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Hounsome L, Herr D, Bryant R, Smith R, Loman L, Harris J, Youhan U, Dzene E, Hadjipantelis P, Long H, Laurence T, Riley S, Cumming F. Epidemiological impact of a large number of false negative SARS-CoV-2 test results in South West England during September and October 2021. Epidemics 2024; 46:100739. [PMID: 38211389 DOI: 10.1016/j.epidem.2023.100739] [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: 07/24/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
During September and October 2021, a substantial number of Polymerase Chain Reaction (PCR) tests in England processed at a single laboratory were incorrectly reported as negative. We estimate the number of false negative test results issued and investigate the epidemiological impact of this incident. We estimate the number of COVID-19 cases that would have been reported had the sensitivity of the laboratory test procedure not dropped for the period 2 September to 12 October. In addition, by making comparisons between the most affected local areas and comparator populations, we estimate the number of additional infections, cases, hospitalisations and deaths that could have occurred as a result of increased transmission due to false negative test results.We estimate that around 39,000 tests may have been false negatives during this period and, as a direct result of this incident, the most affected areas in the South-West of England could have experienced between 6000 and 34,000 additional reportable cases, with a central estimate of around 24,000 additional reportable cases. Using modelled relationships between key variables, we estimate that this central estimate could have translated to approximately 55,000 additional infections.Each false negative likely led to around 1.5 additional infections. The incident is likely to have had a measurable impact on cases and infections in the affected areas in the South-West of England. IMPACT STATEMENT: These results indicate the significant negative impact of incorrect testing on COVID outcomes; and make a substantial contribution to understanding the impact of testing systems and the need to ensure high accuracy in testing and reporting of results.
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Affiliation(s)
- L Hounsome
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK.
| | - D Herr
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - R Bryant
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - R Smith
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - L Loman
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - J Harris
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - U Youhan
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - E Dzene
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - P Hadjipantelis
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - H Long
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - T Laurence
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
| | - S Riley
- Director General, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK.
| | - F Cumming
- Advanced Analytics Team, Data, Analytics and Surveillance, UKHSA, Nobel House, 17 Smith Square, London SW1P 3JR, UK
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Metcalf C, Klein SL, Read JM, Riley S, Cummings D, Guan Y, Kwok KO, Huachen Z, Jiang CQ, Lam TH, Lessler J. Survival at older ages: are greater influenza antibody titers protective? Med Hypotheses 2023; 178:111135. [PMID: 37744025 PMCID: PMC10512879 DOI: 10.1016/j.mehy.2023.111135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Antibodies are a core element of the immune system's defense against infectious diseases. We hypothesize that antibody titres might therefore be an important predictor of survival in older individuals. This is important because biomarkers that robustly measure survival have proved elusive, despite their potential utility in health care settings. We present evidence supporting the hypothesis that influenza antibody titres are associated with overall survival of older individuals, and indicate a role for biological sex in modulating this association. Since antibody titres can be modulated by vaccination, these results have important implications for public health policy on influenza control in aging populations.
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Affiliation(s)
- Cje Metcalf
- Dept of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - S L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J M Read
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, UK
| | - S Riley
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Dat Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Yi Guan
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- Guangzhou No. 12 Hospital, Guangzhou, Guangdong, China
| | - K O Kwok
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Z Huachen
- School of Public Health, University of Hong Kong, Hong Kong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - C Q Jiang
- Guangzhou No. 12 Hospital, Guangzhou, Guangdong, China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - J Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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3
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Kwok KO, Chan EYY, Riley S, Cowling B, Ip M. Carriage prevalence of antimicrobial resistance in Hong Kong: a longitudinal study (abridged secondary publication). Hong Kong Med J 2022; 28 Suppl 6:25-28. [PMID: 36535795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- K O Kwok
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - E Y Y Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - S Riley
- MRC Centre for Outbreak Analysis and Modelling, Department for Infectious Disease Epidemiology, Imperial College London
| | - B Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong
| | - M Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong
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4
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Schubert CC, Perkins AJ, Myers LJ, Damush TM, Penney LS, Zhang Y, Schwartzkopf AL, Preddie AK, Riley S, Menen T, Bravata DM. Effectiveness of the VA-Geriatric Resources for Assessment and Care of Elders (VA-GRACE) program: An observational cohort study. J Am Geriatr Soc 2022; 70:3598-3609. [PMID: 36054760 PMCID: PMC10087268 DOI: 10.1111/jgs.18013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/01/2022] [Accepted: 07/29/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND As the Department of Veterans Affairs (VA) healthcare system seeks to expand access to comprehensive geriatric assessments, evidence-based models of care are needed to support community-dwelling older persons. We evaluated the VA Geriatric Resources for Assessment and Care of Elders (VA-GRACE) program's effect on mortality and readmissions, as well as patient, caregiver, and staff satisfaction. METHODS This retrospective cohort included patients admitted to the Richard L. Roudebush VA hospital (2010-2019) who received VA-GRACE services post-discharge and usual care controls who were potentially eligible for VA-GRACE but did not receive services. The VA-GRACE program provided home-based comprehensive, multi-disciplinary geriatrics assessment, and ongoing care. Primary outcomes included 90-day and 1-year all-cause readmissions and mortality, and patient, caregiver, and staff satisfaction. We used propensity score modeling with overlapping weighting to adjust for differences in characteristics between groups. RESULTS VA-GRACE patients (N = 683) were older than controls (N = 4313) (mean age 78.3 ± 8.2 standard deviation vs. 72.2 ± 6.9 years; p < 0.001) and had greater comorbidity (median Charlson Comorbidity Index 3 vs. 0; p < 0.001). VA-GRACE patients had higher 90-day readmissions (adjusted odds ratio [aOR] 1.55 [95%CI 1.01-2.38]) and higher 1-year readmissions (aOR 1.74 [95%CI 1.22-2.48]). However, VA-GRACE patients had lower 90-day mortality (aOR 0.31 [95%CI 0.11-0.92]), but no statistically significant difference in 1-year mortality was observed (aOR 0.88 [95%CI 0.55-1.41]). Patients and caregivers reported that VA-GRACE home visits reduced travel burden and the program linked Veterans and caregivers to needed resources. Primary care providers reported that the VA-GRACE team helped to reduce their workload, improved medication management for their patients, and provided a view into patients' daily living situation. CONCLUSIONS The VA-GRACE program provides comprehensive geriatric assessments and care to high-risk, community-dwelling older persons with high rates of satisfaction from patients, caregivers, and providers. Widespread deployment of programs like VA-GRACE will be required to support Veterans aging in place.
