, Duke University, Durham, NC, USA. .,INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d'Heres, France.
| | - Robert Andrus
- Department of Geography, University of Colorado Boulder, Boulder, CO, USA
| | | | - Yves Bergeron
- Forest Research Institute, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, QC, Canada
| | - Michal Bogdziewicz
- Department of Systematic Zoology, Faculty of Biology, Adam Mickiewicz University, Poznan, Poland
| | - Don C Bragg
- USDA Forest Service, Southern Research Station, Monticello, AR, USA
| | - Dale Brockway
- USDA Forest Service Southern Research Station, Auburn, AL, USA
| | | | - Susan Cohen
- Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Benoit Courbaud
- INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d'Heres, France
| | - Robert Daley
- Greater Yellowstone Network, National Park Service, Bozeman, MT, USA
| | - Adrian J Das
- USGS Western Ecological Research Center, Three Rivers, CA, USA
| | - Michael Dietze
- Earth and Environment, Boston University, Boston, MA, USA
| | - Timothy J Fahey
- USDA Forest Service Southern Research Station, Auburn, AL, USA
| | - Istem Fer
- Finnish Meteorological Institute, Helsinki, Finland
| | | | - Catherine A Gehring
- Department of Biological Science, Northern Arizona University, Flagstaff, AZ, USA
| | | | | | - Qinfeng Guo
- USDA Forest Service Southern Research Station, Eastern Forest Environmental Threat Assessment Center, Research Triangle Park, NC, USA
| | | | - Ines Ibanez
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
| | - Jill Johnstone
- Department of Biology, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Johannes Knops
- Health and Environmental Sciences Department, Xian Jiaotong-Liverpool University, Suzhou, China
| | - Walter D Koenig
- Hastings Reservation, University of California Berkeley, Carmel Valley, CA, USA
| | - Georges Kunstler
- INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d'Heres, France
| | | | - Kristin L Legg
- Greater Yellowstone Network, National Park Service, Bozeman, MT, USA
| | - Jordan Luongo
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - James A Lutz
- Department of Wildland Resources, Utah State University Ecology Center, Logan, UT, USA
| | - Diana Macias
- Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | | | - Yassine Messaoud
- Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada
| | | | - Emily Moran
- Department of Geography, University of Colorado Boulder, Boulder, CO, USA
| | - Jonathan A Myers
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Chase Nunez
- Department for the Ecology of Animal Societies, Max Planck Institute of Animal Behavior, Konstanz, Germany
| | - Robert Parmenter
- Valles Caldera National Preserve, National Park Service, Jemez Springs, NM, USA
| | - Sam Pearse
- Fort Collins Science Center, Fort Collins, CO, USA
| | - Scott Pearson
- Department of Natural Sciences, Mars Hill University, Mars Hill, NC, USA
| | | | - Ethan Ready
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Miranda D Redmond
- Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO, USA
| | - Chantal D Reid
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Kyle C Rodman
- INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d'Heres, France
| | - C Lane Scher
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | - Amanda M Schwantes
- Ecology and Evolutionary Biology, University of Toronto, Toronto, ON, Canada
| | - Erin Shanahan
- Greater Yellowstone Network, National Park Service, Bozeman, MT, USA
| | - Shubhi Sharma
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | | | - Samantha Sutton
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | - Margaret Swift
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Thomas T Veblen
- INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d'Heres, France
| | - Amy V Whipple
- Department of Biological Science, Northern Arizona University, Flagstaff, AZ, USA
| | - Thomas G Whitham
- Department of Biological Science, Northern Arizona University, Flagstaff, AZ, USA
| | - Andreas P Wion
- Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO, USA
| | - Kai Zhu
- University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Roman Zlotin
- Geography Department and Russian and East European Institute, Bloomington, IN, USA
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16
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Clark JS, Andrus R, Aubry-Kientz M, Bergeron Y, Bogdziewicz M, Bragg DC, Brockway D, Cleavitt NL, Cohen S, Courbaud B, Daley R, Das AJ, Dietze M, Fahey TJ, Fer I, Franklin JF, Gehring CA, Gilbert GS, Greenberg CH, Guo Q, HilleRisLambers J, Ibanez I, Johnstone J, Kilner CL, Knops J, Koenig WD, Kunstler G, LaMontagne JM, Legg KL, Luongo J, Lutz JA, Macias D, McIntire EJB, Messaoud Y, Moore CM, Moran E, Myers JA, Myers OB, Nunez C, Parmenter R, Pearse S, Pearson S, Poulton-Kamakura R, Ready E, Redmond MD, Reid CD, Rodman KC, Scher CL, Schlesinger WH, Schwantes AM, Shanahan E, Sharma S, Steele MA, Stephenson NL, Sutton S, Swenson JJ, Swift M, Veblen TT, Whipple AV, Whitham TG, Wion AP, Zhu K, Zlotin R. Continent-wide tree fecundity driven by indirect climate effects. Nat Commun 2021; 12:1242. [PMID: 33623042 PMCID: PMC7902660 DOI: 10.1038/s41467-020-20836-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/01/2020] [Indexed: 01/31/2023] Open
Abstract
Indirect climate effects on tree fecundity that come through variation in size and growth (climate-condition interactions) are not currently part of models used to predict future forests. Trends in species abundances predicted from meta-analyses and species distribution models will be misleading if they depend on the conditions of individuals. Here we find from a synthesis of tree species in North America that climate-condition interactions dominate responses through two pathways, i) effects of growth that depend on climate, and ii) effects of climate that depend on tree size. Because tree fecundity first increases and then declines with size, climate change that stimulates growth promotes a shift of small trees to more fecund sizes, but the opposite can be true for large sizes. Change the depresses growth also affects fecundity. We find a biogeographic divide, with these interactions reducing fecundity in the West and increasing it in the East. Continental-scale responses of these forests are thus driven largely by indirect effects, recommending management for climate change that considers multiple demographic rates.
