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Heffernan B, Forbes E, Seeberger L, Shattuck J, Cook M, Ayele R, Kluger BM. Perceptions of palliative care in Huntington's disease: A qualitative study. Parkinsonism Relat Disord 2024; 120:106007. [PMID: 38241953 PMCID: PMC10949181 DOI: 10.1016/j.parkreldis.2024.106007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
INTRODUCTION Palliative care focuses on improving patient and family quality of life by managing symptoms, psychosocial issues and spiritual concerns. Huntington's disease is a progressive neurodegenerative disorder with no current disease modifying therapy. Although the palliative care model has been postulated to be an integral part of HD care, there are gaps in knowledge about how this care should be implemented. This study aims to identify perceptions of palliative care in Huntington's Disease (HD), palliative care needs of people living with HD, and at what point they feel they would benefit from these resources. METHODS Participants volunteered from a large academic institution patient base to be involved in semi structured interviews that explored patient and caregiver experience surrounding their diagnosis, disease management, quality of life, and areas for improvement. Inclusion criteria for participants was a diagnosis of Huntington's disease and/or a self-identified caregiver of a person living with the disease. RESULTS A total of 12 independent patients, three independent caregivers, and five dyads completed the interviews. Themes identified included needs that would provide patient and caregiver centered treatment, current gaps in care, an openness and desire for palliative care, and knowledge about the desired timing of palliative care in treatment plans. CONCLUSION People living with HD and caregivers of people with HD most desire access to treatment that would focus on symptom management, availability of social resources, advanced care planning and spiritual wellbeing. The preferred timing of this intervention for most individuals would be at the onset of symptoms.
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Affiliation(s)
- B Heffernan
- University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA.
| | - E Forbes
- University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA
| | - L Seeberger
- University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA
| | - J Shattuck
- University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA
| | - M Cook
- University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA
| | - R Ayele
- University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA
| | - B M Kluger
- University of Rochester, 919 Westfall Rd, Rochester, NY, 14618, USA
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2
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Burnside G, Cheyne CP, Leeming G, Humann M, Darby A, Green MA, Crozier A, Maskell S, O’Halloran K, Musi E, Carmi E, Khan N, Fisher D, Corcoran R, Dunning J, Edmunds WJ, Tharmaratnam K, Hughes DM, Malki-Epshtein L, Cook M, Roberts BM, Gallagher E, Howell K, Chand M, Kemp R, Boulter M, Fowler T, Semple MG, Coffey E, Ashton M, García-Fiñana M, Buchan IE. COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region. J R Soc Med 2024; 117:11-23. [PMID: 37351911 PMCID: PMC10858718 DOI: 10.1177/01410768231182389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/25/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted. DESIGN Prospective, population-wide observational study. SETTING Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings. PARTICIPANTS A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021. MAIN OUTCOME MEASURES SARS-CoV-2 infections detected using audience self-swabbed (5-7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO2 concentrations were monitored. RESULTS A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO2 concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high. CONCLUSIONS We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events.
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Affiliation(s)
- Girvan Burnside
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Christopher P Cheyne
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Gary Leeming
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Michael Humann
- Department of Psychology, University of Liverpool, Liverpool L69 7ZA, UK
| | - Alistair Darby
- Department of Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool L69 3BX, Liverpool, UK
| | - Alexander Crozier
- Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Simon Maskell
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool L69 3BX, UK
| | - Kay O’Halloran
- Department of Communication and Media, University of Liverpool, Liverpool L69 7ZG, UK
| | - Elena Musi
- Department of Communication and Media, University of Liverpool, Liverpool L69 7ZG, UK
| | - Elinor Carmi
- Department of Sociology and Criminology, City University, London EC1V 0HB, UK
| | - Naila Khan
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Debra Fisher
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Rhiannon Corcoran
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Jake Dunning
- Pandemic Sciences Institute, University of Oxford, Oxford OX3 7DQ, UK
| | - W John Edmunds
- Centre for Mathematical Modelling of Infectious Diseases and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Kukatharmini Tharmaratnam
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - David M Hughes
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Liora Malki-Epshtein
- Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UK
| | - Malcolm Cook
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK
| | - Ben M Roberts
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK
| | - Eileen Gallagher
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Kate Howell
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Meera Chand
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Robin Kemp
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Matthew Boulter
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
| | - Tom Fowler
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
| | - Malcolm G Semple
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Emer Coffey
- Liverpool City Council, Liverpool L3 1AH, UK
| | - Matt Ashton
- Liverpool City Council, Liverpool L3 1AH, UK
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GB, UK
| | - The COVID-19 Genomics UK (COG-UK) Consortium
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
- Department of Psychology, University of Liverpool, Liverpool L69 7ZA, UK
- Department of Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Department of Geography and Planning, University of Liverpool L69 3BX, Liverpool, UK
- Division of Biosciences, University College London, London WC1E 6BT, UK
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool L69 3BX, UK
- Department of Communication and Media, University of Liverpool, Liverpool L69 7ZG, UK
- Department of Sociology and Criminology, City University, London EC1V 0HB, UK
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK
- Pandemic Sciences Institute, University of Oxford, Oxford OX3 7DQ, UK
- Centre for Mathematical Modelling of Infectious Diseases and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Department of Civil, Environmental and Geomatic Engineering, University College London, London WC1E 6BT, UK
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK
- Clinical and Public Health Group, UK Health Security Agency, London SW1P 3JR, UK
- William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
- Liverpool City Council, Liverpool L3 1AH, UK
- Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GB, UK
- *Shared senior authorship
| | - Marta García-Fiñana
- Deparment of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
| | - Iain E Buchan
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GB, UK
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Kandola T, Venkatesan S, Zhang J, Lerbakken BT, Von Schulze A, Blanck JF, Wu J, Unruh JR, Berry P, Lange JJ, Box AC, Cook M, Sagui C, Halfmann R. Pathologic polyglutamine aggregation begins with a self-poisoning polymer crystal. eLife 2023; 12:RP86939. [PMID: 37921648 PMCID: PMC10624427 DOI: 10.7554/elife.86939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
A long-standing goal of amyloid research has been to characterize the structural basis of the rate-determining nucleating event. However, the ephemeral nature of nucleation has made this goal unachievable with existing biochemistry, structural biology, and computational approaches. Here, we addressed that limitation for polyglutamine (polyQ), a polypeptide sequence that causes Huntington's and other amyloid-associated neurodegenerative diseases when its length exceeds a characteristic threshold. To identify essential features of the polyQ amyloid nucleus, we used a direct intracellular reporter of self-association to quantify frequencies of amyloid appearance as a function of concentration, conformational templates, and rational polyQ sequence permutations. We found that nucleation of pathologically expanded polyQ involves segments of three glutamine (Q) residues at every other position. We demonstrate using molecular simulations that this pattern encodes a four-stranded steric zipper with interdigitated Q side chains. Once formed, the zipper poisoned its own growth by engaging naive polypeptides on orthogonal faces, in a fashion characteristic of polymer crystals with intramolecular nuclei. We further show that self-poisoning can be exploited to block amyloid formation, by genetically oligomerizing polyQ prior to nucleation. By uncovering the physical nature of the rate-limiting event for polyQ aggregation in cells, our findings elucidate the molecular etiology of polyQ diseases.