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Affiliation(s)
- Cathy C. Schubert
- Medicine ServiceRichard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
- Department of Internal MedicineIndiana University School of MedicineIndianapolisIndianaUSA
| | - Anthony J. Perkins
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- Department of BiostatisticsIndiana University School of Medicine, IUPUIIndianapolisIndianaUSA
| | - Laura J. Myers
- Department of Internal MedicineIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Teresa M. Damush
- Department of Internal MedicineIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
- Regenstrief InstituteIndianapolisIndianaUSA
| | - Lauren S. Penney
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, South Texas Veterans Health Care SystemSan AntonioTexasUSA
- Department of MedicineUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Ying Zhang
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- Department of BiostatisticsCollege of Public Health, University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Ashley L. Schwartzkopf
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Alaina K. Preddie
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Sam Riley
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Tetla Menen
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
| | - Dawn M. Bravata
- Medicine ServiceRichard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
- Department of Internal MedicineIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Expanding expertise Through E‐Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI)IndianapolisIndianaUSA
- VA HSR&D Center for Health Information and Communication (CHIC); Richard L. Roudebush VA Medical CenterIndianapolisIndianaUSA
- Regenstrief InstituteIndianapolisIndianaUSA
- Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA
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Tahir B, Reilly J, Tay J, Clinch H, Boindala N, Hughes J, Riley S, Roxby P, Tozer-Loft S, Aung T, Qureshi M, Das T, Hatton M. 146P Impact of heart, lung and oesophageal doses on overall survival (OS) of small cell lung cancer (SCLC) patients following radical chemo-radiotherapy (RT). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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6
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Wheldon L, Morgan J, Lee MJ, Riley S, Brown SR, Wyld L. EP.TH.602Exploring decision-making of healthcare professionals in patients with benign large non-pedunculated colonic polyps (BLNPCP) virtually using combined focus group and nominal group technique. Br J Surg 2021. [DOI: 10.1093/bjs/znab309.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
We aimed to elicit key factors that influence healthcare professional decision-making when deciding treatment for BLNPCP.
Background
Benign large non-pedunculated colonic polyps (BLNPCP) may harbour covert malignancy and opinions differ about the optimal treatment modality. There are several options available, including endoscopic mucosal resection, endoscopic submucosal resection, combined endoscopic laparoscopic surgery and surgical resection. Despite widespread availability of endoscopic resection techniques, there are high rates of surgery in the UK.
Methods
Three focus groups of healthcare professionals, comprised of either consultant colorectal surgeons, nurse endoscopists and consultant gastroenterologists, were conducted virtually utilising the Nominal Group Technique. Meetings were recorded and transcribed verbatim. Themes were devolved using the framework approach for qualitative analysis. A priority-ranked list of factors influencing healthcare professional decision-making in this setting was generated.
Results
Five main themes were identified as influencing decision-making: Shared decision making (patient preference, informed consent); Patient factors (co-morbidity, age, life-expectancy); Polyp factors (Location, size, morphology, risk of cancer); Healthcare professionals (skill-set, personal preference); System factors (techniques availability locally, regional referral networks). Nominal Group Technique generated 55 items across the three focus groups. Nurses and gastroentologists ranked patient factors (particularly drug history and tolerance of procedure) and shared decision making (patient preference) more highly then surgeons. Surgeons placed greater emphasis on polyp factors particularly location and the risk of submucosal invasive carcinoma.
Conclusion
Decision making is complex and multifactorial. These results support the benefits of complex polyp MDTs and patient involvement in the decision-making. The complexity of decision-making may underpin wide variation in practice.
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Affiliation(s)
- L Wheldon
- Sheffield Teaching Hospitals NHS Foundation Trust
- Department of Oncology and Metabolism, The University of Sheffield
| | - J Morgan
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
- Department of Oncology and Metabolism, The University of Sheffield
| | - MJ Lee
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
- Department of Oncology and Metabolism, The University of Sheffield
| | - S Riley
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - SR Brown
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - L Wyld
- Department of Oncology and Metabolism, The University of Sheffield
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
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7
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Wheldon L, Spence O, Lee MJ, Riley S, Brown SR, Wyld L. TP7.2.20 Systematic Review and meta-analysis of Interventions for Benign Large Non-Pedunculated Colonic Polyps (BLNPCP). Br J Surg 2021. [DOI: 10.1093/bjs/znab362.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To examine the efficacy of treatment options for benign large non-pedunculated colonic polyps (BLNPCP).
Background
BLNPCP may harbour covert malignancy and opinions differ about the optimal treatment modality, be it endoscopic mucosal resection (EMR), endoscopic submucosal resection (ESD), combined endoscopic laparoscopic surgery (CELS) or surgical resection (SR). Despite the widespread availability of endoscopic resection (ER) techniques, rates of surgery in the UK remain high.
Methods
This review is reported in line with PRISMA guidelines (PROSPERO registration: CRD42021148944). EMBASE, CENTRAL, and MEDLINE databases were searched from January 2000 to January 2020 to evaluate interventions for treating BLNPCP in adults. The primary outcome was recurrence, adverse events were secondary outcomes. Meta-analysis was performed using a random effects model expressed as a percentage with 95% confidence interval. Quality assessment was performed using ROBINS-I.
Results
Ten studies (2499 polyps in 2327patients) were included (five assessed EMR, four SR, two CELS, two ESD). All studies were at moderate risk of bias. SR, ESD and CELS had the lowest recurrence rates 0% CI:0-1, 1% CI:0-2 and 2% CI:0-12 respectively. EMR had the highest (15% CI:9-22). SR complication rate was 12% CI:7-19, ESD 12% CI:9-15, CELS and EMR 11% CI:0-45 and 7% CI:5-9 respectively. Rescue surgery for complication or finding of invasive cancer was 17% CI:5-35 for ESD, CELS 14% CI:3-30, EMR 11% CI:7-15, SR 4% CI:2-6.
Conclusion
These data provide information that should be taken into account when considering the choice of intervention. It will allow a more robust shared decision-making process to occur.
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Affiliation(s)
- L Wheldon
- Sheffield Teaching Hospitals NHS Foundation Trust
- Department of Oncology and Metabolism, The University of Sheffield
| | - O Spence
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - MJ Lee
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
- Department of Oncology and Metabolism, The University of Sheffield
| | - S Riley
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - SR Brown
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - L Wyld
- Department of Oncology and Metabolism, The University of Sheffield
- Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
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Freed K, Cuomo K, Hubbard A, Riley S, Menzel K, Sharma K, Florido R, Hsu S, Kilic A, Choi C, Aslam M, Umapathi P, Fioretti R, Klemans N, Gilotra N. Management of Heart Failure in Left Ventricular Assist Device (LVAD) Patients Utilizing an Outpatient Diuresis Clinic. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Cross SH, Mckie L, Hurd TW, Riley S, Wills J, Barnard AR, Young F, MacLaren RE, Jackson IJ. The nanophthalmos protein TMEM98 inhibits MYRF self-cleavage and is required for eye size specification. PLoS Genet 2020; 16:e1008583. [PMID: 32236127 PMCID: PMC7153906 DOI: 10.1371/journal.pgen.1008583] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/13/2020] [Accepted: 03/06/2020] [Indexed: 12/31/2022] Open
Abstract
The precise control of eye size is essential for normal vision. TMEM98 is a highly conserved and widely expressed gene which appears to be involved in eye size regulation. Mutations in human TMEM98 are found in patients with nanophthalmos (very small eyes) and variants near the gene are associated in population studies with myopia and increased eye size. As complete loss of function mutations in mouse Tmem98 result in perinatal lethality, we produced mice deficient for Tmem98 in the retinal pigment epithelium (RPE), where Tmem98 is highly expressed. These mice have greatly enlarged eyes that are very fragile with very thin retinas, compressed choroid and thin sclera. To gain insight into the mechanism of action we used a proximity labelling approach to discover interacting proteins and identified MYRF as an interacting partner. Mutations of MYRF are also associated with nanophthalmos. The protein is an endoplasmic reticulum-tethered transcription factor which undergoes autoproteolytic cleavage to liberate the N-terminal part which then translocates to the nucleus where it acts as a transcription factor. We find that TMEM98 inhibits the self-cleavage of MYRF, in a novel regulatory mechanism. In RPE lacking TMEM98, MYRF is ectopically activated and abnormally localised to the nuclei. Our findings highlight the importance of the interplay between TMEM98 and MYRF in determining the size of the eye.
