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Esteve R, Barrado-Moreno V, Ramírez-Maestre C, Serrano-Ibáñez ER, de la Vega R, Ruiz-Párraga GT, Sainero-Tirado G, Fernández Baena M, Jensen M, López-Martínez AE. Psychological profiles and prescription opioid misuse, craving, and withdrawal in people with chronic pain. Eur J Pain 2024. [PMID: 38189159 DOI: 10.1002/ejp.2233] [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: 09/03/2023] [Revised: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND The negative consequences of prescription opioid misuse and opioid use disorder make it relevant to identify factors associated with this problem in individuals with chronic pain. This cross-sectional study aimed at identifying subgroups of people with chronic pain based on their psychological profiles, prescription opioid misuse, craving, and withdrawal. METHODS The sample comprised 185 individuals with chronic pain. We performed hierarchical cluster analysis on impulsivity, anxiety sensitivity, pain acceptance, pain intensity, opioid misuse, craving, and withdrawal. RESULTS The four-cluster solution was the optimal one. Misuse, craving, and anxiety sensitivity were higher among people in the Severe-problems cluster than among people in the other three clusters. Withdrawal was the highest in the High-withdrawal cluster. Impulsivity was higher among people in the Severe-problems and High-withdrawal clusters than those in the Moderate-problems and Mild-problems clusters. Pain acceptance was higher among people in the Mild-problems cluster than among people in the other three clusters. Anxiety sensitivity and misuse were higher among people in the Moderate-problems cluster than among people in the Mild-problems cluster. CONCLUSIONS These results support that impulsivity, anxiety sensitivity, and pain acceptance are useful constructs to identify subgroups of people with chronic pain according to their level of prescription opioid misuse, craving, and withdrawal. The results of this study may help in selecting the early intervention most suitable for each of the identified profiles. SIGNIFICANCE The psychological profile of individuals with chronic pain, prescription opioid misuse, craving, and withdrawal is characterized by fearing anxiety-related symptoms due to the catastrophic interpretation of such symptoms and reacting impulsively to negative moods. In contrast, participants with high pain acceptance had less prescription opioid misuse, craving, and withdrawal. The profiles identified in this study could help clinicians select targets for intervention among profiles with similar needs and facilitate early interventions to prevent opioid misuse onset or aggravation.
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Affiliation(s)
- R Esteve
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - V Barrado-Moreno
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - C Ramírez-Maestre
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - E R Serrano-Ibáñez
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - R de la Vega
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - G T Ruiz-Párraga
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - G Sainero-Tirado
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | | | - M Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - A E López-Martínez
- Facultad de Psicología y Logopedia, Universidad de Málaga, Andalucía Tech, Málaga, Spain
- Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
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Remde H, Schmidt-Pennington L, Reuter M, Landwehr LS, Jensen M, Lahner H, Kimpel O, Altieri B, Laubner K, Schreiner J, Bojunga J, Kircher S, Kunze CA, Pohrt A, Teleanu MV, Hübschmann D, Stenzinger A, Glimm H, Fröhling S, Fassnacht M, Mai K, Kroiss M. Outcome of Immunotherapy in Adrenocortical Carcinoma - A retrospective cohort study. Eur J Endocrinol 2023:7187724. [PMID: 37260092 DOI: 10.1093/ejendo/lvad054] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/13/2023] [Accepted: 04/18/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Clinical trials with immune checkpoint inhibitors (ICI) in adrenocortical carcinoma (ACC) have yielded contradictory results. We aimed to evaluate treatment response and safety of ICI in ACC in a real-life setting. DESIGN Retrospective cohort study of 54 patients with advanced ACC receiving ICI as compassionate use at six German reference centres between 2016 and 2022. METHODS Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and treatment-related adverse events (TRAE) were assessed. RESULTS In 52 patients surviving at least 4 weeks after initiation of ICI, ORR was 13.5% (6-26) and DCR 24% (16-41). PFS was 3.0 months (95%CI 2.3-3.7). In all patients, median OS was 10.4 months (3.8-17). 17 TRAE occurred in 15 patients, which was associated with a longer PFS of 5.5 (1.9-9.2) vs. 2.5 (2.0- 3.0) months (HR 0.29, 95%CI 0.13-0.66, p=0.001) and OS of 28.2 (9.5-46.8) vs. 7.0 (4.1-10.2) months (HR 0.34, 95%CI 0.12-0.93). Positive tissue staining for programmed cell death ligand 1 (PD-L1) was associated with a longer PFS of 3.2 (2.6-3.8) vs. 2.3 (1.6-3.0, p<0.05) months. Adjusted for concomitant mitotane use, treatment with nivolumab was associated with lower risk of progression (HR 0.36, 0.15-0.90) and death (HR 0.20, 0.06-0.72) compared to pembrolizumab. CONCLUSIONS In the real-life setting we observe a response comparable to other second-line therapies and an acceptable safety profile in ACC patients receiving different ICI. The relevance of PD-L1 as a marker of response and the potentially more favourable outcome in nivolumab treated patients require confirmation.
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Affiliation(s)
- H Remde
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - L Schmidt-Pennington
- Department of Endocrinology & Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Insitute of Health, 10117 Berlin, Germany
| | - M Reuter
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - L-S Landwehr
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - M Jensen
- Department of Endocrinology & Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Insitute of Health, 10117 Berlin, Germany
| | - H Lahner
- Department of Endocrinology and Metabolism, University Hospital Duisburg-Essen, Essen, Germany
| | - O Kimpel
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - B Altieri
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - K Laubner
- Division of Endocrinology and Diabetology, Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg
| | - J Schreiner
- University Hospital Munich, Department of Internal Medicine IV, Ludwig-Maximilians-University München, Munich, Germany
| | - J Bojunga
- Department of Internal Medicine 1, Division of Endocrinology, Goethe University Frankfurt, Faculty 16 Medicine, Frankfurt am Main, Germany
| | - S Kircher
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - C A Kunze
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A Pohrt
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M V Teleanu
- National Center for Tumor Diseases Heidelberg and German Cancer Research Center, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - D Hübschmann
- Computational Oncology Group, Molecular Precision Oncology Program, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ) Heidelberg, Germany
- Pattern Recognition and Digital Medicine Group, Heidelberg Institute for Stem cell Technology and Experimental Medicine (HI-STEM) gGmbH, Heidelberg, Germany
- German Cancer Consortium, Im Neuenheimer Feld 280, 69120 Heidelberg Germany
| | - A Stenzinger
- Universitätsklinikum Heidelberg, Institut für Pathologie, Im Neuenheimer Feld 224, 69120 Heidelberg
| | - H Glimm
- Department for Translational Medical Oncology, National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
- Translational Medical Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Translational Functional Cancer Genomics, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK) Dresden, Germany
| | - S Fröhling
- National Center for Tumor Diseases Heidelberg and German Cancer Research Center, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany
- German Cancer Consortium, Im Neuenheimer Feld 280, 69120 Heidelberg Germany
| | - M Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - K Mai
- Department of Endocrinology & Metabolism, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Insitute of Health, 10117 Berlin, Germany
| | - M Kroiss
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
- University Hospital Munich, Department of Internal Medicine IV, Ludwig-Maximilians-University München, Munich, Germany
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Espiñeira I, Alzate D, Araos J, Pellegrino F, Tunesi M, Jensen M, Donati PA. Propofol versus sodium thiopentone for the treatment of status epilepticus and refractory status epilepticus in dogs. N Z Vet J 2023; 71:128-132. [PMID: 36688794 DOI: 10.1080/00480169.2023.2172089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AIMS To compare the effect on mortality and length of hospital stay of propofol with that of sodium thiopentone for the management of dogs with status epilepticus (SE) and refractory status epilepticus (RSE). METHODS In this cohort study, medical records of a veterinary referral clinic in Argentina were retrospectively searched for dogs that were hospitalised and required induction of therapeutic coma (TC) with either propofol or sodium thiopentone for the management of SE or RSE of any cause. A logistic regression model was performed to evaluate the association between the type of anaesthetic used and in-hospital mortality adjusting for the type of epilepsy (idiopathic, structural, or reactive). Kaplan-Meier estimated survival curves for the length of hospital stay by the type of anaesthetic drug were compared using the log-rank test (deaths were considered censored events). Cox proportional hazards regression was used to estimate hazard ratios for time to hospital discharge, unadjusted and adjusted for type of epilepsy. RESULTS A total of 24 dogs with SE were included in the study: eight treated with propofol and 16 treated with sodium thiopentone. Four dogs treated with propofol (proportion = 0.50; 95% CI = 0.15-0.84), and eight treated with sodium thiopentone (proportion = 0.50; 95% CI = 0.50-0.74) died during hospitalisation. The median hospitalisation time was 43 (IQR 24-56) hours for dogs that were treated with propofol and 72 (IQR 64-96) hours for dogs that were treated with sodium thiopentone. There was no evidence of a difference in the median duration of TC in dogs treated with propofol (12 (IQR 8-24) hours) or with sodium thiopentone (12 (IQR 7.5-20) hours; p = 0.946). In the logistic regression model, no evidence of association between the anaesthetic protocol for the management of RSE and in-hospital mortality, adjusted for the type of epilepsy, was found (OR 1.09 (95% CI = 0.17-6.87); p = 0.925). Cox regression analysis revealed a difference in the time to hospital discharge, adjusted by the type of epilepsy, between treatment groups (HR = 0.05 (95% CI = 0.01-0.54); p = 0.013). CONCLUSIONS AND CLINICAL RELEVANCE The time spent in hospital before discharge was longer in dogs with RSE treated with sodium thiopentone compared to those treated with propofol. However, as the sample size was very small, the results obtained in the present study should be analysed with caution. Further studies including a greater number of dogs are required.
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Affiliation(s)
- I Espiñeira
- UCICOOP, Buenos Aires, Argentina.,Small Animal Clinic, Faculty of Veterinary Sciences, University of Buenos Aires, Buenos Aires, Argentina
| | - D Alzate
- Canines and Felines Animal Hospital, Medellín, Colombia
| | - J Araos
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - F Pellegrino
- Department of Anatomy, Faculty of Veterinary Sciences, University of Buenos Aires, Buenos Aires, Argentina
| | - M Tunesi
- UCICOOP, Buenos Aires, Argentina
| | - M Jensen
- UCICOOP, Buenos Aires, Argentina
| | - P A Donati
- UCICOOP, Buenos Aires, Argentina.,Department of Anaesthesiology and Algiology, Faculty of Veterinary Sciences, University of Buenos Aires, Buenos Aires, Argentina
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Requejo S, Guevara HG, Viamonte M, Gudino R, Rosales H, Jensen M. Trauma P-57803199-390 Treatment of post traumatic zygomatic coronoid ankylosis. Systematic review. Int J Oral Maxillofac Surg 2023. [DOI: 10.1016/j.ijom.2022.09.008] [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: 01/31/2023]
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Suarez A, Garcia Guevara H, Olate S, Viamonte M, Jensen M. Treatments associated with the management of condylar resorption after orthognathic surgery. Systematic review. Int J Oral Maxillofac Surg 2023. [DOI: 10.1016/j.ijom.2022.09.022] [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: 01/31/2023]
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Freitag F, Valverde A, Jensen M, Sanchez A, Gomez D, Bailey C. Comparison of rostral spread of lumbosacral epidural volume calculated by body weight or length of the vertebral column in dogs. Vet Anaesth Analg 2023. [DOI: 10.1016/j.vaa.2022.09.008] [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: 01/19/2023]
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Ferré LB, Aguirregabiria B, Cerviño N, Bello R, Jensen M, Fresno C, Kjelland ME, Colazo M. 178 Fixed-time artificial insemination in virgin beef heifers using a seven-day progesterone-based protocol: gonadotrophin-releasing hormone versus oestradiol salts. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab178] [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: 12/09/2022] Open
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Ferré LB, Aguirregabiria B, Cerviño N, Bello R, Jensen M, Kjelland ME, Colazo M. 179 Injectable progesterone priming prior to fixed-time artificial insemination in primiparous and multiparous suckled beef cows. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab179] [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: 12/07/2022] Open
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Graupe M, Tignor A, Veneziale K, Jensen M, Khadr L, Beckstrom H, Gister M, Hendricks K, NL M, Roberts F, Youngberg S, Schachtner S. Accelerating Improvement: The Pediatric Acute Care Cardiology Collaborative (PAC3) Data Timeliness Project. Int J Qual Health Care 2022; 34:6771334. [DOI: 10.1093/intqhc/mzac086] [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: 03/08/2022] [Revised: 08/11/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Pediatric Acute Care Cardiology Collaborative (PAC3) is a learning network focused on improving acute care cardiology patient outcomes. Data submission timeliness is a vulnerability for PAC3 and most clinical registries, directly affecting collaborative benchmarking, quality improvement (QI) and research projects.
Methods
PAC3 conducted a collaborative-wide QI project addressing data timeliness and efficiency. Data analysis of submitted cases from September 2019 – February 2020 revealed nine “High Performer” centers who submitted cases within 67 days of hospital dicharge (the limit for timeliness) >90% of the time, and eight “High Potential” sites who submitted timely cases <75% of the time. The SMART aim was to increase case submission timeliness in “High Potential” centers from 41% to 80% by December 2020. A secondary aim was for “High Performer” site timeliness to be maintained. During the intervention phase (March-December 2020), PDSA cycles included webinars, facilitated exploratory conversations, data review, and development of a best practice guide (“Getting Started Toolkit”). Onboarded “New Centers” starting in 2020 were also invited to test intervention effectiveness. Balancing measures included data collector job satisfaction and stress, and resubmission rates.
