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Jenkins V, Matthews L, Solis-Trapala I, Gage H, May S, Williams P, Bloomfield D, Zammit C, Elwell-Sutton D, Betal D, Finlay J, Nicholson K, Kothari M, Santos R, Stewart E, Bell S, McKinna F, Teoh M. Patients' experiences of a suppoRted self-manAGeMent pAThway In breast Cancer (PRAGMATIC): quality of life and service use results. Support Care Cancer 2023; 31:570. [PMID: 37698629 PMCID: PMC10497681 DOI: 10.1007/s00520-023-08002-z] [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: 02/27/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To describe trends and explore factors associated with quality of life (QoL) and psychological morbidity and assess breast cancer (BC) health service use over a 12-month period for patients joining the supported self-management (SSM)/patient-initiated follow-up (PIFU) pathway. METHODS Participants completed questionnaires at baseline, 3, 6, 9 and 12 months that measured QoL (FACT-B, EQ 5D-5L), self-efficacy (GSE), psychological morbidity (GHQ-12), roles and responsibilities (PRRS) and service use (cost diary). RESULTS 99/110 patients completed all timepoints; 32% (35/110) had received chemotherapy. The chemotherapy group had poorer QoL; FACT-B total score mean differences were 8.53 (95% CI: 3.42 to 13.64), 5.38 (95% CI: 0.17 to 10.58) and 8.00 (95% CI: 2.76 to 13.24) at 6, 9 and 12 months, respectively. The odds of psychological morbidity (GHQ12 >4) were 5.5-fold greater for those treated with chemotherapy. Financial and caring burdens (PRRS) were worse for this group (mean difference in change at 9 months 3.25 (95% CI: 0.42 to 6.07)). GSE and GHQ-12 scores impacted FACT-B total scores, indicating QoL decline for those with high baseline psychological morbidity. Chemotherapy patients or those with high psychological morbidity or were unable to carry out normal activities had the highest service costs. Over the 12 months, 68.2% participants phoned/emailed breast care nurses, and 53.3% visited a hospital breast clinician. CONCLUSION The data suggest that chemotherapy patients and/or those with heightened psychological morbidity might benefit from closer monitoring and/or supportive interventions whilst on the SSM/PIFU pathway. Reduced access due to COVID-19 could have affected service use.
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Affiliation(s)
- V Jenkins
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK.
| | - L Matthews
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK
| | - I Solis-Trapala
- School of Medicine, Keele University, University Road, Staffordshire, England, UK
| | - H Gage
- Surrey Health Economics Centre/Department of Clinical and Experimental Medicine, Leggett Building, University of Surrey, Guildford, Surrey, England, UK
| | - S May
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK
| | - P Williams
- Department of Mathematics, University of Surrey, Guildford, Surrey, England, UK
| | - D Bloomfield
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - C Zammit
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - D Elwell-Sutton
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
| | - D Betal
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - J Finlay
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - K Nicholson
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - M Kothari
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - R Santos
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - E Stewart
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - S Bell
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - F McKinna
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - M Teoh
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
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Gibaud A, Younas D, Matthews L, Narayanan T, Longkaew K, Hageberg IU, Chushkin Y, Breiby DW, Chattopadhyay B. Insights into the precipitation kinetics of CaCO 3 particles in the presence of polystyrene sulfonate using in situ small-angle X-ray scattering. J Appl Crystallogr 2023; 56:1114-1124. [PMID: 37555223 PMCID: PMC10405600 DOI: 10.1107/s1600576723005356] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/16/2023] [Indexed: 08/10/2023] Open
Abstract
The formation of calcium carbonate (CaCO3) nanoparticles (NPs) in the presence of polystyrene sulfonate (PSS) as an additive was examined by time-resolved small-angle X-ray scattering (SAXS) in a flow system that mimics experimental conditions used at home facilities where the precipitation can be achieved in a beaker. The experiments were carried out at low concentrations to remain in the dilute regime. A model-independent analysis was performed using the Porod invariant which defines the scale factor, leaving only the distribution of radii as the adjustable parameter. The presence of the PSS additive strongly retards the precipitation of CaCO3 NPs. The formation of NPs reaches a state of equilibrium after a few minutes. Here, it is shown that the concentration of precursors at a fixed PSS concentration plays a key role in determining the size of the NPs obtained. A full analysis of the SAXS patterns was carried out using the Hurd-Flower model to account for the weaker intensity decay than the classical Porod behaviour. The temporal evolution of the particle radii was determined. Wide-angle X-ray scattering experiments carried out simultaneously show that the particles formed have the structure of vaterite with growth consistent with the evolution of the Porod invariant.
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Affiliation(s)
- A. Gibaud
- IMMM, Le Mans Université, Bld O. Messiaen, 72085 Le Mans, Cedex 9, France
| | - D. Younas
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, Trondheim 7491, Norway
| | - L. Matthews
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, 38043 Grenoble, Cedex 9, France
| | - T. Narayanan
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, 38043 Grenoble, Cedex 9, France
| | - K. Longkaew
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, Trondheim 7491, Norway
| | - I. U. Hageberg
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, Trondheim 7491, Norway
| | - Y. Chushkin
- European Synchrotron Radiation Facility, 71 Avenue des Martyrs, 38043 Grenoble, Cedex 9, France
| | - D. W. Breiby
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, Trondheim 7491, Norway
| | - B. Chattopadhyay
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, Trondheim 7491, Norway
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Matthews L, Teoh M, May S, Zammit C, Bloomfield D, Kothari M, Betal D, Santos R, Stewart E, Finlay J, Nicholson K, Elwell-Sutton D, McKinna F, Gage H, Bell S, Jenkins V. CN61 Patients’ experiences of a suppoRted self-manAGeMent pAThway In breast Cancer (PRAGMATIC): Interview results. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Lee E, Matthews L, Shah K, Lee F, Schoggins J, Vandergriff T, Yancey K, Wang R. 252 West Nile Virus presenting as a bullous dermatosis with evidence for keratinocyte involvement in viral replication. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Newman C, Egan AM, Ahern T, Al-Kiyumi M, Bacon S, Bahaeldein E, Balan G, Brassill MJ, Breslin E, Brosnan E, Carmody L, Clarke H, Coogan Kelly C, Culliney L, Davern R, Durkan M, Elhilo K, Cullen E, Fenlon M, Ferry P, Gabir A, Guinan L, Hanlon G, Heffernan M, Higgins T, Hoashi S, Kgosidialwa O, Khamis A, Kinsley B, Kirwan B, James A, Kyithar P, Liew A, Malik I, Matthews L, McGurk C, McHugh C, Moloney Y, Murphy MS, Murphy P, Nagodra D, Noctor E, Nolan M, O'Connor A, O'Connor E, O'Halloran D, O'Mahoney L, O'Shea T, O'Sullivan EP, Peters M, Roberts G, Rooney H, Sharma J, Smyth A, Synnott M, Tarachand B, Tighe M, Todd M, Towers M, Tuthill A, Mahmood W, Yousif O, Dunne FP. Retrospective national cohort study of pregnancy outcomes for women with type 1 and type 2 diabetes mellitus in Republic of Ireland. Diabetes Res Clin Pract 2022; 189:109947. [PMID: 35709911 DOI: 10.1016/j.diabres.2022.109947] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/14/2022] [Accepted: 06/09/2022] [Indexed: 11/03/2022]
Abstract
AIM Report the outcomes of pregnant women with type 1 and type 2 diabetes and to identify modifiable and non-modifiable factors associated with poor outcomes. METHODS Retrospective analysis of pregnancy preparedness, pregnancy care and outcomes in the Republic of Ireland from 2015 to 2020 and subsequent multivariate analysis. RESULTS In total 1104 pregnancies were included. Less than one third attended pre-pregnancy care (PPC), mean first trimester haemoglobin A1c was 7.2 ± 3.6% (55.5 ± 15.7 mmol/mol) and 52% received pre-conceptual folic acid. Poor preparation translated into poorer pregnancy outcomes. Livebirth rates (80%) were comparable to the background population however stillbirth rates were 8.7/1000 (four times the national rate). Congenital anomalies occurred in 42.5/1000 births (1.5 times the background rate). More than half of infants were large for gestational age and 47% were admitted to critical care. Multivariate analyses showed strong associations between non-attendance at PPC, poor glycaemic control and critical care admission (adjusted odds ratio of 1.68 (1.48-1.96) and 1.61 (1.43-1.86), p < 0.05 respectively) for women with type 1 diabetes. Smoking and teratogenic medications were also associated with critical care admission and hypertensive disorders of pregnancy. CONCLUSION Pregnancy outcomes in women with diabetes are suboptimal. Significant effort is needed to optimize the modifiable factors identified in this study.
