1
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Hubbard T, Liu X, Sulieman M, Drew P, Brown I, English R, Abbas I, Potiszil K, Barta M, Jackson N, King P. Evaluating a novel patient pathway to manage symptomatic breast referrals (the blue flag clinic): a longitudinal observational study. Ann R Coll Surg Engl 2023. [PMID: 37489547 DOI: 10.1308/rcsann.2023.0028] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION A novel referral pathway for exhibited breast symptom (EBS) referrals to manage increasing referrals of urgent suspected cancer (USC) was implemented in our trust. We report on the safety and effect on compliance with the 2-week-wait rule (2WW). METHODS A single-centre longitudinal observational study included all patients referred to a UK breast unit during 13 May 2019 to 27 March 2020 (period 1) and 8 February 2021 to 31 January 2022 (period 2). USC referrals were assessed in a one-stop clinic (red flag clinic [RFC]); EBS referrals were assessed in a new clinic in which clinical evaluation was performed and imaging occurred subsequently (blue flag clinic [BFC]). Patients were followed up to determine the symptomatic interval cancer rate. RESULTS There were 9,695 referrals; 1,655 referrals (17%) were assessed in the BFC after 63 exclusions. Some 95.9% of patients had a benign clinical examination (P1/P2), 80.1% had imaging (mammogram or ultrasound) and 4% had a tissue biopsy. In total, 16/1,655 (0.97%) BFC patients and 510/7,977 (8.2%) RFC patients were diagnosed with breast cancer (breast cancer detection rate). Some 1,631 patients (with 1,639 referrals) were discharged and followed up for a median of 17 months (interquartile range 12-32) with one subsequent cancer diagnosis (symptomatic interval cancer rate, 0.06%). Implementation of the BFC pathway increased 3-month average trust performance of USC referrals with 2WW standard from 8.5% to 98.7% (period 1) and from 30% to 66% (period 2). CONCLUSIONS The BFC pathway for EBS patients is safe and implementation led to improvement against the 2WW target for USC referrals, ensuring resources are prioritised to patients with the highest likelihood of breast cancer.
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Affiliation(s)
- Tje Hubbard
- Royal Cornwall Hospitals NHS Trust, UK
- University of Exeter, UK
| | - X Liu
- Royal Cornwall Hospitals NHS Trust, UK
| | | | - P Drew
- Royal Cornwall Hospitals NHS Trust, UK
| | - I Brown
- Royal Cornwall Hospitals NHS Trust, UK
| | - R English
- Royal Cornwall Hospitals NHS Trust, UK
| | - I Abbas
- Royal Cornwall Hospitals NHS Trust, UK
| | | | - M Barta
- Royal Cornwall Hospitals NHS Trust, UK
| | - N Jackson
- Royal Cornwall Hospitals NHS Trust, UK
| | - P King
- Royal Cornwall Hospitals NHS Trust, UK
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2
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Ngu NLY, Boyd DT, Morgan B, Surampudi A, Brown I, Bykersma C, Kennett G, Yesmin A, Peng Y, Bell S, Le S. Impact of increased alcohol consumption during the COVID-19-related lockdowns on admissions with liver disease, gastrointestinal bleeding and pancreatitis in Melbourne, Victoria. Intern Med J 2023; 53:830-834. [PMID: 37134235 DOI: 10.1111/imj.16042] [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: 07/17/2022] [Accepted: 02/26/2023] [Indexed: 05/05/2023]
Abstract
This audit collates data on alcohol-related gastrointestinal (GI) admissions at Monash Health, Victoria, during the prolonged, coronavirus disease 2019 (COVID-19)-related lockdown July to October 2020 compared with the same periods in 2019 and 2021. We found a 58% increase in admissions in 2020 and a 16% increase in 2021, which also increased disproportionately to overall health service emergency presentations. Self-reported alcohol consumption increased by 2.5-fold and was greatest in 2020. Clinical severity was unchanged and cirrhosis was the only factor associated with severe disease. This study suggests an association between the pandemic-related lockdown, alcohol consumption and alcohol-related GI hospitalisation. Our study provides support for resourcing and adapting alcohol and other drug services during and beyond the COVID-19 lockdown.
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Affiliation(s)
- Natalie L Y Ngu
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - David T Boyd
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Beth Morgan
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia
| | - Anusha Surampudi
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia
| | - Imogen Brown
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia
| | - Chloe Bykersma
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Grace Kennett
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Anika Yesmin
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Yuhong Peng
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sally Bell
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Suong Le
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia
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3
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Carnegie L, Hasan M, Mahmud R, Hoque MA, Debnath N, Uddin MH, Lewis NS, Brown I, Essen S, Giasuddin M, Pfeiffer DU, Samad MA, Biswas P, Raghwani J, Fournié G, Hill SC. H9N2 avian influenza virus dispersal along Bangladeshi poultry trading networks. Virus Evol 2023; 9:vead014. [PMID: 36968264 PMCID: PMC10032359 DOI: 10.1093/ve/vead014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023] Open
Abstract
Avian influenza virus subtype H9N2 is endemic in Bangladesh's poultry population. The subtype affects poultry production and poses a potential zoonotic risk. Insufficient understanding of how the poultry trading network shapes the dissemination of avian influenza viruses has hindered the design of targeted interventions to reduce their spread. Here, we use phylodynamic analyses of haemagglutinin sequences to investigate the spatial spread and dispersal patterns of H9N2 viruses in Bangladesh's poultry population, focusing on its two largest cities (Dhaka and Chattogram) and their poultry production and distribution networks. Our analyses suggest that H9N2 subtype avian influenza virus lineage movement occurs relatively less frequently between Bangladesh's two largest cities than within each city. H9N2 viruses detected in single markets are often more closely related to viruses from other markets in the same city than to each other, consistent with close epidemiological connectivity between markets. Our analyses also suggest that H9N2 viruses may spread more frequently between chickens of the three most commonly sold types (sunali-a cross-bred of Fayoumi hen and Rhode Island Red cock, deshi-local indigenous, and exotic broiler) in Dhaka than in Chattogram. Overall, this study improves our understanding of how Bangladesh's poultry trading system impacts avian influenza virus spread and should contribute to the design of tailored surveillance that accommodates local heterogeneity in virus dispersal patterns.
