1
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Dark HE, Paterson C, Daya GN, Peng Z, Duggan MR, Bilgel M, An Y, Moghekar A, Davatzikos C, Resnick SM, Loupy K, Simpson M, Candia J, Mosley T, Coresh J, Palta P, Ferrucci L, Shapiro A, Williams SA, Walker KA. Proteomic Indicators of Health Predict Alzheimer's Disease Biomarker Levels and Dementia Risk. Ann Neurol 2024; 95:260-273. [PMID: 37801487 PMCID: PMC10842994 DOI: 10.1002/ana.26817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/06/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE Few studies have comprehensively examined how health and disease risk influence Alzheimer's disease (AD) biomarkers. The present study examined the association of 14 protein-based health indicators with plasma and neuroimaging biomarkers of AD and neurodegeneration. METHODS In 706 cognitively normal adults, we examined whether 14 protein-based health indices (ie, SomaSignal® tests) were associated with concurrently measured plasma-based biomarkers of AD pathology (amyloid-β [Aβ]42/40 , tau phosphorylated at threonine-181 [pTau-181]), neuronal injury (neurofilament light chain [NfL]), and reactive astrogliosis (glial fibrillary acidic protein [GFAP]), brain volume, and cortical Aβ and tau. In a separate cohort (n = 11,285), we examined whether protein-based health indicators associated with neurodegeneration also predict 25-year dementia risk. RESULTS Greater protein-based risk for cardiovascular disease, heart failure mortality, and kidney disease was associated with lower Aβ42/40 and higher pTau-181, NfL, and GFAP levels, even in individuals without cardiovascular or kidney disease. Proteomic indicators of body fat percentage, lean body mass, and visceral fat were associated with pTau-181, NfL, and GFAP, whereas resting energy rate was negatively associated with NfL and GFAP. Together, these health indicators predicted 12, 31, 50, and 33% of plasma Aβ42/40 , pTau-181, NfL, and GFAP levels, respectively. Only protein-based measures of cardiovascular risk were associated with reduced regional brain volumes; these measures predicted 25-year dementia risk, even among those without clinically defined cardiovascular disease. INTERPRETATION Subclinical peripheral health may influence AD and neurodegenerative disease processes and relevant biomarker levels, particularly NfL. Cardiovascular health, even in the absence of clinically defined disease, plays a central role in brain aging and dementia. ANN NEUROL 2024;95:260-273.
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Affiliation(s)
- Heather E. Dark
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | | | - Gulzar N. Daya
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Zhongsheng Peng
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Michael R. Duggan
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Abhay Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christos Davatzikos
- Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | | | | | - Julián Candia
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD USA
| | - Thomas Mosley
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Priya Palta
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, New York, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD USA
| | - Allison Shapiro
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus
| | | | - Keenan A. Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
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2
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Cauldwell M, Adamson D, Batia K, Bhagra C, Bolger A, Everett T, Fox C, Girling J, Head C, English K, Hudsmith L, James R, Johnson M, MacKiliop L, McAuliffe FM, Mariappa G, Orchard E, O'Brien M, Siddiqui F, Simpson L, Simpson M, Timmons P, Vause S, Wander G, Walker N, Steer PJ. Direct current cardioversion in pregnancy: a multicentre study. BJOG 2023. [PMID: 37039253 DOI: 10.1111/1471-0528.17457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Direct current cardioversion (DCCV) in pregnancy is rarely required and typically only documented in single case reports or case series. A recent UK confidential enquiry reported on several maternal deaths where appropriate DCCV appeared to have been withheld. DESIGN Retrospective cohort study. SETTING Seventeen UK and Ireland specialist maternity centres. SAMPLE Twenty-seven pregnant women requiring DCCV in pregnancy. MAIN OUTCOME MEASURES Maternal and fetal outcomes following DCCV. RESULTS Twenty-seven women had a total of 29 DCCVs in pregnancy. Of these, 19 (70%) initial presentations were to Emergency Departments and eight (30%) to maternity settings. There were no maternal deaths. Seventeen of the women (63%) had a prior history of heart disease. Median gestation at DCCV was 28 weeks, median gestation at delivery was 35 weeks, with a live birth in all cases. The abnormal heart rhythms documented at the first cardioversion were atrial fibrillation in 12/27 (44%) cases, atrial flutter in 8/27 (30%), supraventricular tachycardia in 5/27 (19%) and atrial tachycardia in 2/27 (7%). Fetal monitoring was undertaken following DCCV on 14/29 (48%) occasions (10 of 19 (53%) at ≥26 weeks) and on 2/29 (7%) occasions, urgent delivery was required post DCCV. CONCLUSIONS Direct current cardioversion in pregnancy is rarely required but should be undertaken when clinically indicated according to standard algorithms to optimise maternal wellbeing. Once the woman is stable post DCCV, gestation-relevant fetal monitoring should be undertaken. Maternity units should develop multidisciplinary processes to ensure pregnant women receive the same standard of care as their non-pregnant counterparts.
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Affiliation(s)
- M Cauldwell
- Department of Obstetrics, Maternal Medicine Service, St George's Hospital, Blackshaw Road, London, UK
| | - D Adamson
- Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - K Batia
- Department of Obstetric Anaesthesia, St Mary's Hospital Manchester, Manchester, UK
| | - C Bhagra
- Department of Cardiology, Addenbrookes Hospital, Cambridge, UK
| | - A Bolger
- Department of Adult Congenital Heart Disease, Glenfield Hospital, Leicester, UK
| | - T Everett
- Department of Obstetrics, Leeds Teaching Hospitals, Leeds, UK
| | - C Fox
- Department of Obstetrics, Birmingham Women's and Children's Hospital, Mindelson Way, Birmingham, UK
| | - J Girling
- Department of Obstetrics, West Middlesex University Hospital, Isleworth, UK
| | - C Head
- Cardiology Department, Norfolk and Norwich University Hospital, Norfolk, UK
| | - K English
- Department of Adult Congenital Heart Disease, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - L Hudsmith
- Department of Adult Congenital Heart Disease, University Hospitals Birmingham, Birmingham, UK
| | - R James
- Sussex Cardiac Centre, University Hospitals Sussex, Brighton, UK
| | - M Johnson
- Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
| | - L MacKiliop
- Women's Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - F M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - G Mariappa
- Department of Obstetrics, West Middlesex University Hospital, Isleworth, UK
| | - E Orchard
- Department of Cardiology, Oxford University Hospitals, Oxford, UK
| | - M O'Brien
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - F Siddiqui
- Department of Obstetrics, Royal Leicester Infirmary, Leicester, UK
| | - L Simpson
- Department of Obstetrics, Edinburgh Royal Infirmary, Edinburgh, UK
| | - M Simpson
- Scottish Adult Congenital Cardiac Service, NHS Golden Jubilee, Clydebank, UK
| | - P Timmons
- Maternal Medicine Service, Norfolk and Norwich University Hospital, Norfolk, UK
| | - S Vause
- Saint Mary's Managed Clinical Service, Manchester University Foundation Trust, Manchester, UK
| | - G Wander
- Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
| | - N Walker
- Scottish Adult Congenital Cardiac Service, NHS Golden Jubilee, Clydebank, UK
| | - P J Steer
- Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
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Mitchell B, Saklatvala J, Martin N, Smith C, Barker J, Renteria M, Simpson M. 306 Exploring the relationship between acne and mental health. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.318] [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: 11/19/2022]
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4
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Carrasco-Zanini J, Pietzner M, Lindbohm JV, Wheeler E, Oerton E, Kerrison N, Simpson M, Westacott M, Drolet D, Kivimaki M, Ostroff R, Williams SA, Wareham NJ, Langenberg C. Proteomic signatures for identification of impaired glucose tolerance. Nat Med 2022; 28:2293-2300. [PMID: 36357677 PMCID: PMC7614638 DOI: 10.1038/s41591-022-02055-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 09/27/2022] [Indexed: 11/12/2022]
Abstract
The implementation of recommendations for type 2 diabetes (T2D) screening and diagnosis focuses on the measurement of glycated hemoglobin (HbA1c) and fasting glucose. This approach leaves a large number of individuals with isolated impaired glucose tolerance (iIGT), who are only detectable through oral glucose tolerance tests (OGTTs), at risk of diabetes and its severe complications. We applied machine learning to the proteomic profiles of a single fasted sample from 11,546 participants of the Fenland study to test discrimination of iIGT defined using the gold-standard OGTTs. We observed significantly improved discriminative performance by adding only three proteins (RTN4R, CBPM and GHR) to the best clinical model (AUROC = 0.80 (95% confidence interval: 0.79-0.86), P = 0.004), which we validated in an external cohort. Increased plasma levels of these candidate proteins were associated with an increased risk for future T2D in an independent cohort and were also increased in individuals genetically susceptible to impaired glucose homeostasis and T2D. Assessment of a limited number of proteins can identify individuals likely to be missed by current diagnostic strategies and at high risk of T2D and its complications.
