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Radford S, Leighton P, Coad J, Moran G. Stakeholder-identified barriers and enablers to ultrasound implementation in inflammatory bowel disease services in the UK: a qualitative interview study. BMJ Open 2023; 13:e067528. [PMID: 37349092 PMCID: PMC10314467 DOI: 10.1136/bmjopen-2022-067528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES The study sought to explore and better understand the perceptions and experiences of stakeholders in relation to the use of ultrasound for the assessment of inflammatory bowel disease (IBD) in adults in the UK. DESIGN A qualitative semistructured interview study, using template analysis and normalisation process theory, was undertaken. SETTING Interviews were conducted using virtual meeting software. RESULTS Fourteen participants were enrolled between 2nd of June 2021 and 6th of September 2021. Participants were from the following roles: medical gastroenterology and radiology doctors, IBD nurse specialists, patients living with IBD, healthcare service managers. Participants reported that perceived barriers included reliance on established imaging and care pathways, reluctance to change, lack of trust in ultrasound in relation to perceived lack of precision and the initial financial and time outlay in establishing an ultrasound service. Participants were enthusiastic for the uptake of ultrasound and discussed enablers to ultrasound uptake including the benefits to patients in terms of reduction in waiting times and earlier diagnosis and treatment allocation, reduced number of hospital appointments and patients having better understanding of their health. CONCLUSION There are perceived barriers to achieving implementation of ultrasound. There is scant literature to effectively assess these reported barriers. Therefore, there is further research required in the areas of the impact of the use of ultrasound for the assessment of IBD in the UK.
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Affiliation(s)
- Shellie Radford
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Paul Leighton
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Jane Coad
- University of Nottingham School of Health Sciences, Nottingham, UK
| | - Gordon Moran
- Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK
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2
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Fatani H, Olaru A, Stevenson R, Alharazi W, Jafer A, Atherton P, Brook M, Moran G. Systematic review of sarcopenia in inflammatory bowel disease. Clin Nutr 2023; 42:1276-1291. [PMID: 37352818 DOI: 10.1016/j.clnu.2023.05.002] [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: 08/18/2022] [Revised: 03/10/2023] [Accepted: 05/02/2023] [Indexed: 06/25/2023]
Abstract
INTRODUCTION There is growing evidence of increased muscle atrophy in IBD patients, likely resulting in a higher sarcopenia prevalence in IBD. The aims of this systematic review are A1; to estimate sarcopenia prevalence in IBD patients, A2; to investigate its impact on IBD patients, and A3; the effectiveness of nutritional interventions on muscle mass and/or strength in IBD patients. METHODS On 28 July 2021, three electronic databases were used to identify eligible studies, including peer-reviewed studies (randomised controlled trials [RCTs], non-RCTs, observation studies) in adult (⩾ 18 years) IBD patients. For A1 and A2 only, studies defined low muscle mass and/or strength cut-off points. For A2, studies assessed association between sarcopenia and IBD complication. For A3, studies assessed the nutrition effect among IBD patients. RESULTS 35 studies were included, 34 for A1, 20 for A2, and three for A3. 42% of adult IBD patients have myopenia, 34% have pre-sarcopenia, and 17% sarcopenia. Myopenic IBD was significantly associated with therapy failure including IBD-related surgery risk in six studies, risk of medical therapy failure in four studies, risk of hospitalisation in one study. A significant association existed with postoperative complications risk in IBD patients in four studies, reduction in BMD in two studies, and increased incidence of non-alcoholic fatty liver disease (NAFLD) in one study. Sarcopenia in IBD was significantly associated with a reduction in BMD in one study. Two studies found a personalised nutrition plan (high protein) in IBD patients significantly improved muscle mass. One study found a significant positive association between muscle mass and dietary intake including high protein intake. CONCLUSION Over one third of adult IBD patients have myopenia and pre-sarcopenia, and nearly a fifth have sarcopenia. Myopeninc IBD is significantly associated with increased risk of IBD therapy failure, postoperative complications, and low BMD, with possible association with increased NAFLD risk. Nutritional therapy may play a role in reversing low muscle mass though yet unclear if this is through disease activity reversal. Further studies on adult IBD patients focusing on sarcopenia/myopenia are needed with recommended study designs of 1) standardised population-based definitions with recommended standard methods used to measure skeletal muscle mass, 2) prospective studies with IBD patients stratified by Montreal classification, disease activity, disease duration and concomitant medication to observe muscle changes, 3) mechanistic studies on sarcopenia aetiology, specifically focusing on protein handling atrophy and absorption, 4) properly designed RCT to assess nutrition intervention in sarcopenic IBD patients.
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Affiliation(s)
- Hala Fatani
- The Nottingham Digestive Diseases Centre (NDDC), School of Medicine, University of Nottingham, Nottingham, UK; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & National Institute of Health Research, Nottingham Biomedical Research Centre, University of Nottingham, UK.
| | - Adina Olaru
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Waad Alharazi
- School of Biosciences, University of Nottingham, Nottingham, UK
| | - Ayman Jafer
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Philip Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & National Institute of Health Research, Nottingham Biomedical Research Centre, University of Nottingham, UK; Centre Of Metabolism, Ageing & Physiology (COMAP), School of Medicine, University of Nottingham, Derby, UK
| | - Matthew Brook
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & National Institute of Health Research, Nottingham Biomedical Research Centre, University of Nottingham, UK; Centre of Metabolism, Ageing & Physiology (COMAP), School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Gordon Moran
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & National Institute of Health Research, Nottingham Biomedical Research Centre, University of Nottingham, UK; Translational Medical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, UK
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3
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Ellul P, Schembri J, Baldacchino VA, Molnar T, Resal T, Allocca MA, Furfaro F, Dal Buono, Theodoropoulou A, Fragaki M, Tsoukali E, Mantzaris GJ, Phillips F, Radford S, Moran G, Gonzalez HA, Sebastian S, Fousekis F, Christodoulou D, Snir Y, Lerner Z, Yanai H, Michalopoulos G, Tua J, Camilleri L, Papamichael K, Karmiris K, Katsanos K. Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease. J Crohns Colitis 2022; 17:489-496. [PMID: 36322687 DOI: 10.1093/ecco-jcc/jjac169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND AIM Post-inflammatory polyps (PIPs) are considered as indicators of previous episodes of severe inflammation and mucosal ulceration. Inflammatory bowel disease (IBD), namely Crohn's disease (CD) and ulcerative colitis (UC), exhibit a perpetuating, relapsing, and remitting pattern and PIPs is a frequent sequela of chronicity. The aim of this study was to determine whether a high PIPs burden is associated with a more severe disease course in patients with IBD. METHODS This was a multinational, multicentre, retrospective study. IBD patients previously diagnosed with PIPs were retrieved from the endoscopic database of each centre. PIPs burden was evaluated and associated with demographic and clinical data as well as factors indicating a more unfavorable disease course. RESULTS A total of 504 IBD patients with PIPs were recruited (male: 61.9%). The mean age at IBD diagnosis was 36.9 (±16.8) years. Most patients (74.8%) were diagnosed with UC. A high PIPs burden was present in 53.4% of patients. On multivariable Cox regression analysis, high PIPs burden was independently associated with treatment escalation (HR 1.35, 95% CI 1.04-1.75; P=0.024), hospitalization (HR 1.90; 95% CI 1.24 - 2.90; P=0.003), need for surgery (HR 2.28; 95% CI 1.17-4.44, P=0.02) and younger age at diagnosis (HR 0.99, 95% CI 0.98-0,99; p=0.003). CONCLUSION PIPs burden was associated with a more severe outcome. Future prospective studies should focus on the characterisation of PIPs burden as to further risk stratify this patient cohort.