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Affiliation(s)
| | - M Hasan
- Animal Health Research Division, Bangladesh Livestock Research Institute (BLRI), Dhaka 1341, Bangladesh
| | - R Mahmud
- Department of Medicine & Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University (CVASU), Zakir Hossain Road, Khulshi, Chattogram 4202, Bangladesh
| | - M A Hoque
- Department of Medicine & Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University (CVASU), Zakir Hossain Road, Khulshi, Chattogram 4202, Bangladesh
| | - N Debnath
- Department of Medicine & Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University (CVASU), Zakir Hossain Road, Khulshi, Chattogram 4202, Bangladesh
| | - M H Uddin
- Department of Medicine & Surgery, Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University (CVASU), Zakir Hossain Road, Khulshi, Chattogram 4202, Bangladesh
| | - N S Lewis
- Department of Virology, Animal and Plant Health Agency (APHA), Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB, UK
| | - I Brown
- Department of Virology, Animal and Plant Health Agency (APHA), Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB, UK
| | - S Essen
- Department of Virology, Animal and Plant Health Agency (APHA), Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Md Giasuddin
- Animal Health Research Division, Bangladesh Livestock Research Institute (BLRI), Dhaka 1341, Bangladesh
| | - D U Pfeiffer
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield, Hertfordshire AL9 7TA, UK
- Department of Infectious Diseases and Public Health, City University of Hong Kong, 83 Tat Chee Ave, Kowloon Tong, Hong Kong SAR, PR China
| | - M A Samad
- Animal Health Research Division, Bangladesh Livestock Research Institute (BLRI), Dhaka 1341, Bangladesh
| | - P Biswas
- Department of Microbiology and Veterinary Public Health, Chattogram Veterinary and Animal Sciences University (CVASU), Zakir Hossain Road, Khulshi, Chattogram 4202, Bangladesh
| | - J Raghwani
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield, Hertfordshire AL9 7TA, UK
| | | | - S C Hill
- *Corresponding authors: E-mail: ;
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4
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Le T, Brown I, Taylor M, Deng J, Parthasarathy V, Bordeaux Z, Alphonse M, Alhariri J, Kang S, Semenov Y, Kwatra S. 195 Cutaneous toxicities associated with immune checkpoint inhibitors: An observational, pharmacovigilance study. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.202] [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: 10/17/2022]
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5
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Brown I, Rolnik DL, Fernando S, Menezes M, Ramkrishna J, da Silva Costa F, Meagher S. Ultrasound findings and detection of fetal abnormalities before 11 weeks of gestation. Prenat Diagn 2021; 41:1675-1684. [PMID: 34643279 DOI: 10.1002/pd.6055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/11/2021] [Accepted: 09/29/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the proportion of major fetal structural abnormalities that can be detected before 11 gestational weeks. METHODS We conducted a retrospective study of individual patient files at a tertiary provider of obstetric and gynecological ultrasound in Melbourne, Australia. All women who had a pre-cell-free DNA ultrasound with a crown-rump length of less than 45 mm and had one or more ultrasounds at a later gestation were included in the analysis. The primary outcome was the incidence of a fetal structural abnormality. RESULTS A total of 3333 cases were included in the final analysis. Overall, 316 fetuses (9.5%) had a structural abnormality detected at any point throughout gestation, of which 86 were major structural abnormalities (2.6%). Sixteen fetal abnormalities were detected before 11 weeks of gestation, including 15 major abnormalities (17.4% of the major anomalies). All major fetal abnormalities detected before 11 gestational weeks were confirmed at later ultrasound examinations or the pregnancy did not continue (in four cases due to termination of pregnancy and in one case spontaneous miscarriage before first trimester morphology ultrasound). CONCLUSION Detection of fetal abnormalities is possible before 11 weeks of gestation. Early suspicion is more likely in cases of major structural abnormalities.
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Affiliation(s)
- Imogen Brown
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.,Women's and Newborn, Monash Health, Melbourne, Victoria, Australia
| | - Daniel Lorber Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.,Women's and Newborn, Monash Health, Melbourne, Victoria, Australia.,Monash Ultrasound for Women, Melbourne, Victoria, Australia
| | - Shavi Fernando
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.,Women's and Newborn, Monash Health, Melbourne, Victoria, Australia
| | - Melody Menezes
- Monash Ultrasound for Women, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Fabricio da Silva Costa
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.,Maternal Fetal Medicine Unit, Gold Coast University Hospital and School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Simon Meagher
- Monash Ultrasound for Women, Melbourne, Victoria, Australia
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6
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Dash D, He B, Brown I, Zou J. 107 Real-Time Computer Vision TTE Analytics using Existing Ultrasound Workflows. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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7
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Roh Y, Sutaria N, Pritchard T, Williams K, Brown I, Choi J, Patel D, Alphonse M, Semenov Y, Archer N, Kwatra S. 655 Plasma cytokine profiles in atopic dermatitis: Association with itch intensity. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Richards C, Levic K, Fischer J, Eglinton T, Ramsay G, Kumarasinghe P, Raftopoulos S, Brown I. International validation of a risk prediction algorithm for patients with malignant colorectal polyps. Colorectal Dis 2020; 22:2105-2113. [PMID: 32931132 DOI: 10.1111/codi.15365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/31/2020] [Indexed: 02/08/2023]
Abstract
AIM The optimal management strategy for patients with endoscopically resected malignant colorectal polyps (MCP) has yet to be defined. The aim of this study was to validate a published decision-making tool, termed the Scottish Polyp Cancer Study (SPOCS) algorithm, on a large international population. METHODS The SPOCS algorithm allocates patients to risk groups based on just two variables: the polyp resection margin and the presence of lymphovascular invasion (LVI). The risk groups are termed low (clear margin, LVI absent), medium (clear margin, LVI present) or high (involved/non-assessable margin). The International Polyp Cancer Collaborative was formed to validate the algorithm on data from Australia, Denmark, UK and New Zealand. RESULTS In total, 1423 patients were included in the final dataset. 680/1423 (47.8%) underwent surgical resection and 108/680 (15.9%) had residual disease (luminal disease 8.8%, lymph node metastases 8.8%). The SPOCS algorithm classified 602 patients as low risk (in which 1.5% had residual disease), 198 patients as medium risk (in which 7.1% had residual disease) and 484 as high risk (in which 14.5% had residual disease) (P < 0.001, χ2 test). Receiver operating characteristic curve analysis demonstrated good accuracy of the algorithm in predicting residual disease (area under the curve 0.732, 95% CI 0.687-0.778, P < 0.001). When patients were designated as low risk, the negative predictive value was 98.5%. CONCLUSION The SPOCS algorithm can be used to predict the risk of residual disease in patients with endoscopically resected MCPs. Surgery can be safely avoided in patients who have a clear margin of excision and no evidence of LVI.
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Affiliation(s)
- C Richards
- Department of Surgery, Raigmore Hospital, Inverness, UK
| | - K Levic
- Gastrounit - Surgical Division, Copenhagen University Hospital, Copenhagen, Denmark
| | - J Fischer
- Department of General Surgery, North Shore Hospital, Auckland, New Zealand
| | - T Eglinton
- Department of Surgery, University of Otago, Dunedin, New Zealand
| | - G Ramsay
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, UK
| | - P Kumarasinghe
- Pathwest, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - S Raftopoulos
- Department of Gastroenterology, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - I Brown
- Envoi Specialist Pathologists, Brisbane, Queensland, Australia
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9
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Brown I, Fernando S, Menezes M, da Silva Costa F, Ramkrishna J, Meagher S, Rolnik DL. The importance of ultrasound preceding cell-free DNA screening for fetal chromosomal abnormalities. Prenat Diagn 2020; 40:1439-1446. [PMID: 32662897 DOI: 10.1002/pd.5788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aims to determine the incidence of ultrasound findings that may change clinical management on the day of blood-sampling for cell-free DNA (cfDNA) screening. METHODS A retrospective study was conducted at a tertiary provider of obstetric and gynecological ultrasound in Melbourne, Australia. Individual patient files were reviewed and results were collated for maternal characteristics, pre-cfDNA ultrasound reports, results and test characteristics of both cfDNA and diagnostic testing, and genetic counselling notes. The primary outcome was a potential change in patient management due to findings detected on the pre-cfDNA ultrasound. RESULTS Of 6250 pre-cfDNA ultrasounds, 6207 were included in analysis. Of these, 598 (9.6%) pregnancies had a finding on pre-cfDNA ultrasound that had the potential to change management. The reasons for this potential change in management were detection of gestational age below 10 weeks (245, 3.9%), miscarriage (175, 2.8%), demised twin (43, 0.7%), fetal edema (115, 1.9%) and major structural abnormalities (20, 0.3%). These findings were more common in patients of advanced maternal age and in spontaneous conceptions. CONCLUSIONS An ultrasound prior to cfDNA screening has the potential to change clinical management in almost one in 10 women. The proportion is higher in older age groups and lower in IVF-conceived pregnancies.