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Affiliation(s)
- Julia Carrasco-Zanini
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Joni V Lindbohm
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
- The Klarman Cell Observatory, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Eleanor Wheeler
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Erin Oerton
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nicola Kerrison
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | | | | | - Mika Kivimaki
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | | | - Nicholas J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK.
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5
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Williams SA, Ostroff R, Hinterberg MA, Coresh J, Ballantyne CM, Matsushita K, Mueller CE, Walter J, Jonasson C, Holman RR, Shah SH, Sattar N, Taylor R, Lean ME, Kato S, Shimokawa H, Sakata Y, Nochioka K, Parikh CR, Coca SG, Omland T, Chadwick J, Astling D, Hagar Y, Kureshi N, Loupy K, Paterson C, Primus J, Simpson M, Trujillo NP, Ganz P. A proteomic surrogate for cardiovascular outcomes that is sensitive to multiple mechanisms of change in risk. Sci Transl Med 2022; 14:eabj9625. [PMID: 35385337 DOI: 10.1126/scitranslmed.abj9625] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A reliable, individualized, and dynamic surrogate of cardiovascular risk, synoptic for key biologic mechanisms, could shorten the path for drug development, enhance drug cost-effectiveness and improve patient outcomes. We used highly multiplexed proteomics to address these objectives, measuring about 5000 proteins in each of 32,130 archived plasma samples from 22,849 participants in nine clinical studies. We used machine learning to derive a 27-protein model predicting 4-year likelihood of myocardial infarction, stroke, heart failure, or death. The 27 proteins encompassed 10 biologic systems, and 12 were associated with relevant causal genetic traits. We independently validated results in 11,609 participants. Compared to a clinical model, the ratio of observed events in quintile 5 to quintile 1 was 6.7 for proteins versus 2.9 for the clinical model, AUCs (95% CI) were 0.73 (0.72 to 0.74) versus 0.64 (0.62 to 0.65), c-statistics were 0.71 (0.69 to 0.72) versus 0.62 (0.60 to 0.63), and the net reclassification index was +0.43. Adding the clinical model to the proteins only improved discrimination metrics by 0.01 to 0.02. Event rates in four predefined protein risk categories were 5.6, 11.2, 20.0, and 43.4% within 4 years; median time to event was 1.71 years. Protein predictions were directionally concordant with changed outcomes. Adverse risks were predicted for aging, approaching an event, anthracycline chemotherapy, diabetes, smoking, rheumatoid arthritis, cancer history, cardiovascular disease, high systolic blood pressure, and lipids. Reduced risks were predicted for weight loss and exenatide. The 27-protein model has potential as a "universal" surrogate end point for cardiovascular risk.
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Affiliation(s)
| | | | | | - Josef Coresh
- Johns Hopkins University, Baltimore, MD 21218, USA
| | | | | | - Christian E Mueller
- Cardiovascular Research Institute, University of Basel, Basel 4001, Switzerland
| | - Joan Walter
- Cardiovascular Research Institute, University of Basel, Basel 4001, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, University of Zürich, Zürich 7491, Switzerland
| | - Christian Jonasson
- Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Rury R Holman
- Diabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK
| | - Svati H Shah
- Division of Cardiology, Duke Department of Medicine, and Duke Molecular Physiology Institute, Duke University, Durham, NC 27710, USA
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Roy Taylor
- Newcastle Magnetic Resonance Centre, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU, UK
| | - Michael E Lean
- School of Medicine, Nursing and Dentistry, University of Glasgow, Glasgow G12 8QQ, UK
| | | | - Hiroaki Shimokawa
- Tohoku University Graduate School of Medicine, Sendai 980-8576, Japan.,Graduate School, International University of Health and Welfare, Narita 286-8686, Japan
| | - Yasuhiko Sakata
- Tohoku University Graduate School of Medicine, Sendai 980-8576, Japan
| | - Kotaro Nochioka
- Tohoku University Graduate School of Medicine, Sendai 980-8576, Japan
| | | | - Steven G Coca
- Mt Sinai Clinical and Translational Science Research Unit, Icahn School of Medicine at Mount Sinai, New York, NY 11766, USA
| | - Torbjørn Omland
- Department of Cardiology, Akershus University Hospital and University of Oslo, Oslo 1478, Norway
| | | | | | | | | | | | | | | | | | | | - Peter Ganz
- Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA 94110, USA
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6
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Saklatvala J, Mitchell B, Martin N, Barker J, Han J, Smith C, Renteria M, Simpson M. 160 Genome-wide association meta-analysis of acne reveals 29 novel risk loci and molecular overlap with Mendelian hair and skin disorders and other complex traits. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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7
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Douroudis K, Ramessur R, Dand N, Smith C, Simpson M. 038 Differences in clinical features and comorbid burden between HLA-C*06:02 carrier groups in more than 9,000 people with psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Tsakok T, Group BS, Consortium P, Smith C, Simpson M. 048 The anti-drug antibody response is associated with amino acid variation within the HLADRB1 peptide-binding groove. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Lowis E, Simpson M. P.124 Ruptured renal artery aneurysm in pregnancy. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Simpson M, Hall JL. Transversus abdominis muscle as a gastric or intestinal on-lay flap in two dogs and one cat. J Small Anim Pract 2021; 62:918-923. [PMID: 33599994 DOI: 10.1111/jsap.13273] [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: 04/15/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Abstract
Historically, omentalisation and serosal patching have been used to augment gastrointestinal wall defects or incisions where gastrointestinal viability is of concern. This report describes the novel use of a transversus abdominis muscle on-lay flap to augment and provide support to compromised intestine in three cases. The muscle flap was used to support: the ileum following reduction of an intussusception in a dog (case 1), the gastric wall following gastric strangulation, dilation and volvulus in a diaphragmatic rupture in a cat (case 2) and the jejunum following enterotomy and full-thickness ulcer resection with primary repair in a dog (case 3). All animals were discharged within 4 days postoperatively with no short- or long-term complications reported by either the referring veterinary surgeons on routine postoperative examination or on telephone follow-up with the owners (case 1: 10 months, case 2: 30 months, case 3: 6 weeks). The creation of a flap of the transversus abdominis muscle may provide a useful alternative or adjunct to previously described techniques for supporting the gastrointestinal tract when gastrointestinal tissue viability is questionable or resection is not feasible. Further prospective clinical evaluation studies would be indicated to determine whether the muscle flap remains viable or compare whether this technique should be recommended over conventional methods.
