1
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Lambrou AS, South E, Ballou ES, Paden CR, Fuller JA, Bart SM, Butryn DM, Novak RT, Browning SD, Kirby AE, Welsh RM, Cornforth DM, MacCannell DR, Friedman CR, Thornburg NJ, Hall AJ, Hughes LJ, Mahon BE, Daskalakis DC, Shah ND, Jackson BR, Kirking HL. Early Detection and Surveillance of the SARS-CoV-2 Variant BA.2.86 - Worldwide, July-October 2023. MMWR Morb Mortal Wkly Rep 2023; 72:1162-1167. [PMID: 37883327 PMCID: PMC10602619 DOI: 10.15585/mmwr.mm7243a2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Early detection of emerging SARS-CoV-2 variants is critical to guiding rapid risk assessments, providing clear and timely communication messages, and coordinating public health action. CDC identifies and monitors novel SARS-CoV-2 variants through diverse surveillance approaches, including genomic, wastewater, traveler-based, and digital public health surveillance (e.g., global data repositories, news, and social media). The SARS-CoV-2 variant BA.2.86 was first sequenced in Israel and reported on August 13, 2023. The first U.S. COVID-19 case caused by this variant was reported on August 17, 2023, after a patient received testing for SARS-CoV-2 at a health care facility on August 3. In the following month, eight additional U.S. states detected BA.2.86 across various surveillance systems, including specimens from health care settings, wastewater surveillance, and traveler-based genomic surveillance. As of October 23, 2023, sequences have been reported from at least 32 countries. Continued variant tracking and further evidence are needed to evaluate the full public health impact of BA.2.86. Timely genomic sequence submissions to global public databases aided early detection of BA.2.86 despite the decline in the number of specimens being sequenced during the past year. This report describes how multicomponent surveillance and genomic sequencing were used in real time to track the emergence and transmission of the BA.2.86 variant. This surveillance approach provides valuable information regarding implementing and sustaining comprehensive surveillance not only for novel SARS-CoV-2 variants but also for future pathogen threats.
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2
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Taha TY, Townsend MB, Pohl J, Karem KL, Damon IK, Mbala Kingebeni P, Muyembe Tamfum JJ, Martin JW, Pittman PR, Huggins JW, Satheshkumar PS, Bagarozzi DA, Reynolds MG, Hughes LJ. Design and Optimization of a Monkeypox virus Specific Serological Assay. Pathogens 2023; 12:pathogens12030396. [PMID: 36986317 PMCID: PMC10054672 DOI: 10.3390/pathogens12030396] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
Monkeypox virus (MPXV), a member of the Orthopoxvirus (OPXV) genus, is a zoonotic virus, endemic to central and western Africa that can cause smallpox-like symptoms in humans with fatal outcomes in up to 15% of patients. The incidence of MPXV infections in the Democratic Republic of the Congo, where the majority of cases have occurred historically, has been estimated to have increased as much as 20-fold since the end of smallpox vaccination in 1980. Considering the risk global travel carries for future disease outbreaks, accurate epidemiological surveillance of MPXV is warranted as demonstrated by the recent Mpox outbreak, where the majority of cases were occurring in non-endemic areas. Serological differentiation between childhood vaccination and recent infection with MPXV or other OPXVs is difficult due to the high level of conservation within OPXV proteins. Here, a peptide-based serological assay was developed to specifically detect exposure to MPXV. A comparative analysis of immunogenic proteins across human OPXVs identified a large subset of proteins that could potentially be specifically recognized in response to a MPXV infection. Peptides were chosen based upon MPXV sequence specificity and predicted immunogenicity. Peptides individually and combined were screened in an ELISA against serum from well-characterized Mpox outbreaks, vaccinee sera, and smallpox sera collected prior to eradication. One peptide combination was successful with ~86% sensitivity and ~90% specificity. The performance of the assay was assessed against the OPXV IgG ELISA in the context of a serosurvey by retrospectively screening a set of serum specimens from the region in Ghana believed to have harbored the MPXV-infected rodents involved in the 2003 United States outbreak.
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Affiliation(s)
- Taha Y. Taha
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Michael B. Townsend
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jan Pohl
- Biotechnology Core Facility Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Kevin L. Karem
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Inger K. Damon
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Placide Mbala Kingebeni
- Institut National de Recherche Biomédicale, Ministère de la Santé Publique, Kinshasa P.O. Box 1197, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe Tamfum
- Institut National de Recherche Biomédicale, Ministère de la Santé Publique, Kinshasa P.O. Box 1197, Democratic Republic of the Congo
| | - James W. Martin
- Department of Clinical Research, Division of Medicine, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD 21702, USA
| | - Phillip R. Pittman
- Department of Clinical Research, Division of Medicine, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD 21702, USA
| | - John W. Huggins
- Department of Clinical Research, Division of Medicine, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, MD 21702, USA
| | - Panayampalli S. Satheshkumar
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Dennis A. Bagarozzi
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Mary G. Reynolds
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Laura J. Hughes
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
- Correspondence:
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3
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Hughes LJ, Daley S, Farina N, Tabet N, Banerjee S. Care home staff perceptions of implementing a quality of life instrument into routine care practice: A qualitative study. Health Soc Care Community 2022; 30:e6500-e6510. [PMID: 36305684 DOI: 10.1111/hsc.14095] [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] [Received: 04/01/2022] [Revised: 08/11/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Quality of life is an important outcome in older-adult care. Measuring resident quality of life may offer ways to improve it and to improve quality of care. However, in the UK quality of life is rarely measured as a part of routine care. Our study aimed to understand the views of care home staff about using a quality of life instrument as a part of routine care in order to support its implementation into routine practice. In a qualitative study, we conducted 35 interviews with care home staff and two focus groups with four care home managers from three care homes in East Sussex, England. Data were collected between September 2015 and February 2016. Care staff and managers were aged on average 40 (SD = 12.2) and 43.7 (SD = 14.4) years and had worked in the care sector an average of 11.4 (SD = 10.2) and 23.7 (SD = 14.1) years, respectively. Participants were predominantly female and white British. Interviews and focus groups were analysed using thematic analysis. Findings identified two overarching themes of 'Perceived gains' and 'Implementation'. Overall, there was a lot of positivity towards using a quality of life instrument in routine practice. This positivity was an important feature in how the instrument was perceived as fitting into practice. Participants identified several barriers and discussed how to overcome them. Results from the study demonstrate that routine measurement of quality of life is positively received by care staff. They believed that measuring quality of life as a part of care practice could lead to improvements in resident quality of life, staff knowledge and understanding and care practices. The findings suggest that routinely measuring quality of life as a part of normal care could also have more far-reaching effects on the provision of person-centred care provided by care staff.
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Affiliation(s)
- Laura J Hughes
- Brighton and Sussex Medical School, Brighton, UK
- King's College London, London, UK
| | | | | | - Naji Tabet
- Brighton and Sussex Medical School, Brighton, UK
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4
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Shragai T, Pratt C, Castro Georgi J, Donnelly MAP, Schwartz NG, Soto R, Chuey M, Chu VT, Marcenac P, Park GW, Ahmad A, Albanese B, Totten SE, Austin B, Bunkley P, Cherney B, Dietrich EA, Figueroa E, Folster JM, Godino C, Herzegh O, Lindell K, Relja B, Sheldon SW, Tong S, Vinjé J, Thornburg NJ, Matanock AM, Hughes LJ, Stringer G, Hudziec M, Beatty ME, Tate JE, Kirking HL, Hsu CH. Household characteristics associated with surface contamination of SARS-CoV-2 and frequency of RT-PCR and viral culture positivity-California and Colorado, 2021. PLoS One 2022; 17:e0274946. [PMID: 36215247 PMCID: PMC9550039 DOI: 10.1371/journal.pone.0274946] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Received: 04/05/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
While risk of fomite transmission of SARS-CoV-2 is considered low, there is limited environmental data within households. This January-April 2021 investigation describes frequency and types of surfaces positive for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) among residences with ≥1 SARS-CoV-2 infection, and associations of household characteristics with surface RT-PCR and viable virus positivity. Of 1232 samples from 124 households, 27.8% (n = 342) were RT-PCR positive with nightstands (44.1%) and pillows (40.9%) most frequently positive. SARS-CoV-2 lineage, documented household transmission, greater number of infected persons, shorter interval between illness onset and sampling, total household symptoms, proportion of infected persons ≤12 years old, and persons exhibiting upper respiratory symptoms or diarrhea were associated with more positive surfaces. Viable virus was isolated from 0.2% (n = 3 samples from one household) of all samples. This investigation suggests that while SARS-CoV-2 on surfaces is common, fomite transmission risk in households is low.
