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Dodge MC, Ye L, Duffy ER, Cole M, Gawel SH, Werler MM, Daghfal D, Andry C, Kataria Y. Kinetics of SARS-CoV-2 Serum Antibodies Through the Alpha, Delta, and Omicron Surges Among Vaccinated Health Care Workers at a Boston Hospital. Open Forum Infect Dis 2023; 10:ofad266. [PMID: 37396669 PMCID: PMC10314714 DOI: 10.1093/ofid/ofad266] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/15/2023] [Indexed: 07/04/2023] Open
Abstract
Background Longitudinal serology studies can assist in analyzing the kinetics of antibodies to SARS-CoV-2, helping to inform public health decision making. Our study aims to characterize circulating antibody trends over 18 months in vaccinated participants with and without evidence of COVID-19 infection. Methods A cohort of health care workers employed at Boston Medical Center was followed to collect serum samples and survey data over 6 time points from July 2020 through December 2021 (N = 527). History of SARS-CoV-2 infection, vaccination, and booster status were confirmed, where possible, through electronic medical records. Serum was assessed for the qualitative and semiquantitative detection of IgG antibody levels (anti-nucleoprotein [anti-N] and anti-spike [anti-S], respectively). Piecewise regression models were utilized to characterize antibody kinetics over time. Results Anti-S IgG titers remained above the positivity threshold following infection and/or vaccination throughout the 18-month follow-up. Among participants with no evidence of COVID-19 infection, titers declined significantly faster in the initial 90 days after full vaccination (β = -0.056) from December 2020 to March 2021 as compared with the decline observed following booster dose uptake (β = -0.023, P < 0.001). Additionally, COVID-19 infection prior to vaccination significantly attenuated the decline of anti-S IgG when compared with no infection following vaccine uptake (P < 0.001). Lastly, fewer participants contracted Omicron when boosted (12.7%) compared to fully vaccinated (17.6%). Regardless of vaccination status, participants who were Omicron positive had lower anti-S IgG titers than those who did not test positive, but this difference was not significant. Conclusions These findings provide novel 18-month kinetics of anti-S IgG antibodies and highlight the durability of hybrid immunity, underlining the strong humoral response stimulated by combined infection and vaccination.
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Affiliation(s)
- Maura C Dodge
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Lei Ye
- Department of Biostatistics, Abbott Core Diagnostics, Abbott Park, Illinois, USA
| | - Elizabeth R Duffy
- Department of Pathology and Laboratory Medicine, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Manisha Cole
- Department of Pathology and Laboratory Medicine, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Susan H Gawel
- Department of Biostatistics, Abbott Core Diagnostics, Abbott Park, Illinois, USA
| | - Martha M Werler
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - David Daghfal
- Department of Biostatistics, Abbott Core Diagnostics, Abbott Park, Illinois, USA
| | - Chris Andry
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts, USA
- Department of Pathology and Laboratory Medicine, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
| | - Yachana Kataria
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts, USA
- Department of Pathology and Laboratory Medicine, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
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Dodge MC, Cole M, Duffy ER, Werler MM, Kataria Y. Fifteen-Month Follow-Up of Anti-Spike Receptor-Binding Domain SARS-CoV-2 Antibodies among Healthcare Workers in Boston, MA. J Appl Lab Med 2022; 7:1430-1437. [DOI: 10.1093/jalm/jfac056] [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] [Received: 03/23/2022] [Accepted: 06/07/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Background
Boston Medical Center (BMC) is a safety net hospital in Boston, and from the initial wave of COVID-19 there has been an overwhelming concern about the exposure of healthcare workers (HCWs) to SARS-CoV-2.
Methods
We conceived a study to follow a cohort of BMC HCWs, beginning in July 2020 and continuing for 15 months, collecting survey data and serum samples at approximately 3-month intervals. Serum samples were analyzed using the Abbott Architect i2000 for SARS-CoV-2 antibodies (anti-spike1-Receptor Binding Domain IgG and anti-nucleoprotein IgG). Positive anti-n IgG results were used, in addition to reverse transcription-PCR results, for identifying cases of infection. History of COVID-19 and vaccination status were confirmed, where possible, using electronic medical records. Participants were grouped according to vaccination and infection status in September 2021 for analysis of anti-s IgG trends.
Results
A majority of HCWs remain well above the positivity threshold for anti-spike IgG antibodies for up to 11 months post-vaccination and 15 months post-infection, regardless of combinations and permutations of vaccination and infection. Those with COVID-19 infection before vaccination had significantly higher median serum antibody concentrations in comparison to HCWs with no prior infection at each follow-up time point.
Conclusions
These findings further support what is known regarding the decline in serum antibody concentrations following natural infection and vaccination, adding knowledge of serum antibody levels for up to 15 months post- infection and 11 months post-vaccination.
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Affiliation(s)
- Maura C Dodge
- Boston Medical Center , Boston, MA , USA
- Boston University School of Medicine , Boston, MA , USA
| | - Manisha Cole
- Boston Medical Center , Boston, MA , USA
- Boston University School of Medicine , Boston, MA , USA
| | - Elizabeth R Duffy
- Boston Medical Center , Boston, MA , USA
- Boston University School of Medicine , Boston, MA , USA
| | - Martha M Werler
- Boston University School of Medicine , Boston, MA , USA
- Boston University School of Public Health , Boston, MA , USA
| | - Yachana Kataria
- Boston Medical Center , Boston, MA , USA
- Boston University School of Medicine , Boston, MA , USA
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Rizvi S, McNeela N, Masood I, Akinlade O, Ajaja O, Cole M. 1068 QIP ASSESSING ROUTINE RECORDING OF OVERNIGHT VITAL SIGNS (OVS) AND OVERNIGHT MEDICATIONS ADMINISTRATIONS (OMARS) IN ELDERLY CARE. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Poor sleep is experienced by up to half of hospital inpatients1, associated with poor cognition, weak immunity, hypertension and increased mortality2. Recent studies recommend fewer sleep interruptions through targeted reductions in routine recording of overnight vital signs (OVS) and overnight medication administrations (OMARS) 3. The following standards were agreed at New Cross Hospital for audit (expected compliance 90%); 1. Routine OVS for stable patients shouldn’t be done overnight (2,200 pm to 0600 am). 2. Routine OMARS shouldn’t be undertaken overnight. These were derived after scrutinizing following; NICE CG1034 and QS635, NSF (Department of health)-4.256, RCP Acute care toolkit 37, CG508.
Method
Retrospective data recorded over 10 days in May and August 2021 from electronic records which included 61 elderly patients in 1st and 53 in 2nd audit cycle. Exclusion was Early Warning Score ≥ 3. We also ran night shift surveys to observe staff perceptions, completed online.
