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Ripa L, Sandmark J, Hughes G, Shamovsky I, Gunnarsson A, Johansson J, Llinas A, Collins M, Jung B, Novén A, Pemberton N, Mogemark M, Xiong Y, Li Q, Tångefjord S, Ek M, Åstrand A. Selective and Bioavailable HDAC6 2-(Difluoromethyl)-1,3,4-oxadiazole Substrate Inhibitors and Modeling of Their Bioactivation Mechanism. J Med Chem 2023; 66:14188-14207. [PMID: 37797307 DOI: 10.1021/acs.jmedchem.3c01269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Histone deacetylase 6 (HDAC6) is a unique member of the HDAC family mainly targeting cytosolic nonhistone substrates, such as α-tubulin, cortactin, and heat shock protein 90 to regulate cell proliferation, metastasis, invasion, and mitosis in tumors. We describe the identification and characterization of a series of 2-(difluoromethyl)-1,3,4-oxadiazoles (DFMOs) as selective nonhydroxamic acid HDAC6 inhibitors. By comparing structure-activity relationships and performing quantum mechanical calculations of the HDAC6 catalytic mechanism, we show that potent oxadiazoles are electrophilic substrates of HDAC6 and propose a mechanism for the bioactivation. We also observe that the inherent electrophilicity of the oxadiazoles makes them prone to degradation in water solution and the generation of potentially toxic products cannot be ruled out, limiting the developability for chronic diseases. However, the oxadiazoles demonstrate high oral bioavailability and low in vivo clearance and are excellent tools for studying the role of HDAC6 in vitro and in vivo in rats and mice.
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Affiliation(s)
- Lena Ripa
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Jenny Sandmark
- Discovery Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Glyn Hughes
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Igor Shamovsky
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Anders Gunnarsson
- Discovery Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Julia Johansson
- Clinical Pharmacology and Safety Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Antonio Llinas
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Mia Collins
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Bomi Jung
- Discovery Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Anna Novén
- Discovery Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Nils Pemberton
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Mickael Mogemark
- Clinical Pharmacology and Safety Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Yao Xiong
- Pharmaron Beijing, Co. Ltd., No. 6, Taihe Road, BDA, Beijing 100176, China
| | - Qing Li
- Pharmaron Beijing, Co. Ltd., No. 6, Taihe Road, BDA, Beijing 100176, China
| | - Stefan Tångefjord
- Discovery Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Margareta Ek
- Discovery Sciences, Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
| | - Annika Åstrand
- Respiratory & Immunology (R&I), Research and Early Development, BioPharmaceuticals R&D, AstraZeneca, Pepparedsleden 1, 43183 Mölndal, Sweden
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Nilsson M, Berggren K, Berglund S, Cerboni S, Collins M, Dahl G, Elmqvist D, Grimster NP, Hendrickx R, Johansson JR, Kettle JG, Lepistö M, Rhedin M, Smailagic A, Su Q, Wennberg T, Wu A, Österlund T, Naessens T, Mitra S. Discovery of the Potent and Selective Inhaled Janus Kinase 1 Inhibitor AZD4604 and Its Preclinical Characterization. J Med Chem 2023; 66:13400-13415. [PMID: 37738648 DOI: 10.1021/acs.jmedchem.3c00554] [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: 09/24/2023]
Abstract
JAK-STAT cytokines are critical in regulating immunity. Persistent activation of JAK-STAT signaling pathways by cytokines drives chronic inflammatory diseases such as asthma. Herein, we report on the discovery of a highly JAK1-selective, ATP-competitive series of inhibitors having a 1000-fold selectivity over other JAK family members and the approach used to identify compounds suitable for inhaled administration. Ultimately, compound 16 was selected as the clinical candidate, and upon dry powder inhalation, we could demonstrate a high local concentration in the lung as well as low plasma concentrations, suggesting no systemic JAK1 target engagement. Compound 16 has progressed into clinical trials. Using 16, we found JAK1 inhibition to be more efficacious than JAK3 inhibition in IL-4-driven Th2 asthma.
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Affiliation(s)
- Magnus Nilsson
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Kristina Berggren
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Susanne Berglund
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Silvia Cerboni
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Mia Collins
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Göran Dahl
- Structure and Biophysics, Research and Early Development, Discovery Science, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - David Elmqvist
- Early Product Development, Pharmaceutical Sciences, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Neil P Grimster
- Oncology R&D, AstraZeneca R&D, Waltham, Massachusetts 02451, United States
| | - Ramon Hendrickx
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Johan R Johansson
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Jason G Kettle
- Oncology R&D, AstraZeneca R&D, Waltham, Massachusetts 02451, United States
| | - Matti Lepistö
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Magdalena Rhedin
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Amir Smailagic
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Qibin Su
- Oncology R&D, AstraZeneca R&D, Waltham, Massachusetts 02451, United States
| | - Tiiu Wennberg
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Allan Wu
- Discovery Sciences, R&D, AstraZeneca R&D, Waltham, Massachusetts 02451, United States
| | - Torben Österlund
- Mechanistic Biology & Profiling, Research and Early Development, Discovery Science, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Thomas Naessens
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Suman Mitra
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
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Nandana V, Rathnayaka-Mudiyanselage IW, Muthunayak NS, Hatami A, Mousseau CB, Ortiz-Rodríguez LA, Vaishnav J, Collins M, Gega A, Mallikaarachchi KS, Yassine H, Ghosh A, Biteen JS, Zhu Y, Champion MM, Childers WS, Schrader JM. The BR-body proteome contains a complex network of protein-protein and protein-RNA interactions. bioRxiv 2023:2023.01.18.524314. [PMID: 36712072 PMCID: PMC9882336 DOI: 10.1101/2023.01.18.524314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Bacterial RNP bodies (BR-bodies) are non-membrane-bound structures that facilitate mRNA decay by concentrating mRNA substrates with RNase E and the associated RNA degradosome machinery. However, the full complement of proteins enriched in BR-bodies has not been defined. Here we define the protein components of BR-bodies through enrichment of the bodies followed by mass spectrometry-based proteomic analysis. We found 111 BR-body enriched proteins, including several RNA binding proteins, many of which are also recruited directly to in vitro reconstituted RNase E droplets, showing BR-bodies are more complex than previously assumed. While most BR-body enriched proteins that were tested cannot phase separate, we identified five that undergo RNA-dependent phase separation in vitro, showing other RNP condensates interface with BR-bodies. RNA degradosome protein clients are recruited more strongly to RNase E droplets than droplets of other RNP condensates, implying that client specificity is largely achieved through direct protein-protein interactions. We observe that some RNP condensates assemble with preferred directionally, suggesting that RNA may be trafficked through RNP condensates in an ordered manner to facilitate mRNA processing/decay, and that some BR-body associated proteins have the capacity to dissolve the condensate. Finally, we find that RNA dramatically stimulates the rate of RNase E phase separation in vitro, explaining the dissolution of BR-bodies after cellular mRNA depletion observed previously. Altogether, these results suggest that a complex network of protein-protein and protein-RNA interactions controls BR-body phase separation and RNA processing.
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Affiliation(s)
- V Nandana
- Wayne State University, Department of Biological Sciences, Detroit, MI
| | - I W Rathnayaka-Mudiyanselage
- Wayne State University, Department of Biological Sciences, Detroit, MI
- Wayne State University, Department of Chemistry, Detroit, MI
| | - N S Muthunayak
- Wayne State University, Department of Biological Sciences, Detroit, MI
| | - A Hatami
- Wayne State University, Department of Chemical Engineering and Materials Science, Detroit, MI
| | - C B Mousseau
- University of Notre Dame, Department of Chemistry, Notre Dame, IN
| | | | - J Vaishnav
- Wayne State University, Department of Chemical Engineering and Materials Science, Detroit, MI
| | - M Collins
- University of Pittsburgh, Department of Chemistry, Pittsburgh, PA
| | - A Gega
- Wayne State University, Department of Biological Sciences, Detroit, MI
| | | | - H Yassine
- Wayne State University, Department of Biological Sciences, Detroit, MI
| | - A Ghosh
- Wayne State University, Department of Biological Sciences, Detroit, MI
| | - J S Biteen
- University of Michigan, Department of Chemistry, Ann Arbor, MI
| | - Y Zhu
- Wayne State University, Department of Chemical Engineering and Materials Science, Detroit, MI
| | - M M Champion
- University of Notre Dame, Department of Chemistry, Notre Dame, IN
| | - W S Childers
- University of Pittsburgh, Department of Chemistry, Pittsburgh, PA
| | - J M Schrader
- Wayne State University, Department of Biological Sciences, Detroit, MI
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Horndahl J, Svärd R, Berntsson P, Wingren C, Li J, Abdillahi SM, Ghosh B, Capodanno E, Chan J, Ripa L, Åstrand A, Sidhaye VK, Collins M. HDAC6 inhibitor ACY-1083 shows lung epithelial protective features in COPD. PLoS One 2022; 17:e0266310. [PMID: 36223404 PMCID: PMC9555642 DOI: 10.1371/journal.pone.0266310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022] Open
Abstract
Airway epithelial damage is a common feature in respiratory diseases such as COPD and has been suggested to drive inflammation and progression of disease. These features manifest as remodeling and destruction of lung epithelial characteristics including loss of small airways which contributes to chronic airway inflammation. Histone deacetylase 6 (HDAC6) has been shown to play a role in epithelial function and dysregulation, such as in cilia disassembly, epithelial to mesenchymal transition (EMT) and oxidative stress responses, and has been implicated in several diseases. We thus used ACY-1083, an inhibitor with high selectivity for HDAC6, and characterized its effects on epithelial function including epithelial disruption, cytokine production, remodeling, mucociliary clearance and cell characteristics. Primary lung epithelial air-liquid interface cultures from COPD patients were used and the impacts of TNF, TGF-β, cigarette smoke and bacterial challenges on epithelial function in the presence and absence of ACY-1083 were tested. Each challenge increased the permeability of the epithelial barrier whilst ACY-1083 blocked this effect and even decreased permeability in the absence of challenge. TNF was also shown to increase production of cytokines and mucins, with ACY-1083 reducing the effect. We observed that COPD-relevant stimulations created damage to the epithelium as seen on immunohistochemistry sections and that treatment with ACY-1083 maintained an intact cell layer and preserved mucociliary function. Interestingly, there was no direct effect on ciliary beat frequency or tight junction proteins indicating other mechanisms for the protected epithelium. In summary, ACY-1083 shows protection of the respiratory epithelium during COPD-relevant challenges which indicates a future potential to restore epithelial structure and function to halt disease progression in clinical practice.