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Affiliation(s)
- James S. Clark
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA ,grid.450307.5INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d’Heres, France
| | - Robert Andrus
- grid.266190.a0000000096214564Department of Geography, University of Colorado Boulder, Boulder, CO USA
| | - Melaine Aubry-Kientz
- grid.266096.d0000 0001 0049 1282School of Natural Sciences, University of California, Merced, Merced, CA USA
| | - Yves Bergeron
- grid.265695.bForest Research Institute, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, QC Canada
| | - Michal Bogdziewicz
- grid.5633.30000 0001 2097 3545Department of Systematic Zoology, Faculty of Biology, Adam Mickiewicz University, Poznan, Poland
| | - Don C. Bragg
- grid.497399.90000 0001 2106 5338USDA Forest Service, Southern Research Station, Monticello, AR USA
| | - Dale Brockway
- grid.472551.00000 0004 0404 3120USDA Forest Service Southern Research Station, Auburn, AL USA
| | - Natalie L. Cleavitt
- grid.5386.8000000041936877XNatural Resources, Cornell University, Ithaca, NY USA
| | - Susan Cohen
- grid.10698.360000000122483208Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Benoit Courbaud
- grid.450307.5INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d’Heres, France
| | - Robert Daley
- grid.454846.f0000 0001 2331 3972Greater Yellowstone Network, National Park Service, Bozeman, MT USA
| | - Adrian J. Das
- grid.2865.90000000121546924USGS Western Ecological Research Center, Three Rivers, CA USA
| | - Michael Dietze
- grid.189504.10000 0004 1936 7558Earth and Environment, Boston University, Boston, MA USA
| | - Timothy J. Fahey
- grid.472551.00000 0004 0404 3120USDA Forest Service Southern Research Station, Auburn, AL USA
| | - Istem Fer
- grid.8657.c0000 0001 2253 8678Finnish Meteorological Institute, Helsinki, Finland
| | - Jerry F. Franklin
- grid.34477.330000000122986657Forest Resources, University of Washington, Seattle, WA USA
| | - Catherine A. Gehring
- grid.261120.60000 0004 1936 8040Department of Biological Science, Northern Arizona University, Flagstaff, AZ USA
| | - Gregory S. Gilbert
- grid.205975.c0000 0001 0740 6917University of California, Santa Cruz, Santa Cruz, CA USA
| | - Cathryn H. Greenberg
- grid.472551.00000 0004 0404 3120USDA Forest Service, Bent Creek Experimental Forest, Asheville, NC USA
| | - Qinfeng Guo
- grid.472551.00000 0004 0404 3120USDA Forest Service Southern Research Station, Eastern Forest Environmental Threat Assessment Center, Research Triangle Park, NC USA
| | - Janneke HilleRisLambers
- grid.34477.330000000122986657Department of Biology, University of Washington, Seattle, WA USA
| | - Ines Ibanez
- grid.214458.e0000000086837370School for Environment and Sustainability, University of Michigan, Ann Arbor, MI USA
| | - Jill Johnstone
- grid.25152.310000 0001 2154 235XDepartment of Biology, University of Saskatchewan, Saskatoon, SK Canada
| | - Christopher L. Kilner
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Johannes Knops
- grid.440701.60000 0004 1765 4000Health and Environmental Sciences Department, Xian Jiaotong-Liverpool University, Suzhou, China
| | - Walter D. Koenig
- grid.47840.3f0000 0001 2181 7878Hastings Reservation, University of California Berkeley, Carmel Valley, CA USA
| | - Georges Kunstler
- grid.450307.5INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d’Heres, France
| | - Jalene M. LaMontagne
- grid.254920.80000 0001 0707 2013Department of Biological Sciences, DePaul University, Chicago, IL USA
| | - Kristin L. Legg
- grid.454846.f0000 0001 2331 3972Greater Yellowstone Network, National Park Service, Bozeman, MT USA
| | - Jordan Luongo
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - James A. Lutz
- grid.53857.3c0000 0001 2185 8768Department of Wildland Resources, Utah State University Ecology Center, Logan, UT USA
| | - Diana Macias
- grid.266832.b0000 0001 2188 8502Department of Biology, University of New Mexico, Albuquerque, NM USA
| | | | - Yassine Messaoud
- grid.265704.20000 0001 0665 6279Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec Canada
| | - Christopher M. Moore
- grid.254333.00000 0001 2296 8213Department of Biology, Colby College, Waterville, ME USA
| | - Emily Moran
- grid.266190.a0000000096214564Department of Geography, University of Colorado Boulder, Boulder, CO USA
| | - Jonathan A. Myers
- grid.4367.60000 0001 2355 7002Department of Biology, Washington University in St. Louis, St. Louis, MO USA
| | - Orrin B. Myers
- grid.266832.b0000 0001 2188 8502University of New Mexico, Albuquerque, NM USA
| | - Chase Nunez
- grid.507516.00000 0004 7661 536XDepartment for the Ecology of Animal Societies, Max Planck Institute of Animal Behavior, Konstanz, Germany
| | - Robert Parmenter
- grid.454846.f0000 0001 2331 3972Valles Caldera National Preserve, National Park Service, Jemez Springs, NM USA
| | - Sam Pearse
- grid.2865.90000000121546924Fort Collins Science Center, Fort Collins, CO USA
| | - Scott Pearson
- grid.435676.50000 0000 8528 5973Department of Natural Sciences, Mars Hill University, Mars Hill, NC USA
| | - Renata Poulton-Kamakura
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Ethan Ready
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Miranda D. Redmond
- grid.47894.360000 0004 1936 8083Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO USA
| | - Chantal D. Reid
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Kyle C. Rodman
- grid.450307.5INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d’Heres, France
| | - C. Lane Scher
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - William H. Schlesinger
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Amanda M. Schwantes
- grid.17063.330000 0001 2157 2938Ecology and Evolutionary Biology, University of Toronto, Toronto, ON Canada
| | - Erin Shanahan
- grid.454846.f0000 0001 2331 3972Greater Yellowstone Network, National Park Service, Bozeman, MT USA
| | - Shubhi Sharma
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Michael A. Steele
- grid.268256.d0000 0000 8510 1943Department of Biology, Wilkes University, Wilkes-Barre, PA USA
| | - Nathan L. Stephenson
- grid.2865.90000000121546924USGS Western Ecological Research Center, Three Rivers, CA USA
| | - Samantha Sutton
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Jennifer J. Swenson