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Affiliation(s)
- Sally H. Cross
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - Lisa Mckie
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Toby W. Hurd
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Sam Riley
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Jimi Wills
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Alun R. Barnard
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, The John Radcliffe Hospital, Oxford, United Kingdom
| | - Fiona Young
- Electron Microscopy, Pathology, Western General Hospital, Edinburgh, United Kingdom
| | - Robert E. MacLaren
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, The John Radcliffe Hospital, Oxford, United Kingdom
| | - Ian J. Jackson
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
- Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
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10
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Arinaminpathy N, Riley S, Barclay WS, Saad-Roy C, Grenfell B. Population implications of the deployment of novel universal vaccines against epidemic and pandemic influenza. J R Soc Interface 2020; 17:20190879. [PMID: 32126190 PMCID: PMC7115234 DOI: 10.1098/rsif.2019.0879] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 02/12/2020] [Indexed: 11/14/2022] Open
Abstract
There is increasing interest in the development of new, 'universal' influenza vaccines (UIVs) that--unlike current vaccines--are effective against a broad range of seasonal influenza strains, as well as against novel pandemic viruses. While the existing literature discusses the potential epidemiological benefits of UIVs, it is also important to anticipate their potential unintended population consequences. Using mathematical modelling, we illustrate two such types of adverse consequences. First, by reducing the amount of infection-induced immunity in a population without fully replacing it, a seasonal UIV programme may permit larger pandemics than in the absence of vaccination. Second, the more successful a future UIV programme is in reducing transmission of seasonal influenza, the more vulnerable the population could become to the emergence of a vaccine escape variant. These risks could be mitigated by optimal deployment of any future UIV vaccine: namely, the use of a combined vaccine formulation (incorporating conventional as well as multiple universal antigenic targets) and achieving sufficient population coverage to compensate for any reductions in infection-induced immunity. In the absence of large-scale trials of UIVs, disease-dynamic models can provide helpful, early insights into their potential impact. In future, data from continuing vaccine development will be invaluable in developing robustly predictive modelling approaches.
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Affiliation(s)
- N. Arinaminpathy
- MRC Centre for Global Infectious Disease Analysis, Faculty of Medicine, Imperial College London, London, UK
| | - S. Riley
- MRC Centre for Global Infectious Disease Analysis, Faculty of Medicine, Imperial College London, London, UK
| | - W. S. Barclay
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - C. Saad-Roy
- Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - B. Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
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11
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Jenkinson C, Wang E, Duvall S, Chaplyn E, Riley S, Gupta A. Pneumomediastinum: A Review of Presentation and Radiology Findings. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Wishner KF, Seibel BA, Roman C, Deutsch C, Outram D, Shaw CT, Birk MA, Mislan KAS, Adams TJ, Moore D, Riley S. Ocean deoxygenation and zooplankton: Very small oxygen differences matter. Sci Adv 2018; 4:eaau5180. [PMID: 30585291 PMCID: PMC6300398 DOI: 10.1126/sciadv.aau5180] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/21/2018] [Indexed: 06/09/2023]
Abstract
Oxygen minimum zones (OMZs), large midwater regions of very low oxygen, are expected to expand as a result of climate change. While oxygen is known to be important in structuring midwater ecosystems, a precise and mechanistic understanding of the effects of oxygen on zooplankton is lacking. Zooplankton are important components of midwater food webs and biogeochemical cycles. Here, we show that, in the eastern tropical North Pacific OMZ, previously undescribed submesoscale oxygen variability has a direct effect on the distribution of many major zooplankton groups. Despite extraordinary hypoxia tolerance, many zooplankton live near their physiological limits and respond to slight (≤1%) changes in oxygen. Ocean oxygen loss (deoxygenation) may, thus, elicit major unanticipated changes to midwater ecosystem structure and function.
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Affiliation(s)
- K. F. Wishner
- Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - B. A. Seibel
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - C. Roman
- Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - C. Deutsch
- School of Oceanography, University of Washington, Seattle, WA 98195, USA
- Department of Biology, University of Washington, Seattle, WA 98195, USA
| | - D. Outram
- Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - C. T. Shaw
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - M. A. Birk
- College of Marine Science, University of South Florida, St. Petersburg, FL 33701, USA
| | - K. A. S. Mislan
- School of Oceanography, University of Washington, Seattle, WA 98195, USA
- eScience Institute, University of Washington, Seattle, WA 98195, USA
| | - T. J. Adams
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - D. Moore
- Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
| | - S. Riley
- Graduate School of Oceanography, University of Rhode Island, Narragansett, RI 02882, USA
- Oregon State University, Corvallis, OR 97331, USA
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Kwok K, Riley S, Wei V, Wong D, Hsu E, Yu K, Lee S, Chen H. Investigation of characteristics of residents in RCHEs associated with MRSA colonization after implementation of infection control training program. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3657] [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] Open
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Wong J, Ip M, Tang A, Wei V, Wong S, Riley S, Read J, Kwok K. Prevalence and risk factors of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) carriage in Asia-Pacific region from 2000 to 2016: A systematic review and meta-analysis. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Hatton M, Robinson S, Bradshaw J, Riley S, Das T, Lee C, Fisher P, Bates E, Tozer-Loft S, Tahir B. 111O Impact of cardiac doses on survival of non-small cell lung cancer (NSCLC) patients following radical accelerated radiotherapy. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Varagunam M, Hardwick R, Riley S, Chadwick G, Cromwell D, Groene O. Changes in volume, clinical practice and outcome after reorganisation of oesophago-gastric cancer care in England: A longitudinal observational study. Eur J Surg Oncol 2018; 44:524-531. [DOI: 10.1016/j.ejso.2018.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 11/17/2017] [Accepted: 01/02/2018] [Indexed: 02/06/2023] Open
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17
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Chadwick G, Riley S, Hardwick RH, Crosby T, Hoare J, Hanna G, Greenaway K, Varagunam M, Cromwell DA, Groene O. Population-based cohort study of the management and survival of patients with early-stage oesophageal adenocarcinoma in England. Br J Surg 2016; 103:544-52. [PMID: 26865114 DOI: 10.1002/bjs.10116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/12/2015] [Accepted: 12/21/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Until recently, oesophagectomy was the treatment of choice for early oesophageal cancer. Endoscopic treatment has been introduced relatively recently. This observational national database study aimed to describe how endoscopic therapy has been introduced in England and to examine the safety of this approach. METHODS A population-based cohort study was undertaken of patients diagnosed with oesophageal adenocarcinoma between October 2007 and June 2009 using three linked national databases. Patients with early-stage disease (T1 tumours with no evidence of spread) were identified, along with the primary treatment modality where treatment intent was curative. Short-term outcomes after treatment and 5-year survival were evaluated. RESULTS Of 5192 patients diagnosed with oesophageal adenocarcinoma, 306 (5·9 per cent) were considered to have early-stage disease before any treatment, of whom 239 (79·9 per cent of 299 patients with data on treatment intent) were managed with curative intent. Of 175 patients who had an oesophagectomy, 114 (65·1 (95 per cent c.i. 57·6 to 72·7) per cent) survived for 5 years. Among these, 47 (30·3 per cent of 155 patients with tissue results available) had their disease upstaged after pathological staging; this occurred more often in patients who did not have staging endoscopic ultrasonography before surgery. Of 41 patients who had an endoscopic resection, 27 (66 (95 per cent c.i. 49 to 80) per cent) survived for 5 years. Repeat endoscopic therapy was required by 23 (56 per cent) of these 41 patients. CONCLUSION Between 2007 and 2009, oesophagectomy remained the initial treatment of choice (73·2 per cent) among patients with early-stage oesophageal cancer treated with curative intent; one in five patients were managed endoscopically, and this treatment was more common in elderly patients. Although the groups had different patient characteristics, 5-year survival rates were similar.