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Affiliation(s)
- P Ellul
- Division of Gastroenterology, Mater Dei hospital, Malta
| | - J Schembri
- Division of Gastroenterology, Mater Dei hospital, Malta
| | | | - T Molnar
- Department of Medicine, Szent-Györgyi Albert Medical School, University of Szeged, Hungary
| | - T Resal
- Department of Medicine, Szent-Györgyi Albert Medical School, University of Szeged, Hungary
| | - M A Allocca
- Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy
| | - F Furfaro
- Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Milan, Italy
| | - Dal Buono
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Theodoropoulou
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - M Fragaki
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - E Tsoukali
- Department of Gastroenterology, GHA "Evangelismos-Polykliniki', Athens, Greece
| | - G J Mantzaris
- Department of Gastroenterology, GHA "Evangelismos-Polykliniki', Athens, Greece
| | - F Phillips
- Nottingham University Hospitals NHS Trust, Nottingham, England
| | - S Radford
- Nottingham University Hospitals NHS Trust, Nottingham, England
| | - G Moran
- Nottingham University Hospitals NHS Trust, Nottingham, England
| | | | - S Sebastian
- Hull University Teaching Hospitals, Hull, UK
| | - F Fousekis
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - D Christodoulou
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Y Snir
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel
| | - Z Lerner
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel
| | - H Yanai
- Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel
| | - G Michalopoulos
- Gastroenterology department "Tzaneion" General Hospital of Piraeus, Greece
| | - J Tua
- Division of Gastroenterology, Mater Dei hospital, Malta
| | - L Camilleri
- Faculty of Science, University of Malta, Malta
| | - K Papamichael
- Center for Inflammatory Bowel Diseases, Division of Gastroenterology, Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - K Karmiris
- Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
| | - K Katsanos
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Shaban N, Hoad CL, Naim I, Alshammari M, Radford SJ, Clarke C, Marciani L, Moran G. Imaging in inflammatory bowel disease: current and future perspectives. Frontline Gastroenterol 2022; 13:e28-e34. [PMID: 35812031 PMCID: PMC9234729 DOI: 10.1136/flgastro-2022-102117] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/22/2022] [Indexed: 02/04/2023] Open
Abstract
The use of cross-sectional imaging and ultrasonography has long complemented endoscopic assessment of inflammatory bowel disease (IBD). Clinical symptoms alone are often not enough to assess disease activity, so a reliance on non-invasive techniques is essential. In this paper, we aim to examine the current use of radiological modalities in aiding the management of patients with IBD. We focus on the various sections of the gastrointestinal tract and how different modalities can aid in assessing current disease state and response to treatments. We also have a look at how newer sequences in cross-sectional imaging and ultrasonography can allow for better differentiation of disease activity (ie, fibrotic vs inflammatory) as well improve evaluation of small bowel, colonic and perianal disease. Furthermore, we examine how advanced image processing has the potential to allow radiology to be a surrogate for biomarkers. An example of this is explored when reviewing the ability of MR sequences to quantify visceral fat, which potentially plays a role in determining disease activity in Crohn's disease. Lastly, we look into the expected role for artificial intelligence to be used as an adjunct to radiology to better improve IBD evaluation.
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Affiliation(s)
- Nader Shaban
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Caroline L Hoad
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham University Park Campus, Nottingham, UK
| | - Iyad Naim
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham University Park Campus, Nottingham, UK
| | - Meshari Alshammari
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham University Park Campus, Nottingham, UK
| | - Shellie Jean Radford
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham University Park Campus, Nottingham, UK
| | - Christopher Clarke
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Luca Marciani
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham University Park Campus, Nottingham, UK
| | - Gordon Moran
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham University Park Campus, Nottingham, UK
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5
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Radford SJ, Taylor S, Moran G. Ultrasound use to assess Crohn's disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members. Frontline Gastroenterol 2022; 13:471-476. [PMID: 36250164 PMCID: PMC9555127 DOI: 10.1136/flgastro-2021-102065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Small bowel ultrasound has very good diagnostic accuracy for disease extent, presence and activity in Crohn's Disease, is well tolerated by patients and is cheaper when compared with MRI. However, uptake of ultrasound in the UK is limited. METHODS An online survey to assess the current usage of ultrasound throughout the UK was undertaken by BSG IBD group members between 9/06/2021- 25/06/2021. Responses were anonymous. RESULTS 103 responses were included in the data analysis. Responses came from 66 different NHS trusts from 14 different regions of the UK. All respondents reported that they currently have an MRI service for Crohn's disease, whereas only 31 had an ultrasound service. Average time for results to be reported for MRI scans was reported as between 4- and 6 weeks, with a range of 2 days to 28 weeks. The average time for an ultrasound to be reported was stated as 1-4 weeks, with a range of 0-8 weeks. There was disparity between the reported confidence of clinicians making clinical decisions when using ultrasound compared to MRI. Of those respondents who did not have access to an ultrasound service, 72 stated that they would be interested in developing an ultrasound service. CONCLUSION There is an appetite for the uptake of ultrasound in the UK for assessment of Crohn's disease, however, there remains a significant number of UK centres with little or no access to an ultrasound service. Further research is necessary to understand why this is the case.
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Affiliation(s)
- Shellie Jean Radford
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Gordon Moran
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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6
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Shariff S, Moran G, Grimes C, Cooney RM. Current Use of EEN in Pre-Operative Optimisation in Crohn's Disease. Nutrients 2021; 13:4389. [PMID: 34959941 PMCID: PMC8709272 DOI: 10.3390/nu13124389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022] Open
Abstract
Despite the increasing array of medications available for the treatment of Crohn's disease and a focus on mucosal healing, approximately 35% of patients with Crohn's disease undergo bowel surgery at some stage. The importance of nutritional optimisation before Crohn's surgery is well-highlighted by surgical, nutritional, and gastroenterological societies with the aim of reducing complications and enhancing recovery. Surgical procedures are frequently undertaken when other treatment options have been unsuccessful, and, thus, patients may have lost weight and/or required steroids, and are therefore at higher risk of post-operative complications. EEN is used extensively in the paediatric population to induce remission, but is not routinely used in the induction of remission of adult Crohn's disease or in pre-operative optimisation. Large prospective studies regarding the role of pre-operative EEN are lacking. In this review, we evaluate the current literature on the use of EEN in pre-operative settings and its impact on patient outcomes.
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Affiliation(s)
- Sharafaath Shariff
- Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Birmingham B15 2GW, UK; (S.S.); (R.M.C.)
| | - Gordon Moran
- Room D1406 West Block: Queen’s Medical Centre, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK
| | - Caris Grimes
- Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, UK;
| | - Rachel Margaret Cooney
- Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Birmingham B15 2GW, UK; (S.S.); (R.M.C.)
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7
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Radford SJ, Clarke C, Shinkins B, Leighton P, Taylor S, Moran G. Clinical utility of small bowel ultrasound assessment of Crohn's disease in adults: a systematic scoping review. Frontline Gastroenterol 2021; 13:280-286. [PMID: 35722606 PMCID: PMC9186037 DOI: 10.1136/flgastro-2021-101897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/01/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Ultrasound (US) is an alternative to magnetic resonance enterography, and has the potential to significantly reduce waiting times, expedite clinical decision-making and improve patient experience. Point of care US is an advantage of the US imaging modality, where same day scanning, interpretation and treatment decisions can be made. AIM To systematically scope the literature on point of care US use in small bowel Crohn's disease, generating a comprehensive list of factors relating to the current understanding of clinical utility of this imaging modality. METHODS Searches included MEDLINE, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, clinicaltrial.gov,'TRIP' and Epistemonikos. Reference lists of included studies were hand searched. Search terms were searched for as both keywords and subject headings (MeSH) as appropriate. Searches were performed with the 'suggested search terms' and 'explode' selection, and restricted to 'human', 'adult' and 'English language' publications. No date limits were applied to be as inclusive as possible. Two investigators conducted abstract and full-text review. No formal quality appraisal process was undertaken; however, quality of sources was considered when reporting findings. A narrative synthesis was conducted. RESULTS The review included 42 sources from the UK, Europe, Japan, Canada and the USA. Small bowel ultrasound (SBUS) has been shown to be as accurate in detecting the presence of small bowel Crohn's disease, is quicker, safer and more acceptable to patients, compared with magnetic resonance enterography. SBUS is used widely in central Europe and Canada but has not been embraced in the UK. Further research considering economic evaluation, clinical decision-making and exploration of perceived barriers to future implementation of SBUSs is required.