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Affiliation(s)
- M Simpson
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, EH25 9RG, UK
| | - J L Hall
- Wear Referrals Veterinary Hospital, Bradbury, Stockton-on-Tees, TS212ES, UK
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Woods GA, Simpson M, Boag A, Paris J, Piccinelli C, Breheny C. Complications associated with bone marrow sampling in dogs and cats. J Small Anim Pract 2020; 62:209-215. [PMID: 33274762 DOI: 10.1111/jsap.13274] [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] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the prevalence of complications during bone marrow sampling and associated patient and procedural factors in dogs and cats. MATERIALS AND METHODS Retrospective cohort study, records were evaluated to identify dogs and cats that had bone marrow sampling between 2012 and 2019. Data including signalment, the presence of specific clinicopathological findings, anatomical site of bone marrow sampling, number of attempts, diagnostic quality of sampling, analgesia protocol and complications postprocedure were recorded. RESULTS A total of 131 dogs and 29 cats were included in the study. Complications were recorded in 22 of 160 (14%) of cases. Pain was the most common complication of bone marrow sampling in 20 of 22 (91%) of cases with bruising reported in the remaining patients. A local anaesthetic block was used in 98 of 160 (61%) of patients. CLINICAL SIGNIFICANCE Excluding pain, complications associated with bone marrow sampling were rare and no clear association were detected between patient or procedural variables. Haemorrhage and infection are rare complications in dogs and cats when thrombocytopenia and neutropenia are present. Peri-procedure analgesia is strongly recommended to minimise complications.
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Affiliation(s)
- G A Woods
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK
| | - M Simpson
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK
| | - A Boag
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK.,The Queen's Medical Research Institute, Centre for Cardiovascular Science, University of Edinburgh, EH16 4T, UK
| | - J Paris
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK
| | - C Piccinelli
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK.,Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK
| | - C Breheny
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, EH25 9RG, UK
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Ruple A, Jones M, Simpson M, Page R. The Golden Retriever Lifetime Study: Assessing factors associated with owner compliance after the first year of enrollment. J Vet Intern Med 2020; 35:142-149. [PMID: 33191623 PMCID: PMC7848307 DOI: 10.1111/jvim.15921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 11/29/2022] Open
Abstract
Background The Golden Retriever Lifetime Study (GRLS) is one of the largest canine cohort studies undertaken in the United States to date. This study design allows for evaluation of multiple exposures and outcomes throughout the lifetime of each dog, but relies on participants to comply with study requirements over a long period of time. Failure to do so can lead to biased reporting of results. Objectives To examine factors associated with dog owner compliance for GRLS. Animals Golden Retrievers (n = 3044) whose owners elected to participate in GRLS. Methods Prospective, cohort study. A logistic regression model was constructed to examine associations between data collected at the time of initial enrollment in GRLS and the outcome of failure to fulfill all study obligations at the end of the first year after enrollment in GRLS. Results There were 192 (6.3%) owners who did not comply with study requirements 1 year after enrollment. Owners of dogs without a record of vaccination had nearly 4 times higher odds (adjusted OR: 3.7, 95% CI: 1.5, 9.2) of being noncompliant than owners of vaccinated dogs and owners of dogs that slept in the garage had nearly 6 times higher odds (adjusted OR: 5.7, 95% CI: 1.9, 17.0) of being noncompliant than owners of dogs that slept in their bedroom. Conclusions and Clinical Importance Survey questions about a dog's sleeping location at night and vaccination status are important indicators of an owner's odds of compliance in a prospective study. Use of similar questions during enrollment in cohort studies might help to predict owner compliance that can aid in subject selection.
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Affiliation(s)
- Audrey Ruple
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Melissa Jones
- Department of Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | | | - Rodney Page
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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13
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Young Y, Thompson T, Simpson M. O8 Exploring access to and attitudes towards abortion and contraception among Black women living in the south. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Supsrisunjai C, Chao-kai H, Michael M, Duval C, Lee J, Yang H, Huang H, Chaikul T, Onoufriadis A, Steiner R, Ariens R, Sarig O, Sprecher E, Eskin-Schwartz M, Samlaska C, Simpson M, Calonje J, Parsons M, McGrath J. 259 Coagulation factor XIII-A subunit missense mutation in the pathobiology of autosomal dominant multiple dermatofibromas. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.265] [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: 10/24/2022]
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15
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Wloch K, Simpson M, Gowrie-Mohan S. Local anaesthetic resistance in a patient with Ehlers-Danlos syndrome undergoing caesarean section with continuous spinal anaesthesia. Anaesth Rep 2020; 8:56-58. [PMID: 32537613 DOI: 10.1002/anr3.12040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 02/05/2023] Open
Abstract
A patient with a diagnosis of Ehlers-Danlos syndrome was scheduled to undergo elective caesarean section with a combined spinal-epidural anaesthetic technique. The epidural attempt resulted in an inadvertent dural puncture, and we decided subsequently to place an intrathecal catheter. She required high repeated doses of hyperbaric bupivacaine (32.5 mg over 1 h) through the catheter to establish adequate sensory blockade, together with supplemental analgesic techniques. Soon after the procedure, she recovered motor function rapidly and required further supplemental analgesia. We believe this is the first report of possible local anaesthetic resistance with an intrathecal catheter anaesthetic technique for a patient with Ehlers-Danlos syndrome. If there is resistance to the first dose of intrathecal local anaesthetic, a general anaesthetic may be the best option for such patients.
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Affiliation(s)
- K Wloch
- Addenbrookes Hospital Cambridge UK
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Hevener W, Beine B, Woodruff J, Munafo D, Fernandez C, Rusk S, Nygate Y, Glattard N, Piper D, Sheedy C, Simpson M, Turkington F, Shokoueinejad M. 0636 Using AI To Predict Future CPAP Adherence and the Impact of Behavioral and Technical Interventions. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Clinical management of CPAP adherence remains an ongoing challenge. Behavioral and technical interventions such as patient outreach, coaching, troubleshooting, and resupply may be deployed to positively impact adherence. Previous authors have described adherence phenotypes that retrospectively categorize patients by discrete usage patterns. We design an AI model that predictively categorizes patients into previously studied adherence phenotypes and analyzes the statistical significance and effect size of several types of interventions on subsequent CPAP adherence.
Methods
We collected a cross-sectional cohort of subjects (N = 13,917) with 455 days of daily CPAP usage data acquired. Patient outreach notes and resupply data were temporally synchronized with daily CPAP usage. Each 30-days of usage was categorized into one of four adherence phenotypes as defined by Aloia et al. (2008) including Good Users, Variable Users, Occasional Attempters, and Non-Users. Cross-validation was used to train and evaluate a Recurrent Neural Network model for predicting future adherence phenotypes based on the dynamics of prior usage patterns. Two-sided 95% bootstrap confidence intervals and Cohen’s d statistic were used to analyze the significance and effect size of changes in usage behavior 30-days before and after administration of several resupply interventions.
Results
The AI model predicted the next 30-day adherence phenotype with an average of 90% sensitivity, 96% specificity, 95% accuracy, and 0.83 Cohen’s Kappa. The AI model predicted the number of days of CPAP non-use, use under 4-hours, and use over 4-hours for the next 30-days with OLS Regression R-squared values of 0.94, 0.88, and 0.95 compared to ground truth. Ten resupply interventions were associated with statistically significant increases in adherence, and ranked by adherence effect size using Cohen’s d. The most impactful were new cushions or masks, with a mean post-intervention CPAP adherence increase of 7-14% observed in Variable User, Occasional Attempter, and Non-User groups.
Conclusion
The AI model applied past CPAP usage data to predict future adherence phenotypes and usage with high sensitivity and specificity. We identified resupply interventions that were associated with significant increases in adherence for struggling patients. This work demonstrates a novel application for AI to aid clinicians in maintaining CPAP adherence.