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Margaret Swift
- grid.26009.3d0000 0004 1936 7961Nicholas School of the Environment, Duke University, Durham, NC USA
| | - Thomas T. Veblen
- grid.450307.5INRAE, LESSEM, University Grenoble Alpes, Saint-Martin-d’Heres, France
| | - Amy V. Whipple
- grid.261120.60000 0004 1936 8040Department of Biological Science, Northern Arizona University, Flagstaff, AZ USA
| | - Thomas G. Whitham
- grid.261120.60000 0004 1936 8040Department of Biological Science, Northern Arizona University, Flagstaff, AZ USA
| | - Andreas P. Wion
- grid.47894.360000 0004 1936 8083Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO USA
| | - Kai Zhu
- grid.205975.c0000 0001 0740 6917University of California, Santa Cruz, Santa Cruz, CA USA
| | - Roman Zlotin
- grid.411377.70000 0001 0790 959XGeography Department and Russian and East European Institute, Bloomington, IN USA
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17
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Shi T, Denouel A, Tietjen AK, Campbell I, Moran E, Li X, Campbell H, Demont C, Nyawanda BO, Chu HY, Stoszek SK, Krishnan A, Openshaw P, Falsey AR, Nair H. Global Disease Burden Estimates of Respiratory Syncytial Virus-Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta-Analysis. J Infect Dis 2020; 222:S577-S583. [PMID: 30880339 DOI: 10.1093/infdis/jiz059] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Respiratory syncytial virus-associated acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in older adults aged ≥65 years. We aimed to identify all studies worldwide investigating the disease burden of RSV-ARI in this population. We estimated the community incidence, hospitalization rate, and in-hospital case-fatality ratio (hCFR) of RSV-ARI in older adults, stratified by industrialized and developing regions, using data from a systematic review of studies published between January 1996 and April 2018 and 8 unpublished population-based studies. We applied these rate estimates to population estimates for 2015 to calculate the global and regional burdens in older adults with RSV-ARI in the community and in hospitals for that year. We estimated the number of in-hospital deaths due to RSV-ARI by combining hCFR data with hospital admission estimates from hospital-based studies. In 2015, there were about 1.5 million episodes (95% confidence interval [CI], .3 million-6.9 million) of RSV-ARI in older adults in industrialized countries (data for developing countries were missing), and of these, approximately 14.5% (214 000 episodes; 95% CI, 100 000-459 000) were admitted to hospitals. The global number of hospital admissions for RSV-ARI in older adults was estimated at 336 000 hospitalizations (uncertainty range [UR], 186 000-614 000). We further estimated about 14 000 in-hospital deaths (UR, 5000-50 000) related to RSV-ARI globally. The hospital admission rate and hCFR were higher for those aged ≥65 years than for those aged 50-64 years. The disease burden of RSV-ARI among older adults is substantial, with limited data from developing countries. Appropriate prevention and management strategies are needed to reduce this burden.
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Affiliation(s)
- Ting Shi
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Angeline Denouel
- Global Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | - Anna K Tietjen
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Iain Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Emily Moran
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Xue Li
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Clarisse Demont
- Global Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Lyon, France
| | | | - Helen Y Chu
- Department of Medicine, University of Washington, Seattle
| | | | - Anand Krishnan
- All India Institute of Medical Sciences, New Delhi, India
| | - Peter Openshaw
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ann R Falsey
- University of Rochester School of Medicine, New York
- ReSViNET Foundation, Zeist, the Netherlands
| | - Harish Nair
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
- ReSViNET Foundation, Zeist, the Netherlands
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18
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Abstract
Abstract
Introduction
Sleep misperception is a phenomenon often identified in insomnia literature, in which individuals subjective reporting does not match objective measurements of their own sleep. Research indicates that anxiety symptoms may play a role in sleep misperception. This study assessed the relationship between sleep misperception, sleep quality, and anxiety in a young adult population with sub-clinical insomnia and anxiety symptoms. Linear regression models examined the relationships between sleep quality, anxiety symptoms, and sleep misperception.
Methods
This sample consisted of 130 young adults recruited from a University in the Bronx, NY. Anxiety was assessed using the Beck Anxiety Inventory (BAI), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Objective measures of sleep were collected via wrist-based actigraphy over a period of 7-14 days. Subjective sleep measures were collected via an online sleep diary. A misperception index was calculated to determine the discrepancy between subjective and objective sleep measures based on a formula established in previous research.
Results
Higher anxiety symptoms were associated with greater sleep disturbance. Higher sleep misperception was not associated with greater sleep disturbance. There was a significant, positive relationship between sleep misperception and anxiety symptoms (r=0.18, p=0.000). Gender emerged as an important covariate, with males exhibiting significantly higher sleep misperception and underestimating TST (M=-0.31, SD=0.22) compared to females (M=-0.18, SD=0.12).
Conclusion
Sleep misperception was not related to sleep quality, but was strongly related to anxiety symptoms in this population. In a sub-clinical young adult sample, sleep misperception is associated with anxiety but not sleep quality, and has significant gender differences. These findings contribute to sleep misperception literature with potential applications in diagnosis and treatment of insomnia and anxiety.