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Affiliation(s)
- Shellie Jean Radford
- NIHR Nottingham Biomedical Research Centre—Gastrointestinal and Liver Research Theme, School of Medicine, Nottingham, UK
| | - Chris Clarke
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, Nottingham, UK
| | - Bethany Shinkins
- University of Leeds Faculty of Medicine and Health, Leeds, West Yorkshire, UK
| | - Paul Leighton
- School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Gordon Moran
- NIHR Nottingham Biomedical Research Centre—Gastrointestinal and Liver Research Theme, School of Medicine, Nottingham, UK
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8
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Din S, Gaya D, Kammermeier J, Lamb CA, Macdonald J, Moran G, Parkes G, Pollok R, Sebastian S, Segal J, Selinger C, Smith PJ, Steed H, Arnott ID. Inflammatory bowel disease clinical service recovery during the COVID-19 pandemic. Frontline Gastroenterol 2021; 13:77-81. [PMID: 34966535 PMCID: PMC8666864 DOI: 10.1136/flgastro-2021-101805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 02/04/2023] Open
Affiliation(s)
- Shahida Din
- Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
| | - Daniel Gaya
- Gastroenterology Unit, Glasgow Royal Infirmary, Glasgow, UK
| | - Jochen Kammermeier
- Pediatric Gastroenterology, Evelina London Children's Hospital, London, UK
| | - Christopher A Lamb
- Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK,Department of Gastroenterology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Jonathan Macdonald
- Department of Gastroenterology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Gordon Moran
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK,Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
| | - Gareth Parkes
- Department of Gastroenterology, Royal London Hospital, London, UK
| | | | - Shaji Sebastian
- IBD Unit, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Jonathan Segal
- Department of Gastroenterology, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK
| | - Christian Selinger
- Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK
| | - Philip J Smith
- Department of Hepatology and Liver Transplantation, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
| | - Helen Steed
- Department of Gastroenterology, New Cross Hospital, Wolverhampton, UK
| | - Ian D Arnott
- The Edinburgh IBD Unit, Western General Hospital, Edinburgh, UK
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9
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Radford SJ, McGing J, Czuber-Dochan W, Moran G. Systematic review: the impact of inflammatory bowel disease-related fatigue on health-related quality of life. Frontline Gastroenterol 2020; 12:11-21. [PMID: 33489066 PMCID: PMC7802486 DOI: 10.1136/flgastro-2019-101355] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Fatigue is frequently reported in inflammatory bowel disease (IBD) and impacts on health-related quality of life (HRQoL). HRQoL has not been systematically reviewed in IBD fatigue. AIM To investigate what impact IBD fatigue has on HRQoL in adults with IBD. METHODS Systematic searches (CINAHL, EMBASE, PsychINFO, Medline) were conducted on 25 September 2018, restricted to 'human', 'adult', 'primary research' and 'English language'. Search terms encompassed concepts of 'fatigue', 'IBD' and 'HRQoL'. A 5-year time limit (2013-2018) was set to include the most relevant publications. Publications were screened, data extracted and quality appraised by two authors. A narrative synthesis was conducted. RESULTS Eleven studies were included, presenting data from 2823 participants. Fatigue experiences were significantly related to three HRQoL areas: symptom acceptance, psychosocial well-being and physical activity. Patients reporting high fatigue levels had low symptom acceptance. Psychosocial factors were strongly associated with both fatigue and HRQoL. Higher social support levels were associated with higher HRQoL. Physical activity was impaired by higher fatigue levels, lowering HRQoL, but it was also used as a means of reducing fatigue and improving HRQoL. Quality appraisal revealed methodological shortcomings in a number of studies. Notably, use of multiple measures, comparison without statistical adjustment and fatigue and HRQoL assessment using the same tool were some of the methodological shortcomings. CONCLUSION Psychosocial factors, symptom management and acceptance and physical activity levels have significant impact on HRQoL. Results support application of psychosocial or exercise interventions for fatigue management. Further exploration of HRQoL factors in IBD fatigue is required, using validated fatigue and HRQoL measures. PROSPERO REGISTRATION NUMBER CRD42018110005.
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Affiliation(s)
- Shellie Jean Radford
- Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jordan McGing
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Wladyslawa Czuber-Dochan
- Florence Nightingale school of Nursing, Midwifery and Pallative care, King's College London, London, UK
| | - Gordon Moran
- Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Sebastian S, Lisle J, Subramanian S, Dhar A, Shenoy A, Limdi J, Butterworth J, Allen PB, Samuel S, Moran G, Shenderey R, Parkes G, Raine T, Lobo AJ, Kennedy NA. Practice pattern variability in the management of acute severe colitis: a UK provider survey. Frontline Gastroenterol 2019; 11:272-279. [PMID: 32587670 PMCID: PMC7307042 DOI: 10.1136/flgastro-2019-101277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/22/2019] [Accepted: 07/31/2019] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Lack of comparative trial data on dosing regimens of infliximab in patients with acute severe ulcerative colitis (ASUC) failing intravenous corticosteroids has resulted in variability of rescue regimes in ASUC with potential impact on clinical outcomes. We aimed to evaluate practice variability and physician perspectives in decision-making with rescue therapy. METHODOLOGY An internet-based survey of members of the inflammatory bowel disease (IBD) section of the British Society of Gastroenterology was conducted. The survey evaluated provider characteristics and general practice in the setting of ASUC, followed by a vignette with linked questions. RESULTS The response rate of the survey was 31% (209/682 IBD section members). 134 (78%) reported they would use standard infliximab dose (5 mg/kg) while 37 (22%) favoured a higher front-loading dose of 10 mg/kg citing low albumin, high C-reactive protein as their reason for their preference. IBD specialists chose the higher front-loading dose more often compared with other gastroenterologists (p=0.01) In the specific case vignette, accelerated induction (AI) was favoured by 51% of the respondents while 25% used the standard induction regime and 19% favoured colectomy. IBD specialists more often favoured AI compared with other gastroenterologists (p=0.03) with the main reason being presence of predictors of low infliximab levels (74%). The reasons cited for favouring standard induction (n=57) included lack of evidence for AI (18), their usual practice (11), unlicensed regime (7), and safety concerns (4). CONCLUSIONS There are significant variations in practice in the use of infliximab rescue therapies with an urgent need for development of care pathways to standardise practice.
