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Sanchez V, Dobzinski N, Fox R, Galor A. Rethinking Sjögren Beyond Inflammation: Considering the Role of Nerves in Driving Disease Manifestations. Eye Contact Lens 2024; 50:200-207. [PMID: 38350094 PMCID: PMC11045324 DOI: 10.1097/icl.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 02/15/2024]
Abstract
ABSTRACT Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease characterized by destruction of mucosal glands resulting in dry eye and dry mouth. Ocular presentations can be heterogenous in SS with corneal nerves abnormalities that are structural, functional, or both. Some individuals present with corneal hyposensitivity, with a phenotype of decreased tear production and epithelial disruption. Others present with corneal hypersensitivity, with a phenotype of neuropathic pain including light sensitivity and pain out of proportion to signs of tear dysfunction. A similar correlate can be found outside the eye, with dry mouth predominating in some individuals while pain conditions predominate in others. Understanding how nerve status affects SS phenotype is an important first step to improving disease management by targeting nerve abnormalities, as well as inflammation.
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Affiliation(s)
- Victor Sanchez
- New York University Grossman School of Medicine, New York, NY, 10016
| | - Noa Dobzinski
- Miami Veterans Administration Medical Center, Miami, FL, 33125
| | - Robert Fox
- Rheumatology, Scripps Memorial Hospital and Research Foundation, La Jolla, CA, 92037
| | - Anat Galor
- Miami Veterans Administration Medical Center, Miami, FL, 33125
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, 33163
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Stern ME, Theofilopoulos AN, Steven P, Niederkorn JY, Fox R, Calonge M, Scheid C, Pflugfelder SC. Immunologic basis for development of keratoconjunctivitis sicca in systemic autoimmune diseases: Role of innate immune sensors. Ocul Surf 2024; 32:130-138. [PMID: 38395195 DOI: 10.1016/j.jtos.2024.02.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
The literature is filled with citations reporting an increased incidence of chronic dry eye disease, also known as keratoconjunctivitis sicca, in patients with systemic autoimmune diseases such as rheumatoid arthritis, Sjögren's Syndrome, systemic sclerosis and lupus. As the most environmentally exposed mucosal surface of the body, the conjunctiva constantly responds to environmental challenges which are typically self limited, but when persistent and unresolved may provoke pathogenic innate and adaptive immune reactions. Our understanding of the pathophysiological mechanisms by which systemic autoimmune diseases cause dry eye inducing ocular surface inflammation continues to evolve. Conjunctival immune tone responds to self or foreign danger signals (including desiccating stress) on the ocular surface with an initial non-specific innate inflammatory response. If unchecked, this can lead to activation of dendritic cells that present antigen and prime T and B cells resulting in an adaptive immune reaction. These reactions generally resolve, but dysfunctional, hyper-responsive immune cells found in systemic autoimmune diseases that are recruited to the ocular surface can amplify inflammatory stress responses in the ocular surface and glandular tissues and result in autoimmune reactions that disrupt tear stability and lead to chronic dry eye disease. We here propose that unique features of the ocular surface immune system and the impact of systemic immune dysregulation in autoimmune diseases, can predispose to development of dry eye disease, and exacerbate severity of existing dry eye.
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Affiliation(s)
- Michael E Stern
- University of Cologne, Department of Ophthalmology, Cologne, Germany; IOBA, Department of Ophthalmology, University of Valladolid, Valladolid, Spain.
| | | | - Philipp Steven
- University of Cologne, Department of Ophthalmology, Cologne, Germany; University of Cologne, Department of Internal Medicine - 1, Cologne, Germany
| | - Jerry Y Niederkorn
- Southwestern School of Medicine, Department of Ophthalmology, Dallas, TX, USA
| | - Robert Fox
- Scripps Hospital, Department of Rheumatology, La Jolla, CA, USA
| | - Margarita Calonge
- IOBA, Department of Ophthalmology, University of Valladolid, Valladolid, Spain
| | - Christof Scheid
- University of Cologne, Department of Internal Medicine - 1, Cologne, Germany
| | - Stephen C Pflugfelder
- Ocular Surface Center, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
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Martsenkovskyi D, Shevlin M, Ben-Ezra M, Bondjers K, Fox R, Karatzias T, Martsenkovska I, Martsenkovsky I, Pfeiffer E, Sachser C, Vallières F, Hyland P. Mental health in Ukraine in 2023. Eur Psychiatry 2024; 67:e27. [PMID: 38533632 PMCID: PMC10988158 DOI: 10.1192/j.eurpsy.2024.12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Very little is known about the mental health of the adult population of Ukraine following Russia's full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. METHODS A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. RESULTS Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia's 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. CONCLUSION Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia's full-scale invasion. Ukraine's mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.
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Affiliation(s)
- Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | | | - Kristina Bondjers
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Scotland
| | - Inna Martsenkovska
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Igor Martsenkovsky
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Elisa Pfeiffer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Frédérique Vallières
- Trinity Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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Fox R, Lassner F, Prescher A. The Morphology of the Dorsal Part of the First Rib in Neurogenic Thoracic Outlet Syndrome Patients: A Retrospective Clinical Study. J Pers Med 2024; 14:150. [PMID: 38392583 PMCID: PMC10890555 DOI: 10.3390/jpm14020150] [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: 12/20/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The recurrence or persistence of symptoms after thoracic outlet decompression (TOD) in patients with neurogenic thoracic outlet syndrome (NTOS) is not uncommon. Some authors have shown significantly better clinical outcomes in patients who underwent TOD with exarticulation of the first rib compared to a group who underwent TOD with preservation of the dorsal portion of the first rib. Several other case series have shown significant improvement after redo surgery with removal of the dorsal first rib remnant. This indicates the importance of the dorsal part of the first rib in NTOS. However, radical exarticulation may not always be necessary. In this study, we tried to answer the question of whether there is a morphological difference in the dorsal part of the first rib in NTOS patients that might help in the diagnosis and treatment of NTOS. METHODS We used the CT data of 21 NTOS patients who underwent TOD surgery and measured the dorsal part of the first rib, then compared them with a quota sample. RESULTS We found no difference in the dorsal part of the first rib between NTOS patients and the quota sample in our data. CONCLUSIONS As there was no detectable difference, we were not able to use these data to help decide whether exarticulation is necessary in achieving adequate symptom relief. Therefore, we advocate exarticulation of the first rib when TOD is indicated.
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Affiliation(s)
- Robert Fox
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, 52074 Aachen, Germany
| | | | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, 52074 Aachen, Germany
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Hyland P, Hamer R, Fox R, Vallières F, Karatzias T, Shevlin M, Cloitre M. Is Dissociation a Fundamental Component of ICD-11 Complex Posttraumatic Stress Disorder? J Trauma Dissociation 2024; 25:45-61. [PMID: 37401797 DOI: 10.1080/15299732.2023.2231928] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 05/09/2023] [Indexed: 07/05/2023]
Abstract
ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a disorder of six symptom clusters including reexperiencing, avoidance, sense of threat, affective dysregulation, negative self-concept, and disturbed relationships. Unlike earlier descriptions of complex PTSD, ICD-11 CPTSD does not list dissociation as a unique symptom cluster. We tested whether the ICD-11 CPTSD symptoms can exist independently of dissociation in a nationally representative sample of adults (N = 1,020) who completed self-report measures. Latent class analysis was used to identify unique subsets of people with distinctive symptom profiles. The best fitting model contained four classes including a "low symptoms" class (48.9%), a "PTSD" class (14.7%), a "CPTSD" class (26.5%), and a "CPTSD + Dissociation" class (10.0%). These classes were related to specific adverse childhood experiences, notably experiences of emotional and physical neglect. The "PTSD," "CPTSD," and "CPTSD + Dissociation" classes were associated with a host of poor health outcomes, however, the "CPTSD + Dissociation" class had the poorest mental health and highest levels of functional impairment. Findings suggest that ICD-11 CPTSD symptoms can occur without corresponding dissociative experiences, however, when CPTSD symptoms and dissociative experiences occur together, health outcomes appear to be more severe.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Ruby Hamer
- Department of Medicine, Monash University, Melbourne, Australia
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
| | | | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- NHS Lothian Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern, Ireland
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
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Perta K, Bae Y, Vuolo J, Bressmann T, Fox R. The Role of Instructions in Motor Learning of Oral Versus Nasalized Speech Targets. J Speech Lang Hear Res 2023; 66:4398-4413. [PMID: 37870844 DOI: 10.1044/2023_jslhr-23-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
PURPOSE The purpose of this study was to investigate how general, implicit instructions with auditory-perceptual emphasis; specific, explicit instructions with biomechanical focus; or both affect learning of oral-nasal balance control in speech. METHOD Thirty healthy, vocally untrained participants were assigned to one of three instructional groups (i.e., implicit, explicit, and integrated) and learned to produce oral versus nasalized vowel-, syllable-, and phrase-level targets during once-weekly sessions over 4 weeks. Learning gains and performance variability were analyzed using nasometry. RESULTS We observed a significant main effect of instruction type on learning gains at phrase level (p = .016). Specifically, the integrated group (M = 59.8%) significantly outperformed the explicit group (M = 37.9%) and numerically outperformed the implicit group (M = 45.1%). For nasalized phrase targets, results revealed a significant main effect of instruction type on performance variability (p = .042), but pairwise comparisons between instruction groups were not significant. CONCLUSIONS The integration of implicit processes via auditory-perceptual modeling and explicit processes via relevant biomechanical directives resulted in larger motor learning gains, especially at higher levels of task complexity (i.e., phrase) compared to providing implicit or explicit instruction alone. The higher performance variability (i.e., less stable productions) that was sometimes induced by explicit instruction did not negatively impact learning when integrated with implicit instruction. Clinical implications for speech/voice therapy models are discussed.
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Affiliation(s)
- Karen Perta
- Department of Hearing, Speech and Language Sciences, Ohio University, Athens
| | - Youkyung Bae
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Janet Vuolo
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Tim Bressmann
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
| | - Robert Fox
- Department of Speech and Hearing Science, The Ohio State University, Columbus
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Gibney A, de Paiva REF, Singh V, Fox R, Thompson D, Hennessy J, Slator C, McKenzie CJ, Johansson P, McKee V, Westerlund F, Kellett A. A Click Chemistry-Based Artificial Metallo-Nuclease. Angew Chem Int Ed Engl 2023; 62:e202305759. [PMID: 37338105 DOI: 10.1002/anie.202305759] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/21/2023]
Abstract
Artificial metallo-nucleases (AMNs) are promising DNA damaging drug candidates. Here, we demonstrate how the 1,2,3-triazole linker produced by the Cu-catalysed azide-alkyne cycloaddition (CuAAC) reaction can be directed to build Cu-binding AMN scaffolds. We selected biologically inert reaction partners tris(azidomethyl)mesitylene and ethynyl-thiophene to develop TC-Thio, a bioactive C3 -symmetric ligand in which three thiophene-triazole moieties are positioned around a central mesitylene core. The ligand was characterised by X-ray crystallography and forms multinuclear CuII and CuI complexes identified by mass spectrometry and rationalised by density functional theory (DFT). Upon Cu coordination, CuII -TC-Thio becomes a potent DNA binding and cleaving agent. Mechanistic studies reveal DNA recognition occurs exclusively at the minor groove with subsequent oxidative damage promoted through a superoxide- and peroxide-dependent pathway. Single molecule imaging of DNA isolated from peripheral blood mononuclear cells shows that the complex has comparable activity to the clinical drug temozolomide, causing DNA damage that is recognised by a combination of base excision repair (BER) enzymes.
