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Turner L, Wang JC, Martinez JR, Najjar S, Rajapaksha Arachchilage T, Sahrai V. US businesses engaged in direct-to-consumer marketing of perinatal stem cell interventions following the Food and Drug Administration's enforcement discretion era. Cytotherapy 2024; 26:393-403. [PMID: 38340106 DOI: 10.1016/j.jcyt.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND AIMS The goal of this study was to analyze online marketing representations made by 300 US businesses selling allogeneic perinatal stem cell products. The study was conducted after a period of enforcement discretion by the US Food and Drug Administration (FDA). METHODS Data mining and content analysis were used to identify, analyze and categorize marketing claims made on the websites of 300 businesses selling perinatal stem cell interventions. RESULTS The study identified types of perinatal interventions companies advertised, geographic locations of clinics selling such products, types of companies operating in this space, diseases and injuries such businesses claim to treat, prices companies charge for such interventions, brand names of advertised perinatal cell products and identities of suppliers. CONCLUSIONS A substantial number of US businesses market unapproved perinatal stem cell products for various indications. This widespread commercial activity occurred following the conclusion of a period of enforcement discretion by the FDA and suggests the need for more robust and comprehensive regulatory responses to businesses selling unapproved perinatal stem cell products.
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Affiliation(s)
- Leigh Turner
- Program in Public Health, University of California Irvine, Irvine, California, USA; Department of Health, Society and Behavior, University of California Irvine, Irvine, California, USA; Sue and Bill Gross Stem Cell Research Center, University of California Irvine, Irvine, California, USA; Department of Family Medicine, University of California Irvine, Irvine, California, USA.
| | - Jia Chieng Wang
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | - Juan Ramon Martinez
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | - Shemms Najjar
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | | | - Victoria Sahrai
- Program in Public Health, University of California Irvine, Irvine, California, USA
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Turner L, Martinez JR, Najjar S, Rajapaksha Arachchilage T, Wang JC. Businesses marketing purported stem cell treatments and exosome therapies for COVID-19: An analysis of direct-to-consumer online advertising claims. Stem Cell Reports 2023; 18:2010-2015. [PMID: 37890484 PMCID: PMC10679647 DOI: 10.1016/j.stemcr.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
We identified 38 businesses advertising purported stem cell interventions and exosome products for COVID-19. These companies operated or facilitated access to 60 clinics. More than 75% of these clinics were based in the United States and Mexico. Thirty-six of the businesses marketed their stem cell and exosome products as treatments for Long COVID, six advertised them as "immune boosters," five claimed to treat patients in the acute infection phase, and two claimed their products were preventive. The least expensive product cost $2,950, the most expensive was $25,000, and the average listed cost for patients was $11,322. The promotion of these products is concerning because they have not been approved by national regulators and do not appear to be supported by convincing safety and efficacy data.
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Affiliation(s)
- Leigh Turner
- Program in Public Health, University of California, Irvine, 653 E. Peltason Drive, 2nd Floor, Irvine, CA 92697-3957, USA; Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA; Department of Family Medicine, University of California, Irvine, Irvine, CA, USA.
| | - Juan Ramon Martinez
- Program in Public Health, University of California, Irvine, 653 E. Peltason Drive, 2nd Floor, Irvine, CA 92697-3957, USA
| | - Shemms Najjar
- Program in Public Health, University of California, Irvine, 653 E. Peltason Drive, 2nd Floor, Irvine, CA 92697-3957, USA
| | - Thevin Rajapaksha Arachchilage
- Program in Public Health, University of California, Irvine, 653 E. Peltason Drive, 2nd Floor, Irvine, CA 92697-3957, USA
| | - Jia Chieng Wang
- Program in Public Health, University of California, Irvine, 653 E. Peltason Drive, 2nd Floor, Irvine, CA 92697-3957, USA
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Turner L, Martinez JR, Najjar S, Arachchilage TR, Sahrai V, Wang JC. Regulatory claims made by US businesses engaged in direct-to-consumer marketing of purported stem cell treatments and exosome therapies. Regen Med 2023; 18:857-868. [PMID: 37867326 DOI: 10.2217/rme-2023-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Aim: This study investigated whether US businesses engaged in direct-to-consumer online marketing of purported stem cell therapies and stem cell-derived exosome products made claims concerning the regulatory status of these interventions. Methods: We used data mining and content analysis of company websites to examine regulatory-related representations made by US businesses marketing stem cell treatments and exosome therapies. Results: More than two thirds of such businesses did not make explicit representations about the regulatory status of their marketed products. Businesses that made claims about the regulatory status of the stem cell and exosome products they sold used range of representations concerning the legal standing of these interventions. Conclusion: The absence of information addressing the regulatory status of stem cell interventions and exosome products and the use of what appeared to be inaccurate information concerning the regulatory status of numerous products likely complicates efforts by customers to make informed health-related decisions.
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Affiliation(s)
- Leigh Turner
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Room 3543, Irvine, CA 92697-3957, USA
- Department of Health, Society, & Behavior, University of California Irvine, Irvine, CA 92697-3957, USA
- Sue & Bill Gross Stem Cell Research Center, University of California, Irvine, CA 92697-3957, USA
| | - Juan Ramon Martinez
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Room 3543, Irvine, CA 92697-3957, USA
| | - Shemms Najjar
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Room 3543, Irvine, CA 92697-3957, USA
| | - Thevin Rajapaksha Arachchilage
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Room 3543, Irvine, CA 92697-3957, USA
| | - Victoria Sahrai
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Room 3543, Irvine, CA 92697-3957, USA
| | - Jia Chieng Wang
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Room 3543, Irvine, CA 92697-3957, USA
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Turner L, Martinez JR, Najjar S, Arachchilage TR, Sahrai V, Wang JC. Safety and efficacy claims made by US businesses marketing purported stem cell treatments and exosome therapies. Regen Med 2023; 18:781-793. [PMID: 37795701 DOI: 10.2217/rme-2023-0118] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
Aim: Examining websites of US businesses engaged in direct-to-consumer advertising of putative stem cell treatments and exosome therapies, this study investigated the marketing claims such companies make about the purported safety and efficacy of these products. Methods: Data mining and content analysis of company websites were used to identify and analyze safety and efficacy claims. Results: Of the 978 businesses analyzed, less than half the companies made identifiable claims about the safety and efficacy of their advertised stem cell and exosome products. We also explored how companies framed the stem cell and exosome products they promoted. Representations ranged from assertions that such products are unproven and investigational to claims they constituted cures. Most advertising frames fell between these poles. Conclusion: Some businesses include in their marketing representations claims about the safety and efficacy of advertised products. Businesses that did not make such assertions use other techniques to attract prospective clients.
