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Brown P, Cooper C, Dening KH, Hoe J, Burton A. An exploration of how specialist dementia nurses perceive and maintain the skills and competencies that frame their specialism: A qualitative survey. Heliyon 2024; 10:e27856. [PMID: 38596077 PMCID: PMC11001773 DOI: 10.1016/j.heliyon.2024.e27856] [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: 08/11/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/11/2024] Open
Abstract
Background UK policy for complex and long-term health conditions including dementia has recommended that specialist nursing intervention is offered across the trajectory of the condition, but there is a lack of agreement regarding the skills and competencies that specialist nurses are expected to possess. Admiral Nurses are the largest UK group of specialist dementia nurses. Objective To explore how Admiral Nurses met and were supported to meet competencies as defined in the Admiral Nurse Competency Framework, and to develop and maintain skills as dementia specialists. Design Cross-sectional, semi-structured survey. Setting Online national survey. Participants Admiral (specialist dementia) Nurses. Methods We co-designed our survey with Admiral Nurses; then invited Admiral Nurses to complete it in 2022-23 Data were analysed thematically. Results 68 (20% of all Admiral Nurses) completed the survey; most were female (85.2%), from a white ethnic group (88.2%); they reported on average 24 years of nursing experience. We identified three themes in responses: 1.Having time and skills for meaningful support, explored how participants were resourced with time and skills to understand and address family carer client needs by active listening, tailoring person-centred support, and "walking alongside" families. 2.Partnering family carers, concerned how they co-designed interventions with family carers, learning from these collaborative partnerships where expertise was shared. 3.Practice and peer-based learning, explored how participants took responsibility for using available training, peer learning and self-reflection to develop their practice. Conclusions Admiral Nurse roles enabled respondents to develop as autonomous practitioners and to access resources that supported them to build and sustain their dementia specialist practice. Learning was practice based, through partnerships with family carer clients, peer support and self-directed learning. Specialist nursing models may help address the global health workforce emergency, through enabling creative practice development and valued roles that support retention of experienced nurses.
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Affiliation(s)
- Pat Brown
- Division of Psychiatry, University College London, London, UK & Dementia UK, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK, And East London NHS Foundation Trust
| | - Karen Harrison Dening
- School of Health & Life Sciences, De Montfort University, Leicester, Leicestershire & Dementia UK, London, UK
| | - Juanita Hoe
- Geller Institute of Ageing and Memory (GIAM), University of West London, London, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, London, UK
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Abstract
PURPOSE OF REVIEW Dementia policy priorities recommend that people who are living with dementia and their family should have access to support and interventions delivered by dementia specialists, including specialist nurses. However, specialist dementia nursing models and role-related competencies are not clearly defined. We systematically review the current evidence regarding specialist dementia nursing models and their impacts. RECENT FINDINGS Thirty-one studies from across three databases, and grey literature were included in the review. One framework defining specific specialist dementia nursing competencies was found. We did not find convincing evidence of the effectiveness of specialist nursing dementia services, relative to standard models of care from the current, limited evidence base, although families living with dementia valued it. No Randomised Controlled Trial (RCT) has compared the impact of specialist nursing on client and carer outcomes relative to less specialist care, although one nonrandomised study reported that specialist dementia nursing reduces emergency and inpatient service use compared with a usual care group. SUMMARY Current models of specialist dementia nursing are numerous and heterogeneous. Further exploration of the specialist nursing skills and the impact of specialist nursing interventions is needed to usefully inform workforce development strategies and clinical practice.
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Affiliation(s)
- Pat Brown
- Division of Psychiatry, University college London, and Dementia UK
| | | | - Jordan Ayden
- Division of Psychiatry, University College London
| | - Karen Harrison Dening
- Faculty of Health and Life Sciences, De Montfort University, Leicester, and Dementia UK
| | - Juanita Hoe
- Geller Institute of Ageing and Memory (GIAM), University of West London
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Wolverson E, Harrison Dening K, Gower Z, Brown P, Cox J, McGrath V, Pepper A, Prichard J. What are the information needs of people with dementia and their family caregivers when they are admitted to a mental health ward and do current ward patient information leaflets meet their needs? Health Expect 2023; 26:1227-1235. [PMID: 36934455 PMCID: PMC10154859 DOI: 10.1111/hex.13738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 03/20/2023] Open
Abstract
INTRODUCTION An admission to a mental health ward is an uncertain and unexpected part of a person's journey with dementia and consequently, families require information about what to expect and how to prepare. This study aimed to establish the information needs of people with dementia and their families at the point of admission to a mental health ward and to collate existing ward information leaflets to explore if they meet these information needs. METHODS This research was conducted in two parts: (1) a qualitative study using focus groups, one with people with dementia and family carers with lived experience of such an admission (n = 6), and another with Admiral Nurses (n = 6) to explore information needs at the point of admission. (2) Each National Health Service (NHS) mental health trust (n = 67) was asked to provide a copy of their ward information shared at admission. A total of 30 leaflets were received from 15 NHS trusts; after removing duplicates, 22 were included. A content analysis was conducted to evaluate to what extent leaflets met the information needs identified by focus groups. RESULTS Two main categories 'honest, accurate and up-to-date information' and 'who is the information for' and four subcategories were derived from focus group data. Participants felt that people with dementia and their families were likely to have different information needs. Material for people with dementia needed to be in an accessible format. Information should cover the aim of the admission, a timeline of what to expect and details about how families will be involved in care. Practical information about what to pack and ward facilities was valued. Participants spoke about the need to consider the tone of the information, given that people are likely to be distressed. The information leaflets reviewed did not meet the information needs identified by focus group participants. CONCLUSIONS People with dementia and family carers have different information needs at the point of admission to a mental health ward. Information provided to people with dementia needs to be in an accessible format with content relevant to these needs. Wards should aim to co-create information to ensure that they meet people's information needs. PATIENT OR PUBLIC CONTRIBUTION This research was supported by a patient and public involvement (PPI) group of people with dementia and carers who have experience in mental health wards. The idea for the study came from the group and was motivated by their experiences. The PPI group helped with the design of the study and took part in the focus groups. The information generated has been written up in this paper, and the knowledge generated has also been used to co-create a guide for wards on writing their information leaflets and to support the co-creation of a public information leaflet by Dementia UK about mental health admissions for people with dementia.
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Affiliation(s)
- Emma Wolverson
- School of Psychology and Social Work, University of Hull, Hull, UK.,Dementia UK, London, UK
| | | | - Zoe Gower
- Humber Teaching NHS Foundation Trust, Hull, UK
| | - Pat Brown
- Dementia UK, London, UK.,Mental Health Neuroscience, University College London, London, UK
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Brown P, Harrison Dening K. Assessing and managing agitation as a symptom of dementia. Nurs Older People 2023; 35:e1433. [PMID: 36883890 DOI: 10.7748/nop.2023.e1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 03/09/2023]
Abstract
Behavioural and psychological symptoms of dementia (BPSD) affect more than one third of people with dementia at some point during the course of their condition. Agitation is the third most common BPSD but is the least well understood in terms of identification and management. Furthermore, agitation as a symptom of dementia is often confused with agitation as a way of expressing an emotion or unmet need. Psychosocial interventions are recommended to support the person with dementia and their family carers to manage agitation as a symptom of dementia, as well as other BPSD, in a person-centred manner. Some psychosocial interventions for managing agitation as a symptom of dementia have shown benefits, but further investigation of the usefulness of a range of interventions is needed. This article discusses the assessment and management of agitation as a symptom of dementia and illustrates their application through a case study.
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Affiliation(s)
- Pat Brown
- Dementia UK, London, England and PhD student, University College London, London, England
| | - Karen Harrison Dening
- Dementia UK, London, England and honorary professor of dementia nursing, De Montfort University, Leicester, England
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Brown P, Merritt A, Skerratt S, Swarbrick M. Recent trends in medicinal chemistry and enabling technologies. Highlights from the Society for Medicines Research Conference. London - December 8, 2022. DRUG FUTURE 2023. [DOI: 10.1358/dof.2023.48.3.3567668] [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: 03/16/2023]
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Courtier N, Williamson K, Brown P, Pope E, Chivers E, Mundy LA. A personal journey to build leadership skills through collaboration to support radiography research and evidence-based practice. J Med Imaging Radiat Sci 2022; 53:S15-S17. [PMID: 35909060 PMCID: PMC9715992 DOI: 10.1016/j.jmir.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/01/2022] [Accepted: 07/13/2022] [Indexed: 12/24/2022]
Abstract
Introduction The Covid-19 pandemic continues to impact on how radiotherapy is delivered, how staff do their job and how patients are cared for. Part of the UK NHS response to the covid-19 crisis was to accelerate final year radiotherapy students into work as therapeutic radiographers. The study objective is to explore the experiences of a cohort of new registrants who started work in May 2020. Methods In depth interviews were conducted remotely with newly qualified therapeutic radiography registrants regarding their first 12 months working in UK NHS cancer centres. Data were analysed within and across cases using a framework analysis and synthesised thematically. Results Eleven radiographers were interviewed, working across six different sites. Key generated themes are the risk of impaired professional socialisation due to incongruence between students’ expectations and the reality in clinical departments. We use Bridges Transitional Model to show how a combination of the disrupted/undefined end to university and a perceived lack of recognition of professional knowledge, skills and values evident in our data may leave participants stuck in a middle stage of the transition process. Slower than expected professional development led to demotivation, which was also associated with rising covid-19 case numbers. Conclusion The covid-19 pandemic accentuated and heightened the existing challenge of professional integration and socialisation faced by new therapeutic radiography staff. Demotivation and potentially attrition are more likely in this environment. Compassionate leadership that fosters the mentorship of junior cohorts as part of a flexible preceptorship package could mitigate these risks.
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Affiliation(s)
- N Courtier
- Department of Radiotherapy & Oncology, Cardiff University, Cardiff. Wales, UK
| | - K Williamson
- Department of Radiotherapy & Oncology, Cardiff University, Cardiff. Wales, UK
| | - P Brown
- Department of Radiotherapy & Oncology, Cardiff University, Cardiff. Wales, UK
| | - E Pope
- Department of Radiotherapy & Oncology, Cardiff University, Cardiff. Wales, UK
| | - E Chivers
- Department of Radiotherapy & Oncology, Cardiff University, Cardiff. Wales, UK
| | - LA Mundy
- Department of Radiotherapy & Oncology, Cardiff University, Cardiff. Wales, UK
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Matias K, Brown P, Durham D, Godusevic L, Stamper S. 343 Developing cystic fibrosis patient food insecurity education with circle of care partnership. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01033-5] [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: 11/07/2022]
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Brown P, Leverton M, Burton A, Harrison‐Dening K, Beresford‐Dent J, Cooper C. How does the delivery of paid home care compare to the care plan for clients living with dementia? Health Soc Care Community 2022; 30:e3158-e3170. [PMID: 35195320 PMCID: PMC9544825 DOI: 10.1111/hsc.13761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/18/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
Many people living with dementia choose to remain in their own homes, supported by home-care workers, who provide care that is specified in care plans. We explored how care plans of clients living with dementia, compared with ethnographic observations of home care they received. In a secondary, reflexive thematic analysis, we reviewed care plans for 17 clients living with dementia and transcripts from 100 h of observations with 16 home-care workers delivering care to them. Our overarching theme was: Care plans as a starting point but incomplete repository. Clients' care plans provided useful background information but did not reflect a wealth of knowledge home-care workers built through practice. Two sub-themes described: (a) Person-centred care planning: whether and how the care plan supported tailoring of care to clients' needs and (b) Filling in the gaps: home-care workers often worked beyond the scope of vague, incomplete or out-of-date care plans. We found considerable inconsistencies between care plans and the care that was delivered. Care plans that were comprehensive about care needs, and rich in person-specific information aided the delivery of person-centred care. Lack of documentation was sometimes associated with observed failures in person-centred care, as helpful information and strategies were not shared. Including information in care plans about how, as well as what care tasks, should be completed, and frequently discussing and updating care plans can create more person-centred plans that reflect changing needs. Electronic care planning systems may support this.