Results
OVS recording showed poor compliance of 0% and 3.77%. OMARS were done in less than half of patients but improved in subsequent audit cycle to about in 1/3rd of patients (77.35% compliance). No patient became unwell or required escalation of care. The estimated time spent on these interventions was 2.5 hours/week or 30 days in 1 calendar year. Almost all survey participants agreed to stop OVS while 66.6% of them agreed to stop OMARS in both cycles. 39.39% in 1st cycle believed that this strategy can cause harm and this misperception was reduced to 22.22% in subsequent cycle.
Conclusion
Our QIP advocates for rationalizing interventions and ensuring we only complete interventions where clinically relevant9. It showed improvement in reducing OMARS but success in stopping OVS couldn’t be fully translated in true spirits, possibly due to common misperceptions which will be further addressed in subsequent audit cycles.
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Affiliation(s)
- S Rizvi
- Dept of Acute Medicine; BHH-University Hospitals Birmingham NHS Foundation trust
| | - N McNeela
- Dept of Elderly Care; New Cross Hospital (Royal Wolverhampton NHS Trust)
| | - I Masood
- Dept of Elderly Care; New Cross Hospital (Royal Wolverhampton NHS Trust)
| | - O Akinlade
- Dept of Elderly Care; New Cross Hospital (Royal Wolverhampton NHS Trust)
| | - O Ajaja
- Dept of Elderly Care; New Cross Hospital (Royal Wolverhampton NHS Trust)
| | - M Cole
- Dept of Elderly Care; New Cross Hospital (Royal Wolverhampton NHS Trust)
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Cole M. Remembering Alexander Luria…. Cultural-Historical Psychology 2022. [DOI: 10.17759/chp.2022180306] [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] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Nguyen H, Weber S, Kataria Y, Cole M, Duffy E, Ragan E, Turcinovic J, Miller N, Hanage WP, Connor J, Pierre C, Jacobson K, Lodi S, Bouton T. 376. Sensitivity and Specificity of the WHO Probable SARS-CoV-2 Case Definition Among Symptomatic Healthcare Personnel. Open Forum Infect Dis 2021. [PMCID: PMC8690484 DOI: 10.1093/ofid/ofab466.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background SARS-CoV-2 continues to spread globally, including in limited resource settings. It is therefore important to derive general case definitions that can be useful and accurate in the absence of timely test results. We aim to validate the World Health Organization (WHO) case definition, a symptom-screening tool currently used to identify SARS-CoV-2 cases in a cohort of symptomatic health care providers (HCP) who completed a symptom survey interview and received a PCR test at Boston Medical Center (BMC) between March 13, 2020 and May 5, 2020. Methods We classified each HCP as a probable or not probable case of SARS-CoV-2 based on the WHO case definition. Using PCR test as gold standard, we computed the sensitivity and specificity of the WHO case definition. We used a stepwise logistic regression model on all PCR-tested HCP to identify symptoms predictive of PCR positivity. Results Of 328 included HCP, 109 (33.2%) were PCR positive, 213 (64.9%) negative, and 6 (1.8%) had indeterminate test result. The sensitivity and specificity of the WHO case definition were 65.1% and 74.6%, respectively. The positive predictive value was 56.8% and the negative predictive value was 80.7%. Symptoms found to be predictive of PCR positivity were fever, headache, loss of smell and/or loss of taste, and muscle ache/joint pain. Sore throat was found to be predictive of PCR negativity. The area under the curve using the final model was 0.8412. All statistically significant symptoms included in the final model, were also included in the WHO case definition. ![]()
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Conclusion In our largely symptomatic HCP cohort, our model yielded similar symptoms to those identified in the WHO probable case definition. As seen in similar studies, it is unlikely that further adjustment will improve the performance of a SARS-CoV-2 case definition. However, it is concerning that 35% (38/109) of PCR positive SARS-CoV-2 HCP would have been classified as not probable cases by the WHO definition, given that this definition does not even include asymptomatic cases. This is further evidence for global building of laboratory capacity and development of affordable diagnostics to improve global pandemic control. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Han Nguyen
- Boston University School of Public Health, Boston, Massachusetts
| | - Sarah Weber
- Boston Medical Center, Boston, Massachusetts
| | | | | | | | | | | | | | | | | | | | | | - Sara Lodi
- Boston University School of Public Health, Boston, Massachusetts
| | - Tara Bouton
- Boston Medical Center, Boston, Massachusetts
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Ragan EJ, McCallum C, Marathe J, Cole M, Hofman M, Henderson AJ, Flack T, Miller NS, Burks EJ, Zhao GQ, Denis R, Lin NH, Jacobson KR, Andry CD, Pelton SI, Duffy ER, Bhadelia N. Pandemic Response Requires Research Samples: A U.S. Safety-Net Hospital's Experience and Call for National Action. Ann Intern Med 2021; 174:1727-1732. [PMID: 34724402 DOI: 10.7326/m21-2857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Biorepositories provide a critical resource for gaining knowledge of emerging infectious diseases and offer a mechanism to rapidly respond to outbreaks; the emergence of the novel coronavirus, SARS-CoV-2, has proved their importance. During the COVID-19 pandemic, the absence of centralized, national biorepository efforts meant that the onus fell on individual institutions to establish sample repositories. As a safety-net hospital, Boston Medical Center (BMC) recognized the importance of creating a COVID-19 biorepository to both support critical science at BMC and ensure representation in research for its urban patient population, most of whom are from underserved communities. This article offers a realistic overview of the authors' experience in establishing this biorepository at the onset of the COVID-19 pandemic during the height of the first surge of cases in Boston, Massachusetts, with the hope that the challenges and solutions described are useful to other institutions. Going forward, funders, policymakers, and infectious disease and public health communities must support biorepository implementation as an essential element of future pandemic preparedness.
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Affiliation(s)
- Elizabeth J Ragan
- Section of Infectious Diseases and Research Operations, Boston Medical Center, Boston, Massachusetts (E.J.R.)
| | - Caitryn McCallum
- Section of Infectious Diseases, Boston Medical Center, and Center for Emerging Infectious Diseases Policy and Research, Boston University, Boston, Massachusetts (C.M.)
| | - Jai Marathe
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (J.M., N.H.L., K.R.J.)
| | - Manisha Cole
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Melissa Hofman
- Clinical Data Warehouse, Boston Medical Center, Boston, Massachusetts (M.H.)
| | - Andrew J Henderson
- Section of Infectious Diseases, Boston Medical Center, and Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts (A.J.H.)
| | - Tyler Flack
- Research Operations, Boston Medical Center, Boston, Massachusetts (T.F.)
| | - Nancy S Miller
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Eric J Burks
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Grace Qing Zhao
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Ridiane Denis
- General Clinical Research Unit, Boston University, Boston, Massachusetts (R.D.)
| | - Nina H Lin
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (J.M., N.H.L., K.R.J.)