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Affiliation(s)
- Imogen Brown
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Shavi Fernando
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Melody Menezes
- Monash Ultrasound for Women, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Fabricio da Silva Costa
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.,Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Daniel L Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.,Monash Ultrasound for Women, Melbourne, Australia
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10
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Miller G, Durre H, Brown I. 22. Correlation between endoscopic and microscopic appearance in lymphocytic gastritis. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.023] [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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11
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Miller G, Brown I. 23. P53 IN BARRETT’S oesophagus with changes indefinite for dysplasia. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Horigan V, Gale P, Adkin A, Brown I, Clark J, Kelly L. A qualitative risk assessment of cleansing and disinfection requirements after an avian influenza outbreak in commercial poultry. Br Poult Sci 2019; 60:691-699. [PMID: 31474117 DOI: 10.1080/00071668.2019.1655707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
1. During an avian influenza (AI) outbreak in the United Kingdom, the joint aim of the poultry industry and the Government is to eliminate and prevent the spread of infection, through control measures based on the current European Union (EU) Council Directive (2005/94/EC). An essential part of these measures is the cleansing and disinfection (C&D) of infected premises.2. This risk assessment assessed the differences in re-infection in a repopulated flock if the EU Directive is interpreted to permit secondary C&D to be undertaken either with or without dismantling complex equipment. The assessment estimated the probability of virus survival on different types of equipment in a depopulated contaminated poultry house before and after preliminary and secondary C&D procedures. A risk matrix spreadsheet tool was used to carry out the assessment and concluded that, provided secondary C&D is carried out with due diligence (i.e. carried out to a defined code of practice as agreed by both industry and policymakers), the risk of re-infection from equipment is negligible, both with and without dismantling complex equipment in all farm types considered.3. By considering the equipment types individually, the assessment identified those areas of the house which may still contain viable virus post-preliminary C&D and on which attention should be focussed during secondary C&D. The generic risk pathway and matrix spreadsheet tool have the potential to be used for other pathogens and species, given appropriate data.
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Affiliation(s)
- V Horigan
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK
| | - P Gale
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK
| | - A Adkin
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK
| | - I Brown
- Department of Virology, Animal and Plant Health Agency, Surrey, UK
| | - J Clark
- Department of Virology, Animal and Plant Health Agency, Surrey, UK
| | - L Kelly
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Surrey, UK.,Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
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13
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Vidler J, Walker N, Clouston A, Brown I. 32. Myxoglobulosis of the appendix: A case series and literature review. Pathology 2019. [DOI: 10.1016/j.pathol.2018.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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14
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Abstract
Young adults with intellectual disability, 15 with IQs of 55 to 75 and 15 with IQs of 40 to 54, rated 12 cartoon riddles of six levels of difficulty. Mirth and comprehension were also scored. Analyses indicated that participants considered the jokes funny but there was a strong tendency to respond to the visual aspects of the jokes rather than to the auditory aspects.
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Affiliation(s)
- I Brown
- Centre for Health Promotion, University of Toronto, Banting Institute, Ontario, Canada
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15
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Lu C, Park S, Richner TJ, Derry A, Brown I, Hou C, Rao S, Kang J, Moritz CT, Fink Y, Anikeeva P. Flexible and stretchable nanowire-coated fibers for optoelectronic probing of spinal cord circuits. Sci Adv 2017; 3:e1600955. [PMID: 28435858 PMCID: PMC5371423 DOI: 10.1126/sciadv.1600955] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 02/10/2017] [Indexed: 05/24/2023]
Abstract
Studies of neural pathways that contribute to loss and recovery of function following paralyzing spinal cord injury require devices for modulating and recording electrophysiological activity in specific neurons. These devices must be sufficiently flexible to match the low elastic modulus of neural tissue and to withstand repeated strains experienced by the spinal cord during normal movement. We report flexible, stretchable probes consisting of thermally drawn polymer fibers coated with micrometer-thick conductive meshes of silver nanowires. These hybrid probes maintain low optical transmission losses in the visible range and impedance suitable for extracellular recording under strains exceeding those occurring in mammalian spinal cords. Evaluation in freely moving mice confirms the ability of these probes to record endogenous electrophysiological activity in the spinal cord. Simultaneous stimulation and recording is demonstrated in transgenic mice expressing channelrhodopsin 2, where optical excitation evokes electromyographic activity and hindlimb movement correlated to local field potentials measured in the spinal cord.
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Affiliation(s)
- Chi Lu
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Seongjun Park
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Thomas J. Richner
- Departments of Rehabilitation Medicine and Physiology and Biophysics, Center for Sensorimotor Neural Engineering, UW Institute for Neuroengineering, University of Washington, Seattle, WA 98195, USA
| | - Alexander Derry
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Imogen Brown
- Department of Materials, University of Oxford, Oxford OX1 3PH, UK
| | - Chong Hou
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Siyuan Rao
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Jeewoo Kang
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Chet T. Moritz
- Departments of Rehabilitation Medicine and Physiology and Biophysics, Center for Sensorimotor Neural Engineering, UW Institute for Neuroengineering, University of Washington, Seattle, WA 98195, USA
| | - Yoel Fink
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Advanced Functional Fabrics of America Inc., 500 Technology Square, NE47-525, Cambridge, MA 02139, USA
| | - Polina Anikeeva
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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16
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Brown I, Peyton S, Miller G. Ileal ‘carcinoid’ tumours: underappreciated, highly malignant and often multiple. Pathology 2017. [DOI: 10.1016/j.pathol.2016.09.015] [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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17
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Chambers C, Brown I, Miller G, Peyton S. Ileal ‘carcinoid’ tumours: underappreciated, highly malignant and often multiple. Pathology 2017. [DOI: 10.1016/j.pathol.2016.12.168] [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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18
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Affiliation(s)
- T. Y. K. Chan
- Department of Radiology, Broomfield Hospital, Chelmsford, U.K
| | - I. Brown
- Department of Radiology, Broomfield Hospital, Chelmsford, U.K
| | - N. Sathanathan
- Department of Radiology, Broomfield Hospital, Chelmsford, U.K
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Busby L, Brown I, Mwango G, Rawlings-Fein M, Sundaram P, Mutch C, Rehani B, Dillon W. RISE (Radiology International Student Education): creation and
utilization of virtual online classroom for global radiology
education. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.141] [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] Open
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Brown I, Busby L, Dowd C, Salamon N, Romero J, Vagal A, Mutch C, Cooke D, Hetts S, Dillon W, Rehani B. Making imaging around the world better: global survey of radiologists in
10 Countries. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.140] [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] Open
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Fuller C, Löndt B, Dimitrov KM, Lewis N, van Boheemen S, Fouchier R, Coven F, Goujgoulova G, Haddas R, Brown I. An Epizootiological Report of the Re-emergence and Spread of a Lineage of Virulent Newcastle Disease Virus into Eastern Europe. Transbound Emerg Dis 2015; 64:1001-1007. [PMID: 26671034 DOI: 10.1111/tbed.12455] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 05/16/2014] [Indexed: 11/28/2022]
Abstract
A number of contemporary outbreaks of Newcastle disease (ND) in Israel, Turkey, Georgia and Bulgaria have all been caused by a very similar viruses related to lineage 5a (genotype VIIa). Comparison with published ND virus (NDV) sequences suggests that this virus strain originated in South-East Asia and on introduction has circulated widely in backyard poultry in the Middle East and into Eastern Europe. An intracerebral pathogenicity index of 1.9 was obtained for a representative isolate from Bulgaria. In addition, the International Reference Laboratory for ND has characterized a molecular epidemiologically linked virus that has been reported to have caused disease in well-vaccinated broiler chickens in Pakistan. In the 1990s, another strain from the 5a lineage NDV was introduced into Europe and spread across the continent causing numerous outbreaks up to 1999. Despite improved controls, including good diagnostic tests and widespread vaccination, in commercial poultry, the novel circulating NDV strains described here have been established widely in the region and represent an increased risk for similar disease outbreak events to reoccur within the EU.
