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Chan S, Cazzolli R, Jaure A, Johnson DW, Hawley CM, Craig JC, Sautenet B, van Zwieten A, Cao C, Dobrijevic E, Wilson G, Scholes-Robertson N, Carter S, Vastani T, Cho Y, Blumberg E, Brennan DC, Huuskes BM, Knoll G, Kotton C, Mamode N, Muller E, Phan Ha HA, Tedesco-Silva H, White DM, Viecelli AK. Report of the Standardized Outcomes in Nephrology-transplant Consensus Workshop on Establishing a Core Outcome Measure for Infection in Kidney Transplant Recipients. Transplantation 2024; 108:588-592. [PMID: 38385339 DOI: 10.1097/tp.0000000000004839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Samuel Chan
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network and the Medical School, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Rosanna Cazzolli
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
| | - Allison Jaure
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
| | - David W Johnson
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network and the Medical School, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Carmel M Hawley
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network and the Medical School, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Jonathan C Craig
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, SA, Australia
| | - Benedicte Sautenet
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
| | - Christopher Cao
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Ellen Dobrijevic
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
| | - Greg Wilson
- Australasian Kidney Trials Network and the Medical School, The University of Queensland, Brisbane, QLD, Australia
| | - Nicole Scholes-Robertson
- Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, SA, Australia
| | - Simon Carter
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
| | - Tom Vastani
- Sydney School of Public Health, Faculty of Medicine and Health, NSW, Australia
| | - Yeoungjee Cho
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Emily Blumberg
- Division of Infectious Diseases, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | - Brooke M Huuskes
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Greg Knoll
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Camille Kotton
- Transplant and Immunocompromised Host Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Nizam Mamode
- Department of Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, England, United Kingdom
| | - Elmi Muller
- Department of Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Hai An Phan Ha
- Kidney Diseases and Dialysis Department, Viet Duc University Hospital, Vietnam
| | - Helio Tedesco-Silva
- Division of Nephrology, Hospital do Rim, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - David M White
- Centre for Health Action and Policy, The Rogosin Institute, New York, NY
| | - Andrea K Viecelli
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network and the Medical School, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
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Kapelios C, Tseliou E, Alharethi R, Shah K, Hanff T, Kyriakopoulos C, Sideris K, Taleb I, Stehlik J, Carter S, Kfoury A, Caine W, Selzman C, Fang J, Wever-Pinzon O, Drakos S. Impaired Liver Function is Associated with Hypotension and Elevated Right Atrial Pressure but Not Depressed Cardiac Index in Chronic Heart Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.503] [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: 04/05/2023] Open
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3
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Green D, Singh A, Tippett VL, Tattersall L, Shah KM, Siachisumo C, Ward NJ, Thomas P, Carter S, Jeys L, Sumathi V, McNamara I, Elliott DJ, Gartland A, Dalmay T, Fraser WD. YBX1-interacting small RNAs and RUNX2 can be blocked in primary bone cancer using CADD522. J Bone Oncol 2023; 39:100474. [PMID: 36936386 PMCID: PMC10015236 DOI: 10.1016/j.jbo.2023.100474] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023] Open
Abstract
Primary bone cancer (PBC) comprises several subtypes each underpinned by distinctive genetic drivers. This driver diversity produces novel morphological features and clinical behaviour that serendipitously makes PBC an excellent metastasis model. Here, we report that some transfer RNA-derived small RNAs termed tRNA fragments (tRFs) perform as a constitutive tumour suppressor mechanism by blunting a potential pro-metastatic protein-RNA interaction. This mechanism is reduced in PBC progression with a gradual loss of tRNAGlyTCC cleavage into 5' end tRF-GlyTCC when comparing low-grade, intermediate-grade and high-grade patient tumours. We detected recurrent activation of miR-140 leading to upregulated RUNX2 expression in high-grade patient tumours. Both tRF-GlyTCC and RUNX2 share a sequence motif in their 3' ends that matches the YBX1 recognition site known to stabilise pro-metastatic mRNAs. Investigating some aspects of this interaction network, gain- and loss-of-function experiments using small RNA mimics and antisense LNAs, respectively, showed that ectopic tRF-GlyTCC reduced RUNX2 expression and dispersed 3D micromass architecture in vitro. iCLIP sequencing revealed YBX1 physical binding to the 3' UTR of RUNX2. The interaction between YBX1, tRF-GlyTCC and RUNX2 led to the development of the RUNX2 inhibitor CADD522 as a PBC treatment. CADD522 assessment in vitro revealed significant effects on PBC cell behaviour. In xenograft mouse models, CADD522 as a single agent without surgery significantly reduced tumour volume, increased overall and metastasis-free survival and reduced cancer-induced bone disease. Our results provide insight into PBC molecular abnormalities that have led to the identification of new targets and a new therapeutic.