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (J.M., N.H.L., K.R.J.)
| | - Christopher D Andry
- Department of Pathology and Laboratory Medicine, Boston Medical Center, and Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts (C.D.A., E.R.D.)
| | - Stephen I Pelton
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Boston University Medical Center, Department of Epidemiology, Boston University School of Public Health, and Maxwell Finland Laboratory for Infectious Diseases, Boston, Massachusetts (S.I.P.)
| | - Elizabeth R Duffy
- Department of Pathology and Laboratory Medicine, Boston Medical Center, and Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts (C.D.A., E.R.D.)
| | - Nahid Bhadelia
- Section of Infectious Diseases, Boston Medical Center, and Center for Emerging Infectious Diseases Policy and Research and National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts (N.B.)
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Cole M, Yap C, Buckley C, Ng WF, McInnes I, Filer A, Siebert S, Pratt A, Isaacs JD, Stocken DD. TRAFIC: statistical design and analysis plan for a pragmatic early phase 1/2 Bayesian adaptive dose escalation trial in rheumatoid arthritis. Trials 2021; 22:433. [PMID: 34229728 PMCID: PMC8259060 DOI: 10.1186/s13063-021-05384-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/17/2021] [Indexed: 11/19/2022] Open
Abstract
Background Adaptive model-based dose-finding designs have demonstrated advantages over traditional rule-based designs but have increased statistical complexity but uptake has been slow especially outside of cancer trials. TRAFIC is a multi-centre, early phase trial in rheumatoid arthritis incorporating a model-based design. Methods A Bayesian adaptive dose-finding phase I trial rolling into a single-arm, single-stage phase II trial. Model parameters for phase I were chosen via Monte Carlo simulation evaluating objective performance measures under clinically relevant scenarios and incorporated stopping rules for early termination. Potential designs were further calibrated utilising dose transition pathways. Discussion TRAFIC is an MRC-funded trial of a re-purposed treatment demonstrating that it is possible to design, fund and implement a model-based phase I trial in a non-cancer population within conventional research funding tracks and regulatory constraints. The phase I design allows borrowing of information from previous trials, all accumulated data to be utilised in decision-making, verification of operating characteristics through simulation, improved understanding for management and oversight teams through dose transition pathways. The rolling phase II design brings efficiencies in trial conduct including site and monitoring activities and cost. TRAFIC is the first funded model-based dose-finding trial in inflammatory disease demonstrating that small phase I/II trials can have an underlying statistical basis for decision-making and interpretation. Trial registration Trials Registration: ISRCTN, ISRCTN36667085. Registered on September 26, 2014.
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Affiliation(s)
- M Cole
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - C Yap
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, Sutton, UK
| | - C Buckley
- School of Immunity and Infection, University of Birmingham, Birmingham, UK
| | - W F Ng
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - I McInnes
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - A Filer
- School of Immunity and Infection, University of Birmingham, Birmingham, UK
| | - S Siebert
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - A Pratt
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - J D Isaacs
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - D D Stocken
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
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Stanescu T, Mousavi SH, Cole M, Barberi E, Wachowicz K. Quantification of magnetic susceptibility fingerprint of a 3D linearity medical device. Phys Med 2021; 87:39-48. [PMID: 34116316 DOI: 10.1016/j.ejmp.2021.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The study investigates the numerical modelling as well as experimental validation of magnetic susceptibility effects with respect to a 3D linearity phantom used for the quantification of MR image distortions. METHODS Magnetic field numerical simulations based on finite difference methods were conducted to generate the susceptibility (χ) model of the MRID3D phantom. Experimental data was acquired and analyzed for eight different MR scanners to include a wide range of scanning parameters. Distortion vector fields were generated by applying a harmonic analysis based on finite elements methods. Phantom scans for the same setup but with opposite polarities of the frequency encoding gradient were processed in conjunction with the susceptibility modelling to separately quantify three field components due to gradient non-linearities (GNL), B0 inhomogeneities and χ perturbations. RESULTS The numerical modelling showed a significant range of χ value of up to 8.23 ppm, with a mean value of 2.9 ppm. The χ perturbations were found to be mostly present at the end plates of the cylindrical phantom design. The simulations also showed that setup rotations of up to 10° introduced only negligible variations in the χ model of less than 0.1 ppm. This allows for a straightforward practical implementation of the modelling as a single lookup table. After correcting for the χ perturbations, the B0 inhomogeneities were derived and found to be in good agreement with either the MR system manufacturer specifications or experimental data available in the literature. CONCLUSIONS It is possible to accurately model the magnetic susceptibility signature of a 3D linearity device and remove it as a post-processing correction step. This is important as the procedure unlocks the ability of determining both the GNL field and B0 map of the scanner without the need of extra acquisitions or phantoms.
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Affiliation(s)
- T Stanescu
- Princess Margaret Cancer Centre, University Health Network, Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada.
| | - S H Mousavi
- Princess Margaret Cancer Centre, University Health Network, Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada
| | - M Cole
- Modus QA, London, Ontario N6H 5L6, Canada
| | - E Barberi
- Modus QA, London, Ontario N6H 5L6, Canada
| | - K Wachowicz
- Cross Cancer Institute, Alberta Health Services, Department of Radiation Oncology, University of Alberta, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada
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Kataria Y, Cole M, Duffy E, de la Cena K, Schechter-Perkins EM, Bouton TC, Werler MM, Pierre C, Ragan EJ, Weber SE, Jacobson KR, Andry C. Seroprevalence of SARS-CoV-2 IgG antibodies and risk factors in health care workers at an academic medical center in Boston, Massachusetts. Sci Rep 2021; 11:9694. [PMID: 33958668 PMCID: PMC8102593 DOI: 10.1038/s41598-021-89107-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/20/2021] [Indexed: 12/24/2022] Open
Abstract
Healthcare workers (HCWs) are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that causes Coronavirus Disease (COVID-19). We aim to assess the seroprevalence of SARS-CoV-2 IgG among healthcare workers and compare risk-factors between seropositive and seronegative HCWs. In this observational study, serum samples were collected from HCWs between July 13th to 26th, 2020 at Boston Medical Center (BMC). Samples were subsequently tested for SARS-CoV-2 IgG antibody using the Abbott SARS-CoV-2 IgG assay. Participants also answered a questionnaire capturing data on demographics, history of COVID-19 symptoms, occupation, infection prevention and control measures. Overall, 95 of 1743 (5.5%) participants tested positive for SARS-CoV-2 IgG. Of these, 1.8% of the participants had mild or no COVID-19 symptoms and did not require a diagnostic test. Seropositivity was not associated with gender, occupation, hand hygiene and personal protective equipment (PPE) practices amongst HCWs. However, lack of physical distancing among health care workers in work areas and break room was associated with seropositivity (p = 0.05, p = 0.003, respectively). The majority of the HCWs are negative for SARS-CoV-2 IgG. This data highlights the need to promote infection prevention measures, and the importance of distance amongst co-workers to help mitigate infection rates.