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Affiliation(s)
- Alex Gibney
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Raphael E F de Paiva
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Vandana Singh
- Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Robert Fox
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Damien Thompson
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, Department of Physics, University of Limerick, Ireland
| | - Joseph Hennessy
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Creina Slator
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Christine J McKenzie
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Pegah Johansson
- Laboratory of Clinical Chemistry, Sahlgrenska University Hospital Gothenburg, Sweden
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Vickie McKee
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Fredrik Westerlund
- Department of Life Sciences, Chalmers University of Technology, Gothenburg, Sweden
| | - Andrew Kellett
- SSPC, the, Science Foundation Ireland Research Centre for Pharmaceuticals, School of Chemical Sciences, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
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Joyce D, De Brún A, Symmons SM, Fox R, McAuliffe E. Remote patient monitoring for COVID-19 patients: comparisons and framework for reporting. BMC Health Serv Res 2023; 23:826. [PMID: 37537615 PMCID: PMC10401771 DOI: 10.1186/s12913-023-09526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/09/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND COVID-19 has challenged health services throughout the world in terms of hospital capacity and put staff and vulnerable populations at risk of infection. In the face of these challenges, many health providers have implemented remote patient monitoring (RPM) of COVID-19 patients in their own homes. However systematic reviews of the literature on these implementations have revealed wide variations in how RPM is implemented; along with variations in particulars of RPM reported on, making comparison and evaluation difficult. A review of reported items is warranted to develop a framework of key items to enhance reporting consistency. The aims of this review of remote monitoring for COVID-19 patients are twofold: (1) to facilitate comparison between RPM implementations by tabulating information and values under common domains. (2) to develop a reporting framework to enhance reporting consistency. METHOD A review of the literature for RPM for COVID-19 patients was conducted following PRISMA guidelines. The Medline database was searched for articles published between 2020 to February 2023 and studies reporting on items with sufficient detail to compare one with another were included. Relevant data was extracted and synthesized by the lead author. Quality appraisal was not conducted as the the articles considered were evaluated as informational reports of clinical implementations rather than as studies designed to answer a research question. RESULTS From 305 studies retrieved, 23 studies were included in the review: fourteen from the US, two from the UK and one each from Africa, Ireland, China, the Netherlands, Belgium, Australia and Italy. Sixteen generally reported items were identified, shown with the percentage of studies reporting in brackets: Reporting Period (82%), Rationale (100%), Patients (100%), Medical Team (91%) Provider / Infrastructure (91%), Communications Platform (100%), Patient Equipment (100%), Training (48%), Markers (96%), Frequency of prompt / Input (96%),Thresholds (82%), Discharge (61%), Enrolled (96%), Alerts/Escalated (78%), Patient acceptance (43%), and Patient Adherence (52%). Whilst some studies reported on patient training and acceptance, just one reported on staff training and none on staff acceptance. CONCLUSIONS Variations in reported items were found. Pending the establishment of a robust set of reporting guidelines, we propose a reporting framework consisting of eighteen reporting items under the following four domains: Context, Technology, Process and Metrics.
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Affiliation(s)
- David Joyce
- Interdisciplinary Research Education and Innovation in Health Systems (IRIS) Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Aoife De Brún
- Interdisciplinary Research Education and Innovation in Health Systems (IRIS) Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Sophie Mulcahy Symmons
- Interdisciplinary Research Education and Innovation in Health Systems (IRIS) Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Robert Fox
- Interdisciplinary Research Education and Innovation in Health Systems (IRIS) Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Eilish McAuliffe
- Interdisciplinary Research Education and Innovation in Health Systems (IRIS) Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland.
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McGinty G, Fox R, Hyland P. Assessing prevalence, validity, and correlates of ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder in Ireland. Psychol Trauma 2023:2023-65569-001. [PMID: 37104789 DOI: 10.1037/tra0001472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND The most frequently used measure of the 11th edition of the International Classification of Diseases (ICD-11) complex posttraumatic stress disorder (CPTSD) is the International Trauma Questionnaire (ITQ). While there is strong support for the psychometric properties of the ITQ, few studies have assessed its reliability and validity in nationally representative samples. Additionally, several correlates of ICD-11 CPTSD have been identified; however, few studies have assessed multiple correlates simultaneously. OBJECTIVE To assess the factorial validity and internal reliability of the ITQ in a nationally representative sample of adults living in Ireland (N = 1,100); determine the prevalence rates of ICD-11 posttraumatic stress disorder (PTSD) and CPTSD; and identify correlates of CPTSD symptoms and how CPTSD symptoms relate to risk of suicide. METHOD Confirmatory factor analysis was performed to evaluate the factorial validity of the ITQ, and structural equation modeling (SEM) was used to determine the unique multivariate associations between 10 predictor variables (age, sex, urban dwelling, unemployment status, number of traumatic events, COVID-19 infection, knowing someone who died from COVID-19, loneliness, social support, and sleep problems) and symptoms of CPTSD, and the unique associations between CPTSD symptoms and suicide risk. RESULTS The ITQ produces reliable and valid scores, 11.2% of people met requirements for ICD-11 PTSD (2.4%) or CPTSD (8.8%), exposure to a higher number of traumatic life events, higher levels of loneliness, and more sleep problems predicted CPTSD symptoms; and negative self-concept (NSC) symptoms were most strongly associated with suicidality. CONCLUSIONS Where the risk of suicide is high, treating symptoms of NSC, loneliness, and sleep problems may be advisable. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Robert Fox
- School of Business, National College of Ireland
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Vermesch P, Gold R, Bar-Or A, Cree B, Fox R, Giovannoni G, Li B, Piani-Meier D, Karlsson G, Kappos L. 147 Siponimod preserves retinal thickness: findings from the EXPAND OCT substudy. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.191] [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
AimTo evaluate changes in retinal thickness (µm), including the retinal nerve fibre layer (RNFL) and combined ganglion cell and inner plexiform layers (GCIPL), in patients receiving siponimod or placebo.MethodsChanges in optical coherence tomography (OCT) measurements from screening to M12 and M24 were compared between the two treatment groups using mixed models for repeated measures adjusted for treatment, age, sex and respective baseline OCT variables.ResultsThe OCT sub-study included 159 patients (siponimod, n=104; placebo, n=55). RNFL thickness at M12 numerically favoured siponimod (0.39 vs −0.99; p=0.099) but not at M24 (−0.05 vs. 0.48; p=0.642). However, fewer assessments were available for RNFL at M24 than M12. The between-group difference in GCIPL thinning was 0.21 (−2.55 vs −2.76; p=0.875) at M12 and 3.82 (−0.47 vs −4.29; p=0.01) at M24. Siponimod reduced retinal thinning vs placebo at M12 (change from baseline: 0.66 vs −1.86; p=0.006) and M24 (−0.05 vs −2.3; p=0.033). Changes of retinal thickness and GCIPL at the subfield areas also favoured siponimod over placebo.ConclusionsThese results support the sensitivity of OCT as a measure of tissue damage in progressive MS and are in line with previously reported beneficial effects of siponimod on other neurodegeneration related outcomes. Funding: Novartis Pharma AG, Basel, Switzerland.
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Fox R, Klug J, Thompson D, Kellett A, Reilly A. Stability of co-crystals – a density functional theory study. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Fox R. X-linked genes exhibit skewed expression in Sjogren's disease (SjD): a further step toward understanding the female predominance of autoimmune disease. J Mol Med (Berl) 2022; 100:1267-1269. [PMID: 35982186 PMCID: PMC9402745 DOI: 10.1007/s00109-022-02223-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/16/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Robert Fox
- Division of Rheumatology, Scripps Memorial Hospital and Research Foundation-Ximed, La Jolla, CA, USA.
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Salinsky LM, Fox R, Anastasio N, Cunningham KA. R‐(‐)2,5‐dimethoxy‐4‐iodoamphetamine (DOI) Blunts the Discriminative Stimulus Properties of Oxycodone. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r5549] [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)
- Leah M. Salinsky
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Robert Fox
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
| | - Noelle Anastasio
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
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Hyland P, Karatzias T, Ford JD, Fox R, Spinazzola J. The Latent Structure of Child and Adolescent Psychopathology and its Association with Different Forms of Trauma and Suicidality and Self-Harm : LATENT STRUCTURE OF PSYCHOPATHOLOGY. Res Child Adolesc Psychopathol 2022; 50:1501-1513. [PMID: 35476235 PMCID: PMC9616783 DOI: 10.1007/s10802-022-00925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/24/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a multidimensional and hierarchical model of the latent structure of psychopathology. While HiTOP has received much support in child/adolescent community samples, fewer studies have assessed this model in clinical samples of children/adolescents. Here, we modelled the latent structure of 45 symptoms of psychopathology from a clinical sample of children/adolescents and assessed how dimensions of psychopathology were related to specific forms of trauma and suicidality/self-harm. Clinician-derived assessments were obtained from 507 people aged 7-18 years. Confirmatory factor analysis was used to determine the optimal fitting model, and structural equation modelling was used to estimate associations with trauma exposure and suicidality/self-harm. The best fitting model(s) included five first-order factors reflecting Fear, Distress, Externalizing, Thought Disorder, and Traumatic Stress, with a higher-order general factor (p) accounting for the covariation between these factors. Unique associations were identified between specific forms of trauma and each dimension of psychopathology. p was strongly associated with suicidality/self-harm, and of the first-order factors, Distress was most strongly associated with suicidality/self-harm. Findings support the predictions of HiTOP that the latent structure of child/adolescent psychopathology can be effectively described by a multidimensional and hierarchal model. Moreover, we found tentative evidence for a unique dimension of Traumatic Stress psychopathology. Our findings also highlight the unique associations between specific forms of early life trauma and specific dimensions of psychopathology, and the importance of Distress related psychopathology for suicidality/self-harm in children and adolescents.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Thanos Karatzias
- Department of Psychology, Edinburgh Napier University, Edinburgh, Scotland
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
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15
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Marrie RA, Kosowan L, Cutter G, Fox R, Salter A. Disparities in Telehealth Care in Multiple Sclerosis. Neurol Clin Pract 2022; 12:223-233. [DOI: 10.1212/cpj.0000000000001167] [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] [Received: 12/08/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022]
Abstract
Background and Objectives:The COVID-19 pandemic has dramatically increased telehealth use. We assessed access to and use of telehealth care including videoconferencing, and usability of videoconferencing among persons with multiple sclerosis (MS).Methods:In Fall 2020, we surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Participants reported availability and receipt of MS care or education through telehealth. Participants who completed ≥1 live videoconferencing visit completed the Telehealth Usability Questionnaire (TUQ). We tested factors associated with access to and receipt of telehealth care using logistic regression. We tested factors associated with TUQ scores using quantile regression.Results:Of the 8434 participants to whom the survey was distributed, 6043 responded (71.6%); 5403 were eligible for analysis. Of the respondents, 4337 (80.6%) were women, and they had a mean (SD) age of 63.2 (10.0) years. Overall, 2889 (53.5%) reported access to MS care via telehealth, 2110 (39.1%) reported receipt of MS care via telehealth including 1523 (28%) via videoconference. Among participants who reported telehealth was available, older age was associated with decreased odds of having a telehealth video visit; higher income and being physically active were associated with increased odds. Older age and moderate to very severe visual symptoms were associated with lower perceived usability of telehealth.Conclusion:Older age, lower socioeconomic status and disease-related impairments are associated with less access to and use of telehealth services in people with MS. Barriers to telehealth should be addressed to avoid aggravating health care disparities when using digital medicine.