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Key Words
- CADD522
- CADD522, computer aided drug design molecule 522
- CI, confidence interval
- CNV, copy number variant
- CS, chondrosarcoma
- CTC, circulating tumour cell
- DE, differentially expressed
- ES, Ewing sarcoma
- HD, high definition
- HR, hazard ratio
- OS, osteosarcoma
- RBP, RNA binding protein
- RNU6-1, U6 small nuclear 1
- ROI, region-of-interest
- Rnl, T4 RNA ligase
- SNV, single nucleotide variant
- SV, structural variant
- bone cancer
- iCLIP, individual nucleotide resolution cross-linking and immunoprecipitation
- mRNA, messenger RNA
- miRNA
- miRNA, microRNA
- piRNA, piwi interacting RNA
- sRNA, small RNA
- small RNA
- tRF
- tRF, transfer RNA fragment
- tRNA, transfer RNA
- ysRNA, Y RNA-derived sRNA
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Affiliation(s)
- Darrell Green
- Biomedical Research Centre, Norwich Medical School, University of East Anglia, Norwich, UK
- Corresponding author.
| | - Archana Singh
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Victoria L. Tippett
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, UK
| | - Luke Tattersall
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, UK
| | - Karan M. Shah
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, UK
| | | | - Nicole J. Ward
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Paul Thomas
- School of Biological Sciences, University of East Anglia, Norwich, UK
- Henry Wellcome Laboratory for Cell Imaging, Faculty of Science, University of East Anglia, Norwich, UK
| | - Simon Carter
- Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, UK
| | - Lee Jeys
- Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, UK
| | - Vaiyapuri Sumathi
- Musculoskeletal Pathology, University Hospitals Birmingham, Royal Orthopaedic Hospital, Birmingham, UK
| | - Iain McNamara
- Orthopaedics & Trauma, Norfolk and Norwich University Hospital, Norwich, UK
| | | | - Alison Gartland
- The Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, The University of Sheffield, UK
| | - Tamas Dalmay
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - William D. Fraser
- Biomedical Research Centre, Norwich Medical School, University of East Anglia, Norwich, UK
- Clinical Biochemistry, Diabetes and Endocrinology, Norfolk and Norwich University Hospital, Norwich, UK
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Kyriakopoulos C, Giannouchos T, Mylavarapu R, Krauspe E, Sheffield E, Sideris K, Elmer A, Vance N, Carter S, Hanff T, Wever-Pinzon O, Stehlik J, Selzman C, Drakos S, Goodwin M. Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.782] [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: 04/05/2023] Open
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5
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Watkins JD, Carter S, Atkinson G, Koumanov F, Betts JA, Holst JJ, Gonzalez JT. Glucagon-like peptide-1 secretion in people with versus without type 2 diabetes: a systematic review and meta-analysis of cross-sectional studies. Metabolism 2023; 140:155375. [PMID: 36502882 DOI: 10.1016/j.metabol.2022.155375] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS The aim of this systematic review was to synthesise the study findings on whether GLP-1 secretion in response to a meal tolerance test is affected by the presence of type 2 diabetes (T2D). The influence of putative moderators such as age, sex, meal type, meal form, and assay type were also explored. METHODS A literature search identified 32 relevant studies. The sample mean and SD for fasting GLP-1TOTAL and GLP-1TOTAL iAUC were extracted and used to calculate between-group standardised mean differences (SMD), which were meta-analysed using a random-effects model to derive pooled estimates of Hedges' g and 95 % prediction intervals (PI). RESULTS Pooled across 18 studies, the overall SMD in GLP-1TOTAL iAUC between individuals with T2D (n = 270, 1047 ± 930 pmol·L-1·min) and individuals without T2D (n = 402, 1204 ± 937 pmol·L-1·min) was very small, not statistically significant and heterogenous across studies (g = -0.15, p = 0.43, PI: -1.53, 1.23). Subgroup analyses demonstrated an effect of assay type whereby Hedges' g for GLP-1 iAUC was greater in individuals with, versus those without T2D when using ELISA or Mesoscale (g = 0.67 [moderate], p = 0.009), but not when using RIA (g = -0.30 [small], p = 0.10). Pooled across 30 studies, the SMD in fasting GLP-1TOTAL between individuals with T2D (n = 580, 16.2 ± 6.9 pmol·L-1) versus individuals without T2D (n = 1363, 12.4 ± 5.7 pmol·L-1) was small and heterogenous between studies (g = 0.24, p = 0.21, PI: -1.55, 2.02). CONCLUSIONS Differences in fasting GLP-1TOTAL and GLP-1TOTAL iAUC between individuals with, versus those without T2D were generally small and inconsistent between studies. Factors influencing study heterogeneity such as small sample sizes and poor matching of groups may help to explain the wide prediction intervals observed. Considerations to improve comparisons of GLP-1 secretion in T2D and potential mediating factors more important than T2D diagnosis per se are outlined. PROSPERO ID CRD42020195612.