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Affiliation(s)
- Jenny Horndahl
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Rebecka Svärd
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Pia Berntsson
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Cecilia Wingren
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Jingjing Li
- Bioscience Asthma, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Suado M. Abdillahi
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Baishakhi Ghosh
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Erin Capodanno
- Department of Biology, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Justin Chan
- Department of Public Health Studies, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Lena Ripa
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Annika Åstrand
- Project Leader Department, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Venkataramana K. Sidhaye
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Mia Collins
- Bioscience COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
- * E-mail:
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Collins M, Imbrogno M, Kramer E, Brewington J, Zhang N, Sharon P, Kopras E, Meeker J, Morgan H, Ostmann A, O'Grady S, Trapnell B, Clancy J, Hudock K. 380 Neutrophil extracellular traps disrupt bronchial epithelial barrier function: Alpha-1 antitrypsin to the rescue. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kenkare Z, Murray T, Schramm C, Collins M. 342 Partnership in education–cystic fibrosis center patient education practices on home nebulizer care in relationship to published guidelines. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01032-3] [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: 11/06/2022]
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Nilsson M, Rhedin M, Hendrickx R, Berglund S, Piras A, Blomgran P, Cavallin A, Collins M, Dahl G, Dekkak B, Ericsson T, Hagberg N, Holmberg AA, Leffler A, Lundqvist AJ, Markou T, Pinkerton J, Rönnblom L, Siu S, Taylor V, Wennberg T, Zervas D, Laurence ADJ, Mitra S, Belvisi MG, Birrell M, Borde A. Characterization of Selective and Potent JAK1 Inhibitors Intended for the Inhaled Treatment of Asthma. Drug Des Devel Ther 2022; 16:2901-2917. [PMID: 36068788 PMCID: PMC9441147 DOI: 10.2147/dddt.s354291] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Janus kinase 1 (JAK1) is implicated in multiple inflammatory pathways that are critical for the pathogenesis of asthma, including the interleukin (IL)-4, IL-5, IL-13, and thymic stromal lymphopoietin cytokine signaling pathways, which have previously been targeted to treat allergic asthma. Here, we describe the development of AZD0449 and AZD4604, two novel and highly selective JAK1 inhibitors with promising properties for inhalation. Methods The effects of AZD0449 and AZD4604 in JAK1 signaling pathways were assessed by measuring phosphorylation of signal transducer and activator of transcription (STAT) proteins and chemokine release using immunoassays of whole blood from healthy human volunteers and rats. Pharmacokinetic studies performed on rats evaluated AZD0449 at a lung deposited dose of 52 μg/kg and AZD4604 at 30 µg/kg. The efficacy of AZD0449 and AZD4604 was assessed by evaluating lung inflammation (cell count and cytokine levels) and the late asthmatic response (average enhanced pause [Penh]). Results Both compounds inhibited JAK1-dependent cytokine signaling pathways in a dose-dependent manner in human and rat leukocytes. After intratracheal administration in rats, both compounds exhibited low systemic exposures and medium-to-long terminal lung half-lives (AZD0449, 34 hours; AZD4604, 5 hours). Both compounds inhibited STAT3 and STAT5 phosphorylation in lung tissue from ovalbumin (OVA)-challenged rats. AZD0449 and AZD4604 also inhibited eosinophilia in the lung and reduced the late asthmatic response, measured as Penh in the OVA rat model. Conclusion AZD0449 and AZD4604 show potential as inhibitors of signaling pathways involved in asthmatic immune responses, with target engagement demonstrated locally in the lung. These findings support the clinical development of AZD0449 and AZD4604 for the treatment of patients with asthma.
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Affiliation(s)
- Magnus Nilsson
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
- Correspondence: Magnus Nilsson, Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, SE-431 83, Sweden, Tel +46722237222, Email
| | - Magdalena Rhedin
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Ramon Hendrickx
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Susanne Berglund
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Antonio Piras
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Parmis Blomgran
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Anders Cavallin
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Mia Collins
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Göran Dahl
- Discovery Science, R&D, AstraZeneca, Gothenburg, Sweden
| | - Bilel Dekkak
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Therese Ericsson
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Niklas Hagberg
- Rheumatology and Science for Life Laboratories, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ann Aurell Holmberg
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Agnes Leffler
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Anders J Lundqvist
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Thomais Markou
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - James Pinkerton
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Lars Rönnblom
- Rheumatology and Science for Life Laboratories, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Stacey Siu
- Rigel Pharmaceuticals, South San Francisco, CA, USA
| | | | - Tiiu Wennberg
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Dimitrios Zervas
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Arian D J Laurence
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Suman Mitra
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Maria G Belvisi
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Mark Birrell
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Annika Borde
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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Collins M, Ali S, Wiss IP, Senna M. 204 Adverse events associated with hydroxychloroquine use in cicatricial alopecia patients. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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McAndry C, Collins M, Tills O, Spicer JI, Truebano M. Regulation of gene expression during ontogeny of physiological function in the brackishwater amphipod Gammarus chevreuxi. Mar Genomics 2022; 63:100948. [PMID: 35427917 DOI: 10.1016/j.margen.2022.100948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
Abstract
Embryonic development is a complex process involving the co-ordinated onset and integration of multiple morphological features and physiological functions. While the molecular basis of morphological development in embryos is relatively well known for traditional model species, the molecular underpinning of the development of physiological functions is not. Here, we used global gene expression profiling to investigate the transcriptional changes associated with the development of morphological and physiological function in the amphipod crustacean Gammarus chevreuxi. We compared the transcriptomes at three timepoints during the latter half of development, characterised by different stages of the development of heart form and function: 10 days post fertilisation (dpf, Early: no heart structure visible), 15 dpf (Middle: heart present but not fully functional), and 18 dpf (Late: regular heartbeat). Gene expression profiles differed markedly between developmental stages, likely representing a change in the activity of different processes throughout the latter period of G. chevreuxi embryonic development. Differentially expressed genes belonged to one of three distinct clusters based on their expression patterns across development. One of these clusters, which included key genes relating to cardiac contractile machinery and calcium handling, displayed a pattern of sequential up-regulation throughout the developmental period studied. Further analyses of these transcripts could reveal genes that may influence the onset of a regular heartbeat. We also identified morphological and physiological processes that may occur alongside heart development, such as development of digestive caeca and the cuticle. Elucidating the mechanisms underpinning morphological and physiological development of non-model organisms will support improved understanding of conserved mechanisms, addressing the current phylogenetic gap between relatively well known model species.
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Affiliation(s)
- C McAndry
- Marine Biology and Ecology Research Centre, School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - M Collins
- Marine Biology and Ecology Research Centre, School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - O Tills
- Marine Biology and Ecology Research Centre, School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - J I Spicer
- Marine Biology and Ecology Research Centre, School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - M Truebano
- Marine Biology and Ecology Research Centre, School of Biological and Marine Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK.
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10
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Marchand N, Chinnawar R, Arena J, McCarney L, Collins M. Process Development and Manufacturing: PLATFORM CLARIFICATION FOR AAV AND LENTIVIRUS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00450-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Collins M, Tomic R, Myers C, O'Boye A, Brakman E, Perottino G, Arunachalam A. Malnutrition in Lung Transplant Recipients: Weighing the Outcomes. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Viecelli MD A, Robison L, Scholes-Robertson N, Guha C, Hawley C, Johnson D, Roberts M, Krishnasamy R, Collins M, Cho Y, Reidlinger D. POS-597 STRUCTURED CONSUMER ENGAGEMENT TO IMPROVE CLINICAL TRIALS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Moreira A, Faria T, Oliveira J, Kavara A, Schofield M, Sanderson T, Collins M, Gantier R, Alves P, Carrondo M, Peixoto C. Enhancing the purification of Lentiviral vectors for clinical applications. Sep Purif Technol 2021. [DOI: 10.1016/j.seppur.2021.118598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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14
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Collins M, Fitzpatrick K, Kiernan AM, Moss H, Harmon D. Pilot Study on Music in the Waiting Room of Outpatient Pain Clinics. Pain Manag Nurs 2021; 23:318-323. [PMID: 34688552 DOI: 10.1016/j.pmn.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 08/17/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study explores live and recorded music listening in the outpatient pain clinic. There is evidence demonstrating the effectiveness of live and recorded music in a hospital setting but a comparison study of this kind has yet to be conducted. METHODS A multimethod survey study design was used. A questionnaire utilizing rating scales was self-administered across two outpatient pain clinic waiting rooms. Patients were included through convenience sampling. In one clinic, a playlist of recorded music curated by two of the authors was provided. In the second clinic, a music therapy student played live music using guitar, flute, and voice. The questionnaire gathered data on music's impact on pain and emotional states, as well as attitudes toward music in the waiting room. Quantitative data was analyzed using descriptive statistics and qualitative data, gathered in the questionnaires open ended question, was analyzed using thematic analysis. RESULTS The questionnaire was completed by 200 adult patients. Patients reported lowered levels of anxiety, stress, and pain in both clinics, as well as a shorter waiting time and more caring experience. Patients in the live music clinic reported that music lowered levels of stress, nervousness, agitation, and pain more than in the recorded music clinic. CONCLUSIONS Participants in this study identified that music is a useful tool in the pain clinic waiting room. This study contributes to evidence that music should be considered as a complimentary treatment for people living with pain and in the wider hospital setting. Additional research is warranted with a control group, pre- and posttesting, and studies of music in hospitals in a range of cultural contexts.
