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Tchalova K, Lydon JE, Atkinson L, Fleming AS, Kennedy J, Lecompte V, Meaney MJ, Moss E, O'Donnell KA, O'Donnell KJ, Silveira PP, Sokolowski MB, Steiner M, Bartz JA. Variation in the mu-opioid receptor gene (OPRM1) moderates the influence of maternal sensitivity on child attachment. Transl Psychiatry 2024; 14:181. [PMID: 38580654 PMCID: PMC10997775 DOI: 10.1038/s41398-024-02888-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
The endogenous opioid system is thought to play an important role in mother-infant attachment. In infant rhesus macaques, variation in the μ-opioid receptor gene (OPRM1) is related to differences in attachment behavior that emerges following repeated separation from the mother; specifically, infants carrying at least one copy of the minor G allele of the OPRM1 C77G polymorphism show heightened and more persistent separation distress, as well as a pattern of increased contact-seeking behavior directed towards the mother during reunions (at the expense of affiliation with other group members). Research in adult humans has also linked the minor G allele of the analogous OPRM1 A118G polymorphism with greater interpersonal sensitivity. Adopting an interactionist approach, we examined whether OPRM1 A118G genotype and maternal (in)sensitivity are associated with child attachment style, predicting that children carrying the G allele may be more likely to develop an ambivalent attachment pattern in response to less sensitive maternal care. The sample consisted of 191 mothers participating with their children (n = 223) in the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) project, a community-based, birth cohort study of Canadian mothers and their children assessed longitudinally across the child's development. Maternal sensitivity was coded from at-home mother-child interactions videotaped when the child was 18 months of age. Child attachment was assessed at 36 months using the Strange Situation paradigm. As predicted, G allele carriers, but not AA homozygotes, showed increasing odds of being classified as ambivalently attached with decreasing levels of maternal sensitivity. Paralleling earlier non-human animal research, this work provides support for the theory that endogenous opioids contribute to the expression of attachment behaviors in humans.
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Affiliation(s)
- K Tchalova
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - J E Lydon
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - L Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - A S Fleming
- Department of Psychology, University of Toronto Mississauga, Toronto, ON, Canada
| | - J Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - V Lecompte
- L'Université du Québec à Montréal, Montréal, QC, Canada
| | - M J Meaney
- Department of Psychology, McGill University, Montréal, QC, Canada
- Douglas Research Centre, Montréal, QC, Canada
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
| | - E Moss
- L'Université du Québec à Montréal, Montréal, QC, Canada
| | - K A O'Donnell
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - K J O'Donnell
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - P P Silveira
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - M B Sokolowski
- Department of Ecology and Evolutionary Biology, University of Toronto, Toronto, ON, Canada
| | - M Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - J A Bartz
- Department of Psychology, McGill University, Montréal, QC, Canada.
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Gao X, Han Z, Zhao Y, Zhou G, Lyu X, Qi Z, Liu F, Tucker ME, Steiner M, Han C. Interaction of microorganisms with carbonates from the micro to the macro scales during sedimentation: Insights into the early stage of biodegradation. J Environ Manage 2024; 356:120714. [PMID: 38537463 DOI: 10.1016/j.jenvman.2024.120714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/21/2024] [Accepted: 03/19/2024] [Indexed: 04/07/2024]
Abstract
The assembly process of Organic Matter (OM) from single molecules to polymers and the formation process of Ca-CO3 ion-pairs are explored at the micro-scale, and then the relationship between OM and carbonate based on the results of microbially-induced carbonate precipitation (MICP) laboratory experiments is established at the macro-scale. Molecular dynamics (MD) is used to model the assembly of OM (a) in an aqueous solution, (b) on surfaces of calcite (10 1‾ 4) crystals and (c) on defective calcite (101‾ 4) crystal surfaces. From the MICP experiments, carbonate minerals containing abundant OM were precipitated and were characterized by Scanning Electron Microscopy (SEM), X-Ray Diffractometry (XRD) and Fourier Transform Infrared Spectroscopy (FTIR). The results of the MD show that OM is assembled into polymers in all three simulation systems. Although the Ca-CO3 ion-pairs and OM were briefly combined, the aggregation assembly of OM molecules and the precipitation of carbonate calcium are not related in the long run. The highly specific surface area of the defective calcite shows an increase in the adsorption of OM. The van der Waals forces, which are primarily responsible for controlling the assembly of OM molecules, increase with the degree of aggregation. According to the MICP experiments, OM is enriched on the mineral surfaces, and more OM is found at the steps of defective crystals with their larger surface areas. Through MD and MICP laboratory experiments, this work systematically describes the interaction of OM and carbonate minerals from the micro to the macro scales, and this provides insight into the interaction between OM and carbonates and biogeochemical processes related to the accumulation of OM in sediments.
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Affiliation(s)
- Xiao Gao
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China; College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Zuozhen Han
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Yanyang Zhao
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Gang Zhou
- College of Safety and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Xiaowei Lyu
- Qingdao Qiushi Industrial Technology Research Institute, Qingdao 266427, China
| | - Zhenhua Qi
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Fang Liu
- College of Chemical Engineering, China University of Petroleum, Qingdao 266580, China; State Key Laboratory of Petroleum Pollution Control, Beijing 102206, China
| | - Maurice E Tucker
- School of Earth Sciences, University of Bristol, Bristol BS8 1RJ, UK; Cabot Institute, University of Bristol, Cantock's Close, Bristol BS8 1UJ, UK
| | - Michael Steiner
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Department of Earth Sciences, Freie Universität Berlin, Malteserstrasse 74-100, Haus D, Berlin 12249, Germany
| | - Chao Han
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China.
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Gao X, Han Z, Zhao Y, Zhang J, Zhai D, Li J, Qin Y, Liu F, Wang Q, Steiner M, Han C. Microbial-mineral interaction experiments and density functional theory calculations revealing accelerating effects for the dolomitization of calcite surfaces by organic components. Sci Total Environ 2024; 915:169971. [PMID: 38211867 DOI: 10.1016/j.scitotenv.2024.169971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
Carbonates represent major sedimentary rocks in on the continental and oceanic crust of Earth and are often closely related to microbial activities. However, the origin of magnesium-containing carbonates, such as dolomites, has not yet been fully resolved and was debated for many years. In order to reveal the specific role of organic components and microbes on the precipitation of magnesium ions, different dolomitization experiments were carried out with various setups for the presence of eight amino acids and microbes. The Gibbs free energy for dehydration of Mg[6(H2O)]2+ and organic‑magnesium complexes (OMC) at the calcite (101¯4) step edges were calculated by density functional theory (DFT). Combined results of X-ray diffraction (XRD), scanning electron microscope-energy disperse spectroscopy (SEM-EDS), transmission electron microscope (TEM), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR) and high resolution transmission electron microscopy (HRTEM) indicated that magnesium ions were incorporated into the crystal lattice of calcite after calcite reacting with organic‑magnesium solutions (OMS). Dolomite was formed on the surface of calcite under the presence of microbes. The Gibbs free energy barrier of asp, glu, gly, thr, tyr, lys, ser, and ala bonding to Mg[6(H2O)]2+ were 17.8, 16.2, 14.8, 16.5, 19.2, 14.5, 19.0, 17.0 kcal/mol, those are lower than that of the direct dehydration of Mg[6(H2O)]2+ of 19.45 kcal/mol. The Gibbs free barrier of OMC bonding at the acute step ([481¯] and [4¯41]) of 29.7/34.25 kcal/mol are lower than that of Mg[6(H2O)]2+ of 32.45/36.7 kcal/mol and the Gibbs free barrier of OMC bonding at the obtuse step ([481¯] and [4¯41]) of 42.07/47.6 kcal/mol are lower than that of Mg[6(H2O)]2+ of 55.4/60.34 kcal/mol. The enhancing effects of organic components and microbes on the precipitation of magnesium ions were collectively determined through experimental and theoretical calculation, thus setting up a new direction for future studies of dolomitization with a focus on microbial- mineral interactions.
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Affiliation(s)
- Xiao Gao
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Zuozhen Han
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Yanyang Zhao
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China
| | - Jingzhou Zhang
- School of Water Conservancy and Hydroelectric Power, Hebei University of Engineering, Handan 056002, China
| | - Dong Zhai
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Jie Li
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Yulei Qin
- Department of Bioengineering, College of Chemical and Environmental Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Fang Liu
- College of Chemical Engineering, China University of Petroleum, Qingdao 266580, China; State Key Laboratory of Petroleum Pollution Control, Beijing 102206, China
| | - Qiyu Wang
- Key Laboratory of Sedimentary Basin and Oil and Gas Resources, Ministry of Natural Resources, Chengdu 610081, China
| | - Michael Steiner
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Department of Earth Sciences, Freie Universität Berlin, Malteserstrasse 74-100, Haus D, Berlin 12249, Germany
| | - Chao Han
- Shandong Provincial Key Laboratory of Depositional Mineralization and Sedimentary Minerals, College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China; Laboratory for Marine Mineral Resources, Center for Isotope Geochemistry and Geochronology, Qingdao National Laboratory for Marine Science and Technology, Qingdao 266237, China.
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Toenges R, Steiner M, Weber CF, Miesbach W. Investigation of acquired dysfibrinogenaemia in adult patients with sepsis using fibrinogen function vs. concentration ratios: a cross-sectional study. Front Med (Lausanne) 2023; 10:1294301. [PMID: 38152302 PMCID: PMC10752225 DOI: 10.3389/fmed.2023.1294301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction Inherited or acquired molecular abnormalities form a clinically heterogeneous group of fibrinogen disorders called dysfibrinogenaemia. Apart from a pediatric case report and in contrast to other clinical conditions, acquired dysfibrinogenaemia has not been previously reported in septic patients. Methods In an observational cohort study, 79 adult septic patients were investigated for the presence of acquired dysfibrinogenaemia at the time of their admission to the intensive care unit (ICU) of the University Hospital Frankfurt. Following established recommendations, fibrinogen clotting activity vs. antigen ratios were analyzed using Clauss fibrinogen, prothrombin-derived fibrinogen, and radial immunodiffusion (RID) fibrinogen concentration. Results Prothrombin-derived fibrinogen levels were highest (527 ± 182 mg/dL) followed by Clauss fibrinogen (492 ± 209 mg/dL) and radial immunodiffusion fibrinogen (426 ± 159 mg/dL). Very few cases demonstrated hypofibrinogenaemia making overt disseminated intravascular coagulation (DIC) unlikely in the cohort investigated. Clauss/RID fibrinogen ratios were lower (1.17 ± 0.19) compared to prothrombin time-derived/RID ratios (1.35 ± 0.33). Using the Clauss/RID dataset, 21% of patients (16/76 patients) demonstrated values below a threshold ratio for suspected acquired dysfibrinogenaemia arbitrarily set at 1.0. In contrast, prothrombin-derived ratios were below the threshold in only 7% (4/58 patients). Discussion The results point to the presence of acquired dysfibrinogenaemia in part of adult septic patients. If confirmed in further studies, this may form part of a specific laboratory signature of a sepsis-associated coagulation phenotype.
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Affiliation(s)
- Rosa Toenges
- Department of Medicine, Hemostaseology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Christian Friedrich Weber
- Department for Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
- Department for Anesthesiology, Intensive Care Medicine and Emergency Medicine, Asklepios Clinics Hamburg, AK Wandsbek, Hamburg, Germany
| | - Wolfgang Miesbach
- Department of Medicine, Hemostaseology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
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Rametov NM, Steiner M, Bizhanova NA, Abdel ZZ, Yessimseit DT, Abdeliyev BZ, Mussagalieva RS. Mapping Plague Risk Using Super Species Distribution Models and Forecasts for Rodents in the Zhambyl Region, Kazakhstan. Geohealth 2023; 7:e2023GH000853. [PMID: 37965638 PMCID: PMC10641984 DOI: 10.1029/2023gh000853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/16/2023]
Abstract
One of the most extensive natural plague centers, or foci, is located in Central Asia, in particular, the Zhambyl region in Southern Kazakhstan. Here, we conducted plague surveillance from 2000 to 2020 in the Zhambyl region in Kazakhstan and confirmed 3,072 cases of infected wild animals. We used Species Distribution Modeling by employing MaxEnt, and identified that the natural plague foci are primarily located in the Moiynqum, Betpaqdala, and Tauqum Deserts. The Zhambyl region's central part, including the Moiynqum and Sarysu districts, has a high potential risk of plague outbreak for the rural towns and villages. Since the phenomenon of climate change has been identified as a determinant that affects the rodent populations, thereby elevating the likelihood of an outbreak of plague, we investigated the potential dissemination routes of the disease under the changing climate conditions, thus creating Species Distribution Forecasts for the rodent species in southern part of Kazakhstan for the year 2100. By 2100, in case of increasing temperatures, the range of host species is likely to expand, leading to a higher risk of plague outbreaks. The highest risk of disease transmission can be expected at the outer limits of the modeled total distribution range, where infection rates are high, but antibody presence is low, making many species susceptible to the pathogen. To mitigate the risk of a potential plague outbreak, it is necessary to implement appropriate sanitary-epidemiological measures and climate mitigation policies.