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Affiliation(s)
- Talya Shragai
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Caroline Pratt
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | | | - Marisa A. P. Donnelly
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Noah G. Schwartz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Raymond Soto
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Meagan Chuey
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Victoria T. Chu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Perrine Marcenac
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Geun Woo Park
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ausaf Ahmad
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bernadette Albanese
- Tri-County Health Department, Adams, Arapahoe, and Douglas Counties, Colorado, United States of America
| | - Sarah Elizabeth Totten
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Brett Austin
- Health and Human Services, San Diego County, California, United States of America
| | - Paige Bunkley
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Blake Cherney
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A. Dietrich
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erica Figueroa
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer M. Folster
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire Godino
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Owen Herzegh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristine Lindell
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Boris Relja
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah W. Sheldon
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Natalie J. Thornburg
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Almea M. Matanock
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Laura J. Hughes
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Meghan Hudziec
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Mark E. Beatty
- Health and Human Services, San Diego County, California, United States of America
| | - Jacqueline E. Tate
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hannah L. Kirking
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher H. Hsu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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5
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McCormick DW, Konkle SL, Magleby R, Chakrabarti AK, Cherney B, Lindell K, Namageyo-Funa A, Visser S, Soto RA, Donnelly MAP, Stringer G, Austin B, Beatty ME, Stous S, Albanese BA, Chu VT, Chuey M, Dietrich EA, Drobeniuc J, Folster JM, Killerby ME, Lehman JA, McDonald EC, Ruffin J, Schwartz NG, Sheldon SW, Sleweon S, Thornburg NJ, Hughes LJ, Petway M, Tong S, Whaley MJ, Kirking HL, Tate JE, Hsu CH, Matanock A. SARS-CoV-2 infection risk among vaccinated and unvaccinated household members during the Alpha variant surge - Denver, Colorado, and San Diego, California, January-April 2021. Vaccine 2022; 40:4845-4855. [PMID: 35803846 PMCID: PMC9250903 DOI: 10.1016/j.vaccine.2022.06.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND COVID-19 vaccination reduces SARS-CoV-2 infection and transmission. However, evidence is emerging on the degree of protection across variants and in high-transmission settings. To better understand the protection afforded by vaccination specifically in a high-transmission setting, we examined household transmission of SARS-CoV-2 during a period of high community incidence with predominant SARS-CoV-2 B.1.1.7 (Alpha) variant, among vaccinated and unvaccinated contacts. METHODS We conducted a household transmission investigation in San Diego County, California, and Denver, Colorado, during January-April 2021. Households were enrolled if they had at least one person with documented SARS-CoV-2 infection. We collected nasopharyngeal swabs, blood, demographic information, and vaccination history from all consenting household members. We compared infection risks (IRs), RT-PCR cycle threshold values, SARS-CoV-2 culture results, and antibody statuses among vaccinated and unvaccinated household contacts. RESULTS We enrolled 493 individuals from 138 households. The SARS-CoV-2 variant was identified from 121/138 households (88%). The most common variants were Alpha (75/121, 62%) and Epsilon (19/121, 16%). There were no households with discordant lineages among household members. One fully vaccinated secondary case was symptomatic (13%); the other 5 were asymptomatic (87%). Among unvaccinated secondary cases, 105/108 (97%) were symptomatic. Among 127 households with a single primary case, the IR for household contacts was 45% (146/322; 95% Confidence Interval [CI] 40-51%). The observed IR was higher in unvaccinated (130/257, 49%, 95% CI 45-57%) than fully vaccinated contacts (6/26, 23%, 95% CI 11-42%). A lower proportion of households with a fully vaccinated primary case had secondary cases (1/5, 20%) than households with an unvaccinated primary case (66/108, 62%). CONCLUSIONS Although SARS-CoV-2 infections in vaccinated household contacts were reported in this high transmission setting, full vaccination protected against SARS-CoV-2 infection. These findings further support the protective effect of COVID-19 vaccination and highlight the need for ongoing vaccination among eligible persons.
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Affiliation(s)
- David W McCormick
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stacey L Konkle
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reed Magleby
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ayan K Chakrabarti
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Blake Cherney
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristine Lindell
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Apophia Namageyo-Funa
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susanna Visser
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Raymond A Soto
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marisa A P Donnelly
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ginger Stringer
- Colorado Department of Public Health and the Environment, Denver, CO, USA
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Mark E Beatty
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Sarah Stous
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | | | - Victoria T Chu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Meagan Chuey
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Elizabeth A Dietrich
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jan Drobeniuc
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer M Folster
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marie E Killerby
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer A Lehman
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric C McDonald
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Jasmine Ruffin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Noah G Schwartz
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah W Sheldon
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sadia Sleweon
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natalie J Thornburg
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura J Hughes
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marla Petway
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa J Whaley
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hannah L Kirking
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E Tate
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher H Hsu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Almea Matanock
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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6
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Waltenburg MA, Whaley MJ, Chancey RJ, Donnelly MA, Chuey MR, Soto R, Schwartz NG, Chu VT, Sleweon S, McCormick DW, Uehara A, Retchless AC, Tong S, Folster JM, Petway M, Thornburg NJ, Drobeniuc J, Austin B, Hudziec MM, Stringer G, Albanese BA, Totten SE, Matzinger SR, Staples JE, Killerby ME, Hughes LJ, Matanock A, Beatty M, Tate JE, Kirking HL, Hsu CH. Household Transmission and Symptomology of Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant among Children-California and Colorado, 2021. J Pediatr 2022; 247:29-37.e7. [PMID: 35447121 PMCID: PMC9015725 DOI: 10.1016/j.jpeds.2022.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/30/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the household secondary infection risk (SIR) of B.1.1.7 (Alpha) and non-Alpha lineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children. STUDY DESIGN During January to April 2021, we prospectively followed households with a SARS-CoV-2 infection. We collected questionnaires, serial nasopharyngeal swabs for reverse transcription polymerase chain reaction testing and whole genome sequencing, and serial blood samples for serology testing. We calculated SIRs by primary case age (pediatric vs adult), household contact age, and viral lineage. We evaluated risk factors associated with transmission and described symptom profiles among children. RESULTS Among 36 households with pediatric primary cases, 21 (58%) had secondary infections. Among 91 households with adult primary cases, 51 (56%) had secondary infections. SIRs among pediatric and adult primary cases were 45% and 54%, respectively (OR, 0.79; 95% CI, 0.41-1.54). SIRs among pediatric primary cases with Alpha and non-Alpha lineage were 55% and 46%, respectively (OR, 1.52; 95% CI, 0.51-4.53). SIRs among pediatric and adult household contacts were 55% and 49%, respectively (OR, 1.01; 95% CI, 0.68-1.50). Among pediatric contacts, no significant differences in the odds of acquiring infection by demographic or household characteristics were observed. CONCLUSIONS Household transmission of SARS-CoV-2 from children and adult primary cases to household members was frequent. The risk of secondary infection was similar among child and adult household contacts. Among children, household transmission of SARS-CoV-2 and the risk of secondary infection was not influenced by lineage. Continued mitigation strategies (eg, masking, physical distancing, vaccination) are needed to protect at-risk groups regardless of virus lineage circulating in communities.
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Affiliation(s)
- Michelle A. Waltenburg
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA,Reprint requests: Michelle A. Waltenburg, DVM, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329
| | - Melissa J. Whaley
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rebecca J. Chancey
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marisa A.P. Donnelly
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Meagan R. Chuey
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA,County of San Diego Health and Human Services Agency, San Diego, CA
| | - Raymond Soto
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Noah G. Schwartz
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Victoria T. Chu
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sadia Sleweon
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - David W. McCormick
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Anna Uehara
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Adam C. Retchless
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Suxiang Tong
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer M. Folster
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marla Petway
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Natalie J. Thornburg
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jan Drobeniuc
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, CA
| | | | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver, CO
| | | | - Sarah E. Totten
- Colorado Department of Public Health and Environment, Denver, CO
| | | | - J. Erin Staples
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marie E. Killerby
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Laura J. Hughes
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Almea Matanock
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark Beatty
- County of San Diego Health and Human Services Agency, San Diego, CA
| | - Jacqueline E. Tate
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Hannah L. Kirking
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christopher H. Hsu
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
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7
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Chu VT, Schwartz NG, Donnelly MAP, Chuey MR, Soto R, Yousaf AR, Schmitt-Matzen EN, Sleweon S, Ruffin J, Thornburg N, Harcourt JL, Tamin A, Kim G, Folster JM, Hughes LJ, Tong S, Stringer G, Albanese BA, Totten SE, Hudziec MM, Matzinger SR, Dietrich EA, Sheldon SW, Stous S, McDonald EC, Austin B, Beatty ME, Staples JE, Killerby ME, Hsu CH, Tate JE, Kirking HL, Matanock A. Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection. JAMA Intern Med 2022; 182:701-709. [PMID: 35486394 PMCID: PMC9055515 DOI: 10.1001/jamainternmed.2022.1827] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE As self-collected home antigen tests become widely available, a better understanding of their performance during the course of SARS-CoV-2 infection is needed. OBJECTIVE To evaluate the diagnostic performance of home antigen tests compared with reverse transcription-polymerase chain reaction (RT-PCR) and viral culture by days from illness onset, as well as user acceptability. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from January to May 2021 in San Diego County, California, and metropolitan Denver, Colorado. The convenience sample included adults and children with RT-PCR-confirmed infection who used self-collected home antigen tests for 15 days and underwent at least 1 nasopharyngeal swab for RT-PCR, viral culture, and sequencing. EXPOSURES SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The primary outcome was the daily sensitivity of home antigen tests to detect RT-PCR-confirmed cases. Secondary outcomes included the daily percentage of antigen test, RT-PCR, and viral culture results that were positive, and antigen test sensitivity compared with same-day RT-PCR and cultures. Antigen test use errors and acceptability were assessed for a subset of participants. RESULTS This study enrolled 225 persons with RT-PCR-confirmed infection (median [range] age, 29 [1-83] years; 117 female participants [52%]; 10 [4%] Asian, 6 [3%] Black or African American, 50 [22%] Hispanic or Latino, 3 [1%] Native Hawaiian or Other Pacific Islander, 145 [64%] White, and 11 [5%] multiracial individuals) who completed 3044 antigen tests and 642 nasopharyngeal swabs. Antigen test sensitivity was 50% (95% CI, 45%-55%) during the infectious period, 64% (95% CI, 56%-70%) compared with same-day RT-PCR, and 84% (95% CI, 75%-90%) compared with same-day cultures. Antigen test sensitivity peaked 4 days after illness onset at 77% (95% CI, 69%-83%). Antigen test sensitivity improved with a second antigen test 1 to 2 days later, particularly early in the infection. Six days after illness onset, antigen test result positivity was 61% (95% CI, 53%-68%). Almost all (216 [96%]) surveyed individuals reported that they would be more likely to get tested for SARS-CoV-2 infection if home antigen tests were available over the counter. CONCLUSIONS AND RELEVANCE The results of this cohort study of home antigen tests suggest that sensitivity for SARS-CoV-2 was moderate compared with RT-PCR and high compared with viral culture. The results also suggest that symptomatic individuals with an initial negative home antigen test result for SARS-CoV-2 infection should test again 1 to 2 days later because test sensitivity peaked several days after illness onset and improved with repeated testing.