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Affiliation(s)
| | - Aoife M Egan
- Division of Endocrinology Mayo Clinic, Rochester, United States of America
| | - Tomas Ahern
- Our Lady of Lourdes Hospital, Drogheda, Co Louth, Republic of Ireland
| | - Maisa Al-Kiyumi
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Siobhan Bacon
- Sligo University Hospital, Co Sligo, Republic of Ireland
| | | | - Gabriela Balan
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Mary-Jane Brassill
- South Tipperary General Hospital, Clonmel, Co Tipperary, Republic of Ireland
| | - Emily Breslin
- Sligo University Hospital, Co Sligo, Republic of Ireland
| | | | | | - Hilda Clarke
- Portiuncula University Hospital, Co Galway, Republic of Ireland
| | | | - Linda Culliney
- Cork University Hospital, Cork, Co Cork, Republic of Ireland
| | - Recie Davern
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Maeve Durkan
- Bon Secours Hospital, Cork, Co Cork, Republic of Ireland
| | - Kalthoom Elhilo
- Portlaoise General Hospital, Portlaoise, Co Laois, Republic of Ireland
| | - Elizabeth Cullen
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Mairead Fenlon
- Wexford General Hospital, Co Wexford, Republic of Ireland
| | - Pauline Ferry
- Letterkenny General Hospital, Letterkenny, Co Donegal, Republic of Ireland
| | - Ahmed Gabir
- University Hospital Waterford, Co Waterford, Republic of Ireland
| | - Linda Guinan
- South Tipperary General Hospital, Clonmel, Co Tipperary, Republic of Ireland
| | - Geraldine Hanlon
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Republic of Ireland
| | - Marie Heffernan
- South Infirmary Victoria University Hospital, Cork, Co Cork, Republic of Ireland
| | - Tom Higgins
- University Hospital Kerry, Tralee, Co Kerry, Republic of Ireland
| | - Shu Hoashi
- Mullingar Regional Hospital, Mullingar, Co Westmeath, Republic of Ireland
| | | | - Amjed Khamis
- Letterkenny General Hospital, Letterkenny, Co Donegal, Republic of Ireland
| | - Brendan Kinsley
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Breda Kirwan
- Galway University Hospital, Galway, Republic of Ireland
| | - Anne James
- Our Lady of Lourdes Hospital, Drogheda, Co Louth, Republic of Ireland
| | - Pyeh Kyithar
- Portlaoise General Hospital, Portlaoise, Co Laois, Republic of Ireland
| | - Aaron Liew
- Portiuncula University Hospital, Co Galway, Republic of Ireland
| | | | - Linda Matthews
- Our Lady of Lourdes Hospital, Drogheda, Co Louth, Republic of Ireland
| | - Colm McGurk
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Republic of Ireland
| | - Cathy McHugh
- Sligo University Hospital, Co Sligo, Republic of Ireland
| | - Yvonne Moloney
- University of Limerick UL Hospitals Group, Co Limerick, Republic of Ireland
| | - Matt S Murphy
- South Infirmary Victoria University Hospital, Cork, Co Cork, Republic of Ireland
| | - Paula Murphy
- Cork University Hospital, Cork, Co Cork, Republic of Ireland
| | - Dina Nagodra
- Portlaoise General Hospital, Portlaoise, Co Laois, Republic of Ireland
| | - Eoin Noctor
- University of Limerick UL Hospitals Group, Co Limerick, Republic of Ireland
| | - Marie Nolan
- University Hospital Kerry, Tralee, Co Kerry, Republic of Ireland
| | - Aislong O'Connor
- Letterkenny General Hospital, Letterkenny, Co Donegal, Republic of Ireland
| | - Emily O'Connor
- Portiuncula University Hospital, Co Galway, Republic of Ireland
| | | | - Linda O'Mahoney
- Cork University Hospital, Cork, Co Cork, Republic of Ireland
| | - Triona O'Shea
- University Hospital Waterford, Co Waterford, Republic of Ireland
| | | | - Moby Peters
- University Hospital Waterford, Co Waterford, Republic of Ireland
| | - Graham Roberts
- University Hospital Waterford, Co Waterford, Republic of Ireland
| | - Hannorah Rooney
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Republic of Ireland
| | - Jayant Sharma
- Portlaoise General Hospital, Portlaoise, Co Laois, Republic of Ireland
| | - Aoife Smyth
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Maria Synnott
- Portlaoise General Hospital, Portlaoise, Co Laois, Republic of Ireland
| | | | - Marie Tighe
- Sligo University Hospital, Co Sligo, Republic of Ireland
| | - Marie Todd
- Mayo University Hospital, Co Mayo, Republic of Ireland
| | - Michael Towers
- University Hospital Waterford, Co Waterford, Republic of Ireland
| | | | - Wan Mahmood
- Coombe Women and Infants University Hospital, Dublin, Republic of Ireland
| | - Obada Yousif
- Wexford General Hospital, Co Wexford, Republic of Ireland
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Chen M, Abdul-Rahman A, Archambault D, Dykes J, Ritsos P, Slingsby A, Torsney-Weir T, Turkay C, Bach B, Borgo R, Brett A, Fang H, Jianu R, Khan S, Laramee R, Matthews L, Nguyen P, Reeve R, Roberts J, Vidal F, Wang Q, Wood J, Xu K. RAMPVIS: Answering the challenges of building visualisation capabilities for large-scale emergency responses. Epidemics 2022; 39:100569. [PMID: 35597098 PMCID: PMC9045880 DOI: 10.1016/j.epidem.2022.100569] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 01/09/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
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8
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Rudawsky N, Earl G, Matthews L, Shah K, Griffith R. 247: Evaluation of an educational intervention that supports patient self-management of medications in stable adult outpatients with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01672-6] [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: 11/17/2022]
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9
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Abstract
Abstract
Few interventions are truly simple; complexity can arise from various sources, e.g.:
Aspects of the intervention itself, such as the number of intervention components, the number of groups targeted, how dynamic the intervention is permitted to be. The context in which the intervention is developed and delivered, such as the social, political, economic, and geographical context.
Complex intervention research should be approached with an awareness of these sources of complexity. Systems thinking can be helpful to understanding the dynamic interaction between interventions and their context. This presentation will introduce concepts of complex adaptive systems, e.g. feedback loops, adaptation, emergence, that should be considered when developing and evaluating complex interventions. It will then introduce participants to the research perspectives set out in the new framework: efficacy, effectiveness, theory-based, and systems perspectives. Each perspective is associated with a different type of research question, and therefore appropriate in different circumstances. The presentation will provide information to support participants to consider the research perspective(s) most suited to the research challenge that they are aiming to address.
Main messages
There are multiple sources of complexity, each of which can affect how the intervention works or contributes to change. Complex intervention research can take an efficacy, effectiveness, theory-based, or systems perspective, the choice of which is based on what is known already and what further evidence would be most useful.
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Affiliation(s)
- K Skivington
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Matthews
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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10
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Craig P, Skivington K, Moore L, Simpson S, Matthews L. The new Framework and the Core Elements of complex intervention research. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The new framework will be presented. The main phases of intervention research: development or identification, feasibility, evaluation and implementation are connected to 6 core elements:
Context: any feature of the circumstances in which an intervention is conceived, developed, evaluated and implemented Programme theory: how an intervention is expected to lead to its effects and under what conditions. Programme theory should be tested and refined at all stages and used to guide the identification of uncertainties and research questions Stakeholders: those who are targeted by the intervention, involved in its development or delivery, or more broadly those whose personal or professional interests are affected, that is who have a stake in the topic. This includes patients, the public, and professionals Refinement: the process of ‘fine tuning' or making changes to the intervention once a preliminary version has been developed Uncertainties: identifying key uncertainties that exist given what is already known and what the programme theory, researchers and stakeholders identify as being most important to find out. These judgements inform the framing of research questions that, in turn, govern research perspective choice Economic considerations: exploring the comparative resource and outcome consequences of the interventions for those people and organisations affected
The presentation will discuss how to use the framework, highlighting that complex intervention research can be an iterative process. Repeating of phases is preferable to automatic progression to the next phase if uncertainties remain unresolved.
Main messages
Complex intervention research may begin at any phase, depending on what is appropriate for the intervention in question, and does not necessarily move sequentially through the phases. The core elements should be considered early and revisited continually throughout, as this will make it most likely that the intervention will be implementable in practice.
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Affiliation(s)
- P Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - K Skivington
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - S Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - L Matthews
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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11
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Kwarteng JL, Matthews L, Banerjee A, Sharp LK, Gerber BS, Stolley MR. The association of stressful life events on weight loss efforts among African American breast cancer survivors. J Cancer Surviv 2021; 16:604-613. [PMID: 33977342 DOI: 10.1007/s11764-021-01054-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study examined whether stressful life events were associated with weight loss, central adiposity, and health behavior changes of African American breast cancer survivors (AABCS) participating in a weight loss intervention. METHODS We conducted a secondary-data analyses of Moving Forward, a weight loss efficacy trial for AABCS conducted in 2011-2014. Two-hundred forty-six eligible women were randomized to a 6-month interventionist-guided (IG) or self-guided (SG) weight loss intervention. Data was collected on height, weight, self-reported diet, and self-reported physical activity. Stress (e.g., financial, legal, employment, relationships, safety, prejudice) was measured using an abbreviated version of the Crisis in Family Systems (CRISYS) urban life stress measure. Generalized linear models stratified by group examined the degree to which stress was associated with weight loss or changes in central adiposity, physical activity, and diet during the intervention (Months 1-6) or maintenance (Months 7 to 12) phases. RESULTS Participants reported a median of 3.0 life stressors (range 0 to 22) mostly relating to relationships, safety concerns, and financial problems. In the IG group during the intervention phase, exposure to life stressors was not associated with weight loss (p = 0.15) or change in central adiposity (p = 0.69), physical activity (p = 0.15), or diet (p = 0.26). We found similar associations for the maintenance phase and in the SG group. CONCLUSION/IMPLICATIONS Despite facing stress across a myriad of domains (e.g., relationships, safety, finances), AABCS were successful at initiating and maintaining behaviors to achieve weight loss, reductions in central adiposity, and behavioral changes. Future randomized controlled trials are warranted that include more strategies to address the challenges that AABCS face, to determine whether AABCS in particular might benefit from interventions that address barriers (e.g., stress management) to weight loss. Such strategies are critical for improving quality of life and lowering the risk of cancer recurrence.