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Affiliation(s)
- Leigh Turner
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
- Department of Health, Society, & Behavior, University of California, Irvine, CA 92697-3957, USA
- Sue & Bill Gross Stem Cell Research Center, University of California, Irvine, CA 92697, USA
| | - Juan Ramon Martinez
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Shemms Najjar
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Thevin Rajapaksha Arachchilage
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Victoria Sahrai
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
| | - Jia Chieng Wang
- Program in Public Health, University of California Irvine, UCI Health Sciences Complex, 856 Health Sciences Quad, Irvine, CA 92697-3957, USA
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Barker M, Campbell M, Turner L, Syed ANM, Wei RL, Kabolizadeh P. Assessing Displacement of Plastic Interstitial Catheters in Image-Guided Gynecological HDR Brachytherapy. Int J Radiat Oncol Biol Phys 2023; 117:e642. [PMID: 37785913 DOI: 10.1016/j.ijrobp.2023.06.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Interstitial HDR brachytherapy involves precise, localized delivery to targets with high dose gradients, sparing adjacent organs at risk. Due to the proximity of the rectum and bladder to the target, deviations in the catheters with respect to patient anatomy can change dose to those structures. While utilizing plastic interstitial catheters allows the patient to receive hyperthermia therapy during their course of interstitial treatment, the plastic catheters were observed to show significant deflection when the metal stylets are removed for treatment. The hyperthermia electrodes and the HDR source cable are both wires of approximately the same thickness. The purpose of this study is to assess the magnitude and deflection of the plastic catheters for gynecologic interstitial plans and determine whether using flexible wires for visualization on pre-treatment imaging is suitable for reconstructing the actual treatment received. MATERIALS/METHODS Pre-treatment CT images where the stylets were utilized for catheter visualization were registered to a subsequent CT scan with the metal stylets removed. The original treatment dwell positions were adjusted to the second CT to evaluate 3D catheter displacement and dose distributions calculated for the bladder, rectum, and target. The plans were subsequently reconstructed on a pre-planning CT with flexible 20-gauge wires instead of metal stylets to determine their suitability as a surrogate for stylets. RESULTS Absolute 3D displacement for all patients was 3.5 ± 5.4 mm (n = 3433 catheter dwell positions, mean ± SD, p < 0.001) comparing plans with the stylet in versus out. Absolute catheter deflection for interstitial treatments increased with the removal of the metal stylets with a difference of 0.75 ± 0.49° (n = 313 catheters, mean ± SD, p < 0.01). The plans utilizing flexible wire instead of stylets are observed to correlate with the plans with no stylets with absolute 3D displacement and angular deflection of 1.1 ± 0.6 mm and 0.35° ± 0.3° respectively (n = 39 catheters, mean ± SD, p > 0.2). While the average target EQD2 D90 reduced by 5% ± 5% by planning without the stylets, four patients would have experienced a deviation from the prescription by >10%. There was an overall decrease in bladder D2cc and overall increase in rectal D2cc in the plans with the stylets utilized vs removed. Bladder D2cc, rectal D2cc, and target coverage showed no appreciable difference between utilizing flexible wires and the plans without. The difference in HU between the metal stylets and flexible wires was negligible. CONCLUSION Catheter reconstruction in interstitial gynecological treatments with CT imaging revealed significant changes in catheter positioning with respect to the target volume once the stylets are removed for treatment. Using flexible wires of similar thickness to the source cable allow for more accurate tracking during planning without distorting the patient's anatomy or the treatment images, preserving the integrity of the treatment plan.
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Affiliation(s)
- M Barker
- Memorial Care Medical Center, Long Beach, CA
| | - M Campbell
- Memorial Care Medical Center, Long Beach, CA
| | - L Turner
- Memorial Care Medical Center, Long Beach, CA
| | - A N M Syed
- Memorial Care Medical Center, Long Beach, CA
| | - R L Wei
- Memorial Care Medical Center, Long Beach, CA
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Ikonomou L, Cuende N, Forte M, Grilley BJ, Levine AD, Munsie M, Rasko JEJ, Turner L, Bidkhori HR, Ciccocioppo R, Grignon F, Srivastava A, Weiss DJ, Zettler P, Levine BL. International Society for Cell & Gene Therapy Position Paper: Key considerations to support evidence-based cell and gene therapies and oppose marketing of unproven products. Cytotherapy 2023; 25:920-929. [PMID: 37517865 DOI: 10.1016/j.jcyt.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 08/01/2023]
Abstract
The field of regenerative medicine, including cellular immunotherapies, is on a remarkable growth trajectory. Dozens of cell-, tissue- and gene-based products have received marketing authorization worldwide while hundreds-to-thousands are either in preclinical development or under clinical investigation in phased clinical trials. However, the promise of regenerative therapies has also given rise to a global industry of direct-to-consumer offerings of prematurely commercialized cell and cell-based products with unknown safety and efficacy profiles. Since its inception, the International Society for Cell & Gene Therapy Committee on the Ethics of Cell and Gene Therapy has opposed the premature commercialization of unproven cell- and gene-based interventions and supported the development of evidence-based advanced therapy products. In the present Guide, targeted at International Society for Cell & Gene Therapy members, we analyze this industry, focusing in particular on distinctive features of unproven cell and cell-based products and the use of tokens of scientific legitimacy as persuasive marketing devices. We also provide an overview of reporting mechanisms for patients who believe they have been harmed by administration of unapproved and unproven products and suggest practical strategies to address the direct-to-consumer marketing of such products. Development of this Guide epitomizes our continued support for the ethical and rigorous development of cell and cell-based products with patient safety and therapeutic benefit as guiding principles.
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Affiliation(s)
- Laertis Ikonomou
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, New York, USA; Cell, Gene and Tissue Engineering Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.
| | - Natividad Cuende
- Andalusian Transplant Coordination, Servicio Andaluz de Salud; Sevilla, Spain
| | | | - Bambi J Grilley
- Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston Methodist Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Aaron D Levine
- School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Megan Munsie
- Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John E J Rasko
- Gene and Stem Cell Therapy Program Centenary Institute, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Cell & Molecular Therapies, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Leigh Turner
- Department of Health, Society, and Behavior, Program in Public Health; Stem Cell Research Center; Institute for Clinical and Translational Science; Department of Family Medicine; University of California, Irvine; Irvine, California, USA
| | - Hamid R Bidkhori
- Stem Cell and Regenerative Medicine Research Department, Academic Center for Education, Culture and Research (ACECR)-Khorasan Razavi, Mashhad, Iran
| | - Rachele Ciccocioppo
- Gastroenterology Unit, Department of Medicine, A.O.U.I. Policlinico G.B. Rossi & University of Verona, Verona, Italy
| | - Felix Grignon
- International Society for Cell & Gene Therapy, Vancouver, Canada
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Ranipet Campus, Ranipet & Centre for Stem Cell Research (a unit of inStem Bengaluru) CMC Campus, Vellore, India
| | - Daniel J Weiss
- University of Vermont College of Medicine, Burlington, Vermont, USA
| | - Patricia Zettler
- Moritz College of Law, Drug Enforcement and Policy Center, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Bruce L Levine
- Center for Cellular Immunotherapies, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Zettler PJ, Ikonomou L, Levine AD, Turner L, Grilley B, Roxland BE. An International Society for Cell & Gene Therapy working group short report on the future of expanded access to unapproved cell and gene therapies. Cytotherapy 2023:S1465-3249(23)00058-0. [PMID: 37097267 DOI: 10.1016/j.jcyt.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/27/2023] [Accepted: 02/12/2023] [Indexed: 04/26/2023]
Abstract
Patient interest in non-trial access pathways to investigational cell-and gene-based interventions, such as expanded access in the USA, is increasing, while the regulatory and business environments for non-trial access in the cell and gene therapy field are shifting. Against this background, in 2022 the International Society for Cell & Gene Therapy (ISCT) established a Working Group on Expanded Access to identify practical, ethical, and regulatory issues emerging from the use (and possible misuse) of the expanded access pathway in the cell and gene therapy field. In this Short Report, the Working Group sets the stage for its future activities by analyzing the history of expanded access and identifying three examples of questions that we anticipate arising as uses of expanded access for investigational cell and gene-based interventions increase and evolve.
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Affiliation(s)
- Patricia J Zettler
- Moritz College of Law, Drug Enforcement and Policy Center, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA.
| | - Laertis Ikonomou
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, New York, USA; Cell, Gene and Tissue Engineering Center, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Aaron D Levine
- School of Public Policy, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Leigh Turner
- Department of Health, Society, and Behavior, Department of Family Medicine, Stem Cell Research Center, Institute for Clinical and Translational Science, Bioethics Program, University of California, Irvine, California, USA
| | - Bambi Grilley
- Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital, Houston Methodist Hospital, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Ikonomou L, Magnusson M, Dries R, Herzog EL, Hynds RE, Borok Z, Park JA, Skolasinski S, Burgess JK, Turner L, Mojarad SM, Mahoney JE, Lynch T, Lehmann M, Thannickal VJ, Hook JL, Vaughan AE, Hoffman ET, Weiss DJ, Ryan AL. Stem cells, cell therapies, and bioengineering in lung biology and disease 2021. Am J Physiol Lung Cell Mol Physiol 2022; 323:L341-L354. [PMID: 35762622 PMCID: PMC9484991 DOI: 10.1152/ajplung.00113.2022] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 12/15/2022] Open
Abstract
The 9th biennial conference titled "Stem Cells, Cell Therapies, and Bioengineering in Lung Biology and Diseases" was hosted virtually, due to the ongoing COVID-19 pandemic, in collaboration with the University of Vermont Larner College of Medicine, the National Heart, Lung, and Blood Institute, the Alpha-1 Foundation, the Cystic Fibrosis Foundation, and the International Society for Cell & Gene Therapy. The event was held from July 12th through 15th, 2021 with a pre-conference workshop held on July 9th. As in previous years, the objectives remained to review and discuss the status of active research areas involving stem cells (SCs), cellular therapeutics, and bioengineering as they relate to the human lung. Topics included 1) technological advancements in the in situ analysis of lung tissues, 2) new insights into stem cell signaling and plasticity in lung remodeling and regeneration, 3) the impact of extracellular matrix in stem cell regulation and airway engineering in lung regeneration, 4) differentiating and delivering stem cell therapeutics to the lung, 5) regeneration in response to viral infection, and 6) ethical development of cell-based treatments for lung diseases. This selection of topics represents some of the most dynamic and current research areas in lung biology. The virtual workshop included active discussion on state-of-the-art methods relating to the core features of the 2021 conference, including in situ proteomics, lung-on-chip, induced pluripotent stem cell (iPSC)-airway differentiation, and light sheet microscopy. The conference concluded with an open discussion to suggest funding priorities and recommendations for future research directions in basic and translational lung biology.