Results
“High Performer” and “High Potential” centers submitted 11,358 cases from November 2019-December 2020. Timely submission rates for “High Potential” centers improved from 40.6% to 74.6% and were maintained at >90% for “High Performer” centers. “New Centers” averaged 92.6% timely case submissions during their first six months. Data collector job satisfaction and stress were not impacted, and resubmission rates did not increase.
Conclusions
PAC3’s multi-center QI project increased data submission timeliness in a large pediatric subspecialty registry. The lessons learned and the Toolkit developed can be applied in other registries to improve data submission efficiency, with resultant improvement in benchmarking, QI, research, length of stay and outcomes.
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Affiliation(s)
- M Graupe
- Heart Center Administration, Children’s Health , Dallas, Texas, USA
| | - A Tignor
- James M Anderson Center of Excellence, Cincinnati Children’s Hospital , Cincinnati, Ohio, USA
| | - K Veneziale
- Children’s Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania, USA
| | - M Jensen
- Children’s Mercy Hospital Department of Pediatric Cardiovascular Surgery , Kansas City, Missouri, USA
| | - L Khadr
- University of Michigan Congenital Heart Center, C.S. Mott Children’s Hospital , Ann Arbor, Michigan, USA
| | - H Beckstrom
- Children’s Heart Center, Ann & Robert H. Lurie Children’s Hospital of Chicago , Chicago, Illinois, USA
| | - M Gister
- Heart Center Administration, Children’s Health , Dallas, Texas, USA
| | - K Hendricks
- Heart Center Administration, Children’s Health , Dallas, Texas, USA
| | - Madsen NL
- Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center , Dallas, Texas, USA
| | - F Roberts
- Heart Vascular Institute, UPMC Children’s Hospital of Pittsburgh , Pittsburgh, Pennsylvania USA
| | - S Youngberg
- Intermountain Primary Children’s Hospital , Salt Lake City, Utah, USA
| | - S Schachtner
- Children’s Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Division of Pediatric Cardiology, Cincinnati Children’s Hospital , Cincinnati, Ohio, USA
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Jensen M, Gonano B, Kierulf-Vieira W, Kooyman PJ, Sjåstad AO. Innovative approach to controlled Pt-Rh bimetallic nanoparticle synthesis. RSC Adv 2022; 12:19717-19725. [PMID: 35865203 PMCID: PMC9258337 DOI: 10.1039/d2ra03373a] [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] [Received: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 11/27/2022] Open
Abstract
Precise control of the elemental composition and distribution in bimetallic nanoparticles is of great interest for both fundamental studies and applications, e.g. in catalysis. We present a new innovative and facile synthesis strategy for the production of true solid solution Pt1−xRhx nanoparticles. This constitutes a development of the established heat-up method, where undesired shell formation is fully suppressed, despite utilizing metal precursors with different reaction rates. The concept is demonstrated through synthesis of selected Pt1−xRhx solid solution compositions via the polyalcohol reduction approach. In addition, we provide modified procedures, using the same surface stabilizing agent/metal precursors reaction matrix yielding controlled model Rh(core)–Pt(shell) and Pt(core)–Rh(shell) nanoparticles. Tunable bimetallic solid solution and core–shell nanoparticles with the same capping agent are of key importance in systematic fundamental studies, as functional materials properties may be altered by modifying the surface termination. In this work, we establish an innovative protocol for the production of Pt–Rh solid solution/core–shell nanoparticles with excellent control of element distribution and composition, built upon the well-established heat-up method.![]()
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Affiliation(s)
- M Jensen
- Center for Materials Science and Nanotechnology, Department of Chemistry, University of Oslo P.O. Box 1033 Blindern N-0315 Oslo Norway
| | - B Gonano
- Center for Materials Science and Nanotechnology, Department of Chemistry, University of Oslo P.O. Box 1033 Blindern N-0315 Oslo Norway
| | - W Kierulf-Vieira
- Center for Materials Science and Nanotechnology, Department of Chemistry, University of Oslo P.O. Box 1033 Blindern N-0315 Oslo Norway
| | - P J Kooyman
- Department of Chemical Engineering, University of Cape Town Private Bag X3, Rondebosch 7701 South Africa
| | - A O Sjåstad
- Center for Materials Science and Nanotechnology, Department of Chemistry, University of Oslo P.O. Box 1033 Blindern N-0315 Oslo Norway
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Chandrasekaran V, Bokarewa MI, Oparina N, Andersson KM, Katona G, Erlandsson M, Jensen M, Damdimopoulos A. POS0032 FUNCTIONAL ROLE OF SURVIVIN IN ORGANIZATION OF BIVALENT CHROMATIN REGIONS AND CONSEQUENCE FOR ARTHRITIS-RELEVANT GENE EXPRESSION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4856] [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
BackgroundBivalent chromatin (BvCR) is characterized by the presence of simultaneous active and repressive modifications on histone H3 proteins. Influencing expression of the genes, BvCR determine cell fate and direct differentiation and lineage commitment in primary T cells and contribute to autoimmunity. Survivin is highly expressed during cell division and in effector Th1 cells contributing to aggravation of autoimmune inflammation. Survivin can physically bind to DNA, specifically to Threonine-3 of histone H3 (1). Thus, functional, and mechanistic data point to a potential chromatin regulatory role for survivin, potentially acting in combination with histone epigenetic modifications (EMs).ObjectivesThe goal of our study is to establish the colocalization of survivin with BvCRs and to deduce functional effects of this collaboration on chromatin organization and gene expression.MethodsChromatin from CD4+ T cells of 14 female subjects was immunoprecipitated with survivin antibodies and histone H3K27ac, H3K27me3, H3K4me3 antibodies, and coupled with DNA sequencing (ChIPseq, Hiseq2000, Illumina). BvCR were identified as exact overlaps of the three histone EM peaks and the overlapping regions were searched for co-localization with survivin using the ‘ChIPPeakAnno’ Bioconductor package. Tag counts K27me3>K27ac were defined as inactive/poised BvCR, while tag count K27me3<K27ac were identified asactive BvCR. Motif search was done through the MEME tool, and high/moderate complexity motifs with E-value >10e-5 were selected and scanned through the HOCOMOCO database to identify consensus transcription factor (TF) motifs. TFs co-localized with the BvCD were identified through ReMap database. To identify survivin sensitive genes, CD4+ T cells were treated with survivin inhibitor YM155 and a list of reproducible DEG (log2FC>[0.4], >1 experiment) was mapped and analysed for clustering with BvCR.ResultsCo-localization of survivin ChIP peaks with individual H3-peaks was significantly less frequent compared to overlap with all three (a3)-H3 BvCR (7.1 vs 29.8%, p=8.9e-13). Overlap of a3-H3 peaks not containing survivin was less frequent (34%) compared to those which contained survivin (66%). Notably, survivin peak size was 5.5-fold higher when colocalized with a3-H3 peaks, compared to no, or any single H3 (p<2.2e-16). In contrast, no size difference for any of the H3 EM peaks was found.Further analysis of two non-redundant groups of BvCR that contain (survivin-a3H3, n=4085), and not containing survivin (a3H3noSurv, n = 2131) demonstrated that survivin was mostly associated with inactive BvCR (OR1.29, p=6.6e-6), while no such specificity was found for BvCR with no survivin. Additionally, survivin containing BvCR contained abundant binding sites matching known consensus TF motifs. No sequence-specific motifs were identified in BvCR with no survivin. Comparison of results obtained through HOCOMOCO and ReMap databases resulted in a list of 68 unique TFs. Many of those are key regulators of adaptive immune responses, cellular metabolism, and pluripotency. Differentially expressed genes mapped to BvCR demonstrated enrichment for cellular hormone metabolic processes, regeneration and DNA biosynthesis.ConclusionThis study provides experimental evidence that survivin defines binding specificity in bivalent chromatin regions being associated with regulation of cellular metabolism and renewal of CD4+ T cells that are functionally important to resist autoimmunity.References[1]Kelly AE, Ghenoiu C, Xue JZ, Zierhut C, Kimura H, Funabiki H. Survivin reads phosphorylated histone H3 threonine 3 to activate the mitotic kinase Aurora B Science. 2010 Oct 8; 330(6001): 235–239.Disclosure of InterestsNone declared
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Jensen M, Heilbron K, Bandres-Ciga S, Fontanillas P, Blauwendraat C, Nalls M, Singleton A, Smith GD, Cannon P, Noyce A. Unhealthy traits and risk of Parkinson’s disease: a mendelian randomisation study. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.24] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IntroductionObservational studies have flagged smoking, alcohol and high body mass index (BMI) as potential protective factors against Parkinson’s disease (PD), however it is unclear whether such asso- ciations are causal. Mendelian randomisation (MR) uses gene variants to explore causal trait-outcome effects, minimising bias from observational studies. Using MR, we sought to determine the causal relation- ship between unhealthy traits (tobacco smoking, alcohol intake, and high BMI) and PD risk.MethodsWe used genome-wide association studies to find single nucleotide polymorphisms associated with each trait. Using split-sample MR, we used inverse weighted (IVW) methods to determine the effect of traits on PD. We used MR-Egger and weighted mean methods to check for bias in IVW analyses.ResultsEver-smoking and high BMI causally reduced PD risk (OR 0.96 95%CI 0.92–0.99 p=0.01; OR 0.99 95%CI 0.98–1.00 per 1 kg/m2 p=0.01, respectively). Alcohol causally increased PD risk (OR 1.13 95%CI 1.03–1.24 p=0.01). Sensitivity analyses did not reveal bias from pleiotropy or invalid instruments.ConclusionsMR analysis in over 2.4 million participants showed a protective effect of smoking on PD; war- ranting prioritisation of related therapeutic targets in clinical trials. Conversely, alcohol causally increased PD risk. Higher BMI protected against PD, but the effect was marginal.m.jensen@cantab.net
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Jensen M, Jacobs B, Dobson R, Bandres-Ciga S, Blauwendraat C, Schrag A, Noyce A. Lower lymphocyte count is associated with increased risk of Parkinson’s disease. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.306] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesPatients with established Parkinson’s disease (PD) display differences in blood biomarkers of immune function, including leukocyte differentials, compared to controls. These may be useful biomarkers to predict PD and inform pathogenesis. We sought to identify whether peripheral immune dysregulation was associated with risk of subsequent PD.MethodsWe examined the relationship between incident PD and baseline leukocyte differential count in UK Biobank, a longitudinal cohort with >500,000 participants. We used a range of sensitivity analyses and Mendelian randomization (MR) to further explore the nature of associations.ResultsAfter excluding individuals with comorbidities which could influence inflammation biomarkers, 465 incident PD cases and 312,125 controls remained. Lower lymphocyte count was associated with increased risk of PD diagnosis (per 1-SD decrease in count OR 1.18, 95% CI 1.07–1.32, padjusted=0.01). The association between lower lymphocyte count and increased PD risk remained robust to sensitivity analyses. MR suggested that the effect of lower lymphocyte count on PD risk may be causal (per 1-SD decrease in lymphocyte count; ORMR 1.09, 95% CI 1.01–1.18, p=0.02).ConclusionsWe provide converging evidence from observational analyses in UKB and MR that lower lymphocyte count is associated with an increased risk of subsequent PD.m.jensen@cantab.net
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Offersen B, Alsner J, Nielsen H, Bechmann T, Nielsen M, Mjaaland I, Kamby C, Krkove C, Lorincz T, Al-Rawi S, Stoere E, Schreiber A, Krause M, Kasti U, Matthiessen L, Kedzierawski P, Marinko T, Luukkaa M, Skyttä T, Jensen M, Overgaard J. OC-0102 DBCG phase III randomized trial of hypo- vs standard fractionated RT in 2879 pN+ breast cancer pts. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02478-1] [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: 11/16/2022]
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Jensen S, Erichsen T, Jensen M, Balling P, Petersen J, Poulsen P, Muren L. PO-1572 Development of deformable 3D anthropomorphic dosimetry systems for proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03536-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Beckstead E, Mulokozi G, Jensen M, Smith J, Baldauf M, Dearden KA, Linehan M, Torres S, Glenn J, West JH, Hall PC, Crookston BT. Addressing child undernutrition in Tanzania with the ASTUTE program. BMC Nutr 2022; 8:29. [PMID: 35392969 PMCID: PMC8988343 DOI: 10.1186/s40795-022-00511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Optimal infant and young child feeding practices (IYCFP) reduce childhood stunting and are associated with additional health benefits. In Tanzania, IYCFP are far from optimal where 32% of children under the age of 5 years are stunted. The purpose of this study was to examine whether behavior change communication focused on reducing child undernutrition was associated with improved IYCFP in Tanzania. METHODS A cross-sectional survey was administered to approximately 10,000 households with children under the age of 2 at baseline and endline. Bivariate analyses and logistic regression was used to examine the relationship between exposure to behavior change communication and timely initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, timely complementary feeding (CF), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). RESULTS Mothers who heard a radio spot about IYCFP were more likely than mothers who had not heard a radio spot about IYCFP to begin complementary foods at six months. Their children were also more likely to achieve MMF, MDD, and MAD with odds ratios of 2.227 (p = 0.0061), 1.222 (p = 0.0454), 1.618 (p = < .0001), and 1.511 (p = 0.0002), respectively. Mothers who saw a TV spot about IYCFP were more likely to have greater odds of knowing when to begin complementary feeding, feeding their child a minimally diverse diet (4 food groups or more), and serving a minimum acceptable diet with odds ratios of 1.335 (p = 0.0081), 1.360 (p = 0.0003), and 1.268 (p = 0.0156), respectively. CONCLUSION Exposure to behavior change communication in Tanzania was generally associated with some increased knowledge of optimal IYCFP as well as practicing IYCF behaviors. Behavior change communication planners and implementers may want to consider conducting similar campaigns as an important component of behavior change to reduce undernutrition and poor health outcomes in developing settings.