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Affiliation(s)
- Tej Kandola
- Stowers Institute for Medical ResearchKansas CityUnited States
- The Open UniversityMilton KeynesUnited Kingdom
| | | | - Jiahui Zhang
- Department of Physics, North Carolina State UniversityRaleighUnited States
| | | | | | | | - Jianzheng Wu
- Stowers Institute for Medical ResearchKansas CityUnited States
- Department of Biochemistry and Molecular Biology, University of Kansas Medical CenterKansas CityUnited States
| | - Jay R Unruh
- Stowers Institute for Medical ResearchKansas CityUnited States
| | - Paula Berry
- Stowers Institute for Medical ResearchKansas CityUnited States
| | - Jeffrey J Lange
- Stowers Institute for Medical ResearchKansas CityUnited States
| | - Andrew C Box
- Stowers Institute for Medical ResearchKansas CityUnited States
| | - Malcolm Cook
- Stowers Institute for Medical ResearchKansas CityUnited States
| | - Celeste Sagui
- Department of Physics, North Carolina State UniversityRaleighUnited States
| | - Randal Halfmann
- Stowers Institute for Medical ResearchKansas CityUnited States
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4
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Goff PH, Huynh ET, Lachance K, Harikrishnan N, Cook M, Schaub SK, Tseng YD, Liao JJ, Apisarnthanarax S, Wallner K, Nghiem P, Parvathaneni U. Efficacy of Single-Fraction Postoperative Radiotherapy in Resected, Early-Stage Merkel Cell Carcinoma with High-Risk Features. Int J Radiat Oncol Biol Phys 2023; 117:e298. [PMID: 37785091 DOI: 10.1016/j.ijrobp.2023.06.2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Merkel cell carcinoma (MCC) is an aggressive skin cancer with a high recurrence risk. Postoperative radiotherapy (PORT) improves the local recurrence rate (LRR) in early-stage MCC with risk factors per NCCN guidelines: primary tumor size > 1cm, head/neck (HN) location, immunosuppression, lymphovascular invasion (LVI), and positive/narrow surgical margins. Conventionally fractionated PORT (C-PORT, ∼50 Gy in 25 fractions) is often recommended for localized MCC with these risk factors; however, some institutions elect observation. Prior studies suggest LRR of ∼20% for stage I/II MCC with high-risk features managed with surgery alone. C-PORT significantly decreases LRR but may cause significant morbidity and financial toxicity. We have previously reported that single fraction (SF)-PORT with 8 Gy achieves high rates of in-field control both in the metastatic and adjuvant settings with minimal morbidity. Here, we present updated long-term outcomes of SF-PORT, offered as an alternative to C-PORT with the hypothesis that it improves LRR relative to observation while minimizing toxicity, for resected stage I/II MCC. MATERIALS/METHODS A retrospective, single-institution analysis was completed for stage I/II MCC patients receiving SF-PORT following surgical management. The primary objective was estimating the LRR, defined as recurrence within 2 cm of the primary tumor. Patients with resected, stage I/II MCC with at least one high-risk feature were offered C-PORT as standard of care or SF-PORT as an alternative. RESULTS Forty-six patients (median age: 74.5; range 50-96 years) received SF-PORT to the primary tumor site at a median 44 days after wide local excision (85%), shave/excisional biopsy (13%), or Mohs (2%). Fifty-four percent of patients had 1 high-risk feature, 35% had 2, and 11% had 3 or more. HN (74%) was the most common primary site, 26% of tumors were > 1cm, 26% were LVI+, and 15% of patients were immunosuppressed (pathological margin status was often not available). There were no local recurrences (LRR = 0%) at a median follow-up time of 2.3 years. In-field locoregional control was 96% (44/46 patients) with 2 in-field, regional recurrences observed in draining nodal basins of HN primary lesions. There were 2 out-of-field regional nodal recurrences (1 patient with IMS; neither received elective nodal SFRT). Of 9 patients who received elective nodal SF-PORT, 8 did not have a successful sentinel lymph node biopsy. No MCC-specific deaths were observed. The most common side effect was in-field, grade 1 erythema (13%); no side effects > grade 1 (CTCAE v5) were noted. CONCLUSION SF-PORT is associated with a very low LRR which has proven durable with long-term follow-up. The LRR for SF-PORT appears lower than historical controls treated with surgery alone for patients with resected, stage I/II MCC with high-risk features.
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Affiliation(s)
- P H Goff
- Department of Radiation Oncology, University of Washington / Fred Hutchinson Cancer Center, Seattle, WA
| | - E T Huynh
- University of Washington, Division of Dermatology, Seattle, WA
| | - K Lachance
- University of Washington, Division of Dermatology, Seattle, WA
| | - N Harikrishnan
- University of Washington, Division of Dermatology, Seattle, WA
| | - M Cook
- University of Washington, Division of Dermatology, Seattle, WA
| | - S K Schaub
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - Y D Tseng
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - J J Liao
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - S Apisarnthanarax
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - K Wallner
- University of Washington, Seattle, WA
| | - P Nghiem
- University of Washington, Division of Dermatology, Seattle, WA
| | - U Parvathaneni
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
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5
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Kandola T, Venkatesan S, Zhang J, Lerbakken B, Schulze AV, Blanck JF, Wu J, Unruh J, Berry P, Lange JJ, Box A, Cook M, Sagui C, Halfmann R. Pathologic polyglutamine aggregation begins with a self-poisoning polymer crystal. bioRxiv 2023:2023.03.20.533418. [PMID: 36993401 PMCID: PMC10055281 DOI: 10.1101/2023.03.20.533418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
A long-standing goal of amyloid research has been to characterize the structural basis of the rate-determining nucleating event. However, the ephemeral nature of nucleation has made this goal unachievable with existing biochemistry, structural biology, and computational approaches. Here, we addressed that limitation for polyglutamine (polyQ), a polypeptide sequence that causes Huntington's and other amyloid-associated neurodegenerative diseases when its length exceeds a characteristic threshold. To identify essential features of the polyQ amyloid nucleus, we used a direct intracellular reporter of self-association to quantify frequencies of amyloid appearance as a function of concentration, conformational templates, and rational polyQ sequence permutations. We found that nucleation of pathologically expanded polyQ involves segments of three glutamine (Q) residues at every other position. We demonstrate using molecular simulations that this pattern encodes a four-stranded steric zipper with interdigitated Q side chains. Once formed, the zipper poisoned its own growth by engaging naive polypeptides on orthogonal faces, in a fashion characteristic of polymer crystals with intramolecular nuclei. We further show that self-poisoning can be exploited to block amyloid formation, by genetically oligomerizing polyQ prior to nucleation. By uncovering the physical nature of the rate-limiting event for polyQ aggregation in cells, our findings elucidate the molecular etiology of polyQ diseases.
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Affiliation(s)
- Tej Kandola
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
- The Open University, Milton Keyes, MK7 6AA, UK
| | | | - Jiahui Zhang
- Department of Physics, North Carolina State University, Raleigh, NC 27695, USA
| | | | - Alex Von Schulze
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Jillian F Blanck
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Jianzheng Wu
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jay Unruh
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Paula Berry
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Jeffrey J Lange
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Andrew Box
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Malcolm Cook
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Celeste Sagui
- Department of Physics, North Carolina State University, Raleigh, NC 27695, USA
| | - Randal Halfmann
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Malki-Epshtein L, Adzic F, Roberts BM, Hathway EA, Iddon C, Mustafa M, Cook M. Measurement and rapid assessment of indoor air quality at mass gathering events to assess ventilation performance and reduce aerosol transmission of SARS-CoV-2. Build Serv Eng Res Technol 2023; 44:113-133. [PMID: 38603254 PMCID: PMC9760526 DOI: 10.1177/01436244221137995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
To assess risk factors for COVID-19 transmission and address the closure of mass gathering events since March 2020, the UK Government ran the Events Research Programme (ERP), following which it reopened live events in sports, music, and culture in July 2021. We report the rapid post-occupancy evaluation of Indoor Air Quality (IAQ) and associated long-range airborne transmission risk conducted in the Environmental Study of the ERP. Ten large venues around the UK were monitored with CO2 sensors at a high spatial and temporal resolution during 90 events. An IAQ Index based on CO2 concentration was developed, and all monitored spaces were classified in bands from A to G based on their average and maximum CO2 concentrations from all events. High resolution monitoring and the IAQ Index depicted the overall state of ventilation at live events, and allowed identification of issues with ventilation effectiveness and distribution, and of spaces with poor ventilation and the settings in which long-range airborne transmission risk may be increased. In numerous settings, CO2 concentrations were found to follow patterns relating to event management and specific occupancy of spaces around the venues. Good ventilation was observed in 90% of spaces monitored for given occupancies. Practical applications: High-resolution monitoring of indoor CO2 concentrations is necessary to detect the spatial variation of indoor air quality (IAQ) in large mass gathering event venues. The paper summarises COVID-19 ventilation guidance for buildings and defines a methodology for measurement and rapid assessment of IAQ during occupancy at live events that can be implemented by venue managers. Comparisons of the CO2 concentrations measured during the events identified the spaces at high risk of long-range transmission of airborne pathogens. Building operators should be mindful of the ventilation strategies used relative to the total occupancy in different spaces and the occupant's activities.