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Affiliation(s)
- M Collins
- Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
| | - K Fitzpatrick
- Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland.
| | - A M Kiernan
- Department of Anaesthesia and Pain Medicine, Limerick University Hospital, Limerick, Ireland
| | - H Moss
- Irish World Academy of Music and Dance, University of Limerick, Limerick, Ireland
| | - D Harmon
- Department of Anaesthesia and Pain Medicine, Limerick University Hospital, Limerick, Ireland
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15
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Krepostman N, Collins M, Merchant K, De Sirkar S, Chan L, Allen S, Newman J, Patel D, Fareed J, Berg S, Darki A. Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19. Eur Heart J 2021. [PMCID: PMC8767580 DOI: 10.1093/eurheartj/ehab724.2492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients with documented or suspected COVID-19 infection is the rapid identification of features associated with severe illness using readily available laboratory tests and clinical tools. The sequential organ failure assessment (SOFA) score is a validated tool to facilitate the identification of patients at risk of dying from sepsis. Purpose The aim of this study was to assess the discriminatory accuracy of the SOFA score in predicting clinical decompensation in patients hospitalized with COVID-19 infection. Methods We conducted a retrospective analysis at a three-hospital health system, comprised of one tertiary and two community hospitals, located in the Chicago metropolitan area. All patients had positive SARS-CoV-2 testing and were hospitalized for COVID-19 infection. The primary outcome was clinical decompensation, defined as the composite endpoint of death, ICU admission, or need for intubation. We utilized the most abnormal laboratory values observed during the admission to calculate the SOFA score. Receiver Operating Curves (ROC) were then constructed to determine the sensitivity and specificity of SOFA scores. Results Between March 1st and May 31st 2020, 1029 patients were included in our analysis with 367 patients meeting the study endpoint. The median SOFA score was 2.0 IQR (Q1, Q3 1,4) for the entire cohort. Patients who had in-hospital mortality had a median SOFA score of 4.0 (Q1,Q3 3,7). In patients that met the primary composite endpoint, the median SOFA score was 3.0, IQR (Q1, Q3 2,6). The ROC was 0.776 (95% CI 0.746–0.806, p<0.01). Conclusion The SOFA score demonstrates strong discriminatory accuracy for prediction of clinical decompensation in patients presenting with COVID-19 at our urban hospital system. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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Affiliation(s)
- N Krepostman
- Loyola University Medical Center, Maywood, United States of America
| | - M Collins
- Loyola University Medical Center, Maywood, United States of America
| | - K Merchant
- Loyola University Medical Center, Maywood, United States of America
| | - S De Sirkar
- Loyola University Medical Center, Maywood, United States of America
| | - L Chan
- Loyola University Medical Center, Maywood, United States of America
| | - S Allen
- Loyola University Medical Center, Maywood, United States of America
| | - J Newman
- Loyola University Medical Center, Maywood, United States of America
| | - D Patel
- Loyola University Medical Center, Maywood, United States of America
| | - J Fareed
- Loyola University Medical Center, Maywood, United States of America
| | - S Berg
- Loyola University Medical Center, Maywood, United States of America
| | - A Darki
- Loyola University Medical Center, Maywood, United States of America
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16
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Krepostman N, Collins M, Merchant K, De Sirkar S, Chan L, Allen S, Newman J, Patel D, Fareed J, Berg S, Darki A. Predictors of clinical decompensation in patients presenting with COVID-19 in an urban hospital health system. Eur Heart J 2021. [PMCID: PMC8767592 DOI: 10.1093/eurheartj/ehab724.2473] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a pandemic which has infected more than 128 million people and led to over 2.8 million deaths worldwide. Although the introduction of efficacious vaccines has led to overall declines in the incidence of SARS-CoV-2 infection, there has been a recent increase in infections once more due to the appearance of mutant strains with higher virulence. It therefore remains vital to identify predictors of poor outcomes in this patient population. Purpose The objective of our study was to identify predictors of prolonged hospitalization, intensive care unit (ICU) admission, intubation, and death in patients infected with SARS-CoV-2. Methods We conducted a retrospective analysis of all patients hospitalized with SARS-CoV-2 at our health system that includes one tertiary care center and two community hospitals located in the Chicago metropolitan area. The main outcome was a composite endpoint of hospitalization >28 days, ICU admission, intubation, and death. Explanatory variables associated with the primary outcome in the bivariate analysis (p<0.05) were included in the multivariable logistic regression model. Statistical analysis was performed using IBM SPSS 25.0. Results Between March 1, 2020 and May 31, 2020, 1029 patients hospitalized with SARS-CoV-2 were included in our analysis. Of these patients, 379 met the composite endpoint. Baseline demographics are described in Table 1. Of note, our cohort consisted of a predominantly minority patient population including 47% Hispanic, 17% African American, 16% Caucasian, and 16% other. In bivariate analysis, age, hypertension, tobacco and alcohol abuse, obesity, coronary artery disease, arrhythmias, valvular heart disease, dyslipidemia, hypertension, stroke, diabetes, documented thrombosis, troponin, CRP, ESR, ferritin, LDH, BNP, D-dimer >5x the upper limit of normal, lactate, and right ventricular outflow tract velocity time integral <9.5 were significant. After multivariable adjustment, explanatory variables associated with the composite endpoint included troponin (OR 2.36; 95% CI 1.08–5.17, p 0.03), D-dimer (OR 1.5; 95% CI 1.23–1.98, p<0.01, lactate (OR 1.58; 95% CI 1.28–1.95, p<0.01), and documented thrombosis (OR 3.56; 95% CI 1.30–8.70, p<.05). Race was not a predictor of poor outcomes in the bivariate or multivariate analysis (Table 2). Conclusions In a large urban cohort with a predominantly minority population, we identified several clinical predictors of poor outcomes. Of note, race was not a predictor of the primary endpoint in this study. While recent literature has demonstrated worse outcomes among racial minorities infected with SARS-CoV-2, our data suggests these variations are related to social determinants of health rather than biologic causes. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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Affiliation(s)
- N Krepostman
- Loyola University Medical Center, Maywood, United States of America
| | - M Collins
- Loyola University Medical Center, Maywood, United States of America
| | - K Merchant
- Loyola University Medical Center, Maywood, United States of America
| | - S De Sirkar
- Loyola University Medical Center, Maywood, United States of America
| | - L Chan
- Loyola University Medical Center, Maywood, United States of America
| | - S Allen
- Loyola University Medical Center, Maywood, United States of America
| | - J Newman
- Loyola University Medical Center, Maywood, United States of America
| | - D Patel
- Loyola University Medical Center, Maywood, United States of America
| | - J Fareed
- Loyola University Medical Center, Maywood, United States of America
| | - S Berg
- Loyola University Medical Center, Maywood, United States of America
| | - A Darki
- Loyola University Medical Center, Maywood, United States of America
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17
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Narjes F, Llinas A, von Berg S, Jirholt J, Lever S, Pehrson R, Collins M, Malmberg A, Svanberg P, Xue Y, Olsson RI, Malmberg J, Hughes G, Hossain N, Grindebacke H, Leffler A, Krutrök N, Bäck E, Ramnegård M, Lepistö M, Thunberg L, Aagaard A, McPheat J, Hansson EL, Chen R, Xiong Y, Hansson TG. AZD0284, a Potent, Selective, and Orally Bioavailable Inverse Agonist of Retinoic Acid Receptor-Related Orphan Receptor C2. J Med Chem 2021; 64:13807-13829. [PMID: 34464130 DOI: 10.1021/acs.jmedchem.1c01197] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Inverse agonists of the nuclear receptor RORC2 have been widely pursued as a potential treatment for a variety of autoimmune diseases. We have discovered a novel series of isoindoline-based inverse agonists of the nuclear receptor RORC2, derived from our recently disclosed RORC2 inverse agonist 2. Extensive structure-activity relationship (SAR) studies resulted in AZD0284 (20), which combined potent inhibition of IL-17A secretion from primary human TH17 cells with excellent metabolic stability and good PK in preclinical species. In two preclinical in vivo studies, compound 20 reduced thymocyte numbers in mice and showed dose-dependent reduction of IL-17A containing γδ-T cells and of IL-17A and IL-22 RNA in the imiquimod induced inflammation model. Based on these data and a favorable safety profile, 20 was progressed to phase 1 clinical studies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yafeng Xue
- Mechanistic & Structural Biology, Discovery Science, R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | | | | | | | | | | | | | | | | | | | | | - Linda Thunberg
- Early Chemical Development, Pharmaceutical Sciences, R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Anna Aagaard
- Mechanistic & Structural Biology, Discovery Science, R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Jane McPheat
- Mechanistic & Structural Biology, Discovery Science, R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Eva L Hansson
- Mechanistic & Structural Biology, Discovery Science, R&D, AstraZeneca, Gothenburg SE-431 83, Sweden
| | - Rongfeng Chen
- Pharmaron Beijing Co., Ltd., Taihe Road BDA, Beijing 100176, P. R. China
| | - Yao Xiong
- Pharmaron Beijing Co., Ltd., Taihe Road BDA, Beijing 100176, P. R. China
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18
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Alsaffar A, Collins M, Goodbody P, Hill V, Regan A, Kelly M. Use of Video Consultation in Irish General Practice:The Views of General Practitioners. Ir Med J 2021; 114:322. [PMID: 35579994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction Video consultation involves the live interaction between the doctor and the patient remotely. Prior to the Covid-19 pandemic, the majority of video consultations in primary care were provided by GPs who were not the individual's own GP, which presented safety and continuity issues. This study aims to determine GPs' attitudes to the use of video consultation for their own patients. Methods This was a qualitative study involving semi-structured interviews. Participants were purposively recruited through use of a GP tutor as a key informant and guided by a sampling framework to include those with and without previous video consultation experience. Braun and Clarke thematic analysis was used. Results Participants included eight GPs, half of whom had previously worked with video consultation. Four themes emerged: impact on the consultation, the potential role, and the potential threat to current practice and technology and logistics. There were optimistic and cautious observations within all themes. Conclusion With the increased use of video consultation, Irish General Practice is in a unique position to frame the future its use. The provision of this modality to one's own patients may provide benefit while mitigating some of the pitfalls but would not entirely avoid the potential dangers of video consultation.