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Affiliation(s)
- Yachana Kataria
- Clinical Chemistry, Department of Pathology and Lab Medicine, Boston Medical Center, 670 Albany St., Boston, MA, 02118, USA. .,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Manisha Cole
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth Duffy
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Kyle de la Cena
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Elissa M Schechter-Perkins
- Department of Emergency Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA
| | - Tara C Bouton
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Cassandra Pierre
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Elizabeth J Ragan
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Sarah E Weber
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Chris Andry
- Clinical Chemistry, Department of Pathology and Lab Medicine, Boston Medical Center, 670 Albany St., Boston, MA, 02118, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
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Van Maldegem F, Mugarza E, Molina-Arcas M, Valand K, Rana S, Cole M, Romero-Clavijo P, Boumelha J, Moore C, Downward J. Targeting oncogenic signalling pathways to modulate the lung cancer immune microenvironment. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31238-7] [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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Cole M. The Five‐Year Effect of Medicaid Expansion on Community Health Centers: Coverage, Quality of Care, and Service Volume. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13378] [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] Open
Affiliation(s)
- M. Cole
- School of Public Health Boston University Boston MA United States
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Nguyen K, Trivedi A, Cole M. Association between Receipt of Assistance Accessing Social Programs and Experience of Care for Health Center Patients. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13527] [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] Open
Affiliation(s)
- K. Nguyen
- Brown University School of Public Health Providence RI United States
| | - A. Trivedi
- Brown University School of Public Health Providence RI United States
| | - M. Cole
- Boston University School of Public Health Boston MA United States
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Pratt A, Siebert S, Cole M, Stocken D, Kelly S, Shaikh M, Cranston A, Morton M, Walker J, Frame S, Ng WF, Buckley C, Mcinnes I, Filer A, Isaacs JD. AB0356 TARGETING THE RHEUMATOID ARTHRITIS SYNOVIAL FIBROBLAST VIA CYCLIN DEPENDENT KINASE INHIBITION (TRAFIC): A PHASE 1B STUDY TO DETERMINE THE MAXIMUM TOLERATED DOSE OF SELICICLIB FOR REPURPOSING IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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
Background:Current rheumatoid arthritis (RA) therapeutics target immune inflammation and are subject to ceiling effects, with non-response observed in a third of recipients together with low remission rates. Synovial fibroblasts (SFs) are stromal cells not yet targeted in RA, whose hyperplastic and proliferative properties drive inflammation and tissue destruction. Seliciclib (R-roscovitine) is an orally available cyclin-dependent kinase (CDK) inhibitor that suppresses SF proliferation and ameliorates inflammatory arthritis in rodents.Objectives:To determine the maximum tolerated dose (MTD) of seliciclib in patients with active RA despite anti-TNF, with or without background conventional disease modifying anti-rheumatic drugs (cDMARDs). Safety and pharmacokinetics (PK) were also evaluated.Methods:A restricted, one-stage Bayesian continual reassessment method (CRM) determined MTD based on a target dose-limiting toxicity (DLT) probability of 35%. RA patients (DAS28 ≥3.2) were recruited sequentially to cohorts of 3 subjects each. Cohort 1 received 400mg seliciclib daily for 4 consecutive days each week for 4 weeks, added to existing therapy. Each subsequent cohort received a dose determined by the toxicity-based CRM algorithm, calculated upon conclusion of the previous cohort. Safety was assessed through adverse event (AE) monitoring. Associations with relevant PK parameters were sought.Results:15 anti-TNF recipients were enrolled, 10 of whom were also taking cDMARDs (median DAS28 4.9). Application of the CRM algorithm prompted one dose increment during the study (to 600mg for cohort 2), but reversion to 400mg for subsequent cohorts (Figure 1A). After treatment of 5 cohorts, 400mg was determined the MTD, with a DLT probability of 0.35 (CI 0.18-0.52; Figure 1B). 6 patients experienced DLTs, of which two were classified as serious AEs (SAEs) in keeping with the safety profile of seliciclib; these are summarised in Table 1. Of 43/65 total AEs reported at any dose that didnotcontribute to a DLT, 26 were possibly, probably or definitely related to seliciclib; 19 of these 26 were mild, 7 moderate and none severe. The most frequent AE was mild nausea. No relationship of safety and/or tolerability with concomitant cDMARD use or PK was seen.Table 1.Characteristics of patients who developed HZ at initiation of baricitinibDLTSeliciclib dose (mg)Doses receivedContributing AEsContributing SAEsDescriptionOutcomeA1400830Constipation, N+V, liver injury; fatigue.Resolved2600430Constipation, N+V.Resolved3600101BFever, N+V, renal injury.Resolved4400831BConstipation, N+V, jaundice, liver injury.Resolved5400840Fever, dizziness, liver injury.Resolved6400890Dizziness, N+V, liver injury, bilirubin rise.Persistent AST riseConclusion:The MTD of seliciclib has been defined for RA. No unexpected safety concerns were identified to preclude ongoing evaluation in patients, which focuses on clinical, radiological and biological indicators of efficacy.Disclosure of Interests:Arthur Pratt Grant/research support from: Pfizer, GlaxoSmithKlein, Stefan Siebert Grant/research support from: BMS, Boehringer Ingelheim, Celgene, GlaxoSmithKline, Janssen, Novartis, Pfizer, UCB, Consultant of: AbbVie, Boehringer Ingelheim, Janssen, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, Celgene, Janssen, Novartis, Michael Cole: None declared, Deborah Stocken: None declared, Stephen Kelly: None declared, Muddassir Shaikh: None declared, Amy Cranston: None declared, Miranda Morton: None declared, Jennifer Walker: None declared, Sheelagh Frame Employee of: Cyclacel Ltd., Wan-fai Ng: None declared, Chris Buckley Consultant of: Janssen, Pfizer, GSK, Galapagos, Gillead, Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Andrew Filer: None declared, John D Isaacs Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck, Pfizer, Roche
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Wakerley B, Warner R, Cole M, Stone K, Foy C, Sittampalam M. Cerebrospinal fluid opening pressure: The effect of body mass index and body composition. Clin Neurol Neurosurg 2020; 188:105597. [DOI: 10.1016/j.clineuro.2019.105597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
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Cole M, Fisher G, Voorhees J. 437 Development and characterization of biomimetic dermal matrices to study the impact of aging on human fibroblast function. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cole M, Bandeen-Roche K, Hirsch AG, Kuiper JR, Sundaresan AS, Tan BK, Schleimer RP, Kern RC, Schwartz BS. Longitudinal evaluation of clustering of chronic sinonasal and related symptoms using exploratory factor analysis. Allergy 2018; 73:1715-1723. [PMID: 29729111 DOI: 10.1111/all.13470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Sinonasal symptoms are common and can have several underlying causes. When symptoms occur in specified patterns lasting 3 months or more they meet criteria for chronic rhinosinusitis (CRS). Approaches to CRS symptom measurement do not specify how to measure symptoms and treat specified sinonasal symptoms as generally interchangeable, suggesting that such symptoms should cluster on 1 or 2 latent factors. METHODS We used questionnaire responses to 37 questions on the presence, severity, bother, and frequency of cardinal sinonasal and related symptoms lasting 3 months, from 3535 subjects at 3 time points over 16 months. We completed 5 exploratory factor analyses (EFA) to identify symptom clustering, 1 for each time point and 2 for the differences between adjacent questionnaires. The baseline EFA was used to provide factor scores that were described longitudinally and examined by CRS status. RESULTS Five EFAs identified the same 5 factors (blockage and discharge, pain and pressure, asthma and cold/flu symptoms, smell loss, and ear and eye [mainly allergy] symptoms), with clustering determined by symptom frequency, severity, and degree of bother. Responses to individual questions showed changes over time but when combined into factor scores showed less longitudinal change. All symptom factor scores were progressively higher from never to past to current CRS status. CONCLUSIONS Although the current approaches to symptom characterization in CRS imply a single underlying latent construct, our results suggest that there are at least 3 latent constructs relevant to CRS. Further studies are needed to evaluate whether these clusters have identifiable underlying pathobiologies.