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Affiliation(s)
- Shaji Sebastian
- IBD Unit, Department of Gastroenterology, Hull University Teaching Hospitals NHS Trust, Hull, UK
- Hull York Medical School, Hull, UK
| | - Jessica Lisle
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Sreedhar Subramanian
- Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK
| | - Anjan Dhar
- Department of Gastroenterology, County Durham and Darlington NHS Foundation Trust, Bishop Auckland, UK
| | - Achut Shenoy
- Department of Gastroenterology, Colchester Hospital University NHS Foundation Trust, Colchester, UK
| | - Jimmy Limdi
- Department of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Jeffrey Butterworth
- Department of Gastroenterology, Royal Shrewsbury Hospitals NHS Trust, Shrewsbury, UK
| | - Patrick B Allen
- department of Gastroenterology, Ulster Hospital, Dundonald, UK
| | - Sunil Samuel
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Gordon Moran
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK
| | - Richard Shenderey
- Department of Gastroenterology, Airedale NHS Foundation Trust, Keighley, UK
| | - Gareth Parkes
- Department of Gastroenterology, Royal London Hospital, London, UK
| | - Tim Raine
- Department of Gastroenterology, Addenbrooke’s Hospital, Cambridge, UK
| | - Alan J Lobo
- Gastroenterology Unit, Royal Hallamshire Hospital, Sheffield, UK
| | - Nicholas A Kennedy
- Department of Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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Asafu-Adjei D, Moran G, Li G, Lipsky M, Stember D, Stahl P. 335 Implant Selection Patterns and Reoperation Rates amongst Solid Organ Transplant Recipients that Underwent Penile Prosthesis Surgery. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.215] [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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Olave C, Morales N, Uberti B, Henriquez C, Sarmiento J, Ortloff A, Folch H, Moran G. Tamoxifen induces apoptotic neutrophil efferocytosis in horses. Vet Res Commun 2018; 42:57-63. [PMID: 29297134 DOI: 10.1007/s11259-017-9709-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/26/2017] [Indexed: 02/08/2023]
Abstract
Macrophages and neutrophils are important cellular components in the process of acute inflammation and its subsequent resolution, and evidence increasingly suggests that they play important functions during the resolution of chronic, adaptive inflammatory processes. Exacerbated neutrophil activity can be harmful to surrounding tissues; this is important in a range of diseases, including allergic asthma and chronic obstructive pulmonary disease in humans, and equine asthma (also known as recurrent airway obstruction (RAO). Tamoxifen (TX) is a non-steroidal estrogen receptor modulator with effects on cell growth and survival. Previous studies showed that TX treatment in horses with induced acute pulmonary inflammation promoted early apoptosis of blood and BALF neutrophils, reduction of BALF neutrophils, and improvement in animals' clinical status. The aim of this study was to describe if TX induces in vitro efferocytosis of neutrophils by alveolar macrophages. Efferocytosis assay, myeloperoxidase (MPO) detection and translocation phosphatidylserine (PS) were performed on neutrophils isolated from peripheral blood samples from five healthy horses. In in vitro samples from heathy horses, TX treatment increases the phenomenon of efferocytosis of peripheral neutrophils by alveolar macrophages. Similar increases in supernatant MPO concentration and PS translocation were observed in TX-treated neutrophils, compared to control cells. In conclusion, these results confirm that tamoxifen has a direct effect on equine peripheral blood neutrophils, through stimulation of the engulfment of apoptotic neutrophils by alveolar macrophages.
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Affiliation(s)
- C Olave
- Department of Pharmacology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - N Morales
- Department of Pharmacology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - B Uberti
- Department of Clinical Veterinary Sciences, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - C Henriquez
- Department of Pharmacology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - J Sarmiento
- Department of Physiology, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - A Ortloff
- College of Veterinary Medicine, Universidad Catolica de Temuco, Temuco, Chile
| | - H Folch
- Department of Immunology, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - G Moran
- Department of Pharmacology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile.
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Borlone C, Morales N, Henriquez C, Folch H, Olave C, Sarmiento J, Uberti B, Moran G. In Vitro effects of tamoxifen on equine neutrophils. Res Vet Sci 2016; 110:60-64. [PMID: 28159238 DOI: 10.1016/j.rvsc.2016.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/26/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
Neutrophils participate in innate immunity as the first line of host defense against microorganisms. However, exacerbated neutrophil activity can be harmful to surrounding tissues; this is important in a range of diseases, including allergic asthma and chronic obstructive pulmonary disease in humans, and equine asthma (also known as recurrent airway obstruction (RAO). Tamoxifen (TX) is a non-steroidal estrogen receptor modulator with effects on cell growth and survival. Previous preliminary studies showed that TX treatment in horses with induced acute pulmonary inflammation promoted early apoptosis of blood and BALF neutrophils, reduction of BALF neutrophils, and improvement in animals' clinical status. The aim of this study was to evaluate the in vitro effect of TX on functional tests in equine peripheral blood neutrophils. Chemotaxis, respiratory burst production and phagocytosis assays were performed on neutrophils isolated from peripheral blood samples from 10 healthy horses. Results showed that IL-8 stimulated cells decrease their chemotactic index when treated with TX (1 and 10μM). Respiratory burst production was also dampened after treatment with TX. In conclusion, these results confirm that tamoxifen has a direct action on equine peripheral blood neutrophils. However, more in vivo and in vitro studies are required to fully understand the mechanisms of action of TX on neutrophils, in order to elucidate if it can be used as treatment in disorders such as allergic asthma in humans and horses.
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Affiliation(s)
- C Borlone
- Department of Pharmacology, Faculty of Veterinary Science, Universidad Austral de Chile, Valdivia, Chile
| | - N Morales
- Department of Pharmacology, Faculty of Veterinary Science, Universidad Austral de Chile, Valdivia, Chile
| | - C Henriquez
- Department of Pharmacology, Faculty of Veterinary Science, Universidad Austral de Chile, Valdivia, Chile
| | - H Folch
- Department of Immunology, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - C Olave
- Department of Pharmacology, Faculty of Veterinary Science, Universidad Austral de Chile, Valdivia, Chile
| | - J Sarmiento
- Department of Physiology, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - B Uberti
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Science, Universidad Austral de Chile, Valdivia, Chile
| | - G Moran
- Department of Pharmacology, Faculty of Veterinary Science, Universidad Austral de Chile, Valdivia, Chile.
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Abstract
Reviews three books that deal with the mission, values, and ethics of the library profession, focusing on the theme of the necessity for continuing discussion and rethinking about librarianship’s values and mission in the new, ‘Information Age’. In Alfino and Pierce’s book ‘Information ethics for librarians’, a series of complex philosophical problems are described in a clear manner. Their concise and effective philosophical and historical accounts help to understand how certain ethical dilemmas have arisen. Gorman’s book, ‘ Our singular strengths: meditations for librarians ’, comprises a series of short essays discussing numerous and varied topics covering many aspects of librarianship and the author’s own professional life within the field and commenting on the lives of persons who influenced and inspired him. Gorman’s book, ‘ Our enduring values ’ describes values in terms of stewardship, service, intellectual freedom, rationalism, literacy and learning, equity of access, privacy, and democracy. The defence of basic librarianship values is well-reasoned and fervent and serves to raise doubts about Gorman’s discussion of stewardship as a ‘unique’ librarianship value. Concludes from the three books that access is at the heart of all ethical problems relating to the library’s mission of service. All of the books under review are useful for trying to understand the ethical complexities of librarianship, but ‘Information ethics for librarians’ has the fullest discussion for a framework relating to the complex ethical problems involved.
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Dudley E, Moran G. Book Review: Intellectual freedom manual, 6th edition. Journal of Librarianship and Information Science 2016. [DOI: 10.1177/096100060203400207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Moran G. Book Review: Speaking out! voices in celebration of intellectual freedom, Libraries, access, and intellectual freedom: developing policies for public and academic libraries. Journal of Librarianship and Information Science 2016. [DOI: 10.1177/096100060103300110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dudley E, Moran G. Book Review: Ethical Issues of Information Technology, Library Trends, Winter 2001, 49(3). Journal of Librarianship and Information Science 2016. [DOI: 10.1177/096100060103300408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Miao S, Wang ZJ, Pan L, Butler J, Moran G, Liao R. Scatter to volume registration for model-free respiratory motion estimation from dynamic MRIs. Comput Med Imaging Graph 2016; 52:72-81. [PMID: 27180910 DOI: 10.1016/j.compmedimag.2016.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 10/22/2022]
Abstract
Respiratory motion is one major complicating factor in many image acquisition applications and image-guided interventions. Existing respiratory motion estimation and compensation methods typically rely on breathing motion models learned from certain training data, and therefore may not be able to effectively handle intra-subject and/or inter-subject variations of respiratory motion. In this paper, we propose a respiratory motion compensation framework that directly recovers motion fields from sparsely spaced and efficiently acquired dynamic 2-D MRIs without using a learned respiratory motion model. We present a scatter-to-volume deformable registration algorithm to register dynamic 2-D MRIs with a static 3-D MRI to recover dense deformation fields. Practical considerations and approximations are provided to solve the scatter-to-volume registration problem efficiently. The performance of the proposed method was investigated on both synthetic and real MRI datasets, and the results showed significant improvements over the state-of-art respiratory motion modeling methods. We also demonstrated a potential application of the proposed method on MRI-based motion corrected PET imaging using hybrid PET/MRI.