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Affiliation(s)
- C Fuller
- Animal and Plant Health Agency, Weybridge, UK
| | - B Löndt
- Animal and Plant Health Agency, Weybridge, UK
| | - K M Dimitrov
- National Diagnostic Research Veterinary Medical Institute, Sofia, Bulgaria
| | - N Lewis
- Department of Zoology, University of Cambridge, Cambridge, UK
| | | | - R Fouchier
- Viroscience lab, Erasmus MC, Rotterdam, The Netherlands
| | - F Coven
- Bornova Veterinary Control Institute, Izmir, Turkey
| | - G Goujgoulova
- National Diagnostic Research Veterinary Medical Institute, Sofia, Bulgaria
| | - R Haddas
- Division of Avian Diseases, Kimron Veterinary Institute, Beit-Dagan, Israel
| | - I Brown
- Animal and Plant Health Agency, Weybridge, UK
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Gómez LE, Arias B, Verdugo MÁ, Tassé MJ, Brown I. Operationalisation of quality of life for adults with severe disabilities. J Intellect Disabil Res 2015; 59:925-941. [PMID: 26018763 DOI: 10.1111/jir.12204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 09/02/2014] [Revised: 02/03/2015] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The operationalisation of quality of life for people with more severe disabilities has been acknowledged in the published research for more than two decades. This study aims to contribute to our knowledge and understanding of the quality of life of adults with severe disabilities by developing a set of quality of life indicators appropriate to this population using a Delphi method and the eight-domain conceptual model proposed by Schalock & Verdugo (2002). METHOD The participating panel in the Delphi method included 12 experts who evaluated each proposed item according to four criteria: suitability, importance, observability and sensitivity. Descriptive analyses were used to select the best items in each of the four rounds of this Delphi study, as well as examining the coefficients of concordance that were calculated for the final pool of items. RESULTS The four rounds of the Delphi study resulted in a final pool of 118 items (91 that were considered valid in the first round plus 27 items proposed, reformulated or discussed in the following rounds). Importance and sensitivity were the criteria that received the highest and lowest ratings, respectively, but also the ones that had the highest and lowest mean coefficients of concordance. Experts showed the strongest agreement for items related to material well-being, while the weakest was found for items related to personal development. CONCLUSIONS This study further contributes to our understanding of how to operationalise and measure quality of life in adults with severe disabilities. The item pool generated may prove helpful in the development of instruments for the measurement of quality of life-related outcomes in this population.
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Affiliation(s)
- L E Gómez
- Department of Psychology, University of Oviedo, Plaza Feijoo, s/n., Oviedo, 33003, Spain
| | - B Arias
- Department of Psychology, University of Valladolid, Paseo de Belén 1, Campus Miguel Delibes, Valladolid, 47011, Spain
| | - M Á Verdugo
- Institute on Community Integration (INICO), University of Salamanca, Avda. de la Merced, 109-131, Salamanca, 37005, Spain
| | - M J Tassé
- Nisonger Center, The Ohio State University, 1581 Dodd Dr, Columbus, OH, 43210, USA
| | - I Brown
- Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada
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Shepherd B, Abbas A, McParland P, Fitzsimmons S, Shambrook J, Peebles C, Brown I, Harden S. MRI in adult patients with aortic coarctation: diagnosis and follow-up. Clin Radiol 2015; 70:433-45. [PMID: 25559379 DOI: 10.1016/j.crad.2014.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 11/21/2014] [Accepted: 12/03/2014] [Indexed: 12/20/2022]
Abstract
Aortic coarctation is a disease that usually presents in infancy; however, a proportion of patients present for the first time in adulthood. These lesions generally require repair with either surgery or interventional techniques. The success of these techniques means that increasing numbers of patients are presenting for follow-up imaging in adulthood, whether their coarctation was initially repaired in infancy or as adults. Thus, the adult presenting to the radiologist for assessment of possible coarctation or follow-up of coarctation repair is not an uncommon scenario. In this review, we present details of the MRI protocols and MRI findings in these patients so that a confident and accurate assessment can be made.
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Affiliation(s)
- B Shepherd
- Department of Cardiothoracic Radiology, University Hospital Southampton NHS Trust, Southampton, UK
| | - A Abbas
- Department of Cardiothoracic Radiology, University Hospital Southampton NHS Trust, Southampton, UK
| | - P McParland
- Department of Radiology, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - S Fitzsimmons
- Department of Cardiology, University Hospital Southampton NHS Trust, Southampton, UK
| | - J Shambrook
- Department of Cardiothoracic Radiology, University Hospital Southampton NHS Trust, Southampton, UK
| | - C Peebles
- Department of Cardiothoracic Radiology, University Hospital Southampton NHS Trust, Southampton, UK
| | - I Brown
- Department of Cardiothoracic Radiology, University Hospital Southampton NHS Trust, Southampton, UK
| | - S Harden
- Department of Cardiothoracic Radiology, University Hospital Southampton NHS Trust, Southampton, UK.
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Adlhoch C, Gossner C, Koch G, Brown I, Bouwstra R, Verdonck F, Penttinen P, Harder T. Comparing introduction to Europe of highly pathogenic avian influenza viruses A(H5N8) in 2014 and A(H5N1) in 2005. Euro Surveill 2014; 19:20996. [DOI: 10.2807/1560-7917.es2014.19.50.20996] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since the beginning of November 2014, nine outbreaks of highly pathogenic avian influenza virus (HPAIV) A(H5N8) in poultry have been detected in four European countries. In this report, similarities and differences between the modes of introduction of HPAIV A(H5N1) and A(H5N8) into Europe are described. Experiences from outbreaks of A(H5N1) in Europe demonstrated that early detection to control HPAIV in poultry has proven pivotal to minimise the risk of zoonotic transmission and prevention of human cases.