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Affiliation(s)
- Laertis Ikonomou
- Department of Oral Biology, University at Buffalo, State University of New York, Buffalo, New York
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University at Buffalo, State University of New York, Buffalo, New York
| | - Mattias Magnusson
- Division of Molecular Medicine and Gene Therapy, Lund Stem Cell Center, Lund University, Lund, Sweden
| | - Ruben Dries
- Section of Hematology and Medical Oncology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Erica L Herzog
- Yale Interstitial Lung Disease Center of Excellence, Pulmonary and Critical Care Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Robert E Hynds
- Epithelial Cell Biology in ENT Research Group, Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Zea Borok
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego, California
| | - Jin-Ah Park
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Janette K Burgess
- Department of Pathology and Medical Biology, Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Leigh Turner
- Department of Health, Society, and Behavior, University of California, Irvine Program In Public Health, Irvine, California
| | - Sarah M Mojarad
- Engineering in Society Program, Viterbi School of Engineering, University of Southern California, Los Angeles, California
| | | | - Thomas Lynch
- Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Mareike Lehmann
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Munich, Germany
| | - Victor J Thannickal
- John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Jamie L Hook
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York
- Global Health and Emerging Pathogens Institute, Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Andrew E Vaughan
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Evan T Hoffman
- Department of Medicine, University of Vermont, Burlington, Vermont
| | - Daniel J Weiss
- Department of Medicine, University of Vermont, Burlington, Vermont
| | - Amy L Ryan
- Hastings Center for Pulmonary Research, Department of Medicine, University of Southern California, Los Angeles, California
- Department of Stem Cell and Regenerative Medicine, University of Southern California, Los Angeles, California
- Department of Anatomy and Cell Biology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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Stephens M, O’Hara A, DeVito I, Turner L, Mozdzierz C, Latif H, Zhou G. Gene Editing/Gene Therapies: HIGH-THROUGHPUT RNA SEQUENCING DIRECTLY FROM CELL LYSATES ENABLES REPRODUCIBLE PHENOTYPIC PROFILING FOR CRISPR TREATMENT AND CELL RESPONSE SCREENING APPLICATIONS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00367-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Turner L, Culliford D, Ball J, Kitson-Reynolds E, Griffiths P. The association between midwifery staffing levels and the experiences of mothers on postnatal wards: Cross sectional analysis of routine data. Women Birth 2022; 35:e583-e589. [DOI: 10.1016/j.wombi.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/08/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
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Turner L. Hope, hype, cures, and persons with cerebral palsy. Dev Med Child Neurol 2022; 64:8. [PMID: 34536300 DOI: 10.1111/dmcn.15064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 12/01/2022]
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Akkas F, Turner L, Richardson E. Adverse events related to unapproved stem cell products and other regenerative interventions: recommendations for more robust regulation of the direct-to-consumer marketplace. Regen Med 2021; 17:63-68. [PMID: 34927455 DOI: 10.2217/rme-2021-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Tweetable abstract Adverse events continue to occur in the direct-to-consumer market for unapproved regenerative interventions and US FDA alone cannot adequately address the problem. Other public health strategies are needed to provide better patient protection.
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Affiliation(s)
- Farzana Akkas
- Senior Research Associate, Health Care Products Project, The Pew Charitable Trusts, 901 E Street NW, Washington, DC 20004, USA
| | - Leigh Turner
- Professor, Department of Health, Society & Behavior; Program in Public Health, Member, Stem Cell Research Center, University of California, Irvine, Anteater Instruction & Research Offices, 2nd Floor, 653 E. Peltason Dr., Irvine, CA 92697-3957, USA
| | - Elizabeth Richardson
- Director, Health Care Products Project, The Pew Charitable Trusts, 901 E Street NW, Washington, DC 20004, USA
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13
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Turner L, Munsie M, Levine AD, Ikonomou L. Ethical issues and public communication in the development of cell-based treatments for COVID-19: Lessons from the pandemic. Stem Cell Reports 2021; 16:2567-2576. [PMID: 34653406 PMCID: PMC8516140 DOI: 10.1016/j.stemcr.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022] Open
Abstract
The significant morbidity and mortality of coronavirus disease 19 (COVID-19) prompted a global race to develop new therapies. These include interventions using cell- or cell-derived products, several of which are being tested in well-designed, properly controlled clinical trials. Yet, the search for cell-based COVID-19 treatments has also been fraught with hyperbolic claims; flouting of crucial regulatory, scientific, and ethical norms; and distorted communication of research findings. In this paper, we critically examine ethical issues and public communication challenges related to the development of cell-based therapeutics for COVID-19. Drawing on the lessons learned from this ongoing process, we argue against the rushed development of cell-based interventions. We conclude by outlining ways to improve the ethical conduct of cell-based clinical investigations and public communication of therapeutic claims.
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Affiliation(s)
- Leigh Turner
- Department of Health, Society, and Behavior, Program in Public Health and Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA
| | - Megan Munsie
- School of Biomedical Sciences and Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Aaron D Levine
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA
| | - Laertis Ikonomou
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, 619 Biomedical Research Building (BRB), South Campus, Buffalo, NY 14214-8024, USA.
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Turner L. The American stem cell sell in 2021: U.S. businesses selling unlicensed and unproven stem cell interventions. Cell Stem Cell 2021; 28:1891-1895. [PMID: 34739831 DOI: 10.1016/j.stem.2021.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 01/28/2023]
Abstract
In March 2021, 1,480 U.S. businesses operating 2,754 clinics were found selling purported stem cell treatments for various indications. More than four times as many businesses than were identified 5 years ago are selling stem cell products that are not FDA-approved and lack convincing evidence of safety and efficacy.
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Affiliation(s)
- Leigh Turner
- Department of Health, Society, and Behavior, Program in Public Health, Stem Cell Research Center, Institute for Clinical & Translational Science, University of California, Irvine, AIRB, 653 E. Peltason Drive, Room 2034, Irvine, CA 92697-3957, USA.
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15
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Turner L, Snyder J. Ethical issues concerning a pay-to-participate stem cell study. Stem Cells Transl Med 2021; 10:815-819. [PMID: 34010517 PMCID: PMC8133334 DOI: 10.1002/sctm.20-0428] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/21/2020] [Accepted: 01/22/2021] [Indexed: 12/15/2022] Open
Abstract
In our critique of a pay-to-participate study, we address how the failure to disclose study-related payments appears to have violated STEM CELLS Translational Medicine's editorial policies concerning conflict-of-interest and financial disclosure. Our analysis also identifies broader ethical issues and scientific concerns related to pay-to-participate studies conducted by businesses with a record of selling purported stem cell treatments before determining whether the products they sell are safe and efficacious. Authors of peer-reviewed articles have a responsibility to comply with journal policies and disclose financial conflicts of interest to editors, reviewers, and readers. Authors should also disclose when stem cell interventions being tested in clinical trials have already been sold on a direct-to-consumer basis as "stem cell treatments" by authors' affiliate institutions. Financial conflicts of interest and other forms of possible bias must be disclosed to put clinical studies in context and facilitate the critical assessment of research methods, findings, and conclusions. The apparent failure to comply with journal editorial policies and disclose such financial conflicts warrants careful investigation.