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16
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Fox R, Hyland P, Coogan AN, Cloitre M, Power JM. Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults. J Clin Psychol 2022; 78:321-342. [PMID: 34287862 PMCID: PMC8770684 DOI: 10.1002/jclp.23225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/19/2021] [Accepted: 06/23/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Research examining the relationship between loneliness and Complex Posttraumatic Stress Disorder (CPTSD) is scarce, particularly among older adults. CPTSD includes the core symptoms of PTSD along with additional symptoms reflecting "disturbances in self-organisation" (DSO). This study examined the cross-sectional relationships between loneliness (emotional and social loneliness) and CPTSD symptoms (i.e., PTSD and DSO symptoms) in older adults. METHODS Structural equation modelling was used to examine these relationships in a nationally representative sample of US adults aged 60-70 years (n = 456). RESULTS Controlling for covariates, emotional loneliness was associated with PTSD (β = 0.31) and DSO (β = 0.57) symptoms whereas social loneliness was only associated with DSO symptoms (β = 0.25). The model explained 35.0% of the variance in PTSD symptoms and 71.3% in DSO symptoms. CONCLUSION These findings have important implications for treating and understanding PTSD/CPTSD and their correlates among older adults.
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Affiliation(s)
- Robert Fox
- Department of Psychology, Maynooth University, Kildare, Ireland,Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery & Health Systems, University College Dublin
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Marylène Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA,Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
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17
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Hyland P, Rochford S, Munnelly A, Dodd P, Fox R, Vallières F, McBride O, Shevlin M, Bentall RP, Butter S, Karatzias T, Murphy J. Predicting risk along the suicidality continuum: A longitudinal, nationally representative study of the Irish population during the COVID-19 pandemic. Suicide Life Threat Behav 2022; 52:83-98. [PMID: 34184787 PMCID: PMC8420335 DOI: 10.1111/sltb.12783] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Little is known about the lifetime prevalence of different indicators of suicidality in the Irish general population; whether suicidality has increased during the COVID-19 pandemic; and what factors associated with belonging to different points on a continuum of suicidality risk. METHODS A nationally representative sample of Irish adults (N = 1,032) completed self-report measures in May 2020 and a follow-up in August 2020 (n = 715). RESULTS Lifetime prevalence rates were 29.5% for suicidal ideation, 12.9% for non-suicidal self-injury (NSSI), and 11.2% for attempted suicide. There were no changes in past two-week rates of NSSI and attempted suicide during the pandemic. Correlations between the indicators of suicidality supported a progression from ideation to NSSI to attempted suicide. Suicidal ideation alone was associated with being male, unemployed, higher loneliness, and lower religiosity. NSSI (with no co-occurring attempted suicide) was associated with a history of mental health treatment. Attempted suicide was associated with ethnic minority status, lower education, lower income, PTSD, depression, and history of mental health treatment. CONCLUSION Suicidal ideation, NSSI, and attempted suicide are relatively common phenomena in the general adult Irish population, and each has unique psychosocial correlates. These findings highlight important targets for prevention and intervention efforts.
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Affiliation(s)
- Philip Hyland
- Department of PsychologyMaynooth UniversityMaynoothIreland,Trinity Centre for Global HealthTrinity College DublinDublinIreland
| | - Sarah Rochford
- National Office for Suicide PreventionHealth Service ExecutiveDublinIreland
| | - Anita Munnelly
- National Office for Suicide PreventionHealth Service ExecutiveDublinIreland
| | - Philip Dodd
- National Office for Suicide PreventionHealth Service ExecutiveDublinIreland
| | - Robert Fox
- Department of PsychologyMaynooth UniversityMaynoothIreland,School of Nursing, Midwifery and Health SystemsUniversity College DublinDublinIreland
| | | | - Orla McBride
- School of PsychologyUlster UniversityColeraineNorthern Ireland
| | - Mark Shevlin
- School of PsychologyUlster UniversityColeraineNorthern Ireland
| | | | - Sarah Butter
- School of PsychologyUniversity of SheffieldSheffieldEngland
| | - Thanos Karatzias
- School of Health & Social CareEdinburgh Napier UniversityEdinburghScotland
| | - Jamie Murphy
- School of PsychologyUlster UniversityColeraineNorthern Ireland
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18
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Bowman SJ, Fox R, Dörner T, Mariette X, Papas A, Grader-Beck T, Fisher BA, Barcelos F, De Vita S, Schulze-Koops H, Moots RJ, Junge G, Woznicki JN, Sopala MA, Luo WL, Hueber W. Safety and efficacy of subcutaneous ianalumab (VAY736) in patients with primary Sjögren's syndrome: a randomised, double-blind, placebo-controlled, phase 2b dose-finding trial. Lancet 2022; 399:161-171. [PMID: 34861168 DOI: 10.1016/s0140-6736(21)02251-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sjögren's syndrome is an autoimmune disease characterised by dry eyes and mouth, systemic features, and reduced quality of life. There are no disease-modifying treatments. A new biologic, ianalumab (VAY736), with two modes of suppressing B cells, has previously shown preliminary efficacy. This dose-finding trial aimed to assess the safety and efficacy of different subcutaneous doses of ianalumab in patients with moderate to severe primary Sjögren's syndrome. METHODS VAY736A2201 was a randomised, parallel, double-blind, placebo-controlled, phase 2b dose-finding study done in 56 centres in 19 countries. Patients aged 18-75 years with primary Sjögren's syndrome with moderate to severe disease activity (European Alliance of Associations for Rheumatology [EULAR] Sjögren's Syndrome Disease Activity Index [ESSDAI] score ≥6) and symptom severity (EULAR Sjögren's Syndrome Patient Reported Index score ≥5) were eligible. Participants were randomly assigned (1:1:1:1) to receive subcutaneous placebo or ianalumab (5 mg, 50 mg, or 300 mg) every 4 weeks for 24 weeks using a secure, online randomisation system. Randomisation was stratified by the ESSDAI score at baseline (≥10 or <10). Study personnel and patients were masked to treatment assignment. The primary outcome was the change in ESSDAI score from baseline to 24 weeks in all randomly assigned patients. Dose-related change in disease activity (ESSDAI) from baseline at week 24 was assessed by multiple comparison procedure with modelling analysis. Safety was measured in all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, NCT02962895. FINDINGS Between June 27, 2017, and Dec 06, 2018, 293 patients were screened, 190 of whom were randomly assigned (placebo n=49, ianalumab 5 mg n=47, ianalumab 50 mg n=47, ianalumab 300 mg n=47). Statistically significant dose-responses were seen for overall disease activity (ESSDAI score) in four of the five dose-response models tested (p<0·025 in four models, p=0·060 in one model). The ESSDAI score decreased from baseline in all ianalumab groups, with the maximal ESSDAI score change from baseline observed in the ianalumab 300 mg group: placebo-adjusted least-squares mean change from baseline -1·92 points (95% CI -4·15 to 0·32; p=0·092). There were four serious adverse events in three patients considered treatment-related (pneumonia [n=1] and gastroenteritis [n=1] in the placebo group; appendicitis plus tubo-ovarian abscess in the same patient in the ianalumab 50 mg group). INTERPRETATION The study met its primary objective, showing a dose-related decrease in disease activity as measured by ESSDAI at week 24. Overall, ianalumab was well tolerated and safe, with no increase in infections. To our knowledge, this is the first large, randomised, controlled trial in primary Sjögren's syndrome that met its primary endpoint, and its results mean there is potential for more studies of this mechanism in the future. FUNDING Novartis.
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Affiliation(s)
- Simon J Bowman
- Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, UK; National Institute for Health Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK; Rheumatology Department, Milton Keynes University Hospital, Milton Keynes, UK.
| | - Robert Fox
- Rheumatology Clinic, Scripps Memorial Hospital and Research Institute, La Jolla, CA, USA
| | - Thomas Dörner
- Department of Medicine, Rheumatology and Clinical Immunology, Charité Universitätsmedizin and Deutsches Rheumaforschungszentrum, Berlin, Germany
| | - Xavier Mariette
- Université Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, INSERM U1184, Le Kremlin Bicêtre, France
| | - Athena Papas
- Division of Oral Medicine, Tufts School of Dental Medicine, Boston, MA, USA
| | - Thomas Grader-Beck
- Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Benjamin A Fisher
- Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, UK; National Institute for Health Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | - Filipe Barcelos
- Chronic Diseases Research Center, Nova Medical School, Lisbon, Portugal; Instituto Português de Reumatologia, Lisbon, Portugal; Rheumatology Department, Hospital Cuf Descobertas, Lisbon, Portugal
| | - Salvatore De Vita
- Clinic of Rheumatology, University Hospital Santa Maria della Misericordia, Department of Medical Area, University of Udine, Udine, Italy
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Robert J Moots
- Department of Rheumatology, Liverpool University Hospitals NHS Foundation Trust and Edge Hill University, Liverpool, UK
| | | | | | | | - Wen-Lin Luo
- Novartis Pharmaceuticals, East Hanover, NJ, USA
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19
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Hyland P, Vallières F, Daly M, Butter S, Bentall RP, Fox R, Karatzias T, MacLachlan M, McBride O, Murphy J, Murphy D, Spikol E, Shevlin M. Trajectories of change in internalizing symptoms during the COVID-19 pandemic: A longitudinal population-based study. J Affect Disord 2021; 295:1024-1031. [PMID: 34706410 PMCID: PMC8413484 DOI: 10.1016/j.jad.2021.08.145] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Longitudinal data indicates that the mental health of the general population may not have been as badly affected by the COVID-19 pandemic as some had feared. Most studies examining change in mental health during the pandemic have assumed population homogeneity which may conceal evidence of worsening mental health for some. In this study, we applied a heterogeneous perspective to determine if there were distinct groups in the population characterised by different patterns of change in internalizing symptoms during the pandemic. METHODS Self-report data were collected from a nationally representative sample of Irish adults (N = 1041) at four time-points between April and December 2020. RESULTS In the entire sample, mean levels of internalizing symptoms significantly declined from March to December 2020. However, we identified four distinct groups with different patterns of change. The most common response was 'Resilience' (66.7%), followed by 'Improving' (17.9%), 'Worsening' (11.3%), and 'Sustained' (4.1%). Belonging to the 'Worsening' class was associated with younger age, city dwelling, current and past treatment for a mental health problem, higher levels of empathy, and higher levels of loneliness. LIMITATIONS Sample attrition was relatively high and although this was managed using robust statistical methods, bias associated with non-responses cannot be entirely ruled out. CONCLUSION The majority of adults experienced no change, or an improvement in internalizing symptoms during the pandemic, and a relatively small proportion of adults experienced a worsening of internalizing symptoms. Limited public mental health resources should be targeted toward helping these at-risk individuals.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Room 1.1.4 Education House, Kildare, Ireland; Trinity Center for Global Health, Trinity College Dublin, Ireland.