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Affiliation(s)
- A Alsaffar
- HSE Western Training Programme in General Practice
| | - M Collins
- HSE Western Training Programme in General Practice
| | - P Goodbody
- HSE Western Training Programme in General Practice
| | - V Hill
- HSE Western Training Programme in General Practice
| | - A Regan
- HSE Western Training Programme in General Practice
| | - M Kelly
- HSE Western Training Programme in General Practice
- School of Medicine, National University of Ireland Galway
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19
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Tomic R, Perottino G, Collins M, Oboye A, Amblavanan A, Sala M. Frailty Measurements are Poor Predictor of Lung Transplantation Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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20
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Collins M, O'Boye A, Perottino G, Pesce L, Tomic R. Weight Change and Outcomes in Lung Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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Kagirita A, Owalla T, Yususf B, Bernard L, Collins M, Andrew B, Muruta A. Preparedness and community led response stops cross border Ebola transmission in Uganda, 2019. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Wong Y, Collins M, Chiu G. PH-0168: Can the use of PET/MR improve target delineation accuracy in RT planning for H&N cancer patients? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Fahy E, Mulvihill C, O'Donoghue G, O'Regan E, Collins M. Neurofibromatosis -1 diagnosed from an intraoral swelling - a case series. Aust Dent J 2020; 66:205-211. [PMID: 32990942 DOI: 10.1111/adj.12797] [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] [Accepted: 09/14/2020] [Indexed: 02/02/2023]
Abstract
The neurofibromatoses [NF 1, NF 2 and schwannomatosis] are a group of genetic disorders that lead to the development of nervous system tumours and have diverse dermatologic, neurologic, ophthalmic, skeletal and vascular effects. The most common is NF 1 (Neurofibromatosis 1) also known as von Recklinghausen's disease, which is one of the most common human genetic diseases. Oral manifestations of NF 1 are reported in 72% of cases and in one of our cases precipitated attendance at a general dental practitioner (GDP), subsequent diagnosis and genetic screening for family members. This disease may go undiagnosed due to its variable expressivity of symptoms. The pivotal importance of a GDP in the discovery and early referral to an oral or oral and maxillofacial surgeon for further investigation and diagnosis of this condition is highlighted. Knowledge of the most common features of neurofibromatosis can facilitate the speedy referral and subsequent diagnosis of generalized neurofibromatosis, local surgical management of benign neoplasms and long term management of its other clinical features. Dentists should be aware of the classic symptoms of this condition and of their role in long-term care in view of the risk of local recurrence and malignant transformation.
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Affiliation(s)
- E Fahy
- Dublin Dental University Hospital, Dublin, Ireland
| | - C Mulvihill
- Dublin Dental University Hospital, Dublin, Ireland
| | - G O'Donoghue
- Dublin Dental University Hospital, Dublin, Ireland
| | - E O'Regan
- Dublin Dental University Hospital, Dublin, Ireland.,Department of Histopathology, St James's Hospital, Dublin, Ireland
| | - M Collins
- Dublin Dental University Hospital, Dublin, Ireland
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24
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Hall H, Leach M, Brosnan C, Collins M. Evolving healthcare; nurses’ attitudes towards complementary therapies. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Integration of complementary therapies alongside conventional medical treatment is common and affects health behaviour and outcomes. Nurses frequently interact with patients and their attitudes to these therapies may play a significant role in decision-making. This mixed-method study investigated nurses' attitudes and behaviour towards complementary therapies.
Methods
A sequential exploratory design was utilised. Qualitative data were collected via interviews with nurses working in primary and tertiary settings, in all states of Australia. Interview data underwent thematic analysis. Findings from the interviews informed the development of a questionnaire, which was used to conduct a national online survey. Survey data were descriptively analysed using frequency distributions and percentages.
Results
Nineteen nurses were interviewed and 614 responded to the survey. Themes that emerged from the qualitative data were; Promoting safe care, Seeking complementary therapies knowledge; Supporting holistic health care and Integrating complementary therapies in practice. Survey responses revealed most nurses (77.5%) discussed complementary therapies with patients. More than one half (55.5%) would 'sometimes' recommend complementary therapies and 12.0% would 'almost always/always' do so. The majority (91.8%) believed nurses should have some understanding of complementary therapies. There was a lack of agreement regarding integration of these therapies into nursing practice.
Conclusions
Nurses were generally supportive of patients' interest in complementary therapies and want basic education about these therapies.
Key messages
Nurses working in Australia often engage with patients about complementary therapies. Increasing nurses’ complementary therapy knowledge is likely to promote informed decision-making and improve patient safety.
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Affiliation(s)
- H Hall
- Nursing & Midwifery, Monash University, Frankston, Australia
- ARCCIM, UTS, Sydney, Australia
| | - M Leach
- ARCCIM, UTS, Sydney, Australia
- Rural Health, University of South Australia, Adelaide, Australia
| | - C Brosnan
- ARCCIM, UTS, Sydney, Australia
- Humanities & Social Science, University of Newcastle, Newcastle, Australia
| | - M Collins
- Nursing & Midwifery, Monash University, Frankston, Australia
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25
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Townsend A, Abraham C, Barnes A, Collins M, Halliday E, Lewis S, Orton L, Ponsford R, Salway S, Whitehead M, Popay J. "I realised it weren't about spending the money. It's about doing something together:" the role of money in a community empowerment initiative and the implications for health and wellbeing. Soc Sci Med 2020; 260:113176. [PMID: 32717663 DOI: 10.1016/j.socscimed.2020.113176] [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] [Revised: 03/02/2020] [Accepted: 06/25/2020] [Indexed: 11/29/2022]
Abstract
Community initiatives aiming to reduce health inequalities are increasingly common in health policy. Though diverse many such initiatives aim to support residents of disadvantaged places to exercise greater collective control over decisions/actions that affect their lives - which research suggests is an important determinant of health - and some seek to achieve this by giving residents control over a budget. Informed by theoretical work in which community capabilities for collective control are conceptualised as different forms of power, and applying a relational lens, this paper presents findings on the potential role of money as a mechanism to enhance these capabilities from an on-going evaluation of a major place-based initiative being implemented in 150 neighbourhoods across England:The Big Local (BL). The research involved semi-structured interviews with 116 diverse stakeholders, including residents and participant observation in a diverse sample of 10 BL areas. We took a thematic constant comparative approach to the analysis of data from across the sites. The findings suggest that the money enabled the development of capabilities for collective control in these communities primarily by enhancing connectivity amongst residents and with external stakeholders. However, residents had to engage in significant 'relational work' to achieve these benefits and tensions around the money could hinder communities' 'power to act'. Greater social connectivity has been shown to directly affect individual and population health by increasing social cohesion and reducing loneliness. Additionally, supporting enhanced collective control of residents in these disadvantaged communities has the potential to improve population health and reduce health inequalities.
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Affiliation(s)
- A Townsend
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, United Kingdom.
| | - C Abraham
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - A Barnes
- School of Health and Related Research, University of Sheffield, United Kingdom
| | - M Collins
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, United Kingdom
| | - E Halliday
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, United Kingdom
| | - S Lewis
- School of Social and Political Science, University of Edinburgh, United Kingdom
| | - L Orton
- Department of Public Health, Policy and Systems, University of Liverpool, United Kingdom
| | - R Ponsford
- Public Health Environments and Society, London School of Hygiene and Tropical Medicine, United Kingdom
| | - S Salway
- School of Health and Related Research, University of Sheffield, United Kingdom; Department of Sociological Studies, University of Sheffield, United Kingdom
| | - M Whitehead
- Department of Public Health, Policy and Systems, University of Liverpool, United Kingdom
| | - J Popay
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, United Kingdom
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26
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Parker S, Buckley W, Truesdell A, Riggio M, Collins M, Boardman B. Barriers to the Use of Assistive Technology with Children: A Survey. Journal of Visual Impairment & Blindness 2020. [DOI: 10.1177/0145482x9008401013] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reports on the responses of 120 teachers and habilitative specialists of multiply handicapped blind and deaf-blind children in Massachusetts to a survey on their use of assistive technology. The respondents reported problems in all areas covered by the survey: knowledge of electronic mobility aids and communication devices; the availability, maintenance, and funding of devices; and adequate information about devices. They especially mentioned the need for resources to assess and match students to appropriate devices and to generate more training for themselves.