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Affiliation(s)
- Leigh Turner
- University of MinnesotaCenter for BioethicsMinneapolisMinnesotaUSA
| | - Jeremy Snyder
- Simon Fraser UniversityFaculty of Health SciencesBurnabyBritish ColumbiaCanada
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16
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Lovell-Badge R, Anthony E, Barker RA, Bubela T, Brivanlou AH, Carpenter M, Charo RA, Clark A, Clayton E, Cong Y, Daley GQ, Fu J, Fujita M, Greenfield A, Goldman SA, Hill L, Hyun I, Isasi R, Kahn J, Kato K, Kim JS, Kimmelman J, Knoblich JA, Mathews D, Montserrat N, Mosher J, Munsie M, Nakauchi H, Naldini L, Naughton G, Niakan K, Ogbogu U, Pedersen R, Rivron N, Rooke H, Rossant J, Round J, Saitou M, Sipp D, Steffann J, Sugarman J, Surani A, Takahashi J, Tang F, Turner L, Zettler PJ, Zhai X. ISSCR Guidelines for Stem Cell Research and Clinical Translation: The 2021 update. Stem Cell Reports 2021; 16:1398-1408. [PMID: 34048692 PMCID: PMC8190668 DOI: 10.1016/j.stemcr.2021.05.012] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022] Open
Abstract
The International Society for Stem Cell Research has updated its Guidelines for Stem Cell Research and Clinical Translation in order to address advances in stem cell science and other relevant fields, together with the associated ethical, social, and policy issues that have arisen since the last update in 2016. While growing to encompass the evolving science, clinical applications of stem cells, and the increasingly complex implications of stem cell research for society, the basic principles underlying the Guidelines remain unchanged, and they will continue to serve as the standard for the field and as a resource for scientists, regulators, funders, physicians, and members of the public, including patients. A summary of the key updates and issues is presented here.
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Affiliation(s)
| | - Eric Anthony
- International Society for Stem Cell Research, Skokie, IL, USA
| | - Roger A Barker
- Cambridge Center for Brain Repair and WT-MRC Stem Cell Institute, Cambridge, UK
| | | | | | | | - R Alta Charo
- University of Wisconsin-Madison, Madison, WI, USA
| | - Amander Clark
- University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | | | | | | | | | - Steve A Goldman
- University of Rochester Medical Center, Rochester, NY, USA; University of Copenhagen, Copenhagen, Denmark
| | | | - Insoo Hyun
- Harvard Medical School, Boston, MA, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Jeffrey Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | | | | | | | | | - Debra Mathews
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Nuria Montserrat
- Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain
| | - Jack Mosher
- International Society for Stem Cell Research, Skokie, IL, USA
| | - Megan Munsie
- University of Melbourne, Melbourne, VIC, Australia
| | - Hiromitsu Nakauchi
- Stanford University, Stanford, CA, USA; University of Tokyo, Tokyo, Japan
| | | | | | - Kathy Niakan
- Francis Crick Institute, London, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | | | | | - Nicolas Rivron
- IMBA-Institute of Molecular Biotechnology, Vienna, Austria
| | | | | | - Jeff Round
- Institute of Health Economics, Edmonton, AB, Canada
| | | | - Douglas Sipp
- RIKEN Center for Developmental Biology, Wako, Japan; Keio University School of Medicine, Tokyo, Japan
| | | | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Azim Surani
- Gurdon Institute, University of Cambridge, Cambridge, UK
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17
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Turner L. ISSCR's Guidelines for Stem Cell Research and Clinical Translation: Supporting development of safe and efficacious stem cell-based interventions. Stem Cell Reports 2021; 16:1394-1397. [PMID: 34048693 PMCID: PMC8190662 DOI: 10.1016/j.stemcr.2021.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/16/2021] [Accepted: 05/16/2021] [Indexed: 12/02/2022] Open
Abstract
The ISSCR’s revised Guidelines for Stem Cell Research and Clinical Translation reflect the organization’s commitment to opposing premature commercialization of stem cell-based interventions and supporting the development of products that meet stringent ethical, scientific, and regulatory standards. The Guidelines contain five important new recommendations concerning clinical translation of stem cell products.
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Affiliation(s)
- Leigh Turner
- University of Minnesota Center for Bioethics, School of Public Health, and College of Pharmacy, Minneapolis, MN 55455, USA.
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18
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Moussiliou A, Turner L, Cottrell G, Doritchamou J, Gbédandé K, Fievet N, Luty AJF, Massougbodji A, Theander TG, Deloron P, Lavstsen T, Tuikue Ndam N. Dynamics of PfEMP1 Antibody Profile From Birth to 12 Months of Age in Beninese Infants. J Infect Dis 2021; 221:2010-2017. [PMID: 32002541 DOI: 10.1093/infdis/jiaa043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Plasmodium falciparum-infected erythrocytes bind to specific endothelial cell receptors via members of the PfEMP1 family exported onto the erythrocyte surface. These interactions are mediated by different types of cysteine-rich interdomain region (CIDR) domains found in the N-terminal region of all PfEMP1. CIDRα1 domains bind endothelial protein C receptor (EPCR), CIDRα2-6 domains bind CD36, whereas the receptor specificity of CIDRβ/γ/δ domains is unknown. METHODS In this study, we investigated the level of immunoglobulin (Ig)G targeting the different types of PfEMP1 CIDR during the first year of life. We used plasma collected longitudinally from children of pregnant women who had been followed closely through pregnancy. RESULTS Antibodies to CIDRα1 domains were more frequent in cord blood compared with antibodies to CIDRα2-6 domains. Higher IgG levels to EPCR-binding CIDRα1 variants positively correlated with the timing of first infections. Antibodies to all PfEMP1 types declined at similar rates to the point of disappearance over the first 6 months of life. At 12 months, children had acquired antibody to all types of CIDR domains, mostly in children with documented P falciparum infections. CONCLUSIONS These observations agree with the notion that the timing and phenotype of first P falciparum infections in life are influenced by the immune status of the mother.
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Affiliation(s)
| | - L Turner
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - G Cottrell
- Université de Paris, MERIT, IRD, Paris, France
| | - J Doritchamou
- Institut de Recherche Clinique du Bénin, Université d'Abomey-Calavi, Cotonou, Bénin
| | - K Gbédandé
- Institut de Recherche Clinique du Bénin, Université d'Abomey-Calavi, Cotonou, Bénin
| | - N Fievet
- Université de Paris, MERIT, IRD, Paris, France
| | - A J F Luty
- Université de Paris, MERIT, IRD, Paris, France
| | - A Massougbodji
- Institut de Recherche Clinique du Bénin, Université d'Abomey-Calavi, Cotonou, Bénin
| | - T G Theander
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - P Deloron
- Université de Paris, MERIT, IRD, Paris, France
| | - T Lavstsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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19
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Mentasti M, David S, Sands K, Khan S, Davies L, Turner L, Wootton M. Rapid detection and differentiation of mobile colistin resistance (mcr-1 to mcr-10) genes by real-time PCR and melt-curve analysis. J Hosp Infect 2021; 110:148-155. [PMID: 33485969 DOI: 10.1016/j.jhin.2021.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/15/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The emergence of multi-drug-resistant (MDR) micro-organisms prompted new interest in older antibiotics, such as colistin, that had been abandoned previously due to limited efficacy or high toxicity. Over the years, several chromosomal-encoded colistin resistance mechanisms have been described; more recently, 10 plasmid-mediated mobile colistin resistance (mcr) genes have been identified. Spread of these genes among MDR Gram-negative bacteria is a matter of serious concern; therefore, reliable and timely mcr detection is paramount. AIM To design and validate a multiplex real-time polymerase chain reaction (PCR) assay for detection and differentiation of mcr genes. METHODS All available mcr alleles were downloaded from the National Center for Biotechnology Information Reference Gene Catalogue, aligned with Clustal Omega and primers designed using Primer-BLAST. Real-time PCR monoplexes were optimized and validated using a panel of 120 characterized Gram-negative strains carrying a wide range of resistance genes, often in combination. Melt-curve analysis was used to confirm positive results. FINDINGS In-silico analysis enabled the design of a 'screening' assay for detection of mcr-1/2/6, mcr-3, mcr-4, mcr-5, mcr-7, mcr-8 and mcr-9/10, paired with an internal control assay to discount inhibition. A 'supplementary' assay was subsequently designed to differentiate mcr-1, mcr-2, mcr-6, mcr-9 and mcr-10. Expected results were obtained for all strains (100% sensitivity and specificity). Melt-curve analysis showed consistent melting temperature results. Inhibition was not observed. CONCLUSIONS The assay is rapid and easy to perform, enabling unequivocal mcr detection and differentiation even when more than one variant is present. Adoption by clinical and veterinary microbiology laboratories would aid the surveillance of mcr genes amongst Gram-negative bacteria.
