1
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Newham E, Gill PG, Benton MJ, Brewer P, Gostling NJ, Haberthür D, Jernvall J, Kankanpää T, Kallonen A, Navarro C, Pacureanu A, Richards K, Robson Brown K, Schneider P, Suhonen H, Tafforeau P, Williams K, Zeller-Plumhoff B, Corfe IJ. Reply to: Revisiting life history and morphological proxies for early mammaliaform metabolic rates. Nat Commun 2022; 13:5564. [PMID: 36151135 PMCID: PMC9508248 DOI: 10.1038/s41467-022-32716-z] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 08/12/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Elis Newham
- School of Engineering and Materials Science, Queen Mary University of London, London, UK.
| | - Pamela G Gill
- School of Earth Sciences, University of Bristol, Bristol, UK. .,Earth Sciences Department, Natural History Museum, London, UK.
| | | | - Philippa Brewer
- Earth Sciences Department, Natural History Museum, London, UK
| | - Neil J Gostling
- School of Biological Sciences, University of Southampton, Southampton, UK
| | | | - Jukka Jernvall
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Tuomas Kankanpää
- Ecology and Genetics Research Unit, University of Oulu, Oulu, Finland
| | - Aki Kallonen
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Charles Navarro
- School of Earth Sciences, University of Bristol, Bristol, UK
| | | | | | - Kate Robson Brown
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK.,Department of Engineering Mathematics, University of Bristol, Bristol, UK
| | - Philipp Schneider
- Bioengineering Science Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,High-Performance Vision Systems, Center for Vision, Automation & Control, AIT Austrian Institute of Technology, Vienna, Austria
| | - Heikki Suhonen
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Paul Tafforeau
- European Synchrotron Radiation Facility, Grenoble, France
| | - Katherine Williams
- Bioengineering Science Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,School of Biological Sciences, University of Portsmouth, Portsmouth, UK
| | - Berit Zeller-Plumhoff
- Institute of Metallic Biomaterials, Helmholtz-Zentrum hereon GmbH, Geesthacht, Germany
| | - Ian J Corfe
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland. .,Geological Survey of Finland, Espoo, Finland.
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2
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Richards K. Circles of Support and Accountability: The Role of Social Relations in Core Member Desistance. Int J Offender Ther Comp Criminol 2022; 66:1071-1092. [PMID: 33040643 DOI: 10.1177/0306624x20964094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Circles of Support and Accountability (CoSA) appear to reduce the sexual recidivism of core members (i.e., individuals convicted of sexual offending). It remains unclear, however, how they do so. While much previous scholarship has hypothesized that the relations between core members and CoSA volunteers promote desistance from sexual offending, there has been no theoretically-informed research that specifically interrogates these relations. This article begins to address this gap by examining the relations formed in and by CoSA through the lens of Donati's theory of relational reflexivity. Drawing on semi-structured interviews with 62 CoSA participants across six CoSA programs located in the USA and Canada, it proffers a new theorization of the role of social relations in core members' desistance. Findings from the study will enable CoSA practitioners around the globe to explicate and deepen their practice around more rigorous theoretical precepts.
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Affiliation(s)
- Kelly Richards
- Queensland University of Technology, Brisbane, QLD, Australia
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3
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Richards K, Biron D. Framing Perpetrators of Sexual Violence Who Participate in Circles of Support and Accountability (CoSA): An Analysis of Global Print Media Reporting. Int J Offender Ther Comp Criminol 2022:306624X221113536. [PMID: 35852435 DOI: 10.1177/0306624x221113536] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Circles of Support and Accountability (CoSA) are now part of the criminal justice landscape in various parts of the world. While CoSA have received considerable media attention, it is not yet known how they are portrayed in the media. This study addressed this gap by analyzing newspaper coverage of CoSA from across the English-speaking world. Overall, it identified that representations of those convicted of sexual violence in print media accounts of CoSA differ substantially from those identified in previous scholarship. We argue therefore that the nature of CoSA as an intervention may allow for more sympathetic and humanistic representation. The findings provide a platform from which the international CoSA community can develop strategic approaches to interacting with the media.
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Affiliation(s)
- Kelly Richards
- Queensland University of Technology-Gardens Point Campus, Brisbane, Australia
| | - Dean Biron
- Queensland University of Technology-Gardens Point Campus, Brisbane, Australia
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4
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Saps M, Nurko S, Benninga MA, Di Lorenzo C, Garza JM, Thapar N, Richards K, Lee JJ, Altepeter T. A Collaborative Effort to Advance Drug Development in Pediatric Constipation and Irritable Bowel Syndrome. J Pediatr Gastroenterol Nutr 2021; 73:145-149. [PMID: 34091541 DOI: 10.1097/mpg.0000000000003191] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
ABSTRACT Pediatric functional gastrointestinal disorders including irritable bowel syndrome with constipation and functional constipation are common conditions in childhood, but no drugs are U.S. Food and Drug Administration (FDA) approved for chronic use in pediatric patients with these disorders. Despite efforts to better standardize the diagnosis of these conditions in children (including recent modifications to the Rome criteria), conducting pediatric clinical trials to support drug approval remains a challenge. In March 2018, FDA, in collaboration with the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, American Gastroenterological Association, and American College of Gastroenterology, convened a public workshop to discuss the challenges and opportunities in conducting pediatric clinical trials in functional gastrointestinal conditions. The workshop assembled gastroenterologists, psychologists, patients, patient advocates, regulators, and industry representatives to discuss trial design and conduct including alternative designs, eligibility criteria, instruments for patient- and observer-reported outcomes, and optimal primary endpoints to support regulatory approval. This report summarizes the workshop, key challenges and knowledge gaps identified, and outlines areas where further research efforts are needed to overcome barriers to developing drugs to treat these conditions.
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Affiliation(s)
- Miguel Saps
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Holtz Children's Hospital, Miami, FL; Miller School of Medicine, University of Miami, Miami, FL
| | - Samuel Nurko
- Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - M A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Carlo Di Lorenzo
- Division of Pediatric Gastroenterology, Hepatology and Nutrition at Nationwide Children's Hospital, Nationwide Children's Hospital, Columbus, OH
| | - Jose M Garza
- GI Care for Kids, Atlanta, GA; Neurogastroenterology and Motility Program, Children's Healthcare of Atlanta, Atlanta, GA
- Neurogastroenterology and Motility Unit, Department of Paediatric Gastroenterology, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom; UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Nikhil Thapar
- Neurogastroenterology and Motility Unit, Department of Paediatric Gastroenterology, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom; UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Paediatric Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia
| | - Kelly Richards
- Division of Regulatory Operations for Immunology and Inflammation, Center for Drug Evaluation and Research, U.S. Food and Drug Administration
| | - Jessica J Lee
- Division of Gastroenterology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
| | - Tara Altepeter
- Division of Gastroenterology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
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5
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Abstract
Policies designed to prevent sexual (re)offending are often proposed on behalf of survivors of sexual violence. However, no research has examined survivors' beliefs about the causes of sexual offending. This is a critical gap, because how individuals understand the causes of sexual offending has long been thought to inform their support for particular policy responses. This article presents findings from the first study to specifically examine survivors' views about the causes of sexual offending, based on interviews with 33 survivors from Australia. It demonstrates that survivors' beliefs are highly complex and multifaceted, and destabilizes the uniform survivor of governmental imagination.
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Affiliation(s)
- Kelly Richards
- Queensland University of Technology, Brisbane, Australia
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6
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Richards K, Geoghegan S, Butler M, Shafi N, Watson D. WS14.2 Potential factors influencing reduced requirements for intravenous antibiotics during the COVID-19 pandemic. J Cyst Fibros 2021. [PMCID: PMC8192164 DOI: 10.1016/s1569-1993(21)00994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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7
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Nolan S, Thorn CE, Ashekuzzaman SM, Kavanagh I, Nag R, Bolton D, Cummins E, O'Flaherty V, Abram F, Richards K, Fenton O. Landspreading with co-digested cattle slurry, with or without pasteurisation, as a mitigation strategy against pathogen, nutrient and metal contamination associated with untreated slurry. Sci Total Environ 2020; 744:140841. [PMID: 32755776 DOI: 10.1016/j.scitotenv.2020.140841] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 06/11/2023]
Abstract
North Atlantic European grassland systems have a low nutrient use efficiency and high rainfall. This grassland is typically amended with unprocessed slurry, which counteracts soil organic matter depletion and provides essential plant micronutrients but can be mobilised during rainfall events thereby contributing to pathogen, nutrient and metal incidental losses. Co-digesting slurry with waste from food processing mitigates agriculture-associated environmental impacts but may alter microbial, nutrient and metal profiles and their transmission to watercourses, and/or soil persistence, grass yield and uptake. The impact of EU and alternative pasteurisation regimes on transmission potential of these various pollutants is not clearly understood, particularly in pasture-based agricultural systems. This study utilized simulated rainfall (Amsterdam drip-type) at a high intensity indicative of a worst-case scenario of ~11 mm hr-1 applied to plots 1, 2, 15 and 30 days after grassland application of slurry, unpasteurised digestate, pasteurised digestate (two conditions) and untreated controls. Runoff and soil samples were collected and analysed for a suite of potential pollutants including bacteria, nutrients and metals following rainfall simulation. Grass samples were collected for three months following application to assess yield as well as nutrient and metal uptake. For each environmental parameter tested: microbial, nutrient and metal runoff losses; accumulation in soil and uptake in grass, digestate from anaerobic co-digestion of slurry with food processing waste resulted in lower pollution potential than traditional landspreading of slurry without treatment. Reduced microbial runoff from digestate was the most prominent advantage of digestate application. Pasteurisation of the digestate further augmented those environmental benefits, without impacting grass output. Anaerobic co-digestion of slurry is therefore a multi-beneficial circular approach to reducing impacts of livestock production on the environment.