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Affiliation(s)
- Jamila L Kwarteng
- Division of Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - L Matthews
- Cancer Center and Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Banerjee
- Division of Biostatistics, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - L K Sharp
- Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - B S Gerber
- Division of Academic Internal Medicine and Geriatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - M R Stolley
- Cancer Center and Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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12
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Matthews L, Irwin E, Ezuma P, Ibrahim I, Bates L, Thompson E, Wright M, Figueiredo R, Bury Y, Wilson C. O67: PERFUSATE GLUCOSE REFLECTS TISSUE GLYCOGENATION DURING LIVER PERFUSION. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Normothermic machine perfusion (NMP) is a method of organ preservation that aims to replicate the physiological environment, achieved by perfusing the livers with a blood-based perfusate at physiological inflow pressures and temperature. NMP also permits viability assessment through evaluation of the perfusate flow rates through the portal vein and hepatic artery. In addition to this, biochemical assessment and perfusate gas analysis can be performed to provide insights into the metabolic activity of the liver.
Method
Discarded human liver grafts (n=6), were perfused for 24 hours. Core biopsies and perfusate samples were taken from each liver at 5 distinct time intervals over 24 hours. Core biopsies were fixed and stained with periodic acid-Schiff and analysed with Leica software to provide a quantitative estimate of the hepatocellular glycogen content.
Result
Hepatic glycogen concentration rose during the first hour, followed by a steady decline thereafter until the end of perfusion. Contrary to our initial hypothesis that glucose concentration within the circuit would show an inverse relationship to glycogen stores in the liver cells, we found that glucose concentration closely followed the same trend.
Conclusion
Change in hepatocyte glycogen content provides an important insight into the synthetic function of a liver destined for transplant. Our research suggests that glucose concentration can be used as a surrogate marker for the synthetic function of a liver on NMP and provides valuable information on the glycogen-synthesising capability of the hepatocytes. In future, this could potentially aid the decision-making process with regards to liver graft transplant viability.
Take-home message
Perfusate glucose concentration could provide an insight into the viability of liver transplants
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Affiliation(s)
| | | | | | - I Ibrahim
- Newcastle University
- Freeman Hospital
| | | | | | | | | | - Y Bury
- Newcastle University
- Freeman Hospital
| | - C Wilson
- Newcastle University
- Freeman Hospital
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13
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Irwin E, Thompson E, Tingle S, Ezuma P, Matthews L, Bates L, Shuttleworth V, Ali S, Sheerin N, Wilson C. O25: TARGETING THE RENAL TUBULAR EPITHELIUM WITH ANTI-MIRNA THERAPY: A POTENTIAL MECHANISM FOR MINIMISING ISCHAEMIA REPERFUSION INJURY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Ischaemia reperfusion injury (IRI) is an unavoidable, significant consequence of renal transplantation. MicroRNAs are small, non-coding RNA molecules that regulate multiple downstream mRNA targets. MiRNA-21-5p and miRNA-24-3p have been previously implicated in IRI. Antisense oligonucleotides (ASOs) block specific microRNAs, with previous work by our group demonstrating their delivery to kidneys using normothermic machine perfusion. Imaging these kidneys revealed ASO localisation around proximal tubule epithelial cells (PTECs). This project aimed to characterise ASO blockade against miRNA-21-5p and miRNA-24-3p in PTECs.
Method
HKC8 cells, a human PTEC cell line, were used throughout these experiments. Cells were placed in a hypoxic incubator for 24hrs, followed by 6hrs of reoxygenation to mimic IRI. HKC8s were transfected with ASOs using lipofectamine. RT-qPCR and Western Blots were used to evaluate expression of antioxidant targets, SOD2 and HMOX1.
Result
MiRNA-21-5p and miRNA-24-3p levels were high throughout hypoxia and reoxygenation. Single blockade with anti-miRNA-21-5p resulted in a significant increase in its downstream target SOD2 (P<0.05). Anti-miRNA-24-3p treatment resulted in no change in either of its downstream targets, HMOX1 or SOD2. This was reflected in the failure of dual blockade to produce a synergistic effect on the shared target, SOD2.
Conclusion
Anti-miRNA-21-5p results in a significant increase of SOD2, which is well characterised as protective during IRI. Anti-miRNA-24-3p appears to have no effect on PTECs, contrary to previous work in endothelial cells, perhaps suggesting a cell specific response of microRNAs. Normothermic machine perfusion could be used to deliver dual ASOs; allowing simultaneous targeting of different kidney cell types.
Take-home message
The delivery of anti-miRNA-21-5p therapy pre-transplant, using normothermic machine perfusion, has the potential to reduce ischaemia reperfusion injury and improve kidney transplant outcomes.
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Affiliation(s)
- E Irwin
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
| | - E Thompson
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
| | - S Tingle
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
| | - P Ezuma
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
| | - L Matthews
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
| | - L Bates
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
| | | | - S Ali
- Institute of Cellular Medicine, Newcastle University
| | - N Sheerin
- Institute of Cellular Medicine, Newcastle University
| | - C Wilson
- NIHR Blood and Transplant Research Unit, Institute of Transplant, Freeman Hospital
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Matthews L, Bates A, Wootton SA, Levett D. The use of bioelectrical impedance analysis to predict post-operative complications in adult patients having surgery for cancer: A systematic review. Clin Nutr 2021; 40:2914-2922. [PMID: 33962360 DOI: 10.1016/j.clnu.2021.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Patients undergoing surgery for cancer are at particular risk of post-operative complications. The pre-operative period is an opportunity to identify and mitigate risk factors and improve outcome. Bioelectrical impedance analysis (BIA) may offer an additional means of identifying patients at risk of post-operative morbidity. AIMS The aim of this systematic review was to assess the use of measures and estimates of body composition determined by BIA as markers of peri-operative risk in adult patients undergoing elective surgery for cancer. METHODS This review was performed in accordance with the PRISMA guidelines. The electronic databases of MEDLINE, EMBASE, CINAHL, CENTRAL and the Web of Science were searched from inception. Studies of adult participants having elective surgery for cancer were included if participants underwent BIA in the peri-operative period and were assessed for post-operative complications. RESULTS 2578 studies were identified, of which 12 were eligible for inclusion. In total the studies report data from 1508 subjects. Five studies examined phase angle or standardized phase angle, six examined derived measures and one examined both. Eight of the 12 demonstrated an association between phase angle and/or body composition and an increased risk of post-operative complications. CONCLUSIONS Bioelectrical impedance analysis in the peri-operative period may be useful in predicting the risk of complications following elective cancer surgery. Phase angle more consistently demonstrates an association than derived estimates. Further high quality studies are needed and should report the raw impedance values, standardized phase angle and the equations used to derive body composition.
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Affiliation(s)
- L Matthews
- Department of Perioperative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK; University of Southampton, Southampton, UK.
| | - A Bates
- National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S A Wootton
- University of Southampton, Southampton, UK; National Institute for Health Research Cancer and Nutrition Collaboration, UK
| | - D Levett
- Department of Perioperative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK; University of Southampton, Southampton, UK
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15
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Newman C, Egan AM, Ahern T, Al-Kiyumi M, Balan G, Brassill MJ, Brosnan E, Carmody L, Clarke H, Coogan Kelly C, Culliney L, Davern R, Durkan M, Fenlon M, Ferry P, Hanlon G, Higgins T, Hoashi S, Khamis A, Kinsley B, Kirwan B, Kyithar P, Liew A, Matthews L, McGurk C, McHugh C, Murphy MS, Murphy P, Nagodra D, Noctor E, Nolan M, O'Connor E, O'Halloran D, O'Mahoney L, O'Sullivan E, Peters M, Roberts G, Rooney H, Smyth A, Tarachand B, Todd M, Tuthill A, Wan Mahmood WA, Yousif O, Dunne FP. Diabetes care and pregnancy outcomes for women with pregestational diabetes in Ireland. Diabetes Res Clin Pract 2021; 173:108685. [PMID: 33548336 DOI: 10.1016/j.diabres.2021.108685] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/16/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
AIMS Pre-gestational diabetes mellitus (PGDM) is associated with adverse outcomes. We aimed to examine pregnancies affected by PGDM; report on these pregnancy outcomes and compare outcomes for patients with type 1 versus type 2 diabetes mellitus; compare our findings to published Irish and United Kingdom (UK) data and identify potential areas for improvement. METHODS Between 2016 and 2018 information on 679 pregnancies from 415 women with type 1 Diabetes Mellitus and 244 women with type 2 diabetes was analysed. Data was collected on maternal characteristics; pregnancy preparation; glycaemic control; pregnancy related complications; foetal and maternal outcomes; unscheduled hospitalisations; congenital anomalies and perinatal deaths. RESULTS Only 15.9% of women were adequately prepared for pregnancy. Significant deficits were identified in availability and attendance at pre-pregnancy clinic, use of folic acid, attaining appropriate glycaemic targets and appropriate retinal screening. The majority of pregnancies (n = 567, 83.5%) resulted in a live birth but the large number of infants born large for gestational age (LGA) (n = 280, 49.4%), born prematurely <37 weeks and requiring neonatal intensive care unit (NICU) admission continue to be significant issues. CONCLUSIONS This retrospective cohort study identifies multiple targets for improvements in the provision of care to women with pre-gestational DM which are likely to translate into better pregnancy outcomes.