| | | | - Michael Daly
- Department of Psychology, Maynooth University, Room 1.1.4 Education House, Kildare, Ireland
| | - Sarah Butter
- Department of Psychology, The University of Sheffield, United Kingdom
| | | | - Robert Fox
- School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, United Kingdom,Rivers Center for Traumatic Stress, NHS Lothian, United Kingdom
| | - Malcolm MacLachlan
- Department of Psychology, Maynooth University, Room 1.1.4 Education House, Kildare, Ireland,HSE National Clinical Programme for People with Disability, Ireland
| | - Orla McBride
- School of Psychology, Ulster University, United Kingdom
| | - Jamie Murphy
- School of Psychology, Ulster University, United Kingdom
| | - David Murphy
- Trinity Center for Global Health, Trinity College Dublin, Ireland
| | - Eric Spikol
- Department of Psychology, Maynooth University, Room 1.1.4 Education House, Kildare, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, United Kingdom
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20
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McGinty G, Fox R, Ben-Ezra M, Cloitre M, Karatzias T, Shevlin M, Hyland P. Sex and age differences in ICD-11 PTSD and complex PTSD: An analysis of four general population samples. Eur Psychiatry 2021; 64:e66. [PMID: 34602122 PMCID: PMC8581703 DOI: 10.1192/j.eurpsy.2021.2239] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is traditionally understood as a disorder that occurs more commonly in women than in men, and in younger age groups than in older age groups. The objective of this study was to determine if these patterns are also observed in relation to International Classification of Diseases (ICD-11) PTSD and complex PTSD (CPTSD). METHODS Secondary data analysis was performed using data collected from three nationally representative samples from the Republic of Ireland (N = 1,020), the United States (N = 1,839), and Israel (N = 1,003), and one community sample from the United Kingdom (N = 1,051). RESULTS Estimated prevalence rates of ICD-11 PTSD were higher in women than in men in each sample, and at a level consistent with existing data derived from Diagnostic and Statistics Manual of Mental Disorders (DSM)-based models of PTSD. Furthermore, rates of ICD-11 PTSD were generally lower in older age groups for men and women. For CPTSD, there was inconsistent evidence of sex and age differences, and some indication of a possible interaction between these two demographic variables. CONCLUSIONS Despite considerable revisions to PTSD in ICD-11, the same sex and age profile was observed to previous DSM-based models of PTSD. CPTSD, however, does not appear to show the same sex and age differences as PTSD. Theoretical models that seek to explain sex and age differences in trauma-related psychopathology may need to be reconsidered given the distinct effects for ICD-11 PTSD and CPTSD.
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Affiliation(s)
- Grainne McGinty
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Robert Fox
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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21
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Wagner J, Salter A, Fox R, Cutter G, Nichol K, Steinerman J, Smith K. Cannabis Use for Symptom Management Among People with Multiple Sclerosis (PwMS): A 2020 NARCOMS Survey. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Fox R, Mulcahy Symmons S, De Brún A, Joyce D, Muldoon EG, McGinty T, O'Reilly KMA, O'Connor E, McAuliffe E. Mixed methods protocol to examine the acceptability and clinical characteristics of a remote monitoring programme for delivery of COVID-19 care, among healthcare staff and patients. BMJ Open 2021; 11:e051408. [PMID: 34588258 PMCID: PMC8482534 DOI: 10.1136/bmjopen-2021-051408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The use of remote monitoring technology to manage the care of patients with COVID-19 has been implemented to help reduce the burden placed on healthcare systems during the pandemic and protect the well-being of both staff and patients. Remote monitoring allows patients to record their signs and symptoms remotely (eg, while self-isolating at home) rather than requiring hospitalisation. Healthcare staff can, therefore, continually monitor their symptoms and be notified when the patient is showing signs of clinical deterioration. However, given the recency of the COVID-19 outbreak, there is a lack of research regarding the acceptance of remote monitoring interventions to manage COVID-19. This study will aim to evaluate the use of remote monitoring for managing COVID-19 cases from the perspective of both the patient and healthcare staff. METHODS AND ANALYSIS Discharged patients from a large urban teaching hospital in Ireland, who have undergone remote monitoring for COVID-19, will be recruited to take part in a cross-sectional study consisting of a quantitative survey and a qualitative interview. A mixed methods design will be used to understand the experiences of remote monitoring from the perspective of the patient. Healthcare staff who have been involved in the provision of remote monitoring of patients with COVID-19 will be recruited to take part in a qualitative interview to understand their experiences with the process. Structural equation modelling will be used to examine the acceptance of the remote monitoring technology. Latent class analysis will be used to identify COVID-19 symptom profiles. Interview data will be examined using thematic analysis. ETHICS AND DISSEMINATION Ethical approval has been granted by the ethical review boards at University College Dublin and the National Research Ethics Committee for COVID-19-related Research. Findings will be disseminated via publications in scientific journals, policy briefs, short reports and social media.
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Affiliation(s)
- Robert Fox
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Sophie Mulcahy Symmons
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Aoife De Brún
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - David Joyce
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Eavan G Muldoon
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Tara McGinty
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Katherine M A O'Reilly
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Respiratory Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Eileen O'Connor
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Eilish McAuliffe
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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23
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Marrie RA, Kosowan L, Cutter GR, Fox R, Salter A. Uptake and Attitudes About Immunizations in People With Multiple Sclerosis. Neurol Clin Pract 2021; 11:327-334. [PMID: 34476124 PMCID: PMC8382432 DOI: 10.1212/cpj.0000000000001099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/15/2021] [Indexed: 01/02/2023]
Abstract
Objective By surveying a multiple sclerosis (MS) population, we tested the hypothesis that influenza vaccine uptake would not meet public health targets and that vaccine misconceptions would contribute to lower than desired uptake. Methods In spring 2020, we surveyed participants in the North American Research Committee on Multiple Sclerosis Registry regarding vaccinations. Participants reported whether they had received hepatitis A, hepatitis B, pneumococcal, shingles, varicella, measles/mumps/rubella, tetanus, or influenza vaccines. Participants who had not received influenza vaccine last year reported the reasons. We summarized responses descriptively. Using multivariable logistic regression, we assessed participant characteristics associated with uptake of seasonal influenza vaccine. Results Of 5,244 eligible respondents, 80.8% were female, with a mean (SD) age of 61.8 (10.1) years. Overall, 43.0% (2,161/5,032) of participants reported that their neurologist had ever asked about their immunization history. The percentage of participants who received the seasonal flu vaccine last year ranged from 59.1% among those aged 18-24 years to 79.9% for persons aged ≥65 years. Among those who did not get the influenza vaccination, the most common reasons were personal preference (29.6%), concerns about possible adverse effects in general (29.3%), and concerns that the vaccine would worsen their MS (23.7%). Conclusion Vaccination uptake is lower than desired in the MS population compared with existing recommendations, including for seasonal influenza. Misconceptions about the safety of vaccination in the context of MS and personal preference appear to play important roles in vaccination choices, highlighting the importance of education about these issues.
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Affiliation(s)
- Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences (RAM), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine Max Rady College of Medicine (LK), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Biostatistics (GRC), University of Alabama at Birmingham, AL; Mellen Center for Multiple Sclerosis (RF), Neurological Institute, Cleveland Clinic, OH; and Department of Biostatistics (AS), Washington University in St. Louis, MO
| | - Leanne Kosowan
- Departments of Internal Medicine and Community Health Sciences (RAM), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine Max Rady College of Medicine (LK), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Biostatistics (GRC), University of Alabama at Birmingham, AL; Mellen Center for Multiple Sclerosis (RF), Neurological Institute, Cleveland Clinic, OH; and Department of Biostatistics (AS), Washington University in St. Louis, MO
| | - Gary R Cutter
- Departments of Internal Medicine and Community Health Sciences (RAM), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine Max Rady College of Medicine (LK), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Biostatistics (GRC), University of Alabama at Birmingham, AL; Mellen Center for Multiple Sclerosis (RF), Neurological Institute, Cleveland Clinic, OH; and Department of Biostatistics (AS), Washington University in St. Louis, MO
| | - Robert Fox
- Departments of Internal Medicine and Community Health Sciences (RAM), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine Max Rady College of Medicine (LK), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Biostatistics (GRC), University of Alabama at Birmingham, AL; Mellen Center for Multiple Sclerosis (RF), Neurological Institute, Cleveland Clinic, OH; and Department of Biostatistics (AS), Washington University in St. Louis, MO
| | - Amber Salter
- Departments of Internal Medicine and Community Health Sciences (RAM), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Family Medicine Max Rady College of Medicine (LK), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Biostatistics (GRC), University of Alabama at Birmingham, AL; Mellen Center for Multiple Sclerosis (RF), Neurological Institute, Cleveland Clinic, OH; and Department of Biostatistics (AS), Washington University in St. Louis, MO
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Simpson-Yap S, Brouwer ED, Kalincik T, Rijke N, Hillert J, Walton C, Edan G, Spelman T, Geyes L, Parciak T, Gautrais C, Lazovski N, Pirmani A, Ardeshirdavani A, Forsberg L, Glaser A, McBurney R, Schmidt H, Bergmann A, Braune S, Stahmann A, Middleton R, Salter A, Fox R, van der Walt A, Butzkueven H, Rojas J, van der Mei I, Nag N, Ivanov R, Olival GSD, Dias AE, Magyari M, Brum DG, Mendes MF, Alonso R, Nicholas R, Bauer J, Chertcoff A, Zabalza A, Arrambide G, Fidao A, Comi G, Peeters L. 1298Associations of DMT therapies with COVID-19 severity in multiple sclerosis. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
People with multiple sclerosis (MS) are a vulnerable group for severe COVID-19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). We examined the characteristics of COVID-19 severity in an international sample of people with MS.
Methods
Data from 12 data-sources in 28 countries were aggregated (sources could include patients from 1-12 countries). Demographic (age, sex), clinical (MS phenotype, disability), and DMT (untreated, alemtuzumab, cladribine, dimethyl-fumarate, glatiramer-acetate, interferon, natalizumab, ocrelizumab, rituximab, siponimod, other) covariates were queried, alongside COVID-19 hospitalisation, admission to ICU, requiring artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression, adjusted for age, sex, MS phenotype, and EDSS.
Results
657 (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19 were analysed. Among suspected+confirmed/confirmed-only COVID-19, 20.9%/26.9% were hospitalised, 5.4%/7.2% were admitted to ICU, 4.1%/5.4% required artificial ventilation, and 3.2%/3.9% died. Older age, progressive MS-phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl-fumarate, ocrelizumab and rituximab were associated with hospitalisation (aOR=1.56,95%CI=1.01-2.41; aOR=2.43,95%CI=1.48-4.02) and ICU admission (aOR=2.30,95%CI=0.98-5.39; aOR=3.93,95%CI=1.56-9.89), though only rituximab was associated with higher risk of artificial ventilation (aOR=4.00,95%CI=1.54-10.39). Importantly, associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death.
Conclusions
Despite the cross-sectional design of this study, the internal and external consistency of these results with prior studies suggests their use may be a risk factor for more severe COVID-19.
Key messages
Anti-CD20 DMTs may be associated with worse COVID-19 severity amongst people with multiple sclerosis.