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Affiliation(s)
| | - Monica Leverton
- NIHR Health & Social Care Workforce Research UnitKings College LondonLondonUK
| | - Alexandra Burton
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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Trivedi S, Stefani L, Byth K, Brown P, Qian P, Kumar S, Thomas S, Thomas L. Left Ventricular Diastolic Dysfunction and Left Atrial Myopathy Independently Predict Atrial Fibrillation Recurrence Post Pulmonary Vein Isolation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trivedi S, Stefani L, Byth K, Brown P, Qian P, Kumar S, Thomas S, Thomas L. Medium-term Maintenance of Sinus Rhythm Post Pulmonary Vein Isolation Results in Significant Cardiac Reverse Remodelling. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brown P, Watts V, Hanna M, Rizk M, Tucker E, Saddlemire A, Peteet B. Two Epidemics and a Pandemic: The Collision of Prescription Drug Misuse and Racism during COVID-19. J Psychoactive Drugs 2021; 53:413-421. [PMID: 34694200 DOI: 10.1080/02791072.2021.1992048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The present study investigated the relationship between perceived racial discrimination and prescription drug misuse (PDM) among Asian, Black, and Latinx Americans during the COVID-19 crisis. U.S. racial/ethnic minorities may have been uniquely affected by two national and one global pandemic: the opioid crisis, racism, and COVID-19. Opioid death rates increased among many groups prior to the pandemic. This country witnessed an increase in racialized acts against people of color across the spectrum in the spring and summer months of the world's COVID-19 outbreak. While studies have shown a clear link between perceived racial discrimination and substance abuse outside of the global pandemic, no identified studies have done so against the backdrop of a global health pandemic. Separate hierarchical regressions revealed a significant association between perceived racial discrimination and PDM for Black Americans, Asian Americans, and Latinx individuals. Findings build on the scant literature on PDM in diverse samples and establish a relationship between perceived racial discrimination and PDM, as previously identified for other abused substances. Future post-pandemic substance misuse interventions should consider the influence of perceived racial discrimination as they help individuals recover from the aftermath of this stressful trifecta.
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Affiliation(s)
- P Brown
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - V Watts
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - M Hanna
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - M Rizk
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - E Tucker
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - A Saddlemire
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
| | - B Peteet
- Department of Psychology, Loma Linda University, Loma Linda, California, USA
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Graham K, Gilligan D, Brown P, van Klinken RD, McColl KA, Durr PA. Use of spatio-temporal habitat suitability modelling to prioritise areas for common carp biocontrol in Australia using the virus CyHV-3. J Environ Manage 2021; 295:113061. [PMID: 34348430 DOI: 10.1016/j.jenvman.2021.113061] [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: 10/31/2020] [Revised: 05/09/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
Common carp (Cyprinus carpio) are an invasive species of the rivers and waterways of south-eastern Australia, implicated in the serious decline of many native fish species. Over the past 50 years a variety of control options have been explored, all of which to date have proved either ineffective or cost prohibitive. Most recently the use of cyprinid herpesvirus 3 (CyHV-3) has been proposed as a biocontrol agent, but to assess the risks and benefits of this, as well as to develop a strategy for the release of the virus, a knowledge of the fundamental processes driving carp distribution and abundance is required. To this end, we developed a novel process-based modelling framework that integrates expert opinion with spatio-temporal datasets via the construction of a Bayesian Network. The resulting weekly networks thus enabled an estimate of the habitat suitability for carp across a range of hydrological habitats in south-eastern Australia, covering five diverse catchment areas encompassing in total a drainage area of 132,129 km2 over a period of 17-27 years. This showed that while suitability for adult and subadult carp was medium-high across most habitats throughout the period, nevertheless the majority of habitats were poorly suited for the recruitment of larvae and young-of-year (YOY). Instead, high population abundance was confirmed to depend on a small number of recruitment hotspots which occur in years of favourable inundation. Quantification of the underlying ecological drivers of carp abundance thus makes possible detailed planning by focusing on critical weaknesses in the population biology of carp. More specifically, it permits the rational planning for population reduction using the biocontrol agent, CyHV-3, targeting areas where the total population density is above a "damage threshold" of approximately 100 kg/ha.
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Affiliation(s)
- K Graham
- CSIRO Australian Centre for Disease Preparedness (ACDP), Geelong, VIC, Australia
| | - D Gilligan
- NSW Department of Primary Industries - Fisheries NSW, NSW, Australia
| | - P Brown
- Centre for Freshwater Ecosystems, School of Life Sciences, La Trobe University, Mildura, VIC, Australia; Fisheries and Wetlands Consulting, Portarlington, VIC, Australia
| | | | - K A McColl
- CSIRO Health and Biosecurity, Geelong, VIC, Australia
| | - P A Durr
- CSIRO Australian Centre for Disease Preparedness (ACDP), Geelong, VIC, Australia.
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Kowalchuk R, Mullikin T, Harmsen W, Rose P, Siontis B, Kim D, Costello B, Morris J, Marion J, Johnson-Tesch B, Gao R, Shiraishi S, Lucido J, Trifiletti D, Olivier K, Owen D, Stish B, Waddle M, Laack N, Park S, Brown P, Merrell K. OC-0405 Development and internal validation of an RPA-based pre-treatment decision tool for spinal SBRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06892-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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DeWees T, Abraha F, Corbin K, Brown P, Hallemeier C, Davis B, Petersen I, Martenson J, Ahmed S, Olivier K, Vern-Gross T, Rule W, Wong W, Vora S, Patel S, Ashman J, Schild S, Trifiletti D, Vargas C, Ma D. PO-1498 Clinical Sensitivity of PROMIS-10 Physical and Mental Quality of Life Domains to Radiation Therapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07949-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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McNutt D, Julius W, Gorban M, Mattingly B, Brown P, Cleaver G. Geometric surfaces: An invariant characterization of spherically symmetric black hole horizons and wormhole throats. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.103.124024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Brown P, Anderson A, Hargreaves B, Morgan A, Isaacs JD, Pratt A. OP0033 REGULATORY T CELL CD39 EXPRESSION AS A PREDICTOR OF EARLY REMISSION-INDUCTION WITH METHOTREXATE IN NEW-ONSET RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The long term outcomes for patients with rheumatoid arthritis (RA) depend on early and effective disease control. Methotrexate remains the key first line disease modifying therapy for the majority of patients, with 40% achieving an ACR50 on monotherapy(1). There are at present no effective biomarkers to predict treatment response, preventing effective personalisation of therapy. A putative mechanism of action of methotrexate, the potentiation of anti-inflammatory adenosine signalling, may inform biomarker discovery. By antagonism of the ATIC enzyme in the purine synthesis pathway, methotrexate has been proposed to increase the release of adenosine moieties from cells, which exert an anti-inflammatory effect through interaction with ADORA2 receptors(2). Lower expression of CD39 (a cell surface 5-’ectonucleotidase required for the first step in the conversion of ATP to adenosine) on circulating regulatory T-Lymphocytes (Tregs) was previously identified in patients already established on methotrexate who were not responding (DAS28 >4.0 vs <3.0)(3). We therefore hypothesised that pre-treatment CD39 expression on these cells may have clinical utility as a predictor of early methotrexate efficacy.Objectives:To characterise CD39 expression in peripheral blood mononuclear cells in RA patients naïve to disease modifying therapy commencing methotrexate, and relate this expression to 4 variable DAS28CRP remission (<2.6) at 6 months.Methods:68 treatment naïve early RA patients starting methotrexate were recruited from the Newcastle Early Arthritis Clinic and followed up for 6 months. Serial blood samples were taken before and during methotrexate therapy with peripheral blood mononuclear cells isolated by density centrifugation. Expression of CD39 by major immune subsets (CD4+ and CD8+ T-cells, B-lymphocytes, natural killer cells and monocytes) was determined by flow cytometry. The statistical analysis used was binomial logistic regression with baseline DAS28CRP used as a covariate due to the significant association of baseline disease activity with treatment response.Results:Higher pre-treatment CD39 expression was observed in circulating CD4+ T-cells of patients who subsequently achieved clinical remission at 6 months versus those who did not (median fluorescence 4854.0 vs 3324.2; p = 0.0108; Figure 1-A). This CD39 expression pattern was primarily accounted for by the CD4+CD25 high sub-population (median fluorescence 9804.7 vs 6455.5; p = 0.0065; Figure 1-B). These CD25 high cells were observed to have higher FoxP3 and lower CD127 expression than their CD39 negative counterparts, indicating a Treg phenotype. No significant associations were observed with any other circulating subset. A ROC curve demonstrates the discriminative utility of differential CD39 expression in the CD4+CD25 high population for the prediction of DAS28CRP remission in this cohort, showing greater specificity than sensitivity for remission prediction(AUC: 0.725; 95% CI: 0.53 - 0.92; Figure 1-C). Longitudinally, no significant induction or suppression of the CD39 marker was observed amongst patients who did or did not achieve remission over the 6 months follow-up period.Figure 1.Six month DAS28CRP remission versus pre-treatment median fluorescence of CD39 expression on CD4+ T-cells (A); CD25 High expressing CD4+ T-cells (B); and ROC curve of predictive utility of pre-treatment CD39 expression on CD25 High CD4+ T-cells (C).Conclusion:These findings support the potential role of CD39 in the mechanism of methotrexate response. Expression of CD39 on circulating Tregs in treatment-naïve RA patients may have particular value in identifying early RA patients likely to respond to methotrexate, and hence add value to evolving multi-parameter discriminatory algorithms.References:[1]Hazlewood GS, et al. BMJ. 2016 21;353:i1777[2]Brown PM, et al. Nat Rev Rheumatol. 2016;12(12):731-742[3]Peres RS, et al. Proc Natl Acad Sci U S A. 2015;112(8):2509-2514Disclosure of Interests:None declared
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d'Amore F, Leppä S, Relander T, Larsen TS, Brown P, Jørgensen J, Mannisto S, Lugtenburg P, Leivonen S, Holte H, Fagerli UM, Lauritzsen GF, Meyer P, Minotti G, Menna P, Liestøl K, Toldbod H. FINAL ANALYSIS OF A NORDIC LYMPHOMA GROUP PHASE IB/IIA TRIAL OF PIXANTRONE, ETOPOSIDE, BENDAMUSTINE AND, IN CD20‐POSITIVE TUMORS, RITUXIMAB IN RELAPSED AGGRESSIVE B‐ OR T‐CELL LYMPHOMAS. Hematol Oncol 2021. [DOI: 10.1002/hon.151_2880] [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: 11/11/2022]
Affiliation(s)
- F d'Amore
- Aarhus University Hospital, Hematology Aarhus N Denmark
| | - S Leppä
- Helsinki University Hospital Oncology Helsinki Finland
| | - T Relander
- Skane University Hospital Oncology Lund Sweden
| | - T. S Larsen
- Odense University Hospital Hematology Odense Denmark
| | - P Brown
- Copenhagen University Hospital Hematology Copenhagen Denmark
| | - J Jørgensen
- Aarhus University Hospital, Hematology Aarhus N Denmark
| | - S Mannisto
- Helsinki University Hospital Oncology Helsinki Finland
| | - P Lugtenburg
- University Medical Center, Erasmus MC Cancer Institute Rotterdam Netherlands
| | - S.‐K Leivonen
- Helsinki University Hospital Oncology Helsinki Finland