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Affiliation(s)
- C Newman
- Galway University Hospital, Galway, Ireland.
| | - A M Egan
- Division of Endocrinology Mayo Clinic, Rochester, United States
| | - T Ahern
- Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland
| | - M Al-Kiyumi
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - G Balan
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - M J Brassill
- South Tipperary General Hospital, Clonmel, Co Tipperary, Ireland
| | - E Brosnan
- Mayo University Hospital, Castlebar, Co Mayo, Ireland
| | - L Carmody
- Galway University Hospital, Galway, Ireland
| | - H Clarke
- Portiuncula University Hospital, Ballinasloe, Co Galway, Ireland
| | - C Coogan Kelly
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Ireland
| | - L Culliney
- Cork University Hospital, Cork, Co Cork, Ireland
| | - R Davern
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Ireland
| | - M Durkan
- Bons Secours Hospital, Cork, Co Cork, Ireland
| | - M Fenlon
- Wexford General Hospital, Co Wexford, Ireland
| | - P Ferry
- Letterkenny General Hospital, Letterkenny, Co Donegal, Ireland
| | - G Hanlon
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Ireland
| | - T Higgins
- University Hospital Kerry, Tralee, Co Kerry, Ireland
| | - S Hoashi
- Mullingar Regional Hospital, Mullingar, Co Westmeath, Ireland
| | - A Khamis
- Letterkenny General Hospital, Letterkenny, Co Donegal, Ireland
| | - B Kinsley
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - B Kirwan
- Galway University Hospital, Galway, Ireland
| | - P Kyithar
- Portlaoise General Hospital, Portlaoise, Co Laois, Ireland
| | - A Liew
- Portiuncula University Hospital, Ballinasloe, Co Galway, Ireland
| | - L Matthews
- Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland
| | - C McGurk
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Ireland
| | - C McHugh
- Sligo University Hospital, Co Sligo, Ireland
| | - M S Murphy
- South Infirmary Victoria Hospital, Cork, Co Cork, Ireland
| | - P Murphy
- Cork University Hospital, Cork, Co Cork, Ireland
| | - D Nagodra
- Portlaoise General Hospital, Portlaoise, Co Laois, Ireland
| | - E Noctor
- Limerick University Hospital, Co Limerick, Ireland
| | - M Nolan
- University Hospital Kerry, Tralee, Co Kerry, Ireland
| | - E O'Connor
- Portiuncula University Hospital, Ballinasloe, Co Galway, Ireland
| | - D O'Halloran
- Cork University Hospital, Cork, Co Cork, Ireland
| | - L O'Mahoney
- Cork University Hospital, Cork, Co Cork, Ireland
| | | | - M Peters
- University Hospital Waterford, Co Waterford, Ireland
| | - G Roberts
- University Hospital Waterford, Co Waterford, Ireland
| | - H Rooney
- St Luke's General Hospital, Kilkenny, Co Kilkenny, Ireland
| | - A Smyth
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - B Tarachand
- University Hospital Waterford, Co Waterford, Ireland
| | - M Todd
- Mayo University Hospital, Castlebar, Co Mayo, Ireland
| | - A Tuthill
- Cork University Hospital, Cork, Co Cork, Ireland
| | - W A Wan Mahmood
- Coombe Women and Infants University Hospital, Dublin, Ireland
| | - O Yousif
- Wexford General Hospital, Co Wexford, Ireland
| | - F P Dunne
- Galway University Hospital, Galway, Ireland
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Basripuzi NH, Sharma RSK, Norhadila Z, Shahar ZS, Nor-Dilaila MS, Mustapha MS, Kolandaiveloo V, Ruviniyia K, Matthews L. Interaction between abomasal blood feeder Haemonchus contortus and intestinal mucosal browser Trichostrongylus colubriformis during co-infection in Boer goats. Vet Parasitol 2020; 287:109274. [PMID: 33086185 DOI: 10.1016/j.vetpar.2020.109274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
This study was conducted to investigate potential interactions between the abomasal blood feeder Haemonchus contortus and the intestinal mucosal browser Trichostrongylus colubriformis among deliberately infected Boer goats. Faecal and blood samples were collected twice a week for eight weeks from 25 parasite-naïve goats. Correlation analysis and multiple linear regression models were conducted to explore the association between phenotypic variables and variables taken at necropsy. Positive associations were identified between total FEC and log T. colubriformis number (r = 0.62, p < 0.05) as well as between IgA and peripheral eosinophil counts (r = 0.65, p < 0.05). A negative correlation was observed between T. colubriformis and log H. contortus number (r=-0.56, p < 0.05). Multiple linear regression models show that H. contortus and T. colubriformis interacted with each other. T. colubriformis appeared to contribute more significantly to the variation of FEC than H. contortus. Co-infection induced an IgA response which was only effective against T. colubriformis but not protective against H. contortus infection. This could be seen via significant associations of IgA with both nematode species but with the effect of IgA differing for H. contortus and T. colubriformis. In this study, H. contortus infection was not detrimental to the goats with no observed impact on PCV. This could be because the growth of T. colubriformis as represented by its length was associated with reduced number and composite burden of H. contortus during co-infection, or possibly due to low infection dosage. Improved understanding of the impact of H. contortus and T. colubriformis and their interaction from natural co-infection studies is beneficial for a better understanding of the goat-parasite interaction and its potential impacts on the health and productivity of animals.
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Affiliation(s)
- N Hayyan Basripuzi
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Bearsden Road, Glasgow, G61 1QH, United Kingdom; Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, Kota Bharu, Kelantan, 16100, Malaysia.
| | - Reuben S K Sharma
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - Z Norhadila
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - Z S Shahar
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - M S Nor-Dilaila
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - M S Mustapha
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - V Kolandaiveloo
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - K Ruviniyia
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM Serdang, Selangor, 43400, Malaysia
| | - L Matthews
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Bearsden Road, Glasgow, G61 1QH, United Kingdom
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McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng 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Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Chaters GL, Johnson PCD, Cleaveland S, Crispell J, de Glanville WA, Doherty T, Matthews L, Mohr S, Nyasebwa OM, Rossi G, Salvador LCM, Swai E, Kao RR. Analysing livestock network data for infectious disease control: an argument for routine data collection in emerging economies. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180264. [PMID: 31104601 DOI: 10.1098/rstb.2018.0264] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Livestock movements are an important mechanism of infectious disease transmission. Where these are well recorded, network analysis tools have been used to successfully identify system properties, highlight vulnerabilities to transmission, and inform targeted surveillance and control. Here we highlight the main uses of network properties in understanding livestock disease epidemiology and discuss statistical approaches to infer network characteristics from biased or fragmented datasets. We use a 'hurdle model' approach that predicts (i) the probability of movement and (ii) the number of livestock moved to generate synthetic 'complete' networks of movements between administrative wards, exploiting routinely collected government movement permit data from northern Tanzania. We demonstrate that this model captures a significant amount of the observed variation. Combining the cattle movement network with a spatial between-ward contact layer, we create a multiplex, over which we simulated the spread of 'fast' ( R0 = 3) and 'slow' ( R0 = 1.5) pathogens, and assess the effects of random versus targeted disease control interventions (vaccination and movement ban). The targeted interventions substantially outperform those randomly implemented for both fast and slow pathogens. Our findings provide motivation to encourage routine collection and centralization of movement data to construct representative networks. This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'. This theme issue is linked with the earlier issue 'Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes'.
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Affiliation(s)
- G L Chaters
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - P C D Johnson
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - S Cleaveland
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - J Crispell
- 2 School of Veterinary Medicine, University College Dublin , Dublin , Ireland
| | - W A de Glanville
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - T Doherty
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK
| | - L Matthews
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - S Mohr
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - O M Nyasebwa
- 6 Department of Veterinary Services, Ministry of Livestock and Fisheries, Nelson Mandela Road , Dar Es Salaam , Tanzania
| | - G Rossi
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK
| | - L C M Salvador
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK.,4 Department of Infectious Diseases, University of Georgia , Athens, GA 30602 , USA.,5 Institute of Bioinformatics, University of Georgia , Athens, GA 30602 , USA
| | - E Swai
- 6 Department of Veterinary Services, Ministry of Livestock and Fisheries, Nelson Mandela Road , Dar Es Salaam , Tanzania
| | - R R Kao
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK
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Fussell SL, Bayliss K, Coops C, Matthews L, Li W, Briscoe WH, Faers MA, Royall CP, van Duijneveldt JS. Reversible temperature-controlled gelation in mixtures of pNIPAM microgels and non-ionic polymer surfactant. Soft Matter 2019; 15:8578-8588. [PMID: 31642834 DOI: 10.1039/c9sm01299k] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We investigate the reversible gelation of poly(N-isopropylacrylamide) (pNIPAM) microgels in the presence of triblock-copolymer (PEO-PPO-PEO type) surfactant. We demonstrate that the association of these polymers with the microgel particles at elevated temperature is responsible for the gelation, due to the temperature responsive nature of the components. This is highlighted by an increase in the apparent hydrodynamic diameter of the particles in dynamic light scattering experiments, which only occurs above the volume phase transition temperature of pNIPAM. The gels that result shrink over a time period much larger than that of the collapse of pNIPAM microgels, and retain the shape of the container they form in. We investigate the mechanism that leads to this gelation and the structure of the gels that result. Confocal microscopy experiments show that both polymers are present in the gel network, indicating that an associative mechanism is responsible for the gelation. We vary the pNIPAM particle architecture to further investigate the gelation process, and find that the cross-link distribution plays a key role in the gelation mechanism, where for uniformly cross-linked particles the gelation is not observed. This shows that the fuzzy corona of the pNIPAM microgels is involved in the association of the polymers, allowing the triblock-copolymer to penetrate the outer corona of the microgels and bridge the particles. The phase transition observed is close to physiological conditions, so these gels have the potential for use in biomedical applications, including tissue engineering.