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Affiliation(s)
- S Nolan
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland Galway, University Road, Co. Galway, Ireland; Teagasc, Environmental Research Centre, Johnstown Castle, Co. Wexford, Ireland
| | - C E Thorn
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland Galway, University Road, Co. Galway, Ireland
| | - S M Ashekuzzaman
- Teagasc, Environmental Research Centre, Johnstown Castle, Co. Wexford, Ireland
| | - I Kavanagh
- Teagasc, Environmental Research Centre, Johnstown Castle, Co. Wexford, Ireland
| | - R Nag
- School of Biosystems and Food Engineering, UCD, Dublin, Ireland
| | - D Bolton
- Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland
| | - E Cummins
- School of Biosystems and Food Engineering, UCD, Dublin, Ireland
| | - V O'Flaherty
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland Galway, University Road, Co. Galway, Ireland
| | - F Abram
- Microbiology, School of Natural Sciences and Ryan Institute, National University of Ireland Galway, University Road, Co. Galway, Ireland
| | - K Richards
- Teagasc, Environmental Research Centre, Johnstown Castle, Co. Wexford, Ireland
| | - O Fenton
- Teagasc, Environmental Research Centre, Johnstown Castle, Co. Wexford, Ireland.
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8
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Newham E, Gill PG, Brewer P, Benton MJ, Fernandez V, Gostling NJ, Haberthür D, Jernvall J, Kankaanpää T, Kallonen A, Navarro C, Pacureanu A, Richards K, Brown KR, Schneider P, Suhonen H, Tafforeau P, Williams KA, Zeller-Plumhoff B, Corfe IJ. Reptile-like physiology in Early Jurassic stem-mammals. Nat Commun 2020; 11:5121. [PMID: 33046697 PMCID: PMC7550344 DOI: 10.1038/s41467-020-18898-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 09/11/2020] [Indexed: 12/12/2022] Open
Abstract
Despite considerable advances in knowledge of the anatomy, ecology and evolution of early mammals, far less is known about their physiology. Evidence is contradictory concerning the timing and fossil groups in which mammalian endothermy arose. To determine the state of metabolic evolution in two of the earliest stem-mammals, the Early Jurassic Morganucodon and Kuehneotherium, we use separate proxies for basal and maximum metabolic rate. Here we report, using synchrotron X-ray tomographic imaging of incremental tooth cementum, that they had maximum lifespans considerably longer than comparably sized living mammals, but similar to those of reptiles, and so they likely had reptilian-level basal metabolic rates. Measurements of femoral nutrient foramina show Morganucodon had blood flow rates intermediate between living mammals and reptiles, suggesting maximum metabolic rates increased evolutionarily before basal metabolic rates. Stem mammals lacked the elevated endothermic metabolism of living mammals, highlighting the mosaic nature of mammalian physiological evolution.
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Affiliation(s)
- Elis Newham
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK. .,Bioengineering Science Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.
| | - Pamela G Gill
- School of Earth Sciences, University of Bristol, Bristol, UK. .,Earth Sciences Department, The Natural History Museum, London, UK.
| | - Philippa Brewer
- Earth Sciences Department, The Natural History Museum, London, UK
| | | | - Vincent Fernandez
- Core Research Laboratories, The Natural History Museum, London, UK.,ESRF, The European Synchrotron, Grenoble, France
| | - Neil J Gostling
- School of Biological Sciences, University of Southampton, Southampton, UK
| | - David Haberthür
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland.,Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Jukka Jernvall
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Tuomas Kankaanpää
- Department of Agricultural Sciences, University of Helsinki, Helsinki, Finland
| | - Aki Kallonen
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Charles Navarro
- School of Earth Sciences, University of Bristol, Bristol, UK
| | | | | | - Kate Robson Brown
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Philipp Schneider
- Bioengineering Science Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Heikki Suhonen
- Department of Physics, University of Helsinki, Helsinki, Finland
| | | | - Katherine A Williams
- Bioengineering Science Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Berit Zeller-Plumhoff
- Institute for Materials Research, Division of Metallic Biomaterials, Helmholtz Zentrum Geesthacht, Geesthacht, Germany
| | - Ian J Corfe
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland. .,Geomaterials and Applied Mineralogy group, Geological Survey of Finland, Espoo, Finland.
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9
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Kumar R, Feltch C, Richards K, Morrison J, Rangel A, Janney R, Shayesteh S, Allen R, Banerjee N. 0438 Automatic Nighttime Agitation and Sleep Disruption Detection Using a Wearable Ankle Device and Machine Learning. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Nighttime agitation behavior such as wandering and restlessness during awake and sleep in people with Alzheimer’s disease (AD) is expensive to manage and adversely affects sleep. Nighttime agitation is mostly noted by subjective caregiver reports. An automated process for this assessment would improve clinical management. Here we report on the RestEaZeTM system that uses an ankle band and machine learning to automatically classify sleep status and nighttime agitation behaviors in older adults with AD.
Methods
We collected data on 7 adults (mean: 81 years, SD: 10.6) with AD. They wore the RestEaZeTM ankle band with a 3-axis accelerometer, a 3-axis gyroscope, and three textile capacitive sensors. A trained Research Assistant (RA) continuously observed for wandering, restlessness, wake, and sleep between 5pm and 7am using the Cohen Mansfield Agitation Inventory (CMAI). We merged, and band-pass filtered the data and divided it into 10-second non-overlapping windows. CMAI labels and time-series features (scaled using StandardScaler) extracted from the RestEaZeTM data were used to train a Random Forest binary classifier. The significant features were extracted based on the impact on the p-value for the classifier. We used the Synthetic Minority Oversampling Technique (SMOTE) to balance the dataset and performed 5-fold cross-validation with a 67-33 train-test split.
Results
We report the sensitivity, specificity, accuracy, and Area-under-the Curve (AUC) for the ROC curve for the classifiers: (1) Sleep/Awake: sensitivity=0.95, specificity=0.87, accuracy=0.92, AUC=0.97; (2) Wandering/Non-Wandering: sensitivity=0.85, specificity=0.99, accuracy=0.98, AUC=0.99; and (3) Restless/Non-Restless: sensitivity=0.84, specificity=0.84, accuracy=0.84, AUC=0.92. The significant features were related to the intensity of movements.
Conclusion
Our preliminary results show the feasibility of using RestEaZeTM for quantitatively measuring nighttime agitation. These can provide clinically useful objective measures of agitation that can be automatically transmitted to clinical or research records with minimal staff time requirements.
Support
The authors acknowledge the funding support from the National Institute on Aging under award R01AG051588 and Arbor Pharmaceuticals for support for Horizant and the matching placebo.
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Affiliation(s)
- R Kumar
- University of Maryland, Baltimore County, Catonsville, MD
| | - C Feltch
- Tanzen Medical, Inc., Baltimore, MD
| | | | | | - A Rangel
- University of Texas, Austin, Austin, TX
| | - R Janney
- University of Texas, Austin, Austin, TX
| | | | - R Allen
- Johns Hopkins University, Baltimore, MD
| | - N Banerjee
- University of Maryland, Baltimore County, Catonsville, MD
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10
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Thomson F, Richards K. 30 The Role of A Virtual Clinic in Reducing Waiting Times for Out-Patient Follow-Up. Age Ageing 2020. [DOI: 10.1093/ageing/afz183.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Topic
Hospital admissions for older people are increasing with subsequent pressure on out-patient (OP) clinics. By early 2018, 350 patients were waiting up to 6 months for follow-up, with limited capacity in existing clinics. There were concerns regarding potential harm to patients from delayed review of significant results.
Intervention
A working group considered options for managing the OP waiting list. We decided to pilot a fortnightly virtual clinic (VC) where cases were reviewed without the patient present. All patients awaiting results were listed for the VC rather than routine OP. Each VC had 50 patients listed. Patient’s GP received a clear action plan. Clinic rules were modified as issues were identified. Links with other specialities evolved reducing the number of missing results. Data was analysed for 50% of consultations between January 2018 and March 2019.