Support
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Affiliation(s)
- W Hevener
- Sleep Data Diagnostics, San Diego, CA
| | - B Beine
- Sleep Data Diagnostics, San Diego, CA
| | | | - D Munafo
- Sleep Data Diagnostics, San Diego, CA
| | | | - S Rusk
- EnsoData Research, EnsoData, Madison, WI
| | - Y Nygate
- EnsoData Research, EnsoData, Madison, WI
| | - N Glattard
- EnsoData Research, EnsoData, Madison, WI
| | - D Piper
- EnsoData Research, EnsoData, Madison, WI
| | - C Sheedy
- EnsoData Research, EnsoData, Madison, WI
| | - M Simpson
- EnsoData Research, EnsoData, Madison, WI
| | | | - M Shokoueinejad
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI
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Horvath D, Dale O, Simpson M. Electrochemical response of various metals to oxygen gas bubbling in molten LiCl–Li2O melt. J Radioanal Nucl Chem 2020. [DOI: 10.1007/s10967-019-06925-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Cauldwell M, Steer PJ, Curtis S, Mohan AR, Dockree S, Mackillop L, Parry H, Oliver J, Sterrenburg M, Bolger A, Siddiqui F, Simpson M, Walker N, Bredaki F, Walker F, Johnson MR. Maternal and fetal outcomes in pregnancies complicated by the inherited aortopathy Loeys-Dietz syndrome. BJOG 2019; 126:1025-1031. [PMID: 30811810 DOI: 10.1111/1471-0528.15670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Pregnancies in women with Loeys-Dietz syndrome (LDS) are rare and are typically documented in case reports only. Early reports suggested high rates of maternal complications during pregnancy and the puerperium, including aortic dissection and uterine rupture, but information on fetal outcomes was very limited. DESIGN A retrospective cohort study. SETTING Eight specialist UK centres. SAMPLE Pregnant women with LDS. METHODS Data was collated on cardiac, obstetric, and neonatal outcomes. MAIN OUTCOME MEASURES Maternal and perinatal outcomes in pregnancies complicated by LDS. RESULTS Twenty pregnancies in 13 women with LDS were identified. There was one miscarriage, one termination of pregnancy, and 18 livebirths. In eight women the diagnosis was known prior to pregnancy but only one woman had preconception counselling. In four women the diagnosis was made during pregnancy through positive genotyping, and the other was diagnosed following delivery. Five women had a family history of aortic dissection. There were no aortic dissections in our cohort during pregnancy or postpartum. Obstetric complications were common, including postpartum haemorrhage (33%) and preterm delivery (50%). In all, 14/18 (78%) of deliveries were by elective caesarean section, at a median gestational age at delivery of 37 weeks. Over half the infants (56%) were admitted to the neonatal unit following delivery. CONCLUSION Women with LDS require multidisciplinary specialist management throughout pregnancy. Women should be referred for preconception counselling to make informed decisions around pregnancy risk and outcomes. Early elective preterm delivery needs to be balanced against a high infant admission rate to the neonatal unit. TWEETABLE ABSTRACT Pregnancy outcomes in women with Loeys-Dietz syndrome.
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Affiliation(s)
- M Cauldwell
- Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
| | - P J Steer
- Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
| | - S Curtis
- Adult Congenital Heart Disease Service, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A R Mohan
- Department of Obstetrics, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - S Dockree
- Women's Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - L Mackillop
- Women's Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - H Parry
- Department of Adult Congenital Heart Disease, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Oliver
- Department of Adult Congenital Heart Disease, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M Sterrenburg
- Department of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, UK
| | - A Bolger
- Department of Adult Congenital Heart Disease, Glenfield Hospital, Leicester, UK
| | - F Siddiqui
- Department of Obstetrics, Royal Leicester Infirmary, Leicester, UK
| | - M Simpson
- Scottish Adult Congenital Cardiac Service, Golden Jubilee National Hospital, Glasgow, UK
| | - N Walker
- Department of Obstetrics, University College Hospital, London, UK
| | - F Bredaki
- Department of Adult Congenital Heart Disease, Bart's Heart Centre, London, UK
| | - F Walker
- Department of Adult Congenital Heart Disease, Bart's Heart Centre, London, UK
| | - M R Johnson
- Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
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Simpson M, Mak M. The effect of transcranial direct current stimulation on motor cortex activity in Parkinson’s disease: A proof-of-principle fNIRS study. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Miskovic A, Simpson M, Dominguez JE, Bullough AS. Recognising obstructive sleep apnoea in pregnancy - a survey of UK obstetric anaesthetists. Anaesthesia 2019; 72:1564. [PMID: 29130279 DOI: 10.1111/anae.14151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Miskovic
- Great Ormond Street Hospital, London, UK
| | - M Simpson
- St James' University Hospital, Leeds, UK
| | | | - A S Bullough
- Loyola University Medical Center, Maywood, IL, USA
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Portacolone E, Covinsky K, Halpern J, Rubinstein R, Ortez Alfaro J, Simpson M, Coleman P, Johnson J. OLDER AFRICAN AMERICANS LIVING ALONE WITH COGNITIVE IMPAIRMENT: PRIORITIES AND CONCERNS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - J Halpern
- School of Public Health, University of California Berkeley
| | | | | | - M Simpson
- University of California San Francisco
| | | | - J Johnson
- University of California San Francisco
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Ducore J, Lawrence JB, Simpson M, Boggio L, Bellon A, Burggraaf J, Stevens J, Moerland M, Frieling J, Reijers J, Wang M. Safety and dose-dependency of eptacog beta (activated) in a dose escalation study of non-bleeding congenital haemophilia A or B patients, with or without inhibitors. Haemophilia 2017; 23:844-851. [PMID: 28984010 DOI: 10.1111/hae.13357] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Varying initial doses of activated eptacog beta (recombinant human FVIIa, rhFVIIa) may provide therapeutic options when treating bleeding in patients with congenital haemophilia who have developed inhibitory antibodies to factor VIII (FVIII) or factor IX (FIX). This study evaluated escalated doses of a new rhFVIIa product as a prelude to selecting the doses for clinical efficacy evaluation in haemophilia patients. AIM To assess the safety, pharmacokinetics, and laboratory pharmacodynamics of 3 doses of rhFVIIa in non-bleeding patients with congenital haemophilia A or B with or without inhibitors. METHODS Adult male patients (18-75 years old) with congenital haemophilia A or B (with or without inhibitors) received infusions of rhFVIIa at doses of 25, 75 or 225 μg/kg body weight. Ten patients were treated at each dose level, and each patient received 2 different dose levels. Descriptive methods were used to analyse the data. RESULTS Administration of rhFVIIa at all doses was well tolerated. Pharmacokinetic analyses showed that peak FVIIa plasma levels (Cmax ) were approximately proportional to dose and correlated well with peak thrombin generation. Total AUC0-inf also was approximately dose proportional. Clot formation and duration correlated with FVIIa activity. Repeat doses did not produce an immunological response. CONCLUSION In the first dose-escalation study of rhFVIIa to support product registration, eptacog beta at doses of 25, 75, and 225 μg/kg was pharmacodynamically active and well tolerated in non-bleeding patients with congenital haemophilia A or B.