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Affiliation(s)
- S L Fussell
- School of Chemistry, University of Bristol, Cantock's Close, Bristol, BS8 1TS, UK.
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Matthews L, Contino K, Schorr C, Hunter K, Nussbaum C, Puri N. A COMPARISON OF A DIDACTIC ULTRASOUND CURRICULUM VS A DIDACTIC AND PRACTICAL BEDSIDE ULTRASOUND CURRICULUM TO IMPROVE INTERNAL MEDICINE RESIDENTS' KNOWLEDGE AND SKILL RETENTION. Chest 2019. [DOI: 10.1016/j.chest.2019.02.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Catt S, Matthews L, Payne H, Mason M, Jenkins V. Patients’ and partners’ views of treatment and care provided for metastatic castrate resistant prostate cancer (mCRPC) in the UK. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy296.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jenkins V, Farewell V, May S, Catt S, Matthews L, Shilling V, Dickson J, Simcock R, Fallowfield L. Do drugs offering only PFS maintain quality of life sufficiently from a patient's perspective? Results from AVALPROFS (Assessing the 'VALue' to patients of PROgression Free Survival) study. Support Care Cancer 2018; 26:3941-3949. [PMID: 29845422 PMCID: PMC6182366 DOI: 10.1007/s00520-018-4273-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/15/2018] [Indexed: 01/03/2023]
Abstract
Purpose Trials of novel drugs used in advanced disease often show only progression-free survival or modest overall survival benefits. Hypothetical studies suggest that stabilisation of metastatic disease and/or symptom burden are worth treatment-related side effects. We examined this premise contemporaneously using qualitative and quantitative methods. Methods Patients with metastatic cancers expected to live > 6 months and prescribed drugs aimed at cancer control were interviewed: at baseline, at 6 weeks, at progression, and if treatment was stopped for toxicity. They also completed Functional Assessment of Cancer Therapy (FACT-G) plus Anti-Angiogenesis (AA) subscale questionnaires at baseline then monthly for 6 months. Results Ninety out of 120 (75%) eligible patients participated: 41 (45%) remained on study for 6 months, 36 progressed or died, 4 had treatment breaks, and 9 withdrew due to toxicity. By 6 weeks, 66/69 (96%) patients were experiencing side effects which impacted their activities. Low QoL scores at baseline did not predict a higher risk of death or dropout. At 6-week interviews, as the side effect severity increased, patients were significantly less inclined to view the benefit of cancer control as worthwhile (X2 = 50.7, P < 0.001). Emotional well-being initially improved from baseline by 10 weeks, then gradually returned to baseline levels. Conclusion Maintaining QoL is vital to most patients with advanced cancer so minimising treatment-related side effects is essential. As side effect severity increased, drugs that controlled cancer for short periods were not viewed as worthwhile. Patients need to have the therapeutic aims of further anti-cancer treatment explained honestly and sensitively. Electronic supplementary material The online version of this article (10.1007/s00520-018-4273-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- V Jenkins
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School (BSMS), University of Sussex, Falmer, Brighton, BN1 9RX, UK.
| | - V Farewell
- MRC Biostatistics Unit, University of Cambridge, School of Clinical Medicine, Robinson Way, Cambridge, CB2 0SR, UK
| | - S May
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School (BSMS), University of Sussex, Falmer, Brighton, BN1 9RX, UK
| | - S Catt
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School (BSMS), University of Sussex, Falmer, Brighton, BN1 9RX, UK
| | - L Matthews
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School (BSMS), University of Sussex, Falmer, Brighton, BN1 9RX, UK
| | - V Shilling
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School (BSMS), University of Sussex, Falmer, Brighton, BN1 9RX, UK
| | - J Dickson
- Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, HA6 2RN, UK
| | - R Simcock
- Sussex Cancer Centre, Brighton & Sussex University Hospitals, Brighton, BN2 5DA, UK
| | - L Fallowfield
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School (BSMS), University of Sussex, Falmer, Brighton, BN1 9RX, UK
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Jenkins V, Payne H, Mason M, May S, Matthews L, Catt S. EXTREQOL Identifies Ongoing Challenges in Maximising Quality of Survival in Men with Metastatic Castrate-resistant Prostate Cancer. Clin Oncol (R Coll Radiol) 2018; 30:331-333. [PMID: 29459101 DOI: 10.1016/j.clon.2018.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/11/2018] [Accepted: 01/21/2018] [Indexed: 11/16/2022]
Affiliation(s)
- V Jenkins
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK.
| | - H Payne
- Department of Oncology, University College Hospital London, London, UK
| | - M Mason
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Velindre Hospital, Cardiff, UK
| | - S May
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - L Matthews
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - S Catt
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
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Fallowfield LJ, Matthews L, Jenkins VA, May SF, Francis A, Rae D, Wallis M. Abstract OT3-08-01: Interview data from women contemplating LORIS trial entry during the feasibility study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-08-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: LORIS is a multi-centre, randomised (1:1) controlled trial of Surgery v Active Monitoring with annual mammography in patients with low risk ductal carcinoma in situ (DCIS). During a 2 year Feasibility Study potential patients were invited to complete the Clinical Trials Questionnaire (CTQ)1 and participate in a semi structured telephone interview about the verbal, written and DVD based trial information. The DVD was produced to complement the patient information sheet (PIS) and incorporates simple graphics and a Q&A session with women asking the Chief Investigator questions about the trial.
Aims:To examine the reasons for trial participation/rejection and obtain feedback about the clarity, timing and usefulness of the PIS and DVD in order to identify potential communication drivers and barriers to trial recruitment.
Methods: Participants completed the CTQ1 prior to randomisation and with their consent were contacted following randomisation for an interview. Women declining the trial were issued with an optional pack containing the CTQ1 and the researchers' contact details if they wanted an interview. The CTQ1 comprises16 reasons that might influence a decision to either accept or decline a trial. For each statement participants register their agreement or disagreement on a scale of 1 (strongly agree) to 5 (strongly disagree) and indicate the most important reason for their decision. Interviews explored factors such as, attitudes about randomisation, and usefulness of the trial information provided.
Results: 41 patients were randomised during feasibility; 20 surgery, 21 active monitoring, 16 patients declined the trial. 40/41(98%) acceptors and 9/16 (56%) decliners completed the CTQ1. The main reason for joining LORIS was:- “I thought the trial offered the best treatment available” 13/40 (32%) and for decling the trial was “The idea of randomisation worried me” (4/9; 44%).
35 interviews were conducted (31/41 (76%) accepted and 4/16 (25%) declined LORIS). At interview acceptors commented that the PIS was very useful and clear (84%; 26/31 & 90%; 28/31, respectively). 74% (23/31) of women who joined LORIS watched the DVD and the majority (19/23; 83%) found it “very useful” and 22 (22/23; 96%) “very easy to understand”. A third of women (10/31) said the PIS and the DVD helped them decide to participate in LORIS. Women who declined the trial had clear treatment preferences; 2/4 did not watch the DVD. Three quarters of women interviewed (19/25) watched the DVD with family members/friends and found it reassuring. One commented it was “Put in words you can understand and not be baffled by”. The most popular aspect was the Q&A session (13/25; 52%).
Conclusions:The LORIS DVD was a useful, easy to understand recruitment tool, complementing the PIS. Many women felt reassured that the content was consistent with, and added to that provided by healthcare professionals. Opinions of family and friends, worries about randomisation and personal preferences exert an influence of those declining these types of trial.
Fallowfield LJ, Jenkins V, et al. (1998) Attitudes of patients to randomised clinical trials of cancer therapy. Eur J Cancer 34(10):1554–1559.
Citation Format: Fallowfield LJ, Matthews L, Jenkins VA, May SF, Francis A, Rae D, Wallis M. Interview data from women contemplating LORIS trial entry during the feasibility study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-08-01.