| | - H Holte
- Oslo University Hospital Oncology Oslo Norway
| | | | | | - P Meyer
- Stavanger University Hospital Oncology Stavanger Norway
| | - G Minotti
- University Hospital Campus Bio‐Medico Clinical Pharmaclogy Laboratory Rome Italy
| | - P Menna
- University Hospital Campus Bio‐Medico Clinical Pharmaclogy Laboratory Rome Italy
| | - K Liestøl
- University of Oslo Informatics Oslo Norway
| | - H Toldbod
- Aarhus University Hospital, Hematology Aarhus N Denmark
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Jurado Zapata S, Maurits M, Abraham Y, Van den Akker E, Barton A, Brown P, Cope A, González-Álvaro I, Goodyear C, van der Helm - van Mil A, Hu X, Huizinga T, Johannesson M, Klareskog L, Lendrem D, McInnes I, Morton F, Paterson C, Porter D, Pratt A, Rodriguez Rodriguez L, Sieghart D, Studenic P, Verstappen S, Padyukov L, Winkler A, Isaacs JD, Knevel R. POS0348 GENETIC SUSCEPTIBILITY VARIANTS FOR RHEUMATOID ARTHRITIS ARE NOT ASSOCIATED WITH EARLY REMISSION; A MULTI-COHORT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1042] [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:Patients who achieve remission promptly could have a specific genetic risk profile that supports regaining immune tolerance. The identification of these genes could provide novel drug targets.Objectives:To test the association between RA genetic risk variants with achieving remission at 6 months.Methods:We computed genetic risk scores (GRS) comprising of the RA susceptibility variants1 and HLA-SE status separately in 4425 patients across eight datasets from inception cohorts. Remission was defined as DAS28CRP<2.6 at 6 months. Missing DAS28CRP values in patients were imputed using predictive mean matching by MICE. We first tested whether baseline DAS28CRP changed with increasing GRS using linear regression. Next, we calculated odds ratios for GRS and HLA-SE on remission using logistic regression. Heterogeneity of the outcome between datasets was mitigated by running inverse variance meta-analysis.Results:Evaluation of the complete dataset, baseline clinical variables did not differ between patients achieving remission and those who did not (Table 1). Distribution of GRS was consistent between datasets. Neither GRS nor HLA-SE was associated with baseline DAS2DAS (OR1.01; 95% CI 0.99-1.04). A fixed effect meta-analysis (Figure 1.) showed no significant effect of the GRS (OR 0.99; 95% CI 0.94-1.03) or HLA-SE (OR 0.8CRP87; 95% CI 0.75-1.01) on remission at 6 months.Table 1.Summary of the data separated by disease activity after 6 months.allRemission at 6 monthsNo remission at 6 monthsN4425*15582430Age, mean (sd)55.38 (13.87)5517 (14.09)55.62 (13.59)Female %68.98%65.43%70.73%ACPA+ %61.94%63.53%61.67%Baseline DAS28, mean (sd)4.76 (1.22)4.47 (1.23)5.1 (1.15)*not all patients had 6 months dataConclusion:In these combined cohorts, RA genetics risk variants are not associated with early disease remission. At baseline there was no difference in genetic risk between patients achieving remission or not. Studies encompassing other genetic variants are needed to elucidate the genetics of RA remission.References:[1]Knevel R et al. Sci Transl Med. 2020;12(545):eaay1548.Acknowledgements:This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 777357, RTCure.This project has received funding from Pfizer Inc.Disclosure of Interests:Samantha Jurado Zapata: None declared, Marc Maurits: None declared, Yann Abraham Employee of: Pfizer, Erik van den Akker: None declared, Anne Barton: None declared, Philip Brown: None declared, Andrew Cope: None declared, Isidoro González-Álvaro: None declared, Carl Goodyear: None declared, Annette van der Helm - van Mil: None declared, Xinli Hu Employee of: Pfizer, Thomas Huizinga: None declared, Martina Johannesson: None declared, Lars Klareskog: None declared, Dennis Lendrem: None declared, Iain McInnes: None declared, Fraser Morton: None declared, Caron Paterson: None declared, Duncan Porter: None declared, Arthur Pratt: None declared, Luis Rodriguez Rodriguez: None declared, Daniela Sieghart: None declared, Paul Studenic: None declared, Suzanne Verstappen: None declared, Leonid Padyukov: None declared, Aaron Winkler Employee of: Pfizer, John D Isaacs: None declared, Rachel Knevel Grant/research support from: Pfizer
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Jørgensen GØ, Favero F, Schmidt Jespersen J, Tulstrup MR, Rodriguez‐Gonzalez FG, Nielsen AF, Sørensen B, Ebbesen LH, Bæch J, Haastrup EK, Nielsen C, Josefsson PL, Thorsgaard M, El‐Galaly TC, Brown P, Weischenfeldt JL, Larsen TS, Grønbæk K, Husby S. CLINICAL IMPACT OF T‐CELL RECEPTOR REPERTOIRE DIVERSITY IN PATIENTS WITH LYMPHOMA UNDERGOING AUTOLOGOUS STEM CELL TRANSPLANTATION. Hematol Oncol 2021. [DOI: 10.1002/hon.1_2880] [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: 11/07/2022]
Affiliation(s)
| | - F Favero
- Finsen laboratory Hematology‐Oncology, Rigshospitalet Copenhagen Denmark
| | | | | | | | - A. F Nielsen
- Rigshospitalet Dept. of Clinical Immunology Copenhagen Denmark
| | - B Sørensen
- Aarhus University Hospitalet Clinical Immunology Aarhus Denmark
| | - L. H Ebbesen
- Aarhus University Hospital Clinical Immunology Aarhus Denmark
| | - J Bæch
- Aalborg University Hospital Clinical Immunology Aalborg Denmark
| | - E. K Haastrup
- Rigshospitalet Dept. of Clinical Immunology Copenhagen Denmark
| | - C Nielsen
- Odense University Hospital Dept. of Clinical Immunology Copenhagen Denmark
| | | | - M Thorsgaard
- Aarhus University Hospital Hematology Aarhus Denmark
| | | | - P Brown
- Rigshospitalet Hematology Copenhagen N Denmark
| | - J. L Weischenfeldt
- Finsen laboratory Hematology‐Oncology, Rigshospitalet Copenhagen Denmark
| | - T. S Larsen
- Odense University Hospital Hematology Odense Denmark
| | - K Grønbæk
- Rigshospitalet Hematology Copenhagen N Denmark
| | - S Husby
- Rigshospitalet Hematology Copenhagen N Denmark
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Courtier N, Brown P, Mundy L, Pope E, Chivers E, Williamson K. Expectations of therapeutic radiography students in Wales about transitioning to practice during the Covid-19 pandemic as registrants on the HCPC temporary register. Radiography (Lond) 2021; 27:316-321. [PMID: 32943355 PMCID: PMC7476453 DOI: 10.1016/j.radi.2020.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/25/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The Covid-19 crisis continues to profoundly impact on radiotherapy practice in the UK. We explore the views of therapeutic radiographer students on entering their first post in unique circumstances as a means to evaluate the support that may minimise negative impacts on their transition to practitioners. METHOD Focus groups were conducted outside of students' final year educational programme and immediately prior to them starting work. Qualitative data were analysed using a framework analysis. RESULTS Emergent themes from the eleven participants were: Covid-19 as a layer on top of underlying anxieties; Degree of readiness for imminent psychological, emotional and practical challenges; Feeling valued as a health professional/radiographer at this time; A mixed student and qualified staff professional identity as HCPC temporary registrants. CONCLUSION Uncertainties related to Covid-19 were seen to add a destabilising component to existing anxieties and challenges. In this context, there are significant risks of impaired professional socialisation due to incongruence between students' expectations and the reality in clinical departments. IMPLICATIONS FOR PRACTICE Informed academic support and flexible clinical preceptorship that address anxieties and congruence barriers are vital to guide new practitioners through a health crisis that presents significant challenges but also opportunity for professional development.
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Affiliation(s)
- N Courtier
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, University Hospital Wales, Heath Campus, Cardiff, CF14 4XN, UK.
| | - P Brown
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, University Hospital Wales, Heath Campus, Cardiff, CF14 4XN, UK
| | - L Mundy
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, University Hospital Wales, Heath Campus, Cardiff, CF14 4XN, UK
| | - E Pope
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, University Hospital Wales, Heath Campus, Cardiff, CF14 4XN, UK
| | - E Chivers
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, University Hospital Wales, Heath Campus, Cardiff, CF14 4XN, UK
| | - K Williamson
- Cardiff University School of Healthcare Sciences, Ty Dewi Sant, University Hospital Wales, Heath Campus, Cardiff, CF14 4XN, UK
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Brown P. Abstract SP020: Beyond Hormones: Newer Pharmacologic Approaches. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-sp20] [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
It is now possible to prevent many breast cancers inhigh-risk women using anti-estrogen hormonal drugs. Several Phase III breast cancer preventiontrials demonstrated that hormonal drugs such as the “selective estrogenreceptor modulators” tamoxifen and raloxifene, and aromatase inhibitors preventthe development of 50% of ER-positive breast cancers in women. However, mostwomen at high risk of breast cancer do not use these cancer preventive drugsdue to concerns about their side effects. To overcome this problem, recent studies havefocused on testing novel approaches for the prevention of breast cancer. Results of preclinical and clinical studiestesting targeted drugs and vaccines for breast cancer prevention show that itis possible to prevent breast cancer with reduced toxicity. Studies seeking to prevent all forms ofbreast cancer, including ER-positive, HER2-positive, and “triple-negative”breast cancer, will be presented and discussed. Novel approaches testing targeted therapies including signalinginhibitors, combinations of preventive agents, and vaccines, will be presented. Many of these interventions prevent breastcancer in animal models, and are now being tested in human clinicaltrials. Results from studies testing novel drugdelivery approaches will also be discussed. Topical gels containing anti-estrogen drugs are being used to reducebreast cell growth and mammographic density in Phase II clinical trials. This topical approach has the potential toprevent ER-positive breast cancers without the toxicity of oral hormonaldrugs. All of these novel preventive measuresoffer great promise to effectively prevent all forms of breast cancer withminimal toxicity.
Citation Format: P Brown. Beyond Hormones: Newer Pharmacologic Approaches [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr SP020.
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Affiliation(s)
- P Brown
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Kamaledeen S, Brown P, Gangi A, Pantelidou M, Chan N. Survey of research participation amongst UK radiology trainees: aspirations, barriers, solutions and the Radiology Academic Network for Trainees (RADIANT). Clin Radiol 2021; 76:302-309. [PMID: 33583566 DOI: 10.1016/j.crad.2021.01.005] [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: 01/01/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
AIM To inform the activity of the newly formed Radiology Academic Network for Trainees (RADIANT) regarding the current level of interest, engagement, and barriers experienced by UK radiology trainees to undertake research. MATERIALS AND METHODS A web-based survey containing nine questions was sent to the UK radiology training programme directors for distribution to trainees. The survey was also distributed to all trainee members of the RADIANT network. This led to 224 responses over a period of 2 months. RESULTS A large proportion of respondents indicated a desire to participate in research in the next 12 months 72.3% (n=162). The most frequently reported barriers to research were lack of time (60.7%, n=136), lack of awareness of local/departmental opportunities (53.6%, n=120), and limited experience in research statistics (46%, n=103). The most favoured factor that would improve access to research was structured research training opportunities, qualified as a project with clear goals and timeline (71%, n=159), protected time for research (68.8%, n=154), and local or national trainee research networks (40.2%, n=90 and 37.1%, n=83, respectively). CONCLUSION Many radiology trainees would like to participate in research, but multiple barriers exist. The formation of RADIANT is seen as a key part of a multifaceted approach to improving access to quality research activity alongside support from local and regional training bodies.