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Affiliation(s)
- G Chadwick
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.,Department of Gastroenterology, St Mary's Hospital, London, UK
| | - S Riley
- Department of Gastroenterology, Northern General Hospital, Sheffield, UK
| | - R H Hardwick
- Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - T Crosby
- Velindre Cancer Centre, Cardiff, UK
| | - J Hoare
- Department of Gastroenterology, St Mary's Hospital, London, UK
| | - G Hanna
- Department of Surgery and Cancer, Imperial College, London, UK
| | - K Greenaway
- Health and Social Care Information Centre, Leeds, UK
| | - M Varagunam
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK
| | - D A Cromwell
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.,Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - O Groene
- Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK.,Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
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Darpo B, Benson C, Dota C, Ferber G, Garnett C, Green CL, Jarugula V, Johannesen L, Keirns J, Krudys K, Liu J, Ortemann-Renon C, Riley S, Sarapa N, Smith B, Stoltz RR, Zhou M, Stockbridge N. Results from the IQ-CSRC prospective study support replacement of the thorough QT study by QT assessment in the early clinical phase. Clin Pharmacol Ther 2015; 97:326-35. [PMID: 25670536 DOI: 10.1002/cpt.60] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 11/09/2022]
Abstract
The QT effects of five "QT-positive" and one negative drug were tested to evaluate whether exposure-response analysis can detect QT effects in a small study with healthy subjects. Each drug was given to nine subjects (six for placebo) in two dose levels; positive drugs were chosen to cause 10 to 12 ms and 15 to 20 ms QTcF prolongation. The slope of the concentration/ΔQTc effect was significantly positive for ondansetron, quinine, dolasetron, moxifloxacin, and dofetilide. For the lower dose, an effect above 10 ms could not be excluded, i.e., the upper bound of the confidence interval for the predicted mean ΔΔQTcF effect was above 10 ms. For the negative drug, levocetirizine, a ΔΔQTcF effect above 10 ms was excluded at 6-fold the therapeutic dose. The study provides evidence that robust QT assessment in early-phase clinical studies can replace the thorough QT study.
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Affiliation(s)
- B Darpo
- Karolinska Institutet, Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd's Hospital, Stockholm, Sweden; iCardiac Technologies, Rochester, New York, USA
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Fusaro M, Giannini S, Miozzo D, Noale M, Tripepi G, Plebani M, Zaninotto M, Piccoli A, Vilei MT, Cristofaro R, Gallieni M, Hamamoto K, Inaba M, Okuno S, Imanishi Y, Ishimura E, Yamakawa T, Shoji S, Rothe HM, Eller P, Mayer G, Ketteler M, Kramar R, Shaheen F, Al Rukhaimi M, Alsahow A, Al-Ali F, Al Salmi I, Al Ghareeb S, Wang M, Bieber B, Robinson BM, Pisoni RL, Waniewski J, Debowska M, Wojcik-Zaluska A, Ksiazek A, Zaluska W, De Broe ME, Wilson RJ, Copley JB, Hiramtasu R, Ubara Y, Hoshino J, Takaichi K, Ghalli FG, Ghalli FG, Ibakkanavar R, Chess J, Roberts G, Riley S, Oliveira ASA, Carvalho CJB, Oliveira CBL, Pessoa CTBC, Leao RAS, Gueiros JEB, Gueiros APS, Okano K, Tsuruta Y, Hibi A, Tsukada M, Miwa N, Kimata N, Tsuchiya K, Akiba T, Nitta K, Mizobuchi M, Ogata H, Hosaka N, Sanada D, Arai N, Koiwa F, Kinugasa E, Shibata T, Akizawa T, Delanaye P, Krzesinski JM, Warling X, Moonen M, Smelten N, Medart L, Pottel H, Cavalier E, Delanaye P, Souberbielle JC, Gadisseur R, Dubois BE, Krzesinski JM, Cavalier E, Matias P, Jorge C, Mendes M, Azevedo A, Navarro D, Ferreira C, Amaral T, Aires I, Gil C, Ferreira A, Kikuchi H, Shimada H, Karasawa R, Suzuki M, An WS, Lee SM, Oh YJ, Son YK, De Paola L, Lombardi G, Panzino MT, Lombardi L, Reichel H, Hahn KM, Kohnle M, Guggenberger C, Delanna F, Sasaki N, Tsunoda M, Ikee R, Hashimoto N, Sola L, Leyun MN, Diaz JC, Sehabiague C, Gonzalez S, Alallon W, Bourbeau K, Lajoie C, Macway F, Fujii T, Suzuki S, Shinozaki M, Tanaka H, Klingele M, Seiler S, Poppleton A, Lepper P, Fliser D, Seidel R, Lun L, Liu D, Li X, Wei X, Miao J, Gao Z, Hu R, De Paola L, Lombardi G, Panzino MT, Lombardi L, Gros B, Galan A, Gonzalez-Parra E, Herrero JA, Echave M, Vegter S, Tolley K, Oyaguez I, Gutzwiller FS, Braunhofer PG, Szucs TD, Schwenkglenks M, Yilmaz VT, Ozdem S, Donmez L, Kocak H, Dinckan A, Cetinkaya R, Suleymanlar G, Ersoy FF. DIALYSIS BONE DISEASE. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Kwok KO, Jiang C, Tan L, Justin L, Read JM, Zhu H, Guan Y, Cummings DA, Riley S. [An international collaborative study on influenza viruses antibody titers and contact patterns of individuals in rural and urban household of Guangzhou]. Zhonghua Liu Xing Bing Xue Za Zhi 2014; 35:433-6. [PMID: 25009036 DOI: pmid/25009036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To describe the influenza viruses antibody levels and contact patterns of individuals in rural and urban regions of Guangzhou and to understand how contact patterns and other factors would correlate with the levels on the titers of antibody. METHODS "Google Map" was used to randomly select the study points from the administrative areas in Guangzhou region. Each participant was required to provide 5 ml blood serum sample to be tested against different strains of H1N1 and H3N2 influenza viruses. RESULTS 1) Using "Google map", 50 study points were selected but only 40 study points would meet the inclusion criteria. The cohort of this study consisted 856 households with 2 801 individuals. 1 821 participants (65% of the total number individuals in the cohort) completed the questionnaires. Among the 1 821 participants, 77.3% (1 407/1 821) and 22.7% (414/1 821) of them were from rural and urban areas respectively. There were more male participants in the rural but more female participants in the urban regions. Majority of the participants were from age group 18-59 followed by group 60 with aged 2-17 the least, in both rural and urban areas. 2) 78.1% (1 423/1 821) of the participants provided their serum samples. There appeared a strong correlation between age of the participants and the strength of their antibodies against that strain when a strain first circulated. In particular, seroprevalence was the highest at the age group 2-17. 3) 'Contact' was defined as persons having physical touch or/and conversation within one meter with the participants. Participants reported all having had large number of contacts. The proportion of participants having contacts with ten persons or above was the highest, ranging from 49.8% to 72.6%, particularly in age group 6-17. Compared to weekdays, participants had fewer contact persons on weekends. CONCLUSION There was a strong correlation between the age of participants at the time when the strains first circulated and the seroprevalence against influenza virus strains of H1N1 and H3N2. Also, age of the participants and the frequencies of their contacts to people, was also correlated.