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Affiliation(s)
- S Miao
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; Medical Imaging Technology, Siemens Healthcare, Princeton, NJ 08540, USA.
| | - Z J Wang
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - L Pan
- Siemens Healthcare, Baltimore, MD 21205, USA
| | - J Butler
- Lawson Health Research Institute, London, ON N6C 2R5, Canada
| | - G Moran
- Siemens Canada, Oakville, ON L6H 0H6, Canada
| | - R Liao
- Medical Imaging Technology, Siemens Healthcare, Princeton, NJ 08540, USA
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Daly P, Moran G. Safety assessment of a novel active ingredient, acetyl aspartic acid, according to the EU Cosmetics Regulation and the Scientific Committee on Consumer Safety guidelines. Int J Cosmet Sci 2015; 37 Suppl 1:21-7. [PMID: 26114401 DOI: 10.1111/ics.12257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/17/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Acetyl aspartic acid (A-A-A) was proposed as a new novel active ingredient for use in cosmetics. The safety of A-A-A was assessed by following an in-house-developed 'New Ingredient Testing Strategy', which was designed in accordance with the Scientific Committee on Consumer Safety (SCCS) notes of guidance and the requirements of Annex I of the EU Cosmetics Regulation. The aim of the project was to determine whether A-A-A was safe for use in cosmetics and to determine a maximum permitted safe level in the formulations. METHODS A literature review was conducted, consulting over 40 different information sources. This highlighted a number of gaps which required testing data. A-A-A was tested for phototoxicity according to OECD test guideline 432, skin irritation according to OECD test guideline 439 and eye irritation according to OECD test guideline 437. Dermal absorption of A-A-A was measured according to OECD test guideline 428 and was used to calculate the margin of safety (MoS). Finally, A-A-A was tested in a human repeat insult patch test (HRIPT) and a 14-day in-use tolerance study. RESULTS A-A-A was non-phototoxic and was non-irritating to skin and eyes in in vitro testing. Dermal absorption was calculated to be 5%. The MoS for A-A-A was 351, at a level of 5%, for all cosmetic product types, indicating no systemic safety toxicity concern. A-A-A at 5% under occlusive patch on a panel of 50 adult volunteers induced no skin irritation or allergic reaction in the HRIPT study. Finally, repeated application of A-A-A to the periocular area, twice per day for 14 days, in 21 female volunteers, demonstrated that 1% A-A-A was well tolerated following dermatological and ophthalmological assessment in a cosmetic formulation. CONCLUSION A-A-A was assessed as safe by the cosmetic safety assessor for use in cosmetics at a level of 5% in all cosmetic product types, in line with the requirements of the EU Cosmetics Regulation and in accordance with the SCCS notes of guidance.
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Affiliation(s)
- P Daly
- Oriflame R&D Ltd, Bray Business Park, Kilruddery, Bray, Co Wicklow, Ireland
| | - G Moran
- Oriflame R&D Ltd, Bray Business Park, Kilruddery, Bray, Co Wicklow, Ireland
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Gentile CL, Weir TL, Cox-York KA, Wei Y, Wang D, Reese L, Moran G, Estrada A, Mulligan C, Pagliassotti MJ, Foster MT. The role of visceral and subcutaneous adipose tissue fatty acid composition in liver pathophysiology associated with NAFLD. Adipocyte 2015; 4:101-12. [PMID: 26167414 DOI: 10.4161/21623945.2014.978662] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/10/2014] [Accepted: 10/15/2014] [Indexed: 11/19/2022] Open
Abstract
Visceral adiposity is associated with type-2-diabetes, inflammation, dyslipidemia and non-alcoholic fatty liver disease (NAFLD), whereas subcutaneous adiposity is not. We hypothesized that the link between visceral adiposity and liver pathophysiology involves inherent or diet-derived differences between visceral and subcutaneous adipose tissue to store and mobilize saturated fatty acids. The goal of the present study was to characterize the fatty acid composition of adipose tissue triglyceride and portal vein fatty acids in relation to indices of liver dysregulation. For 8 weeks rats had free access to control (CON; 12.9% corn/safflower oil; 3.6 Kcal/g), high saturated fat (SAT; 45.2% cocoa butter; 4.5 Kcal/g) or high polyunsaturated fat (PUFA; 45.2% safflower oil; 4.5 Kcal/g) diets. Outcome measures included glucose tolerance, visceral and subcutaneous adipose tissue triglyceride, liver phospholipids and plasma (portal and systemic) free fatty acid composition, indices of inflammation and endoplasmic reticulum stress in the liver and adipose tissue depots and circulating adipo/cytokines. Hepatic triglycerides were significantly increased in both high fat diet groups compared to control and were significantly higher in PUFA compared to SAT. Although glucose tolerance was not different among diet groups, SAT increased markers of inflammation and ER stress in the liver and both adipose tissue depots. Fatty acid composition did not differ among adipose depots or portal blood in any dietary group. Overall, these data suggest that diets enriched in saturated fatty acids are associated with liver inflammation, ER stress and injury, but that any link between visceral adipose tissue and these liver indices does not involve selective changes to fatty acid composition in this depot or the portal vein.
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Moran G, Wei Y, Wang D, Pagliassotti M. The role of mitofusin 2 in saturated fatty acid induced ER stress in H4IIE liver cells (1116.4). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.1116.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G. Moran
- Food Science & Human Nutrition Colorado State UniversityFort CollinsCOUnited States
| | - Y. Wei
- Food Science & Human Nutrition Colorado State UniversityFort CollinsCOUnited States
| | - D. Wang
- Food Science & Human Nutrition Colorado State UniversityFort CollinsCOUnited States
| | - M.J. Pagliassotti
- Food Science & Human Nutrition Colorado State UniversityFort CollinsCOUnited States
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Terp S, Krishnadasan A, Bowen W, Joo J, Furoy D, Chan J, Moran G, Talan D. Introduction of Rapid Methicillin-Resistant Staphylococcus aureus Polymerase Chain Reaction Testing and Antibiotic Selection Among Hospitalized Patients With Purulent Skin Infections. Clin Infect Dis 2014; 58:e129-32. [DOI: 10.1093/cid/ciu039] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Moran G, Folch H, Henriquez C, Ortloff A, Barria M. Reaginic antibodies from horses with Recurrent Airway Obstruction produce mast cell stimulation. Vet Res Commun 2012; 36:251-8. [DOI: 10.1007/s11259-012-9534-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2012] [Indexed: 11/28/2022]
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Bisceglia R, Jenkins JM, Wigg KG, O’Connor TG, Moran G, Barr CL. Arginine vasopressin 1a receptor gene and maternal behavior: evidence of association and moderation. Genes, Brain and Behavior 2012; 11:262-8. [DOI: 10.1111/j.1601-183x.2012.00769.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Moran G. "Near famine": the Roman Catholic Church and the subsistence crisis of 1879-82. Stud Hibernica 2010; 32:155-177. [PMID: 20191701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Forbes LM, Evans EM, Moran G, Pederson DR. Change in Atypical Maternal Behavior Predicts Change in Attachment Disorganization From 12 to 24 Months in a High-Risk Sample. Child Dev 2007; 78:955-71. [PMID: 17517015 DOI: 10.1111/j.1467-8624.2007.01043.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This longitudinal study examined links between disorganization and atypical maternal behavior at 12 and 24 months in 71 adolescent mother-child dyads. Organized attachment and maternal not disrupted behavior were more stable than disorganization and disrupted behavior, respectively. At both ages, disorganization and maternal disrupted behavior were significantly correlated. Change in atypical maternal behavior predicted change in disorganization across time. The results provide substantial support for extant theories linking anomalous maternal behavior to the development of disorganized attachment. The Interesting-but-Scary paradigm, introduced in this study, promises to be a useful tool for assessing attachment and maternal behavior in toddlerhood.