Improvement
311 VC appointments were reviewed: 207 in 2018 and 104 up to March 2019. Maximum 25 cases could be completed per clinic, additional sessions cleared initial backlog within 3 months. Completion time/case ranged from 2-15 minutes depending on complexity. Main reason for VC was test results: 82% in 2018, increasing to 93% in 2019. 61% in 2018, 80% in 2019 were discharged directly from VC. 20% required a 2nd VC for outstanding results. OP review post-VC fell from 16% in 2018 to just 2% in 2019. General OP requirements fell from 24hrs to 10 hours/ week as a result of VCs, releasing consultants for other clinical areas.
Discussion
VCs are an effective means of reviewing outstanding results from recent admissions and OP consultations. Routine listing of patients with outstanding investigations provides a safety net. Most results are normal and do not require follow-up. Repeat CXRs at 6 weeks continue to be requested for severely frail people who are unlikely to benefit.
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Affiliation(s)
- F Thomson
- Hull University Teaching Hospitals NHS Trust
| | - K Richards
- Hull University Teaching Hospitals NHS Trust
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11
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Richards K, Sethu C, Tiernan E. Phalangeal fracture leading to digital amputation, sustained during manipulation for Dupuytren's disease as part of clostridial collagenase treatment. Ann R Coll Surg Engl 2019; 101:e102-e104. [PMID: 30855178 DOI: 10.1308/rcsann.2019.0019] [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: 11/22/2022] Open
Abstract
Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation. An 81-year-old man was treated for a 25-year history of progressively disabling Dupuytren's disease of his left middle and ring fingers. Nine days post-manipulation he presented with persistent pain and swelling and was diagnosed with a displaced fracture of the proximal phalanx of his ring finger. Following discussion of surgical options and potential outcome, he elected to undergo amputation of the digit. He has experienced good treatment results in his middle finger and has no significant functional impairment as a result of this complication. Those offering collagenase injection in the management of Dupuytren's disease should be aware of this potential complication and it should be included in the consent process.
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Affiliation(s)
- K Richards
- Burns and Plastic Surgery Department, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham , UK
| | - C Sethu
- Plastic and Reconstructive Surgery Department, Salisbury District Hospital, Salisbury , Salisbury , UK
| | - E Tiernan
- Plastic and Reconstructive Surgery Department, Salisbury District Hospital, Salisbury , Salisbury , UK
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12
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Robson G, Hammond-Williams J, Richards K, Dyer C, Camacho R, Sinclair A, Neilson V, Ibude A, Buxton S, Lane S, Maynard L. 13THE FRAILTY FLYING SQUAD HOTLINE: DIRECT REFERRAL FROM PARAMEDICS TO THE ACUTE HOSPITAL FRAILTY SERVICE. REPORT OF AN INITIAL PDSA CYCLE. Age Ageing 2019. [DOI: 10.1093/ageing/afy211.13] [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: 11/14/2022] Open
Affiliation(s)
- G Robson
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - J Hammond-Williams
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - K Richards
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - C Dyer
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - R Camacho
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - A Sinclair
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - V Neilson
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - A Ibude
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - S Buxton
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - S Lane
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
| | - L Maynard
- Royal United Hospital NHS Foundation Trust Bath, South Western Ambulance Service NHS Foundation Trust
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13
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Stapley S, Colley S, Richards K. 100DEVELOPMENT OF RECREATIONAL THERAPY ROLE WITHIN THE ELDERLY CARE DEPARTMENT. Age Ageing 2018. [DOI: 10.1093/ageing/afy126.16] [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: 11/13/2022] Open
Affiliation(s)
- S Stapley
- Hull Royal Infirmary, Department of Elderly Care
| | - S Colley
- Hull Royal Infirmary, Department of Elderly Care
| | - K Richards
- Hull Royal Infirmary, Department of Elderly Care
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14
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Brough HA, Kull I, Richards K, Hallner E, Söderhäll C, Douiri A, Penagos M, Melén E, Bergström A, Turcanu V, Wickman M, Lack G. Environmental peanut exposure increases the risk of peanut sensitization in high-risk children. Clin Exp Allergy 2018; 48:586-593. [DOI: 10.1111/cea.13111] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 12/14/2022]
Affiliation(s)
- H. A. Brough
- Paediatric Allergy Group; Department of Women and Children's Heath; School of Life Course Sciences; King's College London; Guys’ Hospital; London UK
- Children's Allergy Service; Guy's and St. Thomas's NHS Foundation Trust; London UK
- Paediatric Allergy Group; School of Immunology & Microbial Sciences; King's College London; Guys' Hospital; London UK
| | - I. Kull
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
- Department of Clinical Science and Education; Södersjukhuset; Karolinska Institutet; Stockholm Sweden
- Sachs’ Children's Hospital; Södersjukhuset; Stockholm Sweden
| | - K. Richards
- Paediatric Allergy Group; Department of Women and Children's Heath; School of Life Course Sciences; King's College London; Guys’ Hospital; London UK
- Paediatric Allergy Group; School of Immunology & Microbial Sciences; King's College London; Guys' Hospital; London UK
| | - E. Hallner
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
| | - C. Söderhäll
- Department of Biosciences and Nutrition; Karolinska Institutet; Stockholm Sweden
- Centre of Allergy Research; Karolinska Institutet; Stockholm Sweden
- Department of Women′s and Children′s Health; Karolinska Institutet; Stockholm Sweden
| | - A. Douiri
- Division of Health & Social Care Research; King's College London; London UK
| | - M. Penagos
- Paediatric Allergy Group; Department of Women and Children's Heath; School of Life Course Sciences; King's College London; Guys’ Hospital; London UK
- Paediatric Allergy Group; School of Immunology & Microbial Sciences; King's College London; Guys' Hospital; London UK
| | - E. Melén
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
- Sachs’ Children's Hospital; Södersjukhuset; Stockholm Sweden
| | - A. Bergström
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
- Centre of Allergy Research; Karolinska Institutet; Stockholm Sweden
| | - V. Turcanu
- Paediatric Allergy Group; Department of Women and Children's Heath; School of Life Course Sciences; King's College London; Guys’ Hospital; London UK
- Paediatric Allergy Group; School of Immunology & Microbial Sciences; King's College London; Guys' Hospital; London UK
| | - M. Wickman
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Centre for Clinical Research Sörmland; Uppsala University; Eskilstuna Sweden
| | - G. Lack
- Paediatric Allergy Group; Department of Women and Children's Heath; School of Life Course Sciences; King's College London; Guys’ Hospital; London UK
- Children's Allergy Service; Guy's and St. Thomas's NHS Foundation Trust; London UK
- Paediatric Allergy Group; School of Immunology & Microbial Sciences; King's College London; Guys' Hospital; London UK
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Sawicka ZS, Phelan F, Richards K, Baxter R, Bennett H. 15THE PICTURE OF FRAILTY AT MID YORKSHIRE. Age Ageing 2017. [DOI: 10.1093/ageing/afx115.15] [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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Jeffery N, Richards K, Athorn K, Morales I. 32IMPLEMENTATION OF A MEDICAL CHECKLIST TOOL TO IMPROVE THE QUALITY OF ELDERLY PATIENT CARE: A QUALITY IMPROVEMENT PROJECT. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Housley SN, Garlow AR, Ducote K, Howard A, Thomas T, Wu D, Richards K, Butler AJ. Increasing Access to Cost Effective Home-Based Rehabilitation for Rural Veteran Stroke Survivors. Austin J Cerebrovasc Dis Stroke 2016; 3:1-11. [PMID: 28018979 PMCID: PMC5175468] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION An estimated 750,000 Americans experience a stroke annually. Most stroke survivors require rehabilitation. Limited access to rehabilitation facilities has a pronounced burden on functional outcomes and quality of life. Robotic devices deliver reproducible therapy without the need for real-time human oversight. This study examined the efficacy of using home-based, telerobotic-assisted devices (Hand and Foot Mentor: HM and FM) to improve functional ability and reduce depression symptoms, while improving access and cost savings associated with rehabilitation. METHODS Twenty stroke survivors performed three months of home-based rehabilitation using a robotic device, while a therapist remotely monitored progress. Baseline and end of treatment function and depression symptoms were assessed. Satisfaction with the device and access to therapy were determined using qualitative surveys. Cost analysis was performed to compare home-based, robotic-assisted therapy to clinic-based physical therapy. RESULTS Compared to baseline, significant improvement in upper extremity function (30.06%, p= 0.046), clinically significant benefits in gait speed (29.03%), moderate improvement in depressive symptoms (28.44%) and modest improvement in distance walked (30.2%) were observed. Participants indicated satisfaction with the device. Home-based robot therapy expanded access to post-stroke rehabilitation for 35% of the people no longer receiving formal services and increased daily access for the remaining 65%, with a cost savings of $2,352 (64.97%) compared to clinic-based therapy. CONCLUSION Stroke survivors made significant clinically meaningful improvements in the use of their impaired extremities using a robotic device in the home. Home-based, robotic therapy reduced costs, while expanding access to a rehabilitation modality for people who would not otherwise have received care.