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Affiliation(s)
| | - G Mulokozi
- ASTUTE Program, IMA World Health, Dar es Salaam, Tanzania
| | - M Jensen
- Brigham Young University, Provo, USA
| | - J Smith
- Brigham Young University, Provo, USA
| | - M Baldauf
- Brigham Young University, Provo, USA
| | - K A Dearden
- ASTUTE Program, IMA World Health, Dar es Salaam, Tanzania
| | - M Linehan
- ASTUTE Program, IMA World Health, Dar es Salaam, Tanzania
| | - S Torres
- ASTUTE Program, IMA World Health, Dar es Salaam, Tanzania
| | - J Glenn
- Brigham Young University, Provo, USA
| | - J H West
- Brigham Young University, Provo, USA
| | - P C Hall
- Brigham Young University, Provo, USA
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Kouli A, Jensen M, Papastavrou V, Scott KM, Kolenda C, Parker C, Solim IH, Camacho M, Martin-Ruiz C, Williams-Gray CH. T lymphocyte senescence is attenuated in Parkinson's disease. J Neuroinflammation 2021; 18:228. [PMID: 34645462 PMCID: PMC8513368 DOI: 10.1186/s12974-021-02287-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 07/08/2021] [Accepted: 10/01/2021] [Indexed: 02/08/2023] Open
Abstract
Background Immune involvement is well-described in Parkinson’s disease (PD), including an adaptive T lymphocyte response. Given the increasing prevalence of Parkinson’s disease in older age, age-related dysregulation of T lymphocytes may be relevant in this disorder, and we have previously observed changes in age-associated CD8+ T cell subsets in mid-stage PD. This study aimed to further characterise T cell immunosenescence in newly diagnosed PD patients, including shifts in CD4+ and CD8+ subpopulations, and changes in markers of cellular ageing in CD8+ T lymphocytes. Methods Peripheral blood mononuclear cells were extracted from the blood of 61 newly diagnosed PD patients and 63 age- and sex-matched controls. Flow cytometric analysis was used for immunophenotyping of CD8+ and CD4+ lymphocyte subsets, and analysis of recent thymic emigrant cells. Telomere length within CD8+ T lymphocytes was assessed, as well as the expression of the telomerase reverse transcriptase enzyme (hTERT), and the cell-ageing markers p16INK4a and p21CIP1/Waf1. Results The number of CD8+ TEMRA T cells was found to be significantly reduced in PD patients compared to controls. The expression of p16INK4a in CD8+ lymphocytes was also lower in patients versus controls. Chronic latent CMV infection was associated with increased senescent CD8+ lymphocytes in healthy controls, but this shift was less apparent in PD patients. Conclusions Taken together, our data demonstrate a reduction in CD8+ T cell replicative senescence which is present at the earliest stages of Parkinson’s disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-021-02287-9.
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Affiliation(s)
- Antonina Kouli
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK.
| | - Melanie Jensen
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK.,Department of Cellular Pathology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, W6 8RF, UK
| | - Vanesa Papastavrou
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - Kirsten M Scott
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - Claire Kolenda
- Bioscience Institute, BioScreening Core Facility, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Craig Parker
- Bioscience Institute, BioScreening Core Facility, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Imtiaz H Solim
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - Marta Camacho
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - Carmen Martin-Ruiz
- Bioscience Institute, BioScreening Core Facility, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Caroline H Williams-Gray
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
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Nicolajsen C, Nielsen PB, Eldrup N, Jensen M, Goldhaber SZ, Lip GYH, Larsen TB, Soegaard M. Changes in antithrombotic treatment in patients with abdominal aortic aneurysmal disease and incident atrial fibrillation: a population-based case-crossover analyses. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1999] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Abdominal aortic aneurysmal (AAA) disease is associated with a high risk of cardiovascular events, and prophylaxis with platelet-inhibitors are recommended at diagnosis. Incident atrial fibrillation (AF) changes that indication to oral anticoagulative (OAC) therapy. However, it is unknown to what extent the recommended change of indication is reflected in the actual antithrombotic treatment in clinical practice.
Purpose
To evaluate the antithrombotic therapy after an incident diagnosis of atrial fibrillation in patients with established AAA.
Methods
In this population-based case-crossover study, using nationwide Danish registries, we identified all patients registered with a diagnosis of AAA between 1997 and 2018, and a subsequent diagnosis of AF. The case-crossover analysis was performed to compare the within-subject antithrombotic therapy in 1-year time-periods before and after AF diagnosis in the study population. A blanking period of 30 days before AF-diagnosis was applied to avoid bias from potentially delayed hospital diagnosis of AF (Figure 1.1). We excluded patients with no eligible reference window due to recent cohort entry and patients with no AF-related indication for shift to OAC (CHA2DS2-VASc score of <1 in men and <2 in women). Odds ratios (OR) with 95% confidence intervals (CIs) comparing antithrombotic therapy before and after AF diagnosis was calculated using McNemars test for matched pair's data. Subgroup analyses of patients diagnosed with AAA between 2011 and 2018 were performed to evaluate changes after introduction of current antithrombotic treatment regimens and direct oral anticoagulants.
Results
A total of 3052 patients were included in the case-crossover analyses. Mean age was 77.8 years and 22.3% were females. Median time from AAA to AF diagnosis was 4.6 years (IQR; 2.6–7.8). Stroke risk in the study population was high with a median CHA2DS2-VASc score of 4 (IQR: 3–5). In the case-period after AF diagnosis, 1004 prescription claims of platelet-inhibitors were registered compared with 1461 claims in the control-period before AF diagnosis, corresponding to a matched OR of 0.31 (95% CI, 0.26–0.36) (Figure 1.2). Conversely, there were 1392 prescription claims for OAC in the case-period compared with 355 in the control-period, corresponding to an OR of 15.75 (95% CI, 12.38–20.31). When restricting the study-population to patients diagnosed with AAA during 2011–2018, the OR was 0.11 (95% CI, 0.07–0.16) for a prescription claim of platelet-inhibitors and 17.7 (95% CI, 11.22–29.17) for OAC before and after AF diagnosis (Figure 1.2).
Conclusion
In patients with established AAA and high risk of stroke, incident AF was associated with low likelihood of treatment with platelet-inhibitor and a high likelihood of OAC-treatment compared with before AF. This association was further strengthened in patients diagnosed after 2011.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The Obel Family Foundation, DenmarkThe Augustinus Foundation, DenmarkThe sponsors played no role in the study design; data collection, analysis, or interpretation; abstract writing; or in the decision to submit the abstract. Figure 1
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Affiliation(s)
- C Nicolajsen
- Aalborg University Hospital, Aalborg Thrombosis Research Unit, Department of Cardiology, Aalborg, Denmark
| | - P B Nielsen
- Aalborg University Hospital, Aalborg Thrombosis Research Unit, Department of Cardiology, Aalborg, Denmark
| | - N Eldrup
- Rigshospitalet, Department of Vascular Surgery, Copenhagen, Denmark
| | - M Jensen
- Aalborg University Hospital, Aalborg Thrombosis Research Unit, Department of Cardiology, Aalborg, Denmark
| | - S Z Goldhaber
- Brigham and Women's Hospital, Thrombosis Research Group, Division of Cardiovascular Medicine, Boston, United States of America
| | - G Y H Lip
- Liverpool Heart and Chest Hospital, Liverpool Center of Cardiovascular Science, Liverpool, United Kingdom
| | - T B Larsen
- Aalborg University Hospital, Aalborg Thrombosis Research Unit, Department of Cardiology, Aalborg, Denmark
| | - M Soegaard
- Aalborg University Hospital, Aalborg Thrombosis Research Unit, Department of Cardiology, Aalborg, Denmark
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Benson CS, Dalgaard F, Rasmussen PV, Hansen ML, Lamberts M, Ruwald MH, Pallisgaard J, Gislason G, Torp-Pedersen C, Uffe Bodtger U, Jensen M, Rasmussen DB. Beta-blocker treatment in atrial fibrillation with chronic obstructive pulmonary disease: a Danish nationwide study from 1995 to 2015. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0289] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) often coexist. Beta-blockers are a mainstay of treatment in AF and are considered safe in COPD patients after myocardial infarction, though real-life studies have demonstrated significant under-use. Little is known on the utilization patterns in patients with AF and COPD.
Purpose
To investigate the temporal trends of beta-blocker utilization in patients following first diagnosis of AF in a hospital setting, with and without concomitant COPD, and determine clinical factors associated with beta-blocker use.
Methods
A nationwide study from 1995 to 2015 using data from the comprehensive Danish health registers. All patients with first registered AF diagnosis in a hospital setting were included. Beta-blocker use was identified by claimed prescriptions within 90 days following AF diagnosis. Factors associated with beta-blocker use or non-use in COPD patients during the most recent period (2010–2015) was examined using multivariable logistic regression and presented as odds ratios (OR) with 95% confidence intervals (95% CI).
Results
A total of 264 180 patients were included, of these 31 981 (12.1%) had COPD. Patients with concurrent COPD were older than those without COPD (median age 76 vs. 74 years), the proportion of males was similar (54%) and patients with COPD had more comorbidities, particularly cardiovascular disease. Across the 21-year study period, fewer patients with COPD used beta-blockers after AF diagnosis, than those without COPD (38.8% vs. 53.2%, p<0.001). Beta-blocker use increased in both groups during the study period (Figure 1). Nevertheless, the proportion of users was consistently lower among patients with COPD, although the difference was smaller during the most contemporary year (2015: 55.5% vs. 61.6% in COPD vs. non-COPD respectively).
Predictors for decreased beta-blocker use included high age, COPD severity represented by use of triple inhaled therapy (OR 0.84 [95% CI 0.77–0.92]), and a history of frequent COPD exacerbations (OR 0.80 [95% CI 0.74–0.86]) (Figure 2).
In a subgroup of COPD patients with complete clinical data from the Danish Register of COPD, severe airflow limitation (Forced Expiratory Volume in 1 second <30% of predicted) and high grade of dyspnoea (Modified Medical Research Council Dyspnoea scale 3–4) were associated with decreased odds for beta-blocker use (OR 0.48 [95% CI 0.38–0.59] and OR 0.67 [95% CI 0.55–0.80], respectively).