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Affiliation(s)
- N. M. Rametov
- National Scientific Center for Particularly Dangerous Infections named after M. AikimbaevAlmatyKazakhstan
- Institute of IonosphereAlmatyKazakhstan
- Department of Geospatial EngineeringSatpaev Kazakh National Research Technical UniversityAlmatyKazakhstan
| | - M. Steiner
- Department of Animal ScienceWageningen University and ResearchWageningenThe Netherlands
| | - N. A. Bizhanova
- Laboratory of TheriologyInstitute of ZoologyAlmatyKazakhstan
- Department of Biodiversity and BioresourcesAl‐Farabi Kazakh National UniversityAlmatyKazakhstan
- Wildlife Without Borders Public FundAlmatyKazakhstan
| | - Z. Zh. Abdel
- National Scientific Center for Particularly Dangerous Infections named after M. AikimbaevAlmatyKazakhstan
| | - D. T. Yessimseit
- National Scientific Center for Particularly Dangerous Infections named after M. AikimbaevAlmatyKazakhstan
| | - B. Z. Abdeliyev
- National Scientific Center for Particularly Dangerous Infections named after M. AikimbaevAlmatyKazakhstan
| | - R. S. Mussagalieva
- National Scientific Center for Particularly Dangerous Infections named after M. AikimbaevAlmatyKazakhstan
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Arya N, Philipp T, Greiner S, Steiner M, Kranz C, Anjass M. Reversible Electrodeposition of Potassium-bridged Molecular Vanadium Oxides: A New Approach Towards Multi-Electron Storage. Angew Chem Int Ed Engl 2023; 62:e202306170. [PMID: 37218398 DOI: 10.1002/anie.202306170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 05/24/2023]
Abstract
Molecular metal oxides, so-called polyoxometalates (POMs), have shown outstanding performance as catalysts and lately attracted interest as materials in energy conversion and storage systems due to their capability of storing and exchanging multiple electrons. Here, we report the first example of redox-driven reversible electrodeposition of molecular vanadium oxide clusters, leading to the formation of thin films. The detailed investigation of the deposition mechanism reveals that the reversibility is dependent on the reduction potential. Correlating electrochemical quartz microbalance studies with X-ray photoelectron spectroscopy (XPS) data gave insight into the redox chemistry and oxidation states of vanadium in the deposited films in dependence on the potential window. A multi-electron reduction of the polyoxovanadate cluster, which facilitates the potassium (K+ ) cation-assisted reversible formation of potassium vanadium oxide thin films was confirmed. At anodic potentials, re-oxidation of the polyoxovanadate and complete stripping of the thin film is observed for films deposited at potentials more positive than -500 mV vs. Ag/Ag+ , while electrodeposition at more negative cathodic potential reduces the electrochemical reversibility of the process and increases the stripping overpotential. As proof of principle, we demonstrate the electrochemical performance of the deposited films for potential use in potassium-ion batteries.
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Affiliation(s)
- Nikhil Arya
- Institute of Inorganic Chemistry I, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- Helmholtz Institute Ulm (HIU), Helmholtzstraße 11, 89081, Ulm, Germany
| | - Tom Philipp
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Simon Greiner
- Institute of Inorganic Chemistry I, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- Helmholtz Institute Ulm (HIU), Helmholtzstraße 11, 89081, Ulm, Germany
| | - Michael Steiner
- Institute of Inorganic Chemistry I, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- Helmholtz Institute Ulm (HIU), Helmholtzstraße 11, 89081, Ulm, Germany
| | - Christine Kranz
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Montaha Anjass
- Institute of Inorganic Chemistry I, Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- Helmholtz Institute Ulm (HIU), Helmholtzstraße 11, 89081, Ulm, Germany
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Rochester CL, Alison JA, Carlin B, Jenkins AR, Cox NS, Bauldoff G, Bhatt SP, Bourbeau J, Burtin C, Camp PG, Cascino TM, Dorney Koppel GA, Garvey C, Goldstein R, Harris D, Houchen-Wolloff L, Limberg T, Lindenauer PK, Moy ML, Ryerson CJ, Singh SJ, Steiner M, Tappan RS, Yohannes AM, Holland AE. Pulmonary Rehabilitation for Adults with Chronic Respiratory Disease: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2023; 208:e7-e26. [PMID: 37581410 PMCID: PMC10449064 DOI: 10.1164/rccm.202306-1066st] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Background: Despite the known benefits of pulmonary rehabilitation (PR) for patients with chronic respiratory disease, this treatment is underused. Evidence-based guidelines should lead to greater knowledge of the proven benefits of PR, highlight the role of PR in evidence-based health care, and in turn foster referrals to and more effective delivery of PR for people with chronic respiratory disease. Methods: The multidisciplinary panel formulated six research questions addressing PR for specific patient groups (chronic obstructive pulmonary disease [COPD], interstitial lung disease, and pulmonary hypertension) and models for PR delivery (telerehabilitation, maintenance PR). Treatment effects were quantified using systematic reviews. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations: The panel made the following judgments: strong recommendations for PR for adults with stable COPD (moderate-quality evidence) and after hospitalization for COPD exacerbation (moderate-quality evidence), strong recommendation for PR for adults with interstitial lung disease (moderate-quality evidence), conditional recommendation for PR for adults with pulmonary hypertension (low-quality evidence), strong recommendation for offering the choice of center-based PR or telerehabilitation for patients with chronic respiratory disease (moderate-quality evidence), and conditional recommendation for offering either supervised maintenance PR or usual care after initial PR for adults with COPD (low-quality evidence). Conclusions: These guidelines provide the basis for evidence-based delivery of PR for people with chronic respiratory disease.
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McAuley HJ, Evans RA, Bolton CE, Brightling CE, Chalmers JD, Docherty AB, Elneima O, Greenhaff PL, Gupta A, Harris VC, Harrison EM, Ho LP, Horsley A, Houchen-Wolloff L, Jolley CJ, Leavy OC, Lone NI, Man WDC, Marks M, Parekh D, Poinasamy K, Quint JK, Raman B, Richardson M, Saunders RM, Sereno M, Shikotra A, Singapuri A, Singh SJ, Steiner M, Tan AL, Wain LV, Welch C, Whitney J, Witham MD, Lord J, Greening NJ. Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort study. EClinicalMedicine 2023; 57:101896. [PMID: 36936404 PMCID: PMC10005893 DOI: 10.1016/j.eclinm.2023.101896] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 03/16/2023] Open
Abstract
Background The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group-robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)-at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding UK Research and Innovation and National Institute for Health Research.
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Affiliation(s)
- Hamish J.C. McAuley
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachael A. Evans
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte E. Bolton
- University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Christopher E. Brightling
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - James D. Chalmers
- University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Annemarie B. Docherty
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Omer Elneima
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | | | - Ayushman Gupta
- University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Victoria C. Harris
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ewen M. Harrison
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ling-Pei Ho
- MRC Human Immunology Unit, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alex Horsley
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Linzy Houchen-Wolloff
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Therapy Department, University Hospitals of Leicester, NHS Trust, Leicester, UK
| | - Caroline J. Jolley
- Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Respiratory Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Olivia C. Leavy
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Nazir I. Lone
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - William D-C Man
- Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, UK
- National Heart and Lung Institute, Imperial College London, London, UK
- Faculty of Life Sciences and Medicine, King's College London, UK
| | - Michael Marks
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Hospital for Tropical Diseases, University College London Hospital, London, UK
- Division of Infection and Immunity, University College London, London, UK
| | - Dhruv Parekh
- University of Birmingham, Birmingham, UK
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Jennifer K. Quint
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Betty Raman
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthew Richardson
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Ruth M. Saunders
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Marco Sereno
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Aarti Shikotra
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Sally J. Singh
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Michael Steiner
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ai Lyn Tan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK
| | - Louise V. Wain
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Julie Whitney
- The School of Life Course & Population Sciences, King's College London, UK
| | - Miles D. Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Janet Lord
- University of Birmingham, Birmingham, UK
| | - Neil J. Greening
- The Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
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Mathur S, Steiner M. Long-term mechanical ventilation: State of the evidence and future directions. Chron Respir Dis 2023; 20:14799731231199764. [PMID: 37649451 PMCID: PMC10472822 DOI: 10.1177/14799731231199764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Sunita Mathur
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Michael Steiner
- Respiratory Medicine, University of Leicester, Leicester, UK
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Toenges R, Steiner M. The Diagnostic Approach to Inherited Mild (to Moderate) Bleeding Disorders: A Current Perspective. Hamostaseologie 2022; 42:420-422. [PMID: 36549293 DOI: 10.1055/a-1946-6426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Rosa Toenges
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, United States.,Goethe University Frankfurt, University Hospital, Dept. of Medicine, Hematology and Oncology, Frankfurt am Main, Germany
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Liu Y, Carlisle E, Zhang H, Yang B, Steiner M, Shao T, Duan B, Marone F, Xiao S, Donoghue PCJ. Saccorhytus is an early ecdysozoan and not the earliest deuterostome. Nature 2022; 609:541-546. [PMID: 35978194 DOI: 10.1038/s41586-022-05107-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/13/2022] [Indexed: 11/09/2022]
Abstract
The early history of deuterostomes, the group composed of the chordates, echinoderms and hemichordates1, is still controversial, not least because of a paucity of stem representatives of these clades2-5. The early Cambrian microscopic animal Saccorhytus coronarius was interpreted as an early deuterostome on the basis of purported pharyngeal openings, providing evidence for a meiofaunal ancestry6 and an explanation for the temporal mismatch between palaeontological and molecular clock timescales of animal evolution6-8. Here we report new material of S. coronarius, which is reconstructed as a millimetric and ellipsoidal meiobenthic animal with spinose armour and a terminal mouth but no anus. Purported pharyngeal openings in support of the deuterostome hypothesis6 are shown to be taphonomic artefacts. Phylogenetic analyses indicate that S. coronarius belongs to total-group Ecdysozoa, expanding the morphological disparity and ecological diversity of early Cambrian ecdysozoans.
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Affiliation(s)
- Yunhuan Liu
- School of Earth Science and Resources, Chang'an University, Xi'an, China
| | - Emily Carlisle
- Bristol Palaeobiology Group, School of Earth Sciences, University of Bristol, Bristol, UK
| | - Huaqiao Zhang
- State Key Laboratory of Palaeobiology and Stratigraphy, Nanjing Institute of Geology and Palaeontology and Center for Excellence in Life and Paleoenvironment, Chinese Academy of Sciences, Nanjing, China.
| | - Ben Yang
- MNR Key Laboratory of Stratigraphy and Palaeontology, Institute of Geology, Chinese Academy of Geological Sciences, Beijing, China
| | - Michael Steiner
- College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao, China.,Department of Earth Sciences, Freie Universität Berlin, Berlin, Germany
| | - Tiequan Shao
- School of Earth Science and Resources, Chang'an University, Xi'an, China
| | - Baichuan Duan
- Key Laboratory of Marine Geology and Metallogeny, First Institute of Oceanography, Ministry of Natural Resource, Qingdao, China
| | - Federica Marone
- Swiss Light Source, Paul Scherrer Institut, Villigen, Switzerland
| | - Shuhai Xiao
- Department of Geosciences, Virginia Tech, Blacksburg, VA, USA.
| | - Philip C J Donoghue
- Bristol Palaeobiology Group, School of Earth Sciences, University of Bristol, Bristol, UK.
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12
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Plekhanova T, Rowlands AV, Evans RA, Edwardson CL, Bishop NC, Bolton CE, Chalmers JD, Davies MJ, Daynes E, Dempsey PC, Docherty AB, Elneima O, Greening NJ, Greenwood SA, Hall AP, Harris VC, Harrison EM, Henson J, Ho LP, Horsley A, Houchen-Wolloff L, Khunti K, Leavy OC, Lone NI, Marks M, Maylor B, McAuley HJC, Nolan CM, Poinasamy K, Quint JK, Raman B, Richardson M, Sargeant JA, Saunders RM, Sereno M, Shikotra A, Singapuri A, Steiner M, Stensel DJ, Wain LV, Whitney J, Wootton DG, Brightling CE, Man WDC, Singh SJ, Yates T. Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a multicentre study. Int J Behav Nutr Phys Act 2022; 19:94. [PMID: 35902858 PMCID: PMC9330990 DOI: 10.1186/s12966-022-01333-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/06/2022] [Indexed: 12/04/2022] Open
Abstract
Background The number of individuals recovering from severe COVID-19 is increasing rapidly. However, little is known about physical behaviours that make up the 24-h cycle within these individuals. This study aimed to describe physical behaviours following hospital admission for COVID-19 at eight months post-discharge including associations with acute illness severity and ongoing symptoms. Methods One thousand seventy-seven patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and individuals with type 2 diabetes were comparators. Results Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean ± SD of 14.9 ± 14.7 min/day of moderate-to-vigorous physical activity (MVPA), with 12.1 ± 1.7 h/day spent inactive and 7.2 ± 1.1 h/day asleep. The values for men were 21.0 ± 22.3 and 12.6 ± 1.7 h /day and 6.9 ± 1.1 h/day, respectively. Over 60% of women and men did not have any days containing a 30-min bout of MVPA. Variability in sleep timing was approximately 2 h in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer total sleep time, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Conclusions Those recovering from a hospital admission for COVID-19 have low levels of physical activity and disrupted patterns of sleep several months after discharge. Our comparative cohorts indicate that the long-term impact of COVID-19 on physical behaviours is significant. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01333-w.