Support
n/a
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Affiliation(s)
| | - E Moran
- Fordham University, Bronx, NY
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19
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Barclay S, Moran E, Boase S, Johnson M, Lovick R, Graffy J, White PL, Deboys B, Harrison K, Swash B. Primary palliative care research: opportunities and challenges. BMJ Support Palliat Care 2019; 9:468-472. [PMID: 30755396 PMCID: PMC6923936 DOI: 10.1136/bmjspcare-2018-001653] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/15/2018] [Accepted: 01/16/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Primary care has a central role in palliative and end of life care: 45.6% of deaths in England and Wales occur under the care of primary care teams at home or in care homes. The Community Care Pathways at the End of Life (CAPE) study investigated primary care provided for patients in the final 6 months of life. This paper highlights the opportunities and challenges associated with primary palliative care research in the UK, describing the methodological, ethical, logistical and gatekeeping challenges encountered in the CAPE study and how these were addressed. THE STUDY METHODS Using a mixed-methods approach, quantitative data were extracted from the general practitioner (GP) and district nurse (DN) records of 400 recently deceased patients in 20 GP practices in the East of England. Focus groups were conducted with some GPs and DNs, and individual interviews held with bereaved carers and other GPs and DNs. THE CHALLENGES ADDRESSED Considerable difficulties were encountered with ethical permissions, with GP, DN and bereaved carer recruitment and both quantitative and qualitative data collection. These were overcome with flexibility of approach, perseverance of the research team and strong user group support. This enabled completion of the study which generated a unique primary palliative care data set.
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Affiliation(s)
- Stephen Barclay
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Emily Moran
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Sue Boase
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Margaret Johnson
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Roberta Lovick
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jonathan Graffy
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Patrick L White
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Brenda Deboys
- Clinical Research Network Eastern; Primary Care, Cambridge, UK
| | - Katy Harrison
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, UK
| | - Brooke Swash
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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20
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Moran E, Baharani J, Dedicoat M, Robinson E, Smith G, Bhomra P, Thien OS, Ryan R. Risk factors associated with the development of active tuberculosis among patients with advanced chronic kidney disease. J Infect 2018; 77:291-295. [PMID: 29928915 DOI: 10.1016/j.jinf.2018.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 11/01/2017] [Revised: 04/04/2018] [Accepted: 06/04/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The risk of developing active TB is greater in those receiving haemodialysis. This study aimed to describe the incidence of active tuberculosis among patients referred for management of kidney disease and dialysis in a high incidence UK city, with the purpose of informing latent TB testing and treatment practice. METHODS Information from the tuberculosis register was cross-referenced with the Department of Renal Medicine patient information system. All patients seen between 1st January 2005 and 1st October 2016 were included in the analyses with the exception of those with prior TB. RESULTS 68 cases of active TB were identified, an incidence of 126/100,000 patient-years (95% CI 97-169). Incidence was lowest in those with CKD 1 or 2 and rose as high as 256/100,000 patient-years (95% CI 183-374) in those receiving renal replacement therapy. 48% of cases were pulmonary and 87% of TB patients gave their ethnicity as either black/black British or Asian/Asian British, significantly more than in the non-TB renal group. Cases occurred steadily over the time period in which patients were in the cohort. CONCLUSION TB incidence was very high among those receiving renal replacement therapy or CKD 4 or 5. Most cases occurred in those of an Asian/Asian British or black/black British background. Testing and treating such patients for latent TB is justified and should include those who have been receiving renal replacement therapy for some years.
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Affiliation(s)
- E Moran
- Dept of Infection, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - J Baharani
- Dept of Renal Medicine, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Dedicoat
- Dept of Infection, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - E Robinson
- Public Health England, Heartlands Hospital, UK
| | - G Smith
- Public Health England, Heartlands Hospital, UK
| | - P Bhomra
- Dept of Infection, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - O S Thien
- Dept of Infection, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Ryan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK; Medical Innovation, Research and Development Unit, University Hospitals Birmingham Foundation Trust, Birmingham, UK
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Moran E, Lauder J, Musser C, Stathos A, Shu M. The genetics of drought tolerance in conifers. New Phytol 2017; 216:1034-1048. [PMID: 28895167 DOI: 10.1111/nph.14774] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/27/2017] [Indexed: 05/20/2023]
Abstract
Contents 1034 I. 1034 II. 1035 III. 1037 IV. 1038 V. 1042 VI. 1043 VII. 1045 References 1045 SUMMARY: As temperatures warm and precipitation patterns shift as a result of climate change, interest in the identification of tree genotypes that will thrive under more arid conditions has grown. In this review, we discuss the multiple definitions of 'drought tolerance' and the biological processes involved in drought responses. We describe the three major approaches taken in the study of genetic variation in drought responses, the advantages and shortcomings of each, and what each of these approaches has revealed about the genetic basis of adaptation to drought in conifers. Finally, we discuss how a greater knowledge of the genetics of drought tolerance may aid forest management, and provide recommendations for how future studies may overcome the limitations of past approaches. In particular, we urge a more direct focus on survival, growth and the traits that directly predict them (rather than on proxies, such as water use efficiency), combining research approaches with complementary strengths and weaknesses, and the inclusion of a wider range of taxa and life stages.