Conclusions
Beta-blocker use in patients with AF and concurrent COPD have increased considerably over a 21-year period yet remained less used than in patients without COPD. The severity of COPD was a strong negative predictor for beta-blocker use following AF diagnosis, suggesting a fear for adverse effects. The lower use of beta-blocker treatment in patients with severe COPD and AF might suggest underuse and warrants further evaluation.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Naestved - Slagelse - Ringsted Hospitals, Region Sjaelland, Denmark Figure 1. Temporal trends of beta-blocker useFigure 2. Factors associated with beta-blocker use
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Affiliation(s)
- C S Benson
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - F Dalgaard
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - P V Rasmussen
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - M L Hansen
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - M Lamberts
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - M H Ruwald
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - J Pallisgaard
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - G Gislason
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
| | - C Torp-Pedersen
- Nordsjaellands Hospital, Department of Cardiology and Clinical Research, Copenhagen, Denmark
| | - U Uffe Bodtger
- University of Southern Denmark, Institute of Regional Health Research, Copenhagen, Denmark
| | - M Jensen
- Hvidorve Hospital, Department of Cardiology, Copenhagen, Denmark
| | - D B Rasmussen
- Herlev and Gentofte Hospital, Department of Cardiology, Copenhagen, Denmark
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Jensen M, Wahab L. Unexpected SARS-CoV-2 positivity in postmortem nasopharyngeal swabs. J Clin Pathol 2021; 75:288. [PMID: 34518362 DOI: 10.1136/jclinpath-2021-207769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/31/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Melanie Jensen
- Department of Cellular Pathology, Northwest London Pathology, Imperial College Healthcare NHS Trust, London, UK
| | - Lutful Wahab
- Department of Pathology, Hemel Hempstead General Hospital, West Hertfordshire Hospital NHS Trust, Hemel Hempstead, Hertfordshire, UK
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Jensen M, Hagglund P, Zhang Y, Rayner B, Hawkins C. Role of extracellular trap release by macrophages during the development of chronic inflammation. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.210] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chandrasekaran V, Katona G, Bokarewa MI, Andersson KM, Erlandsson MC, Jensen M, Oparina N, Damdimopoulos A. POS0397 AGGREGATED SURVIVIN BINDING AROUND HISTONE H3 EPIGENETIC MODIFICATIONS IN RISK LOCI ASSOCIATED WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3212] [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: 11/03/2022]
Abstract
Background:Survivin is an integral part of the Chromosomal Passenger Complex (CPC) which plays a vital role in mitosis. Experiments have demonstrated that survivin can physically bind to DNA. Crystallographic studies show that survivin binds to Threonine-3 of histone H3. In patients with autoimmune diseases, increased survivin expression contributes to an aggravated disease phenotype. Thus, functional, and mechanistic data point to a potential chromatin regulatory role for survivin, possibly in combination with the established gene regulatory function carried out by histone epigenetic modifications (EM).Objectives:The objective of the study was to analyse the co-localization of chromatin bound survivin with three histone H3 epigenetic modifications – acetylated lysine 27 (K27ac) and trimethylated lysine 4 (K4me3) and lysine-27 (K27me3). The second objective was to analyse if survivin-bound DNA sequences overlapped with sequences in the vicinity of 106 GWAS SNPs that are associated with a risk of developing rheumatoid arthritis (RA).Methods:Chromatin from CD4 T cells of 14 female subjects was immunoprecipitated with survivin antibodies and each of the histone H3 antibodies, and coupled with sequencing (ChIPseq, Hiseq2000, Illumina). After mapping the annotations of sequenced regions to the human reference genome hg38, enriched peaks were identified through Homer software. The identified survivin ChIP peaks were analysed for colocalization with peaks of the three histone H3 EMs and with RA risk loci, using the Bioconductor package ‘ChIPPeakAnno’ through RStudio.Results:Among the total of ~13,000 individual survivin ChIP-peaks, 33% colocalized with histone H3 EM peaks. The overlapping peaks show a linear increase in average peak size compared with the peaks showing no colocalization with any H3 EM peak. A maximum of 5.5-fold increase in average peak size was observed when survivin bound peaks overlap with peaks of all three H3 EMs. A major proportion (86%) of top RA risk SNPs was associated with either binding of survivin or H3 EMs. In this subset, 63% of RA risk SNPs were found within an area of 100 kilobases from survivin ChIP-peaks, with preferential enrichment of high-scoring peaks when survivin colocalizes with all 3 H3 EMs. Survivin was bound to risk SNPs annotated to, among others, the major immunological genes CD83, IRF4, CD28, ICOS and IL2RAConclusion:This study presents experimental evidence that survivin binding to DNA preferentially occurred in regions with high density of histone EMs. The increased aggregation of survivin around histone H3 EMs point to its potential regulatory function in gene transcription. Since regions around RA risk SNPs overlap with survivin peaks, survivin’s nuclear function could have immunologically important effects in mechanisms of autoimmune diseases.Disclosure of Interests:None declared
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Steinhauff D, Jensen M, Talbot M, Jia W, Isaacson K, Jedrzkiewicz J, Cappello J, Oottamasathien S, Ghandehari H. Silk-elastinlike copolymers enhance bioaccumulation of semisynthetic glycosaminoglycan ethers for prevention of radiation induced proctitis. J Control Release 2021; 332:503-515. [PMID: 33691185 DOI: 10.1016/j.jconrel.2021.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 12/22/2022]
Abstract
Radiation-induced proctitis (RIP) is a debilitating adverse event that occurs commonly during lower abdominal radiotherapy. The lack of prophylactic treatment strategies leads to diminished patient quality of life, disruption of radiotherapy schedules, and limitation of radiotherapy efficacy due to dose-limiting toxicities. Semisynthetic glycosaminoglycan ethers (SAGE) demonstrate protective effects from RIP. However, low residence time in the rectal tissue limits their utility. We investigated controlled delivery of GM-0111, a SAGE analogue with demonstrated efficacy against RIP, using a series of temperature-responsive polymers to compare how distinct phase change behaviors, mechanical properties and release kinetics influence rectal bioaccumulation. Poly(lactic acid)-co-(glycolic acid)-block-poly(ethylene glycol)-block-poly(lactic acid)-co-(glycolic acid) copolymers underwent macroscopic phase separation, expelling >50% of drug during gelation. Poloxamer compositions released GM-0111 cargo within 1 h, while silk-elastinlike copolymers (SELPs) enabled controlled release over a period of 12 h. Bioaccumulation was evaluated using fluorescence imaging and confocal microscopy. SELP-415K, a SELP analogue with 4 silk units, 15 elastin units, and one elastin unit with lysine residues in the monomer repeats, resulted in the highest rectal bioaccumulation. SELP-415K GM-0111 compositions were then used to provide localized protection from radiation induced tissue damage in a murine model of RIP. Rectal delivery of SAGE using SELP-415K significantly reduced behavioral pain responses, and reduced animal mass loss compared to irradiated controls or treatment with traditional delivery approaches. Histological scoring showed RIP injury was ameliorated for animals treated with GM-0111 delivered by SELP-415K. The enhanced bioaccumulation provided by thermoresponsive SELPs via a liquid to semisolid transition improved rectal delivery of GM-0111 to mice and radioprotection in a RIP model.
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Affiliation(s)
- D Steinhauff
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Utah Center for Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA
| | - M Jensen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - M Talbot
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Utah Center for Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA
| | - W Jia
- Utah Center for Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA
| | - K Isaacson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Utah Center for Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA
| | - J Jedrzkiewicz
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
| | - J Cappello
- Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT 84112, USA
| | - S Oottamasathien
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - H Ghandehari
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Utah Center for Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA; Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT 84112, USA.
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Manisty C, Treibel TA, Jensen M, Semper A, Joy G, Gupta RK, Cutino-Moguel T, Andiapen M, Jones J, Taylor S, Otter A, Pade C, Gibbons J, Lee J, Bacon J, Thomas S, Moon C, Jones M, Williams D, Lambourne J, Fontana M, Altmann DM, Boyton R, Maini M, McKnight A, Chain B, Noursadeghi M, Moon JC. Time series analysis and mechanistic modelling of heterogeneity and sero-reversion in antibody responses to mild SARS‑CoV-2 infection. EBioMedicine 2021; 65:103259. [PMID: 33662833 PMCID: PMC7920816 DOI: 10.1016/j.ebiom.2021.103259] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND SARS-CoV-2 serology is used to identify prior infection at individual and at population level. Extended longitudinal studies with multi-timepoint sampling to evaluate dynamic changes in antibody levels are required to identify the time horizon in which these applications of serology are valid, and to explore the longevity of protective humoral immunity. METHODS Healthcare workers were recruited to a prospective cohort study from the first SARS-CoV-2 epidemic peak in London, undergoing weekly symptom screen, viral PCR and blood sampling over 16-21 weeks. Serological analysis (n =12,990) was performed using semi-quantitative Euroimmun IgG to viral spike S1 domain and Roche total antibody to viral nucleocapsid protein (NP) assays. Comparisons were made to pseudovirus neutralizing antibody measurements. FINDINGS A total of 157/729 (21.5%) participants developed positive SARS-CoV-2 serology by one or other assay, of whom 31.0% were asymptomatic and there were no deaths. Peak Euroimmun anti-S1 and Roche anti-NP measurements correlated (r = 0.57, p<0.0001) but only anti-S1 measurements correlated with near-contemporary pseudovirus neutralising antibody titres (measured at 16-18 weeks, r = 0.57, p<0.0001). By 21 weeks' follow-up, 31/143 (21.7%) anti-S1 and 6/150 (4.0%) anti-NP measurements reverted to negative. Mathematical modelling revealed faster clearance of anti-S1 compared to anti-NP (median half-life of 2.5 weeks versus 4.0 weeks), earlier transition to lower levels of antibody production (median of 8 versus 13 weeks), and greater reductions in relative antibody production rate after the transition (median of 35% versus 50%). INTERPRETATION Mild SARS-CoV-2 infection is associated with heterogeneous serological responses in Euroimmun anti-S1 and Roche anti-NP assays. Anti-S1 responses showed faster rates of clearance, more rapid transition from high to low level production rate and greater reduction in production rate after this transition. In mild infection, anti-S1 serology alone may underestimate incident infections. The mechanisms that underpin faster clearance and lower rates of sustained anti-S1 production may impact on the longevity of humoral immunity. FUNDING Charitable donations via Barts Charity, Wellcome Trust, NIHR.
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Affiliation(s)
- Charlotte Manisty
- Institute of Cardiovascular Sciences, University College London, London, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Thomas Alexander Treibel
- Institute of Cardiovascular Sciences, University College London, London, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Melanie Jensen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Amanda Semper
- National Infection Service, Public Health England, Porton Down, UK
| | - George Joy
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Rishi K Gupta
- Division of Infection and Immunity, University College London, London, UK
| | | | - Mervyn Andiapen
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Jessica Jones
- National Infection Service, Public Health England, Porton Down, UK
| | - Stephen Taylor
- National Infection Service, Public Health England, Porton Down, UK
| | - Ashley Otter
- National Infection Service, Public Health England, Porton Down, UK
| | - Corrina Pade
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Joseph Gibbons
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jason Lee
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Joanna Bacon
- National Infection Service, Public Health England, Porton Down, UK
| | - Steve Thomas
- National Infection Service, Public Health England, Porton Down, UK
| | - Chris Moon
- National Infection Service, Public Health England, Porton Down, UK
| | - Meleri Jones
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Dylan Williams
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Marianna Fontana
- Royal Free London NHS Foundation Trust, London, UK; Division of Medicine, University College London, London, UK
| | - Daniel M Altmann
- Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Rosemary Boyton
- Department of Infectious Disease, Imperial College London, London, UK
| | - Mala Maini
- Division of Infection and Immunity, University College London, London, UK
| | - Aine McKnight
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Benjamin Chain
- Division of Infection and Immunity, University College London, London, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK.
| | - James C Moon
- Institute of Cardiovascular Sciences, University College London, London, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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Hood S, Barrickman N, Djerdjian N, Farr M, Magner S, Roychowdhury H, Gerrits R, Lawford H, Ott B, Ross K, Paige O, Stowe S, Jensen M, Hull K. "I Like and Prefer to Work Alone": Social Anxiety, Academic Self-Efficacy, and Students' Perceptions of Active Learning. CBE Life Sci Educ 2021; 20:ar12. [PMID: 33600218 PMCID: PMC8108489 DOI: 10.1187/cbe.19-12-0271] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Although active learning improves student outcomes in science, technology, engineering, and mathematics (STEM) programs, it may provoke anxiety in some students. We examined whether two psychological variables, social anxiety (psychological distress relating to the fear of negative evaluation by others) and academic self-efficacy (confidence in one's ability to overcome academic challenges), interact with student perceptions of evidence-based instructional practices (EBIPs) and associate with their final grades in a STEM-related course. Human anatomy and physiology students in community college courses rated various EBIPs for their perceived educational value and their capacity to elicit anxiety (N = 227). In general, practices causing students the most anxiety (e.g., cold calling) were reported by students as having the least educational value. When controlling for students' self-reported grade point averages, socially anxious students rated several EBIPs as more anxiety inducing, whereas high-efficacy students reported less anxiety surrounding other EBIPs. Furthermore, mediation analysis revealed that individual differences in academic self-efficacy at the beginning of the term explained some of the negative association between students' social anxiety levels and final grades in the course. Our results, obtained in a community college context, support a growing body of evidence that social anxiety and academic self-efficacy are linked with how students perceive and perform in an active-learning environment.
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Affiliation(s)
- S. Hood
- Bishop’s University, Sherbrooke, QC J1M 1Z7, Canada
- *Address correspondence to: Suzanne Hood (); N. Barrickman ()
| | - N. Barrickman
- Department of Biology, Salt Lake City Community College, Salt Lake City, UT 84123
- *Address correspondence to: Suzanne Hood (); N. Barrickman ()
| | - N. Djerdjian
- Department of Biology, Anoka-Ramsey Community College, South Cambridge, MN 55008-5704
| | - M. Farr
- Department of Biology, Salt Lake City Community College, Salt Lake City, UT 84123
| | - S. Magner
- Department of Biology, Anoka-Ramsey Community College, South Cambridge, MN 55008-5704
| | - H. Roychowdhury
- Science Department, Doña Ana Community College, Las Cruces, NM 88011
| | - R. Gerrits
- Department of Electrical Engineering and Computer Science, Milwaukee School of Engineering, Milwaukee, WI 53202-3109
| | - H. Lawford
- Bishop’s University, Sherbrooke, QC J1M 1Z7, Canada
| | - B. Ott
- Department of Biology, Tyler Junior College, Tyler, TX 75711-9020
| | - K. Ross
- Department of Biomedical Engineering, Georgia Tech and Emory University, Atlanta, GA 30332; and
| | - O. Paige
- Bishop’s University, Sherbrooke, QC J1M 1Z7, Canada
| | - S. Stowe
- Bishop’s University, Sherbrooke, QC J1M 1Z7, Canada
| | - M. Jensen
- **College of Biological Sciences, University of Minnesota, Minneapolis, MN 55455
| | - K. Hull
- Bishop’s University, Sherbrooke, QC J1M 1Z7, Canada
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Bhogal P, Jensen M, Collins G, Spooner O, Makalanda L, Hart D, Jaffer O. Letter in response to: Coagulation markers are independent predictors of increased oxygen requirements and thrombosis in COVID-19. J Thromb Haemost 2020; 18:3382-3384. [PMID: 32846033 PMCID: PMC7461362 DOI: 10.1111/jth.15080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/23/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Pervinder Bhogal
- Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK
| | - Melanie Jensen
- Department of Cardiology, St. Bartholomew's Hospital, Barts NHS Trust, London, UK
| | - George Collins
- Department of Cardiology, St. Bartholomew's Hospital, Barts NHS Trust, London, UK
| | - Oliver Spooner
- Department of Stroke Medicine, The Royal London Hospital, Barts NHS Trust, London, UK
| | - Levansri Makalanda
- Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK
| | - Dan Hart
- Department of Haematology, The Royal London Hospital, Barts NHS Trust, London, UK
| | - Ounali Jaffer
- Department of Interventional Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK
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27
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Holgersen KH, Brønstad I, Jensen M, Brattland H, Reitan SK, Hassel AM, Arentz M, Lara-Cabrera M, Skjervold AE. A combined individual and group-based stabilization and skill training intervention versus treatment as usual for patients with long lasting posttraumatic reactions receiving outpatient treatment in specialized mental health care – a study protocol for a randomized controlled trial. Trials 2020; 21:432. [PMID: 32460840 PMCID: PMC7251667 DOI: 10.1186/s13063-020-04297-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/30/2020] [Indexed: 11/15/2022] Open
Abstract
Background Suffering linked to previous interpersonal trauma is common among patients in mental health care. Diagnostic labels may vary, but the clinical picture is often characterized by long-lasting and complex psychological and somatic symptoms, subjective distress and reduced quality of health and life. A substantial proportion of patients do not recover after individual treatment in ordinary specialized mental healthcare settings, despite the proven usefulness of individual trauma-specific treatments. The therapeutic factors that arise in group settings, such as normalization, shame reduction and corrective relational experiences, may be particularly useful for trauma survivors. However, evidence in support of group treatment for trauma survivors is scarce. This study aims to test whether combining a novel group intervention to individual treatment is superior to conventional individual out-patient treatment in an ordinary community mental health hospital. Methods In a single-site, non-blinded, randomized controlled trial (RCT), the effect of a combined group-based stabilization and skill-training (SST) intervention added to individual treatment will be compared to conventional treatment (treatment as usual, TAU) alone. Participants (N = 160) with ongoing and long-lasting reactions related to known adverse life events from the past will be recruited among patients at general outpatient clinics in a community mental health centre at St. Olav’s University Hospital, Trondheim, Norway. Following baseline assessment and randomization, participants will complete follow-up measures at 4, 8, 13 and 19 months post-baseline. The primary outcome is personal recovery (The questionnaire about the process of recovery , QPR). Secondary outcomes include (1) self-reported symptoms of posttraumatic stress, general mental and somatic health symptoms, well-being, functional impairment and client satisfaction, (2) immunological and endocrine response measured in blood samples and (3) national registry data on occupational status, use of mental health services and pharmacological treatment. Additionally, mechanisms of change via posttraumatic cognitions will be examined. Discussion The addition of a group-based intervention to individual treatment for trauma survivors might prove to be an efficient way to meet the need of long-lasting high-intensity treatment in a large group of patients in mental health care, thereby reducing their suffering and increasing their psychosocial functioning. Trial registration ClinicalTrials.gov: NCT03887559. Registered on 25 March 2019.