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Affiliation(s)
- Kin On Kwok
- School of Public Health, the University of Hong Kong, China
| | | | | | | | | | - Huachen Zhu
- School of Public Health, the University of Hong Kong, China; Shantou University Medical College, Guangdong Province, China
| | - Yi Guan
- School of Public Health, the University of Hong Kong, China; School of Public Health, the University of Hong Kong, China; Shantou University Medical College, Guangdong Province, China
| | | | - S Riley
- School of Public Health, the University of Hong Kong, China; School of Public Health, Imperial College, UK
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Pepin KM, Spackman E, Brown JD, Pabilonia KL, Garber LP, Weaver JT, Kennedy DA, Patyk KA, Huyvaert KP, Miller RS, Franklin AB, Pedersen K, Bogich TL, Rohani P, Shriner SA, Webb CT, Riley S. Using quantitative disease dynamics as a tool for guiding response to avian influenza in poultry in the United States of America. Prev Vet Med 2013; 113:376-97. [PMID: 24462191 PMCID: PMC3945821 DOI: 10.1016/j.prevetmed.2013.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/22/2013] [Accepted: 11/24/2013] [Indexed: 02/02/2023]
Abstract
Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts to poultry. We identified priorities for quantitative research that would build on existing tools for responding to AIV in poultry and concluded that the following knowledge gaps can be addressed with current empirical data: (1) quantification of the spatio-temporal relationships between AIV prevalence in wild hosts and poultry populations, (2) understanding how the structure of different poultry sectors impacts within-flock transmission, (3) determining mechanisms and rates of between-farm spread, and (4) validating current policy-decision tools with data. The modeling studies we recommend will improve our mechanistic understanding of potential AIV transmission patterns in USA poultry, leading to improved measures of accuracy and reduced uncertainty when evaluating alternative control strategies.
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Affiliation(s)
- K M Pepin
- Department of Biology, Colorado State University, Fort Collins, CO, USA; Fogarty International Center, National Institute of Health, Bethesda, MD, USA.
| | - E Spackman
- Southeast Poultry Research Laboratory, Agricultural Research Service, United States Department of Agriculture, Athens, GA, USA.
| | - J D Brown
- Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - K L Pabilonia
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
| | - L P Garber
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - J T Weaver
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - D A Kennedy
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, State College, PA, USA.
| | - K A Patyk
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - K P Huyvaert
- Warner College of Natural Resources, Colorado State University, Fort Collins, CO, USA.
| | - R S Miller
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - A B Franklin
- National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - K Pedersen
- National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - T L Bogich
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
| | - P Rohani
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; Department of Ecology and Evolutionary Biology, Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI, USA.
| | - S A Shriner
- National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - C T Webb
- Department of Biology, Colorado State University, Fort Collins, CO, USA; Fogarty International Center, National Institute of Health, Bethesda, MD, USA.
| | - S Riley
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; MRC Centre for Outbreak Analysis and Disease Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, UK.
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22
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Gupta S, Miskovic D, Bhandari P, Dolwani S, McKaig B, Pullan R, Rembacken B, Riley S, Rutter MD, Suzuki N, Tsiamoulos Z, Valori R, Vance ME, Faiz OD, Saunders BP, Thomas-Gibson S. A novel method for determining the difficulty of colonoscopic polypectomy. Frontline Gastroenterol 2013; 4:244-248. [PMID: 28839733 PMCID: PMC5369843 DOI: 10.1136/flgastro-2013-100331] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 03/19/2013] [Revised: 05/09/2013] [Accepted: 05/11/2013] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Endoscopists are now expected to perform polypectomy routinely. Colonic polypectomy varies in difficulty, depending on polyp morphology, size, location and access. The measurement of the degree of difficulty of polypectomy, based on polyp characteristics, has not previously been described. OBJECTIVE To define the level of difficulty of polypectomy. METHODS Consensus by nine endoscopists regarding parameters that determine the complexity of a polyp was achieved through the Delphi method. The endoscopists then assigned a polyp complexity level to each possible combination of parameters. A scoring system to measure the difficulty level of a polyp was developed and validated by two different expert endoscopists. RESULTS Through two Delphi rounds, four factors for determining the complexity of a polypectomy were identified: size (S), morphology (M), site (S) and access (A). A scoring system was established, based on size (1-9 points), morphology (1-3 points), site (1-2 points) and access (1-3 points). Four polyp levels (with increasing level of complexity) were identified based on the range of scores obtained: level I (4-5), level II (6-9), level III (10-12) and level IV (>12). There was a high degree of interrater reliability for the polyp scores (interclass correlation coefficient of 0.93) and levels (κ=0.888). CONCLUSIONS The scoring system is feasible and reliable. Defining polyp complexity levels may be useful for planning training, competency assessment and certification in colonoscopic polypectomy. This may allow for more efficient service delivery and referral pathways.
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Affiliation(s)
- S Gupta
- Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK
| | - D Miskovic
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | - P Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital, Cosham, Portsmouth, UK
| | - S Dolwani
- Department of Gastroenterology, University Hospital of Wales, Cardiff, UK
| | - B McKaig
- Department of Gastroenterology, New Cross Hospital, Wolverhampton, UK
| | - R Pullan
- Department of Colorectal Surgery, Torbay Hospital, Torquay, UK
| | - B Rembacken
- Department of Gastroenterology, Leeds General Infirmary, Leeds, UK
| | - S Riley
- Department of Gastroenterology, Northern General Hospital, Sheffield, UK
| | - M D Rutter
- Department of Gastroenterology, University Hospital North Tees, Stockton-on-Tees, UK
| | - N Suzuki
- Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK
| | - Z Tsiamoulos
- Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK
| | - R Valori
- Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, UK
| | - M E Vance
- Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK
| | - O D Faiz
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
| | - B P Saunders
- Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK
| | - S Thomas-Gibson
- Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK
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23
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Byon W, Smith MK, Chan P, Tortorici MA, Riley S, Dai H, Dong J, Ruiz-Garcia A, Sweeney K, Cronenberger C. Establishing best practices and guidance in population modeling: an experience with an internal population pharmacokinetic analysis guidance. CPT Pharmacometrics Syst Pharmacol 2013; 2:e51. [PMID: 23836283 PMCID: PMC6483270 DOI: 10.1038/psp.2013.26] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 04/02/2013] [Indexed: 02/03/2023]
Abstract
This tutorial describes the development of a population pharmacokinetic (Pop PK) analysis guidance within Pfizer, which strives for improved consistency and efficiency, and a more systematic approach to model building. General recommendations from the Pfizer internal guidance and a suggested workflow for Pop PK model building are discussed. A description is also provided for mechanisms by which conflicting opinions were captured and resolved across the organization to arrive at the final guidance. CPT: Pharmacometrics & Systems Pharmacology (2013) 2, e51; doi:10.1038/psp.2013.26; advance online publication 3 July 2013
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Affiliation(s)
- W Byon
- Global Clinical Pharmacology, Pfizer, Groton, Connecticut, USA
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24
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Cauchemez S, Van Kerkhove MD, Riley S, Donnelly CA, Fraser C, Ferguson NM. Transmission scenarios for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and how to tell them apart. Euro Surveill 2013. [DOI: 10.2807/ese.18.24.20503-en] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Cauchemez
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - M D Van Kerkhove
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - S Riley
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - C A Donnelly
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - C Fraser
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - N M Ferguson
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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Cauchemez S, Van Kerkhove MD, Riley S, Donnelly CA, Fraser C, Ferguson NM. Transmission scenarios for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and how to tell them apart. Euro Surveill 2013; 18:20503. [PMID: 23787162 PMCID: PMC4088931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Detection of human cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection internationally is a global public health concern. Rigorous risk assessment is particularly challenging in a context where surveillance may be subject to under-ascertainment and a selection bias towards more severe cases. We would like to assess whether the virus is capable of causing widespread human epidemics, and whether self-sustaining transmission is already under way. Here we review possible transmission scenarios for MERS-CoV and their implications for risk assessment and control. We discuss how existing data, future investigations and analyses may help in reducing uncertainty and refining the public health risk assessment and present analytical approaches that allow robust assessment of epidemiological characteristics, even from partial and biased surveillance data. Finally, we urge that adequate data be collected on future cases to permit rigorous assessment of the transmission characteristics and severity of MERS-CoV, and the public health threat it may pose. Going beyond minimal case reporting, open international collaboration, under the guidance of the World Health Organization and the International Health Regulations, will impact on how this potential epidemic unfolds and prospects for control.