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Affiliation(s)
- Tatiana Plekhanova
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Rachael A Evans
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK. .,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
| | - Nicolette C Bishop
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte E Bolton
- University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - James D Chalmers
- University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Enya Daynes
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.,Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Paddy C Dempsey
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
| | - Annemarie B Docherty
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Omer Elneima
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Neil J Greening
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Sharlene A Greenwood
- Department of Physiotherapy and Renal Medicine, King's College Hospital, London, UK.,Department of Renal Medicine, King's College London, London, UK
| | - Andrew P Hall
- University Hospitals of Leicester NHS Trust, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Victoria C Harris
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ewen M Harrison
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Joseph Henson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Ling-Pei Ho
- MRC Human Immunology Unit, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alex Horsley
- Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK
| | - Linzy Houchen-Wolloff
- Department of Respiratory Sciences, University of Leicester, Leicester, UK.,Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Olivia C Leavy
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Nazir I Lone
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK.,Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Michael Marks
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.,Hospital for Tropical Diseases, University College London Hospital, London, UK
| | - Ben Maylor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Hamish J C McAuley
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Claire M Nolan
- Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St, Thomas' NHS Foundation Trust, London, UK.,College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, Uxbridge, UK
| | | | | | - Betty Raman
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Matthew Richardson
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK.,College of Life Sciences, University of Leicester, Leicester, UK
| | - Jack A Sargeant
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Ruth M Saunders
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Marco Sereno
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Aarti Shikotra
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Michael Steiner
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK.,Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - David J Stensel
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Louise V Wain
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Julie Whitney
- School of Life Course & Population Sciences, King's College London, London, UK.,Department of Clinical Gerontology, King's College Hospital, London, UK
| | - Dan G Wootton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.,Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Christopher E Brightling
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - William D-C Man
- Royal Brompton and Harefield Clinical Group, Guys and St Thomas NHS Foundation Trust, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Sally J Singh
- NIHR Leicester Biomedical Research Centre, The Institute for Lung Health, University of Leicester, Leicester, UK
| | - Tom Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
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14
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Yousuf AJ, Mohammed S, Carr L, Yavari Ramsheh M, Micieli C, Mistry V, Haldar K, Wright A, Novotny P, Parker S, Glover S, Finch J, Quann N, Brookes CL, Hobson R, Ibrahim W, Russell RJ, John C, Grimbaldeston MA, Choy DF, Cheung D, Steiner M, Greening NJ, Brightling CE. Astegolimab, an anti-ST2, in chronic obstructive pulmonary disease (COPD-ST2OP): a phase 2a, placebo-controlled trial. Lancet Respir Med 2022; 10:469-477. [PMID: 35339234 DOI: 10.1016/s2213-2600(21)00556-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous inflammatory airway disease. The epithelial-derived IL-33 and its receptor ST2 have been implicated in airway inflammation and infection. We aimed to determine whether astegolimab, a selective ST2 IgG2 monoclonal antibody, reduces exacerbations in COPD. METHODS COPD-ST2OP was a single-centre, randomised, double-blinded, placebo-controlled phase 2a trial in moderate-to-very severe COPD. Participants were randomly assigned (1:1) with a web-based system to received 490 mg subcutaneous astegolimab or subcutaneous placebo, every 4 weeks for 44 weeks. The primary endpoint was exacerbation rate assessed for 48 weeks assessed with a negative binomial count model in the intention-to-treat population, with prespecified subgroup analysis by baseline blood eosinophil count. The model was the number of exacerbations over the 48-week treatment period, with treatment group as a covariate. Safety was assessed in the whole study population until week 60. Secondary endpoints included Saint George's Respiratory Questionnaire for COPD (SGRQ-C), FEV1, and blood and sputum cell counts. The trial was registered with ClinicalTrials.gov, NCT03615040. FINDINGS The exacerbation rate at 48 weeks in the intention-to-treat analysis was not significantly different between the astegolimab group (2·18 [95% CI 1·59 to 2·78]) and the placebo group (2·81 [2·05 to 3·58]; rate ratio 0·78 [95% CI 0·53 to 1·14]; p=0·19]). In the prespecified analysis stratifying patients by blood eosinophil count, patients with 170 or fewer cells per μL had 0·69 exacerbations (0·39 to 1·21), whereas those with more than 170 cells per μL had 0·83 exacerbations (0·49 to 1·40). For the secondary outcomes, the mean difference between the SGRQ-C in the astegolimab group versus placebo group was -3·3 (95% CI -6·4 to -0·2; p=0·039), and mean difference in FEV1 between the two groups was 40 mL (-10 to 90; p=0·094). The difference in geometric mean ratios between the two groups for blood eosinophil counts was 0·59 (95% CI 0·51 to 0·69; p<0·001) and 0·25 (0·19 to 0·33; p<0·001) for sputum eosinophil counts. Incidence of treatment-emergent adverse events was similar between groups. INTERPRETATION In patients with moderate-to-very severe COPD, astegolimab did not significantly reduce exacerbation rate, but did improve health status compared with placebo. FUNDING Funded by Genentech and National Institute for Health Research Biomedical Research Centres.
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Affiliation(s)
- Ahmed J Yousuf
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Seid Mohammed
- Leicester Clinical Trials Unit, College of Life Sciences, University of Leicester, Leicester, UK
| | - Liesl Carr
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Mohammadali Yavari Ramsheh
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Claudia Micieli
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Vijay Mistry
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Kairobi Haldar
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Adam Wright
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Petr Novotny
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sarah Parker
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sarah Glover
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Joanne Finch
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Niamh Quann
- Leicester Clinical Trials Unit, College of Life Sciences, University of Leicester, Leicester, UK
| | - Cassandra L Brookes
- Leicester Clinical Trials Unit, College of Life Sciences, University of Leicester, Leicester, UK
| | - Rachel Hobson
- Leicester Clinical Trials Unit, College of Life Sciences, University of Leicester, Leicester, UK
| | - Wadah Ibrahim
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Richard J Russell
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Catherine John
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | | | | | - Michael Steiner
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Neil J Greening
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Christopher E Brightling
- Institute for Lung Health, National Institute for Health Research Biomedical Research Centre Respiratory Medicine, Department of Respiratory Sciences, University of Leicester, Leicester, UK.
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15
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Perkins GD, Ji C, Connolly BA, Couper K, Lall R, Baillie JK, Bradley JM, Dark P, Dave C, De Soyza A, Dennis AV, Devrell A, Fairbairn S, Ghani H, Gorman EA, Green CA, Hart N, Hee SW, Kimbley Z, Madathil S, McGowan N, Messer B, Naisbitt J, Norman C, Parekh D, Parkin EM, Patel J, Regan SE, Ross C, Rostron AJ, Saim M, Simonds AK, Skilton E, Stallard N, Steiner M, Vancheeswaran R, Yeung J, McAuley DF. Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19: The RECOVERY-RS Randomized Clinical Trial. JAMA 2022; 327:546-558. [PMID: 35072713 PMCID: PMC8787685 DOI: 10.1001/jama.2022.0028] [Citation(s) in RCA: 195] [Impact Index Per Article: 97.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been recommended for acute hypoxemic respiratory failure in patients with COVID-19. Uncertainty exists regarding the effectiveness and safety of these noninvasive respiratory strategies. OBJECTIVE To determine whether either CPAP or HFNO, compared with conventional oxygen therapy, improves clinical outcomes in hospitalized patients with COVID-19-related acute hypoxemic respiratory failure. DESIGN, SETTING, AND PARTICIPANTS A parallel group, adaptive, randomized clinical trial of 1273 hospitalized adults with COVID-19-related acute hypoxemic respiratory failure. The trial was conducted between April 6, 2020, and May 3, 2021, across 48 acute care hospitals in the UK and Jersey. Final follow-up occurred on June 20, 2021. INTERVENTIONS Adult patients were randomized to receive CPAP (n = 380), HFNO (n = 418), or conventional oxygen therapy (n = 475). MAIN OUTCOMES AND MEASURES The primary outcome was a composite of tracheal intubation or mortality within 30 days. RESULTS The trial was stopped prematurely due to declining COVID-19 case numbers in the UK and the end of the funded recruitment period. Of the 1273 randomized patients (mean age, 57.4 [95% CI, 56.7 to 58.1] years; 66% male; 65% White race), primary outcome data were available for 1260. Crossover between interventions occurred in 17.1% of participants (15.3% in the CPAP group, 11.5% in the HFNO group, and 23.6% in the conventional oxygen therapy group). The requirement for tracheal intubation or mortality within 30 days was significantly lower with CPAP (36.3%; 137 of 377 participants) vs conventional oxygen therapy (44.4%; 158 of 356 participants) (absolute difference, -8% [95% CI, -15% to -1%], P = .03), but was not significantly different with HFNO (44.3%; 184 of 415 participants) vs conventional oxygen therapy (45.1%; 166 of 368 participants) (absolute difference, -1% [95% CI, -8% to 6%], P = .83). Adverse events occurred in 34.2% (130/380) of participants in the CPAP group, 20.6% (86/418) in the HFNO group, and 13.9% (66/475) in the conventional oxygen therapy group. CONCLUSIONS AND RELEVANCE Among patients with acute hypoxemic respiratory failure due to COVID-19, an initial strategy of CPAP significantly reduced the risk of tracheal intubation or mortality compared with conventional oxygen therapy, but there was no significant difference between an initial strategy of HFNO compared with conventional oxygen therapy. The study may have been underpowered for the comparison of HFNO vs conventional oxygen therapy, and early study termination and crossover among the groups should be considered when interpreting the findings. TRIAL REGISTRATION isrctn.org Identifier: ISRCTN16912075.