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28
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Melgaard L, Overvad T, Jensen M, Lip G, Larsen T, Nielsen P. Thromboembolic risk in non-anticoagulated atrial fibrillation patients with valvular heart disease and low CHA2DS2-VASc scores: are these patients truly low risk of stroke? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0516] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with atrial fibrillation and valvular heart disease (VHD) beyond moderate-to-severe mitral stenosis and/or a mechanical prosthetic valve, so-called EHRA Type 2 VHD, have been associated with a higher risk of thromboembolism compared with patients with atrial fibrillation and no VHD. A minor but important proportion of patients with atrial fibrillation and EHRA Type 2 VHD has 0 or 1 coexisting CHA2DS2-VASc stroke risk factors, and are therefore not strongly recommended oral anticoagulant therapy according to guidelines. Whether these patients are “truly low” risk of stroke has not been investigated. We aimed to describe the risk of thromboembolism in non-anticoagulated atrial fibrillation patients with and without EHRA Type 2 VHD and with 0 or 1 non-sex comorbidity of the CHA2DS2-VASc score.
Methods
Cohort study of atrial fibrillation patients with and without EHRA Type 2 VHD identified in nationwide Danish registries from 2000–2018. 1-year risk of thromboembolism was estimated for the study population divided into four subgroups in relation to non-sex CHA2DS2-VASc score comorbidities (except for previous thromboembolism) and age category (<65 or 65–74 years).
Results
We identified 1,907 and 53,707 incident atrial fibrillation patients with and without EHRA Type 2 VHD. Median age was 57 years and 55 years in patients with and without EHRA Type 2 VHD and 0 comorbidities and 67 years in patients with and without EHRA Type 2 VHD and 1 comorbidity. Percentage of females was approximately 44% in patients with and without EHRA Type 2 VHD and 0 comorbidities and 33% and 36% in patients with and without EHRA Type 2 VHD and 1 comorbidity. In patients with 1 comorbidity, the most prevalent stroke risk factor of the CHA2DS2-VASc score was hypertension. Cumulative incidence of thromboembolism according to presence of EHRA Type 2 VHD and age category in patients with 0 or 1 non-sex comorbidity of the CHA2DS2-VASc score are presented in the figure (the curve for patients with EHRA Type 2 VHD aged 65–74 years and with 0 comorbidities was omitted due to few events). At 1 year after atrial fibrillation diagnosis, patients with and without EHRA Type 2 VHD aged <65 or 65–74 years and with 0 or 1 comorbidity of the CHA2DS2-VASc score had a risk of thromboembolism ranging 1.3–2.2% and 0.5–1.7% according to age category and number of comorbidities of the CHA2DS2-VASc score. In patients with EHRA Type 2 VHD aged <65 years with 0 or 1 comorbidity, the risk was 1.5% and 2.2% at 1 year after the diagnosis of atrial fibrillation.
Conclusion
In atrial fibrillation patients with EHRA Type 2 VHD, we observed a risk of thromboembolism that may exceed the level above which oral anticoagulation is considered beneficial. No trial has specifically examined patients with EHRA Type 2 VHD and low CHA2DS2-VASc scores and, therefore, our observations may be important to patients who are not recommended oral anticoagulant therapy according to contemporary guidelines.
Figure 1. Cumulative incidence of thromboembolism
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): The study was supported by “The BMS/Pfizer European Thrombosis Investigator Initiated Research Program (ERISTA) 2018” and the Obel Family Foundation.
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Affiliation(s)
- L Melgaard
- Aalborg University Hospital, Department of Cardiology, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
| | - T.F Overvad
- Aalborg University Hospital, Department of Cardiology, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
| | - M Jensen
- Aalborg University Hospital, Department of Cardiology, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
| | - G.Y.H Lip
- University of Liverpool, Center for Cardiovascular Sciences, Liverpool, United Kingdom
| | - T.B Larsen
- Aalborg University Hospital, Department of Cardiology, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
| | - P.B Nielsen
- Aalborg University Hospital, Department of Cardiology, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
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Affiliation(s)
| | | | - Dan Hart
- The Royal London Hospital, London, UK
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Vrou Offersen B, Nielsen H, Jacobsen E, Nielsen M, Krause M, Stenbygaard L, Mjaaland I, Schreiber A, Kasti U, Jensen M, Alsner J, Overgaard J. OC-0371: Hypo- vs normofractionated radiation of early breast cancer in the randomized DBCG HYPO trial. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00395-9] [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: 10/22/2022]
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Treibel TA, Manisty C, Andiapen M, Pade C, Jensen M, Fontana M, Couto-Parada X, Cutino-Moguel T, Noursadeghi M, Moon JC. Asymptomatic health-care worker screening during the COVID-19 pandemic - Authors' reply. Lancet 2020; 396:1394-1395. [PMID: 33129388 PMCID: PMC7598568 DOI: 10.1016/s0140-6736(20)32211-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Thomas A Treibel
- Institute of Cardiovascular Science, University College London, London, UK; Department of Cardiology, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Science, University College London, London, UK; Department of Cardiology, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Mervyn Andiapen
- Centre for Cardiovascular Medicine and Devices, Queen Mary University of London, London, UK
| | - Corinna Pade
- William Harvey Research Institute, Queen Mary University of London, London, UK; The Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Melanie Jensen
- Department of Cardiology, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Marianna Fontana
- National Amyloidosis Centre, Division of Medicine, University College London, London, UK; Royal Free London NHS Foundation Trust, London, UK
| | - Xosé Couto-Parada
- Department of Virology, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Teresa Cutino-Moguel
- Department of Virology, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, London, UK; Department of Cardiology, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.
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32
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Jensen M, Boutitie F, Cheng B, Cho TH, Ebinger M, Endres M, Fiebach JB, Fiehler J, Ford I, Galinovic I, Königsberg A, Puig J, Roy P, Wouters A, Thijs V, Lemmens R, Muir KW, Nighoghossian N, Pedraza S, Simonsen CZ, Gerloff C, Thomalla G. Polypharmacy, functional outcome and treatment effect of intravenous alteplase for acute ischaemic stroke. Eur J Neurol 2020; 28:532-539. [PMID: 33015924 DOI: 10.1111/ene.14566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/26/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Polypharmacy is an important challenge in clinical practice. Our aim was to determine the effect of polypharmacy on functional outcome and treatment effect of alteplase in acute ischaemic stroke. METHODS This was a post hoc analysis of the randomized, placebo-controlled WAKE-UP trial of magnetic resonance imaging guided intravenous alteplase in unknown onset stroke. Polypharmacy was defined as an intake of five or more medications at baseline. Comorbidities were assessed by the Charlson Comorbidity Index (CCI). The primary efficacy variable was favourable outcome defined by a score of 0-1 on the modified Rankin Scale at 90 days. Logistic regression analysis was used to test for an association of polypharmacy with functional outcome, and for interaction of polypharmacy and the effect of thrombolysis. RESULTS Polypharmacy was present in 133/503 (26%) patients. Patients with polypharmacy were older (mean age 70 vs. 64 years; p < 0.0001) and had a higher score on the National Institutes of Health Stroke Scale at baseline (median 7 vs. 5; p = 0.0007). A comorbidity load defined by a CCI score ≥ 2 was more frequent in patients with polypharmacy (48% vs. 8%; p < 0.001). Polypharmacy was associated with lower odds of favourable outcome (adjusted odds ratio 0.50, 95% confidence interval 0.30-0.85; p = 0.0099), whilst the CCI score was not. Treatment with alteplase was associated with higher odds of favourable outcome in both groups, with no heterogeneity of treatment effect (test for interaction of treatment and polypharmacy, p = 0.29). CONCLUSION In stroke patients, polypharmacy is associated with worse functional outcome after intravenous thrombolysis independent of comorbidities. However, polypharmacy does not interact with the beneficial effect of alteplase.
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Affiliation(s)
- M Jensen
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Boutitie
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - B Cheng
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T-H Cho
- Department of Stroke Medicine, CREATIS CNRS UMR 5220-INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France
| | - M Ebinger
- Centrum für Schlaganfallforschung Berlin (CSB), Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Neurologie der Rehaklinik Medical Park Humboldtmühle, Berlin, Germany
| | - M Endres
- Centrum für Schlaganfallforschung Berlin (CSB), Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Partner Site Berlin, German Center for Neurodegenerative Disease (DZNE), Berlin, Germany.,Partner Site Berlin, German Center for Cardiovascular Research (DZHK), Berlin, Germany
| | - J B Fiebach
- Centrum für Schlaganfallforschung Berlin (CSB), Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - J Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Ford
- Robertson Centre for Biostatistics, University of Glasgow, University Avenue, Glasgow, UK
| | - I Galinovic
- Centrum für Schlaganfallforschung Berlin (CSB), Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - A Königsberg
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Puig
- Department of Radiology, Institut de Diagnostic per la Image (IDI), Institut d'Investigació Biomèdica de Girona (IDIBGI), Hospital Dr Josep Trueta, Parc Hospitalari Martí i Julià de Salt - Edifici M2, Girona, Spain
| | - P Roy
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
| | - A Wouters
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,Center for Brain and Disease Research, Laboratory of Neurobiology, Campus Gasthuisberg, VIB, Leuven, Belgium
| | - V Thijs
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Vic., Australia.,Department of Neurology, Austin Health, Heidelberg, Vic., Australia
| | - R Lemmens
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,Center for Brain and Disease Research, Laboratory of Neurobiology, Campus Gasthuisberg, VIB, Leuven, Belgium
| | - K W Muir
- Institute of Neuroscience and Psychology, University of Glasgow, University Avenue, Glasgow, UK
| | - N Nighoghossian
- Department of Stroke Medicine, CREATIS CNRS UMR 5220-INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France
| | - S Pedraza
- Department of Radiology, Institut de Diagnostic per la Image (IDI), Institut d'Investigació Biomèdica de Girona (IDIBGI), Hospital Dr Josep Trueta, Parc Hospitalari Martí i Julià de Salt - Edifici M2, Girona, Spain
| | - C Z Simonsen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - C Gerloff
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Thomalla
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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33
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Jensen M, Thomalla G. Neither asymptomatic nor inevitable: intracerebral hemorrhage after reperfusion treatment. Eur J Neurol 2020; 28:3-4. [PMID: 32986292 DOI: 10.1111/ene.14562] [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] [Received: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022]
Affiliation(s)
- M Jensen
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - G Thomalla
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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34
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Augusto JB, Menacho K, Andiapen M, Bowles R, Burton M, Welch S, Bhuva AN, Seraphim A, Pade C, Joy G, Jensen M, Davies RH, Captur G, Fontana M, Montgomery H, O’Brien B, Hingorani AD, Cutino-Moguel T, McKnight Á, Abbass H, Alfarih M, Alldis Z, Baca GL, Boulter A, Bracken OV, Bullock N, Champion N, Chan C, Couto-Parada X, Dieobi-Anene K, Feehan K, Figtree G, Figtree MC, Finlay M, Forooghi N, Gibbons JM, Griffiths P, Hamblin M, Howes L, Itua I, Jones M, Jardim V, Kapil V, Jason Lee WY, Mandadapu V, Mfuko C, Mitchelmore O, Palma S, Patel K, Petersen SE, Piniera B, Raine R, Rapala A, Richards A, Sambile G, Couto de Sousa J, Sugimoto M, Thornton GD, Artico J, Zahedi D, Parker R, Robathan M, Hickling LM, Ntusi N, Semper A, Brooks T, Jones J, Tucker A, Veerapen J, Vijayakumar M, Wodehouse T, Wynne L, Treibel TA, Noursadeghi M, Manisty C, Moon JC. Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19. Wellcome Open Res 2020; 5:179. [PMID: 33537459 PMCID: PMC7836029 DOI: 10.12688/wellcomeopenres.16051.2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Most biomedical research has focused on sampling COVID-19 patients presenting to hospital with advanced disease, with less focus on the asymptomatic or paucisymptomatic. We established a bioresource with serial sampling of health care workers (HCWs) designed to obtain samples before and during mainly mild disease, with follow-up sampling to evaluate the quality and duration of immune memory. Methods: We conducted a prospective study on HCWs from three hospital sites in London, initially at a single centre (recruited just prior to first peak community transmission in London), but then extended to multiple sites 3 weeks later (recruitment still ongoing, target n=1,000). Asymptomatic participants attending work complete a health questionnaire, and provide a nasal swab (for SARS-CoV-2 RNA by RT-PCR tests) and blood samples (mononuclear cells, serum, plasma, RNA and DNA are biobanked) at 16 weekly study visits, and at 6 and 12 months. Results: Preliminary baseline results for the first 731 HCWs (400 single-centre, 331 multicentre extension) are presented. Mean age was 38±11 years; 67% are female, 31% nurses, 20% doctors, and 19% work in intensive care units. COVID-19-associated risk factors were: 37% black, Asian or minority ethnicities; 18% smokers; 13% obesity; 11% asthma; 7% hypertension and 2% diabetes mellitus. At baseline, 41% reported symptoms in the preceding 2 weeks. Preliminary test results from the initial cohort (n=400) are available: PCR at baseline for SARS-CoV-2 was positive in 28 of 396 (7.1%, 95% CI 4.9-10.0%) and 15 of 385 (3.9%, 2.4-6.3%) had circulating IgG antibodies. Conclusions: This COVID-19 bioresource established just before the peak of infections in the UK will provide longitudinal assessments of incident infection and immune responses in HCWs through the natural time course of disease and convalescence. The samples and data from this bioresource are available to academic collaborators by application https://covid-consortium.com/application-for-samples/.