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Affiliation(s)
- S N Housley
- Department of Physical Therapy, Georgia State University, USA
| | - A R Garlow
- Department of Physical Therapy, Georgia State University, USA
| | - K Ducote
- Department of Physical Therapy, Georgia State University, USA
| | - A Howard
- Department of Physical Therapy, Georgia State University, USA
| | - T Thomas
- Department of Physical Therapy, Georgia State University, USA
| | - D Wu
- Department of Physical Therapy, Georgia State University, USA
| | - K Richards
- Department of Physical Therapy, Georgia State University, USA
| | - A J Butler
- Department of Physical Therapy, Georgia State University, USA; Department of Veteran's Affairs, Atlanta Rehabilitation Research and Development Center of Excellence, USA; Neuroscience Institute, Joint Center for Advanced Brain Imaging, Center for Behavioral Neuroscience, Georgia State University, USA
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Shah NN, Merchant MS, Cole DE, Jayaprakash N, Bernstein D, Delbrook C, Richards K, Widemann BC, Wayne AS. Vincristine Sulfate Liposomes Injection (VSLI, Marqibo®): Results From a Phase I Study in Children, Adolescents, and Young Adults With Refractory Solid Tumors or Leukemias. Pediatr Blood Cancer 2016; 63:997-1005. [PMID: 26891067 PMCID: PMC6689398 DOI: 10.1002/pbc.25937] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 01/07/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Vincristine sulfate liposome injection (VSLI; Marqibo®) is an encapsulated preparation of standard vincristine in sphingomyelin/cholesterol liposomes. Clinical trials in adults have demonstrated safety, tolerability, and activity, leading to Food and Drug Administration (FDA) approval for adults with relapsed acute lymphoblastic leukemia (ALL). Pediatric experience with VSLI is limited. PROCEDURE This single center, phase I dose escalation study examined the safety, toxicity, maximum tolerated dose, and pharmacokinetics of VSLI administered weekly to pediatric patients age <21 years with relapsed or chemotherapy-refractory solid tumors or leukemia. RESULTS Twenty-one subjects were treated in total. Median age was 13.3 years (range 2-19). Fourteen subjects completed one 28-day cycle of therapy and five subjects completed more than one cycle. No subject experienced dose-limiting toxicity (DLT) at the first dose level (1.75 mg/m(2) /dose, dose range: 2-3.7 mg). At the second dose level (2.25 mg/m(2) /dose, dose range: 1.3-4.5 mg), one subject had transient dose-limiting grade 4 transaminase elevation, and this dose level was expanded with no additional DLT observed. The second dose level then opened to an expansion phase to evaluate activity in ALL. Clinical activity included minimal residual disease negative complete remission in one subject with ALL and stable disease in nine subjects. Clearance of total vincristine was found to be approximately 100-fold lower in comparison to published data using standard vincristine. CONCLUSIONS Children tolerate 2.25 mg/m(2) /dose of weekly VSLI (the adult FDA-approved dose) with evidence for clinical activity without dose-limiting neurotoxicity. Future plans include studying VSLI as substitution for standard vincristine with combination chemotherapy in children with ALL.
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Affiliation(s)
- Nirali N. Shah
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland,Correspondence to: Nirali N. Shah, Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Building 10, Room 1W-3750, 9000 Rockville Pike, Bethesda, MD 20892-1104.
| | - Melinda S. Merchant
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Diane E. Cole
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Nalini Jayaprakash
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Donna Bernstein
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Cindy Delbrook
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Kelly Richards
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Brigitte C. Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Alan S. Wayne
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland,Division of Hematology, Oncology and Blood & Marrow Transplantation, Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Mace CS, Folwell A, Richards K. 25PATIENT SURVEY INVESTIGATING CATERING CHOICES ON ‘CARE FOR THE ELDERLY’ WARDS. Age Ageing 2015. [DOI: 10.1093/ageing/afv106.25] [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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20
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Folwell A, Maslen H, Parsons K, Davidson R, Richards K. 30REDUCING PRESCRIBING ERRORS THROUGH PERSONALISED FEEDBACK. Age Ageing 2015. [DOI: 10.1093/ageing/afv106.30] [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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21
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Shah NN, Stetler-Stevenson M, Yuan CM, Richards K, Delbrook C, Kreitman RJ, Pastan I, Wayne AS. Characterization of CD22 expression in acute lymphoblastic leukemia. Pediatr Blood Cancer 2015; 62:964-9. [PMID: 25728039 PMCID: PMC4405453 DOI: 10.1002/pbc.25410] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [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: 10/27/2014] [Accepted: 12/03/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND CD22 is a B-lineage differentiation antigen that has emerged as a leading therapeutic target in acute lymphoblastic leukemia (ALL). PROCEDURE Properties of CD22 expression relevant to therapeutic targeting were characterized in primary samples obtained from children and young adults with relapsed and chemotherapy refractory B-precursor (pre-B) ALL. RESULTS CD22 expression was demonstrated in all subjects (n = 163) with detection on at least 90% of blasts in 155 cases. Median antigen site density of surface CD22 was 3,470 sites/cell (range 349-19,653, n = 160). Blasts from patients with known 11q23 (MLL) rearrangement had lower site density (median 1,590 sites/cell, range 349-3,624, n = 20 versus 3,853 sites/cell, range 451-19,653, n = 140; P = <0.0001) and 6 of 21 cases had sub-populations of blasts lacking CD22 expression (22%-82% CD22 +). CD22 expression was maintained in serial studies of 73 subjects, including those treated with anti-CD22 targeted therapy. The levels of soluble CD22 in blood and marrow by ELISA were low and not expected to influence the pharmacokinetics of anti-CD22 directed agents. CONCLUSIONS These characteristics make CD22 an excellent potential therapeutic target in patients with relapsed and chemotherapy-refractory ALL, although cases with MLL rearrangement require close study to exclude the presence of a CD22-negative blast population.
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Affiliation(s)
- Nirali N. Shah
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | | | | | - Kelly Richards
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | - Cindy Delbrook
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD
| | | | - Ira Pastan
- Laboratory of Molecular Biology, CCR, NCI, NIH, Bethesda, MD
| | - Alan S. Wayne
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), NIH, Bethesda, MD,Laboratory of Molecular Biology, CCR, NCI, NIH, Bethesda, MD,Children's Center for Cancer and Blood Diseases, Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
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22
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Richards K, Forouhi P, Johnston A, Malata CM. Pre-operative thrombotic complications of neoadjuvant chemotherapy for breast cancer: Implications for immediate breast reconstruction. Ann Med Surg (Lond) 2015; 4:80-4. [PMID: 25834732 PMCID: PMC4372642 DOI: 10.1016/j.amsu.2014.11.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/01/2014] [Accepted: 11/04/2014] [Indexed: 01/05/2023] Open
Abstract
UNLABELLED Thrombotic complications arising during the treatment of breast cancer can impact the breast reconstruction pathway. We set out to review the details of cases of thromboembolism occurring during neoadjuvant chemotherapy and peri-operatively to study the impact of the event and its management on subsequent breast reconstruction. METHODS We retrospectively reviewed the medical records of seven patients who had experienced a thrombotic event during their treatment of breast cancer between 2008 and 2012, who then proceeded to breast reconstruction. We recorded size and grade of tumour, neoadjuvant chemotherapeutic regimen, details of port insertion, planned reconstruction, thrombotic event and its management and the surgery performed and outcome. RESULTS All patients received chemotherapy via central venous access and went on to present with local symptomatic thrombosis. They were managed with anticoagulant regimens at the time of mastectomy and reconstruction, which were unique for each patient. The results revealed delays to surgery and modifications to planned reconstruction. DISCUSSION The majority of patients developing thrombotic complications go on to achieve successful reconstruction. There is significant variation in the anticoagulation management in this patient group. Identification of optimal anticoagulant regimes and the possibilities for prophylaxis may prove key in informing surgeons when planning the reconstructive process. CONCLUSION An awareness of the effects of thrombotic events in this patient group is important in terms of developing an understanding of its impact on the performance of reconstruction, on the management of anticoagulation peri-operatively and on monitoring for post-operative complications.