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Affiliation(s)
- Emily Moran
- UC Merced, 5200 N Lake Rd, Merced, CA, 95343, USA
| | | | - Cameron Musser
- Yale School of Forestry & Environmental Studies, 195 Prospect Street, New Haven, CT, 06511, USA
| | | | - Mengjun Shu
- UC Merced, 5200 N Lake Rd, Merced, CA, 95343, USA
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22
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Zellner H, Moss O, Hicks-McGarry S, Moran E, Becker E, Peterson S, Foley S. Differences in Respiratory Muscle Strength in Well-nourished versus Malnourished Hospitalized Patients. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Grigas T, Ovadnevaite J, Ceburnis D, Moran E, McGovern FM, Jennings SG, O’Dowd C. Sophisticated Clean Air Strategies Required to Mitigate Against Particulate Organic Pollution. Sci Rep 2017; 7:44737. [PMID: 28303958 PMCID: PMC5356191 DOI: 10.1038/srep44737] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 10/06/2016] [Accepted: 02/13/2017] [Indexed: 11/16/2022] Open
Abstract
Since the 1980's, measures mitigating the impact of transboundary air pollution have been implemented successfully as evidenced in the 1980-2014 record of atmospheric sulphur pollution over the NE-Atlantic, a key region for monitoring background northern-hemisphere pollution levels. The record reveals a 72-79% reduction in annual-average airborne sulphur pollution (SO4 and SO2, respectively) over the 35-year period. The NE-Atlantic, as observed from the Mace Head research station on the Irish coast, can be considered clean for 64% of the time during which sulphate dominates PM1 levels, contributing 42% of the mass, and for the remainder of the time, under polluted conditions, a carbonaceous (organic matter and Black Carbon) aerosol prevails, contributing 60% to 90% of the PM1 mass and exhibiting a trend whereby its contribution increases with increasing pollution levels. The carbonaceous aerosol is known to be diverse in source and nature and requires sophisticated air pollution policies underpinned by sophisticated characterisation and source apportionment capabilities to inform selective emissions-reduction strategies. Inauspiciously, however, this carbonaceous concoction is not measured in regulatory Air Quality networks.
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Affiliation(s)
- T. Grigas
- School of Physics and Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, Galway, Ireland
| | - J. Ovadnevaite
- School of Physics and Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, Galway, Ireland
| | - D. Ceburnis
- School of Physics and Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, Galway, Ireland
| | - E. Moran
- Met Éireann Glasnevin, Dublin 9, D09 Y921, Ireland
| | - F. M. McGovern
- Environmental Protection Agency, Clonskeagh, Dublin 14, D14 YR62, Ireland.
| | - S. G. Jennings
- School of Physics and Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, Galway, Ireland
| | - C. O’Dowd
- School of Physics and Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, Galway, Ireland
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24
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Barry JA, Moran E, Thomas M, Hardiman PJ. Prolactin and hostility in hospitalised patients and healthy women: A systematic review and meta-analysis. J OBSTET GYNAECOL 2016; 35:499-507. [PMID: 25356539 DOI: 10.3109/01443615.2014.970523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of this systematic review and meta-analysis was to assess any difference in the self-ratings of hostility in mentally healthy women with different levels of prolactin (PRL). Electronic databases (PubMed, MEDLINE, EMBASE and the Cochrane Library) were searched up to 2nd July 2012 for published literature comparing hostility levels in women with different levels of PRL. Keyword pairs ('prolactin' and 'aggression', 'prolactin' and 'hostil*', 'prolactin' and 'anger', and 'prolactin' and 'angry') were entered simultaneously. From 1065 resulting titles, and one unpublished study, 214 articles underwent full-text review by authors JB and EM. Studies were selected based on clinical relevance. Eight comparative studies consisting of 242 female patients with high PRL levels, 207 female patients with normal PRL levels and 127 healthy controls with normal PRL levels were included. Data were analysed using the inverse variance method with a random-effects model. Analysis revealed significantly higher hostility in patients with high PRL compared with that in healthy control women (Z = 1.94, p < 0.05; Hedges' g = 0.72; 95% confidence interval [CI]: -0.01-1.45), significantly higher hostility in patient controls compared with that in healthy controls (Z = 1.94, p < 0.05; Hedges' g = 0.47; 95% CI: 0.00-0.94) and non-significantly higher hostility levels in patients with high PRL compared with that in patients with normal PRL levels (Z = 1.45, p < 0.15; Hedges' g = 0.38; 95% CI: -0.13-0.89). In this meta-analysis, hostility appears to be accounted for partly by PRL levels and also partly by patient status, perhaps due to the stress of being a patient. Methodological considerations and implications for patient care are discussed.
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Affiliation(s)
- J A Barry
- a Institute for Women's Health, University College London Medical School , London , UK
| | - E Moran
- b Department of Neurology , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA
| | - M Thomas
- c Department of Clinical Biochemistry , Royal Free London Hospital , London , UK
| | - P J Hardiman
- a Institute for Women's Health, University College London Medical School , London , UK
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25
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Affiliation(s)
- E Moran
- North Middlesex Hospital, London N 18, and Clay bury Hospital, Woodford Bridge, Essex
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26
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Solaro C, Ponzio M, Moran E, Tanganelli P, Pizio R, Ribizzi G, Venturi S, Mancardi GL, Battaglia MA. The changing face of multiple sclerosis: Prevalence and incidence in an aging population. Mult Scler 2015; 21:1244-50. [DOI: 10.1177/1352458514561904] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 09/30/2014] [Indexed: 11/17/2022]
Abstract
Objective: To assess multiple sclerosis (MS) incidence from 1998 to 2007, and MS prevalence on 31 December 2007, in the province of Genoa, Italy. Methods: We identified MS cases diagnosed before 31 December 2007 by analyzing archives of hospitals with neurological or rehabilitation wards, the local Italian MS society, family doctor records and requests for oligoclonal band analysis on cerebrospinal fluid (CSF). Results: A total of 1312 MS patients were residing in the province of Genoa on the prevalence day; 431 (32.85%) were men and 881 (67.15%) were women; mean age was 50.6 (± 13.9). The overall crude MS prevalence rate was 148.5/100,000; 103.1/100,000 in men and 189.1/100,000 in women. The crude mean annual MS incidence rate was 6.6 cases/100,000 (4.4/100,000 men; 8.6/100,000 women). Mean age at diagnosis was 39.5 ± 12.3 (men: 39.9 ± 13.0; women: 39.3 ± 11.9). A mean annual incidence of 4 MS patients ≥ 60 was observed. Conclusions: We observed an increased MS prevalence in the province of Genoa, compared to 1997. The mean age at diagnosis was relatively high (39 years old), 18% of our MS patients were over 65, and a notable incidence increase was seen in patients over 60. This has important implications, in terms of the need to organize the health system to better serve elderly MS patients, especially considering comorbidities and different medical needs of elderly MS patients; and to increase awareness within the medical community about the increasing risk of newly-presenting MS in the older population.