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Affiliation(s)
- J Ducore
- University of California, Davis Health System, Sacramento, CA, USA
| | | | - M Simpson
- Rush University Medical Center, Chicago, IL, USA
| | - L Boggio
- Rush University Medical Center, Chicago, IL, USA
| | | | - J Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands
| | - J Stevens
- Centre for Human Drug Research, Leiden, The Netherlands
| | - M Moerland
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | - J Reijers
- Centre for Human Drug Research, Leiden, The Netherlands
| | - M Wang
- Hemophilia & Thrombosis Center, University of Colorado, Aurora, CO, USA
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Cauldwell M, Steer P, Coats L, Hodson K, Head C, Jakes A, Bonner S, Maudin L, Abraham D, English K, Walker N, Simpson M, Bolger A, Siddiqui F, Johnson M. 969Pregnancy outcomes in a cohort of women with a Fontan repair: a UK multicentre study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Simpson M. Birds of the Darwin region. N McCrie and R Noske. CSIRO publishing, 2015. 464 pages. A$79.95. ISBN 9781486300341. Aust Vet J 2017. [DOI: 10.1111/avj.12520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Champney F, Maddock L, Welford J, Kemp J, Allan V, Persidskikh Y, Orini M, Ang R, Workman A, Wong L, Honarbakhsh S, Leong K, Silberbauer J, O'Nunain S, Gomes J, McCready J, Bostock J, Shaw K, McKenna C, Bailey J, Honarbakhsh S, Casas J, Wallace J, Hunter R, Schilling R, Perel P, Morley K, Banerjee A, Hemingway H, Mrochak A, Ilyina T, Goncharik D, Chasnoits A, Plashinskaya L, Taggart P, Hayward M, Lambiase P, Hosford P, Kasparov S, Lambiase P, Tinker A, Gourine A, Kettlewell S, Dempster J, Colman M, Rankin A, Myles R, Smith G, Tester D, Jaye A, FitzPatrick D, Evans M, Fleming P, Jeffrey I, Cohen M, Simpson M, Ackerman M, Behr E, Srinivasan N, Kirkby C, Firman E, Tobin L, Murphy C, Lowe M, Hunter RJ, Finlay M, Schilling RJ, Lambiase PD, Ng F, Tomlinson L, Nuthoo S, Cajilog E, Lefroy D, Qureshi N, Koa-Wing M, Whinnett Z, Linton N, Davies D, Lim P, Peters N, Kanagaratnam P, Varnava A. ORAL ABSTRACTS (1)Allied Professionals7CRYOABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION - IS AN EP LAB REQUIRED?8A PATHWAY TO SAFETY - ANTICOAGULATION COMPLIANCE IN CIED PATIENTS WITH AF9UNDERSTANDING THE WAYS IN WHICH OCCUPATION IS AFFECTED BY POSTURAL TACHYCARDIA SYNDROME: A UK OCCUPATIONAL THERAPY PERSPECTIVE10DEVELOPMENT OF AN INTERGRATED SUPPORT PATHWAY FOR PATIENTS FULFILLING NICE CRITERIA FOR AN INTERNAL CARDIOVASCULAR DEBRIBRILLATOR (ICD) IN A DISTRICT GENERAL HOSPITAL11ARE CARDIOVASCULAR RISK FACTORS ALSO ASSOCIATED WITH THE INCIDENCE OF ATRIAL FIBRILLATION? A SYSTEMATIC REVIEW AND FIELD SYNOPSIS OF 23 FACTORS IN 32 INITIALLY HEALTHY COHORTS OF 20 MILLION PARTICIPANTS12BRAIN MRI FINDINGS IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING CARDIOVERSIONBasic Science/Sudden Cardiac Death13PRELIMINARY ASSESSMENT OF THE “RE-ENTRY VULNERABILITY INDEX” AS A MARKER OF CARDIAC INSTABILITY IN THE HUMAN HEART USING WHOLE-HEART CONTACT EPICARDIAL MAPPING14OPTOGENETIC STIMULATION OF BRAINSTEM'S VAGAL PREGANGLIONIC NEURONES IS ASSOCIATED WITH NEURONAL NITRIC OXIDE SYNTHASE-DEPENDENT PROLONGATION OF VENTRICULAR EFFECTIVE REFRACTORY PERIOD15A DYNAMIC-CLAMP STUDY OF L-TYPE Ca2+ CURRENT IN RABBIT AND HUMAN ATRIAL MYOCYTES: THE CONTRIBUTION OF WINDOW ICaL TO EARLY AFTERDEPOLARISATIONS16WHOLE EXOME SEQUENCING IN SUDDEN INFANT DEATH SYNDROME17MEDIUM TERM SURVIVAL AND FAMILY SCREENING OUTCOMES IN AN IDIOPATHIC VENTRICULAR FIBRILLATION COHORT - A MULTICENTRE EXPERIENCE18CLINICAL CHARACTERISTICS OF SCD SURVIVORS WITH BRUGADA SYNDROME:- ARE SPONSANEOUS TYPE I ECG AND PREVIOUS SYNCOPE REALLY ASSOCIATED WITH HIGH RISK? Europace 2016. [DOI: 10.1093/europace/euw270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Simpson M, Navarini A, Smith C, Barker J. 148 Identification of multiple genetic loci associated with severe acne vulgaris. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Klamroth R, Simpson M, von Depka-Prondzinski M, Gill JC, Morfini M, Powell JS, Santagostino E, Davis J, Huth-Kühne A, Leissinger C, Neumeister P, Bensen-Kennedy D, Feussner A, Limsakun T, Zhou M, Veldman A, St Ledger K, Blackman N, Pabinger I. Comparative pharmacokinetics of rVIII-SingleChain and octocog alfa (Advate(®) ) in patients with severe haemophilia A. Haemophilia 2016; 22:730-8. [PMID: 27434619 DOI: 10.1111/hae.12985] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND rVIII-SingleChain, a novel recombinant factor VIII (rFVIII), has been designed as a B-domain truncated construct with covalently bonded heavy and light chains, aiming to increase binding affinity to von Willebrand factor (VWF). Preclinical studies confirmed greater affinity for VWF, giving improved pharmacokinetic and pharmacodynamic properties compared with full-length rFVIII. AIM To investigate the pharmacokinetics of rVIII-SingleChain and compare them against those of full-length rFVIII. METHODS This study enrolled 27 patients with severe haemophilia A in the AFFINITY clinical trial programme. After a 4-day washout period, all patients received a single infusion of 50 IU kg(-1) octocog alfa (Advate(®) ); after a ≥4-day postinfusion washout period, they received a single infusion of 50 IU kg(-1) rVIII-SingleChain. Blood samples for pharmacokinetic assessments of each product were collected before infusion (predose) and at 0.5, 1, 4, 8, 10, 24, 32, 48 and 72 h postinfusion for both products. RESULTS rVIII-SingleChain had a longer mean half-life (t1/2 ) (14.5 vs. 13.3 h), lower mean clearance (CL) (2.64 vs. 3.68 mL h(-1) kg(-1) ), higher mean residence time (20.4 vs. 17.1 h) and larger mean AUCinf (2090 vs. 1550 IU?h dL(-1) ) than octocog alfa, respectively. The mean AUCinf after rVIII-SingleChain infusion was ~35% larger than after octocog alfa. A similar pattern was observed for AUC0-last . No serious adverse events or inhibitors were reported. CONCLUSIONS rVIII-SingleChain has a favourable pharmacokinetic profile compared with octocog alfa and was well tolerated. The prolonged t1/2 , larger AUC and reduced CL of rVIII-SingleChain may permit longer dosing intervals, thereby improving patient adherence to prophylactic treatment.