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Affiliation(s)
- S Kamaledeen
- Department of Radiology, Queen Alexandra Hospital, Cosham, Portsmouth, UK
| | - P Brown
- Leeds and West Yorkshire Radiology Academy, Leeds General Infirmary, Great George St, Leeds, UK
| | - A Gangi
- Department of Radiology, Queen Alexandra Hospital, Cosham, Portsmouth, UK
| | - M Pantelidou
- Department of Radiology, Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | - N Chan
- Department of Neuroradiology, King's College Hospital, London, UK.
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Brown P, Dimarco A, Bradley J, Nucifora G, Miller C, Schmitt M. Risk stratification and prognostic value of CMR in DCM; parametric mapping and GLS- value beyond EF and LGE? Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Dr Pamela Brown was suppoerted by funding from Alliance Medical.
Background; Arrhythmia risk stratification and device implantation in dilated cardiomyopathy (DCM) poses significant challenges and as demonstrated by the DANISH trial appears to have reached the asymptote of clinical efficacy. A body of evidence now demonstrates that risk stratification of and device selection for DCM patients may be enhanced by inclusion of patients" LGE-status. Furthermore, it has been suggested that CMR based parametric mapping and strain analysis may further advance risk stratification.
Methods; 703 patients with DCM undergoing clinically indicated CMR scans and prospectively enrolled into the UHSM-CMR study (NCT02326324) between 03/2015-12/2018 were analysed. Multivariable Cox proportional hazard models and Youden index driven C-statistics were used to assess additive prognostic value of GLS, T1 and ECV mapping on the combined endpoint of cardiovascular death, cardiac transplantation, LVAD insertion or hospitalisation for heart failure in models incorporating NHYA class, EF and LGE status. Additionally. the value of GLS, T1, and ECV on predicting significant arrhythmic events (SAV) (ventricular arrhythmia (VA), resuscitated cardiac arrest (rCA) or sudden cardiac death (SCD)) was assessed.
Results; Patients (mean age 59, 66% male, 60% ≥NYHA II, mean EF 42%, mean GLS -12%, mean ECV 27%) were on good medical therapy (beta blocker 74%%, ACE 79%, MRA 38%, Entresto 5%, CRT 23%). Mean follow-up was 21 months; the combined endpoint occurred in 34 patients (5%). On univariate analysis NYHA class (HR 2.44 (1.67-3.57), p < 0.001), ECV (HR 1.14 (1.05-1.22), p < 0.001), GLS% (HR 1.14 (1.07-1.21) p < 0.001,) T1 (HR 1.06 (1.005-1.1), p = 0.03), RVEF (HR 0.95 (0.93-0.98), p < 0.001), LVEF (HR 0.92 (0.9-0.95), p < 0.001) were all significantly associated with outcome. On multivariate analysis only EF and NYHA class was associated with outcome.
SAV occurred as the first manifestation of disease or during follow up in 27 patients (4%). At univariate analysis LGE, ECV, GLS, EF and NYHA class were all associated with SAV. However, on multivariable analysis only EF, LGE and ECV (HR 1.11 (1.01-1.22), p = 0.03) but not GLS remained independently predictive in a model already incorporating EF, NYHA and LGE.
Conclusion
Optimally treated DCM populations have very low event rates. CMR based assessment of fibrosis status/burden with both LGE and ECV assessment has the potential to enhance patient selection for ICD therapy. Whilst GLS is increasingly recognised as a sensitive imaging biomarker of early disease detection it provides no additive value, likely because of it’s high co-linearity with EF, in models already containing EF, NYHA class and LGE status.
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Affiliation(s)
- P Brown
- Wythenshawe Hospital, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Dimarco
- Hospital Universitari de Bellvitge, Cardiology, Barcelona, Spain
| | - J Bradley
- Wythenshawe Hospital, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - G Nucifora
- Wythenshawe Hospital, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - C Miller
- Wythenshawe Hospital, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - M Schmitt
- Wythenshawe Hospital, Manchester, United Kingdom of Great Britain & Northern Ireland
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Zada M, Klimis H, Brown P, Zecchin R, Altman M, Thomas L. Prospective Analysis of Demographic and Echocardiographic Determinants of Exercise Capacity Following ST-Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.099] [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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Ferkh A, Stefani L, Trivedi S, Brown P, Altman M, Thomas L. Comparison of 2-Dimensional Single Plane, Biplane and Triplane With 3-Dimensional Left Atrial Strain. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.198] [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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Alavijeh M, Brown P, Butterworth S, Macdonald G. Advances in Genetic Medicine. Highlights from The Society for Medicines Research Online Meeting. Virtual -December 3, 2020. DRUG FUTURE 2021. [DOI: 10.1358/dof.2021.46.3.3277085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Khamisse E, Dunoyer C, Ar Gouilh M, Brown P, Meurens F, Meyer G, Monchatre-Leroy E, Pavio N, Simon G, Le Poder S. Opinion paper: Severe Acute Respiratory Syndrome Coronavirus 2 and domestic animals: what relation? Animal 2020; 14:2221-2224. [PMID: 32638677 PMCID: PMC7308594 DOI: 10.1017/s1751731120001639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- E Khamisse
- Direction de l'évaluation des risques, ANSES, 94700Maisons-Alfort, France
| | - C Dunoyer
- Direction de l'évaluation des risques, ANSES, 94700Maisons-Alfort, France
| | - M Ar Gouilh
- Groupe de Recherche sur l'Adaptation Microbienne, Normandie Université, 14000Caen, France
- Service de Virologie, CHU de Caen, 14000Caen, France
| | - P Brown
- Laboratoire de Ploufragan-Plouzané-Niort, ANSES, 22440Ploufragan, France
| | - F Meurens
- BIOEPAR, Oniris, INRAE, 44307Nantes, France
| | - G Meyer
- ENVT, INRAE, 31076Toulouse, France
| | - E Monchatre-Leroy
- Laboratoire de la rage et de la faune sauvage, ANSES, 54220Malzéville, France
| | - N Pavio
- UMR Virologie, ENVA, INRAE, ANSES Laboratoire de santé animale, 94700Maisons-Alfort, France
| | - G Simon
- Laboratoire de Ploufragan-Plouzané-Niort, ANSES, 22440Ploufragan, France
| | - S Le Poder
- UMR Virologie, ENVA, INRAE, ANSES Laboratoire de santé animale, 94700Maisons-Alfort, France
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Ambrosini S, Montecucco F, Akhmedov A, Mohammed S, Brown P, Rossi F, Kiss A, Luscher T, Costantino S, Paneni F. Methylation of the hippo signalling effector YAP by SETD7 drives myocardial ischemic injury. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Myocardial ischemia/reperfusion (I/R) injury is one of the most deleterious cardiovascular conditions and a leading cause of mortality. The Hippo pathway effector YAP critically regulates cardiomyocyte proliferation and survival during myocardial I/R injury. However, the mechanisms regulating YAP activation in this setting remain poorly understood. Post-translational modifications of proteins, namely methylation, modulate pathways implicated in myocardial I/R injury. The methyltransferase SETD7 is emerging as a regulator of cell survival via methylation of histone and non-histone proteins. Whether SETD7 participates to myocardial I/R injury remains elusive.
Purpose
To investigate the role of SETD7 in regulating Hippo signaling during myocardial I/R injury.
Methods
Neonatal rat ventricular myocytes (NRVM) were exposed to normal glucose levels or glucose deprivation (GD) for 15 h, in the presence of the selective SETD7 inhibitor [(R)-PFI-2] or its inactive enantiomer [(S)-PFI-2]. Western blot and real time PCR were employed to investigate the effects of energy stress on SETD7 and the Hippo pathway, while apoptosis was assessed by Caspase-3 activity assay. YAP activity was assessed through chromatin immunoprecipitation assay (ChIP), its localization was examined by confocal microscopy while mono-methylation was assessed by immunoblotting. SETD7 knockout (SETD7−/−) mice and wild-type (WT) littermates (male, 8–12 weeks old) underwent 1 h of left anterior descending (LAD) coronary artery ligation followed by 24 h of reperfusion. Infarct size was assessed by TTC staining and shown as infarct size per ventricle surface (I/V). Cardiac function was investigated at 24h by conventional and Tissue Doppler Imaging (TDI) echocardiography.
Results
GD in NRVMs led to upregulation of SETD7 and physical interaction with the pro-survival transcriptional cofactor YAP, resulting in its direct mono-methylation. Furthermore SETD7-dependent methylation of YAP led to its cytosolic retention and subsequent reduction of YAP binding to the promoter of pro-survival genes. Of note, pharmacological inhibition of SETD7 by (R)-PFI-2 blunted YAP mono-methylation while restoring its nuclear retention. Mechanistically, SETD7 inhibition promoted YAP binding to catalase and superoxide dismutase (SOD) gene promoters, thus preventing GD-induced mitochondrial oxidative stress and apoptosis. In line with our in vitro findings, SETD7−/− mice showed decreased infarct size as compared to WT littermates and preserved cardiac systolic (ejection fraction, fractional shortening) and diastolic function, as assessed by both conventional and TDI echocardiography.
Conclusions
We show that SETD7-dependent methylation of YAP is required for its inactivation, thus leading to myocyte oxidative stress and apoptosis. Pharmacological modulation of SETD7 by (R)-PFI-2 may represent a new therapeutic approach to prevent myocardial ischemic damage through modulation of the Hippo pathway.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Swiss Heart Foundation
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Affiliation(s)
- S Ambrosini
- University of Zurich, Schlieren, Switzerland
| | | | - A Akhmedov
- University of Zurich, Schlieren, Switzerland
| | | | - P Brown
- University of Toronto, Toronto, Canada
| | - F Rossi
- University of British Columbia, Vancouver, Canada
| | - A Kiss
- Medical University of Vienna, Vienna, Austria
| | - T.F Luscher
- University of Zurich, Schlieren, Switzerland
| | | | - F Paneni
- University of Zurich, Schlieren, Switzerland
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Zhong J, Frood R, Brown P, Nelstrop H, Prestwich R, McDermott G, Currie S, Vaidyanathan S, Scarsbrook AF. Machine learning-based FDG PET-CT radiomics for outcome prediction in larynx and hypopharynx squamous cell carcinoma. Clin Radiol 2020; 76:78.e9-78.e17. [PMID: 33036778 DOI: 10.1016/j.crad.2020.08.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022]
Abstract
AIM To determine whether machine learning-based radiomic feature analysis of baseline integrated 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) computed tomography (CT) predicts disease progression in patients with locally advanced larynx and hypopharynx squamous cell carcinoma (SCC) receiving (chemo)radiotherapy. MATERIALS AND METHODS Patients with larynx and hypopharynx SCC treated with definitive (chemo)radiotherapy at a specialist cancer centre undergoing pre-treatment PET-CT between 2008 and 2017 were included. Tumour segmentation and radiomic analysis was performed using LIFEx software (University of Paris-Saclay, France). Data were assigned into training (80%) and validation (20%) cohorts adhering to TRIPOD guidelines. A random forest classifier was created for four predictive models using features determined by recursive feature elimination: (A) PET, (B) CT, (C) clinical, and (D) combined PET-CT parameters. Model performance was assessed using area under the curve (AUC) receiver operating characteristic (ROC) analysis. RESULTS Seventy-two patients (40 hypopharynx 32 larynx tumours) were included, mean age 61 (range 41-77) years, 50 (69%) were men. Forty-five (62.5%) had chemoradiotherapy, 27 (37.5%) had radiotherapy alone. Median follow-up 26 months (range 12-105 months). Twenty-seven (37.5%) patients progressed within 12 months. ROC AUC for models A, B, C, and D were 0.91, 0.94, 0.88, and 0.93 in training and 0.82, 0.72, 0.70, and 0.94 in validation cohorts. Parameters in model D were metabolic tumour volume (MTV), maximum CT value, minimum standardized uptake value (SUVmin), grey-level zone length matrix (GLZLM) small-zone low grey-level emphasis (SZLGE) and histogram kurtosis. CONCLUSION FDG PET-CT derived radiomic features are potential predictors of early disease progression in patients with locally advanced larynx and hypopharynx SCC.