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Affiliation(s)
- M Mentasti
- Specialist Antimicrobial and Chemotherapy Unit, Public Health Wales, University Hospital of Wales, Cardiff, UK.
| | - S David
- Centre for Genomic Pathogen Surveillance, Wellcome Genome Campus, Cambridge, UK
| | - K Sands
- School of Medicine, Cardiff University, Cardiff, UK; Department of Zoology, University of Oxford, Oxford, UK
| | - S Khan
- Specialist Antimicrobial and Chemotherapy Unit, Public Health Wales, University Hospital of Wales, Cardiff, UK
| | - L Davies
- Specialist Antimicrobial and Chemotherapy Unit, Public Health Wales, University Hospital of Wales, Cardiff, UK
| | - L Turner
- Specialist Antimicrobial and Chemotherapy Unit, Public Health Wales, University Hospital of Wales, Cardiff, UK
| | - M Wootton
- Specialist Antimicrobial and Chemotherapy Unit, Public Health Wales, University Hospital of Wales, Cardiff, UK
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20
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Shah K, Woldendorp K, Harris J, Keech A, Morton R, Ng M, Elder D, Seco M, Nguyen M, Turner L, Wu J, Watson D, Doyle M. R29 Hospital Resource Use and Costs of Isolated Aortic Valve Replacement Procedures in Patients with aortic stenosis, by STS risk scores in New South Wales, Australia. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Snyder J, Bateman-House A, Turner L. Is right to try being tried? Using crowdfunding data to better understand usage of nontrial pre-approval access pathways. Regen Med 2020; 15:1979-1985. [PMID: 33023369 DOI: 10.2217/rme-2020-0043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The US FDA has two nontrial pre-approval access pathways: expanded access (EA) and right to try (RTT). Reports of successful RTT use are scarce, and the FDA has not yet published RTT usage data, yet proponents tout its utility. In the face of this discrepancy and a lack of transparency of usage statistics, our aim is to add to the limited understanding of RTT usage. Materials & m ethods: We searched crowdfunding campaigns referencing 'expanded access', 'right to try' or 'compassionate use' since 2018. Results: We identified 26 EA campaigns, 29 RTT campaigns and two referencing both. Twenty one EA campaigns described being approved to receive access to the requested experimental medical product versus one RTT campaign. Conclusion: RTT is associated with poor understanding of nontrial pre-approval access. These campaigns suggest RTT is not offering a practical alternative to EA. Cost remains a significant barrier to these patients.
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Affiliation(s)
- Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby BC V5A 1S6, Canada
| | - Alison Bateman-House
- Division of Medical Ethics, Department of Population Health, Grossman School of Medicine, NYU Langone Health, New York, NY 10016, USA
| | - Leigh Turner
- Center for Bioethics, University of Minnesota, Minneapolis, MN 55455, USA
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22
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Mazza D, McCarthy E, Singh N, Carey M, Turner L, Harris M. "There's always something else": Patient perspectives on improving the implementation of obesity guidelines in general practice. Obes Res Clin Pract 2020; 14:437-442. [PMID: 32962956 DOI: 10.1016/j.orcp.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The prevalence of obesity in Australia is rising. National guidelines for the management of overweight and obesity exist but our previous work demonstrates poor implementation of key elements in general practice. The aim of this study was to describe patient perspectives on the implementation of obesity guidelines in general practice. METHODS Qualitative study of 40 people living with obesity (PwO) who were recruited through general practices in Melbourne, Australia. PwO had a recorded BMI in the overweight range or above (>25), had attended a consultation in the last 6 months and had a diagnosis of at least one of the following: diabetes, kidney disease, hyperlipidemia, hypertension, or cardiovascular disease. Semi-structured telephone interviews were conducted with patients. Interviews were audio-recorded, transcribed verbatim and analysed thematically. RESULTS While a strong general practitioner (GP)-patient relationship enabled conversation to occur about weight management there was uncertainty as to whether patients or GPs should broach the topic of weight. Patients described complacency regarding their weight and often being unprepared to take up GP advice. Other health issues were felt to take precedence, and patients described inconsistent provision of information and resources to assist them in tackling their weight problems. CONCLUSIONS It is imperative to take into account patient perspectives on obesity management in general practice in order to improve health outcomes. This study provides valuable insights into how PwO can be better managed. Interventions should also include strategies to help patients maintain motivation in making lifestyle changes to support healthy weight loss.
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Affiliation(s)
- D Mazza
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.
| | - E McCarthy
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - N Singh
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - M Carey
- School of Medicine and Public Health, University of Newcastle, Australia
| | - L Turner
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - M Harris
- School of Public Health and Community Medicine, University of New South Wales, Australia
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23
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Thomas JMH, Mollart C, Turner L, Heasman P, Fayon P, Trewin A. Artificial Synthesis of Conjugated Microporous Polymers via Sonogashira-Hagihara Coupling. J Phys Chem B 2020; 124:7318-7326. [PMID: 32786713 DOI: 10.1021/acs.jpcb.0c04850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Amorphous network materials are becoming increasingly important with applications, for example, as supercapacitors, battery anodes, and proton conduction membranes. The design of these materials is hampered by the amorphous nature of the structure and sensitivity to synthetic conditions. Here, we show that through artificial synthesis, fully mimicking the catalytic formation cycle, and full synthetic conditions, we can generate structural models that can fully describe the physical properties of these amorphous network materials. This opens up pathways for the rational design where complex structural influences, such as the solvent and catalyst choice, can be taken into account.
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Affiliation(s)
- J M H Thomas
- Institute of Integrative Biology, University of Liverpool, Liverpool L69 7ZB, U.K
| | - C Mollart
- Department of Chemistry, Lancaster University, Bailrigg, Lancaster LA1 4YB, U.K
| | - L Turner
- Department of Chemistry, Lancaster University, Bailrigg, Lancaster LA1 4YB, U.K
| | - P Heasman
- Department of Chemistry, Lancaster University, Bailrigg, Lancaster LA1 4YB, U.K
| | - P Fayon
- Department of Chemistry, Lancaster University, Bailrigg, Lancaster LA1 4YB, U.K
| | - A Trewin
- Department of Chemistry, Lancaster University, Bailrigg, Lancaster LA1 4YB, U.K
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24
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Clarke A, Beenstock J, Lukacs JN, Turner L, Limmer M. Major risk factors for sexual minority young people's mental and physical health: findings from a county-wide school-based health needs assessment. J Public Health (Oxf) 2020; 41:e274-e282. [PMID: 30252096 DOI: 10.1093/pubmed/fdy167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/31/2018] [Revised: 07/26/2018] [Accepted: 09/04/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Childhood health is an important adult health predictor. Sexual orientation is increasingly recognized as influential on children and young people's (CYP) mental and physical health. METHODS Data came from a cross-sectional survey of year 9 children attending schools in two local authorities in the north-west of England, including mental and physical health indicators, and demographic characteristics including sexual orientation. The sample of 8058 represented 67.8% of the eligible population. Data were analysed by sexual orientation, sexual majority or sexual minority. RESULTS Children reporting their sexual orientation as sexual minority reported worse mental and physical health outcomes and behaviours than sexual majority peers; had higher odds of being lonely (odds ratios (OR) = 8.24, 95% C.I.: 6.56-10.37), having self-harmed (OR = 7.28, 95% C.I.: 5.78-9.15), being bullied (OR = 4.76, 95% C.I.: 3.74-6.05) or perceiving themselves as overweight (OR = 2.40, 95% C.I.: 1.89-3.06). CONCLUSIONS It is important to identify and support children in a sexual minority. Research is required to understand differences between children within sexual minorities and the impact on outcomes and rights. Health and social policy and services, should respond to the vulnerabilities of sexual minority CYP.