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Affiliation(s)
- L M Forbes
- University of Western Ontario, London, ON, Canada.
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Mothersill C, Moran G, McNeill F, Gow MD, Denbeigh J, Prestwich W, Seymour CB. A role for bioelectric effects in the induction of bystander signals by ionizing radiation? Dose Response 2007; 5:214-29. [PMID: 18648606 DOI: 10.2203/dose-response.06-011.mothersill] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The induction of "bystander effects" i.e. effects in cells which have not received an ionizing radiation track, is now accepted but the mechanisms are not completely clear. Bystander effects following high and low LET radiation exposure are accepted but mechanisms are still not understood. There is some evidence for a physical component to the signal. This paper tests the hypothesis that bioelectric or biomagnetic phenomena are involved. Human immortalized skin keratinocytes and primary explants of mouse bladder and fish skin, were exposed directly to ionizing radiation or treated in a variety of bystander protocols. Exposure of cells was conducted by shielding one group of flasks using lead, to reduce the dose below the threshold of 2mGy (60)Cobalt gamma rays established for the bystander effect. The endpoint for the bystander effect in the reporter system used was reduction in cloning efficiency (RCE). The magnitude of the RCE was similar in shielded and unshielded flasks. When cells were placed in a Faraday cage the magnitude of the RCE was less but not eliminated. The results suggest that liquid media or cell-cell contact transmission of bystander factors may be only part of the bystander mechanism. Bioelectric or bio magnetic fields may have a role to play. To test this further, cells were placed in a Magnetic Resonance Imaging (MRI) machine for 10 min using a typical head scan protocol. This treatment also induced a bystander response. Apart from the obvious clinical relevance, the MRI results further suggest that bystander effects may be produced by non-ionizing exposures. It is concluded that bioelectric or magnetic effects may be involved in producing bystander signaling cascades commonly seen following ionizing radiation exposure.
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Affiliation(s)
- C Mothersill
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, 660 Concession St., Hamilton, Ontario, Canada.
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Borompichaichartkul C, Moran G, Srzednicki G, Price W. Nuclear magnetic resonance (NMR) and magnetic resonance imaging (MRI) studies of corn at subzero temperatures. J FOOD ENG 2005. [DOI: 10.1016/j.jfoodeng.2004.07.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lastere S, Dalban C, Collin G, Descamps D, Girard PM, Clavel F, Costagliola D, Brun-Vezinet F, Brun-Vezinet F, Clavel F, Costagliola D, Dalban C, Girard PM, Matheron S, Meynard JL, Morand-Joubert L, Peytavin G, Vray M, Beguinot I, Waldner A, Beumont M, Semaille C, Bentata M, Berlureau P, Gérard L, Molina JM, Hor R, Bayol-Honnet G, Lascoux-Combe C, Drobacheff C, Hoen B, Dupon M, Lacut JY, Goujard C, Rousseau C, Vincent V, Diemer M, Lepeu G, Zerazhi H, de Truchis P, Berthé H, Jeantils V, Tazi CT, Vittecoq D, Escaut L, Dupont B, Nait-Ighil L, Rozenbaum W, Nguyen TH, Boué F, Galanaud P, Kazatchkine M, Piketty C, Bernasconi C, Salmon-Ceron D, Michon C, Chandemerle C, Lascaux AS, Magnier JD, Schneider L, Ait-Mohand H, Simon A, Herson S, Bollens D, Picard O, Tangre P, Bonarek M, Morlat P, Trépo C, Cotte L, Gastaut JA, Poizot-Martin I, Moran G, Masson S, Bennai Y, Belarbi L, Prevot MH, Fournier I, Reynes J, Baillat V, Raffi F, Esnault JL, Ceppi C, Cassuto JP, Arvieux C, Chapplain JM, Rey D, Krantz V, Besnier JM, Bastides F, Obadia M, Aquilina C, Bazin C, Verdon R, Piroth L, Grappin M, Sissoko D, Valette M, May T, Burty C, Debab Y, Caron F, Elharrar B, Launay O, Winter C, Chapuis L, Auperin I, Gilquin J. Impact of Insertions in the HIV-1 P6 Ptapp Region on the Virological Response to Amprenavir. Antivir Ther 2004. [DOI: 10.1177/135965350400900215] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We evaluated the impact of genetic changes within p6Gag gene on the virological response (VR, mean decrease in plasma viral load at week 12) to unboosted amprenavir (APV). Gag-protease fragments, including gag p2, p7, p1, p6 regions and whole protease (PR) were sequenced from baseline plasma specimens of 84 highly pre-treated but APV-naive patients included in the NARVAL (ANRS 088) trial. The correlation between baseline p6Gag polymorphism, PR mutations, baseline characteristics and VR to APV was analysed in univariate analysis. Insertions (P459Ins) within p6 protein, leading to partial or complete duplication of the PTAPP motif, were significantly associated with a decreased VR (P459Ins versus wild-type; –0.3 ±0.8 vs –1.1 ±1.2 log copies/ml, P=0.007) and were more frequent when the V82A/F/T/S PR mutation was present ( P=0.020). In multivariate analysis, after adjustment on the predictive factors of the VR in the NARVAL trial and on the PR mutations linked with response, there was a strong trend to an association ( P=0.058) between the presence of P459Ins and an altered VR. In conclusion, these results suggest that insertions in the p6 region of HIV-1 gag gene may affect the VR, in highly pre-treated patients receiving an unboosted APV-containing regimen.