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Affiliation(s)
- Victoria T Chu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Noah G Schwartz
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marisa A P Donnelly
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meagan R Chuey
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia.,County of San Diego Health and Human Services Agency, San Diego, California
| | - Raymond Soto
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna R Yousaf
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily N Schmitt-Matzen
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sadia Sleweon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jasmine Ruffin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie Thornburg
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Harcourt
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Azaibi Tamin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gimin Kim
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M Folster
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura J Hughes
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suxiang Tong
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver
| | | | - Sarah E Totten
- Colorado Department of Public Health and Environment, Denver
| | | | | | - Elizabeth A Dietrich
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah W Sheldon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Stous
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Eric C McDonald
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Mark E Beatty
- County of San Diego Health and Human Services Agency, San Diego, California
| | - J Erin Staples
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marie E Killerby
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher H Hsu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacqueline E Tate
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah L Kirking
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Almea Matanock
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
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8
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Paudyal P, Skinner E, Majeed-Hajaj S, Hughes LJ, Magar NK, Keeling DI, Armes J, Kulasabanathan K, Ford E, Sharp R, Cassell JA. COVID-19 health information needs of older adults from ethnic minority groups in the UK: a qualitative study. BMJ Open 2022; 12:e059844. [PMID: 35725268 PMCID: PMC9213778 DOI: 10.1136/bmjopen-2021-059844] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to identify the COVID-19 health information needs of older adults from ethnic minority groups in the UK. STUDY DESIGN A qualitative study using semistructured interviews. SETTING AND PARTICIPANTS Indian and Nepalese older adults (≥65 years), their families (≥18 years) and healthcare professionals (HCPs) (≥18 years) engaging with these communities. Participants were recruited between July and December 2020 from Kent, Surrey and Sussex through community organisations. RESULTS 24 participants took part in the study; 13 older adults, 7 family members and 4 HCPs. Thirteen participants were female, and the majority (n=17) spoke a language other than English at home. Older participants mostly lived in multigenerational households, and family and community were key for providing support and communicating about healthcare needs. Participants' knowledge of COVID-19 varied widely; some spoke confidently about the subject, while others had limited information. Language and illiteracy were key barriers to accessing health information. Participants highlighted the need for information in multiple formats and languages, and discussed the importance of culturally appropriate avenues, such as community centres and religious sites, for information dissemination. CONCLUSION This study, undertaken during the COVID-19 pandemic, provides insight into how health information can be optimised for ethnic minority older adults in terms of content, format and cultural relevance. The study highlights that health information interventions should recognise the intersection between multigenerational living, family structure, and the health and well-being of older adults, and should promote intergenerational discussion.
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Affiliation(s)
- Priyamvada Paudyal
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Emily Skinner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | | | | | | | | | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Rebecca Sharp
- Kent Surrey Sussex Academic Health Science Network, Crawley, UK
| | - Jackie A Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
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9
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Soto R, Hsu C, Chuey M, Donnelly M, Chu VT, Schwartz NG, Tong S, Thornburg NJ, Killerby ME, Staples JE, Kirking HL, Tate J, Matanock A, Stringer G, Albanese B, Beatty M, Hughes LJ. 373. Household transmission of SARS-CoV-2 B.1.1.7 lineage –2 U.S. States, 2021. Open Forum Infect Dis 2021. [PMCID: PMC8643738 DOI: 10.1093/ofid/ofab466.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background In December 2020, B.1.1.7 lineage of SARS-CoV-2 was first detected in the United States and has since become the dominant lineage. Previous investigations involving B.1.1.7 suggested higher rates of transmission relative to non-B.1.1.7 lineages. We conducted a household transmission investigation to determine the secondary infection rates (SIR) of B.1.1.7 and non-B.1.1.7 SARS-CoV-2 lineages. Methods From January–April 2021, we enrolled members of households in San Diego County, CA, and Denver, CO metropolitan area (Tri-County), with a confirmed SARS-CoV-2 infection in a household member with illness onset date in the previous 10 days. CDC investigators visited households at enrollment and 14 days later at closeout to obtain demographic and clinical data and nasopharyngeal (NP) samples on all consenting household members. Interim visits, with collection of NP swabs, occurred if a participant became symptomatic during follow-up. NP samples were tested for SARS-CoV-2 using TaqPath™ RT-PCR test, where failure to amplify the spike protein results in S-Gene target failure (SGTF) may indicate B.1.1.7 lineage. Demographic characteristics and SIR were compared among SGTF and non-SGTF households using two-sided p-values with chi-square tests; 95% confidence intervals (CI) were calculated with Wilson score intervals. Results 552 persons from 151 households were enrolled. 91 (60%) households were classified as SGTF, 57 (38%) non-SGTF, and 3 (2%) indeterminant. SGTF and non-SGTF households had similar sex distribution (49% female and 52% female, respectively; P=0.54) and age (median 30 years, interquartile range (IQR 14–47) and 31 years (IQR 15–45), respectively). Hispanic people accounted for 24% and 32% of enrolled members of SGTF and non-SGTF households, respectively (p=0.04). At least one secondary case occurred in 61% of SGTF and 58% of non-SGTF households (P=0.66). SIR was 52% (95%[CI] 46%-59%) for SGTF and 45% (95% CI 37%-53%) for non-SGTF households (P=0.18). Conclusion SIRs were high in both SGTF and non-SGTF households; our findings did not support an increase in SIR for SGTF relative to non-SGTF households in this setting. Sequence confirmed SARS-CoV-2 samples will provide further information on lineage specific SIRs. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Raymond Soto
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Meagan Chuey
- Centers for Disease Control and Prevention, San Deigo, California
| | | | | | | | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | - Marie E Killerby
- Centers for Disease Control and Prevention, San Deigo, California
| | | | | | - Jacqueline Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Mark Beatty
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Laura J Hughes
- Centers for Disease Control and Prevention, San Deigo, California
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10
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Farina N, Williams A, Clarke K, Hughes LJ, Thomas S, Lowry RG, Banerjee S. Barriers, motivators and facilitators of physical activity in people with dementia and their family carers in England: dyadic interviews. Aging Ment Health 2021; 25:1115-1124. [PMID: 32067474 DOI: 10.1080/13607863.2020.1727852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Physical activity may have a number of physical and mental health benefits for people with dementia and their carers. However, there is limited evidence about factors that influence physical activity participation in these groups. This study therefore looks at the barriers, facilitators and motivators of physical activity in people with dementia, from both the perspective of the person with dementia and their carer. METHOD Thirty participants (15 sets of community-dwelling people with dementia and their family carers) were recruited from the South East of England. The participants took part in semi-structured dyadic interviews about their views of physical activity. Interviews were analysed using inductive thematic analysis at an individual level and comparisons were made between the groups. RESULTS Common motivator themes across persons with dementia and family carers were emotional and physical wellbeing, and social connectedness. Physical health was seen as a common barrier in both groups. Physical activity in the person with dementia was encouraged and supported by the family carer. For the carer, their caring role, and limited time acted as barriers to their participation. CONCLUSION Themes such as social connectedness, positive emotion and health were seen as key motivators to physical activity, which indicate that people with dementia and carers use physical activity as a means to maintain and improve their quality of life. Supporting family members to better facilitate such activities could encourage physical activity in people with dementia.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Alice Williams
- Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Kirsty Clarke
- Global and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Laura J Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Serena Thomas
- Research and Development, Sussex Partnership NHS Foundation Trust, Hove, UK
| | - Ruth G Lowry
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
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11
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Chida AS, Goldstein JM, Lee J, Tang X, Bedi K, Herzegh O, Moon JL, Petway D, Bagarozzi DA, Hughes LJ. Comparison of Zika virus inactivation methods for reagent production and disinfection methods. J Virol Methods 2021; 287:114004. [PMID: 33098957 PMCID: PMC10901439 DOI: 10.1016/j.jviromet.2020.114004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/10/2020] [Accepted: 10/18/2020] [Indexed: 02/03/2023]
Abstract
Zika virus (ZIKV) infection remains a public health concern necessitating demand for long-term virus production for diagnostic assays and R&D activities. Inactivated virus constitutes an important component of the Trioplex rRT-PCR assay and serological IgM assay (MAC-ELISA). The aim of our study is to establish standard methods of ZIKV inactivation while maintaining antigenicity and RNA integrity. We tested viral supernatants by four different inactivation methods: 1. Heat inactivation at 56 °C and 60 °C; 2. Gamma-Irradiation; 3. Chemical inactivation by Beta-propiolactone (BPL) and 4. Fast-acting commercial disinfecting agents. Effectivity was measured by cytopathic effect (CPE) and plaque assay. RNA stability and antigenicity were measured by RT-PCR and MAC-ELISA, respectively. Results: Heat inactivation: Low titer samples, incubated at 56 °C for 2 h, showed neither CPE or plaques compared to high titer supernatants that required 2.5 h. Inactivation occurred at 60 °C for 60 min with all virus titers. Gamma irradiation: Samples irradiated at ≥3 Mrad for low virus concentrations and ≥5Mrad for high virus titer completely inactivated virus. Chemical Inactivation: Neither CPE nor plaques were observed with ≥0.045 % BPL inactivation of ZIKV. Disinfectant: Treatment of viral supernatants with Micro-Chem Plus™, inactivated virus in 2 min, whereas, Ethanol (70 %) and STERIS Coverage® Spray TB inactivated the virus in 5 min.