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Affiliation(s)
- A Clarke
- Children and Family Health Service, Lancashire Care NHS Foundation Trust, Preston , UK
| | - J Beenstock
- Lancashire Care NHS Foundation Trust, Preston, UK.,Faculty of Health & Medicine, Lancaster University, UK
| | - J N Lukacs
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - L Turner
- Lancashire LGBT, Preston PR2 8PS, UK
| | - M Limmer
- Division of Health Research, Lancaster University, Lancaster, UK
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25
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Abstract
In the midst of a global public health emergency, some businesses are taking advantage of widespread fears by marketing purported stem cell treatments for COVID-19. Such businesses target prospective clients with misleading claims, expose patients to potentially risky stem cell-based products, and undermine efforts to develop evidence-based treatments for COVID-19.
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Affiliation(s)
- Leigh Turner
- Center for Bioethics, School of Public Health, and College of Pharmacy, University of Minnesota, 410 Church Street SE, N520, Minneapolis, MN 55455, USA.
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26
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Asada Y, Turner L, Schwartz M, Chriqui JF. "Bridging, brokering, and buffering": a theoretical exploration of school leaders' engagement with local school wellness policy implementation. Implement Sci Commun 2020; 1:44. [PMID: 32885201 PMCID: PMC7427866 DOI: 10.1186/s43058-020-00029-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 03/25/2020] [Indexed: 11/26/2022] Open
Abstract
Background The Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296) prompted the expansion of federal requirements for local school wellness policies, which aim to improve health promoting practices across school districts in the USA. This qualitative study examined how school district superintendents—as key school leaders who are often listed as the district accountability figure for wellness policies applicable to kindergarten through 12th grade—engaged with wellness policy implementation. The inquiry was guided by evidence-informed implementation and leadership frameworks, including the Consolidated Framework for Implementation Research (CFIR) and “bridging, buffering, and brokering” strategies from education leadership theory. Methods We conducted focus groups and interviews with superintendents (n = 39) from 23 states. Interviews were recorded and professionally transcribed; transcripts were team-coded in Atlas.ti v8 using an iteratively revised coding guide that was informed by CFIR, pilot testing, and during weekly analyst meetings. Principles of constant comparative analysis were employed to develop themes. Results Most superintendents’ reported positive perspectives and personal motivations to engage with wellness policy implementation. Within the CFIR process domain, superintendents demonstrated adaptive leadership traits and employed a combination of “bridging, buffering, and brokering” strategies to lead implementation activities. Rather than focus on personal traits, an emphasis on specific strategies highlights actions that may be applied. Conclusions The findings offer practical strategies to support superintendents with implementation, as well as a formative contribution to the dearth of theoretical frameworks in school wellness literature, particularly by advancing the specific understanding of leadership roles within a broader implementation framework. The application of education theory allowed for a deeper inquiry into the potential ways that leaders’ strategies and engagement influences implementation more broadly.
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Affiliation(s)
- Y Asada
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt Rd, M/C 275, Chicago, IL 60608 USA
| | - L Turner
- College of Education, Boise State University, 1910 University Drive, Boise, Idaho 83725 USA
| | - M Schwartz
- UConn Rudd Center for Food Policy and Obesity University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT 06103 USA
| | - J F Chriqui
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 W Roosevelt Rd, M/C 275, Chicago, IL 60608 USA
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Smith C, Martin-Lillie C, Higano JD, Turner L, Phu S, Arthurs J, Nelson TJ, Shapiro S, Master Z. Challenging misinformation and engaging patients: characterizing a regenerative medicine consult service. Regen Med 2020; 15:1427-1440. [PMID: 32319855 PMCID: PMC7466910 DOI: 10.2217/rme-2020-0018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 02/13/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
Aim: To address the unmet needs of patients interested in regenerative medicine, Mayo Clinic created a Regenerative Medicine Consult Service (RMCS). We describe the service and patient satisfaction. Materials & methods: We analyzed RMCS databases through retrospective chart analysis and performed qualitative interviews with patients. Results: The average patient was older to elderly and seeking information about regenerative options for their condition. Patients reported various conditions with osteoarthritis being most common. Over a third of consults included discussions about unproven interventions. About a third of patients received a clinical or research referral. Patients reported the RMCS as useful and the consultant as knowledgeable. Conclusion: An institutional RMCS can meet patients' informational needs and support the responsible translation of regenerative medicine.
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Affiliation(s)
- Cambray Smith
- Biomedical Ethics Research Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Charlene Martin-Lillie
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Jennifer Dens Higano
- Mayo Clinic Alix School of Medicine, 200 First Street, SW, Rochester, MN 55905, USA
| | - Leigh Turner
- Center for Bioethics, School of Public Health & College of Pharmacy, University of Minnesota, N520 Boynton, 410 Church Street SE, Minneapolis, MN 55455, USA
| | - Sydney Phu
- School of History, Philosophy & Religion, Oregon State University, 322 Milam Hall, 2520 SW Campus Way, Corvallis, OR 97331, USA
| | - Jennifer Arthurs
- Center for Regenerative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Timothy J Nelson
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
- Department of General Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Shane Shapiro
- Center for Regenerative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
- Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Zubin Master
- Biomedical Ethics Research Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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Shah K, Elder D, Nguyen M, Turner L, Doyle M, Woldendorp K, Seco M, Law C, Wilson M, Keech A, Ng M, Morton R. 628 Transcatheter Aortic Valve Implantation (TAVI) Versus Surgical Aortic Valve Replacement (SAVR) for Aortic Stenosis: A Cost-Comparison Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schmidt MF, Turner L, Bradley M, Shepherd J. 2738 Comparing Postoperative Pain with Laparoscopic Versus Robotic Sacrocolpopexy. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fu W, Smith C, Turner L, Fojtik J, Pacyna JE, Master Z. Characteristics and Scope of Training of Clinicians Participating in the US Direct-to-Consumer Marketplace for Unproven Stem Cell Interventions. JAMA 2019; 321:2463-2464. [PMID: 31237628 PMCID: PMC6593626 DOI: 10.1001/jama.2019.5837] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study describes the credentials and scope of training of physician and nonphysician practitioners working for US companies marketing unproven stem cell procedures.
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Affiliation(s)
- Wayne Fu
- Albany Medical College, Albany, New York
| | - Cambray Smith
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota
| | - Leigh Turner
- University of Minnesota Center for Bioethics, Minneapolis
| | - Joseph Fojtik
- Illinois Department of Financial and Professional Regulations, Chicago
| | - Joel E. Pacyna
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota
| | - Zubin Master
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota
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Snyder J, Turner L. Crowdfunding for stem cell-based interventions to treat neurologic diseases and injuries. Neurology 2019; 93:252-258. [DOI: 10.1212/wnl.0000000000007838] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/14/2019] [Indexed: 12/20/2022] Open
Abstract
ObjectiveTo characterize the marketplace for direct-to-consumer (DTC) unproven stem cell-based interventions (SCBI) for neurologic diseases and injuries using crowdfunding data.MethodsSearch terms were developed from previous empirical studies of DTC businesses and the International Classification of Diseases–11 for neurologic diseases and used to query GoFundMe's internal search engine. Campaigns initiated November 2017–2018 and seeking SCBI for neurologic diseases and injuries (n = 1,030) were reviewed to identify the number of donors, number of Facebook shares, recipient location, funding pledged, funding requested, underlying neurologic condition, treatment location, and treatment facility name.ResultsA total of 1,030 crowdfunding campaigns for SCBI for neurologic diseases and injuries requested $33,449,979 and received $5,057,069 from 38,713 donors. The most common neurologic condition identified was multiple sclerosis (MS) (n = 404, 35.5%). Of campaigns naming specific destination facilities (n = 392), the most common clinical settings identified were the Stem Cell Institute in Panama City, Panama (n = 91, 23.2%), StemGenex in San Diego, California (n = 44, 11.2%), and Clinica Ruiz in Puebla, Mexico (n = 36, 9.2%).ConclusionsMS dominated the total number of crowdfunding campaigns. Most campaigns were linked to individuals from regions geographically proximal to destination facilities advertising SCBI for particular neurologic diseases. Most of the clinical destinations were located in comparatively high-income countries such as the United States, Mexico, and Panama. These findings provide considerable insight into the DTC marketplace for SCBI. Analysis of crowdfunding campaigns can be used to develop more targeted patient education initiatives and health policies related to domestic and international travel for unproven SCBI.