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Affiliation(s)
- M. Cole
- Department of Biostatistics; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
| | - K. Bandeen-Roche
- Department of Biostatistics; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
| | - A. G. Hirsch
- Department of Epidemiology and Health Services Research; Geisinger Health System; Danville PA USA
| | - J. R. Kuiper
- Department of Environmental Health and Engineering; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
| | - A. S. Sundaresan
- Department of Epidemiology and Health Services Research; Geisinger Health System; Danville PA USA
| | - B. K. Tan
- Department of Otolaryngology Head and Neck Surgery and the Division of Allergy and Immunology; Department of Medicine; Northwestern University Feinberg School of Medicine; Chicago IL USA
| | - R. P. Schleimer
- Department of Otolaryngology Head and Neck Surgery and the Division of Allergy and Immunology; Department of Medicine; Northwestern University Feinberg School of Medicine; Chicago IL USA
| | - R. C. Kern
- Department of Otolaryngology Head and Neck Surgery and the Division of Allergy and Immunology; Department of Medicine; Northwestern University Feinberg School of Medicine; Chicago IL USA
| | - B. S. Schwartz
- Department of Epidemiology and Health Services Research; Geisinger Health System; Danville PA USA
- Department of Environmental Health and Engineering; Johns Hopkins University Bloomberg School of Public Health; Baltimore MD USA
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Sarment L, De Angelus C, Accolla R, Cole M, Brabender J, Bird J, Muelenaer A, Muelenaer P. Novel Device for Rapid Acquisition of Heart Rates in Neonatal Patients
for future use in Malawi. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.307] [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: 10/19/2022] Open
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Affiliation(s)
- W. H. Bowen
- Department of Dental Science, Royal College of Surgeons of England, London, England
| | - B. Cohen
- Department of Dental Science, Royal College of Surgeons of England, London, England
| | - M. Cole
- Department of Dental Science, Royal College of Surgeons of England, London, England
| | - G. Colman
- Department of Dental Science, Royal College of Surgeons of England, London, England
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Lisankie M, Saint-hilaire R, Wein D, Wilson J, Cole M. 227 Split-flow Emergency Department Layout Improves Operational Flow and Decreases Process Variation. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.241] [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: 11/28/2022]
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Abstract
he importance of high-quality research to address our knowledge deficits in relation to the causes of hospital-acquired infection has been acknowledged by the Department of Health. However, the contribution of nursing research may be restricted by confusion over the use of different paradigms and the discipline's lack of research pedigree. This paper discusses how nursing and infection control has historically favoured quantitative methods as they are associated with rigour, objectivity, generalisation and increased credibility. However, increasingly nurse researchers are turning to qualitative methods as they better explain the complex behavioural issues that affect practice. The paper describes a number of qualitative methods and infection control studies that have adopted these approaches. It concludes by suggesting that infection control nurses, because of their close relationship with practice are well placed to consider the merits of qualitative research as a way of contributing towards the discipline's research agenda.
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Affiliation(s)
- M. Cole
- University of Nottingham, School of Nursing, Grantham and District Hospital, 101 Manthorpe Road, Grantham, Lincolnshire NG31 8DG
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Abstract
odern health care requires a workforce that is capable of exploring complex issues, articulate,M and has the capacity to develop problem-solving strategies based on reflective decision-making. The importance of education in the prevention of health care-associated infection is well documented, however measuring the effectiveness of infection control educational programmes has been problematic with insufficient programmes and unsatisfactory levels of compliance being reported. Nursing has traditionally favoured didactic approaches to teaching that suffer from theory overload and treat learners as empty vessels waiting to be filled with knowledge. Infection control nurses should consider innovative student-centred approaches such as problem-based learning (PBL) that recognises learners as cognitive beings, with a frame of reference constructed from a lifetime of experience. In PBL a problem or trigger is encountered in the learning process and serves as a focus for the application of problem-solving or reasoning skills. Clinically relevant material can translate problem solving into the learner's experiential language, enhance intrinsic motivation and assist them to become more adaptable and self-directed. As content experts, ICNs are well positioned to produce material grounded in reality, which will stimulate the students and guide them towards their learning outcomes. An example of a problem-based case study is included.