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Affiliation(s)
- Asiya S Chida
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jason M Goldstein
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Joo Lee
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Xiaoling Tang
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kanwar Bedi
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Owen Herzegh
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jonathan L Moon
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - David Petway
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Dennis A Bagarozzi
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Laura J Hughes
- Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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12
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Farina N, Griffiths AW, Hughes LJ, Parveen S. Measuring adolescent attitudes towards dementia: The revalidation and refinement of the A-ADS. J Health Psychol 2020; 27:374-385. [PMID: 32909455 DOI: 10.1177/1359105320953479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The A-ADS is one the first validated measures of attitudes of dementia in adolescents, though further validation is needed. 630 adolescents were recruited from secondary schools in England. A Principal Component Analysis was completed (n = 230) followed by a Confirmatory Factor Analysis (n = 400). Reducing the A-ADS into a single factor, 13-item measure (Brief A-ADS) improved the model fit of the measure (χ2 = 182.75, DF = 65, CMIN/DF = 2.81, p < 0.001, CFI = 0.90, RMSEA = 0.07). The scale demonstrated good internal consistency, good predictive and concurrent validity. Building on the validation of the A-ADS, the Brief A-ADS is suitable to capture attitudes towards dementia amongst adolescents.
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13
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Abstract
Objectives: There is a lack of understanding about how adolescents perceive dementia, and what their dementia related experiences are. Without such information, it is hard to make a case for the need to raise awareness of dementia in adolescents, and the best strategies to achieve this.Methods: In a cohort of 901 adolescents (aged 13-18) from the South East of England, we explored what the experiences and perceptions of dementia were using a series of questionnaires. Descriptive data of individual items were reported, comparing differences between genders.Results: The adolescents within this study tended to have positive or neutral attitudes towards dementia, though there was evidence that a proportion of adolescents had misconceptions or held negative attitudes (e.g. 28.5% of adolescents disagreed with the statement 'In general, I have positive attitudes about people with dementia'). We also identified that the adolescents had a range of experiences of dementia including providing some form of care for someone with dementia (23.2%), though most had indirect contact with dementia through TV and movies (77.3%), or adverts (80.2%). Females nearly always had better attitudes towards dementia and had significantly more contact with dementia.Conclusions: Considering that adolescents are already forming negative attitudes and misconceptions of dementia, it is important that we raise awareness about dementia in this age group.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Laura J Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Alys W Griffiths
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Sahdia Parveen
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
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14
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Farina N, Hughes LJ, Jones E, Parveen S, Griffiths AW, Galvin K, Banerjee S. The effect of a dementia awareness class on changing dementia attitudes in adolescents. BMC Geriatr 2020; 20:188. [PMID: 32487024 PMCID: PMC7265248 DOI: 10.1186/s12877-020-01589-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/20/2020] [Indexed: 01/06/2023] Open
Abstract
Background Current evidence suggests that negative and stigmatising attitudes towards dementia may develop at a young age. There are a number of dementia education and awareness initiatives aimed at reducing stigma, though they have not been robustly evaluated to establish the impact on dementia attitudes or suitability in adolescent populations. This study explored the efficacy and satisfaction of one such initiative (Dementia Friends) in a British adolescent sample. Methods 301 adolescents (M = 12.6 years old, SD = 0.73) were assigned to either receive Dementia Friends (a 60-min interactive class that teaches about dementia and its effects on people’s lives) or education as usual. All participants completed a series of validated questionnaires pre- and post-intervention, related to dementia attitudes (Brief A-ADS and KIDS). Results Adolescents in the dementia awareness group showed little to no improvements between time-points. The change scores in the dementia awareness group did not significantly differ to the control group based on both KIDS (d = − 0.003, p = 0.98) and Brief A-ADS (d = 0.14, p = 0.13) measures. There was no Group x Time effect after controlling for confounding variables. Conclusions Dementia Friends is successful in terms of reach and impact, though this study suggests that it may fall short of achieving its goal of improving attitudes towards dementia. Importantly, Dementia Friends did not have a negative effect on attitudes, and the majority of adolescents enjoyed the sessions. It is important that these findings are replicated in a larger randomised-controlled study.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9RY, UK.
| | - Laura J Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9RY, UK
| | - Ellen Jones
- Brighton and Hove Dementia Action Alliance, Brighton, UK
| | - Sahdia Parveen
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Alys W Griffiths
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Kathleen Galvin
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, Plymouth, UK
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15
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Hughes LJ, Townsend MB, Gallardo-Romero N, Hutson CL, Patel N, Doty JB, Salzer JS, Damon IK, Carroll DS, Satheshkumar PS, Karem KL. Magnitude and diversity of immune response to vaccinia virus is dependent on route of administration. Virology 2020; 544:55-63. [PMID: 32174514 DOI: 10.1016/j.virol.2020.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 01/14/2023]
Abstract
Historic observations suggest that survivors of smallpox maintained lifelong immunity and protection to subsequent infection compared to vaccinated individuals. Although protective immunity by vaccination using a related virus (vaccinia virus (VACV) strains) was the key for smallpox eradication, it does not uniformly provide long term, or lifelong protective immunity (Heiner et al., 1971). To determine differences in humoral immune responses, mice were inoculated with VACV either systemically, using intranasal inoculation (IN), or locally by an intradermal (ID) route. We hypothesized that sub-lethal IN infections may mimic systemic or naturally occurring infection and lead to an immunodominance reaction, in contrast to localized ID immunization. The results demonstrated systemic immunization through an IN route led to enhanced adaptive immunity to VACV-expressed protein targets both in magnitude and in diversity when compared to an ID route using a VACV protein microarray. In addition, cytokine responses, assessed using a Luminex® mouse cytokine multiplex kit, following IN infection was greater than that stemming from ID infection. Overall, the results suggest that the route of immunization (or infection) influences antibody responses. The greater magnitude and diversity of response in systemic infection provides indirect evidence for anecdotal observations made during the smallpox era that survivors maintain lifelong protection. These findings also suggest that systemic or disseminated host immune induction may result in a superior response, that may influence the magnitude of, as well as duration of protective responses.
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Affiliation(s)
- Laura J Hughes
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA.
| | - Michael B Townsend
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Nadia Gallardo-Romero
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Christina L Hutson
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Nishi Patel
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Jeff B Doty
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Johanna S Salzer
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Inger K Damon
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Darin S Carroll
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Panayampalli Subbian Satheshkumar
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Kevin L Karem
- Centers for Disease Control and Prevention, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, 1600 Clifton Road, Atlanta, GA, 30333, USA.