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Affiliation(s)
- J Zhong
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - R Frood
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - P Brown
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Nelstrop
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R Prestwich
- Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G McDermott
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Currie
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Radiotherapy Research Group, Leeds Institute of Medical Research, Faculty of Medicine & Health, University of Leeds, Leeds, UK
| | - S Vaidyanathan
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A F Scarsbrook
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Radiotherapy Research Group, Leeds Institute of Medical Research, Faculty of Medicine & Health, University of Leeds, Leeds, UK
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Burke JR, Brown P, Quyn A, Lambie H, Tolan D, Sagar P. Tumour growth rate of carcinoma of the colon and rectum: retrospective cohort study. BJS Open 2020; 4:1200-1207. [PMID: 32996713 PMCID: PMC8370463 DOI: 10.1002/bjs5.50355] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/18/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The growth pattern of colorectal cancer is seldom investigated. This cohort study aimed to explore tumour growth rate in colorectal cancers managed non-surgically or deemed not resectable, and to determine its implication for prognosis. METHODS Consecutive patients with colonic or rectal adenocarcinoma were identified through the colorectal multidisciplinary team database at Leeds Teaching Hospitals NHS Trust over a 2-year interval. Patients who received no treatment (surgery, stenting, colonic defunctioning procedures, chemotherapy, radiotherapy) and who underwent CT twice more than 5 weeks apart were included. Multidetector CT/three-dimensional image analysis was performed independently by three experienced radiologists. RESULTS Of 804 patients reviewed, 43 colorectal cancers were included in the final analysis. Median age at first CT was 80 (73-85) years and the median interval between scans was 150 (i.q.r. 72-471) days. An increase in T category was demonstrated in 31 of 43 tumours, with a median doubling time of 211 (112-404) days. The median percentage increase in tumour volume was 34·1 (13·3-53·9) per cent per 62 days. The all-cause 3-year mortality rate was 81 per cent (35 of 43) with a median survival time of 1·1 (0·4-2·2) years after the initial diagnostic scan. In those obstructed, the relative risk of death from subsequent perforation was 1·26 (95 per cent c.i. 1·07 to 1·49; P = 0·005). CONCLUSION This study documented a median doubling time of 211 days, with a concerning suggestion of tumour progression, which has implications for the current management standard.
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Affiliation(s)
- J. R. Burke
- John Golligher Colorectal Surgery UnitLeedsUK
- Leeds Institute of Biomedical and
Clinical SciencesSt James's University HospitalLeedsUK
| | - P. Brown
- Department of Clinical Radiology, Gastrointestinal and Abdominal Radiology,
St James's University Hospital, Leeds Teaching Hospitals NHS TrustLeedsUK
| | - A. Quyn
- John Golligher Colorectal Surgery UnitLeedsUK
- Leeds Institute of Biomedical and
Clinical SciencesSt James's University HospitalLeedsUK
| | - H. Lambie
- Department of Clinical Radiology, Gastrointestinal and Abdominal Radiology,
St James's University Hospital, Leeds Teaching Hospitals NHS TrustLeedsUK
| | - D. Tolan
- Department of Clinical Radiology, Gastrointestinal and Abdominal Radiology,
St James's University Hospital, Leeds Teaching Hospitals NHS TrustLeedsUK
| | - P. Sagar
- John Golligher Colorectal Surgery UnitLeedsUK
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Brown P, Oliver E, Dening KH. Supporting family carers via the Admiral Nurse Dementia Helpline: reflection on a case study. Nurs Older People 2020; 32:16-20. [PMID: 32400141 DOI: 10.7748/nop.2020.e1248] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2020] [Indexed: 06/11/2023]
Abstract
In the UK, the quality of post-diagnostic care and support for people with dementia and their family carers is variable and depends on the availability of services in each person's local area. This article considers the support services available for families affected by dementia and discusses how telephone helplines can assist those who may have no access to other types of support. It presents a case study describing a call to the Admiral Nurse Dementia Helpline, a service run by nurses with expertise in dementia care and provided by the charity Dementia UK. This is followed by a reflection on the call from the nurse's perspective. The case study-based reflection demonstrates the complexity of providing support through a helpline and the specialist knowledge and skills required to provide the appropriate level of support.
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Wiest C, Tinkhauser G, Pogosyan A, Bange M, Muthuraman M, Groppa S, Baig F, Mostofi A, Pereira EA, Tan H, Brown P, Torrecillos F. Local field potential activity dynamics in response to deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Neurobiol Dis 2020; 143:105019. [PMID: 32681881 PMCID: PMC7115855 DOI: 10.1016/j.nbd.2020.105019] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/17/2020] [Accepted: 07/11/2020] [Indexed: 02/06/2023] Open
Abstract
Local field potentials (LFPs) may afford insight into the mechanisms of action of deep brain stimulation (DBS) and potential feedback signals for adaptive DBS. In Parkinson's disease (PD) DBS of the subthalamic nucleus (STN) suppresses spontaneous activity in the beta band and drives evoked resonant neural activity (ERNA). Here, we investigate how STN LFP activities change over time following the onset and offset of DBS. To this end we recorded LFPs from the STN in 14 PD patients during long (mean: 181.2 s) and short (14.2 s) blocks of continuous stimulation at 130 Hz. LFP activities were evaluated in the temporal and spectral domains. During long stimulation blocks, the frequency and amplitude of the ERNA decreased before reaching a steady state after ~70 s. Maximal ERNA amplitudes diminished over repeated stimulation blocks. Upon DBS cessation, the ERNA was revealed as an under-damped oscillation, and was more marked and lasted longer after short duration stimulation blocks. In contrast, activity in the beta band suppressed within 0.5 s of continuous DBS onset and drifted less over time. Spontaneous activity was also suppressed in the low gamma band, suggesting that the effects of high frequency stimulation on spontaneous oscillations may not be selective for pathological beta activity. High frequency oscillations were present in only six STN recordings before stimulation onset and their frequency was depressed by stimulation. The different dynamics of the ERNA and beta activity with stimulation imply different DBS mechanisms and may impact how these activities may be used in adaptive feedback.
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Affiliation(s)
- C Wiest
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - G Tinkhauser
- Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - A Pogosyan
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - M Bange
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Mainz University Hospital, Mainz, Germany
| | - M Muthuraman
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Mainz University Hospital, Mainz, Germany
| | - S Groppa
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Mainz University Hospital, Mainz, Germany
| | - F Baig
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK; Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St. George's, University of London, London, UK
| | - A Mostofi
- Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St. George's, University of London, London, UK
| | - E A Pereira
- Neurosciences Research Centre, Molecular and Clinical Sciences Institute, St. George's, University of London, London, UK
| | - H Tan
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - P Brown
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - F Torrecillos
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
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Brown P, Butterworth S, Hann M, Jeffrey P, Porter R, Swarbrick M, Ward S. Recent Clinical Disclosures and SMR Award. Highlights from The Society for Medicines Research Symposium. London, UK - December 5, 2019. DRUG FUTURE 2020. [DOI: 10.1358/dof.2020.45.1.3127029] [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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Deshmukh T, Geenty P, Geraghty L, Emmerig D, Sivapathan S, Hogg M, Brown P, Panicker S, Altman M, Gottlieb D, Thomas L. P790 Bi-ventricular dysfunction in patients after bone marrow transplant: the value of strain imaging. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiovascular events are a significant cause of morbidity and mortality in cancer survivors, particularly occurring at 5-10 years after their cancer therapy.
Purpose
To assess the utility of strain imaging by 2-dimensional (2D) speckle tracking echocardiography in detecting bi-ventricular dysfunction, as compared to traditional measures, in patients post bone marrow transplantation (BMT) with previous anthracycline (AC) therapy for haematological conditions.
Methods
50 consecutive patients post BMT + AC, reviewed at a long-term survivor clinic, were compared to 50 age and gender matched controls. 48/50 patients received AC doses below the recommended cumulative lifetime thresholds set by the European Society of Medical Oncology. 2D left ventricular global longitudinal strain (LV GLS) and right ventricle free wall strain (RV FWS) were compared to conventional measures of bi-ventricular function.
Results
The mean LVEF (58 ± 6% vs 63 ± 6%) and RV fractional area change (FAC) (39 ± 5% vs 44 ± 5%), although reduced in the BMT + AC group vs controls, were within normal limits. LV GLS was reduced in BMT + AC patients as compared to controls (-17.8 ± 3.1% vs -20.5 ± 2.2%, p < 0.01) while RV FWS was also reduced (-23.2 ± 4.0% vs -27.9 ± 2.7%, p < 0.001). In BMT + AC patients with a preserved LVEF (LVEF > 53%), 28% (11/40) had reduced GLS (GLS < -17%) while 52% (24/46) of those with preserved FAC (FAC > 35%) had reduced FWS (FWS < -25%). Major adverse cardiac events (MACE) occurred in 9/50 patients in the BMT + AC group and none in the control group. 8/9 patients had normal biventricular function as assessed by traditional parameters (LVEF and RV FAC) but 5/9 patients had reduced LV GLS and/or RV FWS.
Conclusions
Subclinical bi-ventricular dysfunction is common in patients post BMT + AC therapy, and can be detected using strain analysis, despite preserved LV and RV systolic function using conventional measures. MACE occurred at a significantly higher rate in BMT patients exposed to AC. More than half of MACE events occurred in patients with reduced LV or RV strain, with preserved bi-ventricular function by traditional measures. LV GLS and RV FWS should be utilised for early identification of subclinical dysfunction in BMT patients.
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Affiliation(s)
- T Deshmukh
- Westmead Hospital, Cardiology, Sydney, Australia
| | - P Geenty
- Westmead Hospital, Cardiology, Sydney, Australia
| | | | - D Emmerig
- Westmead Hospital, Sydney, Australia
| | - S Sivapathan
- Westmead Hospital, Cardiology, Sydney, Australia
| | - M Hogg
- Westmead Hospital, Haematology, Sydney, Australia
| | - P Brown
- Westmead Hospital, Cardiology, Sydney, Australia
| | - S Panicker
- Westmead Hospital, Cardiology, Sydney, Australia
| | - M Altman
- Westmead Hospital, Cardiology, Sydney, Australia
| | - D Gottlieb
- Westmead Hospital, Haematology, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Cardiology, Sydney, Australia
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Trivedi S, Stefani L, Brown P, Kizana E, Kumar S, Thomas S, Thomas L. P353 Structural, functional, and electromechanical alterations in patients with paroxysmal atrial fibrillation compared to healthy controls. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Methods
We sought to evaluate the clinical and echocardiographic differences between healthy controls and paroxysmal atrial fibrillation (AF) patients. Clinical and echocardiographic parameters (performed in sinus rhythm) in 46 paroxysmal AF patients were compared with a departmental database of 83 health controls.