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Affiliation(s)
- João B Augusto
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Katia Menacho
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mervyn Andiapen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ruth Bowles
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Maudrian Burton
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
- NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Sophie Welch
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Anish N Bhuva
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Andreas Seraphim
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Corinna Pade
- William Harvey Research Institute, Queen Mary University of London, London, UK
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - George Joy
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Melanie Jensen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Rhodri H Davies
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Gabriella Captur
- Institute of Cardiovascular Science, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Marianna Fontana
- Institute of Cardiovascular Science, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - Hugh Montgomery
- Centre for Human Health and Performance, University College London, London, UK
| | - Ben O’Brien
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Aroon D Hingorani
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Áine McKnight
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - Hakam Abbass
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mashael Alfarih
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Zoe Alldis
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Georgina L Baca
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Alex Boulter
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | | | - Natalie Bullock
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Nicola Champion
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Carmen Chan
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | | | - Keenan Dieobi-Anene
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Karen Feehan
- Division of Medicine, University College London, London, UK
| | - Gemma Figtree
- Royal North Shore Hospital; The University of Sydney, Sydney, Australia
| | - Melanie C Figtree
- Royal North Shore Hospital; The University of Sydney, Sydney, Australia
| | - Malcolm Finlay
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Nasim Forooghi
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Joseph M Gibbons
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - Peter Griffiths
- School of Health Sciences, University of Southampton & NIHR Applied Research Collaboration (ARC), Wessex, UK
| | - Matt Hamblin
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Lee Howes
- Institute of Cardiovascular Science, University College London, London, UK
| | - Ivie Itua
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Meleri Jones
- Wolfson Institute of Preventative Medicine, Centre for Cancer Prevention, Queen Mary University of London, London, UK
| | - Victor Jardim
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Vikas Kapil
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Wing-Yiu Jason Lee
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - Vineela Mandadapu
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Celina Mfuko
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Oliver Mitchelmore
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Susana Palma
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Kush Patel
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Steffen E Petersen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
- NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Brian Piniera
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Alicja Rapala
- Institute of Cardiovascular Science, University College London, London, UK
| | - Amy Richards
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Genine Sambile
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Jorge Couto de Sousa
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | | | - George D Thornton
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Jessica Artico
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Dan Zahedi
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ruth Parker
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Mathew Robathan
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Lauren M Hickling
- East London NHS Foundation Trust Unit for Social and Community Psychiatry, Newham Centre for Mental Health, London, UK
| | - Ntobeko Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | | | | | | | - Art Tucker
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Jessry Veerapen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mohit Vijayakumar
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Theresa Wodehouse
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Lucinda Wynne
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Thomas A Treibel
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
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Chahalis E, Daines C, Jensen M, Miller J. HIA on affordable housing policies and its effect on health and services of vulnerable populations. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
Lack of affordable housing in Utah for vulnerable populations such as immigrants/refugees, low-income families, single parents and individuals with disabilities. A health impact assessment is necessary to identify the negative health impacts that arise and to determine how a policy to provide more funding for affordable housing can benefit the population. This issue is not specific to Utah and is comparable to other housing situations and policies throughout the U.S.
Description
The six steps of an HIA were completed in 4 months to analyze the potential health effects of affordable housing policy changes among low-income families in Utah. The HIA team completed an extensive literature review and communicated with several stakeholders, policy makers, and community leaders. Public state and national data was gathered and analyzed using a logic model and characterization of effects table.
Results
The bill to increase funding will increase affordable housing units throughout Utah. The negative health impacts for the population will decrease such as respiratory illnesses, hospital visits, crime, mental health disorders, and stress. The bill would also help to increase family housing stability, economic development, educational opportunities for children, and access to transportation.
Lessons
The recommendations include the use of funding for new development or the renovation of existing units, the location of developments should be near public transit to allow residents to take advantage of services that previously would not have been accessible. Developments should be an integrated approach that includes social support and case management services to narrow the gap in Utah and other areas in the U.S.
Key messages
Policies to increase affordable housing produce positive health impacts for vulnerable populations. Overall efforts for affordable housing will give these vulnerable populations better access to basic human needs.
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Affiliation(s)
- E Chahalis
- Public Health, Brigham Young University, Provo, USA
| | - C Daines
- Public Health, Brigham Young University, Provo, USA
| | - M Jensen
- Public Health, Brigham Young University, Provo, USA
| | - J Miller
- Public Health, Brigham Young University, Provo, USA
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36
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Beckstead E, Niedfeldt H, Chahalis E, Jensen M, Reher B, Torres S, Jusril H, Rachmi CN, West J, Hall C. Using technology to access health information: greater WASH knowledge/behaviors in Indonesian mothers. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.686] [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: 11/13/2022] Open
Abstract
Abstract
Background
Despite attention, childhood stunting in Indonesia persists. Proper WASH (Water, Sanitation, and Hygiene) practices help lower childhood stunting. As internet access in Indonesia grows, seeking health information online is increasing. However, research on using technology to increase WASH knowledge and behaviors in Indonesia is limited. The purpose of this study is to assess whether Indonesian women using technology to access health information have higher WASH knowledge and behaviors.
Methods
1,740 mothers with children under the age of two were randomly selected with three-stage cluster sampling. They were surveyed and interviewed about handwashing and sanitary defecation benefits, steps, and practices. Adjusted and unadjusted logistic and linear regression models were used to compare WASH outcomes between those who used technology to access health information and the control group. The models controlled for mother's age, mother's education, and total household income.
Results
Participants who used technology to access health information were more likely to know the benefits (OR = 2.603; CI = 1.666-4.067) and five critical times (OR = 1.217; CI=.969-1.528) of proper handwashing. Mothers were more likely to know the risks of open defecation (OR = 1.627; CI = 1.170-2.264) and understand disease transmission from stool (OR = 1.894; CI = 1.438-2.495). Those using technology to access health information were more likely to report using a gooseneck, squat toilet, septic tank, or closed ground to discard feces than the control group (OR = 3.858; CI = 2.628-5.665).
Conclusions
Using technology to access health information was associated with increased handwashing and defecation knowledge and safe elimination of feces. It was not associated with an increase in handwashing with soap. Technology can be used to increase WASH knowledge and behavior, but further research is needed to effectively use technology to increase optimal handwashing behaviors.
Key messages
Increasing technology access may encourage good water, sanitation and hygiene behavior change. Using technology to access health information yielded safer defecation practices but not better handwashing practices. Further research is needed.
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Affiliation(s)
- E Beckstead
- Public Health, Brigham Young University, Provo, USA
| | - H Niedfeldt
- Public Health, Brigham Young University, Provo, USA
| | - E Chahalis
- Public Health, Brigham Young University, Provo, USA
| | - M Jensen
- Public Health, Brigham Young University, Provo, USA
| | - B Reher
- Public Health, Brigham Young University, Provo, USA
| | - S Torres
- Neglected Tropical Diseases, RTI International, Washington D.C., USA
| | - H Jusril
- Center for Health Research, Universitas Indonesia, Depok, Indonesia
| | - C N Rachmi
- Utama Integra, Reconstra, Jakarta, Indonesia
| | - J West
- Public Health, Brigham Young University, Provo, USA
| | - C Hall
- Public Health, Brigham Young University, Provo, USA
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37
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Augusto JB, Menacho K, Andiapen M, Bowles R, Burton M, Welch S, Bhuva AN, Seraphim A, Pade C, Joy G, Jensen M, Davies RH, Captur G, Fontana M, Montgomery H, O’Brien B, Hingorani AD, Cutino-Moguel T, McKnight Á, Abbass H, Alfarih M, Alldis Z, Baca GL, Boulter A, Bracken OV, Bullock N, Champion N, Chan C, Couto-Parada X, Dieobi-Anene K, Feehan K, Figtree G, Figtree MC, Finlay M, Forooghi N, Gibbons JM, Griffiths P, Hamblin M, Howes L, Itua I, Jones M, Jardim V, Kapil V, Jason Lee WY, Mandadapu V, Mfuko C, Mitchelmore O, Palma S, Patel K, Petersen SE, Piniera B, Raine R, Rapala A, Richards A, Sambile G, Couto de Sousa J, Sugimoto M, Thornton GD, Artico J, Zahedi D, Parker R, Robathan M, Hickling LM, Ntusi N, Semper A, Brooks T, Jones J, Tucker A, Veerapen J, Vijayakumar M, Wodehouse T, Wynne L, Treibel TA, Noursadeghi M, Manisty C, Moon JC. Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19. Wellcome Open Res 2020; 5:179. [PMID: 33537459 PMCID: PMC7836029 DOI: 10.12688/wellcomeopenres.16051.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 01/20/2024] Open
Abstract
Background: Most biomedical research has focused on sampling COVID-19 patients presenting to hospital with advanced disease, with less focus on the asymptomatic or paucisymptomatic. We established a bioresource with serial sampling of health care workers (HCWs) designed to obtain samples before and during mainly mild disease, with follow-up sampling to evaluate the quality and duration of immune memory. Methods: We conducted a prospective observational study on HCWs from three hospital sites in London, initially at a single centre (recruited just prior to first peak community transmission in London), but then extended to multiple sites 3 weeks later (recruitment still ongoing, target n=1,000). Asymptomatic participants attending work complete a health questionnaire, and provide a nasal swab (for SARS-CoV-2 RNA by RT-PCR tests) and blood samples (mononuclear cells, serum, plasma, RNA and DNA are biobanked) at 16 weekly study visits, and at 6 and 12 months. Results: Preliminary baseline results for the first 731 HCWs (400 single-centre, 331 multicentre extension) are presented. Mean age was 38±11 years; 67% are female, 31% nurses, 20% doctors, and 19% work in intensive care units. COVID-19-associated risk factors were: 37% black, Asian or minority ethnicities; 18% smokers; 13% obesity; 11% asthma; 7% hypertension and 2% diabetes mellitus. At baseline, 41% reported symptoms in the preceding 2 weeks. Preliminary test results from the initial cohort (n=400) are available: PCR at baseline for SARS-CoV-2 was positive in 28 of 396 (7.1%, 95% CI 4.9-10.0%) and 15 of 385 (3.9%, 2.4-6.3%) had circulating IgG antibodies. Conclusions: This COVID-19 bioresource established just before the peak of infections in the UK will provide longitudinal assessments of incident infection and immune responses in HCWs through the natural time course of disease and convalescence. The samples and data from this bioresource are available to academic collaborators by application https://covid-consortium.com/application-for-samples/.