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Affiliation(s)
- C Solaro
- Neurology Unit, Head and Neck Department, Azienda Sanitaria Locale 3 - ASL3, Genoa, Italy
| | - M Ponzio
- Research Department, Italian Foundation of Multiple Sclerosis, Genoa, Italy
| | - E Moran
- Neurology Unit, Head and Neck Department, Azienda Sanitaria Locale 3 - ASL3, Genoa, Italy
| | - P Tanganelli
- Neurology Unit, Head and Neck Department, Azienda Sanitaria Locale 3 - ASL3, Genoa, Italy
| | - R Pizio
- Neurology Department - Lavagna Hospital, Genoa, Italy
| | - G Ribizzi
- Neurology Department, San Martino Hospital, Genoa, Italy
| | - S Venturi
- Neurology Department, Galliera Hospital, Genoa, Italy
| | - GL Mancardi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genoa; Italy
| | - MA Battaglia
- Department of Life Science, University of Siena, Italy
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27
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Abstract
This study tested the hypothesis that women with higher prolactin feel more hostility, anger and aggression. A total of 66 women with moderate fertility problems were grouped into the 50% who had the highest and the 50% who had the lowest levels of prolactin. Levels of hostility, aggression and anger were compared. Women with higher prolactin levels did not report significantly increased hostility. After Bonferroni correction, women with lower prolactin showed non-significantly increased scores on two measures of state anger, and on a measure of trait temper. When comparing those with the highest and lowest 20% of prolactin levels, those with lower prolactin had non-significantly higher scores on trait temper and outward expression of anger, and non-significantly lower scores for control of anger. Although non-significant, these findings run counter to those of earlier studies on this topic. Implications for future research and patient care are discussed.
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Affiliation(s)
- J. A. Barry
- Institute for Women’s Health, University College London, London, UK
| | - E. Moran
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - H. S. Parekh
- Institute for Women’s Health, University College London, London, UK
| | - T. Morewood
- Institute for Women’s Health, University College London, London, UK
| | - M. Thomas
- Department of Clinical Biochemistry, Royal Free London Hospital, London, UK
| | - P. J. Hardiman
- Institute for Women’s Health, University College London, London, UK
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28
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Boase S, Moran E, Barclay S. THE COMMUNITY CARE PATHWAYS AT THE END OF LIFE (CAPE) STUDY- EARLY FINDINGS. BMJ Support Palliat Care 2014. [DOI: 10.1136/bmjspcare-2014-000654.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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29
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Abstract
Veterinary viral vaccines generally comprise either attenuated or chemically inactivated viruses which have been propagated on mammalian cell substrates or specific pathogen free (SPF) eggs. New generation vaccines include chemically inactivated virally-infected whole cell vaccines. The NM57 cell line is a bovine nasal turbinate persistently infected (non-lytic infection) with a strain of the respiratory syncytial virus (RSV). The potential of microcarrier technology for the cultivation in bioreactors of this anchorage dependent cell line for RSV vaccine production has been investigated. Both Cytodex 3 and Cultispher S microcarriers proved most suitable from a selection of microcarriers as growth substrates for this NM57 cell line. Maximum cell densities of 4.12×105 cells ml-1and 5.52×105 cells ml-1 respectively were obtained using Cytodex 3 (3 g l-1) and and Cultispher S (1 g l-1) in 5 l bioreactor cultures. The fact that cell growth was less sensitive to agitation rate when cultured on Cultispher S microcarriers, and that cells were efficiently harvested from this microcarrier by an enzymatic method, suggested Cultispher S is suitable for further evaluation at larger bioreactor scales (>5 l) than that described here.
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Affiliation(s)
- E Moran
- MFM Laboratories Ltd., 4 Warner Dr., Springwood Industrial Estate, Braintree, Essex, CM7 2YW, UK
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Tortolina L, Castagnino N, De Ambrosi C, Moran E, Patrone F, Ballestrero A, Parodi S. A multi-scale approach to colorectal cancer: from a biochemical- interaction signaling-network level, to multi-cellular dynamics of malignant transformation. Interplay with mutations and onco-protein inhibitor drugs. Curr Cancer Drug Targets 2012; 12:339-55. [PMID: 22385511 DOI: 10.2174/156800912800190910] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 05/23/2011] [Accepted: 12/22/2011] [Indexed: 11/22/2022]
Abstract
This review article is part of a special Current Cancer Drug Targets issue devoted to colorectal cancer and molecularly targeted treatments. In our paper we made an attempt to connect more basic aspects with preclinical, pharmacological / therapeutic and clinical aspects. Reconstruction of a Molecular Interaction Map (MIM) comprising an important part of the G0 - G1 - S cell cycle transition, was a major component of our review. Such a MIM serves also as a convenient / organized database of a large set of important molecular events. The frequency of mutated / altered signaling-proteins indicates the importance of this signaling-network region. We have considered problems at different scale levels. Our MIM works at a biochemical-interaction level. We have also touched the multi-cellular dynamics of normal and aberrant colon crypts. Until recently, dynamic simulations at a biochemical or multi-cellular scale level were considered as a sort of esoteric approach. We tried to convince the reader, also on the basis of a rapidly growing literature, mostly published in high quality journals, that suspicion towards simulations should dissipate, as the limitations and advantages of their application are better appreciated, opening the door to their permanent adoption in everyday research. What is really required is a more interdisciplinary mentality and an interdisciplinary approach. The prize is a level of understanding going beyond mere intuition.