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Affiliation(s)
- C Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - C Gossner
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- School of Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands
| | - G Koch
- Central Veterinary Institute of Wageningen University and Research Centre, Lelystad, The Netherlands
| | - I Brown
- Animal and Plant Health Agency-Weybridge, Addlestone, Surrey, United Kingdom
| | - R Bouwstra
- Central Veterinary Institute of Wageningen University and Research Centre, Lelystad, The Netherlands
| | - F Verdonck
- European Food Safety Authority (EFSA), Parma, Italy
| | - P Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - T Harder
- Friedrich-Loeffler-Institute (FLI), Federal Research Institute for Animal Health, Greifswald – Insel Riems, Germany
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Langford R, Brown I, Vickery J, Mitchell K, Pritchard C, Creanor S. Study protocol for a double blind, randomised, placebo-controlled trial of continuous subpectoral local anaesthetic infusion for pain and shoulder function following mastectomy: SUB-pectoral Local anaesthetic Infusion following MastEctomy (SUBLIME) study. BMJ Open 2014; 4:e006318. [PMID: 25270861 PMCID: PMC4179566 DOI: 10.1136/bmjopen-2014-006318] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Over 16 000 mastectomies are performed in England and Wales annually. Acute postoperative pain and nausea are common. The most frequently occurring long-term complications are chronic pain (up to 50%) and reduced shoulder function (reported at 35%). Regional techniques that improve acute postoperative pain relief may reduce the incidence of these complications. This study assesses the effectiveness of a 24-hour continuous local anaesthetic in the subpectoral plane in improving postoperative pain and quality of life in patients undergoing mastectomy. METHODS AND ANALYSIS This is a randomised, double blind, placebo-controlled, two-centre, parallel group trial in women undergoing mastectomy with or without axillary involvement. One hundred and sixty participants will be randomised in a 1:1 ratio to receive either 0.25% levobupivacaine or 0.9% saline by subpectoral infusion postoperatively for 24 h. All participants will be provided with an intravenous morphine patient-controlled analgesia (PCA) system. Participants will be followed-up for 24 h in hospital and at approximately 14 days and 6 months postoperatively. Joint primary outcome measures are total morphine consumption and total pain score (captured via patient-recorded visual analogue scale (VAS) 4 hourly) during the first 24 h postoperatively. Primary statistical analysis of total pain is based on the area under the curve of pain versus time graph. Secondary outcomes include PCA attempts in first 24 h; VAS pain scores and shoulder function by goniometry at 24 h, 14 days (approximately) and 6 months; Verbal Rating Scale pain scores in first 24 h; Brief Pain Inventory and Oxford Shoulder Score at 6 months; duration of hospital stay; incidence of postoperative nausea and vomiting; cost-effectiveness. ETHICS AND DISSEMINATION The study is approved by the South West England Research Ethics Committee (12/SW/0149). RESULTS will be published in a peer-reviewed journal and presented at local, national and international scientific meetings. TRIAL REGISTRATION ISRCTN46621916. EudraCT 2011-005775-16.
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Affiliation(s)
- R Langford
- Department of Anaesthesia, Royal Cornwall Hospital, Truro, UK
| | - I Brown
- Department of Surgery, Royal Cornwall Hospital, Truro, UK
| | - J Vickery
- Peninsula Clinical Trials Unit, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - K Mitchell
- Department of Anaesthesia, Royal Cornwall Hospital, Truro, UK
| | - C Pritchard
- NIHR Research Design Service (South West), Truro, UK
| | - S Creanor
- Centre for Biostatistics, Bioinformatics & Biomarkers, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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Brown I. Public Health Ethics. Occup Med (Lond) 2013. [DOI: 10.1093/occmed/kqt040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vincent A, Awada L, Brown I, Chen H, Claes F, Dauphin G, Donis R, Culhane M, Hamilton K, Lewis N, Mumford E, Nguyen T, Parchariyanon S, Pasick J, Pavade G, Pereda A, Peiris M, Saito T, Swenson S, Van Reeth K, Webby R, Wong F, Ciacci-Zanella J. Review of Influenza A Virus in Swine Worldwide: A Call for Increased Surveillance and Research. Zoonoses Public Health 2013; 61:4-17. [DOI: 10.1111/zph.12049] [Citation(s) in RCA: 206] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- A. Vincent
- Virus and Prion Research Unit; USDA-ARS NADC; Ames IA USA
| | - L. Awada
- World Organization for Animal Health (OIE); Paris France
| | - I. Brown
- Animal Health and Veterinary Laboratories Agency; Weybridge UK
| | - H. Chen
- Harbin Veterinary Research Institute; Harbin China
| | - F. Claes
- Food and Agriculture Organization of the United Nations (FAO); Rome Italy
| | - G. Dauphin
- Food and Agriculture Organization of the United Nations (FAO); Rome Italy
| | | | - M. Culhane
- University of Minnesota Veterinary Diagnostic Lab; St. Paul MN USA
| | - K. Hamilton
- World Organization for Animal Health (OIE); Paris France
| | - N. Lewis
- Department of Zoology; University of Cambridge; Cambridge UK
| | - E. Mumford
- World Health Organization (WHO); Geneva Switzerland
| | - T. Nguyen
- Department of Animal Health; National Centre for Veterinary Diagnostics; Hanoi Vietnam
| | | | - J. Pasick
- Canadian Food Inspection Agency; Winnepeg Canada
| | - G. Pavade
- World Organization for Animal Health (OIE); Paris France
| | - A. Pereda
- Instituto de Virología - INTA; Buenos Aires Argentina
| | - M. Peiris
- Hong Kong University; Hong Kong City Hong Kong
| | - T. Saito
- National Institute of Animal Health; Ibaraki Japan
| | | | | | - R. Webby
- St. Jude Children's Research Hospital; Memphis TN USA
| | - F. Wong
- Australian Animal Health Laboratory; CSIRO Livestock Industries; Geelong Vic. Australia
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Abstract
BACKGROUND The limited literature that exists about intellectual disabilities (ID) in Nigeria suggests that perceptions of ID may be shaped by social and cultural beliefs, and that socio-economic factors have prevented the development of policy and services. The present study sought to explore these suggestions in more detail by administering the Family Quality of Life Survey, an instrument used extensively throughout the world to collect comprehensive data on family quality of life. Its specific purposes were: (1) to describe the family quality of life of Nigerian families that have a son or daughter with ID and (2) to provide some initial ideas about the relationship between the families' life experiences and government policy and provision of services. METHOD Eighty main caregivers from 80 families that received services for their sons and daughters with ID from two community agencies volunteered to participate. Two trained assistants administered the Family Quality of Life Survey in accordance with the administration methods set out by the Survey authors. Quantitative data and explanatory comments were also collected. RESULTS Regarding the first study purpose, all nine life domains of the Family Quality of Life Survey were rated as important. The two main outcome measures, Attainment and Satisfaction, showed that three domains (Family relationships, Influence of values and Health) were sources of quality for families, but that three domains (Support from services, Support from others and Leisure) detracted from family quality of life. Measures of Opportunities, Initiative and Stability were somewhat related to one another, and with the two main outcome measures. Participants' explanatory comments suggested that the main caregivers perceived some domains to make their lives better and others did not. Regarding the second study purpose, it was only possible with the data available to make suggestions, but it seemed that there is a strong need for the development of government policy and services, and for education and training. CONCLUSIONS The results of this study suggest that some areas of family life contribute to quality of life for Nigerian families and other areas of life are problematic for families. Although this study is not representative of all Nigerian families that have a son or daughter with ID, it provides important initial information on the family experience with disability in Nigeria.
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Affiliation(s)
- P M Ajuwon
- Department of Counseling, Leadership, and Special Education, Missouri State University, Springfield, MO 65897, USA.