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Affiliation(s)
- S. Parker
- Division of Development and Behavioral Pediatrics, Department of Pediatrics, Boston City Hospital, Talbot 214, 818 Harrison Avenue, Boston, MA 02118
| | - W. Buckley
- Deaf-Blind Department, Perkins School for the Blind
| | | | - M. Riggio
- National education consultant, Hilton-Perkins Program
| | - M. Collins
- Hilton-Perkins National Program, Perkins School for the Blind, Watertown, MA 02172
| | - B. Boardman
- Division of General Pediatrics, Boston City Hospital, Boston, MA 02118
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27
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Normahani P, Sounderajah V, Harrop-Griffiths W, Chukwuemeka A, Peters NS, Standfield NJ, Collins M, Jaffer U. Achieving good-quality consent: review of literature, case law and guidance. BJS Open 2020; 4:757-763. [PMID: 32475083 PMCID: PMC7528509 DOI: 10.1002/bjs5.50306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/20/2020] [Accepted: 05/05/2020] [Indexed: 01/22/2023] Open
Abstract
Background Informed consent is an integral part of clinical practice. There is widespread agreement amongst health professionals that obtaining procedural consent needs to move away from a unidirectional transfer of information to a process of supporting patients in making informed, self‐determined decisions. This review aimed to identify processes and measures that warrant consideration when engaging in consent‐based discussions with competent patients undergoing elective procedures. Methods Formal written guidance from the General Medical Council and Royal College of Surgeons of England, in addition to peer‐reviewed literature and case law, was considered in the formulation of this review. Results A framework for obtaining consent is presented that is informed by the key tenets of shared decision‐making (SDM), a model that advocates the contribution of both the clinician and patient to the decision‐making process through emphasis on patient participation, analysis of empirical evidence, and effective information exchange. Moreover, areas of contention are highlighted in which further guidance and research are necessary for improved enhancement of the consent process. Conclusion This SDM‐centric framework provides structure, detail and suggestions for achieving meaningful consent.
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Affiliation(s)
- P Normahani
- Imperial Vascular Unit, London, UK.,Department of Surgery and Cancer, London, UK
| | - V Sounderajah
- Imperial Vascular Unit, London, UK.,Department of Surgery and Cancer, London, UK
| | - W Harrop-Griffiths
- Anaesthetic Department, London, UK.,Department of Surgery and Cancer, London, UK
| | - A Chukwuemeka
- Department of Cardiothoracic Surgery, London, UK.,Department of Surgery and Cancer, London, UK
| | - N S Peters
- Connected Care Bureau, Imperial College NHS Healthcare Trust, London, UK.,National Lung and Heart Institute, Imperial College London, London, UK
| | - N J Standfield
- Imperial Vascular Unit, London, UK.,Department of Surgery and Cancer, London, UK
| | - M Collins
- London Borough of Hounslow Council, London, UK
| | - U Jaffer
- Imperial Vascular Unit, London, UK.,Department of Surgery and Cancer, London, UK
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Cachen L, Nocturne G, Collins M, Meyer A, Carbonnel F, Mariette X, Seror R. THU0382 ARTICULAR MANIFESTATIONS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES TREATED WITH ANTI-TNFΑ. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2563] [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:Articular manifestations are the most frequent extra-digestive manifestations of Inflammatory Bowel Disease (IBD). Anti-TNF have proved to be as effective on articular symptoms as on IBD’s ones, but have been suspected to induce paradoxical articular manifestations.Objectives:The aims of this study were to describe the frequency, the type and the management of all articular manifestations occurring in patients treated with anti-TNF for IBD and to look for factors associated with their occurrence.Methods:In this retrospective monocentric study, we included all patients who received an anti-TNF for an IBD in our tertiary hospital referent for inflammatory rheumatic and bowel diseases. We searched for all incident articular manifestations occurring during treatment with anti-TNF, including new or recurrent articular manifestations. Characteristics of patients with paradoxical articular manifestations (defined as inflammatory articular symptoms occurring while IBD was in remission, without immunization against anti-TNF) were compared to that of patients without articular manifestations to identify factors associated with their occurrence.Results:Through a systematic search of all IBD patients seen in our tertiary hospital between February 2013 and May 2017, we identified 442 patients (36.2±15 years, 50.5% men) who had ever received an anti-TNF for IBD: Crohn’s disease (n=277), ulcerative colitis (154) and undetermined colitis (n=11). 74 (16.7%) had already a history of inflammatory articular manifestations including 37 patients with a diagnosis of spondyloarthritis (SpA) made before anti-TNF’s beginning.Among them, 115 (26%) patients developed a new articular manifestation after a mean of 20 (±22) months of treatment: mechanical in 56 (12.6%) and inflammatory in 59 (13.3%). Within patients with new inflammatory articular manifestations: 39% were paradoxical, 27% were concomitant of an IBD flare, 27% were associated to an immunization against anti-TNF, 3% were induced lupus, 2% were chondrocalcinosis and 2% were polymyalgia rheumatic. Articular manifestations associated to an immunization were linked to a loss of efficiency of the treatment for 62%, with (42%) or without (20%) associated digestive symptoms and 38% were due to delayed hypersensitivity reaction. Among paradoxical articular manifestations, 83% were new articular symptoms, including 35% of SpA de novo, and 17% were recurrence of known articular manifestations. The only predictive factor of paradoxical articular manifestation was a previous diagnosis of SpA (21.7% vs 6.8%; p=0.02). Paradoxical manifestations improved in 17 patients despite continuation of anti-TNF, methotrexate was added in 2 and anti-TNF was discontinued in only 4 patients.Conclusion:Inflammatory articular manifestations occurred in about 13% of patients treated with anti-TNF for IBD. More than a quarter were linked to an immunization against anti-TNF, which has to be searched in this situation. Less than half of them (39%) were paradoxical. In most of cases, they were transitory and did not require anti-TNF’s discontinuation. The only predictive factor of paradoxical articular manifestations was having a history of SpA.References:[1]Thiebault H, et al. Paradoxical articular manifestations in patients with inflammatory bowel diseases treated with infliximab. Eur J Gastroenterol Hepatol, 2016.[2]Fiorino G et al. Paradoxical immune-mediated inflammation in inflammatory bowel disease patients receiving anti-TNF-α agents. Autoimmun Rev, 2014.Disclosure of Interests:Laurie Cachen: None declared, Gaetane Nocturne: None declared, Michael Collins Consultant of: Abbvie, Takeda, MSD, Celgene, Antoine Meyer: None declared, Franck Carbonnel Consultant of: Msd Abbvie Amgen, Xavier Mariette Consultant of: BMS, Gilead, Medimmune, Novartis, Pfizer, Servier, UCB, Raphaèle Seror Consultant of: BMS UCB Pfizer Roche
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Williamson AA, Bhandari E, Cicalese O, Heaps E, Ostan A, Collins M, Lupini F, Mindell JA. 0929 Caregiver-Reported Versus Clinician-Documented Child Sleep Problems and Sleep-Related Health Behaviors in Primary Care. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Sleep problems are highly prevalent in early childhood but often under-identified in pediatric primary care. This study identified the prevalence of caregiver-reported versus primary care provider (PCP)-documented sleep problems and sleep-related health behaviors in young children presenting to well child visits (WCVs).
Methods
Caregivers (85.4% mothers) of 198 young children (2-5 years, M = 3.3, 53.7% female, 62.9% Black) presenting to urban (74.1%) and suburban (25.9%) primary care sites for well child visits (WCVs) completed research surveys on child behavioral sleep problems, snoring, and sleep-related health behaviors (e.g., caffeine consumption) on the day of their child’s WCV. Electronic medical record review was used to identify the rate of PCP-documented sleep problems and related recommendations in the WCV progress note.
Results
Fifteen percent of caregivers reported a child sleep problem according to questionnaire data, which did not significantly differ from the 12.0% of children with a PCP-documented sleep problem in the WCV progress note (p = .31). However, significantly more caregivers (28.3%) reported bedtime difficulties (resistance; tantrums) on questionnaires (p <.001), which were not captured in the 12.0% of WCVs noting sleep problems. A total of 8% of WCVs included child sleep recommendations. Child snoring was reported by 17.0% of caregivers, but was less frequently documented in WCVs (4.5%, p <.001). Although many caregivers reported poor child sleep-related health behaviors, including daily child caffeine consumption (21.1%) and bedroom electronics (62.9%), significantly fewer PCPs documented these issues (caffeine: 2.0%; electronics: 6.6%) or related recommendations (decrease caffeine: 1.0%; eliminate electronics: 3.5%) in the progress note (all p-values <.001).
Conclusion
Although caregiver-endorsed child sleep problems on surveys did not differ from PCP-documented concerns, there are gaps in documenting other problematic sleep-related health behaviors, such as caffeine consumption and electronics use. More resources to address sleep-related health behaviors, as well as sleep problems, in pediatric primary care are needed.