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Affiliation(s)
| | - Stephane Lastere
- Laboratoire de Virologie, Hopital Bichat – Claude Bernard, Paris, France
| | - Cecile Dalban
- INSERM EMI0214, Universite Pierre et Marie Curie – Paris 6, Paris, France
| | - Gilles Collin
- Laboratoire de Virologie, Hopital Bichat – Claude Bernard, Paris, France
| | - Diane Descamps
- Laboratoire de Virologie, Hopital Bichat – Claude Bernard, Paris, France
| | - Pierre-Marie Girard
- Service des Maladies Infectieuses et Tropicales, Hopital Saint Antoine, Paris, France
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- Hôpital Saint-Louis, Paris
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- Hôpital Saint-Jacques, Besançon
| | | | | | - C Goujard
- Hôpital de Bicêtre, Le Kremlin Bicêtre
| | | | | | | | - G Lepeu
- Hôpital Henri Duffaut, Avignon
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- Hôpital Raymond Poincaré, Garches
| | | | | | | | | | - B Dupont
- Institut Pasteur/Hôpital Necker, Paris
| | | | | | | | - F Boué
- Hôpital Antoine Béclère, Clamart
| | | | | | - C Piketty
- Hôpital Européen Georges Pompidou, Paris
| | | | | | | | | | | | | | | | | | - A Simon
- Hôpital Pitié-Salpétrière, Paris
| | - S Herson
- Hôpital Pitié-Salpétrière, Paris
| | | | | | | | | | | | | | | | | | | | - G Moran
- Hôpital Bichat Claude Bernard, Paris
| | - S Masson
- Hôpital Bichat Claude Bernard, Paris
| | - Y Bennai
- Hôpital Bichat Claude Bernard, Paris
| | - L Belarbi
- Hôpital Bichat Claude Bernard, Paris
| | - MH Prevot
- Hôpital Bichat Claude Bernard, Paris
| | | | - J Reynes
- Hôpital Gui de Chauliac, Montpellier
| | - V Baillat
- Hôpital Gui de Chauliac, Montpellier
| | | | | | | | | | | | | | - D Rey
- Centre Hospitalier Universitaire, Strasbourg
| | - V Krantz
- Centre Hospitalier Universitaire, Strasbourg
| | | | | | | | | | - C Bazin
- Centre Hospitalier Universitaire de Caen
| | - R Verdon
- Centre Hospitalier Universitaire de Caen
| | | | | | - D Sissoko
- Centre Hospitalier Univeristaire, Tourcoing
| | - M Valette
- Centre Hospitalier Univeristaire, Tourcoing
| | - T May
- Hôpital de Brabois, Nancy
| | | | - Y Debab
- Hôpital Charles Nicolle, Rouen
| | - F Caron
- Hôpital Charles Nicolle, Rouen
| | - B Elharrar
- Centre Hospitalier Intercommunal, Créteil
| | - O Launay
- Centre Hospitalier Intercommunal, Créteil
| | - C Winter
- Hôpital André Grégoire, Montreuil
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Pateman J, Daines G, Moran G, Thornton S, MacNaughtan A, Line M, Peatling G. Book reviews. Journal of Librarianship and Information Science 2001. [DOI: 10.1177/0961000014245053] [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: 11/16/2022]
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Moran G. Correspondence. The Library Quarterly 2001. [DOI: 10.1086/603256] [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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Abstract
Do siblings develop similar attachment relationships with their mother? Attachment theory suggests that brothers and sisters growing up in the same family are likely to relate in similar ways to their parents, at least when parental attachment representations and interactive styles remain stable across time. In the current study, sibling attachment data from three research groups (from Pennsylvania State University, Leiden University, and the University of Western Ontario) have been pooled to assemble a sufficiently large sample of observations (N = 138 sibling pairs) for a detailed comparison of sibling attachment relationships. Spacing between the births, differences in maternal sensitivity, and gender of siblings were examined as possible sources of concordance of nonconcordance. Attachment security (including disorganized attachment) of each sibling was assessed with the Strange Situation procedure between 12 and 14 months after birth. Maternal sensitivity was observed with the same rating scale in a laboratory play session in one of the studies and in home observations in the others. Sibling relationships were found to be significantly concordant when classified as secure/nonsecure (62% concordance, p < .01, 1-tailed, intraclass correlation = .23) but not when further subcategorized. Maternal insensitivity to both siblings (shared environment) was associated with concordance of sibling nonsecurity. Siblings of the same gender were more likely to form concordant relationships with their mother (68%; p < .01, 1-tailed, intraclass correlation = .37) than those of opposite gender. Same-sex sibling concordance was comparable to the concordance found for monozygotic twins in earlier studies. Genetic factors may, therefore, play a relatively small role in the development of attachment.
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Affiliation(s)
- M H van Ijzendoorn
- Center for Child and Family Studies, Leiden University, The Netherlands.
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Moran G. Book Review: Libraries in the age of mediocrity. Journal of Librarianship and Information Science 2000. [DOI: 10.1177/096100060003200109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Naturalistic assessment of maternal and infant interactive behavior using q-sorts has typically focused on rationally derived variables, such as maternal sensitivity and infant security. In the current study, behavior profiles characteristic of groups of young and adult mothers and their infants were derived empirically through q-factor analysis of the Maternal Behavior Q-sort (Version 3.0) and the Attachment Q-sort (Version 3.0). A three-factor solution best described the behavior profiles characteristic of young mothers. The identified factors were labeled: 'ignoring/neglecting versus interacting', 'accepting versus hostile/rejecting', and 'interfering'. The behavior of adult mothers was less variable and was described with only one factor, which corresponded to the 'accepting versus hostile/rejecting' factor. The factor solutions for infants of young and adult mothers were similar, with four identified factors, or behavioral profiles, discriminating between groups of infants with similar patterns of behavior: 'secure with mother', 'prefers visitor', 'socially withdrawn' and 'demanding with mother'. Infants of young and adult mothers differed with regard to their mean values on the first two identified factors. Results provide support for the relevance of rationally derived domains and criterion sorts in populations of both adult and young mothers, and suggest ways of progressing beyond the currently used, rationally derived variables in assessments of maternal and infant behavior in high- and low-risk populations.
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Affiliation(s)
- H N Bailey
- Department of Psychology, University of Western Ontario, London, Ontario, N6A 5C2, Canada.
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Sullivan DJ, Moran G, Donnelly S, Gee S, Pinjon E, McCartan B, Shanley DB, Coleman DC. Candida dubliniensis: An update. Rev Iberoam Micol 1999; 16:72-76. [PMID: 18473572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- D J Sullivan
- Microbiology Research Laboratory, Department of Oral Pathology and Oral Medicine, School of Dental Science, University of Dublin, Trinity College, Dublin 2, Ireland.
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Pederson DR, Gleason KE, Moran G, Bento S. Maternal attachment representations, maternal sensitivity, and the infant-mother attachment relationship. Dev Psychol 1999. [PMID: 9779739 DOI: 10.1037//0012-1649.34.5.925] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The role of maternal sensitivity as a mediator accounting for the robust association between maternal attachment representations and the quality of the infant-mother attachment relationship was examined. Sixty mother-infant dyads were observed at home and in the Strange Situation at 13 months, and mothers participated in the Adult Attachment Interview (AAI) within the next 6 months. A strong association was found between AAI and Strange Situation classifications, and autonomous mothers were more sensitive at home than were nonautonomous mothers. Mothers in secure relationships were more sensitive at home than mothers in nonsecure relationships. Likewise, infants in secure relationships were more secure as assessed by the Waters' Attachment Q sort than infants in nonsecure relationships. A test of the mediational model revealed that maternal sensitivity accounted for 17% of the relation between AAI and Strange Situation classifications.
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Abstract
The role of maternal sensitivity as a mediator accounting for the robust association between maternal attachment representations and the quality of the infant-mother attachment relationship was examined. Sixty mother-infant dyads were observed at home and in the Strange Situation at 13 months, and mothers participated in the Adult Attachment Interview (AAI) within the next 6 months. A strong association was found between AAI and Strange Situation classifications, and autonomous mothers were more sensitive at home than were nonautonomous mothers. Mothers in secure relationships were more sensitive at home than mothers in nonsecure relationships. Likewise, infants in secure relationships were more secure as assessed by the Waters' Attachment Q sort than infants in nonsecure relationships. A test of the mediational model revealed that maternal sensitivity accounted for 17% of the relation between AAI and Strange Situation classifications.
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Abstract
2H relaxation times T1, T1 rho and T2 for D2O in silica sol-gels are used to monitor porosity and surface interactions within the silica framework as a function of aging. Tetramethoxysilane gels are compared with composites containing low levels of poly(vinyl alcohol) (PVA) prepared under acidic conditions. Non-exponential decay of magnetisation in T1 rho and T2 experiments is attributed to the fractal nature of the pore structure.