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Affiliation(s)
- M. Cole
- University of Nottingham, Grantham and District Hospital School of Nursing, 101 Manthorpe Road, Grantham, Lincolnshire NG31 8DG
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Sathananthan C, Cole M, Chapman M, Down J, Brookes J. Abstract OR003. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000493019.85051.19] [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: 11/05/2022]
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Cole M, Gunther C, Sadigh M. Coordinating community healthcare needs to local services in Paraiso,
Dominican Republic through strategic assessment strategies. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lespérance S, Demaio P, Cole M, Doherty S, Hansen M. Obstetrical care closer to home: team-based high risk care in Canada's Arctic. Rural Remote Health 2016. [DOI: 10.22605/rrh4107] [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: 11/03/2022] Open
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Foster K, Cole M, Hotonu O, Stonebridge J, Hughes G, Simms I, Ison C, Waldram A. How to do it: lessons identified from investigating and trying to control an outbreak of gonorrhoea in young heterosexual adults. Sex Transm Infect 2016; 92:396-401. [PMID: 26936653 DOI: 10.1136/sextrans-2015-052303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 02/10/2016] [Indexed: 11/04/2022] Open
Affiliation(s)
- K Foster
- Health Protection Team, Public Health England North East
| | - M Cole
- Sexually Transmitted Bacteria Reference Unit, Public Health England Centre for Infectious Disease Surveillance and Control, London, UK
| | - O Hotonu
- Northumberland Sexual Health Service, Northumbria NHS Foundation Trust, Morpeth, UK
| | - J Stonebridge
- Health Protection Team, Public Health England North East
| | - G Hughes
- HIV and STI Department, Public Health England Centre for Infectious Disease Surveillance and Control, London, UK
| | - I Simms
- HIV and STI Department, Public Health England Centre for Infectious Disease Surveillance and Control, London, UK
| | - C Ison
- Sexually Transmitted Bacteria Reference Unit, Public Health England Centre for Infectious Disease Surveillance and Control, London, UK
| | - A Waldram
- Field Epidemiology Service Newcastle, Public Health England, Newcastle upon Tyne, UK
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Johnson CE, Johnson JA, Hah HY, Cole M, Gray S, Kolesnichenko V, Kucheryavy P, Goloverda G. Mössbauer studies of stoichiometry of Fe3O4: characterization of nanoparticles for biomedical applications. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s10751-016-1277-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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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Abstract
There is no “gold-standard” material for the operative management of root caries. The aim of this study was to determine if the clinical performance of Biodentine would be acceptable for the restoration of root caries in older adults. A randomized controlled clinical trial was conducted comparing a calcium silicate cement (Biodentine), a high-viscosity glass ionomer cement (Fuji IX GP Extra), and a resin-modified glass ionomer cement (Fuji II LC). Of the 334 volunteers assessed for eligibility, 249 were excluded. A total of 303 lesions in 85 participants were randomized, with 151 lesions allocated to receive Biodentine, 77 to Fuji IX GP Extra, and 77 to Fuji II LC. Patients were reviewed by a calibrated dentist who was not involved in restoration placement and who was blinded to material allocation. Restorations were assessed according to a modified US Public Health Service criteria. The cumulative survival percentages after 6 mo and 1 y were 58.6% and 47.2% in the Biodentine group, 89.6% and 83.8% in the Fuji IX GP Extra group, and 89.5% and 84.9% in the Fuji II LC group, respectively. There were statistically significant differences ( χ2 test, P < 0.001) in restoration failure rates between restoration groups. There was no difference between Fuji IX GP Extra and Fuji II LC, but differences ( P < 0.001) were shown between the Fuji II GP Extra group and the Biodentine group and also between the Fuji II LC group and the Biodentine group at both time points. Based on the results of this study, Biodentine cannot be recommended for the operative management of root caries. Fuji IX GP Extra and Fuji II LC displayed similar success rates, and high-viscosity glass ionomer cement and resin-modified glass ionomer cement continue to be the best available option for the restoration of root caries ( ClinicalTrials.gov NCT01866059). Knowledge Transfer Statement: The results of this study can assist dental practitioners when selecting a restorative material for the operative management of root caries. This randomized controlled trial compared the 1-y clinical performance of a calcium silicate–based material to that of a high-viscosity glass ionomer cement and a resin-modified glass ionomer cement in the operative management of root caries. The study concluded that high-viscosity glass ionomer cement and resin-modified glass ionomer cement continue to be the best available option to dental practitioners when restoring the root surface.
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Affiliation(s)
- M. Hayes
- Restorative Dentistry, University College Cork, Cork, Ireland
| | - C. da Mata
- Restorative Dentistry, University College Cork, Cork, Ireland
| | - S. Tada
- Prosthodontics Department, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - M. Cole
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - G. McKenna
- Restorative Dentistry, Queen’s University Belfast, Belfast, Ireland
| | - F.M. Burke
- Restorative Dentistry, University College Cork, Cork, Ireland
| | - P.F. Allen
- Restorative Dentistry, University College Cork, Cork, Ireland
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Unemo M, Ringlander J, Wiggins C, Fredlund H, Jacobsson S, Cole M, Balla E, Barbara C, Borrego MJ, Brilene T, Chisholm S, Crucitti T, Dam AV, Hoffmann S, Jeverica S, Kohl P, Maikanti P, Mlynarczyk-Bonikowska B, Pakarna G, Pavlik P, Stary A, Stefanelli P, Svanborg G, Syversen G, Tzelepi E, Vazquez J. 006.2 High in vitro susceptibility to the novel spiropyrimidinetrione azd0914 among 873 contemporary clinical neisseria gonorrhoeae isolates in 21 european countries during 2012–2014. Sex Transm Infect 2015. [DOI: 10.1136/sextrans-2015-052270.110] [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: 11/03/2022] Open
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Pond MJ, Hall C, Cole M, Laing KG, Miari V, Jagatia H, Harding-Esch E, Monahan I, Planche T, Hinds J, Ison C, Chisholm S, Butcher PD, Sadiq ST. 005.2 Diagnostic and clinical implications of genotypic fluoroquinolone susceptibility detection for neisseria gonorrhoeae. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.104] [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: 11/03/2022]
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Olsson SB, Challiss RAJ, Cole M, Gardeniers JGE, Gardner JW, Guerrero A, Hansson BS, Pearce TC. Biosynthetic infochemical communication. Bioinspir Biomim 2015; 10:043001. [PMID: 26158233 DOI: 10.1088/1748-3190/10/4/043001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There is an ever-increasing demand for data to be embedded in our environment at ever-decreasing temporal and spatial scales. Whilst current communication and storage technologies generally exploit the electromagnetic properties of media, chemistry offers us a new alternative for nanoscale signaling using molecules as messengers with high information content. Biological systems effectively overcome the challenges of chemical communication using highly specific biosynthetic pathways for signal generation together with specialized protein receptors and nervous systems. Here we consider a new approach for information transmission based upon nature's quintessential example of infochemical communication, the moth pheromone system. To approach the sensitivity, specificity and versatility of infochemical communication seen in nature, we describe an array of biologically-inspired technologies for the production, transmission, detection, and processing of molecular signals. We show how it is possible to implement each step of the moth pheromone pathway for biosynthesis, transmission, receptor protein binding/transduction, and antennal lobe processing of monomolecular and multimolecular signals. For each implemented step, we discuss the value, current limitations, and challenges for the future development and integration of infochemical communication technologies. Together, these building blocks provide a starting point for future technologies that can utilize programmable emission and detection of multimolecular information for a new and robust means of communicating chemical information.