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Abstract
Historically, intervention programmes in intellectual and developmental disabilities have targeted the individual's special needs independent of the family and environmental context. This trend has been changing over the past two decades. This paper presents a literature review on changing trends in family support and the development of family quality of life (FQOL) and intellectual disability from a construct to a theory. The evolution of research in quality of life from the perspective of the individual with the disability to the family is described. A description of the development of FQOL measures is included, specifically an introduction and comparison of the two leading comprehensive initiatives on measuring FQOL - international FQOL project and the FQOL initiative of the Beach Center on Disability, in the USA. This paper provides the conceptual background and context to the other papers presented in this special issue, which focus on FQOL measurement in specific contexts.
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Affiliation(s)
- P S Samuel
- Faculty of Occupational Therapy, Department of Health Care Sciences, Wayne State University, Detroit, Michigan, USA.
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Svraka E, Loga S, Brown I. Family quality of life: adult school children with intellectual disabilities in Bosnia and Herzegovina. J Intellect Disabil Res 2011; 55:1115-1122. [PMID: 21668800 DOI: 10.1111/j.1365-2788.2011.01434.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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIMS This study endeavours to provide initial data on quality of life for families with adult children who have intellectual disabilities (ID) in the Canton of Sarajevo. METHODS The principal measure used was the Family Quality of life Survey 2006 - main caregivers of people with intellectual or developmental disabilities. The sample consisted of the main caregivers of 35 families with adult school children with ID who attended classes in a specially adapted programme in the Center of Vladimir Nazor and in the Vocational Secondary School in Sarajevo. Of the 35 participants, 21 were male and 14 female. Students with disabilities ranged from 19 to 32 years old (mean 21.45). RESULTS Consistent with previous research, the nine domains measured by the scale were all rated high for Importance. Opportunities were considered to be particularly low for Financial Well-Being and Support from Others. These domains were also rated lowest for Attainment and Satisfaction. Initiative was relatively high across all domains, and Stability (the degree to which things were seen as likely to improve or decline) varied slightly across domains but the means indicated that things are expected to stay almost the same or improve slightly. CONCLUSIONS This research provides initial data for family quality of life in Bosnia and Herzegovina. It also provides suggestions for improving quality of life for families that have one or more members with ID. The results should also contribute to rejecting stereotypes and promoting inclusion of children with ID as well as the rights of their families.
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Affiliation(s)
- E Svraka
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Cagran B, Schmidt M, Brown I. Assessment of the quality of life in families with children who have intellectual and developmental disabilities in Slovenia. J Intellect Disabil Res 2011; 55:1164-1175. [PMID: 21375642 DOI: 10.1111/j.1365-2788.2011.01400.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Research was conducted, within the framework of the International Family Quality of Life Project, on the quality of life of families with a member who has a disability. We concentrated on the nine specific domains that the family life measure used, and recorded data from five of its six measurement dimensions: Importance, Opportunities, Initiative, Attainment and Satisfaction. METHOD The sample consisted of 20 families from Slovenia with children who have intellectual or developmental disabilities. The data were collected using the Family Quality of Life Survey-2006. RESULTS Except for Community Interaction, the other domains (Health, Financial Well-Being, Family Relations, Support from Others, Support Services, Influence of Values, Careers, Leisure and Recreation) show statistically significant differences among the five dimensions measured. Importance was rated highest, and Attainment and Opportunities were rated lowest, while Initiative and Satisfaction were evaluated lower than Importance but higher than Attainment and Opportunities. Among the domains of family life, Family Relations was evaluated the highest from the perspective of all five dimensions. CONCLUSIONS The family members rated Importance high for all of the quality of family life domains, but it appears from the lower Opportunities scores that their opportunities are limited; this may result in fewer possibilities for attaining a better quality of life. The results of our research are useful to Slovene researchers who work in the areas of special pedagogy and rehabilitation, politicians, non-governmental organisations and social services. The quality of life of families with children with disabilities, their empowerment and their inclusion into community life should be significantly enhanced when consideration is given to all the family members' support and service needs.
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Affiliation(s)
- B Cagran
- Faculty of Education, University of Maribor, Maribor, Slovenia
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Bertelli M, Bianco A, Rossi M, Scuticchio D, Brown I. Relationship between individual quality of life and family quality of life for people with intellectual disability living in Italy. J Intellect Disabil Res 2011; 55:1136-1150. [PMID: 21883597 DOI: 10.1111/j.1365-2788.2011.01464.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is substantial literature investigating quality of life (QoL) of individuals with intellectual disability (ID). QoL of families of people with ID is emerging as an important field of research. Despite this, there is a lack of studies regarding their relationship. AIM The present paper aimed to study the relationship between QoL scores of individuals with ID and members of their families. METHODS Twenty-seven parents or relatives of 27 adults with ID were recruited by four different research centres across Tuscany (Italy) to be interviewed through the Italian adaptation of the Family Quality of Life Survey - 2006 (FQoLS-2006), a tool developed for use in a multiple-country study on family QoL. The FQoLS-2006 was translated and adapted to Italian through three revisions. The last was submitted to the authors of the original version, who also maintain an electronic data file and data archive for statistical evaluations in various countries. QoL of persons with ID was assessed through the administration of the Quality of Life - Instrument Package. QoL scores were analysed to describe population characteristics and to examine the relationships among measures of individual and family QoL using correlations (Pearson and Spearman). RESULTS Findings showed that family ratings of QoL were generally low. Families interviewed reported a low level of QoL in 'Support from Others' and 'Community Interaction', while 'Family Relationships' and 'Health of the Family' rated higher. For individual QoL, individuals had the lowest scores in the area of 'Spiritual being' and higher scores in the area of 'Physical being'. Correlations examining possible relationships among Importance, Satisfaction and Opportunities found some statistically significant correlation coefficients between some aspects of the three main areas of individual QoL (Being, Belonging and Becoming) and the nine family domains. Most of these correlations regarded family 'Financial Well-Being', 'Family Relationships, 'Support from Service' and 'Support from Others' areas. CONCLUSIONS The results of this study suggest that QoL is perceived somewhat differently by individuals with ID and by members of their families. This difference could negatively impact QoL of people with ID, if their views are not taken into account when planning for family support. The relationships between individual and family QoL appear to be quite complex, and such complexity needs to be clarified in future research.
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Affiliation(s)
- M Bertelli
- CREA (AMG Centre for Research and Evolution), Firenze, Italy.
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Brown I, Wahle KWJ, Cascio MG, Smoum-Jaouni R, Mechoulam R, Pertwee RG, Heys SD. Omega-3 N-acylethanolamines are endogenously synthesised from omega-3 fatty acids in different human prostate and breast cancer cell lines. Prostaglandins Leukot Essent Fatty Acids 2011; 85:305-10. [PMID: 21995886 DOI: 10.1016/j.plefa.2011.09.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 09/19/2011] [Accepted: 09/20/2011] [Indexed: 11/20/2022]
Abstract
Omega-3 (n-3) fatty acids inhibit breast and prostate cancer cell growth. We previously showed that N-acylethanolamine derivatives of n-3 (n-3-NAE) are endocannabinoids, which regulate cancer cell proliferation. These n-3-NAE are synthesised in certain cells/tissues, after supplementing with fatty acids, however, no one has assessed whether and to what extent this occurs in cancer cells. We determined levels of endogenous n-3-NAEs in hormone sensitive and insensitive prostate and breast cancer cells and subsequent effects on other endocannabinoids (anandamide and 2-arachidonoylglycerol), before and after supplementing with DHA and EPA fatty acids, using HPLC tandem mass spectrometry. This is the first study reporting that n-3-NAEs are synthesised from their parent n-3 fatty acids in cancer cells, regardless of tumour type, hormone status or the presence of fatty acid amide hydrolase. This could have important implications for the use of n-3 fatty acids as therapeutic agents in breast and prostate cancers expressing cannabinoid receptors.