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Affiliation(s)
- Gavin D. Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Chen Ji
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
| | - Bronwen A. Connolly
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, Northern Ireland
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, England
- Centre for Human and Applied Physiological Sciences, King’s College London, London, England
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Keith Couper
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
| | - J. Kenneth Baillie
- Roslin Institute, University of Edinburgh, Midlothian, Scotland
- MRC Human Genetics Unit, Institute for Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
- Intensive Care Unit, Royal Infirmary of Edinburgh, Edinburgh, Scotland
| | - Judy M. Bradley
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, Northern Ireland
| | - Paul Dark
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, England
- Salford Royal Hospital, Northern Care Alliance NHS Group, Manchester, England
| | - Chirag Dave
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Anthony De Soyza
- Population and Health Science Institute, NIHR Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, England
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Anna V. Dennis
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Anne Devrell
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
- Research Champion Team, West Midlands Clinical Research Network, Wolverhampton, England
| | - Sara Fairbairn
- Grange University Hospital, Aneurin Bevan University Health Board, Cwmbran, Wales
| | - Hakim Ghani
- Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, England
| | - Ellen A. Gorman
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, Northern Ireland
| | | | - Nicholas Hart
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, England
- Centre for Human and Applied Physiological Sciences, King’s College London, London, England
| | - Siew Wan Hee
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, England
| | - Zoe Kimbley
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Shyam Madathil
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Nicola McGowan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
| | - Benjamin Messer
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Jay Naisbitt
- Fairfield General Hospital, Pennine Acute Hospitals NHS Trust, Northern Care Alliance NHS Group, Bury, England
| | - Chloe Norman
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
| | - Dhruv Parekh
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
- Institute of Inflammation and Ageing, School of Medical and Dental Sciences, University of Birmingham, Birmingham, England
| | - Emma M. Parkin
- Fairfield General Hospital, Pennine Acute Hospitals NHS Trust, Northern Care Alliance NHS Group, Bury, England
| | - Jaimin Patel
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
- Institute of Inflammation and Ageing, School of Medical and Dental Sciences, University of Birmingham, Birmingham, England
| | - Scott E. Regan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
| | - Clare Ross
- Imperial College Healthcare NHS Trust, London, England
| | - Anthony J. Rostron
- Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, England
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, England
| | - Mohammad Saim
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Anita K. Simonds
- Royal Brompton and Harefield Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, England
| | - Emma Skilton
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
| | - Nigel Stallard
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, England
| | - Michael Steiner
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, Department of Respiratory Sciences, University of Leicester, Leicester, England
| | - Rama Vancheeswaran
- Watford General Hospital, West Hertfordshire Hospitals NHS Trust, Watford, England
| | - Joyce Yeung
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, England
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, England
| | - Daniel F. McAuley
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, Northern Ireland
- Royal Victoria Hospital, Belfast, Northern Ireland
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16
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Bickton FM, Mankhokwe T, Nightingale R, Fombe C, Mitengo M, Mwahimba L, Lipita W, Wilde L, Pina I, Yusuf ZK, Ahmed Z, Kamponda M, Limbani F, Shannon H, Chisati E, Barton A, Free RC, Steiner M, Matheson JA, Manise A, Singh SJ, Rylance J, Orme M. Protocol for a single-centre mixed-method pre-post single-arm feasibility trial of a culturally appropriate 6-week pulmonary rehabilitation programme among adults with functionally limiting chronic respiratory diseases in Malawi. BMJ Open 2022; 12:e057538. [PMID: 35105655 PMCID: PMC8804676 DOI: 10.1136/bmjopen-2021-057538] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Malawi has a substantial burden of chronic respiratory diseases (CRDs) which cause significant morbidity and loss of economic productivity, affecting patients, families and health systems. Pulmonary rehabilitation (PR) is a highly recommended non-pharmacological intervention in the clinical management of people with CRDs. However, Malawi lacks published evidence on the implementation of PR for people with CRDs. This trial will test the feasibility and acceptability of implementing a culturally appropriate hospital-based PR programme among adults with functionally limiting CRDs at Queen Elizabeth Central Hospital in Blantyre, Malawi. METHODS AND ANALYSIS This is a single-centre mixed-methods pre-post single-arm feasibility trial. Ten patients aged ≥18 years, with a spirometry confirmed diagnosis of a CRD and breathlessness of ≥2 on the modified Medical Research Council dyspnoea scale, will be consecutively recruited. Their baseline lung function, exercise tolerance and health status will be assessed; including spirometry, Incremental Shuttle Walk Test and Chronic Obstructive Pulmonary Disease Assessment Test, respectively. Pretrial semistructured in-depth interviews will explore their experiences of living with CRD and potential enablers and barriers to their PR uptake. Along with international PR guidelines, these data will inform culturally appropriate delivery of PR. We initially propose a 6-week, twice-weekly, supervised centre-based PR programme, with an additional weekly home-based non-supervised session. Using combination of researcher observation, interaction with the participants, field notes and informal interviews with the participants, we will assess the feasibility of running the programme in the following areas: participants' recruitment, retention, engagement and protocol adherence. Following programme completion (after 6 weeks), repeat assessments of lung function, exercise tolerance and health status will be conducted. Quantitative changes in clinical outcomes will be described in relation to published minimal clinically important differences. Post-trial semistructured interviews will capture participants' perceived impact of the PR programme on their quality of life, enablers, and barriers to fully engaging with the programme, and allow iteration of its design. ETHICS AND DISSEMINATION Ethical approval for this trial was obtained from University of Malawi College of Medicine Research and Ethics Committee (COMREC), Blantyre, Malawi (protocol number: P.07/19/2752) and University of Leicester Research Ethics Committee, Leicester, UK (ethics reference: 31574). The results of the trial will be disseminated through oral presentations at local and international scientific conferences or seminars and publication in a peer-reviewed journal. We will also engage the participants who complete the PR trial and the Science Communication Department at Malawi-Liverpool-Wellcome Trust Clinical Research Programme to organise community outreach activities within Blantyre to educate communities about CRDs and PR. We will also broadcast our trial results through national radio station programmes such as the weekly "Thanzi la Onse" (Health of All) programme by Times Radio Malawi. We will formally present our trial results to Blantyre District Health Office and Malawi Ministry of Health. TRIAL REGISTRATION NUMBER ISRCTN13836793.
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Affiliation(s)
- Fanuel Meckson Bickton
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Talumba Mankhokwe
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Rebecca Nightingale
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cashon Fombe
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Martha Mitengo
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Langsfield Mwahimba
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Wilfred Lipita
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Laura Wilde
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Ilaria Pina
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Zainab K Yusuf
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Zahira Ahmed
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Martin Kamponda
- Medicine Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Felix Limbani
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Harriet Shannon
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Enock Chisati
- Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Andy Barton
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
| | - Robert C Free
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
| | - Michael Steiner
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | | | - Adrian Manise
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Jamie Rylance
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mark Orme
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
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Repp S, Steiner M, Anjass M, Sorsche D, Streb C. Cation-controlled capture of polyoxovanadate-based organic-inorganic 1D architectures. Chem Commun (Camb) 2022; 58:13397-13400. [DOI: 10.1039/d2cc04379c] [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]
Abstract
Metal cations are used to control the selective crystallization of organic-inorganic supramolecular polymers. Two complementary monomers, a dodecanuclear vanadate [V12O32(NO3)]5- and the organic macrocycle cyclen assemble into hybrid host-guest aggregates....
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Doe G, Clanchy J, Wathall S, Chantrell S, Edwards S, Baxter N, Jackson D, Armstrong N, Steiner M, Evans RA. Feasibility study of a multicentre cluster randomised control trial to investigate the clinical and cost-effectiveness of a structured diagnostic pathway in primary care for chronic breathlessness: protocol paper. BMJ Open 2021; 11:e057362. [PMID: 34815293 PMCID: PMC8611440 DOI: 10.1136/bmjopen-2021-057362] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Chronic breathlessness is a common and debilitating symptom, associated with high healthcare use and reduced quality of life. Challenges and delays in diagnosis for people with chronic breathlessness frequently occur, leading to delayed access to therapies. The overarching hypothesis is a symptom-based approach to diagnosis in primary care would lead to earlier diagnosis, and therefore earlier treatment and improved longer-term outcomes including health-related quality of life. This study aims to establish the feasibility of a multicentre cluster randomised controlled trial to assess the clinical and cost-effectiveness of a structured diagnostic pathway for breathlessness in primary care. METHODS AND ANALYSIS Ten general practitioner (GP) practices across Leicester and Leicestershire will be cluster randomised to either a structured diagnostic pathway (intervention) or usual care. The structured diagnostic pathway includes a panel of investigations within 1 month. Usual care will proceed with patient care as per normal practice. Eligibility criteria include patients presenting with chronic breathlessness for the first time, who are over 40 years old and without a pre-existing diagnosis for their symptoms. An electronic template triggered at the point of consultation with the GP will aid opportunistic recruitment in primary care. The primary outcome for this feasibility study is recruitment rate. Secondary outcome measures, including time to diagnosis, will be collected to help inform outcomes for the future trial and to assess the impact of an earlier diagnosis. These will include symptoms, health-related quality of life, exercise capacity, measures of frailty, physical activity and healthcare utilisation. The study will include nested qualitative interviews with patients and healthcare staff to understand the feasibility outcomes, explore what is 'usual care' and the study experience. ETHICS AND DISSEMINATION The Research Ethics Committee Nottingham 1 has provided ethical approval for this research study (REC Reference: 19/EM/0201). Results from the study will be disseminated by presentations at relevant meetings and conferences including British Thoracic Society and Primary Care Respiratory Society, as well as by peer-reviewed publications and through patient presentations and newsletters to patients, where available. TRIAL REGISTRATION NUMBER ISRCTN14483247.
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Affiliation(s)
- Gillian Doe
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - Jill Clanchy
- Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
| | - Simon Wathall
- Institute of Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Stacey Chantrell
- NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sarah Edwards
- NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Noel Baxter
- International Primary Care Respiratory Group, London, UK
| | | | | | - Michael Steiner
- Respiratory Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rachael A Evans
- Respiratory Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK
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Palmieri C, Linden H, Birrell S, Lim E, Schwartzberg L, Rugo H, Cobb P, Jain K, Vogel C, O'Shaughnessy J, Johnston S, Getzenberg R, Barnette K, Steiner M, Brufsky A, Overmoyer B. 100P Efficacy of enobosarm, a selective androgen receptor (AR) targeting agent, in patients with metastatic AR+/ER+ breast cancer resistant to estrogen receptor targeted agents and CDK 4/6 inhibitor in a phase II clinical study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.114] [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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Steiner M, Yang B, Hohl S, Li D, Donoghue P. Exceptionally preserved early Cambrian bilaterian developmental stages from Mongolia. Nat Commun 2021; 12:1037. [PMID: 33589612 PMCID: PMC7884407 DOI: 10.1038/s41467-021-21264-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/06/2021] [Indexed: 11/09/2022] Open
Abstract
Fossilized invertebrate embryonic and later developmental stages are rare and restricted largely to the Ediacaran-Cambrian, providing direct insight into development during the emergence of animal bodyplans. Here we report a new assemblage of eggs, embryos and bilaterian post-embryonic developmental stages from the early Cambrian Salanygol Formation of Dzhabkan Microcontinent of Mongolia. The post-embryonic developmental stages of the bilaterian are preserved with cellular fidelity, possessing a series of bilaterally arranged ridges that compare to co-occurring camenellan sclerites in which the initial growth stages retain the cellular morphology of modified juveniles. In this work we identify these fossils as early post-embryonic developmental stages of camenellans, an early clade of stem-brachiopods, known previously only from isolated sclerites. This interpretation corroborates previous reconstructions of camenellan scleritomes with sclerites arranged in medial and peripheral concentric zones. It further supports the conjecture that molluscs and brachiopods are descended from an ancestral vermiform and slug-like bodyplan.
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Affiliation(s)
- Michael Steiner
- College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao, China. .,Department of Earth Sciences, Freie Universität Berlin, Berlin, Germany.
| | - Ben Yang
- MNR Key Laboratory of Stratigraphy and Palaeontology, Institute of Geology, Chinese Academy of Geological Sciences, Beijing, China
| | - Simon Hohl
- State Key Laboratory of Marine Geology, School of Ocean and Earth Sciences, Tongji University, Shanghai, China
| | - Da Li
- School of Marine Science and Engineering, Nanjing Normal University, Nanjing, China
| | - Philip Donoghue
- School of Earth Sciences, University of Bristol, Bristol, UK.
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Steiner M, Huettmann F. Justification for a taxonomic conservation update of the rodent genus Tamiasciurus: addressing marginalization and mis-prioritization of research efforts and conservation laissez-faire for a sustainability outlook. The European Zoological Journal 2021. [DOI: 10.1080/24750263.2020.1857852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- M. Steiner
- Institute for Arctic Biology, Department of Conservation Ecology, EWHALE Lab, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - F. Huettmann
- Institute for Arctic Biology, Department of Conservation Ecology, EWHALE Lab, University of Alaska Fairbanks, Fairbanks, AK, USA
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Magnes T, Wagner S, Thorner AR, Neureiter D, Klieser E, Rinnerthaler G, Weiss L, Huemer F, Zaborsky N, Steiner M, Weis S, Greil R, Egle A, Melchardt T. Clonal evolution in diffuse large B-cell lymphoma with central nervous system recurrence. ESMO Open 2021; 6:100012. [PMID: 33399078 PMCID: PMC7807834 DOI: 10.1016/j.esmoop.2020.100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prognosis of patients with secondary central nervous system lymphoma (SCNSL) is poor and despite massive advances in understanding the mutational landscape of primary diffuse large B-cell lymphoma (DLBCL), the genetic comparison to SCNSL is still lacking. We therefore collected paired samples from six patients with DLBCL with available biopsies from a lymph node (LN) at primary diagnosis and the central nervous system (CNS) at recurrence. PATIENTS AND METHODS A targeted, massively parallel sequencing approach was used to analyze 216 genes recurrently mutated in DLBCL. Healthy tissue from each patient was also sequenced in order to exclude germline mutations. The results of the primary biopsies were compared with those of the CNS recurrences to depict the genetic background of SCNSL and evaluate clonal evolution. RESULTS Sequencing was successful in five patients, all of whom had at least one discordant mutation that was not detected in one of their samples. Four patients had mutations that were found in the CNS but not in the primary LN. Discordant mutations were found in genes known to be important in lymphoma biology such as MYC, CARD11, EP300 and CCND3. Two patients had a Jaccard similarity coefficient below 0.5 indicating substantial genetic differences between the primary LN and the CNS recurrence. CONCLUSIONS This analysis gives an insight into the genetic landscape of SCNSL and confirms the results of our previous study on patients with systemic recurrence of DLBCL with evidence of substantial clonal diversification at relapse in some patients, which might be one of the mechanisms of treatment resistance.
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Affiliation(s)
- T Magnes
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - S Wagner
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - A R Thorner
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, USA
| | - D Neureiter
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - E Klieser
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - G Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - L Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - F Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - N Zaborsky
- Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - M Steiner
- Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - S Weis
- Division of Neuropathology, Department of Pathology and Neuropathology, Kepler University Hospital and School of Medicine, Johannes Kepler University, Linz, Austria
| | - R Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - A Egle
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - T Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria.