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Affiliation(s)
- João B Augusto
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Katia Menacho
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mervyn Andiapen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ruth Bowles
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Maudrian Burton
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
- NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Sophie Welch
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Anish N Bhuva
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Andreas Seraphim
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Corinna Pade
- William Harvey Research Institute, Queen Mary University of London, London, UK
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - George Joy
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Melanie Jensen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Rhodri H Davies
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Gabriella Captur
- Institute of Cardiovascular Science, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Marianna Fontana
- Institute of Cardiovascular Science, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - Hugh Montgomery
- Centre for Human Health and Performance, University College London, London, UK
| | - Ben O’Brien
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Aroon D Hingorani
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Áine McKnight
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - Hakam Abbass
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mashael Alfarih
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Zoe Alldis
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Georgina L Baca
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Alex Boulter
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | | | - Natalie Bullock
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Nicola Champion
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Carmen Chan
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | | | - Keenan Dieobi-Anene
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Karen Feehan
- Division of Medicine, University College London, London, UK
| | - Gemma Figtree
- Royal North Shore Hospital; The University of Sydney, Sydney, Australia
| | - Melanie C Figtree
- Royal North Shore Hospital; The University of Sydney, Sydney, Australia
| | - Malcolm Finlay
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Nasim Forooghi
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Joseph M Gibbons
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - Peter Griffiths
- School of Health Sciences, University of Southampton & NIHR Applied Research Collaboration (ARC), Wessex, UK
| | - Matt Hamblin
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Lee Howes
- Institute of Cardiovascular Science, University College London, London, UK
| | - Ivie Itua
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Meleri Jones
- Wolfson Institute of Preventative Medicine, Centre for Cancer Prevention, Queen Mary University of London, London, UK
| | - Victor Jardim
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Vikas Kapil
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Wing-Yiu Jason Lee
- The Blizard Institute, Queen Mary University of London School of Medicine and Dentistry, London, UK
| | - Vineela Mandadapu
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Celina Mfuko
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Oliver Mitchelmore
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Susana Palma
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Kush Patel
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Steffen E Petersen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
- NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Brian Piniera
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, UK
| | - Alicja Rapala
- Institute of Cardiovascular Science, University College London, London, UK
| | - Amy Richards
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Genine Sambile
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Jorge Couto de Sousa
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | | | - George D Thornton
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Jessica Artico
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Dan Zahedi
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ruth Parker
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Mathew Robathan
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Lauren M Hickling
- East London NHS Foundation Trust Unit for Social and Community Psychiatry, Newham Centre for Mental Health, London, UK
| | - Ntobeko Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | | | | | | | - Art Tucker
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Jessry Veerapen
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mohit Vijayakumar
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Theresa Wodehouse
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Lucinda Wynne
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Thomas A Treibel
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - Charlotte Manisty
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, London, UK
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK, London, UK
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Andersson KM, Erlandsson M, Oparina N, Damdimopoulos A, Jensen M, Garcia-Bonete MJ, Katona G, Bokarewa MI. THU0037 SURVIVIN INHIBITS TRANSCRIPTION OF PBX1 AND SUPPORTS THE EFFECTOR PHENOTYPE OF THE MEMORY CD4 T CELLS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5426] [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
Background:The oncogenic protein survivin is a marker of severe rheumatoid arthritis (RA). High serum levels of Survivin predict progressive joint damage1and poor treatment response2.Objectives:To study the role of survivin in the transcriptional regulation of phenotype in CD4+T cells.Methods:CD4+T cells of RA female patients were isolated from the perpheral blood. Activated CD4+cells were treated with survivin inhibitor YM155. Transcriptional analysis was done by RNAseq (Illumina) and conventional qPCR. Chromatin of CD4 cells was immunoprecipitated using polyclonal antibodies to survivin and subjected to deep sequencing (survivin ChIPseq, Hiseq2000, Illumina) and aligned to GRCh38. Statistical analysis of differentially expressed genes (DEG) was done in R-studio using Benjamini-Hochberg adjustment for multiple testing (Bioconductor, DESeq2 package).Results:Survivin ChIPseq of the activated CD4+T cells was enriched with the genes engaged in regulatory transcription factor specific DNA binding (GO:0000987, adj p=0.0005) and RNA polymerase II regulatory transcription (GO:0000978, adj p = 0.0004). Among survivin targets were the genes of HOX-B cluster and TALE family proteins MEIS, PKNOX and PBX1 controlling early leukopoesis and T cell maturation. Inhibition of survivin in PBMC resulted in significant upregulation of PBX1 (p=0.023), MEIS3 (p=0.0036), similar tendency was observed for HOXB6 and HOXC4 genes. RNAseq analysis CD4 cells of RA patients with different transcription of PBX1, identified 1636 genes (adj p<10-5). BIRC5, coding for survivin, was 8.3 folds higher in CD4+cells with low PBX1 (p=0.0005). Among the core transcription factors of T helper cell differentiation, we identifed NF-kB1 and NF-kB2, TBX21, IRF4, IRF8 and STAT3, BATF and BATF3. This followed by significantly higher TNF, IFNg and IL17A and IL17F in PBX1lo CD4 T cells. The pathway enrichment analysis of DEG identified strong over-representation of cytokine-specific genes (GO:005125, GO:0005126, GO:0048018, GO:0030545, FDR q-values 10-12-10-9). The genes of IL4, IL5, IL13, IL9, IL3 and CSF2 located within the chromosome 5 were common for all GO-lists, and were higher in PBX1lo, but none of those genes was identified by survivin-ChIPseq or PBX1-ChIPseq. Analysis of ChIPseq data identified the genes of STAT3, IRF4, IRF8 and BATF as common targets for PBX1 and survivin.Conclusion:This genome-wide analysis indicates that survivin regulates transcription of the TALE family protein PBX1 in CD4+ T cells, which has essential effect for differentiation and phenotype of Th subsets. Low PBX1 in RA patients is associated with terminally differentiated effector CD4+ T cells.References:[1]Svensson, B.et.al.Smoking in combination with antibodies to cyclic citrullinated peptides is associated with persistently high levels of survivin in early rheumatoid arthritis: a prospective cohort study.Arthritis Res Ther16, R12 (2014).[2]Levitsky, A.et.al.Serum survivin predicts responses to treatment in active rheumatoid arthritis: a post hoc analysis from the SWEFOT trial.BMC Med13, 247 (2015).Disclosure of Interests:None declared
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Searchfield GD, Spiegel DP, Poppe TNER, Durai M, Jensen M, Kobayashi K, Park J, Russell BR, Shekhawat GS, Sundram F, Thompson BB, Wise KJ. A proof-of-concept study comparing tinnitus and neural connectivity changes following multisensory perceptual training with and without a low-dose of fluoxetine. Int J Neurosci 2020; 131:433-444. [PMID: 32281466 DOI: 10.1080/00207454.2020.1746310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background. This proof-of-concept study investigated a method of multisensory perceptual training for tinnitus, and whether a short, low-dose administration of fluoxetine enhanced training effects and changed neural connectivity.Methods. A double-blind, randomized placebo controlled design with 20 participants (17 male, 3 female, mean age = 57.1 years) involved 30 min daily computer-based, multisensory training (matching visual, auditory and tactile stimuli to perception of tinnitus) for 20 days, and random allocation to take 20 mg fluoxetine or placebo daily. Behavioral measures of tinnitus and correlations between pairs of a priori regions of interest (ROIs), obtained using resting-state functional magnetic resonance imaging (rs-fMRI), were performed before and after the training.Results. Significant changes in ratings of tinnitus loudness, annoyance, and problem were observed with training. No statistically significant changes in Tinnitus Functional Index, Tinnitus Handicap Inventory or Depression Anxiety Stress Scales were found with training. Fluoxetine did not alter any of the behavioural outcomes of training compared to placebo. Significant changes in connectivity between ROIs were identified with training; sensory and attention neural network ROI changes correlated with significant tinnitus rating changes. Rs-fMRI results suggested that the direction of functional connectivity changes between auditory and non-auditory networks, with training and fluoxetine, were opposite to the direction of those changes with multisensory training and placebo.Conclusions. Improvements in tinnitus measures were correlated with changes in sensory and attention networks. The results provide preliminary evidence for changes in rs-fMRI accompanying a multisensory training method in persons with tinnitus.
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Affiliation(s)
- G D Searchfield
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand, New Zealand
| | - D P Spiegel
- Essilor Research and Development, Singapore, Singapore
| | - T N E R Poppe
- Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - M Durai
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - M Jensen
- Bay of Plenty and School of Pharmacy, Pharmacy, Whakatane Hospital, University of Auckland, Auckland, New Zealand
| | - K Kobayashi
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Acoustics Centre, Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - J Park
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand
| | - B R Russell
- School of Pharmacy, Otago University, Dunedin, New Zealand
| | | | - F Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - B B Thompson
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - K J Wise
- Eisdell Moore Centre & Speech Science, The University of Auckland, Auckland, New Zealand
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Lindgren L, Jørgensen PB, Mørup RMS, Jensen M, Rømer L, Kaptein B, Stilling M. Similar patient positioning: A key factor in follow-up studies when using model-based radiostereometric analysis of the hip. Radiography (Lond) 2020; 26:e45-e51. [PMID: 32052775 DOI: 10.1016/j.radi.2019.10.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/30/2019] [Accepted: 10/22/2019] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Despite protocols, patients are not positioned exactly alike at radiostereometric (RSA) follow-up examinations, and it is unknown how much variation is tolerable. We report precision for optimal and extreme position differences from a phantom hip-study, and clinical precision of hip-RSA. METHODS A femoral stem with 3 bead-towers was fixed in a saw bone with bone-markers (phantom), and series of RSA examinations within optimal (5 × 5 cm and 5°) and extreme (20 × 30 cm and 30°) phantom positions were obtained. Double-examination RSA of 12 patients with the same femoral stem type were analyzed. Both model-based (CAD) and marker-based (MM) analysis was used. Precision was reported as standard deviation of differences. RESULTS Precision for translations in the optimal and extreme phantom position were below 0.06 mm and 0.02 mm for MM analysis, and below 0.05 mm and 0.18 mm for CAD analysis, respectively. Precision for rotations in the optimal and extreme phantom rotation were below 0.18° and 0.26° for MM analysis, and below 0.34° and 0.52° for CAD analysis, respectively. Clinical precision was 0.29 mm and 0.44° for MM analysis, and 0.40 mm and 1.59° for CAD analysis. CONCLUSION Extreme differences in patient position during RSA examination negatively affects precision, and CAD model-analysis was more sensitive than MM analysis. Longitudinal translation and rotation about the long stem-axis are the effect parameters which are most affected by position and rotation changes, and also the best indicators of implant loosening. IMPLICATIONS FOR PRACTICE Based on our research, we recommend that similar patient positioning between follow-up RSA examinations is debated and prioritized.
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Affiliation(s)
- L Lindgren
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - P B Jørgensen
- Orthopedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - R M S Mørup
- Orthopedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - M Jensen
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - L Rømer
- Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - B Kaptein
- Biomechanics and Imaging Group (BIG), Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands.
| | - M Stilling
- Orthopedic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
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Searchfield GD, Poppe TNER, Durai M, Jensen M, Kennedy MA, Maggo S, Miller AL, Park J, Russell BR, Shekhawat GS, Spiegel D, Sundram F, Wise K. A proof-of-principle study of the short-term effects of 3,4-methylenedioxymethamphetamine (MDMA) on tinnitus and neural connectivity. Int J Neurosci 2020; 130:671-682. [PMID: 31814488 DOI: 10.1080/00207454.2019.1702544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: This study was conducted to investigate the short-term behavioural and neurophysiological effects of 3,4-methylenedioxymethamphetamine (MDMA) on tinnitus perception.Methods: A double-blind randomized controlled cross-over design. Part 1. Behavioural measures of tinnitus following 30 mg MDMA or placebo administration (N = 5 participants) and Part 2. Behavioural measures of tinnitus and correlations between pairs of apriori regions of interest (ROI) using resting-state functional magnetic resonance imaging (rs-fMRI) before and after 70 mg of MDMA or placebo (N = 8 participants).Results: The results to MDMA were similar to placebo. For the 70 mg dose, there was a significant reduction after 4 h in annoyance and ignore ratings. RsMRI showed decreased connectivity compared with placebo administration between the left hippocampal, right hippocampal, left amygdala and right amygdala regions, and between the right posterior parahippocampal cortex and the left amygdala after two hours of 70 mg MDMA administration. Increased connectivity compared to placebo administration was found post MDMA between the right post-central gyrus and right posterior and superior temporal gyrus, and between the thalamus and frontoparietal network.Conclusions: Following 70 mg of MDMA two tinnitus rating scales significantly improved. There was, however, a placebo effect. Compared with placebo the rsMRI following the MDMA showed reductions in connectivity between the amygdala, hippocampus and parahippocampal gyrus. There is sufficient proof of concept to support future investigation of MDMA as a treatment for tinnitus.
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Affiliation(s)
- G D Searchfield
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand, Auckland, New Zealand
| | - T N E R Poppe
- Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - M Durai
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - M Jensen
- Pharmacy, Whakatane Hospital, Bay of Plenty, School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - M A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - S Maggo
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - A L Miller
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - J Park
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand
| | - B R Russell
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - G S Shekhawat
- Auckland University of Technology, Auckland, New Zealand
| | - D Spiegel
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand
| | - F Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - K Wise
- Auckland University of Technology, Auckland, New Zealand
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Vissing CR, Rasmussen TB, Olesen MS, Pedersen LN, Dybro A, Bundgaard H, Jensen M, Christensen AH. P337Natural history, reversibility and arrhythmias associated with truncating titin variants in dilated cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0171] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Truncating genetic variants in titin (TTNtv) are identified in 15–25% of patients with primary dilated cardiomyopathy (DCM). Previous genotype/phenotype studies have reported conflicting results regarding disease severity and pathologic features associated with TTNtv.
Purpose
To investigate the natural history, reversibility and burden of arrhythmias associated with TTNtv in a Danish cohort with long-term follow-up.