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Affiliation(s)
- K Richards
- Clinical School of Medicine, Cambridge University, UK
| | - P Forouhi
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Johnston
- Department of Anaesthesia and ICU, Cambridge University Hospitals NHS Foundation Trust, UK
| | - C M Malata
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK ; Plastic & Reconstructive Surgery Depatment, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK ; Postgraduate Medical Institute at Anglia Ruskin University, Cambridge, Chelmsford, UK
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23
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Lee DW, Shah N, Stetler-Stevenson M, Sabatino M, Richards K, Delbrook C, Kochenderfer JN, Rosenberg SA, Stroncek D, Mackall CL, Wayne AS. Abstract LB-138: Autologous-collected anti-cd19 chimeric antigen receptor (CAR) T cells for acute lymphocytic leukemia (ALL) and Non-Hodgkin's lymphoma (NHL) in children who have previously undergone allogeneic hematopoietic stem cell transplantation (HSCT). Clin Trials 2014. [DOI: 10.1158/1538-7445.am2013-lb-138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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24
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Innocenti F, Gillis N, Parker J, Hayes N, Eberhard D, Richards K, Auman J, Seiser E. 163 Interrogation of pharmacogenes in cancer patients using targeted DNA sequencing. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70289-8] [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: 10/24/2022]
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25
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Seiser E, Gillis N, Parker J, Hayes D, Eberhard D, Richards K, Auman J, Innocenti F. Pharmacogenetic Evaluation of Targeted Dna Sequencing in Cancer Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu358.45] [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: 11/13/2022] Open
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26
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Rascati K, Richards K, Lopez D, Cheng LI, Wilson J. Progression to insulin for patients with diabetes mellitus on dual oral antidiabetic therapy using the US Department of Defense Database. Diabetes Obes Metab 2013; 15:901-5. [PMID: 23531154 DOI: 10.1111/dom.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/14/2013] [Accepted: 02/14/2013] [Indexed: 11/29/2022]
Abstract
AIM To compare 'progression to insulin' for three cohorts on oral antidiabetic medication combinations: metformin/sulphonylurea (Met/SU), metformin/thiazolidinedione (Met/TZD) and sulphonylurea/thiazolidinedione (SU/TZD). METHODS Retrospective cohort analysis design was used. The subjects were US nationwide members of military and their families. A total of 5608 patients who were on antidiabetic monotherapy for at least 1 year before adding a second agent to their medication regimen between October 2001 and September 2008 participated in this study. Mean age ranged from 64 to 71 years among the cohorts. Cox regression compared the progression to insulin, adjusting for demographics, months of follow-up and co-morbidities [measured with Chronic Disease Score (CDS)]. RESULTS By the end of the 2- to 6-year follow-up period, 14.3% of the Met/TZD cohort, 23.6% of the Met/SU cohort and 28.2% of the SU/TZD cohort had insulin added to their regimen. Those in the Met/SU cohort had a 1.8 times higher probability of progression to insulin than those in the Met/TZD cohort [odds ratio (OR) = 1.80, 95% confidence interval (CI) = 1.51-2.14), and those in the SU/TZD cohort had a 2.5 times higher probability of progression to insulin than those in the Met/TZD cohort (OR = 2.51, 95% CI = 2.04-3.08). CONCLUSION When sensitizers were paired (Met/TZD), a lower percentage of patients progressed to insulin during the study period, as opposed to patients who used a combination of a secretagogue with a sensitizer (SU/TZD or Met/SU).
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Affiliation(s)
- K Rascati
- Health Outcomes and Pharmacy Practice Division, The University of Texas College of Pharmacy, Austin, TX, USA
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27
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Lee DW, Shah N, Stetler-Stevenson M, Sabatino M, Richards K, Delbrook C, Kochenderfer J, Rosenberg SA, Stroncek D, Mackall C, Wayne AS. Autologous-collected anti-CD19 chimeric antigen receptor T cells (19CARTs) for pediatric acute lymphocytic leukemia (ALL) and non-Hodgkin lymphoma (NHL): Clinical activity and cytokine release without graft versus host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.10008] [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: 11/20/2022] Open
Abstract
10008 Background: Despite intensive chemotherapy and HSCT, outcomes in relapsed/refractory pediatric B cell ALL and NHL are poor. To treat children with or without prior allogeneic-HSCT and quickly deliver therapy, we developed a Phase I trial of 19CARTs for both HSCT-naive and post-allo-HSCT patients where autologous-collected T cells are manufactured in 11 days. Methods: T cells collected on Day -11 by lymphopheresis were positively selected and activated using anti-CD3/CD28 beads then transduced with the CD19-CAR gene via retrovirus. Cells were infused after 7 additional days of expansion. Patients (Pt) received fludarabine and cyclophosphamide prior to receiving 1e6 19CARTs/kg. Results: A 59-65 fold expansion of 19CARTs with 39-65% transduction efficiency was achieved in Pt 1 and 3 (ALL, NHL). Pt 1 achieved a complete response (CR). Mild cytokine release syndrome was observed (Gr 3 fever, Gr 2 hypotension) correlating with mild elevation in IL6, GM-CSF, INFg and C reactive protein (CRP; Table). No other non-hematologic, CAR-related Gr ≥3 toxicities were observed. Pt 2 (ALL) received 2.8% of the targeted cell dose due to lack of cell expansion likely from recent prior chemotherapy but experienced a transient CR with significant 19CART expansion (15% blood, 5% marrow, 6% CSF). Importantly, 19CARTs were well tolerated without evidence of GVHD in these post-allo HSCT patients. Conclusions: Autologous-collected allogeneic derived 19CART cells can be rapidly manufactured and safely administered to children with ALL and NHL. Clinical activity can be achieved without GVHD despite inflammatory cytokine generation. 19CARTs offer a potentially effective strategy to treat post-HSCT relapse warranting further study. Clinical trial information: NCT01593696. [Table: see text]
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Affiliation(s)
| | - Nirali Shah
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Kelly Richards
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Cindy Delbrook
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Steven A. Rosenberg
- Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Dave Stroncek
- Department of Transfusion Medicine, National Institutes of Health, Bethesda, MD
| | | | - Alan S. Wayne
- National Cancer Institute, National Institutes of Health, Bethesda, MD
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Mozen D, Slawson D, Dalton W, Littleton M, Schetzina K, Williams C, McKeehan T, Wu T, Richards K. Development of physical activity components for a peer delivered intervention to reduce obesity: Team up for healthy living. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.417] [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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Shah N, Bhojwani D, Silverman L, Whitlock J, Richards K, Stetler-Stevenson M, Buzoianu M, Ibrahim R, Pastan I, Wayne A. A Novel Anti-CD22 Immunotoxin, Moxetumomab Pasudotox (HA22, CAT-8015): Activity in Pediatric Patients with Relapsed Acute Lymphoblastic Leukemia (ALL) After Allogeneic Hematopoietic Stem Cell Transplantation (SCT). Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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30
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Shah N, Loeb D, Khuu H, Stroncek D, Raffeld M, Delbrook C, Richards K, Baird K, Levine J, Leitman S, Mackall C, Fry T, Wayne A. A Pilot Trial of WT1 Peptide-Loaded Allogeneic Dendritic Cell (DC) Vaccination and Donor Lymphocyte Infusion (DLI) for WT1-Expressing Hematologic Malignancies and Post-Transplant Relapse. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.163] [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: 10/14/2022]
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31
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Richards K, Campenni C, Muse-Burke J. Self-care and Well-being in Mental Health Professionals: The Mediating Effects of Self-awareness and Mindfulness. ACTA ACUST UNITED AC 2011. [DOI: 10.17744/mehc.32.3.0n31v88304423806] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Because mental health professionals are susceptible to impairment and burnout that may negatively affect clinical work, it is ethically imperative that they engage in self-care. Previous research has found direct effects of self-care on self-awareness and well-being (e.g., Coster & Schwebel, 1997). Likewise, mindfulness has been found to positively affect well-being (Brown & Ryan, 2003). However, no studies currently available demonstrate a link between self-awareness and well-being. Mindfulness may be the link needed to support this association. A survey of mental health professionals (N = 148) revealed that mindfulness is a significant mediator between self-care and well-being. Consequently, mental health professionals are encouraged to explore their involvement in and beliefs about self-care practices.