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Oey I, Steiner M, Morgan M, Waller D. Patient-directed Volume Reduction for Emphysema: Sequential Surgical and Endobronchial Techniques. Ann Thorac Surg 2020; 112:295-301. [PMID: 33065048 DOI: 10.1016/j.athoracsur.2020.08.015] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/03/2020] [Accepted: 08/07/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lung volume reduction (LVR) surgery has traditionally been performed as a 1-stage bilateral procedure or staged at a predetermined interval. However to maximize the overall benefit we have allowed the patient to determine the timing of further interventions and have added endobronchial LVR into the protocol. We have reviewed the long-term outcome. METHODS Three hundred thirty-one LVR procedures were performed on 254 patients (median age, 61 years [range, 23-79]) with baseline predicted lung function of (mean ± SD) forced expiratory volume in 1 second 28% ± 11% and residual volume 253% ± 53%. The initial procedure was by video-assisted thoracoscopic surgery in 236 patients (unilateral, 227; bilateral, 9), by open surgery in 5, and by endobronchial valve insertion in 13. Sixty-four patients received a second and 13 a third LVR procedure. The median time interval between first and third stage was 5.8 years (range, 1.9-10) RESULTS: In the subgroup of patients who underwent staged procedures there was a significant improvement in predicted forced expiratory volume in 1 second from 28% at baseline to 34% up to 6 years. There was sustained reduction in static lung volumes up to 8 years: Predicted residual volume remained reduced from 259% to 189%. There were sustained improvements over baseline in health status: EuroQol-5D improved from 50 ± 26 to 62 ± 23 (P < .01) for up to 5 years and the Short Form 36-item questionnaire for up to 9 years. Overall 30-day mortality was 3%. Median survival was 5.6 years (95% confidence interval, 4.7-6.9). CONCLUSIONS A program of staged unilateral procedures of LVR has resulted in sustained benefits for up to 9 years in physiology and health status.
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Affiliation(s)
- Inger Oey
- Department of Thoracic, Surgery Glenfield Hospital, Leicester, United Kingdom
| | - Michael Steiner
- Department of Respiratory Medicine, Glenfield Hospital, Leicester, United Kingdom
| | - Mike Morgan
- Department of Respiratory Medicine, Glenfield Hospital, Leicester, United Kingdom
| | - David Waller
- Department of Thoracic, Surgery Glenfield Hospital, Leicester, United Kingdom.
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Crossley D, Stockley J, Bolton CE, Hopkinson NS, Mahadeva R, Steiner M, Wilkinson T, Hurst JR, Gooptu B, Stockley RA. Relationship of CT densitometry to lung physiological parameters and health status in alpha-1 antitrypsin deficiency: initial report of a centralised database of the NIHR rare diseases translational research collaborative. BMJ Open 2020; 10:e036045. [PMID: 32606060 PMCID: PMC7328802 DOI: 10.1136/bmjopen-2019-036045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To establish a database network for the study of alpha-1 antitrypsin deficiency (AATD) and compare the results to CT lung density as the most direct measure of emphysema. DESIGN A central electronic database was established to permit the upload of anonymised patient data from remote sites. Prospectively collected CT data were recorded onto disc, anonymised, analysed at the coordinating centre and compared with the clinical features of the disease. SETTING Tertiary referral centres with expertise in the management of AATD focused on academic Biomedical Research Units and Wellcome Clinical Research Facilities. PARTICIPANTS Data were collected from 187 patients over 1 year from eight UK academic sites. This included patient demographics, postbronchodilator physiology, health status and CT. Analysis was undertaken at the coordinating centre in Birmingham. RESULTS Patient recruitment in the 12 months reached 94% of target (set at 200) covering the whole spectrum of the disease from those with normal lung function to very severe chronic obstructive lung disease. CT scan suitable for analysis was available from 147 (79%) of the patients. CT density, analysed as the threshold for the lowest 15% of lung voxels, showed statistically significant relationships with the objective physiological parameters of lung function as determined by spirometric Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity staging (p<0.001) and carbon monoxide gas transfer (p<0.01). Density also correlated with subjective measures of quality of life (p=0.02). CONCLUSIONS Establishment of the network for data collection and its transfer was highly successful facilitating future collaboration for the study of this rare disease and its management. CT densitometry correlated well with the objective clinical features of the disease supporting its role as the specific marker of the associated emphysema and its severity. Correlations with subjective measures of health, however, were generally weak indicating other factors play a role.
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Affiliation(s)
- Diana Crossley
- College of Medical and Dental Sciences, Institute of Inflammation and Ageing, Centre for Translational Inflammation Research, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK
| | - James Stockley
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK
| | - Charlotte E Bolton
- Department of Respiratory Medicine, NIHR Nottingham BRC respiratory theme, School of Medicine, The University of Nottingham, City Hospital Campus, Nottingham, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College, Royal Brompton Hospital Campus, London, UK
| | - Ravi Mahadeva
- Department of Medicine, Cambridge NIHR BRC, University of Cambridge, Leicester, UK
| | - Michael Steiner
- NIHR Leicester Biomedical Research Centre - Respiratory, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Tom Wilkinson
- Respiratory BRU, University of Southampton, Southampton, UK
| | | | - Bibek Gooptu
- NIHR Leicester Biomedical Research Centre - Respiratory, Institute for Lung Health, University of Leicester, Glenfield Hospital, Leicester, UK
- King's College London, Guy's Hospital Site, Great Maze Pond, London
| | - Robert A Stockley
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK
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Esteban-Ortega MM, Steiner M, García-Lozano I, Thuissard-Vasallo I, Moriche-Carretero M, Muñoz-Fernández S. Reproducibility of manual choroidal thickness measurements using optical coherence tomography. ACTA ACUST UNITED AC 2020; 95:379-385. [PMID: 32532593 DOI: 10.1016/j.oftal.2020.03.013] [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] [Received: 12/25/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Spectral-domain optical coherence tomography (SD-OCT) is the most useful tool to measure choroidal thickness (CT). CT may be increased in ocular and systemic diseases. However, there are concerns relating reproducibility and external validity of OCT. The aim of this study was to assess the inter-observer and intra-observer variability of manual OCT measurements. METHODS CT was manually measured in the central choroid of 40 eyes from 21 subjects (11 healthy and 10 with ankylosing spondylitis) using RTVue-100 OCT (Optovue Inc., Fremont, CA, EE.UU.). Measurements were performed by 9 independent ophthalmologists from 6 different centers. To assess the inter-observer variability, the intra-class correlation coefficient (ICC) method was calculated. Also, intra-observer variability was assessed in 2 of the ophthalmologists. RESULTS The mean subfoveal CT was 364.9±85.1μm (range, 170 to 572). The inter-observer ICC was 0.823 (CI 95%, 0.749 to 0.888, p<0.001). The intra-observer ICCs were 0.885 (CI 95%, 0.783 to 0.939, p<0.001) and 0.925 (CI 95%, 0.859 to 0.960. p<0.001). CONCLUSIONS In this study, manual measurements of CT with OCT showed a good concordance. These results suggest that manual OCT is a valid tool for multicenter studies.
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Affiliation(s)
- M M Esteban-Ortega
- Sección de Oftalmología, Hospital Universitario Infanta Sofía, Madrid, España; Departamento de Medicina, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, España
| | - M Steiner
- Departamento de Medicina, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, España; Sección de Reumatología, Hospital Universitario Infanta Sofía, Madrid, España.
| | - I García-Lozano
- Sección de Oftalmología, Hospital Universitario Infanta Sofía, Madrid, España; Departamento de Medicina, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, España
| | - I Thuissard-Vasallo
- Departamento de Medicina, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, España
| | - M Moriche-Carretero
- Sección de Oftalmología, Hospital Universitario Infanta Sofía, Madrid, España; Departamento de Medicina, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, España
| | - S Muñoz-Fernández
- Departamento de Medicina, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, España; Sección de Reumatología, Hospital Universitario Infanta Sofía, Madrid, España
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Steiner M, Esteban-Ortega MDM, Thuissard-Vasallo I, García-Lozano I, García J, Perez-Blazquez E, Sambricio J, García-Aparicio Á, Casco-Silva BF, Sanz J, Valdés-Sanz N, Fernandez-Espartero C, Díaz-Valle T, Gurrea-Almela M, Fernández-Leroy J, Gómez-Resa M, Pato E, Díaz Valle D, Méndez-Fernández R, Navio Marco MT, Muñoz-Fernández S. AB0726 CHOROIDAL THICKNESS IS A BIOMARKER AND CAN PREDICT THE RESPONSE TO TREATMENT IN ANKYLOSING SPONDYLITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Choroidal thickness (CT) has been proposed and evaluated as a potential marker of systemic inflammation associated with inflammatory diseases as Ankylosing spondylitis (AS). Patients with active AS have a thicker choroid than healthy subjects, regardless of eye inflammation. The evolution of choroid after treatment is poorly known.Objectives:This study evaluates the CT of patients with severe AS disease activity before and after six months of biological therapy.Methods:This prospective multicenter study evaluates the CT in 44 patients with high AS disease activity, naïve for biological treatment, and no history of eye inflammation before and after six months of biological therapy, aged from 18 to 65 years. The correlations between the CT and C-reactive protein (CRP) with the disease activity indices and scales as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), night pain and Patient Global Assessment (PGA) were calculated at baseline and after six months of biological therapy. The concordance between the CT and CRP was determined. Finally, we assessed potential predictors of response to treatment. Clinically important improvement was defined as a decrease in ASDAS score ≥ 1.1 points.Results:Globally, 44 eyes of 44 patients aged between 18-65 years were included in the study, 12 (27%) women. The biological treatments prescribed were: Adalimumab 13 (29.5%), Certolizumab 9 (20.5%), Secukinumab 10 (20%), Etanercept 8 (18%), Infliximab 3 (6.8%), and Golimumab 1 (2.2%).Mean CT values were significantly higher at baseline than after six months of treatment (baseline 355.28±80.46 µm; 6 months, 341.26±81.06 µm) (p<0.001).CT decreased both in patients on biological treatment without effect in eye (Secukinumab and Etanecept; p=0.024) and in patients on treatment with effect in eye (other; p=0.005). Also, CRP, BASDAI, night pain and PGA decreased after six months of treatment ((p<0.001, p<0.001, p<0.001, p<0.001). We found a 95% concordance between CT and CRP at baseline and 6 months.Multivariable analysis showed that clinically important improvement was associated with higher CT and age as independent factors (OR 0.97, CI95% 0.91-0.93; p=0.009, and OR 0.81, CI95% 0.7-0.95; p=0.005). Clinically important improvement was associated with basal CT >374 µm (sensitivity 78 %, [CI 95% 60-90], specificity 78% [CI 95% 52-92], area under the curve of ROC, 0.70, likelihood ratio 3.6).Conclusion:CT decreased significantly after six months of biological treatment. CT and CPR had a 95% concordance. A high CT is associated with risk of failure to biological treatment. CT can be considered as a useful biomarker of inflammation and predictor of response to treatment in AS.References:[1]Karkucak M, Kalkisim A, Kola M, et al. SAT0408 anti Tnf-α therapy provides beneficial effects on choroidal thickness increase in patients with active ankylosing spondylitis: a possible mechanism of infliximab effectiveness in suppressing uveitis attacks.Ann Rheum Dis. 2016;75:817.Disclosure of Interests:None declared
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Flores-Orozco A, Gallistl J, Steiner M, Brandstätter C, Fellner J. Mapping biogeochemically active zones in landfills with induced polarization imaging: The Heferlbach landfill. Waste Manag 2020; 107:121-132. [PMID: 32279051 DOI: 10.1016/j.wasman.2020.04.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/28/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
In this study, we investigate the applicability of the Induced Polarization (IP) imaging method to discriminate between biogeochemically active and inactive areas of a landfill. The elevated amount of degradable organic carbon in landfills results in the development of biogeochemical hot-spots associated with high rates of microbial activity and the generation of landfill gas and leachate as metabolic products. Our results demonstrate that the electrical conductivity is mainly sensitive to the increase in the fluid conductivity associated to leachate production and migration. Whereas images of the polarization effect, expressed in terms of the imaginary component (σ″) or the phase of the complex conductivity (ϕ), reveal the potential to characterize variations in the architecture and biogeochemical activity of the landfill. Correspondingly, biogeochemically active zones (leachable TOC contents above 1500 mg/kg dry waste) are related to high polarization values (σ″ > 10 mS/m, ϕ > 40 mrads), whereas low leachable TOC contents (<300 mg/kg dry waste) in the inactive areas are characterized by low polarization values (σ″ < 1 mS/m, 10 < ϕ < 25). Additionally, landfill sections corresponding to construction and demolition waste (CDW), associated to negligible TOC content, exhibit the lowest polarization response (σ″ < 0.1 mS/m, ϕ < 15). We prove that IP imaging is a well-suited method for landfill investigations that permits an improved characterization of landfill geometry, variation in waste composition, and the discrimination between biogeochemically active and inactive zones.