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Affiliation(s)
- R Klamroth
- Department for Internal Medicine, Vascular Medicine and Haemostaseology, Vivantes Klinikum, Berlin Friedrichshain, Germany
| | - M Simpson
- Rush University Medical Center, Chicago, IL, USA
| | | | - J C Gill
- Medical College of Wisconsin and Blood Center of Wisconsin, Milwaukee, WI, USA
| | - M Morfini
- Ospedaliero Universitaria Careggi, Firenze, Italy
| | - J S Powell
- Hemophilia Treatment Center, UC Davis, Sacramento, CA, USA
| | - E Santagostino
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - J Davis
- University of Miami Hemophilia Treatment Center, Miami, FL, USA
| | - A Huth-Kühne
- Hämophiliezentrum und Gerinnungsambulanz SRH Kurpfalzkrankenhaus, Heidelberg, Germany
| | - C Leissinger
- Louisiana Center for Bleeding and Clotting Disorders, New Orleans, LA, USA
| | - P Neumeister
- Klinische Abteilung für Hämatologie, Medizinische Universität of Graz, Graz, Austria
| | | | - A Feussner
- Clinical R&D, CSL Behring, Marburg, Germany
| | - T Limsakun
- Clinical R&D, CSL Behring, King of Prussia, PA, USA
| | - M Zhou
- Clinical R&D, CSL Behring, King of Prussia, PA, USA
| | - A Veldman
- Clinical R&D, CSL Behring, Marburg, Germany
| | - K St Ledger
- Clinical R&D, CSL Behring, King of Prussia, PA, USA
| | - N Blackman
- Clinical R&D, CSL Behring, King of Prussia, PA, USA
| | - I Pabinger
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
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Mauro D, Lewis M, Pullabhatla V, Vyse S, Simpson M, Cunninghame-Graham D, Syvanen A, Pitzalis C, de Rinaldis E, Vyse T. OP0232 C1qtnf4 Mutation Identified by Exome Sequencing Is Associated with Systemic Lupus Erythematosus and Dysregulation of Tnf-Induced Apoptosis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5597] [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: 11/04/2022]
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Leung J, Harvey L, Moseley A, Whiteside B, Simpson M, Stroud K. Multimodal approach for contracture management after severe traumatic brain injury: a randomised controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shah P, Patel J, Mirza T, Shadid O, Simpson M. Simple orofacial infection resulting in the development of bilateral septic pulmonary emboli - a case of Lemierre's syndrome. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Henry R, Hartley B, Simpson M, Doyle N. The development and evaluation of a holistic needs assessment and care planning learning package targeted at cancer nurses in the UK. Ecancermedicalscience 2014; 8:416. [PMID: 24761157 PMCID: PMC3990662 DOI: 10.3332/ecancer.2014.416] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Indexed: 01/09/2023] Open
Abstract
A project team from the United Kingdom Oncology Nursing Society developed a blended e-learning website to facilitate nurses to further develop their confidence and competencies in a range of skills related to assessing the holistic needs of people with cancer. The project team identified three areas which were integral to an holistic needs assessment (HNA) implementation project. These were project support information, project management skills, and practical competencies delivered in a blended e-learning package containing a series of accessible video presentations, supporting documents, and practical activities. The team worked with internal and external partners to ensure that a robust and inspiring programme was created. www.hnaforcancer.com was launched in October 2012 as a blended learning programme that incorporates e-learning on core subjects. These subjects are packaged as videoed presentations with supporting learning material and can be accessed via the UKONS website. By the end of the programme participants were equipped to identify and explore the essential requirements for HNA and care planning, more able to recognise potential need, and initiate care to prevent or minimise the risk of complications. Participants had also developed confidence and competency in new skills, including basic project management.
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Affiliation(s)
- R Henry
- Living With and Beyond Cancer Forum, The United Kingdom Oncology Nursing Society (UKONS), London, UK
| | - B Hartley
- Living With and Beyond Cancer Forum, The United Kingdom Oncology Nursing Society (UKONS), London, UK
| | - M Simpson
- Living With and Beyond Cancer Forum, The United Kingdom Oncology Nursing Society (UKONS), London, UK
| | - N Doyle
- Living With and Beyond Cancer Forum, The United Kingdom Oncology Nursing Society (UKONS), London, UK
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McPhelim J, Maguire R, Simpson M. 110 Delivering better supportive care to people with lung cancer. Lung Cancer 2014. [DOI: 10.1016/s0169-5002(14)70110-2] [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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Simpson M, Smith TO. Quadriceps tendinopathy — a forgotten pathology for physiotherapists? A systematic review of the current evidence-base. Physical Therapy Reviews 2013. [DOI: 10.1179/1743288x11y.0000000035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Makrythanasis P, van Bon BW, Steehouwer M, Rodríguez-Santiago B, Simpson M, Dias P, Anderlid BM, Arts P, Bhat M, Augello B, Biamino E, Bongers EMHF, del Campo M, Cordeiro I, Cueto-González AM, Cuscó I, Deshpande C, Frysira E, Izatt L, Flores R, Galán E, Gener B, Gilissen C, Granneman SM, Hoyer J, Yntema HG, Kets CM, Koolen DA, Marcelis CL, Medeira A, Micale L, Mohammed S, de Munnik SA, Nordgren A, Psoni S, Reardon W, Revencu N, Roscioli T, Ruiterkamp-Versteeg M, Santos HG, Schoumans J, Schuurs-Hoeijmakers JHM, Silengo MC, Toledo L, Vendrell T, van der Burgt I, van Lier B, Zweier C, Reymond A, Trembath RC, Perez-Jurado L, Dupont J, de Vries BBA, Brunner HG, Veltman JA, Merla G, Antonarakis SE, Hoischen A. MLL2mutation detection in 86 patients with Kabuki syndrome: a genotype-phenotype study. Clin Genet 2013; 84:539-45. [DOI: 10.1111/cge.12081] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 01/25/2023]
Affiliation(s)
- P Makrythanasis
- Departement of Genetic Medicine and Development; University of Geneva; Geneva Switzerland
| | - BW van Bon
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - M Steehouwer
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - B Rodríguez-Santiago
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
| | - M Simpson
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - P Dias
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - BM Anderlid
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine; Karolinska Institutet
- Department of Clinical Genetics; Karolinska University Hospital; Stockholm Sweden
| | - P Arts
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - M Bhat
- Centre for Human Genetics; Bangalore India
| | - B Augello
- Medical Genetics Unit; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo
| | - E Biamino
- Dipartimento di Scienze Pediatriche; Università di Torino; Torino Italy
| | - EMHF Bongers
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - M del Campo
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
- Programa de Medicina Molecular y Genética; Hospital Vall d'Hebron
| | - I Cordeiro
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - AM Cueto-González
- Programa de Medicina Molecular y Genética; Hospital Vall d'Hebron
- Pediatric Service, Hospital Universitari Mútua de Terrassa; Terrassa (Barcelona) Spain
| | - I Cuscó
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
| | - C Deshpande
- Clinical Genetics, Guy's Hospital; Guy's and St. Thomas' National Health Service (NHS) Foundation Trust; London UK
| | - E Frysira
- Laboratory of Medical Genetics, Medical School; University of Athens; Athens Greece
| | - L Izatt
- Servicio de Genética, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo; Bizkaia, Spain
| | - R Flores
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
| | - E Galán
- Servicio de Genética, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo; Bizkaia, Spain
| | - B Gener
- Clinical Genetics Unit; Hospital de Cruces; Barakaldo Bizkaia Spain
| | - C Gilissen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - SM Granneman
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - J Hoyer
- Institute of Human Genetics; Friedrich-Alexander-University Erlangen-Nuremberg; Erlangen Germany
| | - HG Yntema
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - CM Kets
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - DA Koolen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - CL Marcelis
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - A Medeira
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - L Micale
- Department of Clinical Genetics; Karolinska University Hospital; Stockholm Sweden
| | - S Mohammed
- Clinical Genetics, Guy's Hospital; Guy's and St. Thomas' National Health Service (NHS) Foundation Trust; London UK
| | - SA de Munnik
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - A Nordgren
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine; Karolinska Institutet
- Department of Clinical Genetics; Karolinska University Hospital; Stockholm Sweden
| | - S Psoni
- Laboratory of Medical Genetics, Medical School; University of Athens; Athens Greece