Support
Sleep Research Society Foundation and K23HD094905 (AAW)
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Affiliation(s)
- A A Williamson
- Sleep Center, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - O Cicalese
- Sleep Center, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - E Heaps
- Department of Psychology, Saint Joseph’s University, Philadelphia, PA
| | - A Ostan
- Department of Psychology, Saint Joseph’s University, Philadelphia, PA
| | - M Collins
- Department of Psychology, Saint Joseph’s University, Philadelphia, PA
| | - F Lupini
- Department of Psychology, Saint Joseph’s University, Philadelphia, PA
| | - J A Mindell
- Department of Psychology, Saint Joseph’s University, Philadelphia, PA
- Sleep Center, Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Mindell JA, Goh D, Collins M, Bartle A, Kohyama J, Sekartini R, Veeravigrom M, Leichman ES. 0947 Parent-Perceived Sleep Problems and Sleep Goals in Infants and Toddlers: A Global Sample. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The aim of this study was to assess parent perceptions of sleep problems in young children and parent-identified areas of change in a global sample.
Methods
Caregivers (95.6% mothers) of 1555 infants/toddlers (birth-37 mos; M=12.2 mos; 49.5% male) completed an online survey, representing Indonesia (n=187), Japan (n=718), New Zealand (n=231), Singapore (n=199), and Thailand (n=221). The survey included an abbreviated version of the Brief Infant Sleep Questionnaire, and a list of potential sleep-related areas of change.
Results
36.9% reported a perceived sleep-problem, whereas 92.9% indicated an area of desired change related to their child’s sleep. In terms of areas of change, 82.5% endorsed bedtime/how child falls asleep, 70.0% nighttime sleep, and 57.8% related to the morning. As expected, 99.7% of parents who endorsed a problem indicated a desired change compared to 88.9% who did not perceive a problem, p < .001. Those who noted a problem were more likely to endorse a change at bedtime (92.5%) and during the night (90.1%), compared to the morning (68.8%). There were country-based differences, with caregivers in New Zealand (47.0%) and Singapore (44.2%) more likely to report a child sleep problem compared to Thailand (35.3%), Japan (34.1%) and Indonesia (29.4%), p < .001. No differences were noted in parent-report of desired change across Japan, New Zealand, Singapore, and Thailand (94-96%) but were significantly higher than Indonesia (83.4%).
Conclusion
Although one-third of parents of young children in a global sample indicate a perceived sleep problem, almost all parents wish to change something about their child’s sleep, primarily relate to bedtime and during the night. Sleep education and assessment delivered by health care providers should focus not only on what families consider to be “problematic,” but also what families would like to modify, or improve, about their child’s sleep within a developmentally appropriate framework.
Support
Johnson & Johnson Consumer Inc., Skillman, NJ, USA.
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Affiliation(s)
- J A Mindell
- Saint Joseph’s University, Philadelphia, PA
- Children’s Hospital of Philadelphia, Philadelphia, PA
| | - D Goh
- National University Hospital, Singapore, SINGAPORE
| | - M Collins
- Saint Joseph’s University, Philadelphia, PA
| | - A Bartle
- Sleep Well Clinics, Auckland, NEW ZEALAND
| | - J Kohyama
- Tokyo Bay Urayasu/Ichikawa Medical Center, Urayasu, JAPAN
| | - R Sekartini
- Medical School University of Indonesia, Jakarta, INDONESIA
| | - M Veeravigrom
- Chulalongkorn University and King Chulalongkorn Memorial Hospital/ The Thai Red Cross Society, Bangkok, THAILAND
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Bauman J, Panick J, Galloway T, Ridge J, McShane M, Chwistek M, Collins M, Kinczewski L, Murphy K, Welsh M, Farren M, Clark M, Kelly J, Schuster K, Stokes L, Amrhein S, Bender F, Egleston B, El-jawahri A, Fang C. A Pilot Study of a Comprehensive Palliative Care Intervention to Improve Symptoms and Coping During Curative-Intent Chemoradiation in Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chaput N, Lepage P, Coutzac C, Soularue E, Le Roux K, Monot C, Boselli L, Routier E, Cassard L, Collins M, Vaysse T, Marthey L, Eggermont A, Asvatourian V, Lanoy E, Mateus C, Robert C, Carbonnel F. Baseline gut microbiota predicts clinical response and colitis in metastatic melanoma patients treated with ipilimumab. Ann Oncol 2019; 30:2012. [PMID: 31408090 DOI: 10.1093/annonc/mdz224] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Background Physical fitness is impaired after stroke, yet fitness training after stroke reduces disability. Several international guidelines recommend that fitness training be incorporated as part of stroke rehabilitation. However, information about cost-effectiveness is limited. Methods A decision tree model was used to estimate the cost-effectiveness of a fitness programme for stroke survivors vs. relaxation (control group). This was based on a published randomised controlled trial, from which evidence about quality of life was used to estimate Quality Adjusted Life Years. Costs were based on the cost of the provision of group fitness classes within local community centres and a cost per Quality Adjusted Life Year was calculated. Results The results of the base case analysis found an incremental cost per Quality Adjusted Life Year of £2,343. Conclusions Physical fitness sessions after stroke are a cost-effective intervention for stroke survivors. This information will help make the case for the development of new services.
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Affiliation(s)
- M Collins
- M Collins, Yunus Centre for Social Business and Health, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK,
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Barnes DKA, Morley SA, Bell J, Brewin P, Brigden K, Collins M, Glass T, Goodall-Copestake WP, Henry L, Laptikhovsky V, Piechaud N, Richardson A, Rose P, Sands CJ, Schofield A, Shreeve R, Small A, Stamford T, Taylor B. Marine plastics threaten giant Atlantic Marine Protected Areas. Curr Biol 2019; 28:R1137-R1138. [PMID: 30300595 DOI: 10.1016/j.cub.2018.08.064] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There has been a recent shift in global perception of plastics in the environment, resulting in a call for greater action. Science and the popular media have highlighted plastic as an increasing stressor [1,2]. Efforts have been made to confer protected status to some remote locations, forming some of the world's largest Marine Protected Areas, including several UK overseas territories. We assessed plastic at these remote Atlantic Marine Protected Areas, surveying the shore, sea surface, water column and seabed, and found drastic changes from 2013-2018. Working from the RRS James Clark Ross at Ascension, St. Helena, Tristan da Cunha, Gough and the Falkland Islands (Figure 1A), we showed that marine debris on beaches has increased more than 10 fold in the past decade. Sea surface plastics have also increased, with in-water plastics occurring at densities of 0.1 items m-3; plastics on seabeds were observed at ≤ 0.01 items m-2. For the first time, beach densities of plastics at remote South Atlantic sites approached those at industrialised North Atlantic sites. This increase even occurs hundreds of meters down on seamounts. We also investigated plastic incidence in 2,243 animals (comprising 26 species) across remote South Atlantic oceanic food webs, ranging from plankton to seabirds. We found that plastics had been ingested by primary consumers (zooplankton) to top predators (seabirds) at high rates. These findings suggest that MPA status will not mitigate the threat of plastic proliferation to this rich, unique and threatened biodiversity.
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Affiliation(s)
| | - S A Morley
- British Antarctic Survey, NERC, Cambridge, UK
| | - J Bell
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, UK
| | - P Brewin
- South Atlantic Environment Research Institute, Stanley, Falkland Islands
| | - K Brigden
- South Atlantic Environment Research Institute, Stanley, Falkland Islands
| | - M Collins
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, UK
| | - T Glass
- Tristan da Cunha Conservation Department, Edinburgh, UK Overseas Territory
| | | | - L Henry
- Marine Conservation, ENRD, St. Helena Government
| | - V Laptikhovsky
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, UK
| | | | - A Richardson
- Ascension Island Conservation and Fisheries Department
| | - P Rose
- Pristine Seas, National Geographic Society, Washington DC, USA
| | - C J Sands
- British Antarctic Survey, NERC, Cambridge, UK
| | - A Schofield
- Royal Society for the Protection of Birds, Sandy, UK
| | - R Shreeve
- Marine Conservation, ENRD, St. Helena Government
| | - A Small
- Marine Conservation, ENRD, St. Helena Government
| | - T Stamford
- Centre for Environment, Fisheries and Aquaculture Science, Lowestoft, UK
| | - B Taylor
- St. Helena National Trust, Jamestown, St. Helena
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Correa A, Connolly D, Balcioglu M, Wu HT, Dashner S, Shchegrova S, Kalashnikova E, Pawar H, Uzzo R, Gong Y, Kister D, Collins M, Donovan M, Winters R, Aleshin A, Sethi H, Salari R, Louie M, Zimmermann B, Abbosh P. Presence of circulating tumour DNA in surgically resected renal cell carcinoma is associated with advanced disease and poor patient prognosis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Auclin E, Marthey L, Mas L, Francois E, Sa Cunha A, Bachet JB, Tougeron D, Vienot A, Lecomte T, Hautefeuille V, Forestier J, Collins M, Abdallah R, Coriat R, Pointet AL, Leroy F, Ksontini F, Williet N, Taieb J. FOLFIRINOX in locally advanced (LA) and borderline resectable (BR) pancreatic adenocarcinoma: Update of the AGEO cohort. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.011] [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: 11/14/2022] Open
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Somorin T, Fidalgo B, Hassan S, Sowale A, Kolios A, Parker A, Williams L, Collins M, McAdam EJ, Tyrrel S. Non-isothermal drying kinetics of human feces. Dry Technol 2019; 38:1819-1827. [PMID: 33767602 PMCID: PMC7932498 DOI: 10.1080/07373937.2019.1670205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 05/24/2023]
Abstract
The non-isothermal drying behavior and kinetics of human feces (HF) were investigated by means of thermogravimetric analysis to provide data for designing a drying unit operation. The effect of heating rate and blending with woody biomass were also evaluated on drying pattern and kinetics. At low heating rate (1 K/min), there is effective transport of moisture, but a higher heating rate would be necessary at low moisture levels to reduce drying time. Blending with wood biomass improves drying characteristics of HF. The results presented in this study are relevant for designing non-sewered sanitary systems with in-situ thermal treatment.