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Affiliation(s)
- Liora Malki-Epshtein
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK
| | - Filipa Adzic
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK
| | - Ben M Roberts
- Building Energy Research Group, Loughborough University, Loughborough, UK
| | | | | | | | - Malcolm Cook
- Building Energy Research Group, Loughborough University, Loughborough, UK
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7
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Constantino D, Cook M, Shin D, Meissner M, Abad-Santos M, Bertino F, Monroe E, Hua E, Vaidya S, Chick J. Abstract No. 590 Sharp Recanalization of Symptomatic Chronic Central Venous Occlusions Using the Rösch-Uchida Transjugular Liver Access Set. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.448] [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: 02/27/2023] Open
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8
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Cook M, Rinaldi N, Jarrold K, Flak D, Krukowski L, Lawrence G, Chao S, Angelov L. Utilizing a Paper Simulation to Evaluate Scheduling Workflow. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.874] [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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9
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Adzic F, Roberts BM, Hathway EA, Kaur Matharu R, Ciric L, Wild O, Cook M, Malki-Epshtein L. A post-occupancy study of ventilation effectiveness from high-resolution CO 2 monitoring at live theatre events to mitigate airborne transmission of SARS-CoV-2. Build Environ 2022; 223:109392. [PMID: 35937085 PMCID: PMC9339161 DOI: 10.1016/j.buildenv.2022.109392] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/24/2022] [Accepted: 07/10/2022] [Indexed: 05/20/2023]
Abstract
Mass-gathering events were closed around the world in 2020 to minimise the spread of the SARS-CoV-2 virus. Emerging research on the transmission of SARS-CoV-2 emphasised the importance of sufficient ventilation. This paper presents the results of an indoor air quality (IAQ) monitoring study over 82 events in seven mechanically ventilated auditoria to support the UK government Events Research Programme. Indoor carbon dioxide concentration was measured at high resolution before, during, and after occupancy to allow for assessment of the ventilation systems. Generally, good indoor air quality was measured in all auditoria, with average IAQ found to be excellent or very good for 70% of spaces. In some auditoria, spatial variation in IAQ was identified, indicating poor mixing of the air. In addition, surface and air samples were taken and analysed for the presence of bacteria by culture and SARS-CoV-2 using RT-qPCR in one venue. SARS-CoV-2 RNA was detected on a small number of surfaces at very low copy numbers, which are unlikely to pose an infection risk. Under the ventilation strategies and occupancy levels investigated, it is likely that most theatres pose a low risk of long-range transmission of COVID-19.
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Affiliation(s)
- Filipa Adzic
- Department of Civil, Environmental and Geomatic Engineering, University College London, UK
| | - Ben M Roberts
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, UK
| | | | - Rupy Kaur Matharu
- Department of Civil, Environmental and Geomatic Engineering, University College London, UK
| | - Lena Ciric
- Department of Civil, Environmental and Geomatic Engineering, University College London, UK
| | - Oliver Wild
- Department of Civil, Environmental and Geomatic Engineering, University College London, UK
| | - Malcolm Cook
- Building Energy Research Group, School of Architecture, Building and Civil Engineering, Loughborough University, UK
| | - Liora Malki-Epshtein
- Department of Civil, Environmental and Geomatic Engineering, University College London, UK
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10
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Tay T, Oudit D, Cook M, Green AC. 59 Associations of Biological Sex with Clinicopathologic Features of Cutaneous Melanoma. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.377] [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: 11/05/2022]
Abstract
Abstract
Aim
It is commonly known that women have better prognosis than men after diagnosis of primary cutaneous melanoma. However, few studies have investigated whether histopathological prognostic factors are associated with this difference. This study aimed to investigate if there were sex-specific differences in prognostic features of primary melanoma at time of diagnosis in a large clinical series.
Method
This was a records-based observational study of unselected patients treated for melanoma in a major tertiary oncology centre in the United Kingdoms, 2002–2016. Prognostic features (age at diagnosis; thickness of primary melanoma; ulceration and mitotic count) were extracted from histological reports and sex-specific differences tested for significance using X2 test.
Results
Among 1323 melanoma patients of median age 61 years (range 15–99), and roughly equal proportions of males (640, 48%) and females (683,52%), females had significantly earlier age of presentation on average than males (58 vs 64 years) (p<0.001). Comparing Breslow thickness of <2mm vs ≥2mm, significantly more females (414, 67%) than males (282, 55%) had melanomas <2mm (p<0.001). Other key histopathological factors namely presence of ulceration (p=0.073) and mitotic rate (p=0.618) were not significantly different by sex.
Conclusions
We found that female melanoma patients presented at an earlier age and with thinner primary melanomas than males, but mitotic rate (speed of tumour growth) was not significantly different. These data suggest that females’ better prognosis is explained by their tendency to present earlier with suspicious skin lesions than males.
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Affiliation(s)
- T Tay
- Lancaster Medical School, Lancaster University , Lancaster , United Kingdom
- Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust , Lancaster , United Kingdom
| | - D Oudit
- Christie NHS Foundation Trust , Manchester , United Kingdom
| | - M Cook
- Cancer Research UK Manchester Institute , Manchester , United Kingdom
| | - AC Green
- Cancer Research UK Manchester Institute , Manchester , United Kingdom
- Cancer and Population Studies Group, Queensland Institute of Medical Research , Brisbane , Australia
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Witkam R, Verstappen S, Gwinnutt J, Cook M, O’neill T, Cooper R, Humphreys J. POS0325 THE ASSOCIATION BETWEEN OBESITY, SOCIOECONOMIC POSITION AND KNEE JOINT REPLACEMENT SURGERY IN PATIENTS WITH OSTEOARTHRITIS: RESULTS FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundEvidence suggests that associations of lower socioeconomic position (SEP) with increased incidence of osteoarthritis (OA) are partially mediated by obesity. Obesity and lower SEP are also associated with increased symptoms in OA (i.e. pain/function). However, few studies have investigated whether obesity and lower SEP are also associated with increased risk of knee joint replacement surgeries (kJRS).ObjectivesTo investigate the relationships of obesity and SEP at time of diagnosis with kJRS at follow-up in people with knee OA (kOA).MethodsThe English Longitudinal Study of Ageing is a nationally representative panel study of adults aged ≥50 years with biannual waves of data collection (2002–2019). Participants who self-reported OA diagnosis for the first time in waves 2–8 and knee pain in the same or previous wave of diagnosis were defined as having kOA (baseline). Participants with at least one body mass index (BMI) measurement and one follow-up assessment were included. Underweight/normal weight, overweight and obesity were defined using BMI <25 kg/m2, 25–30 kg/m2 and ≥30kg/m2, respectively. Education, occupation (current or last occupation if retired), wealth quintiles (all individual-based) and index of multiple deprivation quintiles (area-based) were used as SEP indicators. Outcome was the first self-reported kJRS (left or right knee) in waves 3–9. Cox proportional hazards models were used to investigate the associations of obesity and SEP with kJRS, controlling for baseline covariates. Person year follow up was calculated from baseline to either a) date of self-reported kJRS, b) loss to follow-up, c) end of follow-up (wave 9).ResultsThe analysis sample included 1499 people who reported kOA and had ≥1 BMI measure (62.3% female; mean age 66.5y (SD 9.4); 96% white; 47.4% obese). Number of person-years included in the analysis was 8427. Over a mean follow-up of 4.7 years (SD 2.8), 144 (9.6%) reported having kJRS. Obese kOA patients were more likely to report kJRS than non-obese patients (adjHR 1.89 (95% CI 1.33, 2.68)), independent of age, gender, SEP, cardiovascular disease (self-reported) and HbA1c values (measured from collected blood samples). Education and occupation were not associated with kJRS. However, those living in the most deprived areas and with the least amount of wealth were less likely to undergo kJRS compared with the least deprived and wealthiest (HRs adjusted for age and gender 0.37 (95% CI 0.19, 0.73) and 0.55 (95% CI 0.33, 0.93), respectively). There was no evidence of interactions between obesity and SEP indicators.ConclusionObesity increased the likelihood of undergoing kJRS in kOA patients. Therefore, reducing obesity in kOA patients may help to reduce the need for kJRS. Area-deprivation and lower wealth were associated with lower likelihood of kJRS. Taken together with findings from other studies which report associations between lower SEP and worse OA symptoms, our results suggest that there may be social inequalities in the provision of kJRS in England.Table 1.The relationships between obesity at baseline and rates of knee joint replacement surgery over a mean of 4.7 (SD 2.8) years in follow-up in those with knee OA at baseline in the English Longitudinal Study of AgeingPredictorsHR (95% CI)UnadjustedAdjusted for age and genderAdjusted for age, gender and SEPAdjusted for age, gender, SEP, CVD and HbA1cObesity1.56 (1.12, 2.17)1.63 (1.17, 2.28)1.77 (1.26, 2.50)1.89 (1.33, 2.68)Non-obesityrefrefrefrefObesity3.53 (1.77, 7.02)3.58 (1.80, 7.12)4.01 (2.01, 8.03)4.35 (2.16, 8.74)Overweight2.91 (1.43, 5.91)2.81 (1.38, 5.73)2.93 (1.44, 5.98)2.98 (1.46, 6.09)Underweight/normal weightrefrefrefrefBMI per 1 kg/m2 increment1.05 (1.02, 1.07)1.05 (1.03, 1.08)1.06 (1.04, 1.09)1.07 (1.04, 1.10)HR, hazard ratio; CI, confidence interval; SEP, socioeconomic position; CVD, cardiovascular disease; ref, reference category; BMI, body mass index.Disclosure of InterestsNone declared