| | - W Reardon
- National Centre for Medical Genetics; Our Lady's Hospital for Sick Children; Dublin 12 Ireland
| | - N Revencu
- Centre for Human Genetics, Cliniques Universitaires Saint-Luc; Université Catholique de Louvain; Brussels Belgium
| | - T Roscioli
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- School of Women's and Children's Health, Sydney Children's Hospital; University of New South Wales; Sydney Australia
| | - M Ruiterkamp-Versteeg
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - HG Santos
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - J Schoumans
- Department of Medical Genetics, Cancer Cytogenetic Unit; University Hospital of Lausanne; Lausanne Switzerland
- Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - JHM Schuurs-Hoeijmakers
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - MC Silengo
- Dipartimento di Scienze Pediatriche; Università di Torino; Torino Italy
| | - L Toledo
- Hospital Materno Infantil; Unidad de Neurologia Infantil; Las Palmas de Gran Canaria Spain
| | - T Vendrell
- Programa de Medicina Molecular y Genética; Hospital Vall d'Hebron
| | - I van der Burgt
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - B van Lier
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - C Zweier
- Institute of Human Genetics; Friedrich-Alexander-University Erlangen-Nuremberg; Erlangen Germany
| | - A Reymond
- The Center for Integrative Genomics; University of Lausanne; Lausanne
| | - RC Trembath
- Division of Genetics and Molecular Medicine, Guy's Hospital; King's College London School of Medicine; London UK
| | - L Perez-Jurado
- Unitat de Genètica; Universitat Pompeu Fabra
- Hospital del Mas Medical Research Institute (IMIM)
- Quantitative Genomic Medicine Laboratories, Ltd (qGenomics); Barcelona Spain
- CIBER de enfermedades raras (CIBERER)
| | - J Dupont
- Hospital de Santa Maria; Serviço de Genética Médica; Lisbon Portugal
| | - BBA de Vries
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - HG Brunner
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - JA Veltman
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - G Merla
- Medical Genetics Unit; IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo
| | - SE Antonarakis
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Service of Genetic Medicine; University Hospitals of Geneva; Geneva Switzerland
| | - A Hoischen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences and Institute for Genetic and Metabolic Disorders; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
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Lees DC, Simpson M, McKay E, Owen SJ. P48 Should chronic obstructive pulmonary disease be a contra-indication to blocker prescription in patients with concomitant heart failure? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.48] [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: 11/04/2022]
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Simpson M, Brady H, Yin X, Seifert J, Barriga K, Hoffman M, Bugawan T, Barón AE, Sokol RJ, Eisenbarth G, Erlich H, Rewers M, Norris JM. No association of vitamin D intake or 25-hydroxyvitamin D levels in childhood with risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young (DAISY). Diabetologia 2011; 54:2779-88. [PMID: 21858504 PMCID: PMC3478880 DOI: 10.1007/s00125-011-2278-2] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [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: 03/07/2011] [Accepted: 07/25/2011] [Indexed: 12/19/2022]
Abstract
AIMS/HYPOTHESIS The aim of the study was to investigate the association between vitamin D intake and status and the risk of islet autoimmunity (IA) and subsequent type 1 diabetes in children at increased risk of type 1 diabetes. METHODS The Diabetes Autoimmunity Study in the Young (DAISY) in Denver, CO, USA, has been following children at increased risk of diabetes since 1993. As of February 2011, 198 children developed IA during follow-up of 2,644 DAISY children. Vitamin D intake and plasma 25-hydroxyvitamin D [25(OH)D] were measured longitudinally. Proportional hazards regression analyses of time to IA, or type 1 diabetes in IA-positive children, were conducted, with vitamin D intake and 25(OH)D as time-varying covariates. HRs were calculated for a standard deviation difference in exposure, with adjustment for confounders. RESULTS Intake of vitamin D was not associated with the risk of IA (adjusted HR 1.13; 95% CI 0.95, 1.35; p = 0.18) nor progression to diabetes in IA-positive children (adjusted HR 1.30; 95% CI 0.91, 1.86; p = 0.15). Moreover, 25(OH)D level was not associated with the risk of IA (adjusted HR 1.12; 95% CI 0.88, 1.43; p = 0.36), nor progression to diabetes in IA-positive children (adjusted HR 0.91; 95% CI 0.68, 1.22; p = 0.54). In the 128 children in whom we measured 25(OH)D at 9 months of age, 25(OH)D was not associated with risk of IA (n = 30 IA-positive children) (adjusted HR 1.02; 95% CI 0.96, 1.07; p = 0.58). CONCLUSIONS/INTERPRETATION Neither vitamin D intake nor 25(OH)D levels throughout childhood were associated with the risk of IA or progression to type 1 diabetes in our population.
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Affiliation(s)
- M. Simpson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, 13001 East 17th Place, Campus Box B119, Aurora, CO 80045, USA
| | - H. Brady
- University of Colorado Boulder, Boulder, CO, USA
| | - X. Yin
- Colorado School of Public Health, Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
| | - J. Seifert
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, 13001 East 17th Place, Campus Box B119, Aurora, CO 80045, USA
| | - K. Barriga
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - M. Hoffman
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - T. Bugawan
- Roche Molecular Systems Inc., Alameda, CA, USA
| | - A. E. Barón
- Colorado School of Public Health, Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
| | - R. J. Sokol
- The Children’s Hospital of Denver, Aurora, CO, USA
| | - G. Eisenbarth
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - H. Erlich
- Roche Molecular Systems Inc., Alameda, CA, USA
| | - M. Rewers
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - J. M. Norris
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, 13001 East 17th Place, Campus Box B119, Aurora, CO 80045, USA
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Papadopoulou C, Kotronoulas G, Simpson M, Maguire R. 4237 POSTER Supportive Care Needs of Patients With Lung Cancer – a Systematic Review of the Literature. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71403-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kotronoulas G, Papadopoulou C, Simpson M, Maguire R. 4232 POSTER Patient Reported Outcome Measures (PROM) for the Delivery of Supportive Care to People With Lung Cancer – Identification and Selection of Existent Tools. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71398-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Parbhoo A, Simpson M. Treatment of soft tissue invasion of a large recurrent keratocystic odontogenic tumour by marsupialisation alone. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Simpson M. Robert Angus Fletcher Gilbert. West J Med 2010. [DOI: 10.1136/bmj.c3180] [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: 11/04/2022]
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Abstract
AIM As antibiotics are generally not recommended for the treatment of acute sore throat, the availability of clinically efficacious, over-the-counter (OTC) treatment alternatives is becoming increasingly important. This study was designed to determine the analgesic properties of amylmetacresol and 2,4-dichlorobenzyl alcohol (AMC/DCBA) throat lozenges (Strepsils) in the relief of acute sore throat caused by upper respiratory tract infections. METHODS Patients (n = 310) were randomly assigned to receive AMC/DCBA throat lozenges (n = 155) or non-medicated placebo lozenges (n = 155). After baseline assessments, patients completed three rating assessments at 10 timepoints from 5 to 20 min after first dose. Subsequent lozenges were taken as required, and assessments were made at the end of Day 1, 24 h after first dose, and at the end of Days 2 and 3. Analgesic properties were assessed by comparing severity of throat soreness and sore throat relief ratings. Difficulty in swallowing and functional impairment scores were also assessed. RESULTS Amylmetacresol/DCBA throat lozenges reduced throat soreness at 5 min after first dose, which persisted for 2 h and was significantly different vs. non-medicated lozenges at all assessment timepoints for the duration of the 3-day study. Similar significant effects were observed with sore throat relief, easing of difficulty with swallowing and functional impairment scores. There were no differences in adverse events reported between treatment groups. CONCLUSION Amylmetacresol/DCBA throat lozenges provide rapid analgesic effects that last for 2 h, providing ongoing relief long after the lozenge has dissolved. The superior analgesic effects and improvements in functional impairment scores observed with AMC/DCBA throat lozenges translate into pain relief benefits that are clinically meaningful and are thus a suitable OTC treatment option for patients in the self-management of acute sore throat.