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Mazza D, McCarthy E, Carey M, Turner L, Harris M. "90% of the time, it's not just weight": General practitioner and practice staff perspectives regarding the barriers and enablers to obesity guideline implementation. Obes Res Clin Pract 2019; 13:398-403. [PMID: 31109793 DOI: 10.1016/j.orcp.2019.04.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/25/2019] [Accepted: 04/05/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify the views of GPs and general practice staff regarding barriers and enablers to implementation of obesity guideline recommendations in general practice. METHODS Twenty general practitioners (GPs) and 18 practice staff from inner-eastern Melbourne, Australia, participated in semi-structured telephone interviews. The interview schedule was informed by the Theoretical Domains Framework (TDF). Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis. RESULTS Participants lacked familiarity with and knowledge of the NHMRC obesity guidelines. Barriers and enablers were predominantly related to five theoretical domains: (1) environmental context and resources, (2) knowledge, (3) emotion, (4) beliefs about consequences, and (5) motivation and goals. Time pressures in consultations, costs for the patient, reluctance to add to patient burden particularly in those with comorbidities such as mental health issues, lack of awareness about services to refer patients to and GPs' fear of embarrassing patients and losing them were significant barriers. Enablers included having a strong doctor-patient relationship and a sense of responsibility to the patient to address weight. CONCLUSIONS Obesity guidelines and policy makers need to better engage with issues of multimorbidity, socioeconomic disadvantage and workforce issues if recommendations are to be widely adopted in general practice. Tasksharing, teamwork and technology are potential solutions to some of the barriers. Patient perspectives and approaches to being able to overcome stigma and legitimise obesity management in primary care consultations could also assist.
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Affiliation(s)
- D Mazza
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.
| | - E McCarthy
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - M Carey
- School of Medicine and Public Health, University of Newcastle, Australia
| | - L Turner
- Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - M Harris
- School of Public Health and Community Medicine, University of New South Wales, Australia
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Tanner C, Munsie M, Sipp D, Turner L, Wheatland C. The politics of evidence in online illness narratives: An analysis of crowdfunding for purported stem cell treatments. Health (London) 2019; 23:436-457. [DOI: 10.1177/1363459319829194] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Doug Sipp
- RIKEN Center for Biosystems Dynamics Research, Japan
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Myles PS, Smith JA, Kasza J, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussières JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S, Forbes A, Myles P, Smith J, Cooper DJ, Silbert B, McNeil J, Marasco S, Esmore D, Krum H, Tonkin A, Buxton B, Heritier S, Merry A, Liew D, McNeil J, Forbes A, Cooper D, Wallace S, Meehan A, Myles P, Wallace S, Galagher W, Farrington C, Ditoro A, Wutzlhofer L, Story D, Peyton P, Baulch S, Sidiropoulos S, Potgieter D, Baker R, Pesudovs B, O'Loughlin J Wells E, Coutts P, Bolsin S, Osborne C, Ives K, Smith J, Hulley A, Christie-Taylor G, Painter T, Lang S, Mackay H, Cokis C, March S, Bannon P, Wong C, Turner L, Scott D, Silbert B, Said S, Corcoran P, Painter T, de Prinse L, Bussières J, Gagné N, Lamy A, Semelhago L, Chan M, Underwood M, Choi G, Fung B, Landoni G, Lembo R, Monaco F, Simeone F, Marianello D, Alvaro G, De Vuono G, van Dijk D, Dieleman J, Numan S, McGuinness S, Parke R, Raudkivi P, Gilder E, Byrne K, Dunning J, Termaat J, Mans G, Jayarajah M, Alderton J, Waugh D, Platt M, Pai A, Sevillano A, Lal A, Sinclair C, Kunst G, Knighton A, Cubas G, Saravanan P, Millner R, Vasudevan V, Patteril M, Lopez E, Basu R, Lu J. Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial. J Thorac Cardiovasc Surg 2019; 157:644-652.e9. [DOI: 10.1016/j.jtcvs.2018.09.113] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/13/2018] [Accepted: 09/27/2018] [Indexed: 11/30/2022]
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Shah K, Nguyen M, Seco M, Elder D, Turner L, Wu J, Doyle M, Watson D, Woldendorp K, Keech A, Ng M, Morton R. Comparing Hospital Costs Of Trans-Catheter Aortic Valve Replacement and Isolated Surgical Aortic Valve Replacement in Patients with Aortic Stenosis Treated in New South Wales, Australia. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Elder D, Ng M, Morton R, Keech A, Seco M, Shah K, Turner L, Nguyen M, Woldendorp K, Doyle M, Wu J, Watson D. A Comparison of the Number and Demographics of Patients Undergoing Either Isolated Surgical or a Trans-Catheter Aortic Valve Replacement Following the Introduction of a TAVI Program. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zarzeczny A, Atkins H, Illes J, Kimmelman J, Master Z, Robillard JM, Snyder J, Turner L, Zettler PJ, Caulfield T. The stem cell market and policy options: a call for clarity. J Law Biosci 2018; 5:743-758. [PMID: 31143461 PMCID: PMC6534752 DOI: 10.1093/jlb/lsy025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Amy Zarzeczny
- Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK S4S 0A2, Canada
| | - Harold Atkins
- Ottawa Hospital Research Institute, Ottawa Hospital & University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Jonathan Kimmelman
- Biomedical Ethics Unit/Social Studies of Medicine, McGill University. Montreal, QC H3A 1X1, Canada
| | - Zubin Master
- Biomedical Ethics Research Program, Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie M Robillard
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Leigh Turner
- Center for Bioethics, School of Public Health, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Patricia J Zettler
- Centre for Law, Health and Society, College of Law, Georgia State University, Atlanta, GA 30302, USA
| | - Timothy Caulfield
- Faculty of Law and School of Public Health & Health Law Institute, University of Alberta, Edmonton, AB T6G 2H5, Canada
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Douglas J, Lawrence J, Turner L, Knol L, Ellis A. DIETITIANS IN RURAL, ACUTE CARE SETTINGS REPORT GREATER LIKELIHOOD OF RECOMMENDING FEEDING TUBES IN DEMENTIA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Litton E, Bass F, Delaney A, Hillis G, Marasco S, McGuinness S, Myles PS, Reid CM, Smith JA, Bagshaw SM, Keri-Anne Cowdrey HB, Frengley R, Ferrier J, Gilder E, Henderson S, Larobina M, Merthens J, Morgan M, Navarra L, Rudas M, Turner L, Reid K, Wise M, Young N, Young P, McGiffin D, Duncan J, Kaczmarek M, Seevanayagam S, Shaw M, Shardey G, Skillington P, Chorley T, Baker L, Zhang B, Bright C, Baker R, Canning N, Gilfillan, Kruger R, Fayers T, Kyte M, Doran C, Smith J, Baxter H, Seah P, Scaybrook S, James A, Goodwin K, Dignan R, Hewitt N, Gerrard K, Curtis L, Smith J, Baxter H, Tiruvoipati R, Broukal N, Wolfenden H, Muir, Worthington M, Wong C, Tatoulis J, Wynne R, Marshman D, Sze D, Wilson M, Turner L, Passage J, Kolybaba M, Fermanis G, Newbon P, Passage J, Kolybaba M, Newcomb A, Mack J, Duve K, Jansz P, Hunter T, Bissaker P, Dennis N, Burke N, Yadav S, Cooper K, Chard R, Halaka M, Tran L, Huq M, Billah B, Reid CM. Six-Month Outcomes After High-Risk Coronary Artery Bypass Graft Surgery and Preoperative Intra-aortic Balloon Counterpulsation Use: An Inception Cohort Study. J Cardiothorac Vasc Anesth 2018; 32:2067-2073. [DOI: 10.1053/j.jvca.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Indexed: 11/11/2022]
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Abstract
AIM This study examines marketing claims of Canadian businesses engaged in direct-to-consumer advertising of putative stem cell treatments. METHODS Internet searches were used to locate Canadian businesses selling stem cell interventions. Company websites were subjected to detailed analysis. RESULTS In total, 30 Canadian businesses sell stem cell interventions provided at 43 clinics. Autologous stem cells are the most common types of products promoted by such businesses. Company websites minimize risks while making strong claims about benefits of stem cell interventions. DISCUSSION Businesses' representations could result in patients making health-related decisions informed by marketing claims rather than best available scientific evidence. CONCLUSION Although there is absent development of new regulations and guidance, the Canadian direct-to-consumer marketplace for stem cell interventions appears poised for expansion.