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Affiliation(s)
- S B Olsson
- Department of Evolutionary Neuroethology, Max Planck Institute for Chemical Ecology, Jena, Germany
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Fryer S, Stoner L, Lucero A, Witter T, Scarrott C, Dickson T, Cole M, Draper N. Haemodynamic Kinetics and Intermittent Finger Flexor Performance in Rock Climbers. Int J Sports Med 2015; 36:e3. [PMID: 25360584 DOI: 10.1055/s-0034-1395514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- S Fryer
- School of Sport and Exercise, University of Gloucestershire, Gloucestershire, UK
| | - L Stoner
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - A Lucero
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - T Witter
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - C Scarrott
- Department of Maths and Statistics, University of Canterbury, Christchurch, New Zealand
| | - T Dickson
- School of Sport and Physical Education, University of Canterbury, Christchurch, New Zealand
| | - M Cole
- School of Sport and Exercise, University of Gloucestershire, Gloucestershire, UK
| | - N Draper
- School of Sport Performance and Outdoor Leadership, University of Derby, Buxton, United Kingdom
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Fryer S, Stoner L, Lucero A, Witter T, Scarrott C, Dickson T, Cole M, Draper N. Haemodynamic kinetics and intermittent finger flexor performance in rock climbers. Int J Sports Med 2014; 36:137-42. [PMID: 25251449 DOI: 10.1055/s-0034-1385887] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Currently it is unclear whether blood flow (BF) or muscle oxidative capacity best governs performance during intermittent contractions to failure. The aim of this study was to determine oxygenation kinetics and BF responses during intermittent (10 s contraction: 3 s release) contractions at 40% of MVC in rock climbers of different ability (N=38). Total forearm BF, as well as de-oxygenation and re-oxygenation of the flexor digitorum profundus (FDP) and the flexor carpi radialis (FCR) were assessed. Compared to the control, intermediate and advanced groups, the elite climbers had a significantly (p<0.05) greater force time integral (FTI), MVC and MVC/kg. Furthermore, the elite climbers de-oxygenated the FDP significantly more during the first (7.8, 11.9, 12.4 vs. 15.7 O2%) and middle (7.3, 8.8, 10.4 vs.15.3 O2%) phases of contractions as well as for the FCR during the first phase only (8.3, 7, 11.7 vs. 13.3 O2%). They also had a significantly higher BF upon release of the contractions (656, 701, 764 vs. 971 mL ∙ min(-1)). The higher FTI seen in elite climbers may be attributable to a greater blood delivery, and an enhanced O2 recovery during the 3 s release periods, as well as a superior muscle oxidative capacity associated with the greater de-oxygenation during the 10 s contractions.
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Affiliation(s)
- S Fryer
- School of Sport and Exercise, University of Gloucestershire, Gloucestershire, UK
| | - L Stoner
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - A Lucero
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - T Witter
- School of Sport and Exercise, Massey University, Wellington, New Zealand
| | - C Scarrott
- Department of Maths and Statistics, University of Canterbury, Christchurch, New Zealand
| | - T Dickson
- School of Sport and Physical Education, University of Canterbury, Christchurch, New Zealand
| | - M Cole
- School of Sport and Exercise, University of Gloucestershire, Gloucestershire, UK
| | - N Draper
- School of Sport Performance and Outdoor Leadership, University of Derby, Buxton, United Kingdom
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McInnes CJ, Coulter L, Dagleish MP, Fiegna C, Gilray J, Willoughby K, Cole M, Milne E, Meredith A, Everest DJ, MacMaster A. First cases of squirrelpox in red squirrels ( Sciurus vulgaris) in Scotland. Vet rec case rep 2013. [DOI: 10.1136/vetreccr.164.17.528rep] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- C. J. McInnes
- Moredun Research InstitutePentlands Science Park, Bush LoanEdinburghEH26 0PZ
| | - L. Coulter
- Moredun Research InstitutePentlands Science Park, Bush LoanEdinburghEH26 0PZ
| | - M. P. Dagleish
- Moredun Research InstitutePentlands Science Park, Bush LoanEdinburghEH26 0PZ
| | - C. Fiegna
- Moredun Research InstitutePentlands Science Park, Bush LoanEdinburghEH26 0PZ
| | - J. Gilray
- Moredun Research InstitutePentlands Science Park, Bush LoanEdinburghEH26 0PZ
| | - K. Willoughby
- Moredun Research InstitutePentlands Science Park, Bush LoanEdinburghEH26 0PZ
| | - M. Cole
- Scottish Natural HeritageSilvan House, 231 Corstorphine RoadEdinburghEH12 7AT
| | - E. Milne
- Royal (Dick) School of Veterinary StudiesUniversity of EdinburghEaster Bush Veterinary CentreRoslinMidlothianEH25 9RG
| | - A. Meredith
- Royal (Dick) School of Veterinary StudiesUniversity of EdinburghEaster Bush Veterinary CentreRoslinMidlothianEH25 9RG
| | - D. J. Everest
- Veterinary Laboratories Agency — WeybridgeNew HawAddlestoneSurreyKT15 3NB
| | - A‐M. MacMaster
- Red Squirrels in South ScotlandCarlow HouseLocharbriggsDumfriesDG1 1QS
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Cole M, Coleman D, Hopker J, Wiles J. Improved gross efficiency during long duration submaximal cycling following a short-term high carbohydrate diet. Int J Sports Med 2013; 35:265-9. [PMID: 24022570 DOI: 10.1055/s-0033-1348254] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To assess the effect of dietary manipulation on gross efficiency (GE), 15 trained male cyclists completed 3×2 h tests at submaximal exercise intensity (60% Maximal Minute Power). Using a randomized, crossover design participants consumed an isoenergetic diet (~4 000 kcal.day-1) in the 3 days preceding each test, that was either high in carbohydrate (HighCHO, [70% of the total energy derived from carbohydrate, 20% fat, 10% protein]), low in carbohydrate (LowCHO, [70% fat, 20% carbohydrate, 10% protein]) or contained a moderate amount of carbohydrate (ModCHO, [45% carbohydrate, 45% fat, 10% protein]). GE along with blood lactate and glucose were assessed every 30 min, and heart rate was measured at 5 s intervals throughout. Mean GE was significantly greater following the HighCHO than the ModCHO diet (HighCHO=20.4%±0.1%, ModCHO=19.6±0.2%; P<0.001). Additionally, HighCHO GE was significantly greater after 25 min (P=0.015) and 85 min (P=0.021) than in the LowCHO condition. Heart rate responses in the HighCHO condition were significantly lower than during the LowCHO tests (P=0.005). Diet had no effect on blood glucose or lactate (P>0.05). This study suggests that before the measurement of gross efficiency, participants' diet should be controlled and monitored to ensure the validity of the results obtained.
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Affiliation(s)
- M Cole
- Sports Science, Tourism & Leisure, Canterbury Christ Church University, Canterbury, United Kingdom
| | - D Coleman
- Sports Science, Tourism & Leisure, Canterbury Christ Church University, Canterbury, United Kingdom
| | - J Hopker
- Centre for Sport Studies, University of Kent, Chatham, United Kingdom
| | - J Wiles
- Sports Science, Tourism & Leisure, Canterbury Christ Church University, Canterbury, United Kingdom
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Unemo M, Brooks B, Cole M, Ross JDC, White JA, Patel R. Does the ‘2012 IUSTI ECCG report on the diagnosis and management of Neisseria gonorrhoeae infections in Europe’ depict the situation in Europe? Int J STD AIDS 2013; 24:423-6. [DOI: 10.1177/0956462412473383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Gonorrhoea is a major public health concern globally. Of particular grave concern is that resistance to the third generation cephalosporins has been identified during recent years. This paper summarises and discusses the results of the ‘2012 IUSTI European Collaborative Clinical Group (ECCG) report on the diagnosis and management of Neisseria gonorrhoeae infections in Europe’. Although high quality care was reported in many settings, in several other countries the testing, diagnostics, antimicrobial treatment and follow-up of gonorrhoea patients need to be optimized. This, together with increased access to and use of antimicrobial susceptibility testing, is crucial in controlling the emergent spread of cephalosporin-resistant and multidrug-resistant gonorrhoea.