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Simpson M, Mojibian M, Barriga K, Scott F, Fasano A, Rewers M, Norris J. An exploration of Glo-3A antibody levels in children at increased risk for type 1 diabetes mellitus. Pediatr Diabetes 2009; 10:563-72. [PMID: 19622083 PMCID: PMC2814050 DOI: 10.1111/j.1399-5448.2009.00541.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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: 11/29/2022] Open
Abstract
AIMS To determine whether Glo-3A, (formerly referred to as homologue of Glb1 or Glb1) antibodies are associated with islet autoimmunity (IA) in children at increased risk for type 1 diabetes (T1D) and to investigate their relation with environmental correlates of T1D. METHODS We selected a sample from the Diabetes Autoimmunity Study in the Young (DAISY), a prospective study of children at increased risk for T1D. Cases were positive for insulin, glutamic acid decarboxylase (GAD), or insulinoma-associated antigen-2 (IA-2) autoantibodies on two consecutive visits and either diagnosed with diabetes mellitus or still autoantibody positive when selected. Controls were from the same increased risk group, of similar age as the cases but negative for autoantibodies. Sera from 91 IA cases and 82 controls were analyzed in a blinded manner for immunoglobulin G (IgG) antibodies to Glo-3A by ELISA. RESULTS Adjusting for family history of T1D and human leukocyte antigen (HLA)-DR4 positivity, Glo-3A antibodies were not associated with IA case status (OR: 1.01, 95% CI: 0.99-1.03). Adjusting for age, family history of T1D, and HLA-DR4 positivity, Glo-3A antibody levels were inversely associated with breast-feeding duration (beta = -0.08, p = 0.001) and directly associated with current intake of foods containing gluten (beta = 0.24, p = 0.007) in IA cases but not in controls. Zonulin, a biomarker of gut permeability, was directly associated with Glo-3A antibody levels in cases (beta = 0.73, p = 0.003) but not in controls. CONCLUSION Differing correlates of Glo-3A antibodies in IA cases and controls suggest an underlying difference in mucosal immune response.
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Affiliation(s)
- M. Simpson
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - M. Mojibian
- Ottawa Health Research Institute, Ottawa, Ontario K1H8L6, Canada
| | - K. Barriga
- Barbara Davis Center for Childhood Diabetes, University Of Colorado Denver, Aurora, CO, USA
| | - F.W. Scott
- Ottawa Health Research Institute, Ottawa, Ontario K1H8L6, Canada
| | - A. Fasano
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - M. Rewers
- Barbara Davis Center for Childhood Diabetes, University Of Colorado Denver, Aurora, CO, USA
| | - J.M. Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
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Bhatia S, Smith P, Arx D, Simpson M. Human factors in maxillofacial surgery; reducing human errors. Br J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.bjoms.2009.06.172] [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: 10/20/2022]
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Lappin G, Simpson M, Shishikura Y, Garner C. High-performance liquid chromatography accelerator mass spectrometry: Correcting for losses during analysis by internal standardization. Anal Biochem 2008; 378:93-5. [DOI: 10.1016/j.ab.2008.03.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 03/17/2008] [Accepted: 03/19/2008] [Indexed: 11/26/2022]
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Simpson M, Duncan C, Knight R, Strachan MWJ. An evolving headache. Pract Neurol 2008; 8:62-5. [DOI: 10.1136/jnnp.2007.140970] [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: 11/04/2022]
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Kinders R, Parchment RE, Ji J, Kummar S, Murgo AJ, Gutierrez M, Collins J, Rubinstein L, Pickeral O, Steinberg SM, Yang S, Hollingshead M, Chen A, Helman L, Wiltrout R, Simpson M, Tomaszewski JE, Doroshow JH. Phase 0 Clinical Trials in Cancer Drug Development: From FDA Guidance to Clinical Practice. Mol Interv 2007; 7:325-34. [DOI: 10.1124/mi.7.6.9] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Koh S, Simpson M, Lin Y. Uncertainty and contingency plans in ERP‐controlled manufacturing environments. Journal of Ent Info Management 2006. [DOI: 10.1108/17410390610708508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lora A, Simpson M, Freed M, Milzman D. Impact of depressive illness on emergency department recidivism: a new approach to the “frequent flyer”. Ann Emerg Med 2004. [DOI: 10.1016/j.annemergmed.2004.07.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Graffen M, Kennedy D, Simpson M. Quality use of medicines in the rural ambulant elderly: a pilot study. Rural Remote Health 2004; 4:184. [PMID: 15885009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
INTRODUCTION Australia has a rapidly ageing population, especially in rural areas, and strategies to address medicines and the elderly are particularly relevant. The aims of this 18 month study, therefore, were to: (1) determine the influence of a medication review on the quality of life of elderly ambulatory patients managed by a general practitioner; and (2) assess the impact of the medication review process on health outcomes such as medication-related hospital admissions in ambulant elderly patients actively managed by their GP. METHODS The study was conducted within the area serviced by the rural Riverina Division of General Practice, New South Wales, Australia. Patients were identified by clinical audit, and recruited to the study if they met the inclusion criteria of being: older than 65 years, ambulant, living independently and on five or more medications. The study sample consisted of 402 participants (156 men, 38.8%; 246 women, 61.2%). Fifty-eight participants withdrew from the study for a variety of reasons. A two-group (intervention, control) pre- and post-intervention randomized study design was utilized. Quality of life was assessed using SF-36. The medication history and clinical details of the 202 study participants were reviewed by the project pharmacist and their GP. Medication changes were suggested to patients by their GP and follow-up SF36 and review of hospitalisation episodes were conducted after 6 months. RESULTS 3382 medications were identified as being taken, an average of 8.4 medications per patient. After the initial medication review, the study pharmacist suggested an alteration in dose, form or frequency for 687 medications in the intervention group. The GPs recommended an alteration in 243 of patient medications. Of the entire study population (n = 402), only two participants' admission to hospital was specifically attributed to medication-related issues. There were no significant differences between the quality of life assessments for the combined groups; however, the intervention group recorded significantly higher scores in two of the nine dimensions measured: vitality (p 0.009) and mental health (p 0.0001), at the post-intervention assessment. CONCLUSION While the intervention did not reduce hospitalisation episodes and only led to a modest improvement in quality of life, the development of a mutually acceptable form of face-to-face pharmacist/GP medication review, identification of potentially serious adverse drug reactions, identification of previously unreported complementary medicine use, and enhanced GP awareness of the risks of polypharmacy were positive outcomes of the study.
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Affiliation(s)
- M Graffen
- Riverina Division of General Practice, Wagga Wagga, New South Wales, Australia. m.graffen @swsahs.nsw.gov.au
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Abstract
BACKGROUND Renal replacement therapy (RRT) for acute renal failure (ARF) may be provided in many settings within the hospital. Such patients require a high level of care and often have a poor prognosis. No prospective studies have accurately defined this population, making the prediction of necessary resources and the planning of services difficult. AIM To ascertain the incidence, causes and outcomes of acute renal failure requiring renal replacement therapy in Scotland. DESIGN A prospective observational census of all clinical areas providing renal replacement therapy in three Scottish health boards (Grampian, Highland, Tayside). METHODS Patients were identified by liaison with each unit providing RRT. Factors precipitating renal failure and reasons for RRT were recorded at the time of initiation. Comorbid disease burden was scored using the Charlson index. Patient status at 90 days was assessed from case-notes, contacting general practitioners where necessary. RESULTS 375 patients per million population per year received RRT; 203 per million per year for either ARF or acute-on-chronic renal failure. 73.5% of patients receiving RRT for ARF died within 90 days, 23.5% became independent of RRT. The median duration of hospital admission was 19 days. DISCUSSION The annual incidence of ARF requiring RRT is just over 200 per million population, almost twice that of end-stage renal disease requiring RRT. Such treatment places high demands upon health care resources.
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Affiliation(s)
- W Metcalfe
- Department of Medicine and Therapeutics, University of Aberdeen, Glasgow Royal Infirmary, Glasgow, UK.
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