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16
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Abstract
OBJECTIVE To investigate the routine use of a measure of quality of life (QoL) in care homes and assess its psychometric properties when used by care staff. DESIGN A cross-sectional two-phase study. SETTING AND PARTICIPANTS Data were collected from care staff in seven care homes in East Sussex, England. METHOD Phase I: The ability of care staff from two care homes to use the DEMQOL-Proxy without interviewer administration was assessed using agreement analysis between a self-administered and interviewer-administered version of the instrument. Based on these findings, DEMQOL-Proxy was adapted into a new version, DEMQOL-CH, for use as a self-administered instrument in care homes. We assessed agreement between the new DEMQOL-CH and DEMQOL-Proxy to ensure DEMQOL-CH was used correctly. Phase II: A preliminary assessment of the psychometric properties of DEMQOL-CH when used routinely was completed in a further five care homes. RESULTS Phase I: Nineteen care staff from two care homes completed QoL measurements for residents. Systematic error was identified when staff self-completed the DEMQOL-Proxy without an interviewer. We modified the DEMOoL-Proxy to create DEMQOL-CH; this reduced the error, producing a version that could be used more accurately by care staff. Phase II: Eleven care staff from five care homes rated resident QoL routinely. DEMQOL-CH showed acceptable psychometric properties with satisfactory reliability and validity and a clear factor structure. CONCLUSIONS The research presents positive preliminary data on the acceptability, feasibility and performance of routine QoL measurement in care homes using an adapted version of DEMQOL-Proxy, the DEMQOL-CH. Results provide evidence to support the concept that routine measurement of QoL may be possible in care homes. Research is needed to refine and test the methodology and instrument further and to explore the potential for benefits to residents, staff and care homes in larger and more representative populations.
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Affiliation(s)
- Laura J Hughes
- Neuroscience, Brighton and Sussex Medical School, Brighton, UK
| | - Nicolas Farina
- Neuroscience, Brighton and Sussex Medical School, Brighton, UK
| | | | - Naji Tabet
- Neuroscience, Brighton and Sussex Medical School, Brighton, UK
| | - Sube Banerjee
- Neuroscience, Brighton and Sussex Medical School, Brighton, UK
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17
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Parveen S, Farina N, Shafiq S, Hughes LJ, Griffiths AW. What do adolescents perceive to be key features of an effective dementia education and awareness initiative? Dementia 2018; 19:1844-1854. [DOI: 10.1177/1471301218807559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The development of dementia friendly communities is a current global and national priority for the UK. As a response to policy, there have been a number of dementia awareness initiatives disseminated with the aim of reducing the stigma associated with a diagnosis of dementia. The inclusion of adolescents in such initiatives is imperative in order to sustain dementia friendly communities. With this in mind, the aim of this study was to establish the dementia education needs of adolescents and effective dissemination strategies to convey key messages. A total of 42 adolescents aged 12 to 18 years participated in eight focus group discussions. Key themes to emerge from discussions included: the importance of dementia awareness, topics of interest within dementia, preferred methods of learning, the inclusion of the person living with dementia and the use of social media. The findings of the study will enable the development of appropriate dementia awareness initiatives for adolescents and thus facilitate the sustainability of dementia friendly communities.
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Affiliation(s)
- Sahdia Parveen
- Centre for Applied Dementia Studies, University of Bradford, UK
| | - Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, UK
| | - Saba Shafiq
- Centre for Applied Dementia Studies, University of Bradford, UK
| | - Laura J Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, UK
| | - Alys W Griffiths
- Centre for Applied Dementia Studies, University of Bradford, UK; Centre for Dementia Research, Leeds Beckett University, UK
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18
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Hughes LJ, Black LJ, Sherriff JL, Dunlop E, Strobel N, Lucas RM, Bornman JF. Vitamin D Content of Australian Native Food Plants and Australian-Grown Edible Seaweed. Nutrients 2018; 10:nu10070876. [PMID: 29986447 PMCID: PMC6073725 DOI: 10.3390/nu10070876] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/25/2018] [Accepted: 07/03/2018] [Indexed: 01/07/2023] Open
Abstract
Vitamin D has previously been quantified in some plants and algae, particularly in leaves of the Solanaceae family. We measured the vitamin D content of Australian native food plants and Australian-grown edible seaweed. Using liquid chromatography with triple quadrupole mass spectrometry, 13 samples (including leaf, fruit, and seed) were analyzed in duplicate for vitamin D2, vitamin D3, 25-hydroxyvitamin D2, and 25-hydroxyvitamin D3. Five samples contained vitamin D2: raw wattleseed (Acacia victoriae) (0.03 µg/100 g dry weight (DW)); fresh and dried lemon myrtle (Backhousia citriodora) leaves (0.03 and 0.24 µg/100 g DW, respectively); and dried leaves and berries of Tasmanian mountain pepper (Tasmannia lanceolata) (0.67 and 0.05 µg/100 g DW, respectively). Fresh kombu (Lessonia corrugata) contained vitamin D3 (0.01 µg/100 g DW). Detected amounts were low; however, it is possible that exposure to ultraviolet radiation may increase the vitamin D content of plants and algae if vitamin D precursors are present.
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Affiliation(s)
- Laura J Hughes
- School of Public Health, Curtin University, Bentley WA 6102, Australia.
| | - Lucinda J Black
- School of Public Health, Curtin University, Bentley WA 6102, Australia.
| | - Jill L Sherriff
- School of Public Health, Curtin University, Bentley WA 6102, Australia.
| | - Eleanor Dunlop
- School of Public Health, Curtin University, Bentley WA 6102, Australia.
| | - Norbert Strobel
- National Measurement Institute, 1/153 Bertie Street, Port Melbourne VIC 3207, Australia.
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra ACT 2600, Australia.
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth WA 6009, Australia.
| | - Janet F Bornman
- School of Veterinary and Life Sciences, Murdoch University, Murdoch WA 6150, Australia.
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19
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Martin RM, Donovan JL, Turner EL, Metcalfe C, Young GJ, Walsh EI, Lane JA, Noble S, Oliver SE, Evans S, Sterne JAC, Holding P, Ben-Shlomo Y, Brindle P, Williams NJ, Hill EM, Ng SY, Toole J, Tazewell MK, Hughes LJ, Davies CF, Thorn JC, Down E, Davey Smith G, Neal DE, Hamdy FC. Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial. JAMA 2018; 319:883-895. [PMID: 29509864 PMCID: PMC5885905 DOI: 10.1001/jama.2018.0154] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/17/2018] [Indexed: 11/14/2022]
Abstract
Importance Prostate cancer screening remains controversial because potential mortality or quality-of-life benefits may be outweighed by harms from overdetection and overtreatment. Objective To evaluate the effect of a single prostate-specific antigen (PSA) screening intervention and standardized diagnostic pathway on prostate cancer-specific mortality. Design, Setting, and Participants The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) included 419 582 men aged 50 to 69 years and was conducted at 573 primary care practices across the United Kingdom. Randomization and recruitment of the practices occurred between 2001 and 2009; patient follow-up ended on March 31, 2016. Intervention An invitation to attend a PSA testing clinic and receive a single PSA test vs standard (unscreened) practice. Main Outcomes and Measures Primary outcome: prostate cancer-specific mortality at a median follow-up of 10 years. Prespecified secondary outcomes: diagnostic cancer stage and Gleason grade (range, 2-10; higher scores indicate a poorer prognosis) of prostate cancers identified, all-cause mortality, and an instrumental variable analysis estimating the causal effect of attending the PSA screening clinic. Results Among 415 357 randomized men (mean [SD] age, 59.0 [5.6] years), 189 386 in the intervention group and 219 439 in the control group were included in the analysis (n = 408 825; 98%). In the intervention group, 75 707 (40%) attended the PSA testing clinic and 67 313 (36%) underwent PSA testing. Of 64 436 with a valid PSA test result, 6857 (11%) had a PSA level between 3 ng/mL and 19.9 ng/mL, of whom 5850 (85%) had a prostate biopsy. After a median follow-up of 10 years, 549 (0.30 per 1000 person-years) died of prostate cancer in the intervention group vs 647 (0.31 per 1000 person-years) in the control group (rate difference, -0.013 per 1000 person-years [95% CI, -0.047 to 0.022]; rate ratio [RR], 0.96 [95% CI, 0.85 to 1.08]; P = .50). The number diagnosed with prostate cancer was higher in the intervention group (n = 8054; 4.3%) than in the control group (n = 7853; 3.6%) (RR, 1.19 [95% CI, 1.14 to 1.25]; P < .001). More prostate cancer tumors with a Gleason grade of 6 or lower were identified in the intervention group (n = 3263/189 386 [1.7%]) than in the control group (n = 2440/219 439 [1.1%]) (difference per 1000 men, 6.11 [95% CI, 5.38 to 6.84]; P < .001). In the analysis of all-cause mortality, there were 25 459 deaths in the intervention group vs 28 306 deaths in the control group (RR, 0.99 [95% CI, 0.94 to 1.03]; P = .49). In the instrumental variable analysis for prostate cancer mortality, the adherence-adjusted causal RR was 0.93 (95% CI, 0.67 to 1.29; P = .66). Conclusions and Relevance Among practices randomized to a single PSA screening intervention vs standard practice without screening, there was no significant difference in prostate cancer mortality after a median follow-up of 10 years but the detection of low-risk prostate cancer cases increased. Although longer-term follow-up is under way, the findings do not support single PSA testing for population-based screening. Trial Registration ISRCTN Identifier: ISRCTN92187251.