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Affiliation(s)
- T. Somorin
- Department of Chemical & Process Engineering, University of Strathclyde, Glasgow, UK
| | - B. Fidalgo
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - S. Hassan
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - A. Sowale
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - A. Kolios
- Naval Architecture, Ocean & Marine Engineering, University of Strathclyde, Glasgow, UK
| | - A. Parker
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - L. Williams
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - M. Collins
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - E. J. McAdam
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - S. Tyrrel
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
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Michot JM, Lappara A, Simonaggio A, Danlos FX, Belkhir R, Collins M, Berdelou A, Cauquil C, Edhery S, Le Pavec J, Eleonora D, Mateus C, Hollebecque A, Varga A, Soria JC, Massard C, Voisin AL, Marabelle A, Champiat S, Lambotte O. The ImmunoTOX multidisciplinary board: A descriptive study of collaborative management of immune-related adverse events. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Combs J, Puskar A, Blaney N, Collins M, Kontos A. Preliminary Examinations of Concussion in Older Adults. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz026.38] [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
Purpose
This study sought to investigate whether concussion in older adults improves through evaluating their performance on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Vestibular/Ocular-Motor Screen (VOMS) across visits and to describe and better characterize concussion in this at-risk population.
Methods
We conducted a retrospective review of medical records for 69 older adult patients (40 females, 29 males) that presented to a concussion specialty clinic. Participants averaged 64.71 (SD=4.1) years in age and presented within 6-998 days of injury (SD=170.9). Demographics and clinical data were recorded at intake through last appointment. Descriptive analysis, including frequencies, means, and standard deviations were performed as well as paired T-test to compare mean scores for first and last visit. Statistical significance was determined by two-sided p-values <.05.
Results
Twenty out of 69 participants (29%) reported a previous concussion. Concussion symptom severity scores at participants’ first clinic visit averaged 56.19 (SD=26.56) compare with 39.51 (SD=25.53) at their final clinic visit. When comparing ImPACT data, all scores improved comparatively from Visit 1 to Last Visit (P values =0.000-0.014); all VOMS total scores improved as well (P =0.00-0.047). The most frequent primary profile among participants was Vestibular (31.9%).
Conclusion
Older adults diagnosed with concussion showed improvement on ImPACT scores and their symptom severity scores decreased. The most frequent primary concussion profile at initial visit was Vestibular. Further research with this at-risk population is needed.
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Jennings S, French J, Holland C, Collins M, Kontos AP. Comparison of Clinical Outcomes Following Patients' First and Second Concussions. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz026.36] [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
Purpose
The objective of this study was to examine differences in self-reported symptoms, neurocognitive performance, and vestibular-ocular insufficiencies between patients’ first and second concussions. A secondary purpose was to explore the role of risk factors on recovery.
Methods
We conducted a retrospective medical chart review of 73 (32-M/41-F) patients aged 15.69 (SD=1.67) years from a concussion specialty clinic with two separate concussions (84.9% of 1st and 79.5% of 2nd sport-related) that occurred between August 2010 and April 2018. Clinical outcomes included the PCSS, ImPACT, and the Vestibular/Ocular Motor Screening (VOMS). A series of paired samples t-tests were used to compare clinical outcomes along with chi-square analyses for risk factor associations.
Results
Verbal memory scores were higher following the second (M=80.67, SD=15.3) (M=76.32, SD=15.65) (t[73]=–2.18, p=.03) concussion. Visual motor processing speed was faster following the second concussion (M=35.04, SD= 7.90) (M=31.35, SD=7.63) (t[73]=–5.72, p<.001). There were no other significant differences observed. Recovery time was similar for the first (61.07, SD=58.41.5) and second (67.91 SD=70.10) respectively, t(70)=–.91, p=.37. There was no relationship between any risk factors, and recovery time for either injury with the exception a significant association between gender and recovery time (>21 days) with the 1st injury for females (χ2, N=73)=10.58, p=.001.
Conclusion
Findings suggest that a second concussion does not result in more pronounced symptoms, worse neurocognitive performance, or increased deficits on vestibular/ocular performance and/or longer recovery time. The only significant risk factor to a recovery over 21 days included gender.
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Ernst N, Sufrinko A, Collins M, Kontos A. Reliability and Consistency of the Vestibular/Ocular Motor Screening (VOMS) Assessment Near Point of Convergence (NPC) Trials. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz026.37] [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
Purpose
To examine the reliability of near point of convergence (NPC) across three trials and determine if one trial of NPC is adequate to identify receded NPC post-concussion.
Methods
Participants included 263 concussed patients (64.3% male; age=16.92±3.49 years) evaluated within 21 days of injury. NPC was measured in centimeters from the tip of the nose using a fixation stick and a Gulick anthropometric tape measure. A two-way, mixed effect, absolute agreement intraclass correlation coefficient (ICC 3,1) was conducted to evaluate reliability across the three trials. A chi-square analysis examined consistency of NPC classification (normal/abnormal) on the initial trial compared to average across three trials.
Results
Reliability of the three trials was high (.91 [95%CI, .89–.93]). Agreement between Trial 1 classification and classification based on average of all three trials was high (96.2%). Of the 10 participants who were classified differently for Trial 1 compared to average trials, 8 had borderline (e.g., 4–6 cm) measurements on the first trial.
Conclusion
NPC measurement across trials is reliable for the overall sample, but those who fell well below (i.e. 0–1cm) or well above (>8cm) clinical cutoffs on the first trial were almost always below or above respective cutoffs on the average convergence (>99%). Results suggest it is important to measure NPC across multiple trials for patients with initial borderline measurement.
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Weinbren M, Weston V, Woods S, Collins M, Coultas A, O'Connell N, Dunne C. Oxygenating the argument for consistent performance of anaerobic blood cultures and blood volumes collected. J Hosp Infect 2019; 102:351-352. [DOI: 10.1016/j.jhin.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/04/2019] [Indexed: 11/16/2022]
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von Berg S, Xue Y, Collins M, Llinas A, Olsson RI, Halvarsson T, Lindskog M, Malmberg J, Jirholt J, Krutrök N, Ramnegård M, Brännström M, Lundqvist A, Lepistö M, Aagaard A, McPheat J, Hansson EL, Chen R, Xiong Y, Hansson TG, Narjes F. Discovery of Potent and Orally Bioavailable Inverse Agonists of the Retinoic Acid Receptor-Related Orphan Receptor C2. ACS Med Chem Lett 2019; 10:972-977. [PMID: 31223457 DOI: 10.1021/acsmedchemlett.9b00158] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 05/29/2019] [Indexed: 12/31/2022] Open
Abstract
The further optimization of a recently disclosed series of inverse agonists of the nuclear receptor RORC2 is described. Investigations into the left-hand side of compound 1, guided by X-ray crystal structures, led to the substitution of the 4-aryl-thiophenyl residue with the hexafluoro-2-phenyl-propan-2-ol moiety. This change resulted in to compound 28, which combined improved drug-like properties with good cell potency and a significantly lower dose, using an early dose to man prediction. Target engagement in vivo was demonstrated in the thymus of mice by a reduction in the number of double positive T cells after oral dosing.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rongfeng Chen
- Pharmaron Beijing Co., Ltd., Taihe Road BDA, Beijing 100176, P. R. China
| | - Yao Xiong
- Pharmaron Beijing Co., Ltd., Taihe Road BDA, Beijing 100176, P. R. China
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Affiliation(s)
- E Vantomme
- College of Medicine, University of Saskatchewan, Regina, SK, Canada
| | - M Collins
- McMaster University, Hamilton, ON, Canada
| | - F Tayyari
- McMaster University, Hamilton, ON, Canada
| | - K Khan
- McMaster University, Hamilton, ON, Canada
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45
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Fidalgo B, Chilmeran M, Somorin T, Sowale A, Kolios A, Parker A, Williams L, Collins M, McAdam E, Tyrrel S. Non-isothermal thermogravimetric kinetic analysis of the thermochemical conversion of human faeces. Renew Energy 2019; 132:1177-1184. [PMID: 31007417 PMCID: PMC6472681 DOI: 10.1016/j.renene.2018.08.090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/26/2018] [Accepted: 08/28/2018] [Indexed: 06/09/2023]
Abstract
The "Reinvent the Toilet Challenge" set by the Bill & Melinda Gates Foundation aims to bring access to adequate sanitary systems to billions of people. In response to this challenge, on-site sanitation systems are proposed and being developed globally. These systems require in-situ thermal treatment, processes that are not well understood for human faeces (HF). Thermogravimetric analysis has been used to investigate the pyrolysis, gasification and combustion of HF. The results are compared to the thermal behaviour of simulant faeces (SF) and woody biomass (WB), along with the blends of HF and WB. Kinetic analysis was conducted using non-isothermal kinetics model-free methods, and the thermogravimetric data obtained for the combustion of HF, SS and WB. The results show that the devolatilisation of HF requires higher temperatures and rates are slower those of WB. Minimum temperatures of 475 K are required for fuel ignition. HF and SF showed similar thermal behaviour under pyrolysis, but not under combustion conditions. The activation energy for HF is 157.4 kJ/mol, relatively higher than SS and WB. Reaction order for HF is lower (n = 0.4) to WB (n = 0.6). In-situ treatment of HF in on-site sanitary systems can be designed for slow progressive burn.