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Halfmann R, Kandola T, Venkatesan S, Zhang J, Lerbakken B, Blanck JF, Wu J, Unruh J, Berry P, Lange JJ, Von Schulze A, Box A, Cook M, Sagui C. Structure of a pathologic amyloid nucleus determined by rational genetic deconstruction of an intracellular nucleation barrier. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.0r250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Tej Kandola
- Stowers Institute for Medical ResearchKansas CityMO
| | | | - Jaihui Zhang
- Department of PhysicsNorth Carolina State UniversityRaleighNC
| | | | | | - Jianzheng Wu
- Stowers Institute for Medical ResearchKansas CityMO
| | - Jay Unruh
- Stowers Institute for Medical ResearchKansas CityMO
| | - Paula Berry
- Stowers Institute for Medical ResearchKansas CityMO
| | | | | | - Andrew Box
- Stowers Institute for Medical ResearchKansas CityMO
| | - Malcolm Cook
- Stowers Institute for Medical ResearchKansas CityMO
| | - Celeste Sagui
- Department of PhysicsNorth Carolina State UniversityRaleighNC
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13
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Goldstein I, Uloko M, Butera M, Cook M. Inflatable penile prosthesis infection successfully managed by non-operative novel treatment strategies: A case report. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Nero RW, Cook M, Reneker JL, Wang Z, Schultz EA, Stacy BA. Decomposition of Kemp’s ridley (Lepidochelys kempii) and green (Chelonia mydas) sea turtle carcasses and its application to backtrack modeling of beach strandings. ENDANGER SPECIES RES 2022. [DOI: 10.3354/esr01164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
When a sea turtle dies, it typically sinks to the bottom, begins decomposing, and floats to the surface once sufficient internal gases have accumulated to produce positive buoyancy. This process is poorly characterized and is essential to understanding where and when sea turtles found on shore may have died. We conducted decomposition studies with detailed time-temperature histories using carcasses of cold-stunned sea turtles (22 Kemp’s ridleys Lepidochelys kempii and 15 green sea turtles Chelonia mydas) at temperatures of 14-32°C and depths of 2.2-9.5 m. We found strong depth/pressure-related effects; carcasses took longer to float when incubated at greater depths than shallower depths at similar temperatures. Furthermore, carcasses incubated at colder temperatures (~15°C) took 8 times longer to float than those at 32°C at the same depth. We applied accumulated degree hours (ADH; hourly sum of ambient temperatures a carcass experienced) to characterize environmental conditions associated with different stages of decomposition and key events, including buoyancy and sinking. A formula for temperature-correction of ADH was calculated to fit a non-linear increase in decomposition at higher temperatures. These data were then used to improve an existing backtracking model by incorporating water temperature, depth (pressure), bathymetry, and postmortem condition. Heat maps of the probable mortality locations from the model agreed well with carcass and effigy drift experiments, demonstrating the overall reliability of the enhanced model. Our method can be used to estimate at-sea locations where sea turtles found washed ashore in the northern Gulf of Mexico likely died and may help inform similar efforts in other regions.
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Affiliation(s)
- RW Nero
- National Oceanic and Atmospheric Administration, National Marine Fisheries Service, Southeast Fisheries Science Center, Building 1021, Stennis Space Center, Mississippi 39529, USA
| | - M Cook
- National Oceanic and Atmospheric Administration, National Marine Fisheries Service, Southeast Fisheries Science Center, Pascagoula, Mississippi 39567, USA
| | - JL Reneker
- Riverside Technologies Inc., Southeast Fisheries Science Center, Pascagoula, Mississippi 39567, USA
| | - Z Wang
- National Oceanic and Atmospheric Administration National Centers for Environmental Information, Stennis Space Center, Mississippi 39529, USA
- Northern Gulf Institute, Mississippi State University, Stennis Space Center, Mississippi 39529, USA
| | - EA Schultz
- Riverside Technologies Inc., Southeast Fisheries Science Center, Pascagoula, Mississippi 39567, USA
| | - BA Stacy
- National Oceanic and Atmospheric Administration, National Marine Fisheries Service, Office of Protected Resources, University of Florida, College of Veterinary Medicine (duty station), Gainesville, Florida 32611, USA
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Nurse E, Karoly P, Stirling R, Maturana M, Freestone D, Cook M, Cucuzza L. Multiday Cycles of Heart Rate Are Comodulated With Seizure Likelihood: An Observational Cohort Study. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Colleran H, San Diego L, Manning E, Fuller T, Cook M. Diet Patterns and Quality of Student Athletes at an HBCU. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Lee J, Colunga A, Lee J, Pulliam T, Paulson K, Voillet V, Berndt A, Church C, Lachance K, Park S, Yamamoto N, Cook M, Kawasumi M, Nghiem P. 702 The CDK4/6 inhibitor palbociclib enhances the vulnerability of Merkel cell carcinoma via the HIF2α pathway. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.732] [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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18
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Monk RL, Leather J, Qureshi AW, Cook M, Labhart F, Kuntsche E, Heim D. Assessing alcohol-related beliefs using pictographic representations: a systematic approach to the development and validation of the revised alcohol expectancy task. Drugs: Education, Prevention and Policy 2021. [DOI: 10.1080/09687637.2021.1915961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- R. L. Monk
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - J. Leather
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - A. W. Qureshi
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - M. Cook
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - F. Labhart
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Idiap Research Institute, Martigny, Switzerland
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - E. Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - D Heim
- Department of Psychology, Edge Hill University, Ormskirk, UK
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19
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England R, Peirce N, Wedatilake T, Torresi J, Kemp S, Cook M, Mitchell S, Harland A. The Potential for Airborne Transmission of SARS-CoV-2 in Sport: A Cricket Case Study. Int J Sports Med 2021; 42:407-418. [PMID: 33511617 DOI: 10.1055/a-1342-8071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A review of risk factors affecting airborne transmission of SARS-CoV-2 was synthesised into an 'easy-to-apply' visual framework. Using this framework, video footage from two cricket matches were visually analysed, one pre-COVID-19 pandemic and one 'COVID-19 aware' game in early 2020. The number of opportunities for one participant to be exposed to biological secretions belonging to another participant was recorded as an exposure, as was the estimated severity of exposure as defined from literature. Events were rated based upon distance between subjects, relative orientation of the subjects, droplet generating activity performed (e. g., talking) and event duration. In analysis we reviewed each risk category independently and the compound effect of an exposure i. e., the product of the scores across all categories. With the application of generic, non-cricket specific, social distancing recommendations and general COVID-19 awareness, the number of exposures per 100 balls was reduced by 70%. More impressive was the decrease in the most severe compound ratings (those with two or more categories scored with the highest severity) which was 98% and the reduction in exposures with a proximity <1 m, 96%. Analysis of the factors effecting transmission risk indicated that cricket was likely to present a low risk, although this conclusion was somewhat arbitrary omitting a comparison with a non-cricketing activity.
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Affiliation(s)
- Rory England
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Nicholas Peirce
- Department of Sport Science & Medicine, England and Wales Cricket Board, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Thamindu Wedatilake
- Department of Sport Science & Medicine, England and Wales Cricket Board, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Joseph Torresi
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Australia
| | - Simon Kemp
- Medical Services Director, Rugby Football Union, Twickenham, United Kingdom of Great Britain and Northern Ireland.,Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Malcolm Cook
- School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Sean Mitchell
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Andy Harland
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland
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20
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Cook M, Livingston M, Vally H, Callinan S. Australians' support for alcohol price-based policies. Int J Drug Policy 2020; 85:102924. [PMID: 32911321 DOI: 10.1016/j.drugpo.2020.102924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Price-based policies are effective alcohol harm minimisation policy options. This paper examines public support for price-based policies based on patterns of consumption and expenditure, to determine if the extent to which an individual may be affected by a policy influences their support. METHODS The current study included 1,684 Australian residents (59.8% male, Mage 43.8 [SD=16.7]). Respondents who purchased and consumed alcohol in the past six months were asked about their support for potential changes in a series of price-based policies. RESULTS Increasing price was less likely to be supported than either implementing a minimum price or a tax-increase earmarked to pay for alcohol harms. Increasing price and taxing drinkers were more likely to be supported by older people and women. We found no relationship between income or perceived impact of price increases on purchasing and level of support. CONCLUSION Contrary to the idea that public support might be partly influenced by ability to pay for alcohol, support for a minimum unit price was not related to price paid per drink or income, only amount consumed. Thus, heavier drinkers may be inherently unlikely to support price-based policies even when these policies would have little impact on their actual purchasing.