Methods
Patients with DCM, recruited from two Danish tertiary centers, were included based on the presence of a TTNtv in a cardiac expressed titin exon. Data on patients' medical history including symptoms, demography, family history, comorbidities, treatment, ECG features, and echocardiograms were registered. Outcome data including all-cause mortality, need of heart transplantation (HTX) or left ventricular assist device (LVAD), and presence of ventricular and supraventricular arrhythmias were registered. Left ventricular reverse remodeling (LVRR) was defined as an absolute increase in left ventricular ejection fraction (LVEF) ≥10% points or normalization.
Results
A total of 104 patients (71 men, 69%; 72 probands) with definite TTNtv-DCM were included. The mean age at DCM diagnosis was (mean±SD) 45±13 years (43±13 for men; 49±14 for women, p<0.04) and median follow-up was 8.1 years. The mean LVEF was 28±13% at time of diagnosis (26±12% for men; 30±13% for women, p=0.173). During follow-up, 31 patients (30%; 24 men) died or needed HTX/LVAD. Medical therapy was associated with LVRR in 79% of patients 3.6 years after diagnosis. LVRR was maintained long-term in 64% of patients. Women had a better response to medical therapy compared to men (mean LVEF increase 19%; vs 15% in men, p<0.04). Atrial fibrillation/flutter was observed in 40% of patients and ventricular arrhythmias in 23% of patients. Men had an earlier occurrence of both supraventricular and ventricular arrhythmias (p=0.005) with half of the men having experienced an arrhythmia at the age of 54 years.
Freedom from arrhythmias with age
Conclusion
TTNtv leads to a DCM phenotype associated with a marked gender-difference in age at DCM diagnosis and high burden of both supraventricular and ventricular arrhythmias. Importantly, the DCM-TTNtv phenotype was associated with a high degree of reversibility of systolic function following medical therapy.
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Affiliation(s)
- C R Vissing
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - T B Rasmussen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - M S Olesen
- University of Copenhagen, Laboratory for Molecular Cardiology, Copenhagen, Denmark
| | - L N Pedersen
- Aarhus University Hospital, Department of Molecular Medicine, Aarhus, Denmark
| | - A Dybro
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - M Jensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - A H Christensen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
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Melgaard L, Overvad TF, Jensen M, Nielsen PB, Lip GYH, Larsen TB. 210Predictors of thromboembolism in patients with atrial fibrillation and valvular heart disease according to the EHRA classification: beyond mitral stenosis and mechanical prosthetic heart valves. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0057] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) and valvular heart disease (VHD) often coexist. They are independent causes of mortality and morbidity, and both have been associated with risk of thromboembolic events. Historically, the definition of VHD in AF patients has been inconsistent, which led to the proposal of a new classification of AF patients with VHD: the “Evaluated Heartvalves, Rheumatic or Artificial” (EHRA) valve classification, categorizing patients into: EHRA Type 1 VHD and EHRA Type 2 VHD. EHRA Type 1 VHD comprises AF patients with mitral stenosis (moderate-severe, of rheumatic origin) or a mechanical prosthetic valve replacement. EHRA Type 2 VHD includes AF patients with any other heart valve disease or a bioprosthetic valve replacement. The thromboembolic risk in this latter heterogeneous group is uncertain and, thus, identifying clinically relevant predictors of thromboembolism will facilitate more individualized risk stratification and identify high-risk subgroups, thereby, optimize prevention strategies.
Purpose
In a large nationwide cohort study, we aimed to identify clinically relevant predictors of thromboembolism in AF patients with EHRA Type 2 VHD.
Methods
We conducted a cohort study of AF patients with co-existing EHRA Type 2 VHD, identified by ICD-10 codes using record linkage between nationwide registries in Denmark from 2000 through 2018. Time-to-event analysis was applied to describe the association between EHRA Type 2 VHD and risk of thromboembolism. We used a multivariable Cox proportional hazards regression model with time since incident AF diagnosis as the underlying time axis to estimate predictors of the outcome at 5-years of follow-up. Parameters included were clinically relevant risk factors, statin therapy, antithrombotic therapy, and time since VHD diagnosis.
Results
A total of 27,254 patients with EHRA Type 2 VHD was identified. After 5 years of follow-up, the rate of thromboembolism was 3.27 per 100 person-years. History of thromboembolism (HR: 4.85, 95% CI: 4.43–5.31) and age ≥75 (HR: 1.97, 95% CI: 1.70–2.28) were the strongest predictors of thromboembolism, but age 65–74, female sex, vascular disease, diabetes mellitus, hyperlipidemia/hypercholesterolemia, history of bleeding, and increasing CHA2DS2-VASc score were also independent predictors [Figure].
Predictors of thromboembolism
Conclusion
Among AF patients with VHD beyond mitral stenosis and mechanical prosthetic heart valves, the rate of thromboembolism is high after 5 years of follow-up. The strongest clinically relevant predictors of thromboembolism are history of thromboembolism and age ≥75. Future studies examining the optimal antithrombotic prevention strategy for EHRA Type 2 VHD are encouraged.
Acknowledgement/Funding
The study was supported by “The BMS/Pfizer European Thrombosis Investigator Initiated Research Program 2018 (ERISTA)” and the Obel Family Foundation.
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Affiliation(s)
- L Melgaard
- Aalborg University Hospital, Thrombosis Research Unit, Aalborg, Denmark
| | - T F Overvad
- Aalborg University Hospital, Thrombosis Research Unit, Aalborg, Denmark
| | - M Jensen
- Aalborg University Hospital, Thrombosis Research Unit, Aalborg, Denmark
| | - P B Nielsen
- Aalborg University Hospital, Thrombosis Research Unit, Aalborg, Denmark
| | - G Y H Lip
- University of Liverpool, Center for Cardiovascular Sciences, Liverpool, United Kingdom
| | - T B Larsen
- Aalborg University Hospital, Thrombosis Research Unit, Aalborg, Denmark
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Jensen M, Yilmaz M, Pedersen B. Everyday life with long-term chemotherapy induced peripheral neuropathy among patient in adjuvant treatment for colorectal cancer: A multi methods study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz276.029] [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: 11/13/2022] Open
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Babakhanyan I, Jensen M, Kim D, West H, Morrissy E, Powell B, Sargent P, Bailie J. Computerized Cognitive Rehabilitation verses Clinician Directed Therapy in mTBI. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.22] [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: 11/13/2022] Open
Abstract
Abstract
Background
Cognitive problems following mTBI are common and typically managed with one-on-one clinician directed treatment (CDT); however, this is time and labor intensive. Computerized cognitive rehabilitation (CCR) programs overcome these limitation but the comparable efficacy is not well understood in mTBI.
Method
A randomized controlled trial included 13 active duty service members with a history of mTBI and persistent cognitive complaints. Participants received either CCR (N = 6) or CDT (N = 7) during the initial phase of this study. Treatments were one hour, 3 times a week for 4 weeks. Average age was 32.77 (SD = 7.96). Average intelligence estimated by word reading was average (WTAR M = 107.46, SD = 9.32). Specific measures for attention included Symbol Digit Modality Test (SDMT), Paced Auditory Serial Addition Test (PASAT), Conners Continuous Performance Test (CPT-3), as well as Digit Forward (DF), Digit Backward, and Driving from the Neuropsychological Assessment Battery (NAB). Standard scores corrected for age were analyzed. Change scores were computed between pre and post intervention.
Results
There was a significant difference for SDMT (p = 0.034, d = 1.342) and DF (p = 0.0015, d = 2.33), where those who received CDT showed greater improvement. The groups did not differ on Driving, PASAT, CPT-3, and DB (p’s > 0.62).
Conclusions
Preliminary analysis of data suggests that clinician directed treatment was superior to a computerized intervention matched for time and intensity in treating patients with persistent cognitive complaints following mTBI. Large effects were observed on measures of processing speed and focused attention. This may suggest computerized treatment alone is less effective though further data is needed.
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Jensen M, Isaacson K, Steinhauff D, Barber Z, Eisenmenger L, Huo E, Taussky P, Cappello J, Ghandehari H. 03:18 PM Abstract No. 385 Radiopaque silk-elastinlike protein polymer-based embolic. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.460] [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] Open
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Gartrell BD, Battley PF, Clumpner C, Dwyer W, Hunter S, Jensen M, McConnell HM, Michael S, Morgan KJ, Nijman P, Ward JM, White BJ, Ziccardi MH. Captive husbandry and veterinary care of seabirds during the MV Rena oil spill response. Wildl Res 2019. [DOI: 10.1071/wr19006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract
ContextSeabirds were the most common taxa captured alive as part of the oiled wildlife response to the grounding of the container vessel MV Rena in the Bay of Plenty, New Zealand.
AimsTo describe the management of seabirds during the spill response, to outline the common problems encountered and to make recommendations for future responses.
MethodsSeabirds were collected from 7 October 2011 to 14 January 2012. They were stabilised and underwent pretreatment, washing and rinsing procedures to remove oil, followed by swimming physiotherapy to restore waterproofing and long-term housing in outdoor aviaries. The birds were released in batches close to the original sites of capture once the wild habitat was cleaned.
Key results428 live seabirds were admitted. There were two temporal peaks in admissions associated with the ship grounding and when the ship broke up. The majority of live birds were little penguins (Eudyptula minor; 394/428, 92%). Most seabirds admitted (393/428, 91.8%) were contaminated with heavy fuel oil, with the remainder (35/428, 8.2%) found unoiled but starving and/or exhausted or with injuries. Little penguins had lower mortality during rehabilitation (28/394, 7.1%) than other seabird species combined (27/34, 79.4%). Seabirds in poorer body condition on arrival had higher mortality, and unoiled birds were also more likely to die than oiled birds. In oiled little penguins, the degree of oiling on the plumage ranged from 1 to 100%, but mortality was not significantly associated with the degree of oiling (P=0.887). Pododermatitis affected 66% of little penguins. The most common causes of death (n=45) included weakness, anaemia and hypothermia in oiled seabirds (16/45, 35.6%), and starvation and weakness in unoiled seabirds (14/45, 31.1%).
ConclusionsTotal survival to release was 87.1%, primarily influenced by the species involved and the body condition of the birds on arrival. Unoiled seabirds had higher mortality rates than oiled seabirds.
ImplicationsOiled wildlife can be rehabilitated with good success, even when heavily oiled, or to a lesser extent, when found in poor body condition. More work is needed to refine species-specific rehabilitation protocols for seabirds, especially for those being admitted in emaciated body condition.
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Vestergaard M, Jensen A, Drake N, Jensen M. PSXV-34 Effects of feeding either pelleted concentrate and TMR or only TMR from 10 to 18 weeks of age on performance of dairy calves. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.528] [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: 11/15/2022] Open
Affiliation(s)
| | - A Jensen
- Aarhus University,Aarhus, Denmark
| | - N Drake
- Aarhus University,Tjele, Denmark
| | - M Jensen
- Aarhus University,Tjele, Denmark
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Ryan CG, Kirkham R, de Jonge MD, Siddons DP, van der Ent A, Pagés A, Boesenberg U, Kuczewski AJ, Dunn P, Jensen M, Liu W, Harris H, Moorhead GF, Paterson DJ, Howard DL, Afshar N, Garrevoet J, Spiers K, Falkenberg G, Woll AR, De Geronimo G, Carini GA, James SA, Jones MWM, Fisher LA, Pearce M. The Maia Detector and Event Mode. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/08940886.2018.1528430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | | | - M. D. de Jonge
- Australian Synchrotron, ANSTO, Clayton, Victoria, Australia
| | - D. P. Siddons
- Brookhaven National Laboratory, Upton, New York, USA
| | - A. van der Ent
- Sustainable Minerals Institute, University of Queensland, Brisbane, Queensland, Australia
| | - A. Pagés
- CSIRO, Clayton, Victoria, Australia
| | - U. Boesenberg
- European X-ray Free-Electron Laser Facility, Schenefeld, Germany
| | | | - P. Dunn
- CSIRO, Clayton, Victoria, Australia
| | | | - W. Liu
- CSIRO, Clayton, Victoria, Australia
| | - H. Harris
- Department of Chemisty, University of Adelaide, Adelaide, Australia
| | | | - D. J. Paterson
- Australian Synchrotron, ANSTO, Clayton, Victoria, Australia
| | - D. L. Howard
- Australian Synchrotron, ANSTO, Clayton, Victoria, Australia
| | - N. Afshar
- Australian Synchrotron, ANSTO, Clayton, Victoria, Australia
| | - J. Garrevoet
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - K. Spiers
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - G. Falkenberg
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - A. R. Woll
- Cornell High Energy Synchrotron Source, Ithaca, New York, USA
| | | | - G. A. Carini
- Brookhaven National Laboratory, Upton, New York, USA
| | - S. A. James
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - M. W. M. Jones
- Institute for Future Environments, Queensland University of Technology, Brisbane, Queensland, Australia
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Harrington L, Ehlert A, Jenny N, Lopez O, Cushman M, Fitzpatrick A, Mukamal K, Jensen M. HEMOSTATIC PARAMETER LEVELS AND DEMENTIA RISK IN THE CARDIOVASCULAR HEALTH STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Ehlert
- Harvard T.H. Chan School of Public Health
| | - N Jenny
- University of Vermont Larner College of Medicine
| | | | - M Cushman
- University of Vermont Larner College of Medicine
| | | | - K Mukamal
- Beth Israel Deaconess Medical Center
| | - M Jensen
- Harvard T.H. Chan School of Public Health
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