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46
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Abida W, Bryce A, Vogelzang N, Amato R, Percent I, Shapiro J, McDermott R, Hussain A, Patnaik A, Petrylak D, Ryan C, Stanton T, Zhang J, Simmons A, Despain D, Collins M, Golsorskhi T, Scher H, Chowdhury S. Preliminary results from TRITON2: A phase II study of rucaparib in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) associated with homologous recombination repair (HRR) gene alterations. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Chakhtoura M, Ramnitz MS, Khoury N, Nemer G, Shabb N, Abchee A, Berberi A, Hourani M, Collins M, Ichikawa S, El Hajj Fuleihan G. Hyperphosphatemic familial tumoral calcinosis secondary to fibroblast growth factor 23 (FGF23) mutation: a report of two affected families and review of the literature. Osteoporos Int 2018; 29:1987-2009. [PMID: 29923062 DOI: 10.1007/s00198-018-4574-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/14/2018] [Indexed: 01/20/2023]
Abstract
Hyperphosphatemic familial tumoral calcinosis (HFTC), secondary to fibroblast growth factor 23 (FGF23) gene mutation, is a rare genetic disorder characterized by recurrent calcified masses. We describe young Lebanese cousins presenting with HFTC, based on a retrospective chart review and a prospective case study. In addition, we present a comprehensive review on the topic, based on a literature search conducted in PubMed and Google Scholar, in 2014 and updated in December 2017. While the patients had the same previously reported FGF23 gene mutation (homozygous c.G367T variant in exon 3 leading to a missense mutation), they presented with variable severity and age of disease onset (at 4 years in patient 1 and at 23 years in patient 2). A review of the literature revealed several potential patho-physiologic pathways of HFTC clinical manifestations, some of which may be independent of hyperphosphatemia. Most available treatment options aim at reducing serum phosphate level, by stimulating renal excretion or by inhibiting intestinal absorption. HFTC is a challenging disease. While the available medical treatment has a limited and inconsistent effect on disease symptomatology, surgical resection of calcified masses remains the last resort. Research is needed to determine the safety and efficacy of FGF23 replacement or molecular therapy, targeting the specific genetic aberration. Hyperphosphatemic familial tumoral calcinosis is a rare genetic disorder characterized by recurrent calcified masses, in addition to other visceral, skeletal, and vascular manifestations. It remains a very challenging disease.
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Affiliation(s)
- M Chakhtoura
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon.
| | - M S Ramnitz
- Section on Skeletal Disorders and Mineral Homeostasis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - N Khoury
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - G Nemer
- Department of Biochemistry and Molecular Genetics, American University of Beirut Medical Center, Beirut, Lebanon
| | - N Shabb
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Abchee
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Berberi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - M Hourani
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - M Collins
- Section on Skeletal Disorders and Mineral Homeostasis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - S Ichikawa
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - G El Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
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Weinbren M, Collins M, Heathcote R, Umar M, Nisar M, Ainger C, Masters P. Optimization of the blood culture pathway: a template for improved sepsis management and diagnostic antimicrobial stewardship. J Hosp Infect 2018; 98:232-235. [DOI: 10.1016/j.jhin.2017.12.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 12/29/2017] [Indexed: 11/15/2022]
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49
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Kamranvand F, Davey C, Sakar H, Autin O, Mercer E, Collins M, Williams L, Kolios A, Parker A, Tyrrel S, Cartmell E, McAdam E. Impact of fouling, cleaning and faecal contamination on the separation of water from urine using thermally driven membrane separation. SEP SCI TECHNOL 2018; 53:1372-1382. [PMID: 33551521 PMCID: PMC7822070 DOI: 10.1080/01496395.2018.1433688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/24/2018] [Indexed: 01/27/2023]
Abstract
In this study, membrane distillation is evaluated as a technology for non-sewered sanitation, using waste heat to enable separation of clean water from urine. Whilst membrane fouling was observed for urine, wetting was not evident and product water quality met the proposed discharge standard, despite concentration of the feed. Fouling was reversible using physical cleaning, which is similar to previous membrane studies operating without pressure as the driving force. High COD reduction was achieved following faecal contamination, but mass transfer was impeded and wetting occurred which compromised permeate quality, suggesting upstream intervention is demanded to limit the extent of faecal contamination. (100 words).
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Affiliation(s)
- F. Kamranvand
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - C.J. Davey
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - H. Sakar
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
- Environmental Engineering Department, Gebze Technical University, Gebze, 41400, Turkey
| | - O. Autin
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - E. Mercer
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - M. Collins
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - L. Williams
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - A. Kolios
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - A. Parker
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - S. Tyrrel
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - E. Cartmell
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - E.J. McAdam
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, UK
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50
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Chaput N, Lepage P, Coutzac C, Soularue E, Le Roux K, Monot C, Boselli L, Routier E, Cassard L, Collins M, Vaysse T, Marthey L, Eggermont A, Asvatourian V, Lanoy E, Mateus C, Robert C, Carbonnel F. Baseline gut microbiota predicts clinical response and colitis in metastatic melanoma patients treated with ipilimumab. Ann Oncol 2018; 28:1368-1379. [PMID: 28368458 DOI: 10.1093/annonc/mdx108] [Citation(s) in RCA: 775] [Impact Index Per Article: 129.2] [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: 12/11/2022] Open
Abstract
Background Ipilimumab, an immune checkpoint inhibitor targeting CTLA-4, prolongs survival in a subset of patients with metastatic melanoma (MM) but can induce immune-related adverse events, including enterocolitis. We hypothesized that baseline gut microbiota could predict ipilimumab anti-tumor response and/or intestinal toxicity. Patients and methods Twenty-six patients with MM treated with ipilimumab were prospectively enrolled. Fecal microbiota composition was assessed using 16S rRNA gene sequencing at baseline and before each ipilimumab infusion. Patients were further clustered based on microbiota patterns. Peripheral blood lymphocytes immunophenotypes were studied in parallel. Results A distinct baseline gut microbiota composition was associated with both clinical response and colitis. Compared with patients whose baseline microbiota was driven by Bacteroides (cluster B, n = 10), patients whose baseline microbiota was enriched with Faecalibacterium genus and other Firmicutes (cluster A, n = 12) had longer progression-free survival (P = 0.0039) and overall survival (P = 0.051). Most of the baseline colitis-associated phylotypes were related to Firmicutes (e.g. relatives of Faecalibacterium prausnitzii and Gemmiger formicilis), whereas no colitis-related phylotypes were assigned to Bacteroidetes. A low proportion of peripheral blood regulatory T cells was associated with cluster A, long-term clinical benefit and colitis. Ipilimumab led to a higher inducible T-cell COStimulator induction on CD4+ T cells and to a higher increase in serum CD25 in patients who belonged to Faecalibacterium-driven cluster A. Conclusion Baseline gut microbiota enriched with Faecalibacterium and other Firmicutes is associated with beneficial clinical response to ipilimumab and more frequent occurrence of ipilimumab-induced colitis.
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Affiliation(s)
- N Chaput
- Laboratory of Immunomonitoring in Oncology, CNRS-UMS 3655 and INSERM-US23, Gustave Roussy Cancer Campus, Villejuif.,Faculty of Pharmacy, Chatenay-Malabry
| | - P Lepage
- Micalis Institute, INRA, AgroParisTech, Paris
| | - C Coutzac
- Laboratory of Immunomonitoring in Oncology, CNRS-UMS 3655 and INSERM-US23, Gustave Roussy Cancer Campus, Villejuif.,Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre
| | - E Soularue
- Laboratory of Immunomonitoring in Oncology, CNRS-UMS 3655 and INSERM-US23, Gustave Roussy Cancer Campus, Villejuif.,Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre.,Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre
| | - K Le Roux
- Micalis Institute, INRA, AgroParisTech, Paris
| | - C Monot
- Micalis Institute, INRA, AgroParisTech, Paris
| | - L Boselli
- Laboratory of Immunomonitoring in Oncology, CNRS-UMS 3655 and INSERM-US23, Gustave Roussy Cancer Campus, Villejuif
| | - E Routier
- Dermatology Unit, Department of Medicine, Gustave Roussy, Cancer Campus, Villejuif
| | - L Cassard
- Laboratory of Immunomonitoring in Oncology, CNRS-UMS 3655 and INSERM-US23, Gustave Roussy Cancer Campus, Villejuif
| | - M Collins
- Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre.,Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre
| | - T Vaysse
- Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre.,Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre
| | - L Marthey
- Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre.,Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre
| | - A Eggermont
- Dermatology Unit, Department of Medicine, Gustave Roussy, Cancer Campus, Villejuif.,INSERM U1015, Gustave Roussy, Cancer Campus, Villejuif
| | - V Asvatourian
- Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Campus (GRCC), Villejuif.,University Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - E Lanoy
- Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Campus (GRCC), Villejuif.,University Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - C Mateus
- Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre
| | - C Robert
- Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre.,Dermatology Unit, Department of Medicine, Gustave Roussy, Cancer Campus, Villejuif
| | - F Carbonnel
- Faculty of Medicine, University Paris-Saclay, Le Kremlin Bicêtre.,Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin Bicêtre
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