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Gutschall M, Young E, Furman M, Fox R. Community-Academic Partnership for Improving Nutrition Status, Food Security and Disease Outcomes in Rural Appalachia. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.202] [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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Lungu C, Cedarbaum JM, Dawson TM, Dorsey ER, Faraco C, Federoff HJ, Fiske B, Fox R, Goldfine AM, Kieburtz K, Macklin EA, Matthews H, Rafaloff G, Saunders-Pullman R, Schor NF, Schwarzschild MA, Sieber BA, Simuni T, Surmeier DJ, Tamiz A, Werner MH, Wright CB, Wyse R. Seeking progress in disease modification in Parkinson disease. Parkinsonism Relat Disord 2021; 90:134-141. [PMID: 34561166 DOI: 10.1016/j.parkreldis.2021.09.006] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/18/2021] [Accepted: 09/07/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Disease modification in Parkinson disease (PD) has remained an elusive goal, in spite of large investments over several decades. Following a large meeting of experts, this review article discusses the state of the science, possible reasons for past PD trials' failures to demonstrate disease-modifying benefit, and potential solutions. METHODS The National Institute of Neurological Disorders and Stroke (NINDS) convened a meeting including leaders in the field and representatives of key stakeholder groups to discuss drug therapy with the goal of disease modification in PD. RESULTS Important lessons can be learned from previous attempts, as well as from other fields. The selection process for therapeutic targets and agents differs among various organizations committed to therapeutic development. The areas identified as critical to target in future research include the development of relevant biomarkers, refinements of the targeted patient populations, considerations of novel trial designs, and improving collaborations between all stakeholders. CONCLUSIONS We identify potential barriers to progress in disease modification for Parkinson's and propose a set of research priorities that may improve the likelihood of success.
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Affiliation(s)
- Codrin Lungu
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 6001 Executive Blvd, #2188, Rockville, MD, 20852, USA.
| | | | - Ted M Dawson
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E Ray Dorsey
- University of Rochester Medical Center, Rochester, NY, USA
| | - Carlos Faraco
- Division of Clinical Research, NINDS, NIH, Bethesda, MD, USA
| | | | - Brian Fiske
- The Michael J Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Robert Fox
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Karl Kieburtz
- University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | | | | | | | | | - Tanya Simuni
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dalton J Surmeier
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amir Tamiz
- Division of Translational Research, NINDS, NIH, Bethesda, MD, USA
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Quartuccio L, De Marchi G, Longhino S, Manfrè V, Rizzo MT, Gandolfo S, Tommasini A, De Vita S, Fox R. Shared Pathogenetic Features Between Common Variable Immunodeficiency and Sjögren's Syndrome: Clues for a Personalized Medicine. Front Immunol 2021; 12:703780. [PMID: 34322134 PMCID: PMC8311857 DOI: 10.3389/fimmu.2021.703780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/22/2021] [Indexed: 11/17/2022] Open
Abstract
Common variable immunodeficiency disorders (CVID) are a group of rare diseases of the immune system and the most common symptomatic primary antibody deficiency in adults. The “variable” aspect of CVID refers to the approximately half of the patients who develop non-infective complications, mainly autoimmune features, in particular organ specific autoimmune diseases including thyroiditis, and cytopenias. Among these associated conditions, the incidence of lymphoma, including mucosal associated lymphoid tissue (MALT) type, is increased. Although these associated autoimmune disorders in CVID are generally attributed to Systemic Lupus Erythematosus (SLE), we propose that Sjogren’s syndrome (SS) is perhaps a better candidate for the associated disease. SS is an autoimmune disorder characterized by the lymphocytic infiltrates of lacrimal and salivary glands, leading to dryness of the eyes and mouth. Thus, it is a lymphocyte aggressive disorder, in contrast to SLE where pathology is generally attributed to auto-antibody and complement activation. Although systemic lupus erythematosus (SLE) shares these features with SS, a much higher frequency of MALT lymphoma distinguishes SS from SLE. Also, the higher frequency of germ line encoded paraproteins such as the monoclonal rheumatoid factor found in SS patients would be more consistent with the failure of B-cell VDJ switching found in CVID; and in contrast to the hypermutation that characterizes SLE autoantibodies. Thus, we suggest that SS may fit as a better “autoimmune” association with CVID. Examining the common underlying biologic mechanisms that promote lymphoid infiltration by dysregulated lymphocytes and lymphoma in CVID may provide new avenues for treatment in both the diseases. Since the diagnosis of SLE or rheumatoid arthritis is usually based on specific autoantibodies, the associated autoimmune features of CVID patients may not be recognized in the absence of autoantibodies.
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Affiliation(s)
- Luca Quartuccio
- Rheumatology Clinic, ASU FC, Udine, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | | | - Simone Longhino
- Rheumatology Clinic, ASU FC, Udine, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | - Valeria Manfrè
- Rheumatology Clinic, ASU FC, Udine, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | - Maria Teresa Rizzo
- Rheumatology Clinic, ASU FC, Udine, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | | | - Alberto Tommasini
- Pediatric Immunology, IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Salvatore De Vita
- Rheumatology Clinic, ASU FC, Udine, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | - Robert Fox
- Rheumatology Clinic, Scripps Memorial Hospital and Research Foundation, La Jolla, CA, United States
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Dörner T, Bowman SJ, Fox R, Mariette X, Papas A, Grader-Beck T, Fisher BA, Barcelos F, De Vita S, Schulze-Koops H, Moots RJ, Junge G, Woznicki J, Sopala M, Luo WL, Hueber W. POS0692 IANALUMAB (VAY736) SAFETY AND EFFICACY IN PATIENTS WITH SJOGREN’S SYNDROME: 52 WEEK RESULTS FROM A RANDOMISED, PLACEBO-CONTROLLED, PHASE 2B DOSE-RANGING TRIAL. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Sjogren’s syndrome (SS) is an autoimmune disease affecting excretory glands and characterised by B-cell hyperactivity. Ianalumab (VAY736) is a human monoclonal antibody to B-cell activating factor receptor, engineered for direct ADCC-mediated B-cell depletion. A Phase 2b study evaluated the dose-response of VAY736 vs placebo (PBO) in EULAR SS Disease Activity Index (ESSDAI) change from baseline (CHB) and other secondary endpoints.Objectives:Primary results at Week (Wk) 24 were reported previously1. Here we report 52 Wk safety and efficacy from extended blinded treatment period 2 (TP2).Methods:190 patients (pts) were randomised equally to receive s.c. doses of VAY736 (5, 50, 300 mg) or PBO every 4 Wks (q4w). Eligible pts fulfilled American European Consensus Group (AECG) criteria, were anti-Ro/SSA+, had ESSDAI ≥6 and EULAR SS Patient Reported Index (ESSPRI) ≥5. At Wk 24, after completion of the first blinded TP (TP1), PBO-treated pts were switched to VAY736 150 mg, and pts on 300 mg were re-randomised to continue 300 mg or PBO for 28 Wks in TP2. Pts were followed post-treatment for ≥20 Wks. Safety was assessed for all periods. Due to lack of PBO-control in TP2, descriptive efficacy analysis was performed for ESSDAI, ESSPRI, Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F), Physician’s (PhGA) and Patient’s Global Assessments (PaGA), SF-36, and SS symptom diary (SSSD).Results:Overall, there was no dose dependency of treatment emergent adverse events (TEAEs) except for injection site reactions, which were mostly mild to moderate in severity. Lymphopenia and neutropenia were mostly grade (G)1 and G2, no G4. Most common TEAEs were infections and infestations in exposure-adjusted analysis of incidence rates. Nasopharyngitis and upper respiratory tract infections were the most common TEAEs, with no dose response (Table 1). Tracheobronchitis and pneumonia, were mild to moderate severity, not associated with absolute neutrophil count G3, and none led to treatment withdrawal.At Wk 52, efficacy was sustained for pts who continued 300 mg in TP2 (ESSDAI, ESSPRI, PaGA, PhGA CHB: –9.06, –1.91, –22.03, –35.80, respectively). Efficacy was partially lost for pts switched to PBO at Wk 24 (Figure 1). Improvement was noted for PBO pts switched to 150 mg. Stimulated whole salivary flow at Wk 24 was improved for 300 mg (PBO-adjusted CHB 0.20 ml/min; P=0·037); last measurement at Wk 48 was 0.45 and 0.22 ml/min CHB in pts who continued 300 mg or PBO in TP2, respectively.Conclusion:Ianalumab 300 mg was well tolerated up to 52 Wks. Exploratory efficacy showed that continuous dosing of 300 mg s.c. q4w provided sustained clinical benefit. PaGA was the outcome that showed the most prominent change following switch to PBO or VAY736.References:[1]Dörner T, et al. [OP0302]. Ann Rheum Dis. 2020; 79 (suppl 1).Table 1.Key Safety Data (All Study Periods up to Week 52)*n (%)[EAIR]15 mg24 Wks(N=47)50 mg24 Wks(N=47)150 mg28 Wks(N=47)Any 300 mg (N=47)Any AE43 (91.5)43 (91.5)44 (93.6)45 (95.7)[517.5][423.3][621.0][544.6]Any SAE3 (6.4)5 (10.6)8 (17.0)8 (17.0)[5.9][10.7][19.9][13.6]Infections and infestations (SOC)233 (70.2)31 (66.0)34 (72.3)38 (80.9)[154.1][119.2][162.0][127.7]Nasopharyngitis37 [15.5]4 [8.5] 9 [22.1]9 [16.5]Upper respiratory tract infections36 [12.8]8 [17.8]5 [11.6]8 [13.6]Bronchitis33 [6.2]3 [6.2]4 [9.5]4 [6.6]Tracheobronchitis31 [2.0]0 [0.0]0 [0.0]3 [5.0]Pneumonia31 [2.0]0 [0.0]1 [2.2]2 [3.3]Blood & Lymphatic Disorders (SOC)28 (17.0)9 (19.1)6 (12.8)9 (19.1)[18.0][20.8][14.3][16.8]Lymphopenia34 [8.4]4 [8.6]3 [6.8]2 [3.3]Neutropenia35 [10.7]1 [2.1]2 [4.5]4 [6.9]Injection site reaction34 (8.5)9 (19.1)17 (36.2)27 (57.4)*Includes all safety data from TP1, TP2 and post-treatment follow-up; cut-off 06-Feb-20201EAIR, incidence rate per 100 subject years. For patient with an event, exposure time is censored at time of first event;2Number of pts with at least one AE in SOC;3PT, preferred term;SOC, system organ classDisclosure of Interests:Thomas Dörner Consultant of: Novartis, GSK, Sanofi, Janssen, Eli Lilly, Grant/research support from: Deutsche Forschungsgemeinschaft, Simon J. Bowman Consultant of: Astrazeneca, Biogen, BMS, Celgene, Medimmune, MTPharma, Novartis, Ono, UCB, xtlbio, Robert Fox Consultant of: Novartis, Pfizer and Lilly, Xavier Mariette Consultant of: BMS, Galapagos, Gilead, Medimmune, GSK, Grant/research support from: Servier, Athena Papas Consultant of: Novartis, Grant/research support from: Novartis, Thomas Grader-Beck Consultant of: Novartis, Lilly, Grant/research support from: Abbvie, Celgene, Ben A Fisher Consultant of: Novartis, Roche, BMS and Servier, Filipe Barcelos Consultant of: Pfizer and Lilly, Salvatore De Vita Consultant of: Roche, Human Genome Science, Glaxo Smith Kline and Novartis, Hendrik Schulze-Koops Consultant of: Novartis, Robert J Moots Consultant of: Amgen, Chugai, Gilead, Lilly, Novartis, Pfizer, Roche, Grant/research support from: Amgen, Chugai, Gilead, Lilly, Novartis, Pfizer, Roche, Guido Junge Shareholder of: Novartis, Employee of: Novartis, Janice Woznicki Shareholder of: Novartis, Employee of: Novartis, Monika Sopala Shareholder of: Novartis, Employee of: Novartis, Wen-Lin Luo Shareholder of: Novartis, Employee of: Novartis, Wolfgang Hueber Shareholder of: Novartis, Employee of: Novartis
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Hyland P, Shevlin M, Murphy J, McBride O, Fox R, Bondjers K, Karatzias T, Bentall RP, Martinez A, Vallières F. A longitudinal assessment of depression and anxiety in the Republic of Ireland before and during the COVID-19 pandemic. Psychiatry Res 2021; 300:113905. [PMID: 33827013 PMCID: PMC9755108 DOI: 10.1016/j.psychres.2021.113905] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/27/2021] [Indexed: 01/21/2023]
Abstract