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Affiliation(s)
- M Cook
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
| | - M Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - H Vally
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - S Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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21
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Cook M, Livingston M, Wilkinson C, Shanthosh J, Morrison CN. Alcohol Industry vs. Public Health Presentations at Judicial Reviews of Liquor Licence Applications in Australia. Int J Drug Policy 2020; 82:102808. [PMID: 32531514 DOI: 10.1016/j.drugpo.2020.102808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 11/18/2022]
Abstract
Greater densities of alcohol outlets are associated with greater incidence of alcohol-related harms. In Australia, public health advocates aiming to limit alcohol availability expend significant energy objecting to new outlets in licensing and planning hearings. This study identifies and reviews the key scientific arguments put forward by industry and public health representatives in liquor and planning hearings to determine the factors that contribute to decisions by the presiding authority and to identify ways forward for researchers wishing to facilitate harm minimisation through these regulatory forums. Scientific evidence presented in 23 cases from Victoria, New South Wales and Western Australia between 2010 and 2018 were assessed using directed content analysis. Cases were identified through the AustLii and Westlaw online databases. The full transcripts of two cases that were identified as representative of the scientific arguments presented in other included cases were also reviewed. Four main arguments that industry used during hearings were identified-causal inference, non-linearities, differentiation and risk mitigation. These arguments were used across many included hearings and raised fundamental questions that public health evidence was often ill-equipped to respond to. The overall success of industry arguments in liquor and planning hearings highlighted the challenges of applying epidemiological evidence to individual case studies. These findings have particular implications and will be of use for researchers and public health experts participating in future licensing hearings, especially those wishing to prevent alcohol-related harm through regulatory mechanisms such as state licensing authorities (i.e. courts).
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Affiliation(s)
- M Cook
- Centre for Alcohol Policy Research, La Trobe University, Melbourne.
| | - M Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne
| | - C Wilkinson
- Centre for Alcohol Policy Research, La Trobe University, Melbourne; Drug Policy Modelling Program (DPMP) at the Social Policy Research Centre (SPRC), University of New South Wales
| | - J Shanthosh
- The George Institute for Global Health, Newtown, New South Wales; The Australian Prevention Partnership Centre, New South Wales
| | - C N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria
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22
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Peach H, Board R, Cook M, Corrie P, Ellis S, Geh J, King P, Laitung G, Larkin J, Marsden J, Middleton M, Moncrieff M, Nathan P, Powell B, Pritchard-Jones R, Rodwell S, Steven N, Lorigan P. Current role of sentinel lymph node biopsy in the management of cutaneous melanoma: A UK consensus statement. J Plast Reconstr Aesthet Surg 2020; 73:36-42. [DOI: 10.1016/j.bjps.2019.06.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
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23
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Jais C, Hignett S, Halsall W, Kelly D, Cook M, Hogervorst E. Chris and Sally's House: Adapting a home for people living with dementia (innovative practice). Dementia (London) 2019; 20:770-778. [PMID: 31698949 DOI: 10.1177/1471301219887040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
How can domestic housing be adapted to support people living with dementia staying in their own homes for as long as they choose? This paper describes the innovative practice of using evidence-based design personas in a building refurbishment project (Chris and Sally's House) with a multidisciplinary team of architects, ergonomists, psychologists and experts. A 100 sqm Victorian two bedroom house was adapted to help educate house builders, carers and relatives on how to better support those living with dementia to live in their own home for longer. The design principles include clear sight lines, mobility support and provision for overnight carers.
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Affiliation(s)
| | - Sue Hignett
- Loughborough Design School, Loughborough University, Loughborough, UK
| | | | - David Kelly
- Building Research Establishment, Watford, UK
| | - Malcolm Cook
- School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Khan T, Kandola TS, Wu J, Venkatesan S, Ketter E, Lange JJ, Rodríguez Gama A, Box A, Unruh JR, Cook M, Halfmann R. Quantifying Nucleation In Vivo Reveals the Physical Basis of Prion-like Phase Behavior. Mol Cell 2019; 71:155-168.e7. [PMID: 29979963 PMCID: PMC6086602 DOI: 10.1016/j.molcel.2018.06.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/26/2018] [Accepted: 06/07/2018] [Indexed: 01/29/2023]
Abstract
Protein self-assemblies modulate protein activities over biological timescales that can exceed the lifetimes of the proteins or even the cells that harbor them. We hypothesized that these timescales relate to kinetic barriers inherent to the nucleation of ordered phases. To investigate nucleation barriers in living cells, we developed distributed amphifluoric FRET (DAmFRET). DAmFRET exploits a photoconvertible fluorophore, heterogeneous expression, and large cell numbers to quantify via flow cytometry the extent of a protein's self-assembly as a function of cellular concentration. We show that kinetic barriers limit the nucleation of ordered self-assemblies and that the persistence of the barriers with respect to concentration relates to structure. Supersaturation resulting from sequence-encoded nucleation barriers gave rise to prion behavior and enabled a prion-forming protein, Sup35 PrD, to partition into dynamic intracellular condensates or to form toxic aggregates. Our results suggest that nucleation barriers govern cytoplasmic inheritance, subcellular organization, and proteotoxicity.
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Affiliation(s)
- Tarique Khan
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Tejbir S Kandola
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Jianzheng Wu
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | | | - Ellen Ketter
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Jeffrey J Lange
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | | | - Andrew Box
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Jay R Unruh
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Malcolm Cook
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA
| | - Randal Halfmann
- Stowers Institute for Medical Research, Kansas City, MO 64110, USA; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS 66160, USA.
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Khan T, Kandola TS, Wu J, Venkatesan S, Ketter E, Lange JJ, Gama AR, Box A, Unruh JR, Cook M, Halfmann R. Quantifying Nucleation In Vivo Reveals the Physical Basis of Prion-like Phase Behavior. Mol Cell 2019; 73:857. [PMID: 30794793 DOI: 10.1016/j.molcel.2019.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Gilbert F, Cook M, O’Brien T, Illes J. Embodiment and Estrangement: Results from a First-in-Human "Intelligent BCI" Trial. Sci Eng Ethics 2019; 25:83-96. [PMID: 29129011 PMCID: PMC6418065 DOI: 10.1007/s11948-017-0001-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 10/31/2017] [Indexed: 05/21/2023]
Abstract
While new generations of implantable brain computer interface (BCI) devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent-predictive and advisory-BCI technologies essential to prevent potential iatrogenic harms.