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Affiliation(s)
- LJ Fallowfield
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
| | - L Matthews
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
| | - VA Jenkins
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
| | - SF May
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
| | - A Francis
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
| | - D Rae
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
| | - M Wallis
- SHORE-C, BSMS, University of Sussex, Brighton, East Sussex, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; University of Birmingham, Birmingham, United Kingdom; Addenbrook's Hospital, Cambridge, United Kingdom
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Fallowfield L, May S, Matthews L, Jenkins V, Mackay J, Arbon A, Hack B, Hall J, Harper-Wynne C, Hinde S, Moss A, Thanopoulou E, Westwell S, Wlaszly D, Simcock R, Patel G, Bloomfield D. Enhancing decision-making about adjuvant chemotherapy in ER+, HER2- early breast cancer (EBC) following EndoPredict testing. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hinde S, Theriou C, May S, Matthews L, Arbon A, Fallowfield L, Bloomfield D. The cost-effectiveness of EndoPredict to inform adjuvant chemotherapy decisions in early breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx375.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Francis A, Bartlett J, Billingham L, Bowden S, Brookes C, Dodwell D, Evans A, Fairbrother P, Fallowfield L, Gaunt C, Hanby A, Jenkins V, Matthews L, Pinder S, Pirrie S, Rea D, Reed M, Roberts T, Thomas J, Wallis M, Wilcox M, Young J. Abstract OT1-03-01: The UK LORIS trial: Randomizing patients with low or low intermediate grade ductal carcinoma in situ (DCIS) to surgery or active monitoring. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-03-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The independent review of the UK National Health Service Breast Screening Programme reported (The Lancet, Volume 380, Issue 9855, Page 1778, 17 Nov 2012) on the benefits and harms of breast screening. It concluded that breast screening saves lives and acknowledged the existence of overtreatment. It encouraged randomized trials to elucidate the appropriate treatment of screen-detected DCIS to gain a better understanding of its natural history. The LORIS trial addresses the possible overtreatment of low and low/intermediate grade screen-detected (low risk) DCIS by randomizing patients to standard surgical treatment or active monitoring, each with long term follow up.
Trial Design: LORIS is a phase III, multicentre, 2 arm study, with a built in 2 year Feasibility Phase, in patients confirmed to have low risk DCIS defined by strict criteria and determined by central pathology review. Patients will be randomized between standard surgery and active monitoring with annual mammography. Patients will be followed up for a minimum of 10 years.
Eligibility Criteria:
1) Female, age ≥ 46 years
2) Screen-detected or incidental microcalcification (with no mass lesion clinically or on imaging)
3) Low risk DCIS on large volume vacuum-assisted biopsy, confirmed by central pathology review
4) Patient fit to undergo surgery
5) No previous breast cancer or ipsilateral DCIS diagnosis
6) Written informed consent
Specific Aims: The LORIS Trial aims to establish whether patients with newly diagnosed low risk DCIS can safely avoid surgery without detriment to their wellbeing (psychological and physical) and whether those patients that do require surgery can be identified by pathological and radiological means.
Primary endpoint: Ipsilateral invasive breast cancer free survival time
Secondary endpoints: Overall survival; mastectomy rate; time to mastectomy; time to surgery; patient reported outcomes; health resource utilisation and assessment of predictive biomarkers.
A digital image data repository and tissue bank will provide a prospective resource for both translational and imaging studies.
Statistical Methods: A total of 932 patients will be randomized to a non-inferiority design to test the null hypothesis that active monitoring of women diagnosed with low risk DCIS is not non-inferior in terms of ipsilateral invasive breast cancer free survival (iiBCFS) time compared to treatment with surgery. The iiBCFS time will be compared across the two arms on a per protocol and intent-to-treat basis, using a 1-sided (α=0.05) log-rank test for non-inferiority. The iiBCFS rate is assumed to be 97.5% in the surgery arm at 5 years, utilizing 80% power to exclude a difference of more than 2.5% in the active monitoring arm.
Present Accrual and Target Accrual: 32 UK centres are open for the Feasibility Phase of the trial which is nearing completion. The web-based central pathology review process is functioning efficiently, with a one week maximum turn around. Registrations and sites randomizing patients are on or above target. Randomizations are currently approximately 70% of target. A total of 60 centres will open in the main trial.
Contact Information: For further information, please email the LORIS Trial Office LORIS@trials.bham.ac.uk.
Citation Format: Francis A, Bartlett J, Billingham L, Bowden S, Brookes C, Dodwell D, Evans A, Fairbrother P, Fallowfield L, Gaunt C, Hanby A, Jenkins V, Matthews L, Pinder S, Pirrie S, Rea D, Reed M, Roberts T, Thomas J, Wallis M, Wilcox M, Young J. The UK LORIS trial: Randomizing patients with low or low intermediate grade ductal carcinoma in situ (DCIS) to surgery or active monitoring [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-03-01.
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Affiliation(s)
- A Francis
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Bartlett
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - L Billingham
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Bowden
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - C Brookes
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Dodwell
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Evans
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - P Fairbrother
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - L Fallowfield
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - C Gaunt
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - A Hanby
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - V Jenkins
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - L Matthews
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Pinder
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - S Pirrie
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - D Rea
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - M Reed
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - T Roberts
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Thomas
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - M Wallis
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - M Wilcox
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
| | - J Young
- University Hospital Birmingham, Birmingham, United Kingdom; Ontario Institute for Cancer Research, Toronto, Canada; Cancer Research UK Clinical Trials Unit (CRCTU), Birmingham, United Kingdom; University of Leicester, Leicester, United Kingdom; St James's Hospital, Leeds, United Kingdom; University of Dundee, Dundee, United Kingdom; Independent Cancer Patients' Voice, England, United Kingdom; SHORE-C, Brighton and Sussex Medical School, Brighton, United Kingdom; University of Leeds, Leeds, United Kingdom; King's College London, London, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; Addenbrooke's Hospital, Cambridge, United Kingdom
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Alvi FA, Matthews L, Tsai S, Chaudhari A. New Generation Mini-Laparoscopic Instruments in Common Gynecologic Procedures: A Demonstration of Feasibility in a Cadaveric Model. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
This study used the same paired comparison format used in four earlier studies to survey ethnic minority preferences for counselor characteristics. However, in the current study, a statistical procedure designed specifically for paired comparison data that provides a powerful test of the relationship between preferences for counselor characteristics and selected within-group variables was used to analyze Asian American preferences for counselor characteristics. Similar attitudes and values was found to be the most preferred counselor characteristic for both personal and career problems. Also, preferences for counselor characteristics were found to be related to type of problem (personal or career), participant level of acculturation, and participant sex. Implications for future practice and research are discussed
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Francis A, Fallowfield L, Bartlett J, Thomas J, Wallis M, Hanby A, Pinder S, Evans A, Billingham L, Brookes C, Dodwell D, Fairbrother P, Gaunt C, Jenkins V, Matthews L, Pirrie S, Reed M, Roberts T, Wilcox M, Young J, Rea D. Abstract OT2-02-04: The LORIS trial: A multicentre, randomised phase III trial of standard surgery versus active monitoring in women with newly diagnosed low risk ductal carcinoma in situ. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot2-02-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The independent review of the UK National Health Service Breast Screening Programme reported (The Lancet, Volume 380, Issue 9855, Pages 1778 - 1786, 17 November 2012) on the benefits & harms of breast screening. It concluded that breast screening saves lives & acknowledged overtreatment. It encouraged randomized trials to elucidate the appropriate treatment of screen-detected ductal carcinoma in situ (DCIS) to gain a better understanding of its natural history. The LORIS trial addresses overtreatment of low & low/Intermediate grade screen detected (low risk) DCIS by randomizing patients to standard surgical treatment or active monitoring.
Trial Design: LORIS is a phase III, multicentre, 2 arm study, with a 2 year feasibility phase, in patients confirmed to have low risk DCIS by central pathology review. Patients are randomised to standard surgery or active monitoring with annual mammography. Patients will be followed up for a minimum of 10 years.
Key Eligibility Criteria:
1) Female 46 years or over.
2) Screen-detected or incidental microcalcification (with no mass lesion clinically or on imaging)
3) Low risk DCIS on large volume vacuum-assisted biopsy, confirmed by central pathology review
4) Patient fit to undergo surgery
Specific Aims: The LORIS Trial aims to establish whether patients with newly diagnosed low risk DCIS can safely avoid surgery without detriment to their wellbeing (psychological and physical) & whether those patients that do require surgery can be identified by pathological and radiological means.
Primary endpoint: Ipsilateral invasive breast cancer free survival rate at 5 years
Secondary endpoints: Overall survival; mastectomy rate; time to mastectomy; time to surgery; patient reported outcomes & health resource utilisation.
A digital image data repository and tissue bank provide a prospective resource for both translational & imaging studies.
Statistical Methods: A total of 932 patients will be randomized to a non-inferiority design to test the null hypothesis that active monitoring of women diagnosed with low risk DCIS is not non-inferior in terms of 5 year ipsilateral invasive breast cancer free survival (iiBCFS) rate compared to treatment with surgery. The iiBCFS rate will be compared across the two arms on a per protocol and intent-to-treat basis, using a 1-sided (α=0.05) log-rank test for non-inferiority. The iiBCFS rate is assumed to be 97.5% in the surgery arm giving 80% power to exclude a difference of more than 2.5% in the active monitoring arm at 5 years.
Present Accrual and Target Accrual: 21 UK centres are open & the feasibility phase of the trial is recruiting to target. The web based central pathology review process is functioning well with a one week maximum turn around. A further 40 centres will be opened on completion of the feasibility phase.