Few studies have examined changes in mental health before and after the outbreak of COVID-19. We examined changes in the prevalence of major depression and generalized anxiety disorder (GAD) between February 2019 and March-April 2020; if there were changes in major depression and GAD during six weeks of nationwide lockdown; and we identified factors that predicted major depression and GAD across the six-week lockdown period. Nationally representative samples of Irish adults were gathered using identical methods in February 2019 (N = 1020) and March-April 2020 (N = 1041). The latter was reassessed six weeks later. Significantly more people screened positive for depression in February 2019 (29.8% 95% CI = 27.0, 32.6) than in March-April 2020 (22.8% 95% CI = 20.2, 25.3), and there was no change in GAD. There were no significant changes in depression and GAD during the lockdown. Major depression was predicted by younger age, non-city dwelling, lower resilience, higher loneliness, and higher somatic problems. GAD was predicted by a broader set of variables including several COVID-19 specific variables. These findings indicate that the prevalence of major depression and GAD did not increase as a result of, or during the early phase of the COVID-19 pandemic in Ireland.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Ireland; Trinity Centre for Global Health, Trinity College Dublin, Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Northern Ireland
| | - Robert Fox
- Department of Psychology, Maynooth University, Ireland
| | | | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Scotland
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Mulcahy Symmons S, Fox R, Mannion M, Joyce D, De Brún A, Glynn L, Ryan D, Keane N, McAuliffe E. A mixed methods protocol to evaluate the effectiveness and acceptability of COVID-19 Community Assessment Hubs. HRB Open Res 2021; 4:16. [PMID: 34056538 PMCID: PMC8136252 DOI: 10.12688/hrbopenres.13217.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Ireland's health system has been under significant strain due to staff shortages and inadequate capacity. Critical care bed capacity per capita in Ireland is among the lowest in Europe, thus, the coronavirus disease 2019 (COVID-19) pandemic has put additional strain on an over-stretched system. COVID-19 Community Assessment Hubs (CAHs) were established to mitigate unnecessary admission to acute hospitals, and reduce infection spread by supporting COVID-19 positive or suspected positive patients to isolate at home, or in isolation facilities. There is some evidence that similar assessment centres may be a successful triage strategy to reduce burden on hospital and acute care. Aim : The aim of this study is to evaluate the impact of COVID-19 Community Assessment Hubs on service delivery in two regions in Ireland during the pandemic. Methods: A mixed-methods approach will be used, incorporating co-design to engage stakeholders and ensure informed data capture and analysis. Online surveys will assess CAH patients' experiences of access to and quality of care. Clinical patient data from CAHs will be collected and analysed using multinomial logistic regression to check for association with patient demographics and COVID-19 symptoms, and CAH early warning scores and outcomes (Transfer to Emergency Department, Transfer to isolation unit, Sent home with care plan). Semi-structured interviews will be conducted with: patients to elicit an in-depth understanding of experiences and acceptability of attending CAHs; and staff to understand challenges, benefits, and effectiveness of CAHs. Interview data will be analysed using thematic analysis. Discussion: This study will provide valuable insights from both patient and staff perspectives on the operation of CAHs. We will evaluate the effectiveness and acceptability of CAHs and propose areas for improvement of the service. This will contribute to international literature on the use of community assessment centres during infectious disease pandemics.
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Affiliation(s)
- Sophie Mulcahy Symmons
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Robert Fox
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Marese Mannion
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
| | - David Joyce
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Aoife De Brún
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Liam Glynn
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
- HRB Primary Care Clinical Trials Network Ireland, Galway, Ireland
| | - Damien Ryan
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
- ALERT, Emergency Department, University Hospital Limerick, Limerick, V94 F858, Ireland
| | - Niamh Keane
- Department of Public health Nursing, Health Service Executive, Dublin, Ireland
| | - Eilish McAuliffe
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
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Garcia E, Kasper J, Chapman H, Stutz S, Fox R, Anastasio N, Moeller F, Cunningham K. The Growth Hormone Secretagogue Receptor Inverse Agonist/Antagonist PF‐5190457 Suppresses Oxycodone Seeking. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03708] [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)
- Erik Garcia
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
| | - James Kasper
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
| | - Holly Chapman
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
| | - Sonja Stutz
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
| | - Robert Fox
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
| | - Noelle Anastasio
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
- Pharmacology and ToxicologyUniversity of Texas Medical Branch at GalvestonGalvestonTX
| | - Frederick Moeller
- PsychiatryVirginia Commonwealth University School of MedicineRichmondVA
| | - Kathryn Cunningham
- Center for Addiction ResearchUniversity of Texas Medical Branch at GalvestonGalvestonTX
- Pharmacology and ToxicologyUniversity of Texas Medical Branch at GalvestonGalvestonTX
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Fox R, McHugh Power J, Coogan AN, Beekman ATF, van Tilburg TG, Hyland P. Posttraumatic stress disorder and loneliness are associated over time: A longitudinal study on PTSD symptoms and loneliness, among older adults. Psychiatry Res 2021; 299:113846. [PMID: 33706195 DOI: 10.1016/j.psychres.2021.113846] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 02/27/2021] [Indexed: 10/22/2022]
Abstract
Loneliness has a pernicious effect on mental health in later life and is likely to have a bidirectional relationship with psychopathology. However, longitudinal research examining loneliness and posttraumatic stress symptoms among older adults is scarce. This study aimed to examine the longitudinal relationship between different types of loneliness (social and emotional) and posttraumatic stress symptoms. Using two waves of an older adult sample (n = 1,276) from the Longitudinal Aging Study Amsterdam (LASA), this longitudinal relationship was examined using a multivariate two wave-latent change score (2W-LCS) model. There were significant, however, very small increases in both posttraumatic stress symptoms and emotional loneliness over time, whereas, average social loneliness scores did not significantly increase/decrease over time. Changes in both social (β = .16) and emotional loneliness (β = .15) were associated with small changes in posttraumatic stress symptoms, consistent with the existence of a longitudinal association between the constructs, net of covariate effects. Results provide evidence of the existence of a longitudinal association between subtypes of loneliness and posttraumatic stress symptoms, among older adults. Results have implications for clinicians who should identify individuals at risk of developing posttraumatic stress symptoms, and for the theory of both posttraumatic stress disorder and loneliness.
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Affiliation(s)
- Robert Fox
- Department of Psychology, Maynooth University, Kildare, Ireland; Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery & Health Systems, University College Dublin.
| | - Joanna McHugh Power
- Department of Psychology, Maynooth University, Kildare, Ireland; UK CRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands; GGZ inGeest, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Theo G van Tilburg
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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Smith A, Campbell V, Chapman H, Stutz S, Fox R, Moeller FG, Cunningham K, Anastasio N. Phenotypic Motor Impulsivity is Dynamically Altered Following Oxycodone Self‐Administration in Male Rats. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03889] [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)
- Ashley Smith
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
| | | | - Holly Chapman
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
| | - Sonja Stutz
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
| | - Robert Fox
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
| | | | - Kathryn Cunningham
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
| | - Noelle Anastasio
- Center for Addiction ResearchUniversity of Texas Medical BranchGalvestonTX
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Silva J, Merritt C, Li Y, Chen J, Fox R, Liu Z, Brehm V, Anastasio N, Zhou J, Cunningham K. Bromodomain‐Containing Protein 4 (BRD4) Inhibitors as Emerging Therapeutics for Opioid Use Disorder. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03944] [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)
- Jacqueline Silva
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Christina Merritt
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Yi Li
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Jianping Chen
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Robert Fox
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Zhiqing Liu
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Vicroria Brehm
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Noelle Anastasio
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Jia Zhou
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
| | - Kathryn Cunningham
- Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTX
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Manjappa S, Fox R, Caimi P, Reese JS, de Lima M, Malek E. Impact of Daratumumab on Stem Cell Collection, Graft Composition and Engraftment. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00602-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mulcahy Symmons S, Fox R, Mannion M, Joyce D, De Brún A, Glynn L, Ryan D, Keane N, McAuliffe E. A mixed methods protocol to evaluate the effectiveness and acceptability of COVID-19 Community Assessment Hubs. HRB Open Res 2021; 4:16. [PMID: 34056538 PMCID: PMC8136252 DOI: 10.12688/hrbopenres.13217.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 04/03/2024] Open
Abstract
Background: Ireland's health system has been under significant strain due to staff shortages and inadequate capacity. Critical care bed capacity per capita in Ireland is among the lowest in Europe, thus, the coronavirus disease 2019 (COVID-19) pandemic has put additional strain on an over-stretched system. COVID-19 Community Assessment Hubs (CAHs) were established to mitigate unnecessary admission to acute hospitals, and reduce infection spread by supporting COVID-19 positive or suspected positive patients to isolate at home, or in isolation facilities. There is some evidence that similar assessment centres may be a successful triage strategy to reduce burden on hospital and acute care. Aim : The aim of this study is to evaluate the impact of COVID-19 Community Assessment Hubs on service delivery in one region in Ireland. Methods: A mixed-methods approach will be used, incorporating co-design to engage stakeholders and ensure informed data capture and analysis. Online surveys will assess CAH patients' experiences of access to and quality of care. Clinical patient data from CAHs will be collected and analysed using multinomial logistic regression to check for association with patient demographics and COVID-19 symptoms, and CAH early warning scores and outcomes (Transfer to Emergency Department, Transfer to isolation unit, Sent home with care plan). Semi-structured interviews will be conducted with: patients to elicit an in-depth understanding of experiences and acceptability of attending CAHs; and staff to understand challenges, benefits, and effectiveness of CAHs. Interview data will be analysed using a thematic analysis approach. Discussion: This study will provide valuable insights from both patient and staff perspectives on the operation of CAHs. We will evaluate the effectiveness and acceptability of CAHs and propose areas for improvement of the service. This will contribute to international literature on the use of community assessment centres during infectious disease pandemics.