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Affiliation(s)
- F. Gilbert
- Centre for Sensorimotor Neural Engineering, Department of Philosophy, University of Washington, Seattle, WA USA
- National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC USA
- Australian Research Council DECRA Fellow, University of Tasmania, Hobart, Australia
| | - M. Cook
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
- Department of Neurology, St. Vincent’s Hospital, Melbourne, Australia
| | - T. O’Brien
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - J. Illes
- National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC USA
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Haynes F, Cook M, Sanga H, Millward S, Dewar J. P148 Service evaluation of a community exercise programme for people with CF. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30443-0] [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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Haynes F, Cook M, Mosley K, Millward S, Dewar J. P147 Virtual exercise class for CF in patients – a novel way to encourage exercise participation. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cameron S, Brown VJ, Dritschel B, Power K, Cook M. Understanding the relationship between suicidality, current depressed mood, personality, and cognitive factors. Psychol Psychother 2017; 90:530-549. [PMID: 28296207 DOI: 10.1111/papt.12123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 02/05/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Links between suicidality and depressed mood are well established. There is, however, little information about the emotional regulation processes that underlie the relationship between suicidality and current low mood, and how these processes differ between groups of never-suicidal (NS), suicidal ideators, and suicide attempters. As suicidality and depression are heterogeneous constructs, this study aimed to conduct within- and between-group comparisons of known suicide risk factors that are associated with emotion regulation (neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories). DESIGN Correlational design using between- and within-group comparisons from self-report measures. METHODS Inter- and intragroup differences were identified using Pearson's correlation coefficients and tests of difference. An analysis of indirect effects was used to investigate whether the relationship between suicidality and current low mood was mediated by neuroticism, trait aggression, brooding, impulsivity, and overgeneral autobiographical memories, and if this relationship varied according to group type. RESULTS Brooding appeared to be a consistent feature of all three groups and was closely related to current low mood. Compared to the NS group, the relationship between suicide attempts and current low mood showed greater associations with brooding, trait aggression, and overgeneral autobiographical memories. Compared to the NS group, the suicidal ideation group showed stronger associations with neuroticism and impulsivity, but these factors did not correlate with low mood. CONCLUSION These results suggest a need for larger studies to focus on heterogeneity within suicidal populations and consider how different combinations of risk factors may heighten or reduce suicide risk. PRACTITIONER POINTS It is well known that the severity and intensity of suicide and depressed presentations vary because of underlying dispositional and contextual factors (Fried & Nesse, ) which, in turn, affect how events are interpreted and responded to. Despite this, there is little research about how these mechanisms operate in different types of suicide groups, and their influence on the relationship between suicidality and current low mood. Understanding interrelationships that affect current low mood is of clinical significance because past suicidal history and deteriorations in already negative mood are linked to repeated suicide attempts and completion. Our findings show that ruminative brooding, defined as a tendency to repeatedly think about emotional aspects of an event, consistently correlates with current low mood across different types of suicidal groups (NS, suicidal ideators, and suicide attempters), and across analyses. Findings also show that suicidal ideation and attempt groups were associated with specific personality characteristics that increased the propensity of emotional responding and interpretation compared to the NS group. The relationship between suicide attempt and current low mood had a higher propensity to be influenced by trait aggression, brooding, and overgenerality compared to the NS group. In contrast, although the suicidal ideation group correlated more strongly with neuroticism and impulsivity, these factors did not influence current low mood. In terms of clinical practice, these findings imply that specific styles of interpretation and thinking may maintain the relationship between suicidality and current low mood. Given the cross-sectional nature of the study, however, it is not possible to imply causality. Nevertheless, the findings obtained provide some support for transdiagnostic models of cognitive-behavioural processes that could be developed further.
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Affiliation(s)
| | | | | | - Kevin Power
- Tayside Area Psychological Therapies Service, Dundee Health and Social Care Partnership, Dundee, Scotland
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Gerrish T, Ruikar K, Cook M, Johnson M, Phillip M. Analysis of basic building performance data for identification of performance issues. F 2017. [DOI: 10.1108/f-01-2016-0003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The aim of this paper is to demonstrate the use of historical building performance data to identify potential issues with the build quality and operation of a building, as a means of narrowing the scope of in-depth further review.
Design/methodology/approach
The response of a room to the difference between internal and external temperatures is used to demonstrate patterns in thermal response across monitored rooms in a single building, to clearly show where rooms are under-performing in terms of their ability to retain heat during unconditioned hours. This procedure is applied to three buildings of different types, identifying the scope and limitation of this method and indicating areas of building performance deficiency.
Findings
The response of a single space to changing internal and external temperatures can be used to determine whether it responds differently to other monitored buildings. Spaces where thermal bridging and changes in use from design were encountered exhibit noticeably different responses.
Research limitations/implications
Application of this methodology is limited to buildings where temperature monitoring is undertaken both internally for a variety of spaces, and externally, and where knowledge of the uses of monitored spaces is available. Naturally ventilated buildings would be more suitable for analysis using this method.
Originality/value
This paper contributes to the understanding of building energy performance from a data-driven perspective, to the knowledge on the disparity between building design intent and reality, and to the use of basic commonly recorded performance metrics for analysis of potentially detrimental building performance issues.
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Lee WI, Watson A, Chand R, Lam W, Cook M. CPID 4: A CASE OF RECURRENT ONYCHOMYCOSIS WITHOUT AUTOIMMUNITY. Intern Med J 2017. [DOI: 10.1111/imj.4_13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- W-I Lee
- Department of Immunology; Canberra Hospital, ACT Australia
| | - A Watson
- Department of Infectious Diseases; Canberra Hospital, ACT Australia
| | - R Chand
- Centre for Personalised Immunology; Australian National University; ACT Australia
| | - W Lam
- Centre for Personalised Immunology; Australian National University; ACT Australia
| | - M Cook
- Department of Immunology; Canberra Hospital, ACT Australia
- Centre for Personalised Immunology; Australian National University; ACT Australia
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Anantharajah A, Khoo K, Downes M, Cook M. CGR 6: A CURIOUS CASE OF PERIODIC FEVERS, AVASCULAR NECROSIS AND INFLAMMATORY NODULES. Intern Med J 2017. [DOI: 10.1111/imj.6_13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Anantharajah
- Department of Immunology, The Canberra Hospital; Canberra Australia
- Centre for Personalised Immunology; The Australian National University; Canberra Australia
| | - K Khoo
- Department of Rheumatology, The Canberra Hospital; Canberra Australia
| | - M Downes
- Centre for Personalised Immunology; The Australian National University; Canberra Australia
| | - M Cook
- Department of Immunology, The Canberra Hospital; Canberra Australia
- Centre for Personalised Immunology; The Australian National University; Canberra Australia
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Gibson PG, Reddel H, McDonald VM, Marks G, Jenkins C, Gillman A, Upham J, Sutherland M, Rimmer J, Thien F, Katsoulotos GP, Cook M, Yang I, Katelaris C, Bowler S, Langton D, Robinson P, Wright C, Yozghatlian V, Burgess S, Sivakumaran P, Jaffe A, Bowden J, Wark PAB, Yan KY, Kritikos V, Peters M, Hew M, Aminazad A, Bint M, Guo M. Effectiveness and response predictors of omalizumab in a severe allergic asthma population with a high prevalence of comorbidities: the Australian Xolair Registry. Intern Med J 2017; 46:1054-62. [PMID: 27350385 DOI: 10.1111/imj.13166] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/02/2016] [Accepted: 06/21/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Severe asthma is a high impact disease. Omalizumab targets the allergic inflammatory pathway; however, effectiveness data in a population with significant comorbidities are limited. AIMS To describe severe allergic asthma, omalizumab treatment outcomes and predictors of response among the Australian Xolair Registry participants. METHODS A web-based post-marketing surveillance registry was established to characterise the use, effectiveness and adverse effects of omalizumab (Xolair) for severe allergic asthma. RESULTS Participants (n = 192) (mean age 51 years, 118 female) with severe allergic asthma from 21 clinics in Australia were assessed, and 180 received omalizumab therapy. They had poor asthma control (Asthma Control Questionnaire, ACQ-5, mean score 3.56) and significant quality of life impairment (Asthma-related Quality of Life Questionnaire score 3.57), and 52% were using daily oral corticosteroid (OCS). Overall, 95% had one or more comorbidities (rhinitis 48%, obesity 45%, cardiovascular disease 23%). The omalizumab responder rate, assessed by an improvement of at least 0.5 in ACQ-5, was high at 83%. OCS use was significantly reduced. The response in participants with comorbid obesity and cardiovascular disease was similar to those without these conditions. Baseline ACQ-5 ≥ 2.0 (P = 0.002) and older age (P = 0.05) predicted the magnitude of change in ACQ-5 in response to omalizumab. Drug-related adverse events included anaphylactoid reactions (n = 4), headache (n = 2) and chest pains (n = 1). CONCLUSION Australian patients with severe allergic asthma report a high disease burden and have extensive comorbidity. Symptomatic response to omalizumab was high despite significant comorbid disease. Omalizumab is an effective targeted therapy for severe allergic asthma with comorbidity in a real-life setting.