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Affiliation(s)
- Leigh Turner
- Center for Bioethics, School of Public Health, College of Pharmacy, University of Minnesota, N520 Boynton, 410 Church Street SE, Minneapolis, MN 55455, USA
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42
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Biswas S, Turner L, Biswas I. Lactobacillus rhamnosusLRB mediated inhibition of oral streptococci. Mol Oral Microbiol 2018; 33:396-405. [DOI: 10.1111/omi.12242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2018] [Indexed: 12/11/2022]
Affiliation(s)
- S. Biswas
- Department of Microbiology; Molecular Genetics and Immunology; University of Kansas Medical Center; Kansas City Kansas
| | - L. Turner
- Department of Microbiology; Molecular Genetics and Immunology; University of Kansas Medical Center; Kansas City Kansas
| | - I. Biswas
- Department of Microbiology; Molecular Genetics and Immunology; University of Kansas Medical Center; Kansas City Kansas
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Abstract
Aim: This study examines marketing claims of Canadian businesses engaged in direct-to-consumer advertising of putative stem cell treatments. Methods: Internet searches were used to locate Canadian businesses selling stem cell interventions. Company websites were subjected to detailed analysis. Results: In total, 30 Canadian businesses sell stem cell interventions provided at 43 clinics. Autologous stem cells are the most common types of products promoted by such businesses. Company websites minimize risks while making strong claims about benefits of stem cell interventions. Discussion: Businesses’ representations could result in patients making health-related decisions informed by marketing claims rather than best available scientific evidence. Conclusion: Although there is absent development of new regulations and guidance, the Canadian direct-to-consumer marketplace for stem cell interventions appears poised for expansion.
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Affiliation(s)
- Leigh Turner
- Center for Bioethics, School of Public Health, College of Pharmacy, University of Minnesota, N520 Boynton, 410 Church Street SE, Minneapolis, MN 55455, USA
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Parker E, Feinberg T, Lane H, Deitch R, Zemanick A, Saksvig B, Turner L, Hager E. Diet Quality of Urban Elementary and Middle School Teachers is Associated with Healthier Classroom Practices and Self-efficacy Regarding Nutrition and Physical Activity Instruction. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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45
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McKinley E, Knol L, Turner L, Burnham J, Graettinger K, Hernandez-Reif M, Leeper J. Validation of an Instrument to Measure Prenatal Breastfeeding Self-efficacy. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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46
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Wagner DE, Turner L, Panoskaltsis-Mortari A, Weiss DJ, Ikonomou L. Co-opting of ClinicalTrials.gov by patient-funded studies. Lancet Respir Med 2018; 6:579-581. [PMID: 29934051 DOI: 10.1016/s2213-2600(18)30242-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/04/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Darcy E Wagner
- Department of Experimental Medical Sciences, Wallenberg Center for Molecular Medicine, and Lund Stem Cell Center, Faculty of Medicine, Lund University, Lund, Sweden
| | - Leigh Turner
- Center for Bioethics, School of Public Health and College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | | | - Daniel J Weiss
- University of Vermont College of Medicine, Burlington, VT, USA
| | - Laertis Ikonomou
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; Center for Regenerative Medicine of Boston University and Boston Medical Center, Boston, MA 02118, USA.
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Abstract
Aim: To better understand how prospective customers interpret claims of businesses marketing unproven stem cell products that they are engaging in research activities. Materials & methods: The authors examined 408 crowdfunding campaigns for unproven stem cell interventions for references to research activities. Results: The authors identified three overarching themes: research as a signifier of scientific credibility; the experimental nature of stem cells as a rationale for noncoverage by insurers; and contributing to the advancement of science by engaging in research. Conclusion: The NIH, US FDA and others should be concerned about being co-opted to misrepresent the nature of these businesses’ activities. Efforts are also needed to better inform those considering purchasing unproven stem cell interventions about their relationship to legitimate research.
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Affiliation(s)
- Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Leigh Turner
- Center for Bioethics, University of Minnesota, N-302 Boyn HS, 410 Church Street SE, Minneapolis, MN 55455, USA
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Abstract
This study examines crowdfunding campaigns on GoFundMe and YouCaring sponsored by US-based businesses engaging in direct-to-consumer marketing of stem cell interventions to discover whether the benefits and risks are mentioned in the campaign descriptions.
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Affiliation(s)
- Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Leigh Turner
- Center for Bioethics, University of Minnesota, Minneapolis
| | - Valorie A. Crooks
- Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada
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49
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Knetsch CW, Kumar N, Forster SC, Connor TR, Browne HP, Harmanus C, Sanders IM, Harris SR, Turner L, Morris T, Perry M, Miyajima F, Roberts P, Pirmohamed M, Songer JG, Weese JS, Indra A, Corver J, Rupnik M, Wren BW, Riley TV, Kuijper EJ, Lawley TD. Zoonotic Transfer of Clostridium difficile Harboring Antimicrobial Resistance between Farm Animals and Humans. J Clin Microbiol 2018; 56:e01384-17. [PMID: 29237792 PMCID: PMC5824051 DOI: 10.1128/jcm.01384-17] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 08/29/2017] [Accepted: 12/08/2017] [Indexed: 11/20/2022] Open
Abstract
The emergence of Clostridium difficile as a significant human diarrheal pathogen is associated with the production of highly transmissible spores and the acquisition of antimicrobial resistance genes (ARGs) and virulence factors. Unlike the hospital-associated C. difficile RT027 lineage, the community-associated C. difficile RT078 lineage is isolated from both humans and farm animals; however, the geographical population structure and transmission networks remain unknown. Here, we applied whole-genome phylogenetic analysis of 248 C. difficile RT078 strains from 22 countries. Our results demonstrate limited geographical clustering for C. difficile RT078 and extensive coclustering of human and animal strains, thereby revealing a highly linked intercontinental transmission network between humans and animals. Comparative whole-genome analysis reveals indistinguishable accessory genomes between human and animal strains and a variety of antimicrobial resistance genes in the pangenome of C. difficile RT078. Thus, bidirectional spread of C. difficile RT078 between farm animals and humans may represent an unappreciated route disseminating antimicrobial resistance genes between humans and animals. These results highlight the importance of the "One Health" concept to monitor infectious disease emergence and the dissemination of antimicrobial resistance genes.
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Affiliation(s)
- C W Knetsch
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - N Kumar
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - S C Forster
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
| | - T R Connor
- Cardiff School of Biosciences, Sir Martin Evans Building, Cardiff, United Kingdom
| | - H P Browne
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - C Harmanus
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - I M Sanders
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - S R Harris
- Pathogen Genomics, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - L Turner
- Public Health Wales, Microbiology, Wales, United Kingdom
| | - T Morris
- Public Health Wales, Microbiology, Wales, United Kingdom
| | - M Perry
- Public Health Wales, Microbiology, Wales, United Kingdom
| | - F Miyajima
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - P Roberts
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - M Pirmohamed
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - J G Songer
- Department of Veterinary Science and Microbiology, The University of Arizona, Tucson, Arizona, USA
| | - J S Weese
- Department of Pathobiology, Canada Veterinary College, University of Guelph, Guelph, Canada
| | - A Indra
- Institute of Medical Microbiology and Hygiene, Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES), Vienna, Austria
| | - J Corver
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - M Rupnik
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
- National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - B W Wren
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - T V Riley
- Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Western Australia, Australia
- Microbiology & Immunology, School of Pathology & Laboratory Medicine, The University of Western Australia, Western Australia, Australia
| | - E J Kuijper
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - T D Lawley
- Host-Microbiota Interactions Laboratory, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
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50
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Abstract
Hundreds of businesses and clinics in the United States are engaged in direct-to-consumer marketing of unproven and unlicensed stem cell-based interventions. This essay provides an overview of this marketplace, examines advertising techniques companies use to draw clients and legitimate marketing claims, and summarizes the roles the Food and Drug Administration (FDA) and other agencies are supposed to play in regulating the direct-to-consumer marketplace for stem cell interventions. The essay also reviews federal regulations, describes how many businesses selling purported "stem cell treatments" appear to violate these standards, and considers ethical issues and harms associated with widespread promotion of unapproved stem cell products.
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