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Affiliation(s)
- A Flores-Orozco
- TU-Wien, Department of Geodesy und Geoinformation, Geophysics Research Division, Austria.
| | - J Gallistl
- TU-Wien, Department of Geodesy und Geoinformation, Geophysics Research Division, Austria
| | - M Steiner
- TU-Wien, Department of Geodesy und Geoinformation, Geophysics Research Division, Austria
| | - C Brandstätter
- TU Wien, Institute for Water Quality and Resource Management, Austria
| | - J Fellner
- TU Wien, Institute for Water Quality and Resource Management, Austria
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Cost KT, Unternaehrer E, Jonas W, Gaudreau H, Bouvette-Tourcot A, Steiner M, Lydon J, Szatmari P, Meaney M, Fleming A. Once and Again: Intergenerational Transmission of Parenting. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionAnimal and human studies suggest that individual differences in maternal parenting behaviour are transmitted from one generation to the next.ObjectiveThis study aimed to examine potential psychosocial mechanisms underlying an intergenerational transmission of conceptualization of parenting, including affect, cognition, and parental support.MethodsIn a subsample of 201 first-time mothers participating in the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) project, we assessed maternal childhood rearing experiences, using the Parental Bonding Instrument and the Childhood Trauma Questionnaire. At 6 months postpartum, mothers completed questionnaires on parenting stress, symptoms of depression, internalization of maternal care regulation and current relationship with mother and father.ResultsWe found significant direct associations of maltreatment and rearing by the grandmother with parenting stress at 6 months. These associations were mediated through distinct psychosocial pathways: the association of maltreatment on higher parenting stress was fully mediated through more maternal symptoms of depression (z = 2.297; P = 022). The association between sub-optimal rearing provided by the mother and higher parenting stress was mediated through lower internalization of maternal care regulation (z = -2.155; P = 031) and to a lesser degree through more symptoms of depression (z = -1.842; P = 065). Finally, higher quality rearing by the grandfather was indirectly related to lower parenting stress through positive current relationship with the father (z = -2.617; P = 009).ConclusionsThere are distinct pathways by which early experiences manifest in parenting stress. By understanding the structure of dysregulated parenting, clinicians will have practical information to specifically target maternal motivation, social supports, and depressed mood to disrupt maladaptive parenting cognitions and practices.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Cézard G, Gruer L, Steiner M, Douglas A, Davis C, Buchanan D, Katikireddi SV, Millard A, Sheikh A, Bhopal R. Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland: the Scottish Health and Ethnicity Linkage Study. Public Health 2020; 182:32-38. [PMID: 32151824 PMCID: PMC7294220 DOI: 10.1016/j.puhe.2020.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/09/2020] [Accepted: 01/23/2020] [Indexed: 02/05/2023]
Abstract
Objectives To investigate ethnic differences in falls and road traffic injuries (RTIs) in Scotland. Study design A retrospective cohort of 4.62 million people, linking the Scottish Census 2001, with self-reported ethnicity, to hospitalisation and death records for 2001–2013. Methods We selected cases with International Classification of Diseases–10 diagnostic codes for falls and RTIs. Using Poisson regression, age-adjusted risk ratios (RRs, multiplied by 100 as percentages) and 95% confidence intervals (CIs) were calculated by sex for 10 ethnic groups with the White Scottish as reference. We further adjusted for country of birth and socio-economic status (SES). Results During about 49 million person-years, there were 275,995 hospitalisations or deaths from fall-related injuries and 43,875 from RTIs. Compared with the White Scottish, RRs for falls were higher in most White and Mixed groups, e.g., White Irish males (RR: 131; 95% CI: 122–140) and Mixed females (126; 112–143), but lower in Pakistani males (72; 64–81) and females (72; 63–82) and African females (79; 63–99). For RTIs, RRs were higher in other White British males (161; 147–176) and females (156; 138–176) and other White males (119; 104–137) and females (143; 121–169) and lower in Pakistani females (74; 57–98). The ethnic variations differed by road user type, with few cases among non-White motorcyclists and non-White female cyclists. The RRs were minimally altered by adjustment for country of birth or SES. Conclusion We found important ethnic variations in injuries owing to falls and RTIs, with generally lower risks in non-White groups. Culturally related differences in behaviour offer the most plausible explanation, including variations in alcohol use. The findings do not point to the need for new interventions in Scotland at present. However, as the ethnic mix of each country is unique, other countries could benefit from similar data linkage-based research. Ethnic inequalities in injuries are demonstrated in Scotland based on a large sample size and a fine ethnic granularity. White minority ethnic groups had the highest risks of fall-related injuries in Scotland. Fall-related injuries were the least likely in the Pakistani population. Ethnic differences in road traffic injuries varied by the type of road user. Ethnic differences in injuries were not explained by socio-economic status or country of birth.
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Affiliation(s)
- G Cézard
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, UK; Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
| | - L Gruer
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - M Steiner
- Environmental & Occupational Medicine, Section of Population Health, University of Aberdeen, Aberdeen, UK
| | - A Douglas
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - C Davis
- Information Services Division (ISD), NHS National Services Scotland, Edinburgh, UK
| | - D Buchanan
- Information Services Division (ISD), NHS National Services Scotland, Edinburgh, UK
| | - S V Katikireddi
- MRC Social & Public Health Sciences Unit, Evaluation of Social Interventions Programme, University of Glasgow, Glasgow, UK
| | - A Millard
- NHS Health Scotland, Directorate of Public Health Science, Glasgow, UK
| | - A Sheikh
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - R Bhopal
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Yang B, Steiner M, Schiffbauer JD, Selly T, Wu X, Zhang C, Liu P. Ultrastructure of Ediacaran cloudinids suggests diverse taphonomic histories and affinities with non-biomineralized annelids. Sci Rep 2020; 10:535. [PMID: 31953458 PMCID: PMC6968996 DOI: 10.1038/s41598-019-56317-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/26/2019] [Indexed: 11/09/2022] Open
Abstract
Cloudinids have long been considered the earliest biomineralizing metazoans, but their affinities have remained contentious and undetermined. Based on well-preserved ultrastructures of two taxa, we here propose new interpretations regarding both their extent of original biomineralization and their phylogenetic affinity. One of these taxa is a new cloudinid from Mongolia, Zuunia chimidtsereni gen. et sp. nov., which exhibits key characteristics of submicrometric kerogenous lamellae, plastic tube-wall deformation, and tube-wall delamination. Multiple carbonaceous lamellae are also discovered in Cloudina from Namibia and Paraguay, which we interpret to have originated from chitinous or collagenous fabrics. We deduce that these cloudinids were predominantly originally organic (chitinous or collagenous), and postmortem decay and taphonomic mineralization resulted in the formation of aragonite and/or calcite. Further, based on our ultrastructural characterization and other morphological similarities, we suggest that the cloudinids should most parsimoniously be assigned to annelids with originally organic tubes.
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Affiliation(s)
- Ben Yang
- Institute of Geology, Chinese Academy of Geological Sciences, Beijing, 100037, China.
| | - Michael Steiner
- Department of Earth Sciences, Freie Universität Berlin, Berlin, 12249, Germany.
| | - James D Schiffbauer
- Department of Geological Sciences, University of Missouri, Columbia, Missouri, 65211, USA
- X-ray Microanalysis Core Facility, University of Missouri, Columbia, Missouri, 65211, USA
| | - Tara Selly
- Department of Geological Sciences, University of Missouri, Columbia, Missouri, 65211, USA
- X-ray Microanalysis Core Facility, University of Missouri, Columbia, Missouri, 65211, USA
| | - Xuwen Wu
- Laboratory of Marine Organism Taxonomy and Phylogeny, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, 266071, China
| | - Cong Zhang
- Institute of Geology, Chinese Academy of Geological Sciences, Beijing, 100037, China
- School of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao, 266590, China
| | - Pengju Liu
- Institute of Geology, Chinese Academy of Geological Sciences, Beijing, 100037, China
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Kabai E, Poppitz-Spuhler A, Savkin BT, Steiner M. Retrospective analysis of Sr-90 in roe deer antlers originating from north-west Germany. J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-019-06914-x] [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: 10/25/2022]
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Tucher N, Höhn O, Murthy JN, Martinez JC, Steiner M, Armbruster A, Lorenz E, Bläsi B, Goldschmidt JC. Energy yield analysis of textured perovskite silicon tandem solar cells and modules. Opt Express 2019; 27:A1419-A1430. [PMID: 31684495 DOI: 10.1364/oe.27.0a1419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/12/2019] [Indexed: 05/18/2023]
Abstract
Perovskite silicon tandem solar cells combine potentially low production costs with the ability to surpass the efficiency limit of silicon single junction solar cells. Optical modeling and optimization are crucial to achieve this ambitious goal in the near future. The optimization should seek to maximize the energy yield based on realistic environmental conditions. This work analyzes the energy yield of perovskite silicon tandem solar cells and modules based on realistic experimental data, with a special focus on the investigation of surface textures at the front and rear side of the solar cell and its implication for reflection as well as parasitic absorption properties. The investigation reveals a 7.3%rel higher energy yield for an encapsulated tandem cell with a textured front side compared with an encapsulated high efficiency single junction solar cell with 24.3% harvesting efficiency for irradiance data of the year 2014 in Freiburg/Germany.
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Liu J, Steiner M, Dunlop JA, Shu D. Microbial decay analysis challenges interpretation of putative organ systems in Cambrian fuxianhuiids. Proc Biol Sci 2019; 285:rspb.2018.0051. [PMID: 29643211 DOI: 10.1098/rspb.2018.0051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/15/2018] [Indexed: 11/12/2022] Open
Abstract
The Chengjiang fossil Lagerstätte (Cambrian Stage 3) from Yunnan, southern China is renowned for its soft-tissue preservation. Accordingly structures in fuxianhuiids, radiodontans and great appendage arthropods have been interpreted as the nervous and cardiovascular systems, including brains, hearts and blood vessels. That such delicate organ systems survive the fossilization process seems remarkable; given that this mode of preservation involves major taphonomic changes, such as flattening, microbial degradation, chemical alteration and replacement. Here, we document a range of taphonomic preservation states in numerous articulated individuals of Fuxianhuia protensa We suggest that organic (partly iron mineral-replaced) bulbous structures in the head region, previously interpreted as brain tissue, along with sagittally located organic strands interpreted as part of the cardiovascular system or as nerve cords, may be better explained as microbial biofilms that developed following decomposition of the intestine, muscle and other connective tissues, forming halos surrounding the original organic remains.