Contact: LORIS@trials.bham.ac.uk
This project was funded by the National Institute for Health Research [Health Technology Assessment Programme] (project number 11/36/16)
Department of Health Disclaimer: The views & opinions expressed therein are those of the authors & do not necessarily reflect those of the Health Technology Assessment Programme, NIHR, NHS or the Department of Health.
Citation Format: Francis A, Fallowfield L, Bartlett J, Thomas J, Wallis M, Hanby A, Pinder S, Evans A, Billingham L, Brookes C, Dodwell D, Fairbrother P, Gaunt C, Jenkins V, Matthews L, Pirrie S, Reed M, Roberts T, Wilcox M, Young J, Rea D. The LORIS trial: A multicentre, randomised phase III trial of standard surgery versus active monitoring in women with newly diagnosed low risk ductal carcinoma in situ. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT2-02-04.
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Affiliation(s)
- A Francis
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - L Fallowfield
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - J Bartlett
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - J Thomas
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - M Wallis
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - A Hanby
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - S Pinder
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - A Evans
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - L Billingham
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - C Brookes
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - D Dodwell
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - P Fairbrother
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - C Gaunt
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - V Jenkins
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - L Matthews
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - S Pirrie
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - M Reed
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - T Roberts
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - M Wilcox
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - J Young
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - D Rea
- University Hospital Birmingham NHS Trust, Birmingham, West Midlands, United Kingdom; Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; Western General Hospital, Edinburgh, Scotland, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; University of Leeds, Leeds, Yorkshire, United Kingdom; King's College London, London, United Kingdom; Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom; University of Birmingham, Birmingham, West Midlands, United Kingdom; ICPV, London, United Kingdom; Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
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Rankin J, McGuire C, Matthews L, Russell M, Ray D. Facilitators and barriers to the increased supervisory role of senior charge nurses: a qualitative study. J Nurs Manag 2015; 24:366-75. [PMID: 26370219 DOI: 10.1111/jonm.12330] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 11/29/2022]
Abstract
AIMS To explore the experiences of senior charge nurses provided with 'increased supervisory hours'. BACKGROUND Designated supervisory time is essential for senior charge nurses to provide effective clinical leadership. It is important to explore the impact arises of such an increase. METHODS An online questionnaire collected exploratory data from senior charge nurses (n = 60). Semi-structured interviews gathered in-depth qualitative data (n = 12). Findings were analysed for common themes associated with implementation of the increased senior charge nurse supervisory role. RESULTS The majority of senior charge nurses were unable to use their full allocation of supervisory time. They struggled to accomplish leadership goals because of managing staffing levels, increased workload, time constraints and limited support. Factors that facilitated the role included preparation and support, adequate staff capacity, effective leadership skills and availability of supervisory time. The senior charge nurses took pride in providing clinical leadership, promoting staff development and delivering patient care. Support, in terms of preparation, capacity building and ongoing mentoring, was a key factor for achieving senior charge nurse goals. CONCLUSION Senior charge nurses should be supported to maximise supervisory time through the provision of an induction programme, formal coaching and ongoing training and development. IMPLICATIONS FOR NURSING MANAGEMENT Preparation and support is essential for senior charge nurses to deliver enhanced clinical leadership through increased supervisory time.
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Affiliation(s)
- J Rankin
- School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK
| | - C McGuire
- Leading Better Care, School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK
| | - L Matthews
- Leading Better Care, School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK
| | | | - D Ray
- Leading Better Care, School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK
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Fallowfield L, May S, Catt S, Shilling V, Matthews L, Jenkins V. 1534 Patients' understanding about the therapeutic aims of novel drugs shown only to offer PFS benefit. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30624-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fallowfield L, May S, Matthews L, Simcock R, Jenkins V. 1509 Oncologists' decision making about novel therapies for patients with metastatic disease. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30599-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Akbar H, Grala T, Vailati Riboni M, Cardoso F, Verkerk G, McGowan J, Macdonald K, Webster J, Schutz K, Meier S, Matthews L, Roche J, Loor J. Body condition score at calving affects systemic and hepatic transcriptome indicators of inflammation and nutrient metabolism in grazing dairy cows. J Dairy Sci 2015; 98:1019-32. [DOI: 10.3168/jds.2014-8584] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 11/03/2014] [Indexed: 12/15/2022]
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Reuther WJ, Blythe J, Matthews L, Matharu J, Brennan P. A pictorial review of rare anatomical variations of the facial, spinal accessory and cervical nerves reported in Portsmouth in the last decade. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stockman CA, Collins T, Barnes AL, Miller D, Wickham SL, Verbeek E, Matthews L, Ferguson D, Wemelsfelder F, Fleming PA. Qualitative behavioural assessment of the motivation for feed in sheep in response to altered body condition score. Anim Prod Sci 2014. [DOI: 10.1071/an13020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Qualitative behavioural assessment (QBA) has been used to quantify the expressive behaviour of animals, and operant tests have been used to quantify measures of behavioural need. In this study we compared measures of behavioural expression and behaviour in operant tests. We examined the behavioural expression of pregnant ewes of body condition score (BCS) 2 and 3. The ewes were exposed to a feed motivation test in which they received a food reward. Pregnant ewes (48–70 days gestation) were assessed during a food motivation test after they had been maintained at BCS 3 (n = 7) or given a decreasing plane of nutrition that resulted in slow loss of 1 BCS unit (over 10–12 weeks; n = 7) or a fast loss of 1 BCS unit (over 4–6 weeks; n = 7). The feed motivation test involved ewes having the opportunity to approach a food reward and then being moved a given distance away from the reward by an automatic gate; they could then subsequently return to the feeder. Continuous video footage of each ewe during one cycle of the gate (approaching and returning from the food reward) was shown in random order to 11 observers who used their own descriptive terms (free-choice profiling methodology; FCP) to score the animals using QBA. Data of the assessment were analysed with generalised Procrustes analysis (GPA), a multivariate statistical technique associated with FCP. The research group also quantified the feeding behaviour of sheep in the same clips. These behaviours included how sheep approached the feeder, behaviours exhibited at the feeder, and how sheep returned from the feeder. There was consensus amongst observers in terms of their assessment of behavioural expression of the sheep (P < 0.001). The GPA found three main dimensions of assessed behavioural expression in the sheep, which together explained 44% of the variation observed. GPA dimension 1 differed between the three treatment groups (P < 0.05): ewes maintained at BCS 3 scored low on GPA dimension 1 (i.e. were described as more calm/bored/comfortable) compared with ewes that had a slow declining BCS (described as more interested/anxious/excited). GPA dimension 2 scores were not significantly different between treatment groups. However, quantitative behaviours exhibited by sheep during the clips were correlated with qualitative behavioural assessments made by the observers. Animals that spent more time ‘sniffing and looking for more feed’ were attributed lower GPA 2 scores (described as more hungry/searching/excited) (P < 0.05), and animals that ‘did not walk directly to the food reward (but stopped along the way)’ were attributed significantly higher GPA 2 scores (more curious/intimidated/uneasy) (P < 0.01). GPA dimension 3 scores also did not differ between the treatment groups; however, sheep that had a higher number of feeding events during the entire 23-h feed motivation test were attributed lower GPA dimension 3 scores (they were described as more hungry/bold/interested) (P < 0.05), and sheep that consumed a larger amount of the feed reward were attributed higher GPA dimension 3 scores (more curious/concerned/reserved) (P < 0.05). We conclude that QBA is a valuable method of assessing sheep behavioural expression under the conditions tested, in that it provided an integrative characterisation of sheep behavioural expression that was in agreement with quantitative behavioural measures of feeding.
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Spanos D, Hankey CR, Boyle S, Koshy P, Macmillan S, Matthews L, Miller S, Penpraze V, Pert C, Robinson N, Melville CA. Carers' perspectives of a weight loss intervention for adults with intellectual disabilities and obesity: a qualitative study. J Intellect Disabil Res 2013; 57:90-102. [PMID: 22369631 DOI: 10.1111/j.1365-2788.2011.01530.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND To date, no studies have explored the role of carers in supporting adults with intellectual disabilities (ID) and obesity during a weight loss intervention. The present study explored perceptions of carers supporting adults with ID, as they participated in a 6-month multi-component weight loss intervention (TAKE 5). METHODS Semi-structured interviews were used to explore the experiences of 24 carers. The transcripts were analysed qualitatively using thematic analysis. RESULTS Three themes emerged from the analysis: carers' perceptions of participants' health; barriers and facilitators to weight loss; and carers' perceptions of the weight loss intervention. Data analysis showed similarities between the experiences reported by the carers who supported participants who lost weight and participants who did not. Lack of sufficient support from people from the internal and external environment of individuals with ID and poor communication among carers, were identified as being barriers to change. The need for accessible resources tailored to aid weight loss among adults with ID was also highlighted. CONCLUSION This study identified specific facilitators and barriers experienced by carers during the process of supporting obese adults with ID to lose weight. Future research could utilise these findings to inform appropriate and effective weight management interventions for individuals with ID.