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Affiliation(s)
- S Cauchemez
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
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26
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Cowling BJ, Ho LM, Riley S, Leung GM. Statistical algorithms for early detection of the annual influenza peak season in Hong Kong using sentinel surveillance data. Hong Kong Med J 2013; 19 Suppl 4:4-5. [PMID: 23775178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
In Hong Kong, influenza sentinel surveillance systems have been recently established. Methods that compare current data to data from recent weeks may be appropriate to indicate the start of peak influenza activity. These methods can produce reliable and timely alerts at the start of the annual influenza peak season.
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Affiliation(s)
- B J Cowling
- School of Public Health, The University of Hong Kong, 100 Cyberport Road, Hong Kong.
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Riley S, Cowling BJ, Chan KH, Peiris JSM, Leung GM. Viral evolution from one generation of human influenza infection to the next. Hong Kong Med J 2013; 19 Suppl 4:6-10. [PMID: 23775179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
1. In a sub-tropical epidemic, most of the apparent household secondary cases are actually secondary infections. 2. The consensus sequence for the entire influenza virus genome is not usually identical within the same household sample. Rather, there are commonly one or two nucleotide changes. 3. These results hint at an obvious generational threshold for adaptation at the level of the consensus sequence.
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Affiliation(s)
- S Riley
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Hong Kong SAR, China.
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Cowling BJ, Chan KH, Peiris JSM, Riley S, Leung GM. Viral shedding, clinical history and transmission of influenza. Hong Kong Med J 2013; 19 Suppl 4:19-23. [PMID: 23775182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
1. During influenza infections, most viral shedding occurs within a few days of illness onset. 2. Children may be more infectious than adults because they shed more virus. 3. The degree of viral shedding (infectiousness) correlates with symptoms and tympanic temperature.
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Affiliation(s)
- B J Cowling
- School of Public Health, The University of Hong Kong, 100 Cyberport Road, Hong Kong.
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Merrick S, Wong J, Karim M, Gao J, Li M, Figueroa R, Riley S. Superiority of a Real-Time Planning Technique Over Image Guided Radiation Therapy for the Treatment of Primary Prostate Cancers. Pract Radiat Oncol 2013; 3:S18. [DOI: 10.1016/j.prro.2013.01.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wonnacott A, Meran S, Roberts G, Donovan K, Riley S, Phillips AO. Applying estimated glomerular filtration rate to an ageing population: are we in danger of becoming ageist? Eur J Intern Med 2012; 23:705-10. [PMID: 23021873 DOI: 10.1016/j.ejim.2012.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 06/08/2012] [Revised: 08/07/2012] [Accepted: 08/22/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Management of CKD is a major public health concern. The introduction of automated eGFR reporting has seen an increase in labelling of elderly patients with CKD. The prognostic significance of the CKD label in this population remains controversial. AIM To investigate rates of specialist intervention in the over 75's to determine whether these patients may be more appropriately managed in primary care, relieving the burden of excessive outpatient visits in this population. METHODS Retrospective review of patient notes and laboratory reports over 25 consecutive renal outpatient clinics within a single NHS trust. RESULTS 546 patients were studied. The mean age of patient was 68.7 years (SD+/-14.9). The over 75's had more advanced renal disease compared to under 75's (mean eGFR 28.2 vs. 41.3 ml/min/1.73 m(2)), but there was no significant difference in eGFR stability between the older and younger cohort or in the overall rate of intervention (32.5% vs. 30.7% p=0.86). The over 75's had a lower mean haemoglobin (11.8 vs. 12.6, p=<0.001) necessitating greater EPO requirements (25.2% vs. 10.5%, p=<0.001). The greatest intervention was seen in the more advanced CKD patients (29% of CKD 3 vs. 55% of CKD 5), and in those with diagnoses requiring immunosuppression. CONCLUSION Intervention to management may be predictable on the basis of specific diagnoses and advancing CKD stage but not by patient age. We can provide no evidence to suggest that elderly CKD patients are managed any differently to younger patients and in fact have a higher need for attention to and treatment of renal anaemia, validating their attendance in nephrology clinic.
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Affiliation(s)
- A Wonnacott
- Institute of Nephrology, University Hospital Wales, Cardiff, UK.
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Merrick S, Wong J, Karim M, Gao J, Figueroa R, Riley S, Li M. Superiority of a Real-time Planning Technique Over Image Guided Radiation Therapy for the Treatment of Primary Prostate Cancers. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.078] [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: 10/27/2022]
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Palser T, Cromwell D, Hardwick R, Riley S, Greenaway K, Meulen JVD. PS37 Does the Route to Diagnosis Affect Outcomes for Oesophago-Gastric Cancer Patients. Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Carver A, Quinn K, Riley S, Elmer S, Basu J, Mayles P. EP-1423 THE INTERPLAY EFFECT IN LUNG TUMOUR MOTION OVER MULTIPLE FRACTIONS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vinjamuri S, Uzan J, Riley S, Mayles P. PO-0847 18FLUORO-ETHYL CHOLINE PET CT FOR RADIOBIOLOGICALLY OPTIMISED PROSTATE DOSE-PAINTING (BIOPROP). Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71180-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Connolly A, Florence J, Cradock M, Malkus E, Schierbecker J, Siener C, Wulf C, Anand P, Lowes L, Alfano L, Viollet-Callendret L, Flanigan K, Mendell J, McDonald C, Goude E, Johnson L, Nicorici A, Karachunski P, Day J, Dalton J, Farber J, Buser K, Darras B, Riley S, Schriber E, Parad R, Bushby K, Eagle M, MDA DMD Clinical Research Network. Motor and Cognitive Assessment of Infants and Young Boys with Duchenne Muscular Dystrophy; Results from the Muscular Dystrophy Association DMD Clinical Research Center Network (P04.084). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.084] [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] Open
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Riley S, Leung GM, Ho LM, Cowling BJ. Transmission of Japanese encephalitis virus in Hong Kong. Hong Kong Med J 2012; 18 Suppl 2:45-46. [PMID: 22311363] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
1. Pigs are likely to be the main amplifying host for Japanese encephalitis virus. 2. The success of a swine vaccination programme depends on the timing of the loss of maternal antibody protection and seasonal dynamics of the vector population. 3. Vaccination may be ineffective in the face of strong natural infection because of the variability in timing of the loss of maternal antibody protection.4. Evidence in support of swine vaccination as a human health intervention was not found.