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Affiliation(s)
- Sophie Mulcahy Symmons
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Robert Fox
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Marese Mannion
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
| | - David Joyce
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Aoife De Brún
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
| | - Liam Glynn
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
- HRB Primary Care Clinical Trials Network Ireland, Galway, Ireland
| | - Damien Ryan
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
- ALERT, Emergency Department, University Hospital Limerick, Limerick, V94 F858, Ireland
| | - Niamh Keane
- Department of Public health Nursing, Health Service Executive, Dublin, Ireland
| | - Eilish McAuliffe
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland
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Taylor M, Smeltzer M, Ray M, Faris N, Fehnel C, Akinbobola O, Jackson B, Foust C, McHugh L, Signore R, Fox R, Wright J, Optican R, Tonkin K, Robbins E, Osarogiagbon R. MO01.11 The Relative Survival Impact of Thorough Staging and Appropriate Treatment in Non-Small-Cell Lung Cancer (NSCLC). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
The DFT-predicted mechanical properties of crystalline materials are crucial knowledge for their screening, design, and exploitation.
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Affiliation(s)
- Evan Kiely
- Department of Physics, Bernal Institute, University of Limerick, V94 T9PX, Ireland
| | - Reabetswe Zwane
- School of Chemical Sciences, Dublin City University (DCU), Glasnevin, D09 C7F8 Dublin, Ireland
- SSPC, Science Foundation Ireland Research Centre for Pharmaceuticals, University of Limerick, V94 T9PX, Ireland
| | - Robert Fox
- School of Chemical Sciences, Dublin City University (DCU), Glasnevin, D09 C7F8 Dublin, Ireland
- SSPC, Science Foundation Ireland Research Centre for Pharmaceuticals, University of Limerick, V94 T9PX, Ireland
| | - Anthony M. Reilly
- School of Chemical Sciences, Dublin City University (DCU), Glasnevin, D09 C7F8 Dublin, Ireland
- SSPC, Science Foundation Ireland Research Centre for Pharmaceuticals, University of Limerick, V94 T9PX, Ireland
| | - Sarah Guerin
- Department of Physics, Bernal Institute, University of Limerick, V94 T9PX, Ireland
- SSPC, Science Foundation Ireland Research Centre for Pharmaceuticals, University of Limerick, V94 T9PX, Ireland
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Benedict RHB, Tomic D, Cree BA, Fox R, Giovannoni G, Bar-Or A, Gold R, Vermersch P, Pohlmann H, Wright I, Karlsson G, Dahlke F, Wolf C, Kappos L. Siponimod and Cognition in Secondary Progressive Multiple Sclerosis: EXPAND Secondary Analyses. Neurology 2020; 96:e376-e386. [PMID: 33328324 DOI: 10.1212/wnl.0000000000011275] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 08/20/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To investigate the effects of siponimod on cognitive processing speed in patients with secondary progressive (SP) multiple sclerosis (MS), by means of a predefined exploratory and post hoc analysis of the Exploring the Efficacy and Safety of Siponimod in Patients With Secondary Progressive Multiple Sclerosis (EXPAND) study, a randomized controlled trial comparing siponimod and placebo. METHODS EXPAND was a double-blind, placebo-controlled phase 3 trial involving 1,651 patients with SPMS randomized (2:1) to either siponimod 2 mg/d or placebo. Cognitive function was assessed with the Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and Brief Visuospatial Memory Test-Revised (BVMT-R) administered at baseline, 6-month intervals, and end of treatment. RESULTS Between-group differences in mean change from baseline in SDMT scores were significantly better in siponimod- vs placebo-treated patients at month 12 (difference 1.08 [95% confidence interval 0.23-1.94]; p = 0.0132), month 18 (1.23 [0.25-2.21); p = 0.0135), and month 24 (2.30 [1.11-3.50]; p = 0.0002). Siponimod-treated patients were at significantly lower risk for having a 4-point sustained decrease in SDMT score (hazard ratio [HR] 0.79 [0.65-0.96]; p = 0.0157), while their chance for having a 4-point sustained increase in SDMT score was higher (HR 1.28 [1.05-1.55]; p = 0.0131). PASAT and BVMT-R scores did not differ significantly between the 2 treatment groups (all p > 0.28). CONCLUSION Siponimod had a significant benefit on SDMT in patients with SPMS. Siponimod-treated patients were at significantly lower risk for having a ≥4-point decrease in SDMT score and had a significantly higher chance for having a ≥4-point increase in SDMT score, a magnitude of change accepted as clinically meaningful. CLINICALTRIALSGOV IDENTIFIER NCT01665144. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that, for patients with SPMS, siponimod had a significant benefit on cognitive processing speed.
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Affiliation(s)
- Ralph H B Benedict
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland.
| | - Davorka Tomic
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Bruce A Cree
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Robert Fox
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Gavin Giovannoni
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Amit Bar-Or
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Ralf Gold
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Patrick Vermersch
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Harald Pohlmann
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Ian Wright
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Göril Karlsson
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Frank Dahlke
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Christian Wolf
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
| | - Ludwig Kappos
- From the Department of Neurology (R.H.B.B.), University at Buffalo, NY; Novartis Pharma AG (D.T., H.P., G.K., F.D.), Basel, Switzerland; Weill Institute for Neurosciences (B.A.C.), Department of Neurology, University of California San Francisco; Mellen Center for Treatment and Research in Multiple Sclerosis (R.F.), Neurological Institute, Cleveland Clinic, OH; Blizard Institute (GG), Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK; Department of Neurology (A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Neurology (R.G.), St. Josef-Hospital/Ruhr-University Bochum, Germany; Department of Neurology (P.V.), University of Lille, INSERM U1172, CHU Lille, FHU Imminent, France; Novartis Ireland Ltd (I.W.), Dublin; Lycalis sprl (C.W.), Brussels, Belgium; and Neurologic Clinic and Policlinic (G.K., L.K.), Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital and University of Basel, Switzerland
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Fox R, Hyland P, McHugh Power J, Coogan AN. Posttraumatic stress disorder among older adults: A differential item functioning analysis of PTSD in ICD-11 and DSM–5. ACTA ACUST UNITED AC 2020; 12:799-806. [DOI: 10.1037/tra0000596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fox R, Hyland P, McHugh Power J, Coogan AN. Patterns of comorbidity associated with ICD-11 PTSD among older adults in the United States. Psychiatry Res 2020; 290:113171. [PMID: 32526516 DOI: 10.1016/j.psychres.2020.113171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/30/2020] [Accepted: 05/30/2020] [Indexed: 11/16/2022]
Abstract
Little research has been conducted on posttraumatic stress disorder (PTSD) comorbidity among older adults regarding the description of PTSD in the 11th version of the International Classification of Diseases (ICD-11). This study sought to provide evidence of a dimensional model of psychopathology using the 'Hierarchical Taxonomy of Psychopathology' (HiTOP) model as a theoretical framework to explain patterns of ICD-11 PTSD comorbidity. Distinct patterns of ICD-11 PTSD comorbidity among a nationally representative sample (n = 530) of adults aged 60 years and older from the United States were examined using latent class analysis (LCA). Covariates associated with comorbidity classes were assessed through multinomial logistic regression. ICD-11 PTSD was highly comorbid with other psychopathologies. LCA results favoured a two-class solution. Class 1 (71.7%) was characterised by moderate probabilities for major depressive disorder and alcohol use disorder; Class 2 (28.3%) was characterised by a moderate-high probability of general psychopathology and was associated with lower social support, spousal/partner physical abuse, and history of attempted suicide. PTSD was highly comorbid with other disorders among older adults. Distinct patterns of PTSD comorbidity exist among this cohort and these findings can aid clinicians and researchers in understanding and predicting maladaptive responses to trauma and associated psychopathology.
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Affiliation(s)
- Robert Fox
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Joanna McHugh Power
- Department of Psychology, Maynooth University, Kildare, Ireland; UK CRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, Kildare, Ireland.
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Adderley H, Chan J, Alameddine M, Kelly C, Salih Z, Lim K, Fox R, Tetlow C, Arundell D, Wong H, Harries M, Armstrong A, Thorp N. Permanent Hair Loss Associated with Taxane Chemotherapy Use in Breast Cancer: a Retrospective Review at Two Tertiary UK Cancer Centres. Clin Oncol (R Coll Radiol) 2020. [DOI: 10.1016/j.clon.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Berreth T, Wong R, Barker J, Fox R, Maldonado M, Van Cleave C, Zaragoza J, Tinnin M, Tinsley G, Taylor L, Brennan K. The Effects Of Acute Resistance Exercise On Bioelectrical Impedance Analysis Measures Of Body Composition. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686644.56293.7b] [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: 11/21/2022]
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Fox R, Barker J, Berreth T, Maldonado M, Van Cleve C, Wong R, Zaragoza J, Tinnin M, Tinsley G, Taylor L, Brennan KL. The Effects Of Acute Resistance Exercise On Dual-Energy X-Ray Absorptiometry Measures Of Body Composition. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686648.55751.37] [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: 11/21/2022]
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Trummer T, Fox R, Koç JR, de Lima M, Otegbeye F. Cryopreservation of hematopoietic cells using a pre-constituted, protein-free cryopreservative solution with 5% dimethyl sulfoxide. Cytotherapy 2020; 22:613-616. [PMID: 32600975 DOI: 10.1016/j.jcyt.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AIMS Adequate cryopreservation techniques are critical to ensure optimal recovery of functional progenitor cells in hematopoietic cell (HC) transplantation, minimize risk of contamination and prevent infusion-related adverse events (irAEs). In this article, we provide graft function and infusion safety results observed by decreasing the concentration of dimethyl sulfoxide (DMSO) in cryopreservative media and by minimizing processor-dependent formulation. METHODS Ten HC products, collected after standard mobilization of multiple myeloma patients, were cryopreserved with PRIME-XV FreezIS (FreezIS) and compared with products previously cryopreserved with media formulated in-house to achieve a final DMSO concentration of 10% (Std10) and 5% (Std5). At infusion, HCs were analyzed for recovery of CD34+ cells and viability; irAEs and time to engraftment of neutrophils and platelets were also monitored. RESULTS Median CD34+ cell recovery for HC cryopreserved with Std10, Std5 and FreezIS was 38%, 78% and 68%, respectively (P = 0.0002). There were less frequent irAEs with Std5 and FreezIS (10%) compared with Std10 (80%) (P ≤ 0.0001). Median time to neutrophil engraftment was comparable (11 days) for all three groups, while platelet engraftment occurred at a median of 20, 19 and 17 days, respectively (p-values not significant). CONCLUSIONS FreezIS, a Good Manufacturing Practice-grade, pre-constituted cryopreservative with low DMSO content, maintains functional viability of the HC product while reducing the incidence of irAEs compared with 10% DMSO solutions. The pre-constituted nature of this agent also decreases processor-dependent handling, hence decreasing the risk of variability and infection.