Results
AF patients were older and had increased body size (Table 1). 39/46 (84%) of AF patients had hypertension and 23/46 (50%) had diabetes mellitus.
AF patients had increased left ventricular (LV) mass, and reduced diastolic function (lower e’ and increased E/e’ ratio) when compared to healthy controls. Left atrial (LA) volumes were significantly increased in the AF group. All strain parameters – reservoir, conduit, and contractile strain – were impaired in AF patients compared to controls. LA mechanical dispersion (MD) was significantly increased in AF patients. A ratio of indexed LA volume/LA reservoir strain was significantly higher in AF patients over controls.
The duration of AF had an inverse correlation with LA reservoir strain (Fig 1) (r=–0.78; p < 0.001).
Conclusions
Compared to healthy controls, patients with paroxysmal AF have significant structural, functional and electromechanical alterations. LA strain is significantly impaired in paroxysmal AF and correlates with AF duration.
Table 1. Echocardiographic parameters Parameter Controls (mean ± SD) AF patients (mean ± SD) P value Age (years) 48 ± 18 58 ± 14 0.001 Body surface area (m2) 1.9 ± 0.2 2 ± 0.2 0.014 LV mass (g) 178 ± 48 223 ± 68 <0.001 Average e’ velocity (cms-1) 10.3 ±2.7 8.1 ± 2.2 <0.001 E/e’ 7.4 ± 1.9 9.3 ± 3.4 0.001 Indexed LA end systolic volume (ml/m2) 27.2 ± 7.1 39.0 ± 11.6 <0.001 LA ejection fraction 55.2 ± 10.4 48.5 ± 14.0 0.007 LA functional index 43.7 ± 14.6 29.8 ± 14.3 <0.001 LA reservoir strain (%) 34.3 ± 6.8 27.9± 8.1 <0.001 LA conduit strain (%) 18.4 ± 6.2 13.5 ± 4.7 <0.001 LA contractile strain (%) 15.9 ± 3.9 14.4 ± 5.5 0.007 LA mechanical dispersion (ms) 25.8 ± 9.6 30.9 ± 11.6 0.018 Indexed LA volume / Reservoir strain ratio 0.8 ± 0.3 1.6 ± 0.9 <0.001 LV = left ventricular; LA = left atrium; SD = standard deviation
Abstract P353 Figure. Fig 1. AF duration vs. Reservoir strain
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Affiliation(s)
- S Trivedi
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - L Stefani
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - P Brown
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - E Kizana
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - S Kumar
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - S Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
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Emerson P, Mahendran S, Deshmukh T, Stefani L, Trivedi S, Hogg M, Brown P, Altman M, Panicker S, Gottlieb D, Thomas L. 072 Altered LA Strain in Bone Marrow Transplant (BMT) Patients Previously Treated With Anthracyclines: A Marker of an Atrial Myopathy. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.079] [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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37
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Trivedi S, Claessen G, Stefani L, Flannery D, Brown P, Janssens K, Thomas L, La Gerche A. P970 Significant differences in atrial structural and functional parameters leading to differing mechanisms of atrial fibrillation in athletes compared to non-athletes. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction: There is an increased incidence of atrial fibrillation (AF) in endurance athletes. We sought to evaluate the likely mechanistic basis for this phenomenon.
Methods
36 endurance athletes in sinus rhythm, with a previous history of AF (ATH-AF) were compared to age and gender matched endurance athletes with no prior history of AF (ATH), non athletes with paroxysmal AF (NONATH-AF) and age and gender matched healthy controls (CONTROL). A detailed transthoracic echocardiogram was performed with all groups in sinus rhythm, with detailed left atrial (LA) and left ventricular (LV) measurements, including strain analysis.
Results
All athletes had increased LA and LV size when compared with healthy controls (Table 1). Non athletes with paroxysmal AF had increased LA size when compared with controls. However, indexed LA/LV ratio was preserved in athletes and similar to healthy individuals, whilst AF patients had significantly increased LA/LV ratio. Athletes with AF had higher e’ velocity and lower E/e’, whereas e’ was reduced and E/e’ elevated in non-athlete AF patients.
Athletes had impaired LA reservoir and contractile strain, and reduced LV global longitudinal strain (GLS) compared with healthy controls.
Conclusions
Compared to healthy controls, athletes have reduced LA and LV strain, with preserved LV diastolic function and LA/LV ratio. In contrast, altered diastolic function with differential increase in LA volume was observed in AF patients. The increased risk of AF in athletes is likely mediated by different mechanistic processes other than an atrial myopathy consequent to diastolic dysfunction as observed in non-athletes with AF.
Table 1. LA and LV parameters Parameter ATH-AF ATH NONATH-AF CONTROL P value LVEDV indexed (ml/m2) 84 ± 12 79 ± 14 57 ± 10 51 ± 13 <0.001 LVESV indexed (ml/m2) 35 ± 6 34 ± 7 25 ± 8 27 ± 33 0.02 LV ejection fraction (%) 58 ± 4 56 ± 4 56 ± 10 58 ± 8 0.586 LV global longitudinal strain (%) 19.2 ± 1.7 18.9 ± 2.1 21 ± 3.1 21.7 ± 2.9 <0.001 e’ vel (cm/s) 10 ± 2 10 ± 3 8 ± 2 9 ± 2 0.007 E/e’ 5.7 ± 1.3 5.9 ± 1.8 9.1 ± 3.3 7.5 ± 1.5 <0.001 LAV max indexed (ml/m2) 45 ± 11 43 ± 12 38 ± 11 27 ± 8 <0.001 Indexed LAV/LVEDV ratio 0.5 ± 0.1 0.6 ± 0.2 0.7 ± 0.2 0.5 ± 0.1 <0.001 LA reservoir strain (%) 27.2 ± 4.8 28.2 ± 3.7 27.9 ± 8.4 33.2 ± 7.0 <0.001 LA conduit strain (%) 14.2 ± 4.5 14.4 ± 4.0 14.9 ± 5.5 16.6 ± 6.3 0.182 LA contractile strain (%) 13.0 ± 3.1 13.8 ± 3.6 13.0 ± 5.1 16.6 ± 3.1 <0.001 LV = left ventricular, LAV = left atrial volume, LA = left atrial
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Affiliation(s)
- S Trivedi
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - G Claessen
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - L Stefani
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - D Flannery
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - P Brown
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - K Janssens
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - L Thomas
- Westmead Hospital, Department of Cardiology, Sydney, Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Ferkh A, Stefani L, Trivedi S, Brown P, Pathan F, Thomas L. P1504 Inter-vendor comparison of left atrial 2-dimensional strain using multilayer analysis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Left atrial strain (LAS) is increasingly being accepted as a marker of left atrial function. Different vendors utilise different techniques of measuring LAS in echocardiography.
AIMS
To determine the difference between multilayer endocardial and mid-myocardial measurements of LA strain on General Electric (GE) Echopac compared to the TOMTEC system which tracks endocardial strain.
METHODS
Peak reservoir left atrial strain (LAS) was measured on 50 healthy controls using the two different echocardiographic software packages. GE Echopac (v201) 2D-speckle tracking echocardiography technique (LV package) was used to measuremid-myocardial (GE-mid) and endocardial (GE-endo) LAS. This was compared to LAS measurement using TOMTEC (v4.6) which uses an endocardial tracking technique. LAS was measured in 4ch and 2ch views and average biplane strain measurement was obtained.
RESULTS
The mean of GE-mid LAS was 36.3 ± 6.3%, GE-endo LAS was higher with a mean of 44.1 ± 8.0%, while TOMTEC LAS was 42.1 ± 6.3 %. GE-mid and GE-endo LAS correlated well with TOMTEC LAS (r = 0.9, p < 0.001 for both). On Bland-Altman Analysis, GE-mid LAS measurements were systematically lower than TOMTEC LAS (mean difference -5.77), whereas GE-endo LAS had no systematic bias (mean difference 1.99).
CONCLUSIONS
Mid-myocardial peak reservoir left atrial strain, which is routinely measured using GE Echopac software, systematically underestimates LAS as compared to TOMTEC LAS or GE endocardial LAS. This suggests that serial follow up of LAS measurements for patients should be performed on the same software.
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Affiliation(s)
- A Ferkh
- University of Sydney, Sydney, Australia
| | - L Stefani
- University of Sydney, Sydney, Australia
| | - S Trivedi
- University of Sydney, Sydney, Australia
| | - P Brown
- Westmead Hospital, Sydney, Australia
| | - F Pathan
- University of Sydney, Sydney, Australia
| | - L Thomas
- University of Sydney, Sydney, Australia
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Geenty P, Sivapathan S, Deshmukh T, Brown P, Boyd A, Kwok F, Richards D, Altman M, Stewart G, Thomas L. P309 The use of echocardiographic parameters to predict clinical outcomes in AL-amyloidosis cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
AL-amyloidosis has a rapid clinical progression, with cardiac involvement associated with a particularly poor prognosis. Cardiac amyloidosis is diagnosed by either invasive biopsy or conventional echocardiographic parameters such as increased wall thickness, in the absence of other causes. More recently, novel parameters including 2D longitudinal strain have demonstrated diagnostic utility in a range of infiltrative cardiomyopathies including cardiac amyloidosis.
Aim/Method: We sought to evaluate traditional and novel echocardiographic parameters in their ability to predict adverse outcomes in a cohort of AL-amyloid patients. 80 patients who had transthoracic echocardiograms at a single centre were included. Comprehensive echocardiographic assessment was performed, including left ventricular ejection fraction (LVEF), LV Global Longitudinal Strain (GLS), LV mass (indexed to BSA). The primary endpoint was a composite of of major adverse cardiac events (MACE) and all-cause mortality, that was assessed by interrogation of the medical records on a specified censor date.
Results
At a mean follow-up (time from echo to censor date) of 5.4 ± 2.6years, 38/80 (47.5%) of patients experienced the primary endpoint of MACE or death, of which 25/80 (31%) were deaths. LVEF (59 ± 5.6%vs56 ± 6.4%, p = 0.04), GLS (17.4 ± 3.9%vs14.8 ± 4.9%, p = 0.01) basal longitudinal strain (12.3 ± 3.2%vs9.6 ± 3.9%, p = 0.002), indexed LV mass (107 ± 36g/m2vs130 ± 34g/m2, p = 0.06) and E/E’ (13.7 ± 4.9vs20.6 ± 9.6, p < 0.001) were all significantly different between patients who experienced the primary endpoint and those that didn’t. The strongest predictors of outcome were E/E’ (AUC 0.74), LV mass (AUC 0.73) and the ratio GLS:LV mass (AUC 0.73). An E/E’ of 15 had a sensitivity of 71% and specificity of 69%, while an indexed LV mass of 108 had a sensitivity and specificity of 74% and 67% respectively. GLS to LV mass as a cutoff of 0.16 had a sensitivity and specificity of 70% and 69% respectively.
Conclusion
In a cohort of 80 patients with AL-amyloid cardiomyopathy, almost half (47.5%) reached the primary composite endpoint. Diastolic dysfunction as expressed as E/E’, and LV mass were the most powerful predictors of outcome, while global longitudinal strain and LV basal strain were also reduced, and showed superiority over LV ejection fraction in predicting prognosis.