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Affiliation(s)
- Richard M. Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, England
| | - Jenny L. Donovan
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, University Hospitals Bristol NHS Trust, Bristol, England
| | - Emma L. Turner
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Chris Metcalfe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, England
| | - Grace J. Young
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, England
| | - Eleanor I. Walsh
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - J. Athene Lane
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, England
| | - Sian Noble
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Steven E. Oliver
- Department of Health Sciences, University of York and Hull York Medical School, York, England
| | - Simon Evans
- Urology Department, Royal United Hospital, Bath, England
| | - Jonathan A. C. Sterne
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, England
| | - Peter Holding
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England
| | - Yoav Ben-Shlomo
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, University Hospitals Bristol NHS Trust, Bristol, England
| | - Peter Brindle
- Bristol, North Somerset, and South Gloucestershire Clinical Commissioning Group, Bristol, England
| | - Naomi J. Williams
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Elizabeth M. Hill
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Siaw Yein Ng
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Jessica Toole
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Marta K. Tazewell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Laura J. Hughes
- Department of Oncology, Addenbrooke’s Hospital, University of Cambridge, Cambridge, England
| | - Charlotte F. Davies
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Joanna C. Thorn
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - Elizabeth Down
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
| | - George Davey Smith
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, England
| | - David E. Neal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England
- Department of Oncology, Addenbrooke’s Hospital, University of Cambridge, Cambridge, England
| | - Freddie C. Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, England
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20
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Gilchuk I, Gilchuk P, Sapparapu G, Lampley R, Singh V, Kose N, Blum DL, Hughes LJ, Satheshkumar PS, Townsend MB, Kondas AV, Reed Z, Weiner Z, Olson VA, Hammarlund E, Raue HP, Slifka MK, Slaughter JC, Graham BS, Edwards KM, Eisenberg RJ, Cohen GH, Joyce S, Crowe JE. Cross-Neutralizing and Protective Human Antibody Specificities to Poxvirus Infections. Cell 2016; 167:684-694.e9. [PMID: 27768891 PMCID: PMC5093772 DOI: 10.1016/j.cell.2016.09.049] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/02/2016] [Accepted: 09/27/2016] [Indexed: 12/01/2022]
Abstract
Monkeypox (MPXV) and cowpox (CPXV) are emerging agents that cause severe human infections on an intermittent basis, and variola virus (VARV) has potential for use as an agent of bioterror. Vaccinia immune globulin (VIG) has been used therapeutically to treat severe orthopoxvirus infections but is in short supply. We generated a large panel of orthopoxvirus-specific human monoclonal antibodies (Abs) from immune subjects to investigate the molecular basis of broadly neutralizing antibody responses for diverse orthopoxviruses. Detailed analysis revealed the principal neutralizing antibody specificities that are cross-reactive for VACV, CPXV, MPXV, and VARV and that are determinants of protection in murine challenge models. Optimal protection following respiratory or systemic infection required a mixture of Abs that targeted several membrane proteins, including proteins on enveloped and mature virion forms of virus. This work reveals orthopoxvirus targets for human Abs that mediate cross-protective immunity and identifies new candidate Ab therapeutic mixtures to replace VIG.
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Affiliation(s)
- Iuliia Gilchuk
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Pavlo Gilchuk
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Veterans Administration Tennessee Valley Healthcare System, Nashville, TN 37332, USA
| | - Gopal Sapparapu
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Rebecca Lampley
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Vidisha Singh
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Nurgun Kose
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - David L Blum
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Laura J Hughes
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | | | - Michael B Townsend
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Ashley V Kondas
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Zachary Reed
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Zachary Weiner
- Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Victoria A Olson
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Erika Hammarlund
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Hans-Peter Raue
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - Mark K Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR 97006, USA
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA
| | - Kathryn M Edwards
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Roselyn J Eisenberg
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Gary H Cohen
- Department of Microbiology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sebastian Joyce
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Veterans Administration Tennessee Valley Healthcare System, Nashville, TN 37332, USA
| | - James E Crowe
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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21
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Turner EL, Metcalfe C, Donovan JL, Noble S, Sterne JAC, Lane JA, I Walsh E, Hill EM, Down L, Ben-Shlomo Y, Oliver SE, Evans S, Brindle P, Williams NJ, Hughes LJ, Davies CF, Ng SY, Neal DE, Hamdy FC, Albertsen P, Reid CM, Oxley J, McFarlane J, Robinson MC, Adolfsson J, Zietman A, Baum M, Koupparis A, Martin RM. Contemporary accuracy of death certificates for coding prostate cancer as a cause of death: Is reliance on death certification good enough? A comparison with blinded review by an independent cause of death evaluation committee. Br J Cancer 2016; 115:90-4. [PMID: 27253172 PMCID: PMC4931376 DOI: 10.1038/bjc.2016.162] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/18/2016] [Accepted: 04/30/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Accurate cause of death assignment is crucial for prostate cancer epidemiology and trials reporting prostate cancer-specific mortality outcomes. METHODS We compared death certificate information with independent cause of death evaluation by an expert committee within a prostate cancer trial (2002-2015). RESULTS Of 1236 deaths assessed, expert committee evaluation attributed 523 (42%) to prostate cancer, agreeing with death certificate cause of death in 1134 cases (92%, 95% CI: 90%, 93%). The sensitivity of death certificates in identifying prostate cancer deaths as classified by the committee was 91% (95% CI: 89%, 94%); specificity was 92% (95% CI: 90%, 94%). Sensitivity and specificity were lower where death occurred within 1 year of diagnosis, and where there was another primary cancer diagnosis. CONCLUSIONS UK death certificates accurately identify cause of death in men with prostate cancer, supporting their use in routine statistics. Possible differential misattribution by trial arm supports independent evaluation in randomised trials.
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Affiliation(s)
- Emma L Turner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Chris Metcalfe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Sian Noble
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Jonathan A C Sterne
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - J Athene Lane
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Eleanor I Walsh
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Elizabeth M Hill
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Liz Down
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Steven E Oliver
- Department of Health Sciences, University of York and the Hull York Medical School, YO10 5DD, UK
| | - Simon Evans
- Urology Department, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
| | - Peter Brindle
- Avon Primary Care Research Collaborative, South Plaza, Marlborough Street, Bristol BS1 3NX, UK
| | - Naomi J Williams
- School of Social and Community Medicine, University of Bristol, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
| | - Laura J Hughes
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Box 279 (S4), Cambridge CB2 0QQ, UK
| | - Charlotte F Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Siaw Yein Ng
- School of Social and Community Medicine, University of Bristol, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - David E Neal
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Peter Albertsen
- University of Connecticut Health Center, Farmington, St Francis Hospital and Medical Center, Hartford, CT, USA
| | - Colette M Reid
- Department of Palliative Medicine, Bristol Haematology and Oncology Centre, Bristol BS2 8ED, UK
| | - Jon Oxley
- Department of Cellular Pathology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK
| | - John McFarlane
- Urology Department, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
| | - Mary C Robinson
- Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Jan Adolfsson
- Department of Clinical Science, Karolinska Institutet, Stokholm, Sweden
| | - Anthony Zietman
- Harvard Radiation Oncology Program, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Baum
- Department of Surgery, University College London, Gower Street, London WC1E 6BT, UK
| | - Anthony Koupparis
- Department of Urology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
- School of Social and Community Medicine, MRC/University of Bristol Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
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22
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Williams NJ, Hill EM, Ng SY, Martin RM, Metcalfe C, Donovan JL, Evans S, Hughes LJ, Davies CF, Hamdy FC, Neal DE, Turner EL. Standardisation of information submitted to an endpoint committee for cause of death assignment in a cancer screening trial – lessons learnt from CAP (Cluster randomised triAl of PSA testing for Prostate cancer). BMC Med Res Methodol 2015; 15:6. [PMID: 25613468 PMCID: PMC4429825 DOI: 10.1186/1471-2288-15-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/15/2015] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In cancer screening trials where the primary outcome is target cancer-specific mortality, the unbiased determination of underlying cause of death (UCD) is crucial. To minimise bias, the UCD should be independently verified by expert reviewers, blinded to death certificate data and trial arm. We investigated whether standardising the information submitted for UCD assignment in a population-based randomised controlled trial of prostate-specific antigen (PSA) testing for prostate cancer reduced the reviewers' ability to correctly guess the trial arm. METHODS Over 550 General Practitioner (GP) practices (>415,000 men aged 50-69 years) were cluster-randomised to PSA testing (intervention arm) or the National Health Service (NHS) prostate cancer risk management programme (control arm) between 2001 and 2007. Assignment of UCD was by independent reviews of researcher-written clinical vignettes that masked trial arm and death certificate information. A period of time after the process began (the initial phase), we analysed whether the reviewers could correctly identify trial arm from the vignettes, and the reasons for their choice. This feedback led to further standardisation of information (second phase), after which we re-assessed the extent of correct identification of trial arm. RESULTS 1099 assessments of 509 vignettes were completed by January 2014. In the initial phase (n = 510 assessments), reviewers were unsure of trial arm in 33% of intervention and 30% of control arm assessments and were influenced by symptoms at diagnosis, PSA test result and study-specific criteria. In the second phase (n = 589), the respective proportions of uncertainty were 45% and 48%. The percentage of cases whereby reviewers were unable to determine the trial arm was greater following the standardisation of information provided in the vignettes. The chances of a correct guess and an incorrect guess were equalised in each arm, following further standardisation. CONCLUSIONS It is possible to mask trial arm from cause of death reviewers, by using their feedback to standardise the information submitted to them. TRIAL REGISTRATION ISRCTN92187251.