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Affiliation(s)
- Jianni Liu
- Early Life Institute, Shaanxi Key Laboratory of Early Life and Environments, The Key Laboratory of Continental Dynamics, Northwest University, Xi'an 710069, People's Republic of China
| | - Michael Steiner
- Department of Earth Science, Freie Universität Berlin, 12249, Berlin, Germany
| | - Jason A Dunlop
- Museum für Naturkunde, Leibniz Institute for Research on Evolution and Biodiversity at the Humboldt University Berlin, 10115 Berlin, Germany
| | - Degan Shu
- Early Life Institute, Shaanxi Key Laboratory of Early Life and Environments, The Key Laboratory of Continental Dynamics, Northwest University, Xi'an 710069, People's Republic of China.,School of Earth Sciences and Resources, China University of Geosciences, Beijing 100083, People's Republic of China
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Ashdown H, Steiner M. Delivering high value therapies in COPD: the secret is in the marketing. Eur Respir J 2019; 53:53/4/1900215. [PMID: 31023865 DOI: 10.1183/13993003.00215-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Helen Ashdown
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Michael Steiner
- Institute for Lung Health, Leicester Biomedical Research Centre - Respiratory, University of Leicester, Glenfield Hospital, Leicester, UK
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Cox M, O'Connor C, Biggs K, Hind D, Bortolami O, Franklin M, Collins B, Walters S, Wailoo A, Channell J, Albert P, Freeman U, Bourke S, Steiner M, Miles J, O'Brien T, McWilliams D, Schofield T, O'Reilly J, Hughes R. The feasibility of early pulmonary rehabilitation and activity after COPD exacerbations: external pilot randomised controlled trial, qualitative case study and exploratory economic evaluation. Health Technol Assess 2019. [PMID: 29516853 DOI: 10.3310/hta22110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge. OBJECTIVE To assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care. DESIGN Parallel-group, pilot 2 × 2 factorial randomised trial with nested qualitative research and an economic analysis. SETTING Two acute hospital NHS trusts. Recruitment was carried out from September 2015 to April 2016 and follow-up was completed in July 2016. PARTICIPANTS Eligible patients were those aged ≥ 35 years who were admitted with AECOPD, who were non-acidotic and who maintained their blood oxygen saturation level (SpO2) within a prescribed range. Exclusions included the presence of comorbidities that affected the ability to undertake the interventions. INTERVENTIONS (1) Hospital EPR: muscle training delivered at the patient's hospital bed using a cycle ergometer and (2) home EPR: a pulmonary rehabilitation programme delivered in the patient's home. Both interventions were delivered by trained physiotherapists. Participants were allocated on a 1 : 1 : 1 : 1 ratio to (1) hospital EPR (n = 14), (2) home EPR (n = 15), (3) hospital EPR and home EPR (n = 14) and (4) control (n = 15). Outcome assessors were blind to treatment allocation; it was not possible to blind patients. MAIN OUTCOME MEASURES Feasibility of recruiting 76 participants in 7 months at two centres; intervention delivery; views on intervention/research acceptability; clinical outcomes including the 6-minute walk distance (6WMD); and costs. Semistructured interviews with participants (n = 27) and research health professionals (n = 11), optimisation assessments and an economic analysis were also undertaken. RESULTS Over 7 months 449 patients were screened, of whom most were not eligible for the trial or felt too ill/declined entry. In total, 58 participants (76%) of the target 76 participants were recruited to the trial. The primary clinical outcome (6MWD) was difficult to collect (hospital EPR, n = 5; home EPR, n = 6; hospital EPR and home EPR, n = 5; control, n = 5). Hospital EPR was difficult to deliver over 5 days because of patient discharge/staff availability, with 34.1% of the scheduled sessions delivered compared with 78.3% of the home EPR sessions. Serious adverse events were experienced by 26 participants (45%), none of which was related to the interventions. Interviewed participants generally found both interventions to be acceptable. Home EPR had a higher rate of acceptability, mainly because patients felt too unwell when in hospital to undergo hospital EPR. Physiotherapists generally found the interventions to be acceptable and valued them but found delivery difficult because of staffing issues. The health economic analysis results suggest that there would be value in conducting a larger trial to assess the cost-effectiveness of the hospital EPR and hospital EPR plus home EPR trial arms and collect more information to inform the hospital cost and quality-adjusted life-year parameters, which were shown to be key drivers of the model. CONCLUSIONS A full-scale randomised controlled trial using this protocol would not be feasible. Recruitment and delivery of the hospital EPR intervention was difficult. The data obtained can be used to design a full-scale trial of home EPR. Because of the small sample and large confidence intervals, this study should not be used to inform clinical practice. TRIAL REGISTRATION Current Controlled Trials ISRCTN18634494. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Matthew Cox
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Katie Biggs
- Design, Trials and Statistics (DTS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Daniel Hind
- Design, Trials and Statistics (DTS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Oscar Bortolami
- Design, Trials and Statistics (DTS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Matthew Franklin
- Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Stephen Walters
- Design, Trials and Statistics (DTS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Allan Wailoo
- Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Julie Channell
- Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Paul Albert
- Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Ursula Freeman
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Stephen Bourke
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Jon Miles
- Rotherham NHS Foundation Trust, Rotherham, UK
| | - Tom O'Brien
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - David McWilliams
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Terry Schofield
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - John O'Reilly
- Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Rodney Hughes
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Gampenrieder SP, Angela R, Rinnerthaler G, Hackl H, Steiner M, Pulverer W, Weinhaeusel A, Klinglmayr E, Karl T, Ilic S, Hufnagl C, Hauser-Kronberger C, Egle A, Greil R. Abstract P3-10-07: A 3-gene DNA methylation signature fails to predict response to bevacizumab in metastatic breast cancer patients treated within the TANIA phase III trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Biomarkers predicting response to bevacizumab containing therapy in metastatic breast cancer (MBC) are of urgent need. In a retrospective single-institution analysis we have previously shown that a 3-gene methylation signature (MLH1,POLKand TMBIM6) could discriminate between responders and non-responders to a bevacizumab-based therapy in two independent cohorts of patients with MBC with an AUC of 0.94 and 0.86, respectively (Gampenrieder SP et al. Theranostics. 2018. 8(8):2278-2288). Here, we present the validation of these findings within the prospective phase III trial TANIA (Vrdoljak E et al. Ann Oncol. 2016. 27(11):2046-52) randomizing 494 patients with HER2-negative MBC to chemotherapy plus bevacizumab or chemotherapy alone for two consecutive treatment lines (second- and third-line). All patients had already received bevacizumab-containing therapy in the first-line setting.
Patients and methods: DNA isolated from archival FFPE tumor samples was available from 200 patients consenting to optional translational research within the TANIA trial. Out of these, 176 samples were collected prior to first-line bevacizumab therapy and were analyzed retrospectively. Sufficient DNA for methylation analysis was available from 124 patients: 64 treated with chemotherapy plus bevacizumab and 60 treated with chemotherapy alone. All samples were isolated from the primary tumor. Quantitative methylation analysis was performed by pyrosequencing on the PyroMark Q24 Advanced System (Qiagen). PFS and OS analyses were performed in both study arms comparing “predicted responders” (PRED_R) versus “predicted non-responders” (PRED_NR) based either on median dichotomization or according to the cutoffs for individual CpG and the combined 3-CpG methylation logistic regression model.
Results:Out of the 124 evaluable patients, 32 (25.8%) were classified as PRED_R and 92 as RED_NR by the 3-gene methylation signature. PRED_R did not have a significantly different second-line PFS (HR 0.95, 95%CI 0.57-1.57; P = 0.84) or OS (HR 0.91, 95%CI 0.51-1.60; P = 0.73) when treated in the bevacizumab-containing study arm compared to PRED_NR. In addition, PRED_R did not show a longer PFS when treated with bevacizumab compared to PRED_R treated with chemotherapy alone (HR 0.95, 95%CI 0.59-1.54; P = 0.83). Furthermore, there was no difference in third-line PFS and the combination of second- and third-line PFS between PRED_R and PRED-NR in the bevacizumab arm. In the control arm, PRED_NR showed a statistically significant shorter PFS compared to PRED_R (HR 0.50, 95%CI 0.22-0.77; P = 0.006), but not OS (HR 0.95, 95%CI 0.51-1.77; P = 0.86).
Conclusion: Our 3-gene methylation signature was not confirmed as predictive biomarker for bevacizumab efficacy in metastatic breast cancer.
(This research project was partially supported by ROCHE Austria GmbH)
Citation Format: Gampenrieder SP, Angela R, Rinnerthaler G, Hackl H, Steiner M, Pulverer W, Weinhaeusel A, Klinglmayr E, Karl T, Ilic S, Hufnagl C, Hauser-Kronberger C, Egle A, Greil R. A 3-gene DNA methylation signature fails to predict response to bevacizumab in metastatic breast cancer patients treated within the TANIA phase III trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-07.
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Affiliation(s)
- SP Gampenrieder
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - R Angela
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - G Rinnerthaler
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - H Hackl
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - M Steiner
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - W Pulverer
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - A Weinhaeusel
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - E Klinglmayr
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - T Karl
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - S Ilic
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - C Hufnagl
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - C Hauser-Kronberger
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - A Egle
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
| | - R Greil
- Hemostseology, Rheumatology and Infectious Diseases, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; University of Salzburg, Salzburg, Austria; Biocenter, Medical University of Innsbruck, Innsbruck, Austria; Center for Health & Bioresources, Business Unit for Molecular Diagnostics, AIT – Austrian Institute of Technology GmbH, Vienna, Austria; Paracelsus Medical University Salzburg, Salzburg, Austria
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Tedford K, Tech L, Steiner M, Korthals M, Fischer KD. Analysis of Shear Flow-induced Migration of Murine Marginal Zone B Cells In Vitro. J Vis Exp 2018. [PMID: 30531718 DOI: 10.3791/58759] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Marginal zone B cells (MZBs) are a population of B cells that reside in the mouse splenic marginal zones that envelop follicles. To reach the follicles, MZBs must migrate up the shear force of blood flow. We present here a method for analyzing this flow-induced MZB migration in vitro. First, MZBs are isolated from the mouse spleen. Second, MZBs are settled on integrin ligands in flow chamber slides, exposed to shear flow, and imaged under a microscope while migrating. Third, images of the migrating MZBs are processed using the MTrack2 automatic cell tracking plugin for ImageJ, and the resulting cell tracks are quantified using the Ibidi chemotaxis tool. The migration data reveal how fast the cells move, how often they change direction, whether the shear flow vector affects their migration direction, and which integrin ligands are involved. Although we use MZBs, the method can easily be adapted for analyzing migration of any leukocyte that responds to the force of shear flow.
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Affiliation(s)
- Kerry Tedford
- Institute of Biochemistry and Cell Biology, OVGU University of Magdeburg;
| | - Laura Tech
- Institute of Biochemistry and Cell Biology, OVGU University of Magdeburg
| | - Michael Steiner
- Institute of Biochemistry and Cell Biology, OVGU University of Magdeburg
| | - Mark Korthals
- Institute of Biochemistry and Cell Biology, OVGU University of Magdeburg
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38
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Liu J, Lerosey-Aubril R, Steiner M, Dunlop JA, Shu D, Paterson JR. Origin of raptorial feeding in juvenile euarthropods revealed by a Cambrian radiodontan. Natl Sci Rev 2018. [DOI: 10.1093/nsr/nwy057] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The rapid rise of arthropods during the Cambrian quickly established some clades, such as the euarthropod stem-group called Radiodonta, as the dominant and most diverse predators in marine ecosystems. Recent discoveries have shown that the size and dietary ecology of radiodontans are far more diverse than previously thought, but little is known about the feeding habits of juveniles. Here, we document a very small (∼18-mm-long), near-complete specimen of the radiodontan Lyrarapax unguispinus from the early Cambrian Chengjiang Biota of China. This specimen is the smallest radiodontan individual known, representing a juvenile instar. Its adult-like morphology—especially the fully developed spinose frontal appendages and tetraradial oral cone—indicates that L. unguispinus was a well-equipped predator at an early developmental stage, similar to modern raptorial euarthropods, such as mantises, mantis shrimps and arachnids. This evidence, coupled with the basal phylogenetic position of radiodontans, confirms that raptorial feeding habits in juvenile euarthropods appeared early in the evolutionary history of the group.
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Affiliation(s)
- Jianni Liu
- Shaanxi Key Laboratory of Early Life and Environment, The Key Laboratory of Continental Dynamics, Department of Geology, Northwest University, Xi’an 710069, China
| | - Rudy Lerosey-Aubril
- Palaeoscience Research Centre, School of Environmental and Rural Science, University of New England, Armidale, New South Wales 2351, Australia
| | - Michael Steiner
- Institut für Geologische Wissenschaften, FU Berlin, Malteserstraße 74–100, Haus D, 12249 Berlin, Germany
| | - Jason A Dunlop
- Museum für Naturkunde, Leibniz Institute for Evolution and Biodiversity Science, Invalidenstrasse 43, D-10115 Berlin, Germany
| | - Degan Shu
- Shaanxi Key Laboratory of Early Life and Environment, The Key Laboratory of Continental Dynamics, Department of Geology, Northwest University, Xi’an 710069, China
| | - John R Paterson
- Palaeoscience Research Centre, School of Environmental and Rural Science, University of New England, Armidale, New South Wales 2351, Australia
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39
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Dama M, Mahoney JL, Van Lieshout RJ, Frey BN, Steiner M. The Menopause Visual Analogue Scale: a new tool for measuring the severity and response to treatment of symptoms throughout the menopausal transition. Climacteric 2018; 21:502-508. [DOI: 10.1080/13697137.2018.1495705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Dama
- Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada
| | - J. L. Mahoney
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - R. J. Van Lieshout
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - B. N. Frey
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - M. Steiner
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
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40
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Dewart C, Serpico J, Steiner M, Gallo M. Electronic interventions for changing knowledge, attitudes or practice regarding contraception: a systematic review. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.077] [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: 11/15/2022]
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41
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Abstract
SummaryThe effect of vitamin E administration on platelet function was evaluated in a group of normal, healthy volunteers. Platelet aggregation induced by collagen, ADP and epinephrine and platelet adhesion to collagen were measured at weekly intervals in 20 men and 27 women divided into 3 experimental groups of 12 individuals each and one control group of 5 men and 6 women. One experimental group was on a 6-week regimen of vitamin E in increasing dosages (4001.U.-1.2001.U.), the second group received aspirin, 300 mg every other day, and the third group was on a combination of vitamin E and aspirin. In the control group, platelet function was measured at weekly intervals. In women, vitamin E by itself produced a small but significant reduction of collagen-induced platelet aggregation. A similar trend was seen in men. However, the reduction never reached statistical significance. Adhesiveness to collagen was not affected by aspirin ingestion but showed a highly significant reduction in vitamin E and vitamin E + aspirin treated individuals. These results suggest that vitamin E administration could have a beneficial effect in patients suffering from arterial thromboembolic diseases.