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Affiliation(s)
- P Geenty
- Westmead Hospital, Sydney, Australia
| | | | | | - P Brown
- Westmead Hospital, Sydney, Australia
| | - A Boyd
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - F Kwok
- Westmead Hospital, Sydney, Australia
| | - D Richards
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - M Altman
- Westmead Hospital, Sydney, Australia
| | - G Stewart
- Westmead Hospital, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Sydney, Australia
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Geenty P, Shivapathan S, Deshmukh T, Brown P, Boyd A, Taylor M, Kwok F, Altman M, Richards D, Stewart G, Thomas L. P1543 The assessment of regional myocardial strain in classifying amyloid cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
An infiltrative cardiomyopathy is a common manifestation of AL-amyloidosis, with cardiac involvement associated with a poor prognosis. Wild-type transthyretin amyloidosis (wt-TTR), is a distinct clinical entity occurring predominantly in men > 65 yrs, that has gained interest recently due to novel treatment options. Regional strain analysis has been shown to discriminate both forms of cardiac amyloidosis from other causes of concentric left ventricular hypertrophy, with a characteristic pattern of ‘apical sparing’. Due to the significant difference in both the course of the disease and treatment options between groups, a non-invasive echocardiographic method of determining subtype would be valuable.
Aim/Method: We sought to compare traditional and novel echocardiographic parameters in a cohort of AL ( n = 80) and wild type (wt-TTR) amyloid ( n = 32) patients. All amyloid patients underwent comprehensive transthoracic echocardiography, including both conventional parameters and LV longitudinal strain. Further novel parameters were computed including the ratio of global longitudinal strain (GLS) to LV ejection fraction (LVEF), as well as GLS to indexed LV mass.
Results
wt-TTR patients had significantly greater LV mass (176 ± 59g/m2vs118 ± 37g/m2, p < 0.001), and worse diastolic dysfunction as expressed as E/E’ (21.5 ± 11vs17 ± 8, p = 0.04). LVEF was significantly lower in wt-TTR patients however remained in the normal range in both groups (53 ± 6%vs57 ± 6%, p = 0.001), whilst GLS was significantly reduced compared to AL-amyloid patients (11.5 ± 3.4%vs16.2 ± 4.6%, p < 0.001). LVEF:GLS was significantly higher in wt-TTR patients (4.93 ± 1.4vs3.87 ± 1.3, p = 0.001) reflecting a more profound reduction in strain with a relatively preserved ejection fraction. Similarly, the ratio of GLS to LV mass was significantly lower in wt-TTR amyloidosis (0.078 ± 0.05vs0.155 ± 0.07, p < 0.001), reflecting a more significant reduction in strain for a given wall thickness in wt-TTR patients. GLS:LV mass was the strongest discriminator between subtypes (AUC 0.82), with a cutoff of 0.09 giving a sensitivity and specificity of 71% and 80% respectively, for detecting wt-TTR.
Conclusion
In this cohort, patients with wt-TTR had significantly greater increase in LV wall thickness and diastolic dysfunction, which may in part reflect their increased age (77vs62). However, GLS was also significantly reduced compared to AL-amyloid, even when accounting for LV ejection fraction and LV mass, suggesting these composite parameters may have value in determining the subtype of cardiac amyloidosis.
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Affiliation(s)
- P Geenty
- Westmead Hospital, Sydney, Australia
| | | | | | - P Brown
- Westmead Hospital, Sydney, Australia
| | - A Boyd
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - M Taylor
- Westmead Hospital, Sydney, Australia
| | - F Kwok
- Westmead Hospital, Sydney, Australia
| | - M Altman
- Westmead Hospital, Sydney, Australia
| | - D Richards
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - G Stewart
- Westmead Hospital, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Sydney, Australia
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Kimball J, Cui Y, Chen D, Brown P, Rooney WL, Stacey G, Balint-Kurti PJ. Identification of QTL for Target Leaf Spot resistance in Sorghum bicolor and investigation of relationships between disease resistance and variation in the MAMP response. Sci Rep 2019; 9:18285. [PMID: 31797989 PMCID: PMC6893015 DOI: 10.1038/s41598-019-54802-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/14/2019] [Accepted: 11/19/2019] [Indexed: 12/04/2022] Open
Abstract
Target leaf spot (TLS) of sorghum, a foliar disease caused by the necrotrophic fungus Bipolaris cookei (also known as Bipolaris sorghicola), can affect grain yield in sorghum by causing premature drying of leaves and defoliation. Two sorghum recombinant inbred line (RIL) populations, BTx623/BTx642 and BTx623/SC155-14E, were assessed for TLS resistance in replicated trials. Using least square mean trait data, four TLS resistance QTL were identified, two in each population. Of these, three were previously unidentified while a major QTL on chromosome 5 in the BTx623/BTx642 RIL population corresponded to the previously identified TLS resistance gene ds1. A set of sorghum lines were assessed for production of reactive oxygen species induced by treatment with the microbe-associated molecular pattern (MAMP) flg22 (a derivative of flagellin). Flg22-induced ROS production varied between lines in a consistent fashion. One QTL associated with variation in the flg22 response was detected in the RIL populations. No evidence was found to link variation in the MAMP response to variation in TLS resistance.
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Affiliation(s)
- Jennifer Kimball
- Department of Agronomy and Plant Genetics, University of Minnesota, St. Paul, MN, 55108, USA
- Dept of Entomology and Plant Pathology, NC State University, Raleigh, NC, 27695, USA
| | - Yaya Cui
- Divisions of Plant Science and Biochemistry, C. S. Bond Life Science Center, University of Missouri, Columbia, MO, 65211, USA
| | - Dongqin Chen
- Divisions of Plant Science and Biochemistry, C. S. Bond Life Science Center, University of Missouri, Columbia, MO, 65211, USA
| | - Pat Brown
- Department of Plant Sciences, University of California Davis, Davis, CA, 95616, USA
| | - William L Rooney
- Department of Soil and Crop Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Gary Stacey
- Divisions of Plant Science and Biochemistry, C. S. Bond Life Science Center, University of Missouri, Columbia, MO, 65211, USA
| | - Peter J Balint-Kurti
- Dept of Entomology and Plant Pathology, NC State University, Raleigh, NC, 27695, USA.
- Plant Science Research Unit, USDA-ARS, Raleigh, NC, 27695, USA.
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42
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Sanderson DCW, Carmichael LA, Fisk S, Brown P, Burton Y, Clemenson SD, Hart G, Nootenboom H, Pinnioja S, Schreiber GA, Wagner; U, Wiezorek C. Photostimulated Luminescence Detection of Irradiated Herbs, Spices, and Seasonings: International Interlaboratory Trial. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.5.990] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
An interlaboratory trial was conducted to validate photostimulated luminescence (PSL) methods for herbs, spices, and seasonings. Forty products (11 herbs, 17 spices, and 12 seasonings) were purchased from a local commercial source, and randomly selected samples were irradiated with 10 kGy. Four blended products were prepared at Scottish Universities Research and Reactor Centre, mixing varying proportions of irradiated material with the untreated product. Precharacterization against a predefined threshold identified low sensitivity products (black and white peppers) and products with high natural signals (thyme, sage, parsley, and mixed herbs), both of which might be susceptible to misclassification. Precharacterization also revealed whether calibration was likely to resolve overlap between classification categories. Eight sets of screening data and 5 sets of calibrated data were returned by participants. Of the 840 samples sent, 1593 screening measurements and 788 calibrated measurements were received from 662 samples. In screening mode, participants reached definitive conclusions in 87% of cases, 99% of which were correct. Of the remaining 13%, calibration to identify low-sensitivity resolved 60% of cases. Overall, 94% of samples were correctly identified by either screening alone, or screening plus calibration; 6% remained unclassified and therefore required further investigation by thermoluminescence. The results confirm the validity of the PSL method for herbs, spices, seasonings, and blends, and emphasize the need for calibration to identify low-sensitivity samples. This method has now been adopted by the European Committee for Standardization (CEN) and the Codex Alimentarius Commission.
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Affiliation(s)
- David C W Sanderson
- Scottish Universities Research and Reactor Centre (SURRC), Scottish Enterprise Technology Park, Rankine Ave, East Kilbride, G75 OQF, UK
| | - Lorna A Carmichael
- Scottish Universities Research and Reactor Centre (SURRC), Scottish Enterprise Technology Park, Rankine Ave, East Kilbride, G75 OQF, UK
| | - Saffron Fisk
- Scottish Universities Research and Reactor Centre (SURRC), Scottish Enterprise Technology Park, Rankine Ave, East Kilbride, G75 OQF, UK
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43
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Sanderson DCW, Carmichael LA, Fisk S, Brown P, Burton Y, Nootenboom H, Pinnioja S, Schreiber GA, Wagner U. Photostimulated Luminescence Detection of Irradiated Shellfish: International Interlaboratory Trial. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.5.983] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
An interlaboratory trial was conducted to validate photostimulated luminescence (PSL) detection of irradiated shellfish. Five species of shellfish (Nephrops norvegicus, mussels, black tiger prawns, brown shrimps, and king scallops) were presented blind as nonirradiated and irradiated to 0.5 and 2.5 kGy. Precharacterization analysis of each product and treatment was performed on both whole (including shell) and intestinal samples. The results for whole samples (including shell) confirmed that the method was able to distinguish between nonirradiated and irradiated samples, regardless of dose. Intestinal data have identified that the method is dependent on the quantity and sensitivity of grits present within the intestinal tract, which can be assessed using calibration by normalization to 1 kGy. Five laboratories returned both initial screening and calibrated data and sample classification. All laboratories correctly identified all irradiated products using the screening criteria. There were no false positives. The results confirm the validity of the PSL method for shellfish, which has been adopted as a European standard method and by the Codex Alimentarius Commission. Calibration is required where only intestinal material is available. For whole samples with shell, screening alone is sufficient.
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Affiliation(s)
- David C W Sanderson
- Scottish Universities Research and Reactor Centre (SURRC), Scottish Enterprise Technology Park, Rankine Ave, East Kilbride, G75 OQF, UK
| | - Lorna A Carmichael
- Scottish Universities Research and Reactor Centre (SURRC), Scottish Enterprise Technology Park, Rankine Ave, East Kilbride, G75 OQF, UK
| | - Saffron Fisk
- Scottish Universities Research and Reactor Centre (SURRC), Scottish Enterprise Technology Park, Rankine Ave, East Kilbride, G75 OQF, UK
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Mohammed SA, Costantino S, Akhmedov A, Ambrosini S, Karsay G, Brown P, Luscher TF, Paneni F. P736Histone marks induced by the methyltransferase SETD7 modulate angiogenic response in diabetes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0340] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Despite advances in revascularization strategies, type 2 diabetic (T2D) patients with peripheral artery disease (PAD) continue to have a high risk of limb amputation. Hence, strategies that promote vascularization can be considered as a novel therapeutic option in T2D patients with PAD. Epigenetic modifications of histones and DNA have emerged as key modulators of gene expression. Mono-methylation of histone 3 at lysine 4 (H3K4m1) – a specific epigenetic signature induced by the methyltransferase SETD7 – favours a chromatin conformation enabling the transcription of genes involved in inflammation and oxidative stress.
Purpose
To investigate whether SETD7 modulates angiogenesis in experimental diabetes.
Methods
Human aortic endothelial cells (HAECs) were cultured in growth factor-free medium and exposed either to normal glucose (NG, 5 mM) or high glucose (HG, 25 mM) for 48 hours. SETD7 protein and H3K4me1 levels were investigated by Western blot and chromatin immunoprecipitation (ChIP). Knockdown of SETD7 was achieved by small interfering RNA (siRNA). Pharmacological blockade of SETD7 was performed by using the highly selective inhibitor (R)-PFI-2, while its inactive enantiomer, (S)-PFI-2, was used as a control. Scratch and tube formation assays were performed to investigate the impact of SETD7 on angiogenic properties of HAECs. RNA sequencing (RNA-seq) and Ingenuity Pathway Analysis (IPA) were employed to unveil putative genes regulated by SETD7 in HG-treated HAECs. SETD7 expression was also investigated in muscular specimens isolated from type 2 diabetic (db/db) mice and non-diabetic mice undergoing hindlimb ischemia for 21 days.