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Affiliation(s)
- Naomi J Williams
- School of Social and Community Medicine, University of Bristol, based at Royal Hallamshire Hospital, Sheffield, S10 2JF, UK.
| | - Elizabeth M Hill
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Siaw Yein Ng
- School of Social and Community Medicine, University of Bristol, based at Freeman Hospital, High Heaton, Newcastle-upon-Tyne, NE7 7DN, UK.
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Chris Metcalfe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | | | - Laura J Hughes
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - Charlotte F Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | - David E Neal
- Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - Emma L Turner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PS, UK.
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23
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Abstract
By regarding gravity as the convolution of left and right Yang-Mills theories together with a spectator scalar field in the biadjoint representation, we derive in linearized approximation, the gravitational symmetries of general covariance, p-form gauge invariance, local Lorentz invariance, and local supersymmetry from the flat space Yang-Mills symmetries of local gauge invariance and global super-Poincaré symmetry. As a concrete example, we focus on the new minimal (12+12) off shell version of simple four-dimensional supergravity obtained by tensoring the off shell Yang-Mills multiplets (4+4, N_{L}=1) and (3+0, N_{R}=0).
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Affiliation(s)
- A Anastasiou
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - L Borsten
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - M J Duff
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - L J Hughes
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - S Nagy
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
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24
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Hughes LJ, Goldstein J, Pohl J, Hooper JW, Lee Pitts R, Townsend MB, Bagarozzi D, Damon IK, Karem KL. A highly specific monoclonal antibody against monkeypox virus detects the heparin binding domain of A27. Virology 2014; 464-465:264-273. [PMID: 25108113 PMCID: PMC9629035 DOI: 10.1016/j.virol.2014.06.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/10/2014] [Accepted: 06/30/2014] [Indexed: 11/23/2022]
Abstract
The eradication of smallpox and the cessation of global vaccination led to the increased prevalence of human infections in Central Africa. Serologic and protein-based diagnostic assay for MPXV detection is difficult due to cross-reactive antibodies that do not differentiate between diverse orthopoxvirus (OPXV) species. A previously characterized monoclonal antibody (mAb 69-126-3-7) against MPXV [1] was retested for cross-reactivity with various OPXVs. The 14.5 kDa band protein that reacted with mAb 69-126-3 was identified to be MPXV A29 protein (homolog of vaccinia virus Copenhagen A27). Amino acid sequence analysis of the MPXV A29 with other OPXV homologs identified four amino acid changes. Peptides corresponding to these regions were designed and evaluated for binding to mAb 69-126-3 by ELISA and BioLayer Interferometry (BLI). Further refinement and truncations mapped the specificity of this antibody to a single amino acid difference in a 30-mer peptide compared to other OPXV homologs. This particular residue is proposed to be essential for heparin binding by VACV A27 protein. Despite this substitution, MPXV A29 bound to heparin with similar affinity to that of VACV A27 protein, suggesting flexibility of this motif for heparin binding. Although binding of mAb 69-126-3-7 to MPXV A29 prevented interaction with heparin, it did not have any effect on the infectivity of MPXV. Characterization of 69-126-3-7 mAb antibody allows for the possibility of the generation of a serological based species-specific detection of OPXVs despite high proteomic homology.
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Affiliation(s)
- Laura J Hughes
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jason Goldstein
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jan Pohl
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - R Lee Pitts
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Inger K Damon
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kevin L Karem
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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25
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Turner EL, Metcalfe C, Donovan JL, Noble S, Sterne JAC, Lane JA, Avery KN, Down L, Walsh E, Davis M, Ben-Shlomo Y, Oliver SE, Evans S, Brindle P, Williams NJ, Hughes LJ, Hill EM, Davies C, Ng SY, Neal DE, Hamdy FC, Martin RM. Design and preliminary recruitment results of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP). Br J Cancer 2014; 110:2829-36. [PMID: 24867688 PMCID: PMC4056057 DOI: 10.1038/bjc.2014.242] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 04/08/2014] [Accepted: 04/10/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Screening for prostate cancer continues to generate controversy because of concerns about over-diagnosis and unnecessary treatment. We describe the rationale, design and recruitment of the Cluster randomised triAl of PSA testing for Prostate cancer (CAP) trial, a UK-wide cluster randomised controlled trial investigating the effectiveness and cost-effectiveness of prostate-specific antigen (PSA) testing. METHODS Seven hundred and eighty-five general practitioner (GP) practices in England and Wales were randomised to a population-based PSA testing or standard care and then approached for consent to participate. In the intervention arm, men aged 50-69 years were invited to undergo PSA testing, and those diagnosed with localised prostate cancer were invited into a treatment trial. Control arm practices undertook standard UK management. All men were flagged with the Health and Social Care Information Centre for deaths and cancer registrations. The primary outcome is prostate cancer mortality at a median 10-year-follow-up. RESULTS Among randomised practices, 271 (68%) in the intervention arm (198,114 men) and 302 (78%) in the control arm (221,929 men) consented to participate, meeting pre-specified power requirements. There was little evidence of differences between trial arms in measured baseline characteristics of the consenting GP practices (or men within those practices). CONCLUSIONS The CAP trial successfully met its recruitment targets and will make an important contribution to international understanding of PSA-based prostate cancer screening.
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Affiliation(s)
- E L Turner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - C Metcalfe
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - J L Donovan
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S Noble
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - J A C Sterne
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - J A Lane
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - K N Avery
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - L Down
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - E Walsh
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - M Davis
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Y Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S E Oliver
- Department of Health Sciences, University of York and the Hull York Medical School, York YO10 5DD, UK
| | - S Evans
- Royal United Hospital Bath, Combe Park, Bath BA1 3NG, UK
| | - P Brindle
- Avon Primary Care Research Collaborative, Marlborough Street, South Plaza, Bristol BS1 3NX, UK
| | - N J Williams
- School of Social and Community Medicine, University of Bristol, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
| | - L J Hughes
- Department of Oncology, University of Cambridge, Box 279 (S4), Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - E M Hill
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - C Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S Y Ng
- School of Social and Community Medicine, University of Bristol, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK
| | - D E Neal
- Department of Oncology, University of Cambridge, Box 279 (S4), Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - F C Hamdy
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - R M Martin
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
- MRC/University of Bristol Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - the CAP trial group
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
- Department of Health Sciences, University of York and the Hull York Medical School, York YO10 5DD, UK
- Royal United Hospital Bath, Combe Park, Bath BA1 3NG, UK
- Avon Primary Care Research Collaborative, Marlborough Street, South Plaza, Bristol BS1 3NX, UK
- School of Social and Community Medicine, University of Bristol, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
- Department of Oncology, University of Cambridge, Box 279 (S4), Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
- School of Social and Community Medicine, University of Bristol, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
- MRC/University of Bristol Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
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26
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Abstract
We give a unified description of D=3 super-Yang-Mills theory with N=1, 2, 4, and 8 supersymmeties in terms of the four division algebras: reals (R), complexes (C), quaternions (H) and octonions (O). Tensoring left and right super-Yang-Mills multiplets with N=1, 2, 4, 8 we obtain a magic square RR, CR, CC, HR, HC, HH, OR, OC, OH, OO description of D=3 supergravity with N=2, 3, 4, 5, 6, 8, 9, 10, 12, 16.