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Bilimoria KY, Wang X, Cohen ME, Hall BL, Richards K, Merkow RP, Pisters PW, Ko CY. Do cancer centers need to assess quality and outcomes? Introducing a customized ACS-NSQIP for oncology (Onc-NSQIP). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
475 Background: To identify quality improvement opportunities, hospitals can use ACS NSQIP to compare their risk-adjusted performance to other hospitals. However, Cancer Centers have few opportunities to compare their outcomes to similar hospitals for oncologic operations. Our objective was to develop an oncology-specific version of ACS NSQIP (Onc-NSQIP) and determine whether it could be useful for Cancer Centers. Methods: From ACS-NSQIP (2006-2009), patients undergoing major colorectal (n=34,858; 221 hospitals) and pancreatic (n=7,667; 65 hospitals) as well as esophageal, gastric, and soft tissue operations for malignancy were identified. Risk-adjusted postoperative outcomes were assessed with regression models adjusting for demographics, comorbidities, and operative procedure. Relative rankings of NCI-designated Comprehensive Cancer Centers in ACS NSQIP among the other ACS NSQIP hospitals were compared. Results: Cancer Center outcomes varied widely for colorectal and pancreas. For overall colorectal morbidity, Cancer Centers were ranked in the top third (n=4), middle third (n=7), and bottom third (n=10). For colorectal 30-day mortality, Cancer Centers were ranked in the top (n=14), middle (n=3), and bottom third (n=4). For overall pancreatic morbidity, Cancer Centers were ranked in the top (n=5), middle (n=7), and bottom third (n=7). For pancreatic 30-day mortality, Cancer Centers were ranked in the top (n=5), middle (n=6), and bottom third (n=8). Similar results were observed for colorectal and pancreas for DVT/PE, SSI, reoperation, and length of stay. Onc-NSQIP models were comparable to standard ACS NSQIP models. At least some Cancer Centers were statistical outliers for most outcomes (P<0.05). Results were similar for other malignancies. Conclusions: Cancer Center outcomes varied as much as other ACS NSQIP hospitals, demonstrating need for quality assessment. Without standardized risk-adjusted outcomes comparisons, Cancer Centers cannot accurately assess their outcomes to identify quality improvement targets. ACS NSQIP's new platform allows customization so hospitals can compare surgical oncology-specific risk-adjusted processes and outcomes. No significant financial relationships to disclose.
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Affiliation(s)
- K. Y. Bilimoria
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - X. Wang
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - M. E. Cohen
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - B. L. Hall
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - K. Richards
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - R. P. Merkow
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - P. W. Pisters
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - C. Y. Ko
- University of Texas M. D. Anderson Cancer Center, Houston, TX; American College of Surgeons, Chicago, IL; Department of Surgery, Washington University in St. Louis, St. Louis, MS; Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL; David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
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Slatter JG, Templeton IE, Castle JC, Kulkarni A, Rushmore TH, Richards K, He Y, Dai X, Cheng OJ, Caguyong M, Ulrich RG. Compendium of gene expression profiles comprising a baseline model of the human liver drug metabolism transcriptome. Xenobiotica 2009; 36:938-62. [PMID: 17118915 DOI: 10.1080/00498250600861728] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [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: 10/24/2022]
Abstract
Oligonucleotide microarrays were used to study the variability of pharmacokinetics and drug metabolism (PKDM)-related gene expression in 75 normal human livers. The objective was to define and use absorption, distribution, metabolism and excretion (ADME) gene expression variability to discern co-regulated genes and potential surrogate biomarkers of inducible gene expression. RNA was prepared from donor tissue and hybridized on Agilent microarrays against an RNA mass balanced pool from all donors. Clustering of PKDM gene sets revealed donors with distinct patterns of gene expression that grouped genes known to be regulated by the nuclear receptor, pregnane X-receptor (PXR). Fold range metrics and frequency distributions from the heterogeneous human population were used to define the variability of individual PKDM genes in the 75 human livers and were placed in context by comparing expression data with basal ADME gene expression variability in an inbred and diet/environment controlled population of 27 Rhesus livers. The most variable genes in the hepatic transcriptome were mainly related to drug metabolism, intermediary metabolism, inflammation and cell cycle control. Unique patterns of expression across 75 individuals of inducible ADME gene expression allowed their expression to be correlated with the expression of many other genes. Correlated genes for AhR, CAR and PXR responsive genes (CYP1A2, CYP2B6 and CYP3A4) were identified that may be co-regulated and, therefore, provide clues to the identity of surrogate gene or protein markers for CYP induction. In conclusion, microarrays were used to define the variable expression of hepatic ADME genes in a diverse human population, the expression variability of ADME genes was compared with the expression variability in an inbred population of Rhesus monkeys, and genes were defined that may be co-regulated with important inducible CYP genes.
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Biagi JJ, Herbert KE, Smith C, Abdi E, Leahy M, Falkson C, Wolf M, Januszewicz H, Seymour JF, Richards K, Matthews JP, Dale B, Prince HM. A phase II study of dexamethasone, ifosfamide, cisplatin and etoposide (DICE) as salvage chemotherapy for patients with relapsed and refractory lymphoma. Leuk Lymphoma 2009; 46:197-206. [PMID: 15621802 DOI: 10.1080/10428190400014884] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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: 10/26/2022]
Abstract
The 4-day combination of dexamethasone, ifosfamide, cisplatin, and etoposide (DICE) is a salvage regimen for lymphoma. We report a prospective phase II multi-center trial of a modified DICE regimen in relapsed or refractory Hodgkin (HL) or non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL), constituting a single day of intravenous administration followed by 3 days of oral administration, aimed at reducing inpatient days without losing efficacy. Forty patients (median age 56, range 25 - 79) were included: 28 (70%) NHL, 9 (23%) HL and 3 (8%) CLL. Fifty-three per cent had received 2 prior treatment regimens. International Prognostic Index (IPI) was 2 in 75% of NHL patients. Patients aged 55 and those with previous autologous stem cell transplantation (ASCT) started on a lower-dose regimen, with dose escalation possible in 2 patients. Overall response rate was 41%. Thirty-eight per cent of patients had stable disease. With a median of 3.1 years of follow-up, estimated progression-free survival (PFS) and overall survival (OS) rates at 3 years were 15% and 43% respectively. OS was longer in the < 55 compared to the 55 age cohort (P = 0.0091), longer for HL than NHL (P = 0.59 and 0.039 respectively) and longer for Low/Low-Int IPI than High/High-Int IPI (P = 0.0074 and 0.0009 respectively). Median duration of inpatient stay was 3 days. There were no treatment-related deaths. In conclusion, this modification of DICE is an effective and well tolerated salvage regimen, even in this poor prognosis group of patients. Further clinical studies of DICE in first relapse and in older patients, possibly with the addition of rituximab, are warranted.
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Affiliation(s)
- J J Biagi
- Department of Hematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Beare R, Richards K, Murphy S, Petrou S, Reutens D. An assessment of methods for aligning two-dimensional microscope sections to create image volumes. J Neurosci Methods 2008; 170:332-44. [DOI: 10.1016/j.jneumeth.2008.01.012] [Citation(s) in RCA: 12] [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] [Received: 04/04/2007] [Revised: 01/09/2008] [Accepted: 01/09/2008] [Indexed: 11/29/2022]
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Underwood SM, Richards K, Bradley PK, Robertson E. Pilot study of the breast cancer experiences of African American women with a family history of breast cancer: implications for nursing practice. ABNF J 2008; 19:107-113. [PMID: 18717210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Experts in the area of breast cancer detection and control recommend that women at increased risk discuss their risk status and risk management with their health care providers. In spite of the excessive breast cancer burden borne by African American women, little attention has been given to studying breast cancer risk communication and/or breast cancer risk management in this at-risk population group. This report summarizes the outcomes of a study undertaken to explore the degree to which breast cancer, breast cancer risk, and breast cancer risk management were discussed by African American women and their health care providers Targeted for inclusion in the study were African American women who had a first degree relative or multiple second degree relatives that had been diagnosed with pre-menopausal breast cancer. Of particular interest was the extent to which African American women with a family history of breast cancer perceived themselves to be at risk for developing breast cancer and the extent to which they discussed their family history, their breast cancer risk, and, breast cancer risk management with their providers.
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Abstract
OBJECTIVE Actuarial analysis of stoma complications (problematic stomas) is lacking. The objectives of this audit were: to identify the incidence of stoma complications within the UK; to highlight any dissimilarity of incidence from centre to centre; to ascertain if the height of the stoma (distance of stoma lumen from the skin) at the time of fashioning is a predisposing factor to problems; and finally to initiate much needed research. METHOD Commencing 1st January 2005, stoma care services nationwide (256) were invited to audit prospectively their next 50 enteric stomas or for a period of 1 year which ever came first. The definition of a problematic stoma being one, which needed one or more accessories to keep the patient clean and dry for a minimum period of 24 h. The incident is to have happened within 3 weeks of surgery. Factors taken into account were: type of stoma, height of stoma within 48 h of surgery; emergency or elective procedure, problem identified, BMI, gender and underlying diagnosis of the patient. The identities of the participating centres are confidential. RESULTS Of the 256 hospital-based stoma care services within the UK, 93 (36%) participated. A total of 3970 stomas were recorded, of which 1329 (34%) were identified as problematic. Sixty-two centres reported 45-50 stomas with a range of complications 6-96%. The loop ileostomy was found to be the stoma which causes most problems. A stoma of <10 mm is a predisposing factor to complications and problems are more likely to occur following an emergency procedure. More men than women have stomas formed, but have significantly fewer problems and there is no significant difference between underlying diagnoses. CONCLUSION The stoma height, stoma type and gender of the patient are significant risk factors identified in this audit. The BMI of patient did not affect the outcome. Patients undergoing an emergency procedure are more likely to have a problematic stoma. The significant variation of complications from centre to centre indicates surgical technique as being the key factor in stoma formation and subsequent quality of life for the patient.