Results
HG exposure in HAECs led to a time-dependent increase of both SETD7 gene and protein expression, as compared to NG. SETD7 upregulation in HG-treated HAECs was associated with an increase of H3K4me1 levels as well as with impaired endothelial cell migration and tube formation. Of interest, both gene silencing and pharmacological blockade of SETD7 rescued hyperglycemia-induced impairment of angiogenic properties in HAECs. RNA-seq in HG-treated HAECs with and without SETD7 depletion unveiled an array of differentially expressed genes, which were mainly involved in blood vessel growth and angiogenic response, as assessed by IPA analysis. Among dysregulated genes, ChIP assays showed that SETD7-dependent chromatin changes enabled the transcription of Semaphorin 3G (SEMA-3G), a negative regulator of endothelial cell migration. Indeed, gene silencing of SETD7 blunted SEMA-3G expression in HAECs exposed to HG. Consistent with our in vitro observations, SETD7 was upregulated in adductor muscle specimens from db/db mice undergoing hindlimb ischemia as compared to non-diabetic animals.
Conclusions
Pharmacological blockade of SETD7 by (R)-PFI-2 may represent a potential therapeutic approach to boost post-ischemic vascularization in T2D patients with PAD.
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Affiliation(s)
- S A Mohammed
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - S Costantino
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - A Akhmedov
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - S Ambrosini
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - G Karsay
- University Hospital Zurich, Institute for Clinical Chemistry, Zurich, Switzerland
| | - P Brown
- University of Toronto, Structural Genomics Consortium, Toronto, Canada
| | - T F Luscher
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - F Paneni
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
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Ambrosini S, Montecucco F, Akhmedov A, Mohammed SA, Brown P, Rossi F, Luscher TF, Costantino S, Paneni F. P5378The methyltransferase SETD7 promotes myocardial ischemic injury by activating Hippo signalling. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Despite significant advances in coronary revascularization, acute myocardial infarction remains the leading cause of heart failure and death worldwide. The Hippo pathway is a master regulator of cell survival during myocardial ischemia. Upon cellular stress, activation of Hippo signaling leads to cytosolic retention and degradation of the pro-survival transcription factor YAP. Post-translational modifications, namely methylation, critically affect protein functionality in conditions of cellular stress. The SET domain-containing lysine methyltransferase 7 (SETD7) - which induces a specific mono-methylation of both histone and non-histone proteins - has recently emerged as key player in the pathogenesis of vascular disease. However, the role of SETD7 in the heart is largely unknown.
Purpose
The present study investigates whether SETD7 regulates the Hippo pathway during myocardial ischemia.
Methods
Neonatal rat ventricular myocytes (NRVM) were exposed to normal glucose levels or glucose deprivation (GD) for 15 h, in the presence of the selective SETD7 inhibitor [(R)-PFI-2] or its inactive enantiomer [(S)-PFI-2]. Western blot and real time PCR were employed to investigate the effects of energy stress on SETD7 and the Hippo pathway, while apoptosis was assessed by Caspase-3 activity assay. YAP localization was examined by confocal microscopy while its mono-methylation was assessed by immunoblotting. SETD7 knockout (SETD7−/−) mice and wild-type (WT) littermates (male, 8–12 weeks old) underwent 1 h of left anterior descending (LAD) coronary artery ligation followed by 24 h of reperfusion. Infarct size was assessed by TTC staining and shown as infarct size per ventricle surface (I/V). Cardiac function was investigated at 24h by conventional and Tissue Doppler Imaging echocardiography (Vevo 3100, Visualsonics).
Results
GD for 15h in NRVMs led to both YAP phosphorylation and mono-methylation, and subsequent cytosolic retention, as assessed by confocal microscopy. Reduced nuclear content of YAP was confirmed by downregulation of YAP-dependent pro-survival genes, namely Ctgf and Fgf2. GD-induced YAP inactivation was associated with an increase in SETD7 expression. Interestingly, pharmacological inhibition of SETD7 by (R)-PFI-2 blunted YAP mono-methylation, thus restoring nuclear retention of YAP and transcription of pro-survival genes in GD-treated NRVMs. Moreover, (R)-PFI-2 prevented NRVMs apoptosis. In line with our in vitro findings, SETD7−/− mice showed decreased infarct size as compared to WT littermates (I/V: 16.27%±2 vs. 20.54%±3, p<0.005, respectively). Consistently, cardiac function, as assessed by ejection fraction (EF: 46%±2 vs. 38%±5, p<0.001), fractional shortening (FS: 22%±1 vs. 18%±3, p<0.001) as well as by TDI, was preserved in mice lacking SETD7 as compared to WT animals.
Conclusions
Pharmacological modulation of SETD7 by (R)-PFI-2 may represent a novel therapeutic approach to prevent myocardial ischemic damage.
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Affiliation(s)
- S Ambrosini
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - F Montecucco
- University of Genoa, Internal Medicine, Genoa, Italy
| | - A Akhmedov
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - S A Mohammed
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - P Brown
- University of Toronto, Structural Genomics Consortium, Toronto, Canada
| | - F Rossi
- University of British Columbia, Medical Genetics, Vancouver, Canada
| | - T F Luscher
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - S Costantino
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
| | - F Paneni
- University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland
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Mehta M, Gondi V, Ahluwalia M, Brown P. Radiosurgery followed by tumour treating fields (TTFields) for brain metastases (1-10) from NSCLC in the phase III METIS trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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47
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Maraldo M, Nielsen K, Berthelsen A, Petersen P, Loft A, Brown P, Specht L. Outcomes Following Involved Node Radiation Therapy for Early Stage Diffuse Large B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.369] [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: 10/26/2022]
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48
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Leppä S, Jørgensen J, Tierens A, Meriranta L, Østlie I, Brown P, Fagerli U, Larsen T, Mannisto S, Munksgaard L, Maisenhølder M, Vasala K, Meyer P, Jerkeman M, Björkholm M, Fluge Ø, Jyrkkiö S, Ralfkiaer E, Spetalen S, Karjalainen-Lindsberg M, Holte H. YOUNG HIGH RISK PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA INCLUDING BCL-2/MYC
DOUBLE HIT LYMPHOMAS BENEFIT FROM DOSE-DENSE IMMUNOCHEMOTHERAPY WITH EARLY CNS PROPHYLAXIS. Hematol Oncol 2019. [DOI: 10.1002/hon.92_2629] [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: 11/07/2022]
Affiliation(s)
- S. Leppä
- Department of Oncology; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - J. Jørgensen
- Department of Hematology; Aarhus University Hospital; Aarhus Denmark
| | - A. Tierens
- Department of Pathology; University Health Network; Toronto Canada
| | - L. Meriranta
- Department of Oncology; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - I. Østlie
- Department of Pathology; Oslo University Hospital; Oslo Norway
| | - P. Brown
- Department of Hematology; Rigshospitalet; Copengahen Denmark
| | - U. Fagerli
- Department of Oncology; St. Olavs Hospital; Trondheim Norway
| | - T.S. Larsen
- Department of Hematology; Odense University Hospital; Odense Denmark
| | - S. Mannisto
- Department of Oncology; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - L. Munksgaard
- Department of Hematology; Roskilde Hospital; Roskilde Denmark
| | - M. Maisenhølder
- Department of Oncology; University Hospital of North Norway; Tromsø Norway
| | - K. Vasala
- Department of Oncology; Central Finland Central Hospital; Jyväskylä Finland
| | - P. Meyer
- Department of Oncology; Stavanger University Hospital; Stavanger Norway
| | - M. Jerkeman
- Department of Oncology; Skåne University Hospital; Lund Sweden
| | - M. Björkholm
- Department of Hematology; Karolinska University Hospital; Stockholm Sweden
| | - Ø. Fluge
- Department of Oncology; Haukeland University Hospital; Bergen Norway
| | - S. Jyrkkiö
- Department of Oncology; Turku University Hospital; Turku Finland
| | - E. Ralfkiaer
- Department of Pathology; Rigshospitalet; Copenhagen Denmark
| | - S. Spetalen
- Department of Pathology; Oslo University Hospital; Oslo Norway
| | | | - H. Holte
- Department of Oncology; Oslo University Hospital; Oslo Norway
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49
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Lugtenburg P, Brown P, van der Holt B, D’Amore F, Koene H, de Jongh E, Fijnheer R, Loosveld O, Böhmer L, Pruijt H, Verhoef G, Hoogendoorn M, Bilgin Y, Nijland M, Lam K, de Keizer B, de Jong D, Zijlstra J. S1599 RITUXIMAB MAINTENANCE FOR PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA IN FIRST COMPLETE REMISSION: RESULTS FROM A RANDOMIZED HOVON-NORDIC LYMPHOMA GROUP PHASE III STUDY. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000564644.71009.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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50
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Ferkh A, Brown P, O'Keefe E, Zada M, Duggins A, Thiagalingam A, Altman M, Boyd A, Byth K, Kizana E, Denniss AR, Thomas L. Clinical and echocardiographic characteristics of cardioembolic stroke. Eur J Neurol 2019; 26:1310-1317. [PMID: 31062440 DOI: 10.1111/ene.13981] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Ischaemic stroke frequently has a cardioembolic (CE) source. Clinical and echocardiographic parameters associated with CE stroke were evaluated. METHODS In all, 93 consecutive ischaemic stroke patients who underwent a transthoracic echocardiogram were retrospectively analysed; strokes were classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Echocardiographic parameters related to CE stroke, including left atrial volumes and function, were compared to 73 healthy controls. RESULTS Of 93 patients (mean age 66.1 years, 56% male), nine (10%) had large artery atherosclerosis, 38 (41%) CE stroke, two (2%) small vessel disease, two (2%) other and 42 (45%) undetermined aetiology. Left atrial (LA) maximum volumes (LAVImax ) and minimum volumes (LAVImin ) were larger in the CE group than the non-CE group (45 vs. 32 ml/m2 , 32 vs. 13 ml/m2 , respectively, P < 0.001), whilst LA function indices including LA emptying fraction and LA function index (LAFI) were lower in the CE group (34% vs. 55%, and 0.12 vs. 0.35, respectively, P < 0.001). Adjusting for clinical characteristics, LAFI ≤0.3 was an independent predictor of CE stroke (adjusted odds ratio 5.3, P = 0.001). Additionally, LAVImax and LAVImin were larger (61 vs. 44 and 32 vs. 24 ml/m2 respectively, P < 0.01) and LAFI significantly lower (0.34 vs. 0.52, P < 0.001) in the undetermined aetiology group versus healthy controls. CONCLUSIONS Left atrial enlargement with reduced LA function was associated with CE stroke and LAFI was the best independent predictor. LA parameters were also altered in the undetermined aetiology group, suggesting an underlying LA myopathy in this subset.
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Affiliation(s)
- A Ferkh
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - P Brown
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - E O'Keefe
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - M Zada
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - A Duggins
- Neurology Department, Westmead Hospital, Sydney, NSW, Australia
| | - A Thiagalingam
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - M Altman
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - A Boyd
- University of Sydney, Camperdown, NSW, Australia
| | - K Byth
- University of Sydney, Camperdown, NSW, Australia
| | - E Kizana
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia.,Westmead Institute of Medical Research, Sydney, NSW, Australia
| | - A R Denniss
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - L Thomas
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia.,South Western Clinical School, University of New South Wales, Sydney, NSW, Australia
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