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Affiliation(s)
- M Steiner
- The Division of Hematologic Research, The Memorial Hospital, Pawtucket, and Brown University Providence, Rl, U.S.A
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42
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Abstract
SummaryPools of polymerized and total tubulin were measured in human platelets as a function of free sulfhydryl groups both in acid-soluble and acid-precipitable cell fractions. Changes in free thiols were produced either by storage of platelets at room temperature or by addition of the potent oxidizing agent diazene dicarboxylic acid (diamide) and were correlated with shifts in the dynamic equilibrium between assembled and disassembled microtubules and platelet aggregation. Diamide at concentrations of 0.5 to 5 mM depleted acid soluble SH groups and reduced protein thiols while causing a progressive decrease in polymerized tubulin. Similar changes, although not as severe, were initiated by storage of platelets at room temperature. Platelet aggregation especially that induced by collagen showed a positive correlation with the pool of polymerized tubulin. Our results indicate that the state of oxidation of sulfhydryl groups especially in the acid- precipitable fraction plays an important role in determining the position of equilibrium between polymerized and depolymerized tubulin.
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Affiliation(s)
- M Steiner
- The Division of Hematology/Oncology, The Memorial Hospital, Pawtucket, and Brown University, Providence, RI, USA
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43
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Abstract
SummaryEstrogens in high doses have been shown to inhibit, in vitro, the thrombin-neutralizing action of antithrombin III (AT III). In this study we investigate the effect of estrogens on AT III in greater detail. To increase the sensitivity of measurement of AT III activity in the absence of heparin, we have developed an assay system utilizing human platelets, AT III and thrombin. The two proteins derived from human plasma were prepared in high purity. Platelet aggregation was induced by approximately 0.02 NIH U of thrombin. AT III was added in amounts that suppressed 95% of the aggregation-inducing effect of thrombin. Estrogens blocked the thrombin-neutralizing effect of AT III in dose-dependent manner. This effect was shown to be specific for AT III. Neither aggregability of platelets nor aggregating effect of thrombin were affected by the steroid hormone. Evidence for binding of estrogen to AT III was obtained from changes in intrinsic fluorescence of AT III. Activity of AT III was also reduced in increasing order of effectiveness by cholesterol, cortisone, testosterone and progesterone. Our studies suggest a direct effect of estrogens and other steroids on AT III, altering its specific neutralization of thrombin.
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Affiliation(s)
- H Nagasawa
- The Division of Hematologic Research, Department of Medicine, Brown University at The Memorial Hospital, Pawtucket, Rhode Island, U.S.A
| | - B K Kim
- The Division of Hematologic Research, Department of Medicine, Brown University at The Memorial Hospital, Pawtucket, Rhode Island, U.S.A
| | - M Steiner
- The Division of Hematologic Research, Department of Medicine, Brown University at The Memorial Hospital, Pawtucket, Rhode Island, U.S.A
| | - M G Baldini
- The Division of Hematologic Research, Department of Medicine, Brown University at The Memorial Hospital, Pawtucket, Rhode Island, U.S.A
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44
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Orme M, Sherar L, Morgan M, Steiner M, Esliger D, Kingsnorth A, Singh S. The influence of South Asian ethnicity on the incremental shuttle walk test in UK adults. Chron Respir Dis 2018; 15:241-249. [PMID: 29973076 PMCID: PMC6100169 DOI: 10.1177/1479972318785832] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to compare incremental shuttle walking test (ISWT) performance between South Asian and Caucasian British adults, identify predictors of ISWT distance and produce ethnicity-specific reference equations. Data from a mixed gender sample aged 40–75 years from Leicestershire, United Kingdom, were selected for analyses. Analysis of covariance determined differences in ISWT performance between South Asian and Caucasian British ethnic groups. Linear regressions identified predictors of ISWT distance, which determined the reference equations. In total, 144 participants took part in the study (79 South Asian (54 ± 8 years, 71% female) and 65 Caucasian British (58 ± 9 years, 74% female)). Distance walked for the ISWT was shorter for South Asian individuals compared with Caucasian British (451 ± 143 vs. 575 ± 180 m, p < 0.001). The ethnicity-specific reference equations for ISWT distance explained 33–50% of the variance (standard error of the estimate (SEE): 107–119 m) for South Asians and explained 14–58% of the variance (SEE: 121–169 m) for Caucasian British. Ethnicity univariately explained 12.9% of the variance in ISWT distance and was significantly associated with ISWT distance after controlling for age, gender, height, weight, dyspnoea and lung function (B = −70.37; 1 = Caucasian British, 2 = South Asian), uniquely explaining 3.7% of the variance. Predicted values for ISWT performance were lower in South Asian people than in Caucasian British. Ethnicity-specific reference equations should account for this.
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Affiliation(s)
- Mark Orme
- 1 Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre - Respiratory, NIHR Institute of Lung Health, Leicester, UK
| | - Lauren Sherar
- 2 National Centre for Sport and Exercise Medicine, Loughborough, UK.,3 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.,4 NIHR Leicester Biomedical Research Centre - Lifestyle, Leicester, UK
| | - Mike Morgan
- 1 Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre - Respiratory, NIHR Institute of Lung Health, Leicester, UK
| | - Michael Steiner
- 1 Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre - Respiratory, NIHR Institute of Lung Health, Leicester, UK.,2 National Centre for Sport and Exercise Medicine, Loughborough, UK.,3 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Dale Esliger
- 2 National Centre for Sport and Exercise Medicine, Loughborough, UK.,3 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK.,4 NIHR Leicester Biomedical Research Centre - Lifestyle, Leicester, UK
| | - Andrew Kingsnorth
- 2 National Centre for Sport and Exercise Medicine, Loughborough, UK.,3 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Sally Singh
- 1 Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre - Respiratory, NIHR Institute of Lung Health, Leicester, UK.,2 National Centre for Sport and Exercise Medicine, Loughborough, UK.,3 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
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45
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Abstract
SummaryThe function of nonimmune IgG associated with platelets is unknown. In a series of experiments we have investigated this problem, relating amount of platelet-associated IgG (PAIgG) to platelet volume, serotonin release, adherence of platelets to monocytes and platelet senescence. Most of these studies were performed with human platelets. Platelets freed of preexisting PAIgG by incubation at 22° C were incubated with IgG in a series of concentrations ranging from 0.4 — 27.0 X10-6 M. The IgG preparations used were demonstrably free of aggregated forms of the protein. The amount of PAIgG bound to platelets was determined by the use of fluorescein isothiocyanate-conjugated anti-IgG antibody (F-anti-IgG antibody) which was quantified in a fluorospectrophotometer. Newly bound IgG was assayed similarly by the use of F-IgG. A dose-dependent increase in platelet volume was associated with the binding of nonimmune IgG by platelets. The process which leveled off at an IgG concentration of 1.2 —1.5 X10-5 M was almost fully reversible and was not due to platelet shape change or aggregation. Release of serotonin from IgG-treated platelets was relatively small but to the extent that it occurred was positively related to the IgG concentration to which platelets were exposed. Adherence to autologous monocytes studied quantitatively by the use of formaldehyde-fixed cells was also positively related to the amount of IgG on the platelets. Normal or IgG-defident serum had a potent inhibitory (noncompetitive) action on the binding of F-IgG and F-anti-human IgG antibody to human platelets. Cohorts of platelets prepared in rabbits during the recovery phase of immunological thrombocytopenia induced by injection of heterologous antiserum, showed an age-dependent increase of PAIgG and of IgG binding. These results suggest that PAIgG plays a role in the clearance of senescent platelets.
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Affiliation(s)
- K Sugiura
- The Division of Hematologic Research, The Memorial Hospital, Pawtucket, R. I., and Brown University, Providence, R. I., U.S.A
| | - M Steiner
- The Division of Hematologic Research, The Memorial Hospital, Pawtucket, R. I., and Brown University, Providence, R. I., U.S.A
| | - M Baldini
- The Division of Hematologic Research, The Memorial Hospital, Pawtucket, R. I., and Brown University, Providence, R. I., U.S.A
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46
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Abstract
SummaryThe effect of thrombin on the phosphorylating activity of platelet membranes was compared to that of trypsin. Preincubation of non-32P phosphorylated platelet membranes with or without either of these two enzymes resulted in a considerable loss of membrane protein kinase activity which was most severe when trypsin was used. Protein kinase activity and endogenous protein acceptors decreased in parallel. 32P-phosphorylated membranes showed a slow but progressive loss of label which was accelerated by trypsin. Thrombin under these conditions prevented the loss of 32P-phosphate. These results are interpreted to indicate a thrombin-induced destruction of a phosphoprotein phosphatase. The protein kinase activity of phosphorylated platelet membranes using endogenous or exogenous protein substrates showed a significant reduction compared to non-phosphorylated membranes suggesting a deactivation of protein kinase by phosphorylation of platelet membranes. Neither thrombin nor trypsin caused a qualitative change in the membrane polypeptides accepting 32P-phosphate but resulted in quantitative alterations of their ability to become phosphorylated.
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47
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Sehmbi M, Rowley CD, Minuzzi L, Kapczinski F, Steiner M, Sassi RB, Bock NA, Frey BN. Association of intracortical myelin and cognitive function in bipolar I disorder. Acta Psychiatr Scand 2018. [PMID: 29536533 DOI: 10.1111/acps.12875] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Although cognitive dysfunction persists through affective and euthymic states in bipolar disorder (BD), its neurobiological correlates remain undetermined. We explore whole-cortex intracortical myelin (ICM) and cognition in BD-I and controls. METHODS T1 -weighted images (3T) optimized for ICM measurement were analyzed using a surface-based approach. MRI signal was sampled at cortical mid-depth. Cognitive performance was measured via standardized computerized battery and paper-and-pencil Trails B. RESULTS ICM was associated with verbal memory (VM) in BD throughout a cortical network identified with pertinence to VM function, with strongest effects in left caudal middle temporal cortex and left dorsolateral prefrontal cortex (Pcorrected < 0.05). Subanalyses revealed specific association with correct word recognition, without delay. Processing speed, executive function, and reaction time were also predicted by ICM in BD, but not controls, although this did not survive Bonferroni correction. CONCLUSION This is the first study to show VM association with ICM in BD. ICM has been implicated in the integrity of neural connections and neural synchrony. VM dysfunction is one of the most replicated cognitive abnormalities in BD. Therefore, these results provide a novel mechanism for understanding cognitive dysfunction in BD, which can aid in the development of targeted therapeutics to improve cognitive outcomes in BD.
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Affiliation(s)
- M Sehmbi
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - C D Rowley
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - L Minuzzi
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - F Kapczinski
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - M Steiner
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - R B Sassi
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - N A Bock
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada
| | - B N Frey
- Mood Disorders Program, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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48
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Wright E, Harmon E, Steiner M, Nowicki M. Pseudoexstrophy: a forme fruste of bladder exstrophy. Arch Dis Child 2018; 103:610. [PMID: 28768624 DOI: 10.1136/archdischild-2017-312967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Edmond Wright
- School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Edwin Harmon
- Division of Pediatric Urology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Michael Steiner
- Division of Pediatric Radiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Michael Nowicki
- Division of Pediatric Gastroenterology, University of Mississippi Medical Center, Jackson, Mississippi, USA
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49
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Bhopal R, Gruer L, Cézard G, Douglas A, Steiner M, Millard A, Buchanan D, Katikireddi V, Sheikh A. 1.1-O5Mortality, ethnicity and country of birth on a national scale 2001-2013: the Scottish Health and Ethnicity Linkage Study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Bhopal
- The University of Edinburgh, United Kingdom
| | - L Gruer
- The University of Edinburgh, United Kingdom
| | - G Cézard
- The University of Edinburgh, United Kingdom
| | - A Douglas
- The University of Edinburgh, United Kingdom
| | - M Steiner
- The University of Aberdeen, United Kingdom
| | - A Millard
- NHS Health Scotland, Edinburgh, United Kingdom
| | - D Buchanan
- Information Services Division, Edinburgh, United Kingdom
| | - V Katikireddi
- MRC Social and Public Sciences Unit, Glasgow, United Kingdom
| | - A Sheikh
- The University of Edinburgh, United Kingdom
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50
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Gruer L, Millard A, Williams L, Bhopal R, Katikireddi S, Cezard G, Buchanan D, Douglas A, Steiner M, Sheikh A. 3.10-P23All-cause hospitalisation of different ethnic groups: a data linkage cohort study of 4.62 million people in Scotland. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Gruer
- University of Edinburgh, United Kingdom
| | | | | | - R Bhopal
- University of Edinburgh, United Kingdom
| | | | - G Cezard
- University of Edinburgh, United Kingdom
| | - D Buchanan
- Information Services Division, United Kingdom
| | - A Douglas
- University of Edinburgh, United Kingdom
| | - M Steiner
- University of Aberdeen, United Kingdom
| | - A Sheikh
- University of Edinburgh, United Kingdom
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