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Affiliation(s)
- P G Gibson
- Centre for Healthy Lungs, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.
| | - H Reddel
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,University of Sydney, Liverpool Hospital, Sydney, New South Wales, Australia
| | - V M McDonald
- Centre for Healthy Lungs, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia.,School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - G Marks
- Department of Respiratory Medicine, Liverpool Hospital, Sydney, New South Wales, Australia
| | - C Jenkins
- Department of Thoracic Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - A Gillman
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - J Upham
- Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - M Sutherland
- Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, Victoria, Australia
| | - J Rimmer
- St Vincent's Clinic, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - F Thien
- Department of Respiratory Medicine, Box Hill Hospital, Melbourne, Victoria, Australia
| | - G P Katsoulotos
- St George Specialist Centre, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - M Cook
- Department of Immunology, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - I Yang
- Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - C Katelaris
- Department of Respiratory and Sleep Medicine, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - S Bowler
- Department of Respiratory and Sleep Medicine, Mater Adult Hospital, Brisbane, Queensland, Australia
| | - D Langton
- Department of Thoracic Medicine, Frankston Hospital, Melbourne, Victoria, Australia
| | - P Robinson
- Department of Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - C Wright
- Department of Respiratory Medicine, Nambour Hospital, Nambour, Queensland, Australia
| | - V Yozghatlian
- Department of Respiratory and Sleep Medicine, St George Hospital, Sydney, New South Wales, Australia
| | - S Burgess
- QLD Children's Lung and Sleep Specialists, Brisbane, Queensland, Australia
| | - P Sivakumaran
- Department of Respiratory Medicine, Gold Coast District Hospital, Gold Coast, Queensland, Australia
| | - A Jaffe
- Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - J Bowden
- Department of Respiratory, Allergy and Sleep Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - P A B Wark
- Centre for Healthy Lungs, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - K Y Yan
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - V Kritikos
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - M Peters
- Department of Thoracic Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - M Hew
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - A Aminazad
- Department of Respiratory Medicine, Box Hill Hospital, Melbourne, Victoria, Australia
| | - M Bint
- Department of Respiratory Medicine, Nambour Hospital, Nambour, Queensland, Australia
| | - M Guo
- Clinical Management, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
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Lima PC, Taylor RS, Cook M. Pseudocyst formation in the marine parasitic amoeba Neoparamoeba perurans: a short-term survival strategy to abrupt salinity variation. J Fish Dis 2017; 40:1109-1113. [PMID: 28000922 DOI: 10.1111/jfd.12588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 10/20/2016] [Accepted: 10/20/2016] [Indexed: 06/06/2023]
Affiliation(s)
- P C Lima
- Integrated Sustainable Aquaculture Production, CSIRO Agriculture and Food, Woorim, QLD, Australia
| | - R S Taylor
- Integrated Sustainable Aquaculture Production, CSIRO Agriculture and Food, Hobart, TAS, Australia
| | - M Cook
- Integrated Sustainable Aquaculture Production, CSIRO Agriculture and Food, St Lucia, QLD, Australia
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Romolo F, Stamouli A, Romeo M, Cook M, Orsenigo S, Donghi M. An experimental study about the presence of selenium in inorganic gunshot residues (GSR). Forensic Chem 2017. [DOI: 10.1016/j.forc.2017.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cook M, Lachance K, Nguyen M, Redman M, Baker K, Tseng Y, Nghiem P. 365 Outcomes among Merkel cell carcinoma patients with chronic immunosuppression. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.382] [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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Marsden JR, Fox R, Boota NM, Cook M, Wheatley K, Billingham LJ, Steven NM. Effect of topical imiquimod as primary treatment for lentigo maligna: the LIMIT-1 study. Br J Dermatol 2017; 176:1148-1154. [PMID: 27714781 DOI: 10.1111/bjd.15112] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Topical imiquimod is sometimes used for lentigo maligna (LM) in situ melanoma instead of surgery, but frequency of cure is uncertain. Pathological complete regression (pCR) is a logical surrogate marker for cure after imiquimod, although residual LM and atypical melanocytic hyperplasia may not be reliably distinguished. A trial comparing imiquimod vs. surgery might be justified by a high imiquimod pCR rate. OBJECTIVES Primary: to estimate the pCR rate for LM following imiquimod. Secondary: to assess the accuracy of prediction of pCR, using clinical complete regression (cCR) plus negative post-treatment biopsies, tolerability, resource use, patients' preferences and induced melanoma immunity. METHODS This was a single-arm phase II trial of 60 imiquimod applications over 12 weeks for LM then radical resection. A pCR rate ≥ 25 out of 33 would reliably discriminate between pCR rates < 60% and ≥ 85%. Clinical response was assessed and biopsies taken after imiquimod. Patients recorded adverse events in diaries. Patient preference was measured after surgery using a standard gamble tool. RESULTS The pCR rate was 10 of 27 (37%, 95% confidence interval 19-58%). The rate of cCR plus negative biopsies was 12 of 28, of whom seven of 11 had pCR on subsequent surgery. The median dose intensity was 86·7%. Of the 16 surveyed patients, eight preferred primary imiquimod over surgery if the cure rate for imiquimod was 80%, and four of 16 if it was ≤ 40%. CONCLUSIONS The pCR rate was insufficient to justify phase III investigation of imiquimod vs. SURGERY Clinical complete response and negative targeted biopsies left uncertainty regarding pathological clearance. Some patients would trade less aggressive treatment of LM against efficacy.
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Affiliation(s)
- J R Marsden
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, U.K
| | - R Fox
- Cancer Research U.K. Clinical Trials Unit, School of Cancer Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, U.K
| | - N M Boota
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, U.K
| | - M Cook
- Royal Surrey County Hospital, Guildford, U.K
| | - K Wheatley
- Cancer Research U.K. Clinical Trials Unit, School of Cancer Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, U.K
| | - L J Billingham
- Cancer Research U.K. Clinical Trials Unit, School of Cancer Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, U.K
| | - N M Steven
- Cancer Research U.K. Clinical Trials Unit, School of Cancer Sciences, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, U.K
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Zoghi M, Cook M, O’Brien T, Kwan P, Jaberzadeh S, Galea M. P015 The effects of cathodal transcranial direct current stimulation in patienst with focal epilepsy (a pilot study)‘. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cook M, Allos B, O'Beirn M, Denley S, Homer K, Sabel L, Jegannathen A, Chatterjee A, Koh P. 27: Management and outcomes of patients with non-small cell lung cancer (NSCLC) and synchronous brain metastases: A multicentre retrospective review. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30077-6] [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: 11/29/2022]
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Cook M, Smart NA, Van der Touw T. Predicting blood flow responses to rhythmic handgrip exercise from one second isometric contractions. Physiol Res 2016; 65:581-589. [PMID: 26988159 DOI: 10.33549/physiolres.933192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of this work was to predict blood flow responses to rhythmic handgrip exercise from one second isometric contractions. Seven healthy men were studied. Each subject performed a single 1 s handgrip contraction at 10 %, 20 % and 40 % of the maximum handgrip strength. We then repeatedly summed hyperaemic responses from single contractions to predict hyperaemic response to a prolonged bout of rhythmic exercise. There was similarity between steady state brachial blood flow velocity (BBV) extrapolated from single handgrip contractions and during 2 min of rhythmic exercise for 20 % (10.0+/-3.8 cm/s vs. 10.2+/-2.6 cm/s, r=0.93, p=0.003) and 40 % of maximum contractions (14.2+/-5.5 cm/s vs. 15.6+/-3.4 cm/s, r=0.88, p=0.009), but not for 10 % (7.5+/-4.1 cm/s vs. 5.7+/-3.3 cm/s, r=0.94, p=0.018). BBV progressively rose substantially higher during rhythmic contractions than peak BBV observed during single contractions at matched intensity. Respective peak BBV during single contractions and steady state BBV rhythmic contractions were 4.4+/-2.1 and 5.7+/-3.3 cm.s(-1) at 10 % forearm strength (p=0.14), 5.6+/-2.4 and 10.2+/-2.8 cm.s(-1) at 20 % (p=0.002), and 7.0+/-2.5 and 15.6+/-3.6 cm.s(-1) at 40 % (p=0.003). In conclusion, there is similarity between the summated blood flow velocity calculated from a single 1 s muscle contraction and the steady state blood flow velocity response of rhythmic exercise.
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Affiliation(s)
- M Cook
- School of Science and Technology, University of New England, Armidale, Australia.
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Grey D, Cook M, Hofmann P, Mwanga A, Akoko L, Mchembe M, Schecter W. An alliance of educators to support post graduate surgical training in
Tanzania. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Hew M, Gillman A, Sutherland M, Wark P, Bowden J, Guo M, Reddel HK, Jenkins C, Marks GB, Thien F, Rimmer J, Katsoulotos GP, Cook M, Yang I, Katelaris C, Bowler S, Langton D, Wright C, Bint M, Yozghatlian V, Burgess S, Sivakumaran P, Yan KY, Kritikos V, Peters M, Baraket M, Aminazad A, Robinson P, Jaffe A, Powell H, Upham JW, McDonald VM, Gibson PG. Real-life effectiveness of omalizumab in severe allergic asthma above the recommended dosing range criteria. Clin Exp Allergy 2016; 46:1407-1415. [PMID: 27377155 DOI: 10.1111/cea.12774] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 05/26/2016] [Accepted: 06/01/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30-1500 IU/mL) and bodyweight (30-150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry (AXR). OBJECTIVES To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants. METHODS Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight). RESULTS Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 (IQR 632, 1747) IU/mL vs. 209 (IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 (IQR 650, 750) mg] compared to within-range participants [450 (IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire (ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire (AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second (FEV1 ) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV1 . CONCLUSIONS AND CLINICAL RELEVANCE Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg.