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Affiliation(s)
- S Riley
- Department of Community Medicine and School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
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Wong J, Merrick S, Figueroa R, Riley S, Li M, Uemastu M, Karim M, Gao Z. Interfractional Changes in Shape and Size of the Prostatic Fossa --Implication for and Limitation of Image Guided Radiation Therapy: Need for Daily “Instant Re-planning” with Significant Reduction in PTV Margin. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mascia A, Aust C, Schieber B, Baker L, Riley S, Hinten Z, Johnson R, Keole S, Zeidan O. Investigation of Lateral Decubitus Immobilization Techniques in order to Increase the Flexibility of Fixed Beamline Proton Therapy Systems. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Trinick R, Staves S, Riley S, Isherwood D, Heaf L, McNamara P, Southern K. 39* Processing of carrier results following newborn screening for cystic fibrosis: experiences from a UK region. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
BACKGROUND The introduction of eGFR reporting and publication of national CKD guidelines has led to major challenges in primary and secondary care, leading to an increase in the number of referrals to nephrology clinics. We have shown that introduction of a renal patient care pathway reduces nephrology referrals and enables managed discharges of CKD patients to primary care. The aim of this article is to examine the outcome of patients discharged to primary care to find out if there is an associated risk with increased discharge supported by the patient pathway. METHODS The study was carried out within a single NHS Trust covering a population of 560,000. All patients discharged from the trust's renal outpatient clinic between June 2007 and July 2008 were identified. Patient notes and the local laboratory database systems were used to determine the source and timing of tests. RESULTS A total of 31 new referrals and 57 regular follow-ups were discharged during this period. The median age of discharge was 67.5 years. Most subjects (60%) had CKD stage 3 at the time of discharge. A total of 23% of discharges were categorized as CKD stages 1, 2 or normal and 17% of patients had CKD stage 4. Overall, 93% had stable eGFRs prior to discharge, 77.5% of patients had blood pressure within threshold (140/90 according to UK CKD guidelines) and 97.7% of patients had haemoglobins >10 g/dl. Post-discharge 83% of patients had eGFRs recorded by their general practitioner and 92.6% of these were measured within appropriate time frames as per CKD guidelines. The majority of patients (82%) had either improved or stable eGFR post-discharge and only three patients had a significant decline in their eGFR. CONCLUSION These data indicate that selected CKD patients can be appropriately discharged from secondary care and adequately monitored in primary care. Furthermore, we have shown that this was a safe practice for patients.
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Affiliation(s)
- S Meran
- Institute of Nephrology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK.
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Montes J, McDermott MP, Martens WB, Dunaway S, Glanzman AM, Riley S, Quigley J, Montgomery MJ, Sproule D, Tawil R, Chung WK, Darras BT, De Vivo DC, Kaufmann P, Finkel RS. Six-Minute Walk Test demonstrates motor fatigue in spinal muscular atrophy. Neurology 2010; 74:833-8. [PMID: 20211907 DOI: 10.1212/wnl.0b013e3181d3e308] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In spinal muscular atrophy (SMA), weakness, decreased endurance, and fatigue limit mobility. Scales have been developed to measure function across the wide spectrum of disease severity. However, these scales typically are observer dependent, and scores are based on sums across Likert-scaled items. The Six-Minute Walk Test (6MWT) is an objective, easily administered, and standardized evaluation of functional exercise capacity that has been proven reliable in other neurologic disorders and in children. METHODS To study the performance of the 6MWT in SMA, 18 ambulatory participants were evaluated in a cross-sectional study. Clinical measures were 6MWT, 10-m walk/run, Hammersmith Functional Motor Scale-Expanded (HFMSE), forced vital capacity, and handheld dynamometry. Associations between the 6MWT total distance and other outcomes were analyzed using Spearman correlation coefficients. A paired t test was used to compare the mean distance walked in the first and sixth minutes. RESULTS The 6MWT was associated with the HFMSE score (r = 0.83, p < 0.0001), 10-m walk/run (r = -0.87, p < 0.0001), and knee flexor strength (r = 0.62, p = 0.01). Gait velocity decreased during successive minutes in nearly all participants. The average first minute distance (57.5 m) was significantly more than the sixth minute distance (48 m) (p = 0.0003). CONCLUSION The Six-Minute Walk Test (6MWT) can be safely performed in ambulatory patients with spinal muscular atrophy (SMA), correlates with established outcome measures, and is sensitive to fatigue-related changes. The 6MWT is a promising candidate outcome measure for clinical trials in ambulatory subjects with SMA.
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Affiliation(s)
- J Montes
- SMA Clinical Research Center, Department of Neurology, Columbia University, 180 Ft. Washington Ave., 5th Floor, New York, NY 10032, USA.
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Nolan J, Riley S, Loveall S. Color naming based on clinical visual condition: A surprising interaction. J Vis 2010. [DOI: 10.1167/8.6.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Oliveros S, Unger K, Morishita M, Davies C, Riley S, Gudi M, Leonard R, Thomas G, Zitzelsberger H. Molecular Heterogeneity of Grade 3 Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-5167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Histological grade (HG) is one the main prognostic factors used in clinical practice, along with nodal status and tumour size, for the classification of patients into different prognostic groups that support the clinical decision making process and to tailor adjuvant treatment according to specific risk of death or relapse. The aim of this study was to examine the effect of Grade in prognosis in an unselected series of breast cancers, and to examine copy number alteration (CNA) specifically in Grade 3 (G3) breast cancer and its relationship to nodal status (N-ve/N+ve) and clinical outcome, to seek genetically determined markers of prognosis for treatment tailoring in this poor prognosis group.Method: We established a clinical database of 1489 operable Breast Cancer patients attending the Oncology Service at Singleton Hospital, Wales, UK between 1996 and 2002. HG was known for 1339 of these cases, and outcome in 1213, with a median of 5.32 years (range 0.09 - 10.14 years) follow-up. From the 466 G3 cases of primary breast cancer, we analysed 81 cases using 1Mb BAC array CGH for genomic copy number alterations. Spatial normalisation, circular binary segmentation and the CGHcall algorithm was used to generate CGH profiles. Unsupervised hierarchical clustering, supervised, correlation and survival analyses were carried out using packages and tests within the R statistical platform.Results: Patients were characterised according to grade, ER and nodal status. Kaplan Meier analysis for overall survival (OS) and disease specific survival (DFS) confirmed the poor prognosis of G3 (Cox proportional hazards regression, Wald-test p-value << 0.05). The majority of G1 (98%) and G2 (93%) cases were ER +ve, whereas 52.5% G3 cases were ER-ve. ER status was known for 316 of the 466 G3 cases, and ER negativity was significantly associated with a decreased OS (p-value 0.02), but not DFS (p-value: 0.13). Similarly N+vity also showed significant correlation with both OS and DFS (p-values < 0.05). BAC aCGH analysis showed significant copy number gains on chromosomes 1,4,5,7,11 and 21 in N+ve and losses on chromosomes 1,6 and 10 in N-ve G3. One region of chromosome 1 (1p36 – 1p35) in particular was lost in N0 but gained in N+ve, and this was significantly associated with ER-ve/N+ve cases (FDR p-value < 0.05). BAC aCGH profiles did not significantly associate with ER status in G3 disease. Two clusters, delineated on unsupervised hierarchical cluster analysis, correlated with OS. Neither correlated with nodal or ER status, indicating that further analysis may discover genes of prognostic potential within these profiles.Conclusion HG was significantly associated with clinical outcome and ER status. Genomic copy number analysis (CNA) in G3 breast cancer revealed significant associations between DNA alterations and nodal status and OS. The study is currently being extended to investigate the relationship between specific CNA and clinical outcome in G3 disease.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5167.