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Affiliation(s)
- J Cottam
- Clinical Nurse Specialist (Colorectal/Stoma Care), Bedford Hospital, NHS Trust, Kempston Road, Bedford MK42 9DJ, UK.
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Erhardt M, Vetter G, Gilmer D, Bouzoubaa S, Richards K, Jonard G, Guilley H. Subcellular localization of the Triple Gene Block movement proteins of Beet necrotic yellow vein virus by electron microscopy. Virology 2005; 340:155-66. [PMID: 16023167 DOI: 10.1016/j.virol.2005.06.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2005] [Revised: 06/01/2005] [Accepted: 06/07/2005] [Indexed: 11/16/2022]
Abstract
The Triple Gene Block proteins TGBp1, TGBp2, and TGBp3 of Beet necrotic yellow vein virus (BNYVV) are required for efficient cell-to-cell spread of the infection. The TGB proteins can drive cell-to-cell movement of BNYVV in trans when expressed from a co-inoculated BNYVV RNA 3-based 'replicon'. TGBp2 and TGBp3 expressed from the replicon were nonfunctional in this assay if they were fused to the green fluorescent protein (GFP), but addition of a hemagglutinin (HA) tag to their C-termini did not incapacitate movement. Immunogold labeling of ultrathin sections treated with HA-specific antibodies localized TGBp2-HA and TGBp3-HA to what are probably structurally modified plasmodesmata (Pd) in infected cells. A similar subcellular localization was observed for TGBp1. Large gold-decorated membrane-rich bodies containing what appear to be short fragments of endoplasmic reticulum were observed near the cell periphery. The modified gold-decorated Pd and the membrane-rich bodies were not observed when the TGB proteins were produced individually in infections using the Tobacco mosaic virus P30 protein to drive cell-to-cell movement, indicating that these modifications are specific for TGB-mediated movement.
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Affiliation(s)
- M Erhardt
- Institut de Biologie Moléculaire des Plantes du CNRS et de l'Université Louis Pasteur, 67084 Strasbourg, France
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Lauber E, Jonard G, Richards K, Guilley H. Nonregulated expression of TGBp3 of hordei-like viruses but not of potex-like viruses inhibits beet necrotic yellow vein virus cell-to-cell movement. Arch Virol 2005; 150:1459-67. [PMID: 15770352 DOI: 10.1007/s00705-005-0516-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Accepted: 01/20/2005] [Indexed: 10/25/2022]
Abstract
Plant viruses containing a Triple Gene Block (TGB) movement protein gene cassette fall into two classes. We have shown previously that the third TGB protein (TGBp3) of beet necrotic yellow vein virus (BNYVV; Class 1) and peanut clump virus (Class 1) inhibit BNYVV intercellular movement when expressed from a co-inoculated BNYVV RNA 3-based replicon. Here we show that autonomous expression of TGBp3's of four other Class 1 viruses of various genera also inhibits BNYVV movement. No such effect was observed for four Class 2 virus TGBp3's, suggesting that the roles of Class 1 and 2 TGBp3's in movement differ significantly.
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Affiliation(s)
- E Lauber
- Institut de Biologie Moléculaire des Plantes du CNRS et de l'Université Louis Pasteur, Strasbourg, France
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40
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Jefford M, Mileshkin L, Richards K, Thomson J, Matthews JP, Zalcberg J, Jennens R, McLachlan SA, Wein S, Antill Y, Clarke DM. Rapid screening for depression--validation of the Brief Case-Find for Depression (BCD) in medical oncology and palliative care patients. Br J Cancer 2004; 91:900-6. [PMID: 15305199 PMCID: PMC2409870 DOI: 10.1038/sj.bjc.6602057] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Depression in oncology patients is under-recognised and associated with poor outcomes. Screening can increase case recognition. The Brief Case-Find for Depression (BCD) is a four-question, interviewer-administered instrument that has been previously validated in a general medical setting. The primary aim of this study was to validate the BCD in a medical oncology/palliative care setting, primarily by comparing its association with physical illness measures and with the Primary Care Evaluation of Mental Disorders (PRIME-MD), the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS). Eligible adult oncology patients gave informed consent and completed the above measures and a pain scale. Agreement between the BCD and other instruments was assessed. Construct validity was determined by comparing depressed/nondepressed patients with respect to performance status, symptoms, pain score and functional impairment. A total of 100 patients had a median age of 58 (range 21–90) and ECOG performance status (PS) 2 (0–4). In all, 60% had metastatic disease. The therapeutic goal was curative/adjuvant in 39% and palliative in 61%. Prevalence of depression according to the various measures was: BCD 34%, PRIME-MD 12%, BDI 19% and HADS 14%. In total, 45% of patients responded positively to a single-item screening question. The BCD showed fair agreement with the PRIME-MD (kappa=0.21), moderate agreement with the BDI (kappa=0.43) and fair agreement with the HADS (kappa=0.27). Against the PRIME-MD diagnosis of depression, the BCD had greater sensitivity, but lesser specificity and overall agreement, compared with the BDI and depression scale of the HADS. Patients with probable depression (according to BCD) had inferior PS (P=0.0064), increased pain (P=0.045) and greater impairment of functioning (PRIME-MD: P=0.0003). There was no association with gender, age, disease status or therapeutic goal. Depression is common in oncology patients. The BCD is a quick, easy-to-administer screen for depression, which has reasonable psychometric properties in this population.
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Affiliation(s)
- M Jefford
- Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, Victoria 8006, Australia.
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Goldstein RE, Martin WH, Richards K. Minimally invasive radioguided parathyroidectomy (MIRP). MINERVA CHIR 2003; 58:269-79. [PMID: 12955045] [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: 03/04/2023]
Abstract
The technique of parathyroidectomy has traditionally involved a bilateral exploration of the neck with the intent of visualizing 4 parathyroid glands and resecting pathologically enlarged glands. Parathyroid scanning using technetium-99m sestamibi has evolved and can now localize 80% to 90% of parathyroid adenomas. The technique of minimally invasive radioguided parathyroidectomy (MIRP) is a surgical option for most patients with primary hyperparathyroidism and a positive preoperative parathyroid scan. The technique makes use of a hand-held gamma probe that is used intraoperatively to guide the dissection in a highly directed manner with the procedure often performed under local anesthesia. The technique results in excellent cure rates while allowing most patients to leave the hospital within a few hours after the completion of the procedure. Current data also suggest the procedure can decrease hospital charges by approximately 50%. This technique may significantly change the management of primary hyperparathyroidism.
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Affiliation(s)
- R E Goldstein
- Kenneth vonRoenn MD Family Chair in Surgical, Endocrinology and Professor of Surgery, University of Louisville, KY 40202, USA.
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Abstract
Measures of cognition are often used to define and measure the progress of dementia and outcomes of intervention. This paper examines whether measures of psychosocial disability used with those of cognition are more useful than measures of cognition alone, particularly in early dementia. A measure of cognition and two instruments of caregiver burden, used as routine clinical outcome measures of three types of Old Age Psychiatry dementia services, were examined. All cases with dementia in a memory clinic (MC; n = 149), a community mental health service for older people (CMHT; n = 120) and a specialist dementia day hospital (DH; n = 118), in one NHS district were followed up at 12 months. Measures of cognition (MMSE), behaviour, caregiver coping (Problem Checklist; PC) and caregiver mood (Hospital Anxiety and Depression Scale; HAD) were taken at baseline (MC, n = 48; CMHT, n = 113; DH, n = 55) and at follow-up (MC, n = 35; CMHT, n = 34; DH, n = 23). At baseline, all three groups had an average MMSE score of "mild impairment" but measures of behaviour and caregiver burden showed subtle between-group differences. At the 12-month follow-up, cognition remained stable in all groups, but the frequency of day-to-day problems increased and caregiver mood deteriorated in families receiving DH support. The use of psychosocial measures of disability in conjunction with those of cognition, are important in the definition and longitudinal measurement of intervention and support in early dementia.