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Affiliation(s)
- D Spanos
- Institute of Health and Wellbeing, College of Medical and Veterinary Life Sciences, University of Glasgow, UK
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Lewis V, Dell L, Matthews L. Evaluating the feasibility of Goal Attainment Scaling as a rehabilitation outcome measure for veterans. J Rehabil Med 2013; 45:403-9. [DOI: 10.2340/16501977-1131] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Matthews L, Kirk A, Mutrie N. Staff and participant insights of group-based physical activity interventions for Type 2 Diabetes in a clinical practice setting. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Griffiths JT, Matthews L, Pearce CJ, Calder JDF. Incidence of venous thromboembolism in elective foot and ankle surgery with and without aspirin prophylaxis. ACTA ACUST UNITED AC 2012; 94:210-4. [PMID: 22323688 DOI: 10.1302/0301-620x.94b2.27579] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE) is thought to be low following foot and ankle surgery, but the routine use of chemoprophylaxis remains controversial. This retrospective study assessed the incidence of symptomatic venous thromboembolic (VTE) complications following a consecutive series of 2654 patients undergoing elective foot and ankle surgery. A total of 1078 patients received 75 mg aspirin as routine thromboprophylaxis between 2003 and 2006 and 1576 patients received no form of chemical thromboprophylaxis between 2007 and 2010. The overall incidence of VTE was 0.42% (DVT, 0.27%; PE, 0.15%) with 27 patients lost to follow-up. If these were included to create a worst case scenario, the overall VTE rate was 1.43%. There was no apparent protective effect against VTE by using aspirin. We conclude that the incidence of VTE following foot and ankle surgery is very low and routine use of chemoprophylaxis does not appear necessary for patients who are not in the high risk group for VTE.
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Affiliation(s)
- J T Griffiths
- Basingstoke and North Hampshire NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire RG24 9NA, UK.
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Denwood MJ, Love S, Innocent GT, Matthews L, McKendrick IJ, Hillary N, Smith A, Reid SWJ. Quantifying the sources of variability in equine faecal egg counts: implications for improving the utility of the method. Vet Parasitol 2012; 188:120-6. [PMID: 22469484 DOI: 10.1016/j.vetpar.2012.03.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 03/05/2012] [Accepted: 03/06/2012] [Indexed: 10/28/2022]
Abstract
The faecal egg count (FEC) is the most widely used means of quantifying the nematode burden of horses, and is frequently used in clinical practice to inform treatment and prevention. The statistical process underlying the FEC is complex, comprising a Poisson counting error process for each sample, compounded with an underlying continuous distribution of means between samples. Being able to quantify the sources of variability contributing to this distribution of means is a necessary step towards providing estimates of statistical power for future FEC and FECRT studies, and may help to improve the usefulness of the FEC technique by identifying and minimising unwanted sources of variability. Obtaining such estimates require a hierarchical statistical model coupled with repeated FEC observations from a single animal over a short period of time. Here, we use this approach to provide the first comparative estimate of multiple sources of within-horse FEC variability. The results demonstrate that a substantial proportion of the observed variation in FEC between horses occurs as a result of variation in FEC within an animal, with the major sources being aggregation of eggs within faeces and variation in egg concentration between faecal piles. The McMaster procedure itself is associated with a comparatively small coefficient of variation, and is therefore highly repeatable when a sufficiently large number of eggs are observed to reduce the error associated with the counting process. We conclude that the variation between samples taken from the same animal is substantial, but can be reduced through the use of larger homogenised faecal samples. Estimates are provided for the coefficient of variation (cv) associated with each within animal source of variability in observed FEC, allowing the usefulness of individual FEC to be quantified, and providing a basis for future FEC and FECRT studies.
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Affiliation(s)
- M J Denwood
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G61 1QH, UK.
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Matthews L, Brazier A, Kolind SH, Leite MI, Johansen-Berg H, Palace JA. 141 Can MRI be used as a diagnostic tool in neuromyelitis optica spectrum disorder? J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Atkinson DR, Lowe S, Matthews L. Asian-American Acculturation, Gender, and Willingness to Seek Counseling. Journal of Multicultural Counseling and Development 2011. [DOI: 10.1002/j.2161-1912.1995.tb00268.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Codner GF, Stear MJ, Reeve R, Matthews L, Ellis SA. Selective forces shaping diversity in the class I region of the major histocompatibility complex in dairy cattle. Anim Genet 2011; 43:239-49. [DOI: 10.1111/j.1365-2052.2011.02239.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [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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Kellett S, Clarke S, Matthews L. Delivering group psychoeducational CBT in Primary Care: Comparing outcomes with individual CBT and individual psychodynamic-interpersonal psychotherapy. British Journal of Clinical Psychology 2010; 46:211-22. [PMID: 17524214 DOI: 10.1348/014466506x146188] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Within psychological services in Primary Care, service providers are expected and required to deliver clinical services that are prompt, safe and effective. However, long wait-times for treatment are common, with attendant clinical chronicity and risk issues. Evaluations of group-based treatments in Primary Care, which are clinically more efficient than individual treatments, are extremely scarce. The current evaluation attempted to appraise the effectiveness of a service innovation of introducing group-based psychoeducational cognitive-behaviour therapy (CBT; N=43), by comparing outcomes with clients treated in individual CBT (N=68) and individual psychodynamic-interpersonal psychotherapy (N=65). Group psychoeducational participants completed validated scales of psychological functioning (Beck Depression Inventory - 2, BDI-2; Brief Symptom Inventory, BSI; Inventory of Interpersonal Problems, IIP-32; and General Health Questionnaire, GHQ-12) at assessment, start of group, termination of group and 3-month follow-up, whereas participants in the individual therapies completed measures only at initiation and termination of treatment. The results indicate broad similarities between the outcomes achieved by the three services, with rates of clinically significant improvements and deteriorations comparable in the main across services. The results are discussed in terms of identified methodological limitations, service implications and models of service delivery for the psychological therapies in Primary Care.
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Trebble P, Matthews L, Blaikley J, Wayte AWO, Black GCM, Wilton A, Ray DW. Familial glucocorticoid resistance caused by a novel frameshift glucocorticoid receptor mutation. J Clin Endocrinol Metab 2010; 95:E490-9. [PMID: 20861124 PMCID: PMC4110505 DOI: 10.1210/jc.2010-0705] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Familial glucocorticoid resistance is a rare condition with a typical presentation of women with hirsutism and hypertension, with or without hypokalemia. OBJECTIVE The aim was to determine the cause of apparent glucocorticoid resistance in a young woman. PATIENTS AND METHODS We studied a family with a novel glucocorticoid receptor (GR) mutation and a surprisingly mild phenotype. Their discovery resulted from serendipitous measurement of serum cortisol with little biochemical or clinical evidence for either hyperandrogenism or mineralocorticoid excess. RESULTS The causative mutation was identified as a frameshift mutation in exon 6. Transformed peripheral blood lymphocytes were generated to analyze GR expression in vitro. Carriers of the mutation had less full-length GR, but the predicted mutant GR protein was not detected. However, this does not exclude expression in vivo, and so the mutant GR (Δ612GR) was expressed in vitro. Simple reporter gene assays suggested that Δ612GR has dominant negative activity. Δ612GR was not subject to ligand-dependent Ser211 phosphorylation or to ligand-dependent degradation. A fluorophore-tagged construct showed that Δ612GR did not translocate to the nucleus in response to ligand and retarded translocation of the wild-type GR. These data suggest that Δ612GR is not capable of binding ligand and exerts dominant negative activity through heterodimerization with wild-type GR. CONCLUSION Therefore, we describe a novel, naturally occurring GR mutation that results in familial glucocorticoid resistance. The mutant GR protein, if expressed in vivo, is predicted to exert dominant negative activity by impairing wild-type GR nuclear translocation.
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Affiliation(s)
- P Trebble
- School of Medicine, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester M13 9PT, United Kingdom
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Matthews L, Palace J, Deoni S, Leite MI, Johansen-Berg H, Kolind SH. POI16 Comparing MRI measures of myelin integrity as surrogate markers for the clinical expression of primary progressive multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry 2010. [DOI: 10.1136/jnnp.2010.226340.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Trebble P, Matthews L, Blaikley J, Wayte AWO, Black GCM, Wilton A, Ray DW. Familial Glucocorticoid Resistance Caused by a Novel Frameshift Glucocorticoid Receptor Mutation. Mol Endocrinol 2010. [DOI: 10.1210/mend.24.11.9996] [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: 11/19/2022] Open
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Abstract
The study of biological systems commonly depends on inferring the state of a 'hidden' variable, such as an underlying genotype, from that of an 'observed' variable, such as an expressed phenotype. However, this cannot be achieved using traditional quantitative methods when more than one genetic mechanism exists for a single observable phenotype. Using a novel latent class Bayesian model, it is possible to infer the prevalence of different genetic elements in a population given a sample of phenotypes. As an exemplar, data comprising phenotypic resistance to six antimicrobials obtained from passive surveillance of Salmonella Typhimurium DT104 are analysed to infer the prevalence of individual resistance genes, as well as the prevalence of a genomic island known as SGI1 and its variants. Three competing models are fitted to the data and distinguished between using posterior predictive p-values to assess their ability to predict the observed number of unique phenotypes. The results suggest that several SGI1 variants circulate in a few fixed forms through the population from which our data were derived. The methods presented could be applied to other types of phenotypic data, and represent a useful and generic mechanism of inferring the genetic population structure of organisms.
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Affiliation(s)
- M J Denwood
- Boyd Orr Centre for Population and Ecosystem Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G61 1QH, UK
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