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Affiliation(s)
- S. Oliveros
- 1Imperial College London, UK, United Kingdom
| | - K. Unger
- 1Imperial College London, UK, United Kingdom
| | - M. Morishita
- 2Imperial College Healthcare NHS Trust, United Kingdom
| | | | - S. Riley
- 3Singleton Hospital, United Kingdom
| | - M. Gudi
- 1Imperial College London, UK, United Kingdom
| | - R. Leonard
- 1Imperial College London, UK, United Kingdom
| | - G. Thomas
- 1Imperial College London, UK, United Kingdom
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Wu JT, Riley S, Leung GM. Reducing the impact of the next influenza pandemic using household-based public health interventions. Hong Kong Med J 2009; 15 Suppl 9:38-41. [PMID: 20393225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Household-based public health interventions can effectively mitigate the impact of influenza pandemic, and the resources and compliance requirement are realistic and feasible.
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Affiliation(s)
- J T Wu
- Department of Community Medicine, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
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Smith L, Riley S, Peters ER. Schizotypy, delusional ideation and well-being in an American new religious movement population. Clin Psychol Psychother 2009; 16:479-84. [DOI: 10.1002/cpp.645] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Guan Y, Chen H, Li K, Riley S, Leung G, Webster R, Peiris J, Yuen K. A model to control the epidemic of H5N1 influenza at the source. BMC Infect Dis 2007; 7:132. [PMID: 17999754 PMCID: PMC2206044 DOI: 10.1186/1471-2334-7-132] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [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: 01/19/2007] [Accepted: 11/13/2007] [Indexed: 11/21/2022] Open
Abstract
Background No country is fully prepared for a 1918-like pandemic influenza. Averting a pandemic of H5N1 influenza virus depends on the successful control of its endemicity, outbreaks in poultry and occasional spillage into human which carries a case-fatality rate of over 50%. The use of perimetric depopulation and vaccination has failed to halt the spread of the epidemic. Blanket vaccination for all poultry over a large geographical area is difficult. A combination of moratorium, segregation of water fowls from chickens and vaccination have been proved to be effective in the Hong Kong Special Administrative Region (HKSAR) since 2002 despite endemicity and outbreaks in neighbouring regions. Systematic surveillance in southern China showed that ducks and geese are the primary reservoirs which transmit the virus to chickens, minor poultry and even migratory birds. Presentation of the hypothesis We hypothesize that this combination of moratorium, poultry segregation and targeted vaccination if successfully adapted to an affected district or province in any geographical region with high endemicity would set an example for the control in other regions. Testing the hypothesis A planned one-off moratorium of 3 weeks at the hottest month of the year should decrease the environmental burden as a source of re-infection. Backyard farms will then be re-populated by hatchlings from virus-free chickens and minor poultry only. Targeted immunization of the ducks and geese present only in the industrial farms and also the chickens would be strictly implemented as blanket immunization of all backyard poultry is almost impossible. Freely grazing ducks and geese would not be allowed until neutralizing antibodies of H5 subtype virus is achieved. As a proof of concept, a simple mathematical model with susceptible-infected-recovered (SIR) structure of coupled epidemics between aquatic birds (mainly ducks and geese) and chickens was used to estimate transmissibility within and between these two poultry populations. In the field the hypothesis is tested by prospective surveillance of poultry and immunocompetent patients hospitalized for severe pneumonia for the virus before and after the institution of these measures. Implications of the Hypothesis A combination of targeted immunization with the correct vaccine, segregation of poultry species and moratorium of poultry in addition to the present surveillance, biosecurity and hygienic measures at the farm, market and personal levels could be important in the successful control of the H5N1 virus in poultry and human for an extensive geographical region with continuing outbreaks. Alternatively a lesser scale of intervention at the district level can be considered if there is virus detection without evidence of excess poultry deaths since asymptomatic shedding is common in waterfowls.
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Affiliation(s)
- Y Guan
- State Key Laboratory of Emerging Infectious Diseases, the University of Hong Kong, Pokfulam, Hong Kong SAR, China.
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Leung GM, Lim WW, Ho LM, Lam TH, Ghani AC, Donnelly CA, Fraser C, Riley S, Ferguson NM, Anderson RM, Hedley AJ. Seroprevalence of IgG antibodies to SARS-coronavirus in asymptomatic or subclinical population groups. Epidemiol Infect 2006; 134:211-21. [PMID: 16490123 PMCID: PMC2870380 DOI: 10.1017/s0950268805004826] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2005] [Indexed: 01/12/2023] Open
Abstract
We systematically reviewed the current understanding of human population immunity against SARS-CoV in different groups, settings and geography. Our meta-analysis, which included all identified studies except those on wild animal handlers, yielded an overall seroprevalence of 0.10% [95% confidence interval (CI) 0.02-0.18]. Health-care workers and others who had close contact with SARS patients had a slightly higher degree of seroconversion (0.23%, 95% CI 0.02-0.45) compared to healthy blood donors, others from the general community or non-SARS patients recruited from the health-care setting (0.16%, 95% CI 0-0.37). When analysed by the two broad classes of testing procedures, it is clear that serial confirmatory test protocols resulted in a much lower estimate (0.050%, 95% CI 0-0.15) than single test protocols (0.20%, 95% CI 0.06-0.34). Potential epidemiological and laboratory pitfalls are also discussed as they may give rise to false or inconsistent results in measuring the seroprevalence of IgG antibodies to SARS-CoV.
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Affiliation(s)
- G M Leung
- Department of Community Medicine, University of Hong Kong, Pokfulam, Hong Kong, ChinaTakemi Program, Harvard School of Public Health, Boston, MA, USA.
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Matsumoto N, Riley S, Fraser D, Al-Assaf S, Ishimura E, Wolever T, Phillips GO, Phillips AO. Butyrate modulates TGF-β1 generation and function: Potential renal benefit for Acacia(sen) SUPERGUM™ (gum arabic)? Kidney Int 2006; 69:257-65. [PMID: 16408114 DOI: 10.1038/sj.ki.5000028] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Anecdotal evidence suggests that high fibre supplementation of dietary intake may have health benefits in renal disease related to alterations in circulating levels of short-chain fatty acids. The aim of the study was to examine the hypothesis that dietary manipulation may increase serum butyrate and thus have potential beneficial effects in renal disease. We examined the effect of dietary supplementation with a gum arabic sample of standardized molecular characteristics, Acacia(sen) SUPERGUM EM2 (SUPERGUM), on systemic levels of butyrate in normal human subjects. In an in vitro study, we also examined the potential role of butyrate in modifying the generation of the profibrotic cytokine transforming growth factor-beta (TGF-beta1) by renal epithelial cells. Following 8 weeks of dietary supplementation with 25 g/day of SUPERGUM, there was a two-fold increase in serum butyrate (n=7, P=0.03). In vitro work demonstrated that exposure of renal epithelial cells to elevated concentrations of butyrate suppressed both basal and stimulated TGF-beta1 synthesis. The action of butyrate was mediated by suppression of the extracellular signal-regulated kinase/mitogen-activated protein kinase signalling pathway. In addition, butyrate exposures reduced the response of renal epithelial cells to TGF-beta1 as assessed by luciferase activity of a TGF-beta-responsive reporter construct. Attenuation of TGF-beta1 signalling was associated with reduced phosphorylation of Smad 3 and decreased trafficking of TGF-beta1 receptors into signalling, non-lipid raft-associated membrane fractions. In conclusion, the data demonstrate that dietary supplementation with SUPERGU increased serum butyrate, which at least in vitro has beneficial effects on renal pro-fibrotic cytokine generation.
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Affiliation(s)
- N Matsumoto
- Institute of Nephrology, Cardiff University School of Medicine, Heath Park, Cardiff, UK
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