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Affiliation(s)
- K Richards
- Hull & East Riding Community NHS Trust, Hull, UK
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Abstract
AIMS Blood transfusions are often given to surgical patients. This study was designed to assess whether acute normovolaemic haemodilution (ANH) reduces exposure to allogeneic blood, affects clinical outcome and hospital stay, and is feasible in colorectal surgery. METHODS All ASA 1 and 11 patients undergoing colectomies performed between 1997 and 1999 were identified retrospectively from our colorectal cancer database to ascertain our current peri and postoperative transfusion practice. Twenty-six selected patients subsequently underwent ANH during colectomy surgery. The number of patients and units transfused were identified. RESULTS One hundred and twenty-three of 317 (39%) patients identified from our colorectal cancer database were transfused a total of 328 units (median 2, range 1-7). Of the 26 patients undergoing ANH, 4 (15%) were transfused a total of 13 units (median 3, range 2-5). The reduction in number of patients transfused was statistically significant (P=0.017). ANH increased anaesthetic time by a median of 19 min. There were no complications associated with ANH and the median hospital stay was 9 days (range 6-13). CONCLUSIONS In this pilot study of selected patients, ANH is a feasible and effective method of reducing allogeneic blood exposure in major colorectal surgery. A prospective randomised controlled trial is now urgently required.
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Affiliation(s)
- G Sanders
- Colorectal Unit, Department of Surgery, Derriford Hospital, Plymouth, UK
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Mesibov R, Bonham KJ, Doran N, Meggs J, Munks SA, Otley HM, Richards K. INVERTEBR SYST 2002; 16:655. [DOI: 10.1071/it01036] [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: 11/23/2022]
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Erhardt M, Dunoyer P, Guilley H, Richards K, Jonard G, Bouzoubaa S. Beet necrotic yellow vein virus particles localize to mitochondria during infection. Virology 2001; 286:256-62. [PMID: 11485394 DOI: 10.1006/viro.2001.0931] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Fluorescent beet necrotic yellow vein virus (BNYVV) particles were produced by replacing part of the readthrough domain of the minor coat protein P75 with the green fluorescent protein (GFP). The recombinant virus was functional in plants and P75-GFP was incorporated at one end of the rod-shaped virions. Laser scanning confocal microscopy and transmission electron microscopy showed that virus-like particles, almost certainly authentic BNYVV virions, localized to the cytoplasmic surface of mitochondria at early times postinfection but relocated at later times to semiordered clusters in the cytoplasm. This is the first report of specific targeting of plant virus particles to the mitochondria in vivo.
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Affiliation(s)
- M Erhardt
- Institut de Biologie Moléculaire des Plantes, CNRS and Université Louis Pasteur, 12 Rue du Général Zimmer, 67084 Strasbourg Cedex, France
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Abstract
AIMS Fungal infection of diabetic foot ulcers has not been described. We analysed the features of 17 patients with diabetic foot ulcers probably infected with fungi. METHODS Seventeen patients were identified with clinically infected foot ulcers, (i) which had failed to heal despite prolonged antibiotic therapy and intensive podiatric care, (ii) from which Candida spp. was isolated or hyphae +/- yeasts were visualized in material from ulcers or surrounding skin. RESULTS Multiple ulcers arising simultaneously were present in 10 patients (59%), preceded by blistering in seven cases. Single ulcers with markedly ulcerated margins were present in seven (41%) patients and were preceded by blisters in two. All 17 cases had neuropathy and 15 (88%) had severe peripheral vascular disease. All ulcers responded to antifungal therapy. CONCLUSIONS Candida spp. is associated with two distinctive patterns of protracted ulceration in diabetic feet which improve following systemic antifungal therapy. Diabet. Med. 18, 567-572 (2001)
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Affiliation(s)
- A H Heald
- Department of Endocrinology, Hope Hospital, Salford, UK
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Abstract
Training is associated with improved responses to suicidal individuals, but it is not clear whether any training helps or whether the training needs to be in psychology. The authors compared beginning and advanced psychology graduate students and practicing psychologists to nursing graduate students. A total of 139 participants in these 4 groups read a vignette about Pat, who had either contemplated suicide or never contemplated suicide, then completed questions about how they would respond to a distressed telephone call from Pat, how suicidal they thought Pat was, and how good a no-suicide contract would be for Pat. Advanced students and psychologists were more helpful in their responses than beginning graduate students, who were more helpful than nursing graduate students. However, all participants noticed whether Pat had contemplated suicide, and all were faintly positive about no-suicide contracts.
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Affiliation(s)
- K Richards
- University of Southern Mississippi, Hattiesburg, Mississippi, USA.
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Abstract
BACKGROUND Intervention for challenging behaviour of residents living in care homes is a neglected area of research. Pharmacological methods of management are widespread, although support for their efficacy is, on the whole, poor. AIMS There is little research on non-pharmacological methods of management and the present study aimed to add to the small literature in this area, by examining the meaning of behaviour for a given resident, within a functional analytic experimental framework. METHODS The study involved a systematic manipulation of specific trigger situations to evaluate their influence on challenging behaviour, using a single case experimental design. RESULTS Five residents with agitated and aggressive behaviour were successfully managed. The difficulties in engaging staff in the use of non-pharmacological, rather than pharmacological, methods and the scope for future randomised trials using psychological and environmental interventions to manage challenging behaviour, are discussed.
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Affiliation(s)
- E Moniz-Cook
- Department of Clinical Psychology, School of Medicine, University of Hull, Hull HU3 2SG, UK.
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Erhardt M, Morant M, Ritzenthaler C, Stussi-Garaud C, Guilley H, Richards K, Jonard G, Bouzoubaa S, Gilmer D. P42 movement protein of Beet necrotic yellow vein virus is targeted by the movement proteins P13 and P15 to punctate bodies associated with plasmodesmata. Mol Plant Microbe Interact 2000; 13:520-528. [PMID: 10796018 DOI: 10.1094/mpmi.2000.13.5.520] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cell-to-cell movement of Beet necrotic yellow vein virus (BNYVV) is driven by a set of three movement proteins--P42, P13, and P15--organized into a triple gene block (TGB) on viral RNA 2. The first TGB protein, P42, has been fused to the green fluorescent protein (GFP) and fusion proteins between P42 and GFP were expressed from a BNYVV RNA 3-based replicon during virus infection. GFP-P42, in which the GFP was fused to the P42 N terminus, could drive viral cell-to-cell movement when the copy of the P42 gene on RNA 2 was disabled but the C-terminal fusion P42-GFP could not. Confocal microscopy of epidermal cells of Chenopodium quinoa near the leading edge of the infection revealed that GFP-P42 localized to punctate bodies apposed to the cell wall whereas free GFP, expressed from the replicon, was distributed uniformly throughout the cytoplasm. The punctate bodies sometimes appeared to traverse the cell wall or to form pairs of disconnected bodies on each side. The punctate bodies co-localized with callose, indicating that they are associated with plasmodesmata-rich regions such as pit fields. Point mutations in P42 that inhibited its ability to drive cell-to-cell movement also inhibited GFP-P42 punctate body formation. GFP-P42 punctate body formation was dependent on expression of P13 and P15 during the infection, indicating that these proteins act together or sequentially to localize P42 to the plasmodesmata.
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Affiliation(s)
- M Erhardt
- Institut de Biologie Moléculaire des Plantes du CNRS et de l'Université Louis Pasteur, Strasbourg, France
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Brault V, Mutterer J, Scheidecker D, Simonis MT, Herrbach E, Richards K, Ziegler-Graff V. Effects of point mutations in the readthrough domain of the beet western yellows virus minor capsid protein on virus accumulation in planta and on transmission by aphids. J Virol 2000; 74:1140-8. [PMID: 10627524 PMCID: PMC111448 DOI: 10.1128/jvi.74.3.1140-1148.2000] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/1999] [Accepted: 10/21/1999] [Indexed: 11/20/2022] Open
Abstract
Point mutations were introduced into or near five conserved sequence motifs of the readthrough domain of the beet western yellows virus minor capsid protein P74. The mutant virus was tested for its ability to accumulate efficiently in agroinfected plants and to be transmitted by its aphid vector, Myzus persicae. The stability of the mutants in the agroinfected and aphid-infected plants was followed by sequence analysis of the progeny virus. Only the mutation Y201D was found to strongly inhibit virus accumulation in planta following agroinfection, but high accumulation levels were restored by reversion or pseudoreversion at this site. Four of the five mutants were poorly aphid transmissible, but in three cases successful transmission was restored by pseudoreversion or second-site mutations. The same second-site mutations in the nonconserved motif PVT(32-34) were shown to compensate for two distinct primary mutations (R24A and E59A/D60A), one on each side of the PVT sequence. In the latter case, a second-site mutation in the PVT motif restored the ability of the virus to move from the hemocoel through the accessory salivary gland following microinjection of mutant virus into the aphid hemocoel but did not permit virus movement across the epithelium separating the intestine from the hemocoel. Successful movement of the mutant virus across both barriers was accompanied by conversion of A59 to E or T, indicating that distinct features of the readthrough domain in this region operate at different stages of the transmission process.
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Affiliation(s)
- V Brault
- Station de Recherche "Grandes Cultures," INRA, Colmar 68021 Cedex, France
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