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Affiliation(s)
- I Brown
- Translational Medical Sciences, Division of Applied Medicine, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
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Abstract
There is a high non-attendance and dropout attrition from weight management interventions for adults with obesity. Patient dissatisfaction with consultations involving decisions about interventions may be a factor. A systematic review was undertaken of qualitative studies reporting perceptions, experiences, contexts and influences for adults facing, or reflecting on, weight management. The aim was to synthesize a generic model of influences on decision-making about weight management for adult patients. Electronic database and hand searches identified 29 qualitative studies involving 1387 participants (mean age 45.3 years; mean BMI 37.1 kg m(-2) ; 79.9% women). Seven overarching themes were inductively derived from extracted data spanning: cultural identity; social structures such as gender; responses to obesity stigma; previous weight loss experiences; personal motivators and barriers; social support; and practical resources. A model is presented in the paper. Improving decisions about weight management requires attention to how diffuse cultural and psycho-social factors, such as obesity stigma, influence patient choices. Reflection on experiences of previous attempts at weight loss is also essential, as are practical resource factors - particularly for less affluent groups. Considering these factors along with more established theories of individual psychological motivations and barriers may help to improve initial participation and retention within interventions.
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Affiliation(s)
- I Brown
- The Clover Practice Sheffield and Centre for Health and Social Research, Sheffield Hallam University, Sheffield UK;Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield UK
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Thomson A, Palmer J, Brown I. Type of Breast Cancer Surgery and Postoperative Clinical Target Volume — Implications for Radiotherapy Planning. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.490] [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: 11/28/2022]
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Kastl L, Brown I, Schofield AC. miRNA-34a is associated with docetaxel resistance in human breast cancer cells. Breast Cancer Res Treat 2011; 131:445-54. [PMID: 21399894 DOI: 10.1007/s10549-011-1424-3] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 02/21/2011] [Indexed: 01/07/2023]
Abstract
Docetaxel is a chemotherapy drug to treat breast cancer, however as with many chemotherapeutic drugs resistance to docetaxel occurs in 50% of patients, and the underlying molecular mechanisms of drug resistance are not fully understood. Gene regulation through microRNAs (miRNA) has been shown to play an important role in cancer drug resistance. By directly targeting mRNA, miRNAs are able to inhibit genes that are necessary for signalling pathways or drug induced apoptosis rendering cells drug resistant. This study investigated the role of differential miRNA expression in two in vitro breast cancer cell line models (MCF-7, MDA-MB-231) of acquired docetaxel resistance. MiRNA microarray analysis identified 299 and 226 miRNAs altered in MCF-7 and MDA-MB-231 docetaxel-resistant cells, respectively. Docetaxel resistance was associated with increased expression of miR-34a and miR-141 and decreased expression of miR-7, miR-16, miR-30a, miR-125a-5p, miR-126. Computational target prediction revealed eight candidate genes targeted by these miRNAs. Quantitative PCR and western analysis confirmed decreased expression of two genes, BCL-2 and CCND1, in docetaxel-resistant cells, which are both targeted by miR-34a. Modulation of miR-34a expression was correlated with BCL-2 and cyclin D1 protein expression changes and a direct interaction of miR-34a with BCL-2 was shown by luciferase assay. Inhibition of miR-34a enhanced response to docetaxel in MCF-7 docetaxel-resistant cells, whereas overexpression of miR-34a conferred resistance in MCF-7 docetaxel-sensitive cells. This study is the first to show differences in miRNA expression, in particular, increased expression of miR-34a in an acquired model of docetaxel resistance in breast cancer. This serves as a mechanism of acquired docetaxel resistance in these cells, possibly through direct interactions with BCL-2 and CCND1, therefore presenting a potential therapeutic target for the treatment of docetaxel-resistant breast cancer.
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Affiliation(s)
- L Kastl
- Division of Applied Medicine, School of Medicine and Dentistry, College of Life Sciences and Medicine, University of Aberdeen, Medical School, Foresterhill, Aberdeen AB25 2ZD, UK.
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Wermeille J, Bennie M, Brown I. Integrating the community pharmacist into the diabetes team: evaluation of a new care model for patients with Type 2 diabetes mellitus. International Journal of Pharmacy Practice 2011. [DOI: 10.1111/j.2042-7174.2001.tb01120.x] [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: 11/25/2022]
Abstract
Abstract
Focal points
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Affiliation(s)
- J Wermeille
- Lothian Pharmacy Practice Unit and Department of Pharmaceutical Sciences, University of Strathclyde, Glasgow
| | - M Bennie
- Lothian Pharmacy Practice Unit and Department of Pharmaceutical Sciences, University of Strathclyde, Glasgow
| | - I Brown
- Lothian Pharmacy Practice Unit and Department of Pharmaceutical Sciences, University of Strathclyde, Glasgow
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Abstract
ABSTRACTThe photoluminescence (PL) and time resolved spectra of Nd- and Yb-implanted CdS samples are studied under pulsed and CW excitations using Ar+ ion laser for different excitation intensities and temperature (9 - 300 K). The samples were annealed under different conditions using the thermal-pulse method. For CdS:Nd, the PL spectra was recorded in the range 890-930 nm (transitions 4F3/2→4I9/2) and for CdS:Yb it was recorded in the range 985 - 1010 nm (transitions 2F5/2 →2F7/2). The Rise time and decay time were studied for both CdS:Nd and CdS:Yb at different emission lines as a function of temperature and excitation power.
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Khor TS, Brown I, Kattampallil J, Yusoff I, Kumarasinghe MP. Duodenal adenocarcinoma arising from a pyloric gland adenoma with a brief review of the literature. BMJ Case Rep 2010; 2010:2010/dec21_1/bcr1020103385. [PMID: 22802482 DOI: 10.1136/bcr.10.2010.3385] [Citation(s) in RCA: 5] [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: 11/03/2022] Open
Abstract
Pyloric gland-type adenoma of the duodenum with documented malignant progression is rare. A case is presented of an 87-year-old man with bloating and nausea, who on investigation was found to have a polyp on the anteroinferior wall of the duodenal cap. Histologic examination of the polyp showed features of a pyloric gland adenoma (PGA) demonstrating the full spectrum of progression from low- to high-grade dysplasia and finally invasive adenocarcinoma. The carcinoma showed gastric-type differentiation highlighted by its mucin immunohistochemistry profile and was of advanced stage with lymph node metastasis. The literature on PGAs and the little documentations on progression to carcinoma in duodenal PGAs are reviewed.
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Affiliation(s)
- T S Khor
- Department of Histopathology, PathWest, Fremantle Hospital, Fremantle, Australia.