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Affiliation(s)
- M Hew
- The Alfred Hospital & Monash University, Melbourne, Vic., Australia.
| | - A Gillman
- The Alfred Hospital & Monash University, Melbourne, Vic., Australia
| | | | - P Wark
- Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, New Lambton Heights, NSW, Australia
| | - J Bowden
- Flinders Medical Centre, Bedford Park, SA, Australia
| | - M Guo
- Woolcock Institute of Medical Research, Glebe, University of Sydney NSW, Australia
| | - H K Reddel
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - C Jenkins
- Concord Hospital, Concord, NSW, Australia
| | - G B Marks
- Liverpool Hospital, Liverpool, NSW, Australia
| | - F Thien
- Box Hill Hospital, Box Hill, Vic., Australia
| | - J Rimmer
- St Vincent's Clinic, Darlinghurst, NSW, Australia
| | | | - M Cook
- Canberra Hospital, Woden, ACT, Australia
| | - I Yang
- The Prince Charles Hospital, Chermside, Qld, Australia
| | - C Katelaris
- Campbelltown Hospital, Campbelltown, NSW, Australia
| | - S Bowler
- Mater Adult Hospital, South Brisbane, Qld, Australia
| | - D Langton
- Frankston Hospital, Frankston, Vic., Australia
| | - C Wright
- Nambour Hospital, Nambour, Qld, Australia
| | - M Bint
- Nambour Hospital, Nambour, Qld, Australia
| | | | - S Burgess
- QLD Children's Lung and Sleep Specialists, Woolloongabba, Qld, Australia
| | - P Sivakumaran
- Gold Coast District Hospital, Southport, Qld, Australia
| | - K Y Yan
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - V Kritikos
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - M Peters
- Concord Hospital, Concord, NSW, Australia
| | - M Baraket
- Liverpool Hospital, Liverpool, NSW, Australia
| | - A Aminazad
- St Vincent's Clinic, Darlinghurst, NSW, Australia
| | - P Robinson
- Children's Hospital at Westmead, Westmead, NSW, Australia
| | - A Jaffe
- School of Women's & Children's Health, UNSW Medicine, Randwick, NSW, Australia
| | - H Powell
- Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, New Lambton Heights, NSW, Australia
| | - J W Upham
- Princess Alexandra Hospital, Woolloongabba, Qld, Australia
| | - V M McDonald
- Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, New Lambton Heights, NSW, Australia
| | - P G Gibson
- Hunter Medical Research Institute, John Hunter Hospital, University of Newcastle, New Lambton Heights, NSW, Australia
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Viriós A, Pedersen M, Furney S, Girotti M, Hogan K, Saturno G, Galvani E, Sanchez-Laorden B, Ng C, Reis-Filho J, Lorigan P, Cook M, Marais R. Gene-specific interactions between ultraviolet radiation and melanoma. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Cue theory has had a resurgence in recent years as part of modular approaches to vision. Cues often seem to combine according to a weighted linear sum, although interactions may also occur. Conflict studies show that linear perspective and stereo combine to influence slant perception, with perspective weighted surprisingly heavily. We investigated the effect of conflicting linear perspective in reducing stereo slant when perspective is present as a purely cyclopean outline shape, compared with conditions when the shape is also monocularly present. In experiment 1, random line stereograms were generated with cyclopean trapezoids standing out from a background. Their outline convergence either conflicted with or supported a stereo gradient across the surface of the trapezoid. Two stereo slants and two standing disparities were used. In experiment 2, an aperture condition was included with the cyclopean trapezoids behind the surround. There was strong influence of trapezoid direction on perceived slant. This influence was only marginally increased by outlining the trapezoid. These findings demonstrate the effectiveness of cyclopean shape as perspective information. As expected, when the trapezoid was an area seen through an aperture, its direction did not significantly affect stereo slant. We conclude that stereo and perspective cannot be considered as separate modules. In binocular vision, perspective is conveyed stereoscopically.
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Bellou E, Verstappen S, Cook M, Sergeant J, Warren R, Barton A, Bowes J. AB0727 Increased Rates of Hypertension in Patients with Psoriatic Arthritis Compared To Psoriasis Alone: Results from The UK Biobank: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4058] [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: 11/03/2022]
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Lima PC, Taylor RS, Cook M. Involvement of contractile vacuoles in the osmoregulation process of the marine parasitic amoeba Neoparamoeba perurans. J Fish Dis 2016; 39:629-633. [PMID: 26332530 DOI: 10.1111/jfd.12408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 06/30/2015] [Accepted: 07/02/2015] [Indexed: 06/05/2023]
Affiliation(s)
- P C Lima
- CSIRO Agriculture Flagship, Integrated Sustainable Aquaculture Production Program, BIRC, Woorim, Qld, Australia
| | - R S Taylor
- CSIRO Agriculture Flagship, Integrated Sustainable Aquaculture Production Program, Battery Point, TAS, Australia
| | - M Cook
- CSIRO Agriculture Flagship, Integrated Sustainable Aquaculture Production Program, ESP, Dutton Park, Qld, Australia
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Benghiat H, Sanghera P, Cook M, Simmons R, Heyes G, Spooner D, Cruickshank G, Hartley A. PO08ACCOUNTING FOR THE DOSE-VOLUME PARADOX IN STEREOTACTIC RADIOSURGERY OF BRAIN METASTASES:VOLUME STANDARDISED LINEAR QUADRATIC AND LINEAR QUADRATIC CUBIC TUMOUR CONTROL PROBABILITY MODELS AS AUDIT TOOLS. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov284.07] [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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Oude Ophuis C, Verhoef C, Rutkowski P, Voit C, Cook M, Van Leeuwen P, Testori A, Hoekstra H, Grünhagen D, Eggermont A, Van Akkooi A. 2BA The interval between primary melanoma excision and sentinel node biopsy (SNB) does not affect survival; regardless of SNB status - an EORTC Melanoma Group study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31930-x] [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: 11/25/2022]
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Clayton A, Haynes F, Cook M. WS05.6 A pilot study of enhanced community support via internet videoconferencing and physiotherapist home visits. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30032-1] [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: 10/23/2022]
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Subramaniam K, Fallon K, Ruut T, Lane D, McKay R, Shadbolt B, Ang S, Cook M, Platten J, Pavli P, Taupin D. Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn's disease. Aliment Pharmacol Ther 2015; 41:419-28. [PMID: 25580985 DOI: 10.1111/apt.13058] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 09/21/2014] [Accepted: 11/30/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Muscle wasting or sarcopenia arising from chronic inflammation is found in 60% of patients with Crohn's disease. Transcriptional protein NF-κB reduces muscle formation through MyoD transcription and increases muscle breakdown by proteolysis. AIM As TNF is a potent activator of NF-κB, and anti-TNF agent infliximab (IFX) prevents NF-κB activation, to determine whether or not Crohn's patients treated with IFX gain muscle volume and strength. METHODS We performed a prospective, repeated-measures cohort study in adult Crohn's disease patients with an acute disease flare. Patients were instructed not to vary diet or activity. Concomitant medications were kept stable. At week 1 (pre-treatment), week 16 (post-IFX induction) and week 25 (post-first IFX maintenance dose), we assessed (i) MRI volume of quadriceps femoris at anatomical mid-thigh; (ii) maximal concentric quadriceps contractions strength at three specific speeds of contraction; (iii) physical activity by validated instrument (IPAQ); (iv) Three-day food record of intake and composition (food-weighing method); (v) Serum levels of IL6. RESULTS Nineteen patients (58% female; mean age 33.2 ± 10.7 years) were recruited. IFX increased muscle volume in both legs from baseline (right, 1505 cm(3) ) to week 25 (right, 1569 cm(3) ; P = 0.010). IFX also increased muscle strength in both legs from baseline (right 30°/s, 184.8 Nm) to week 25 (right 30°/s, 213.6 Nm; P = 0.002). Muscle volume gain correlated with male gender (P = 0.003). Significant gains in muscle volume and strength were unrelated to prednisolone use. Serum IL6 levels decreased by week 25 (P = 0.037). CONCLUSION The anti-TNF agent infliximab reverses inflammatory sarcopenia in patients with Crohn's disease.
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Affiliation(s)
- K Subramaniam
- Gastroenterology and Hepatology Unit, Canberra Hospital, Garran, ACT, Australia
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