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Affiliation(s)
- L Borsten
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - M J Duff
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - L J Hughes
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - S Nagy
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
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27
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Morgan L, Buddle LJ, Rogers PG, Seccombe LM, MacKenney KA, Hughes LJ. Nasal nitric oxide is useful in an Australian Primary Ciliary Dyskinesia clinic. Cilia 2012. [PMCID: PMC3555932 DOI: 10.1186/2046-2530-1-s1-p7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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28
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Williams N, Hughes LJ, Turner EL, Donovan JL, Hamdy FC, Neal DE, Martin RM, Metcalfe C. Prostate-specific antigen testing rates remain low in UK general practice: a cross-sectional study in six English cities. BJU Int 2011; 108:1402-8. [PMID: 21481132 DOI: 10.1111/j.1464-410x.2011.10163.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE • To estimate rates of prostate-specific antigen (PSA) testing in UK general practices by age, deprivation index and geographical location. SUBJECTS AND METHODS • Practice-based, retrospective data on PSA testing patterns in 2007 were collected from a random sample of 87 general practices using EMIS LV computer systems within the passively observed non-intervention arm of a cluster-randomized controlled trial. • Information for a total of 126 716 men aged 45-89 years with no recorded diagnosis of prostate cancer prior to 1 January 2007 was collected. RESULTS • In all, 7902 (6.2%) of 126 716 men aged 45-89 without a prior diagnosis of prostate cancer underwent at least one PSA test from their general practitioner during 2007 [95% confidence interval (CI) 5.6-7.0%; practice-based inter-quartile range 3.6-8.4%]. • PSA testing rates were 1.4% (95% CI 1.1-1.6%) in men aged 45-49, rising to 11.3% (95% CI 10.0-12.9%) at age 75-79 years (P for trend <0.001). • Testing rates were lowest in the three northern centres (3.5-5.7%) vs the three more southern centres (7.1-8.9%; P < 0.001). • For every 20 points increase in the index of multiple deprivation score, the proportion of men tested fell by 1.7% (95% CI -2.5 to -0.8%; P < 0.001). • Lower proportions of men were subsequently diagnosed with prostate cancer in practices testing more men (odds ratio for a one unit increase in the natural log of testing 0.76; 95% CI 0.60-0.97; P= 0.025). CONCLUSION • Overall levels of PSA testing in UK general practice remain low, but for those tested there are important variations by age, deprivation and geographical location that do not appear to reflect clinical need or the intention of current policy. • PSA testing in general practice is currently skewed towards older men, and current policy enabling all men to make an informed choice about PSA testing is not being effectively implemented as uptake clearly varies by socioeconomic status. • This reinforces the need for robust evidence regarding the costs and benefits of using the PSA test for the detection of localized prostate cancer in the UK, a full assessment of the health economic implications and a revision of the current policy.
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Affiliation(s)
- Naomi Williams
- Nuffield Department of Surgical Sciences, University of Oxford based at the Royal Hallamshire Hospital, Sheffield, UK
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29
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Hughes LJ, Lancaster J, Cord-Ruwisch R. Multistage wastewater treatment using separated storage driven denitrification and nitrification biofilms. Water Sci Technol 2006; 53:51-8. [PMID: 16749439 DOI: 10.2166/wst.2006.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The feasibility of combining a previously reported storage driven denitrification biofilm, where 80% of influent acetate can be converted to poly-beta-hydroxybutyrate (PHB), with a suitable nitrification reactor, either submerged or trickling filter design, to achieve complete biological nitrogen removal was tested. The reactor system showed the potential of complete biological nitrogen removal of waste streams with a C/N ratio as low as 3.93 kg COD/kg N-NH3 at an overall nitrogen removal rate of 1.1 mmole NH3/L/h. While the efficiency and the rates of nitrogen removal were higher than what is observed in traditional or simultaneous nitrification and denitrification (SND) systems, there were two problems that require further development: (a) the incomplete draining of the reactor caused ammonia retention and release in the effluent, limiting the overall N-removal and (b) pH drifts in the nitrification step slowed down the rate of nitrification if not corrected by appropriate pH adjustment or buffering.
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Affiliation(s)
- L J Hughes
- School of Biological Sciences and Biotechnology, Murdoch University, South Street, Murdoch WA 6150 Australia.
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30
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Faville MJ, Vecchies AC, Schreiber M, Drayton MC, Hughes LJ, Jones ES, Guthridge KM, Smith KF, Sawbridge T, Spangenberg GC, Bryan GT, Forster JW. Functionally associated molecular genetic marker map construction in perennial ryegrass (Lolium perenne L.). Theor Appl Genet 2004; 110:12-32. [PMID: 15526086 DOI: 10.1007/s00122-004-1785-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2004] [Accepted: 07/30/2004] [Indexed: 05/10/2023]
Abstract
A molecular marker-based map of perennial ryegrass (Lolium perenne L.) has been constructed through the use of polymorphisms associated with expressed sequence tags (ESTs). A pair-cross between genotypes from a North African ecotype and the cultivar Aurora was used to generate a two-way pseudo-testcross population. A selection of 157 cDNAs assigned to eight different functional categories associated with agronomically important biological processes was used to detect polymorphic EST-RFLP loci in the F(1)(NA(6) x AU(6)) population. A comprehensive set of EST-SSR markers was developed from the analysis of 14,767 unigenes, with 310 primer pairs showing efficient amplification and detecting 113 polymorphic loci. Two parental genetic maps were produced: the NA(6) genetic map contains 88 EST-RFLP and 71 EST-SSR loci with a total map length of 963 cM, while the AU(6) genetic map contains 67 EST-RFLP and 58 EST-SSR loci with a total map length of 757 cM. Bridging loci permitted the alignment of homologous chromosomes between the parental maps, and a sub-set of genomic DNA-derived SSRs was used to relate linkage groups to the perennial ryegrass reference map. Regions of segregation distortion were identified, in some instances in common with other perennial ryegrass maps. The EST-derived marker-based map provides the basis for in silico comparative genetic mapping, as well as the evaluation of co-location between QTLs and functionally associated genetic loci.
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Affiliation(s)
- M J Faville
- Grasslands Research Centre, AgResearch Ltd., Private Bag 11008, Palmerston North, New Zealand
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31
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Faville MJ, Vecchies AC, Schreiber M, Drayton MC, Hughes LJ, Jones ES, Guthridge KM, Smith KF, Sawbridge T, Spangenberg GC, Bryan GT, Forster JW. Functionally associated molecular genetic marker map construction in perennial ryegrass (Lolium perenne L.). Theor Appl Genet 2004. [PMID: 15526086 DOI: 10.1007/s00122-005-1959-y] [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] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A molecular marker-based map of perennial ryegrass (Lolium perenne L.) has been constructed through the use of polymorphisms associated with expressed sequence tags (ESTs). A pair-cross between genotypes from a North African ecotype and the cultivar Aurora was used to generate a two-way pseudo-testcross population. A selection of 157 cDNAs assigned to eight different functional categories associated with agronomically important biological processes was used to detect polymorphic EST-RFLP loci in the F(1)(NA(6) x AU(6)) population. A comprehensive set of EST-SSR markers was developed from the analysis of 14,767 unigenes, with 310 primer pairs showing efficient amplification and detecting 113 polymorphic loci. Two parental genetic maps were produced: the NA(6) genetic map contains 88 EST-RFLP and 71 EST-SSR loci with a total map length of 963 cM, while the AU(6) genetic map contains 67 EST-RFLP and 58 EST-SSR loci with a total map length of 757 cM. Bridging loci permitted the alignment of homologous chromosomes between the parental maps, and a sub-set of genomic DNA-derived SSRs was used to relate linkage groups to the perennial ryegrass reference map. Regions of segregation distortion were identified, in some instances in common with other perennial ryegrass maps. The EST-derived marker-based map provides the basis for in silico comparative genetic mapping, as well as the evaluation of co-location between QTLs and functionally associated genetic loci.
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Affiliation(s)
- M J Faville
- Grasslands Research Centre, AgResearch Ltd., Private Bag 11008, Palmerston North, New Zealand
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32
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Schatz P, Hughes LJ, Chute DL. Underutilization of neuropsychology in traumatic brain injury rehabilitation: is managed care to blame? NeuroRehabilitation 2002; 16:281-7. [PMID: 11790915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We evaluated factors determining which individuals received neuropsychological evaluations (NPEs) following traumatic brain injury (TBI). Comprehensive records from a State-wide/sponsored Head Injury Program were followed from 1985--1995 to monitor effects of managed care on provision (or absence) of formal NPEs and ultimately on rehabilitation outcome. Only 26% of 273 individuals received NPEs (within their first three years post-injury). In the years prior to and after large changes in managed care, there were no differences in the provision of formal NPEs. Discriminant analysis identified functional status at discharge from primary rehabilitation and total number of rehabilitation facilities as the two variables that most distinguished those who had received NPEs with 69% classification accuracy. Between group analyses revealed that individuals were more likely to receive NPEs if they were young, involved in liability claims, attended multiple rehabilitation facilities, or had higher functional status at discharge from primary rehabilitation, regardless of the nature or severity of their TBI. Individuals receiving formal NPEs ultimately achieved higher levels of functional independence, suggesting a potential selection bias. Individuals were no more likely to receive NPEs according to insurance status (private versus government assisted) or as a function of the decade of their injury (1980's versus 1990's). It appears that health-care reform has had no deleterious effect on neuropsychologists' ability to provide consultative services for this population, and following TBI, only a discrete sample of individuals receive and benefit from NPEs.
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Affiliation(s)
- P Schatz
- Department of Psychology, Saint Joseph's University, Philadelphia, PA 19131, USA.
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Abstract
Infantile and childhood hepatoblastoma occurs more frequently in persons heterozygous for the familial adenomatous polyposis (FAP) gene than in the general population. This observation is based on numerous case reports plus the results of an international survey of FAP registries. However, the frequency of this rare tumor in FAP patients is unknown. In a retrospective review of our family history data, 2/470 (0.42%) children born to 241 patients with FAP had hepatoblastoma. This figure is significantly higher than the 1/100,000 incidence of hepatoblastoma in the general population. However, for genetic counseling purposes, an empiric risk of less than 1% for hepatoblastoma can be cited to persons with FAP for their children.
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Affiliation(s)
- L J Hughes
- University of Health Sciences, College of Osteopathic Medicine, Kansas City, Missouri
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