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Abstract
In this study, the Whole Human Genome 44K DNA microarray assay was used for the first time to obtain gene expression profiles in human peripheral blood lymphocytes 2 h after exposure (in suspension) to 6.78 MeV mean energy alpha particles from extracellular (211)At. Lymphocytes were exposed to fluences of 0.3-9.6 x 10(6) alpha particles/cm(2) [corresponding to mean absorbed alpha-particle doses (D(alpha)) of 0.05-1.60 Gy] over 30 min. Significantly modulated expression was identified in 338 early-response genes. Up-regulated expression was evident in 183 early-response genes, while the remaining 155 were down-regulated. Over half of the up-regulated genes and 40% of the down-regulated genes had a known biological process related primarily to cell growth and maintenance and cell communication. Genes associated with cell death were found only in the up-regulated genes and those with development only in the down-regulated genes. Eight selected early-response genes that displayed a sustained up- or down-regulation (CD36, HSPA2, MS4A6A, NFIL3, IL1F9, IRX5, RASL11B and SULT1B1) were further validated in alpha-particle-irradiated lymphocytes of two human individuals using the TaqMan(R) RT-qPCR technique. The results confirmed the observed microarray gene expression patterns. The expression modulation profiles of IL1F9, IRX5, RASL11B and SULT1B1 genes demonstrated similar trends in the two individuals studied. However, no significant linear correlation between increasing relative gene expression and the alpha-particle dose was evident. The results suggest the possibility that a panel of genes that react to alpha-particle radiation does exist and that they merit further study in a greater number of individuals to determine their possible value regarding alpha-particle biodosimetry.
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Affiliation(s)
- A Turtoi
- Forschungszentrum Jülich, Department of Safety and Radiation Protection, Germany.
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Turtoi A, Brown I, Oskamp D, Schneeweiss FHA. Early gene expression in human lymphocytes aftergamma-irradiation–a genetic pattern with potential for biodosimetry. Int J Radiat Biol 2009; 84:375-87. [PMID: 18464067 DOI: 10.1080/09553000802029886] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [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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Werner S, Edwards M, Baum N, Brown I, Brown RI, Isaacs BJ. Family quality of life among families with a member who has an intellectual disability: an exploratory examination of key domains and dimensions of the revised FQOL Survey. J Intellect Disabil Res 2009; 53:501-511. [PMID: 19302473 DOI: 10.1111/j.1365-2788.2009.01164.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The Family Quality of Life Survey (FQOLS-2006) was developed as the result of increased interest in family quality of life (FQOL) among families with a member who has an intellectual disability (ID). The instrument includes nine life domains and six dimensions reflecting the main areas and characteristics of FQOL. The aim of the current study was to provide a descriptive analysis of the domains and dimensions of the survey and to explore their relationship to one another and to global satisfaction. METHOD A convenience sample of 35 participants with a family member who had ID completed the FQOLS-2006 in a large urban centre in Canada. The data were analysed using descriptive analyses. RESULTS The findings showed that although participants differentiated between different domains and dimensions, as reflected in their variability, stability was also found. For example, support from others was rated lowest across most dimensions, while family relationships and health of the family were generally rated higher. CONCLUSIONS The findings strengthen the importance of examining both the overall perception of FQOL as well as the perceptions in individual life domains. Moreover, they highlight the need to examine each life domain according to its various dimensions. In sum, the results call for further examination of the FQOLS-2006 as a useful tool for assessing FQOL and for implementing services based on it.
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Affiliation(s)
- S Werner
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
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Kastl L, Brown I, Lamers E, Schofield A. Altered epigenetic events in docetaxel-resistant human breast cancer cells. Eur J Surg Oncol 2008. [DOI: 10.1016/j.ejso.2008.06.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Keohane PP, Attrill H, Jones BJ, Brown I, Frost P, Silk DB. The roles of lactose and Clostridium difficile in the pathogenesis of enteral feeding associated diarrhoea. Clin Nutr 2008; 1:259-64. [PMID: 16829389 DOI: 10.1016/0261-5614(83)90003-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated the influence of the disaccharide lactose on the incidence of clinically significant enteral feeding associated diarrhoea. In this double blind study both groups each of 25 patients were randomised to receive either a lactose containing diet Clinifeed 400 in 25 patients or a lactose free diet Ensure in 25 patients. Diarrhoea occurred with equal frequency in both treatment groups, even in those patients with symptomatic and biochemical evidence of impaired lactose handling. Although the onset of diarrhoea was significantly associated with antibiotic administration (p<0.01), Cl. difficile was not isolated from the stools of any patient with diarrhoea.
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Affiliation(s)
- P P Keohane
- Departments of Gastroenterology and Clinical Nutrition and Chemical Pathology, Central Middlesex Hospital, London NW10, U.K
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Abstract
BACKGROUND Obesity is associated with increased risks of Barrett's oesophagus and oesophageal adenocarcinoma. Alterations in serum leptin and adiponectin, obesity-related cytokines, have been linked with several cancers and have been postulated as potential mediators of obesity-related carcinogenesis; however, the relationship with Barrett's oesophagus remains unexplored. METHODS Serum leptin and adiponectin concentrations were measured on two subsets of participants within a case-control study conducted in Brisbane, Australia. Cases were people aged 18-79 years with histologically confirmed Barrett's oesophagus newly diagnosed between 2003 and 2006. Population controls, frequency matched by age and sex to cases, were randomly selected from the electoral roll. Phenotype and medical history data were collected through structured, self-completed questionnaires. Odds ratios (OR) and 95% CI were calculated using multivariable logistic regression analysis. RESULTS In the pilot analysis (51 cases, 67 controls) risks of Barrett's oesophagus were highest among those in the highest quartile of serum leptin (OR 4.6, 95% CI 0.6 to 33.4). No association was seen with adiponectin. In the leptin validation study (306 cases, 309 controls), there was a significant threefold increased risk of Barrett's oesophagus among men in the highest quartile of serum leptin (OR 3.3, 95% CI 1.7 to 6.6) and this persisted after further adjustment for symptoms of gastro-oesophageal reflux (OR 2.4, 95% CI 1.1 to 5.2). In contrast, the risk of Barrett's oesophagus among women decreased with increasing serum leptin concentrations. CONCLUSIONS High serum leptin is associated with an increased risk of Barrett's oesophagus among men but not women. This association is not explained simply by higher body mass or gastro-oesophageal reflux among cases. The mechanism remains to be determined.
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Affiliation(s)
- B J Kendall
- Division of Population Studies and Human Genetics, Queensland Institute of Medical Research, Brisbane, Australia
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Nunn A, Brown I. Practical issues affecting the measurement and analysis of physiological data recorded remotely from individuals with spinal cord injury (SCI) during normal daily activities. Conf Proc IEEE Eng Med Biol Soc 2007; 2006:6025-8. [PMID: 17946737 DOI: 10.1109/iembs.2006.260404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Monitoring a range of physiological parameters in SCI patients during extended periods of daily activity and during therapy in rehabilitation raises a no of practical issues. A totally portable system with sensors and data logger can provide a clinically useful monitoring system for SCI to study the behaviour of physiological parameters during rehabilitation allows it to be prescribed and optimised to match the individual patient's needs. Issues affecting our study will be illustrated by looking at results in the most compromised tetraplegic group.
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Affiliation(s)
- A Nunn
- Austin Health, Victorian Spinal Cord Service, Heidelberg, Vic., Australia
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Sangrithi-Wallace J, Brown I, Heys S, Schofield A. O-50 Role of Caveolin-1 expression in docetaxel resistance in breast cancer cells. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71740-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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50
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Brown I, Heys S, Schofield A. 512 POSTER Molecular profile of acquired docetaxel resistance in breast cancer cells. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70451-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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