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Affiliation(s)
- L Tortolina
- Department of Internal Medicine, University of Genoa, Genova, Italy
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Pirrotta I, Fernández-Sanjulián J, Moran E, Alario-Franco MA, Gonzalo E, Kuhn A, García-Alvarado F. Driving Curie temperature towards room temperature in the half-metallic ferromagnet K2Cr8O16by soft redox chemistry. Dalton Trans 2012; 41:1840-7. [PMID: 22167010 DOI: 10.1039/c1dt11558h] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- I Pirrotta
- Departamento de Química Inorgánica I, Facultad de Químicas, Universidad Complutense de Madrid, 28040, Madrid, Spain
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Clark JS, Bell DM, Hersh MH, Kwit MC, Moran E, Salk C, Stine A, Valle D, Zhu K. Individual-scale variation, species-scale differences: inference needed to understand diversity. Ecol Lett 2011; 14:1273-87. [PMID: 21978194 DOI: 10.1111/j.1461-0248.2011.01685.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As ecological data are usually analysed at a scale different from the one at which the process of interest operates, interpretations can be confusing and controversial. For example, hypothesised differences between species do not operate at the species level, but concern individuals responding to environmental variation, including competition with neighbours. Aggregated data from many individuals subject to spatio-temporal variation are used to produce species-level averages, which marginalise away the relevant (process-level) scale. Paradoxically, the higher the dimensionality, the more ways there are to differ, yet the more species appear the same. The aggregate becomes increasingly irrelevant and misleading. Standard analyses can make species look the same, reverse species rankings along niche axes, make the surprising prediction that a species decreases in abundance when a competitor is removed from a model, or simply preclude parameter estimation. Aggregation explains why niche differences hidden at the species level become apparent upon disaggregation to the individual level, why models suggest that individual-level variation has a minor impact on diversity when disaggregation shows it to be important, and why literature-based synthesis can be unfruitful. We show how to identify when aggregation is the problem, where it has caused controversy, and propose three ways to address it.
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Affiliation(s)
- James S Clark
- Nicholas School of the Environment, Duke University, Durham, NC 27708, USA.
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Caffa I, Soncini D, Zoppoli G, Moran E, Patrone F, Ballestrero A, Nencioni A. 1222 POSTER Chemical Screening for Potentiators of Lapatinib Activity in Human Breast Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70834-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bingener J, Bonin E, Moran E, McConico A, Gostout C. Perforated Peptic Ulcer Disease–A Potential for NOTES Procedures? J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Motta G, Cea M, Carbone F, Augusti V, Moran E, Patrone F, Nencioni A. Current standards and future strategies in immunochemotherapy of non-Hodgkin's lymphoma. J BUON 2011; 16:9-15. [PMID: 21674844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The therapeutic options for B-cell non-Hodgkin's lymphoma (NHL) have dramatically expanded with the advent of immune-based treatments. The monoclonal antibody anti- CD20 rituximab represents the best example of these advances and has quickly become incorporated into the therapeutic armamentarium for this hematological disease. In addition, other antibodies are eventually becoming part of treatment approaches to NHL. Furthermore, the role of therapeutic vaccines continues to be an important ongoing research question. Despite this success, several questions on how to optimize the use of monoclonal antibodies in NHL remain open since the best administration schedules, as well as the optimal duration of immunotherapy still have to be determined. Finally the development of resistance to treatment remains the main limit of this innovative approach, necessitating the development of strategies to circumvent resistance itself. This review will summarize the state of the art of antibody-based immunotherapy of NHL and discuss prospective approaches to improve the benefit of these treatments in patients.
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Affiliation(s)
- G Motta
- Department of Internal Medicine, University of Genoa, Genoa, Italy
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O'Kane CM, Moran E, McAuley DF. S48 NGAL inhibits cytoskeletal re-organisation, MMP-2 production and invasion in alveolar epithelial cells in an in vitro model of acute lung injury. Thorax 2010. [DOI: 10.1136/thx.2010.150912.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Clark JS, Bell D, Chu C, Courbaud B, Dietze M, Hersh M, HilleRisLambers J, Ibáñez I, LaDeau S, McMahon S, Metcalf J, Mohan J, Moran E, Pangle L, Pearson S, Salk C, Shen Z, Valle D, Wyckoff P. High-dimensional coexistence based on individual variation: a synthesis of evidence. ECOL MONOGR 2010. [DOI: 10.1890/09-1541.1] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Castagnino N, Tortolina L, Balbi A, Pesenti R, Montagna R, Ballestrero A, Soncini D, Moran E, Nencioni A, Parodi S. Dynamic Simulations of Pathways Downstream of ERBB-Family, Including Mutations and Treatments: Concordance with Experimental Results. Curr Cancer Drug Targets 2010; 10:737-57. [DOI: 10.2174/156800910793605848] [Citation(s) in RCA: 8] [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] [Received: 11/05/2009] [Accepted: 06/18/2010] [Indexed: 11/22/2022]
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Tripathi OP, Jennings SG, O'Dowd CD, Coleman L, Leinert S, O'Leary B, Moran E, O'Doherty SJ, Spain TG. Statistical analysis of eight surface ozone measurement series for various sites in Ireland. ACTA ACUST UNITED AC 2010. [DOI: 10.1029/2010jd014040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- E Moran
- Department of Microbiology and Infectious Disease, John Radcliffe Hospital, Oxford.