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Affiliation(s)
- Tabatha Trummer
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Robert Fox
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Jane Reese Koç
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Marcos de Lima
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
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Dörner T, Bowman SJ, Fox R, Mariette X, Papas A, Grader-Beck T, Fisher BA, Barcelos F, De Vita S, Schulze-Koops H, Moots RJ, Junge G, Woznicki J, Sopala M, Luo WL, Hueber W. OP0302 IANALUMAB (VAY736), A DUAL MODE OF ACTION BIOLOGIC COMBINING BAFF RECEPTOR INHIBITION WITH B CELL DEPLETION, REACHES PRIMARY ENDPOINT FOR TREATMENT OF PRIMARY SJOGREN’S SYNDROME. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Primary Sjogren’s syndrome (pSS) is a multi-organ autoimmune disease mainly affecting excretory glands and characterised by B-cell hyperactivity. No approved systemic treatment is available. Ianalumab (VAY736) is an anti-B-cell activating factor (BAFF) receptor fully human monoclonal antibody, engineered for direct ADCC-mediated B-cell depletion.Objectives:This phase 2b study aimed at establishing a dose-response relationship over a range of VAY736 doses, using change from baseline (BL) in EULAR Sjogren’s Syndrome Disease Activity index (ESSDAI) over 24 Weeks (Wks) as primary endpoint. The study is ongoing with a second blinded treatment period up to Wk52. Here we report efficacy and safety Wk24.Methods:190 patients (pts) were randomised 1:1:1:1 to receive monthly s.c. doses of VAY736 (5, 50, 300mg) or placebo (PBO). Prior to 1st-dose of study treatment, pts received methylprednisolone i.v. 250mg. Eligible pts fulfilled American European Consensus Group (AECG) criteria, were anti-Ro/SSA+, had ESSDAI ≥6 and EULAR Sjogren’s Syndrome Patient Reported Index (ESSPRI) ≥5. Statistical methods included MCP-Mod to assess dose-response on change of ESSDAI from BL and responder rate analysis to calculate the proportion of pts with ≥3 points improvement on ESSDAI. Secondary endpoints included ESSPRI, Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F), Physician’s (PhGA) and Patient’s Global Assessments (PaGA), SF-36, stimulated salivary flow (sSF), Schirmer’s test.Results:Primary endpoint was met with statistically significant dose-response for ESSDAI (Figure). The largest ESSDAI reduction was 1.92 points over PBO for VAY736 300mg at Wk24. Responder rate analysis on ESSDAI revealed for 300mg vs PBO responder rates of 42/47 (89.4%) vs 30/49 (61.2%), a difference of 28.1% (p=0.0019). No differences were seen for 5mg and 50mg vs PBO. PhGA change from BL was significantly different between 300mg and PBO (p=0.022). A numerical trend for sSF improvement for VAY736 300mg compared to PBO was notable at Wk24 (p=0.092). For secondary endpoints ESSPRI and FACIT-F, VAY736 treatment showed no benefits over PBO. PBO responses were generally high. Incidence of treatment emergent AEs was comparable across all studied groups, whereby site injection reactions were most frequent, mostly mild and showed a dose-response.Conclusion:Primary endpoint assessing ESSDAI was met, showing statistically significant dose-response for ianalumab with clinically important improvement for 300mg vs PBO. Preliminary safety profile of ianalumab was good.Figure.ESSDAI Change from Baseline over Time up to Week 24 Reveals a Statistically Significant Dose Response RelationshipDisclosure of Interests:Thomas Dörner Grant/research support from: Janssen, Novartis, Roche, UCB, Consultant of: Abbvie, Celgene, Eli Lilly, Roche, Janssen, EMD, Speakers bureau: Eli Lilly, Roche, Samsung, Janssen, Simon J. Bowman Consultant of: Astrazeneca, Biogen, BMS, Celgene, Medimmune, MTPharma, Novartis, Ono, UCB, xtlbio, Glapagos, Speakers bureau: Novartis, Robert Fox Consultant of: Novartis, Pfizer and Lilly, Xavier Mariette Consultant of: BMS, Gilead, Medimmune, Novartis, Pfizer, Servier, UCB, Athena Papas Grant/research support from: Novartis, Consultant of: Novartis, Thomas Grader-Beck Grant/research support from: Abbvie, Celgene, Consultant of: Novartis, Lilly, Ben A Fisher Consultant of: Novartis, Roche, BMS and Servier, Filipe Barcelos Consultant of: Pfizer and Lilly, Salvatore De Vita Consultant of: Roche, Human Genome Science, Glaxo Smith Kline and Novartis, Hendrik Schulze-Koops Grant/research support from: Pfizer Inc, Robert J Moots: None declared, Guido Junge Shareholder of: Novartis, Employee of: Novartis, Janice Woznicki Shareholder of: Novartis, Employee of: Novartis, Monika Sopala Shareholder of: Novartis, Employee of: Novartis, Wen-Lin Luo Shareholder of: Novartis, Employee of: Novartis, Wolfgang Hueber Shareholder of: Novartis, Employee of: Novartis
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Merritt C, Stutz S, Fox R, Anastasio N, Moeller FG, Cunningham K. Studies of Continuous Lorcaserin Plus Buprenorphine in Rat Fentanyl Self‐Administration. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.06828] [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)
| | - Sonja Stutz
- Center for Addiction Research, University of Texas Medical Branch
| | - Robert Fox
- Center for Addiction Research, University of Texas Medical Branch
| | - Noelle Anastasio
- Center for Addiction Research, University of Texas Medical Branch
| | - F. Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University
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McCleary BV, McNally M, Monaghan D, Mugford DC, Black C, Broadbent R, Chin M, Cormack M, Fox R, Gaines C, Gothard P, Home S, Howes; E, Johnson C, Keeping R, Koliatsou M, Lindhauer M, Marins de Sa R, Martin R, Monaghan D, Nees U, Nishwitz; R, Palmer G, Panozzo J, Recabarren J, Roumeliotis S, Seddig S, Solah V, Sonnet M, Themeier H. Measurement of α-Amylase Activity in White Wheat Flour, Milled Malt, and Microbial Enzyme Preparations, Using the Ceralpha Assay: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.5.1096] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [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
This study was conducted to evaluate the method performance of a rapid procedure for the measurement of α-amylase activity in flours and microbial enzyme preparations. Samples were milled (if necessary) to pass a 0.5 mm sieve and then extracted with a buffer/salt solution, and the extracts were clarified and diluted. Aliquots of diluted extract (containing α-amylase) were incubated with substrate mixture under defined conditions of pH, temperature, and time. The substrate used was nonreducing end-blocked p-nitrophenyl maltoheptaoside (BPNPG7) in the presence of excess quantities of thermostable α-glucosidase. The blocking group in BPNPG7 prevents hydrolysis of this substrate by exo-acting enzymes such as amyloglucosidase, α-glucosidase, and β-amylase. When the substrate is cleaved by endo-acting α-amylase, the nitrophenyl oligosaccharide is immediately and completely hydrolyzed to p-nitrophenol and free glucose by the excess quantities of α-glucosidase present in the substrate mixture. The reaction is terminated, and the phenolate color developed by the addition of an alkaline solution is measured at 400 nm. Amylase activity is expressed in terms of Ceralpha units; 1 unit is defined as the amount of enzyme required to release 1 μmol p-nitrophenyl (in the presence of excess quantities of α-glucosidase) in 1 min at 40°C. In the present study, 15 laboratories analyzed 16 samples as blind duplicates. The analyzed samples were white wheat flour, white wheat flour to which fungal α-amylase had been added, milled malt, and fungal and bacterial enzyme preparations. Repeatability relative standard deviations ranged from 1.4 to 14.4%, and reproducibility relative standard deviations ranged from 5.0 to 16.7%.
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Affiliation(s)
- Barry V McCleary
- Megazyme International Ireland Ltd., Bray Business Park, Bray, County Wicklow, Ireland
| | - Marian McNally
- Megazyme International Ireland Ltd., Bray Business Park, Bray, County Wicklow, Ireland
| | - Dympna Monaghan
- Megazyme International Ireland Ltd., Bray Business Park, Bray, County Wicklow, Ireland
| | - David C Mugford
- BRI Australia Ltd., North Ryde, New South Wales 2113, Australia
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Fox R, Hook J, Marquine MJ, Manly J, Correia B, Slotkin J, Weintraub S, Gershon R. Reliability and Validity of the Spanish Language Measures of the NIH Toolbox Cognition Battery. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz029.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
The NIH Toolbox for Assessment of Neurological and Behavioral Function (NIHTB) was developed under contract from the National Institutes of Health to create a set of easy-to-administer neuropsychological measures, for use across the lifespan (ages 3-85). The NIHTB Cognition Battery (NIHTB-CB) includes two language measures that were developed, calibrated, and normed separately in English and Spanish. This analysis presents the test-retest reliability and construct validity of the Spanish-language picture vocabulary test (S-PVT) and oral reading recognition test (S-ORRT) among adults.
Participants and Method
Participants were adults age 18-85 who took part in the NIHTB norming study in Spanish (N = 408, Age: M = 44.1, SD = 16.7; Education: M = 10.7, SD = 4.3; 65.0% female). Of these, 48 repeated the battery 1 week later. Both the S-PVT and the S-ORRT were administered using computer adaptive testing and scored using item response theory. Spearman’s correlations were used to evaluate test-retest reliability. Convergent validity was evaluated by correlating S-PVT scores with scores on the Batería-III Woodcock-Muñoz Vocabulario Sobre Dibujos, and by correlating S-ORRT scores with scores on a 48-item version of the Word Accentuation Test. Adjusted Spearman’s correlations and general linear models related scores to age, education, and sex.
Results
Both the S-PVT (ρ = 0.87, p < .001) and the S-ORRT (ρ = 0.88, p < .001) demonstrated good test-retest reliability. Good convergent validity was found for both the S-PVT (ρ = 0.76, p < .001) and the S-ORRT (ρ = 0.65, p < .001). Scores on the S-PVT were positively related to education (ρ = 0.38, p < .001), and scores on the S-ORRT were negatively related to age (ρ = -0.18, p < .01) and positively related to education (ρ = 0.30, p < .001).
Conclusions
The Spanish language measures of the NIHTB-CB demonstrated acceptable reliability and validity, suggesting they can be used to measure language ability among Spanish-speaking adults in the United States.
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Hyland P, Shevlin M, Cloitre M, Karatzias T, Vallières F, McGinty G, Fox R, Power JM. Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1089-1099. [PMID: 30293176 DOI: 10.1007/s00127-018-1597-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Loneliness is a recognised public-health concern that is traditionally regarded as a unidimensional construct. Theories of loneliness predict the existence of subtypes of loneliness. In this study, latent class analysis (LCA) was used to test for the presence of loneliness subtypes and to examine their association with multiple mental health variables. METHODS A nationally representative sample of US adults (N = 1839) completed the De Jong Gierveld Loneliness Scale, along with self-report measures of childhood and adulthood trauma, psychological wellbeing, major depression, and generalized anxiety. RESULTS When treated as a unidimensional construct, 17.1% of US adults aged 18-70 were classified as lonely. However, the LCA results identified four loneliness classes which varied quantitatively and qualitatively: 'low' (52.8%), 'social' (8.2%), 'emotional' (26.6%), and 'social and emotional' (12.4%) loneliness. The 'social and emotional' class were characterised by the highest levels of psychological distress, followed by the 'emotional' class. The 'social' loneliness class had similar mental health scores as the 'low' loneliness class. Childhood and adulthood trauma were independently related to the most distressed loneliness classes. CONCLUSIONS Current findings provide support for the presence of subtypes of loneliness and show that they have unique associations with mental health status. Recognition of these subtypes of loneliness revealed that the number of US adults aged 18-70 experiencing loneliness was twice as high as what was estimated when loneliness was conceptualized as a unidimensional construct. The perceived quality, not the quantity, of interpersonal connections was associated with poor mental health.
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Affiliation(s)
- Philip Hyland
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland. .,School of Psychology, Maynooth University, Kildare, Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland, UK
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Science, Stanford University, Palo Alto, CA, USA
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - Frédérique Vallières
- Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Gráinne McGinty
- School of Business, National College of Ireland, Dublin, Ireland
| | - Robert Fox
- School of Psychology, Maynooth University, Kildare, Ireland
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