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Affiliation(s)
- M Unemo
- World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Örebro University Hospital, Örebro, Sweden
| | - B Brooks
- Department of Genitourinary Medicine, Southampton Medical School, University of Southampton, Southampton
| | - M Cole
- Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, Colindale, London
| | - J D C Ross
- Birmingham University Hospital, Birmingham
| | - J A White
- Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - R Patel
- Department of Genitourinary Medicine, Southampton Medical School, University of Southampton, Southampton
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Spiteri G, Cole M, Unemo M, Hoffmann S, Ison C, Laar MVD. O03.2 Antimicrobial Resistance of Neisseria Gonorrhoeae in the European Union: Response to the Threat of Multidrug Resistant Gonorrhoea. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0096] [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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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Erratum: Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [DOI: 10.1038/eye.2013.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Cole M. SPECIALIST PALLIATIVE CARE SERVICE RESPONSIBILITY TO SUPPORT PRIMARY CARE PROVIDERS IN CARE PLANNING AND END OF LIFE CARE: A REVIEW. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.142] [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: 11/03/2022]
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [PMID: 23449508 DOI: 10.1038/eye.2014.11] [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: 12/17/2022] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
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Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013; 27:709-15. [PMID: 23449508 DOI: 10.1038/eye.2013.8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
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Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
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Cole M, Jacobs B, Soubigou-Taconnat L, Balzergue S, Renou JP, Chandler JW, Werr W. Live imaging of DORNRÖSCHEN and DORNRÖSCHEN-LIKE promoter activity reveals dynamic changes in cell identity at the microcallus surface of Arabidopsis embryonic suspensions. Plant Cell Rep 2013; 32:45-59. [PMID: 23011125 DOI: 10.1007/s00299-012-1339-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/24/2012] [Accepted: 08/29/2012] [Indexed: 06/01/2023]
Abstract
KEY MESSAGE : Transgenic DRN::erGFP and DRNL::erGFP reporters access the window from explanting Arabidopsis embryos to callus formation and provide evidence for the acquisition of shoot meristem cell fates at the microcalli surface. The DORNRÖSCHEN (DRN) and DORNRÖSCHEN-LIKE (DRNL) genes encode AP2-type transcription factors, which are activated shortly after fertilisation in the zygotic Arabidopsis embryo. We have monitored established transgenic DRN::erGFP and DRNL::erGFP reporter lines using live imaging, for expression in embryonic suspension cultures and our data show that transgenic fluorophore markers are suitable to resolve dynamic changes of cellular identity at the surface of microcalli and enable fluorescence-activated cell sorting. Although DRN::erGFP and DRNL::erGFP are both activated in surface cells, their promoter activity marks different cell identities based on real-time PCR experiments and whole transcriptome microarray data. These transcriptome analyses provide no evidence for the maintenance of embryogenic identity under callus-inducing high-auxin tissue culture conditions but are compatible with the acquisition of shoot meristem cell fates at the surface of suspension calli.
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Affiliation(s)
- M Cole
- Institut für Entwicklungsbiologie, Biozentrum, Universität zu Köln, Zülpicher Str. 47b, 50674, Köln, Germany
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Barnett N, Taras J, Moharir M, Cole M, Ford-Jones L, Levin L. Speech and Language Support- How Physicians Can Seek and Treat Speech and Language Delays in the Office Setting. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.suppl_a.24ac] [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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Zatz I, Baker R, Brooks A, Cole M, Neilson G, Lowry C, Mardenfeld M, Omran H, Thompson V, Todd T. Design of JET ELM control coils for operation at 350°C. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.03.088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abdul Razak A, Nutt J, O'Toole K, Black F, Cole M, Plummer R, Lunec J, Calvert H. 545 Expression of methylthioadenosine phosphorylase (MTAP) in malignant pleural mesothelioma (MPM) and its implication for pemetrexed-based chemotherapy. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72252-7] [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] Open
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Cole M, Blackwell A, Evans A, Strang RHC. The repellent action of neem oil (Azadirachta indica) against the Scottish biting midge (Culicoides impunctatus). ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.2042-7166.2002.tb03359.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: 11/28/2022]
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Bray J, Sludden J, Griffin MJ, Cole M, Verrill M, Jamieson D, Boddy AV. Influence of pharmacogenetics on response and toxicity in breast cancer patients treated with doxorubicin and cyclophosphamide. Br J Cancer 2010; 102:1003-9. [PMID: 20179710 PMCID: PMC2844036 DOI: 10.1038/sj.bjc.6605587] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Doxorubicin and cyclophosphamide (AC) therapy is an effective treatment for early-stage breast cancer. Doxorubicin is a substrate for ABCB1 and SLC22A16 transporters. Cyclophosphamide is a prodrug that requires oxidation to 4-hydroxycyclophosphamide, which yields a cytotoxic alkylating agent. The initial oxidation is catalysed by cytochrome P450 enzymes including CYP2B6, CYP2C9, CYP2C19 and CYP3A5. Polymorphic variants of the genes coding for these enzymes and transporters have been identified, which may influence the systemic pharmacology of the two drugs. It is not known whether this genetic variation has an impact on the efficacy or toxicity of AC therapy. Methods: Germ line DNA samples from 230 patients with breast cancer on AC therapy were genotyped for the following SNPs: ABCB1 C1236T, G2677T/A and C3435T, SLC22A16 A146G, T312C, T755C and T1226C, CYP2B6*2, *8, *9, *3, *4 and *5, CYP2C9*2 and *3, CYP3A5*3 and CYP2C19*2. Clinical data on survival, toxicity, demographics and pathology were collated. Results: A lower incidence of dose delay, indicative of less toxicity, was seen in carriers of the SLC22A16 A146G, T312C, T755C variants. In contrast, a higher incidence of dose delay was seen in carriers of the SLC22A16 1226C, CYP2B6*2 and CYP2B6*5 alleles. The ABCB1 2677A, CYP2B6*2, CYP 2B6*8, CYP 2B6*9, CYP 2B6*4 alleles were associated with a worse outcome. Conclusion: Variant alleles in the ABCB1, SLC22A16 and CYP2B6 genes are associated with response to AC therapy in the treatment of breast cancer.
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Affiliation(s)
- J Bray
- Northern Institute for Cancer Research, Medical School, Newcastle University, Newcastle upon Tyne, UK
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Cole M, Abd Jamil A, Sutton E, Heather L, Stuckey D, Murray A, Evans R, Clarke K. 004 Peroxisome proliferator-activated receptor alpha is essential for cardiac adaptation to chronic hypoxia. Heart 2010. [DOI: 10.1136/hrt.2009.191049d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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