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Durán A, Arévalo-López A, Castillo-Martínez E, García-Guaderrama M, Moran E, Cruz M, Fernández F, Alario-Franco M. Magneto-thermal and dielectric properties of biferroic YCrO3 prepared by combustion synthesis. J SOLID STATE CHEM 2010. [DOI: 10.1016/j.jssc.2010.06.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ballestrero A, Cirmena G, Dominietto A, Garuti A, Rocco I, Cea M, Moran E, Nencioni A, Miglino M, Raiola AM, Bacigalupo A, Patrone F. Peripheral blood vs. bone marrow for molecular monitoring of BCR-ABL1 levels in chronic myelogenous leukemia, a retrospective analysis in allogeneic bone marrow recipients. Int J Lab Hematol 2010; 32:387-91. [PMID: 19968720 DOI: 10.1111/j.1751-553x.2009.01198.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Molecular monitoring of the BCR-ABL1 transcript in chronic myelogenous leukemia (CML) using quantitative real-time PCR (RQ-PCR) can be performed using either bone marrow (BM) or peripheral blood (PB). However, a recent report by Stock et al. [International Journal of Oncology 28 (2006) 1099] questioned the reliability of PB samples for BCR-ABL1 detection as performed by RQ-PCR. We report a study on 114 CML patients who received allogeneic stem cell transplantation (ASCT), and who were monitored by RQ-PCR using paired samples of BM and PB: the total number of determinations was 428, with a median follow-up after transplant of 8 years. BCR-ABL1 transcript was undetectable or <0.1%, in 106 (49.57%) and 62 (29%) paired determinations, respectively. BCR-ABL1 was >0.1% in 36 (16.8%) paired determinations and was discordant in 10 (4.7%). Agreement between PB and BM results was quantified by the kappa test (k = 0.85; 95% CI 0.76-0.94). This study shows that BCR-ABL1 RQ-PCR monitoring of CML patients after ASCT with PB is concordant with BM in 95.3% of cases, and thus may be used to monitor the disease. This may be relevant when discussing both quality of life issues and the need for post-transplant monitoring with the patient.
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Affiliation(s)
- A Ballestrero
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, Genoa, Italy.
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Cea M, Cagnetta A, Garuti A, Cirmena G, Rocco I, Moran E, Grillo V, Ballestrero A, Patrone F, Nencioni A. Molecular diagnosis and monitoring of chronic myelogenous leukemia: BCR-Abl and more. J BUON 2009; 14:565-573. [PMID: 20148444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The current treatment of chronic myelogenous leukemia (CML) is one of the most successful examples of molecularly targeted therapy in cancer. The identification of the fusion oncogene BCR-ABL allowed the discovery of small molecule inhibitors of its tyrosine kinase activity which, in turn, have literally revolutionized the treatment of this disease. However, large part of a successful clinical management of CML relies on appropriate diagnosis, molecular monitoring and identification of mutations potentially leading to drug resistance. These issues are discussed here together with an overview on how patients treated with tyrosine kinase inhibitors should be monitored.
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MESH Headings
- Drug Resistance, Neoplasm
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Protein Kinase Inhibitors/therapeutic use
- Treatment Outcome
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Affiliation(s)
- M Cea
- Department of Internal Medicine, University of Genoa, Genoa, Italy
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Bingener J, Moran E, Gostout C. QS95. Randomized Trials Evaluating the Physiologic Impact of Notes. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Moran E, Isaacs GS, Naidoo B, Pudifin DJ. Hereditary C1 esterase deficiency in a Zulu kindred. S Afr Med J 2009; 99:40-42. [PMID: 19374086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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48
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Moran E. Preventing thromboembolism in medical inpatients--time to catch up with the surgeons? S Afr Med J 2008; 98:860. [PMID: 19177890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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Gomperts SN, Rentz DM, Moran E, Becker JA, Locascio JJ, Klunk WE, Mathis CA, Elmaleh DR, Shoup T, Fischman AJ, Hyman BT, Growdon JH, Johnson KA. Imaging amyloid deposition in Lewy body diseases. Neurology 2008; 71:903-10. [PMID: 18794492 PMCID: PMC2637553 DOI: 10.1212/01.wnl.0000326146.60732.d6] [Citation(s) in RCA: 360] [Impact Index Per Article: 22.5] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Extrapyramidal motor symptoms precede dementia in Parkinson disease (PDD) by many years, whereas dementia occurs early in dementia with Lewy bodies (DLB). Despite this clinical distinction, the neuropsychological and neuropathologic features of these conditions overlap. In addition to widespread distribution of Lewy bodies, both diseases have variable burdens of neuritic plaques and neurofibrillary tangles characteristic of Alzheimer disease (AD). OBJECTIVES To determine whether amyloid deposition, as assessed by PET imaging with the beta-amyloid-binding compound Pittsburgh Compound B (PiB), can distinguish DLB from PDD, and to assess whether regional patterns of amyloid deposition correlate with specific motor or cognitive features. METHODS Eight DLB, 7 PDD, 11 Parkinson disease (PD), 15 AD, and 37 normal control (NC) subjects underwent PiB-PET imaging and neuropsychological assessment. Amyloid burden was quantified using the PiB distribution volume ratio. RESULTS Cortical amyloid burden was higher in the DLB group than in the PDD group, comparable to the AD group. Amyloid deposition in the PDD group was low, comparable to the PD and NC groups. Relative to global cortical retention, occipital PiB retention was lower in the AD group than in the other groups. For the DLB, PDD, and PD groups, amyloid deposition in the parietal (lateral and precuneus)/posterior cingulate region was related to visuospatial impairment. Striatal PiB retention in the DLB and PDD groups was associated with less impaired motor function. CONCLUSIONS Global cortical amyloid burden is high in dementia with Lewy bodies (DLB) but low in Parkinson disease dementia. These data suggest that beta-amyloid may contribute selectively to the cognitive impairment of DLB and may contribute to the timing of dementia relative to the motor signs of parkinsonism.
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Affiliation(s)
- S N Gomperts
- Massachusetts General Hospital, Boston, MA 02114, USA
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Moran E, Cattaneo C, Mishima H, López de Mishima BA, Silvetti SP, Rodriguez JL, Pastor E. Ammonia oxidation on electrodeposited Pt–Ir alloys. J Solid State Electrochem 2007. [DOI: 10.1007/s10008-007-0407-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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