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Affiliation(s)
- S Wonorahardjo
- School of Chemistry, University of New South Wales, Sydney, Australia
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Henry G, Moran G, Jennings M. Outcome measurement for children with specific speech and language impairment. Int J Lang Commun Disord 1998; 33 Suppl:53. [PMID: 10343664 DOI: 10.3109/13682829809179395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- G Henry
- Dawn House School, Rainworth, Notts
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Affiliation(s)
- M. Rankothge
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia
| | - J. Hook
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia
| | - L. van Gorkom
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia
| | - G. Moran
- School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia
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Abstract
Predictors of psychological distress/adjustment were examined in 25 patients following placement of ICDs. Patients completed a demographic questionnaire and a standardized questionnaire of psychological symptoms (i.e., Symptom Checklist-90 Revised; SCL-90-R). The number of discharges categorized by the patient as inappropriate and appropriate were also ascertained. The number of ICD discharges categorized as inappropriate and diminished levels of physical activity (r = 0.53 and 0.63, P < 0.01, respectively) did significantly relate to overall psychological distress. In addition, after controlling for age and prior psychiatric and physical health status through a stepwise multiple regression analysis, the occurrence of ICD discharges categorized as inappropriate and diminished physical activity continued to significantly predict overall psychological distress (R2 = 0.41, P < 0.01). However, the number of ICD discharges categorized as appropriate did not significantly predict overall psychological distress. The results of this investigation suggest that further refinement of the ICD could reduce the risk of exposure to potential psychological distress, and an analysis of prior and anticipated patient physical activity levels should be a factor when calibrating minimum ICD discharge threshold levels.
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Affiliation(s)
- E S Burgess
- Department of Psychiatry and Behavioral Medicine, Union Memorial Hospital, Baltimore, MD, USA
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Coleman D, Sullivan D, Harrington B, Haynes K, Henman M, Shanley D, Bennett D, Moran G, McCreary C, O'Neill L. Molecular and phenotypic analysis of Candida dubliniensis: a recently identified species linked with oral candidosis in HIV-infected and AIDS patients. Oral Dis 1997; 3 Suppl 1:S96-101. [PMID: 9456666 DOI: 10.1111/j.1601-0825.1997.tb00384.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The discovery and characterisation of a novel species of Candida, termed Candida dubliniensis, associated with oral candidosis in HIV-infected individuals is described. These organisms share several phenotypic characteristics in common with Candida albicans and Candida stellatoidea, including the ability to produce germ tubes and chlamydospores. However, in contrast to these latter two species, C. dubliniensis isolates produce abundant chlamydospores, which are often arranged in contiguous pairs, triplets and other multiples suspended from a single suspensor cell. They belong to C. albicans serotype A and exhibit atypical substrate assimilation profiles. Genomic DNA fingerprinting analysis with the C. albicans-specific probe 27A and five different oligonucleotide probes consisting of short repeat sequence-containing motifs, demonstrated that C. dubliniensis has a distinct genomic organisation relative to C. albicans and C. stellatoidea. This was confirmed by karyotype analysis and random amplified polymorphic DNA (RAPD) analysis. Comparison of 500 bp of the V3 variable region of the large ribosomal subunit genes from 14 separate C. dubliniensis isolates and the corresponding sequences from C. albicans, C. stellatoidea, C. tropicalis, C. glabrata, C. parapsilosis, C. kefyr and C. krusei demonstrated that the C. dubliniensis isolates formed a homogenous cluster (100% similarity), representing a discrete taxon within the genus Candida that was significantly different from the other species analysed.
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Affiliation(s)
- D Coleman
- Department of Oral Medicine and Pathology, School of Dental Science, Trinity College, University of Dublin, Republic of Ireland
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Abstract
OBJECTIVE To investigate the "toxic" total (potential for) hostility component of the type A behavior pattern (assessed by means of the structured interview) as it relates to prediction of restenosis after percutaneous transluminal coronary angioplasty (PTCA). DESIGN Patients with single vessel or multivessel coronary artery disease in whom PTCA had been scheduled or done were administered the structured interview by one trained interviewer prospectively or retrospectively (blinded to angiographic endpoints). MATERIAL AND METHODS A total of 41 patients underwent 53 initial balloon dilations on native arteries by 1 of 5 participating cardiologists. Inclusion criteria for this study were a successful initial PTCA and post-PTCA recatheterization if a patient complained of ischemic symptoms possibly related to restenosis. RESULTS Of the 41 patients, 15 (36.6%) had restenoses at a total of 18 previous angioplasty sites. Patients with high total (potential for) hostility ratings were almost 2.5 times more likely to have restenosis than those with low total (potential for) hostility scores (95% confidence interval = 1.03 to 5.32). Logistic regression revealed that total (potential for) hostility scores predicted post-PTCA restenosis overall as well as when adjusted for gender and race. Total (potential for) hostility scores were also positively associated with the number of arteries restenosed (P = 0.01). CONCLUSION This is the first report of type A total (potential for) hostility behavior conferring an increased risk for restenosis after PTCA. Its modification may be effective in reducing recurrent cardiac events. A coronary-prone behavior modification program for patients with persistent, same-site restenosis after PTCA has been initiated.
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Affiliation(s)
- M Goodman
- Department of Psychiatry and Behavioral Medicine, Union Memorial Hospital, Baltimore, Maryland, USA
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Sullivan D, Haynes K, Moran G, Shanley D, Coleman D. Persistence, replacement, and microevolution of Cryptococcus neoformans strains in recurrent meningitis in AIDS patients. J Clin Microbiol 1996; 34:1739-44. [PMID: 8784580 PMCID: PMC229105 DOI: 10.1128/jcm.34.7.1739-1744.1996] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Six separate human immunodeficiency virus-positive patients with cryptococcal meningitis were each found to have been infected with a unique strain of Cryptococcus neoformans on the basis of genomic DNA finger-printing analysis with the microsatellite sequence-containing oligonucleotide probe (GGAT)4 and by random amplification of polymorphic DNA. Two patients (A and B) experienced a recurrent episode of infection. Between 12 and 16 single-colony isolates recovered from primary isolation media (> 50% of C. neoformans colonies recovered) from cerebrospinal fluid specimens were fingerprinted from both patients during each episode. The fingerprints of both isolate collections from patient B were very similar, although minor polymorphisms were evident in both sets of profiles. The fingerprints of the isolate collection from the initial episode of infection in patient A were also identical to each other, apart from minor polymorphisms, but they were clearly different from the corresponding profiles of the isolate collection from the recurrent episode, the latter of which were completely identical, apart from minor polymorphisms in a single isolate. Furthermore, prolonged storage and in vitro subculture of the isolates did not alter the fingerprint profiles. These results provided convincing evidence that patients A and B were each infected with a single C. neoformans strain during each episode of infection and that in patient B, the same strain persisted and caused both episodes, while in patient A, a different strain was responsible for each episode. The prevalence of polymorphisms in multiple single-colony isolates from both patients also suggested that C. neoformans populations may undergo microevolution.
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Affiliation(s)
- D Sullivan
- School of Dental Science, Department of Oral Medicine and Pathology, Trinity College, University of Dublin, Republic of Ireland
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Pederson DR, Moran G. Expressions of the attachment relationship outside of the strange situation. Child Dev 1996; 67:915-27. [PMID: 8706535] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
41 preterm infants and 38 full-term infants and their mothers were observed at home at 8 and 12 months of age and in the Strange Situation at 18 months in order to compare expressions of attachment relationships in these 2 settings. There was 84% concordance in the distinctions between secure and nonsecure classifications of the mother-infant relationship made at home at 12 months and in the Strange Situation. Classifications of avoidant relationships also displayed high concordance, but only 6 of the 15 dyads classified at home as ambivalent were classified in the same way in the Strange Situation. Mothers in secure relationships as assessed in the Strange Situation were rated as more sensitive at both 8 and 12 months than mothers in either avoidant or ambivalent relationships, whereas the sensitivity of mothers in these two nonsecure relationships did not differ significantly. Infants in secure relationships in the Strange Situation were characterized by more effective secure base behavior and more affective sharing and enjoyment of physical contact, and they were less fussy or difficult during the 12-month home observations.
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Affiliation(s)
- D R Pederson
- Department of Psychology, University of Western Ontario, London, Canada.
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