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Affiliation(s)
- J D Watkins
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK.
| | - S Carter
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK
| | - G Atkinson
- Liverpool John Moores University, Liverpool, UK
| | - F Koumanov
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK
| | - J A Betts
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK
| | - J J Holst
- Biomedical Sciences, Endocrinology Research Section, University of Copenhagen, Denmark
| | - J T Gonzalez
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, UK.
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Kermond R, Carter S, Quinlan C. A child presents with acute kidney injury, alkalosis and hypercalcaemia-a new-age cause for a historical syndrome: Answers. Pediatr Nephrol 2022; 37:1807-1810. [PMID: 35166912 PMCID: PMC8852858 DOI: 10.1007/s00467-022-05465-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Rachael Kermond
- Nephrology Department, Children's Hospital Westmead, Sydney Children's Hospital Network, Sydney, NSW, Australia.
| | - Simon Carter
- Department of Pediatric Nephrology, Royal Children's Hospital, Melbourne, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Catherine Quinlan
- Department of Pediatric Nephrology, Royal Children's Hospital, Melbourne, Australia
- Department of Kidney Regeneration, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
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Kerklaan J, Hanson CS, Carter S, Tong A, Sinha A, Dart A, Eddy AA, Guha C, Gipson DS, Bockenhauer D, Hannan E, Yap HK, Groothoff J, Zappitelli M, Amir N, Alexander SI, Furth SL, Samuel S, Gutman T, Craig JC. Perspectives of Clinicians on Shared Decision Making in Pediatric CKD: A Qualitative Study. Am J Kidney Dis 2022; 80:241-250. [PMID: 35085686 DOI: 10.1053/j.ajkd.2021.12.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/06/2021] [Indexed: 01/27/2023]
Abstract
RATIONALE & OBJECTIVE Clinical decision-making priorities may differ among children, their parents, and their clinicians. This study describes clinicians' perspectives on shared decision making in pediatric chronic kidney disease (CKD) and identifies opportunities to improve shared decision making and care for children with CKD and their families. STUDY DESIGN Semistructured interviews. SETTING & PARTICIPANTS Fifty clinicians participated, including pediatric nephrologists, nurses, social workers, surgeons, dietitians, and psychologists involved in providing care to children with CKD. They worked at 18 hospitals and 4 university research departments across 11 countries (United States of America, Canada, Australia, People's Republic of China, United Kingdom, Germany, France, Italy, Lithuania, New Zealand, and Singapore). ANALYTICAL APPROACH Interview transcripts were analyzed thematically. RESULTS We identified 4 themes: (1) striving to blend priorities (minimizing treatment burden, emphasizing clinical long-term risks, achieving common goals), (2) focusing on medical responsibilities (carrying decisional burden and pressure of expectations, working within system constraints, ensuring safety is foremost concern), (3) collaborating to achieve better long-term outcomes (individualizing care, creating partnerships, encouraging ownership and participation in shared decision making, sensitive to parental distress), and (4) forming cumulative knowledge (balancing reassurance and realistic expectations, building understanding around treatment, harnessing motivation for long-term goals). LIMITATIONS Most clinicians were from high-income countries, so the transferability of the findings to other settings is uncertain. CONCLUSIONS Clinicians reported striving to minimize treatment burden and working with children and their families to manage their expectations and support their decision making. However, they are challenged with system constraints and sometimes felt the pressure of being responsible for the child's long-term outcomes. Further studies are needed to test whether support for shared decision making would promote strategies to establish and improve the quality of care for children with CKD.
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Affiliation(s)
- Jasmijn Kerklaan
- Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia.
| | - Camilla S Hanson
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Simon Carter
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Aditi Sinha
- Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, India
| | - Allison Dart
- Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allison A Eddy
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chandana Guha
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Debbie S Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Detlef Bockenhauer
- Department of Renal Medicine University College London, and Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United Kingdom
| | - Elyssa Hannan
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Hui-Kim Yap
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jaap Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Michael Zappitelli
- Department of Pediatrics, Division of Nephrology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Noa Amir
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Stephen I Alexander
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan L Furth
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Susan Samuel
- Department of Pediatrics, Section of Nephrology, University of Calgary, Calgary, Alberta, Canada
| | - Talia Gutman
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Kermond R, Carter S, Quinlan C. A child presents with acute kidney injury, alkalosis and hypercalcaemia-a new-age cause for a historical syndrome: Questions. Pediatr Nephrol 2022; 37:1805-1806. [PMID: 35166909 DOI: 10.1007/s00467-022-05454-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Rachael Kermond
- Nephrology Department, Children's Hospital Westmead, Sydney Children's Hospital Network, Sydney, NSW, Australia.
| | - Simon Carter
- Department of Pediatric Nephrology, Royal Children's Hospital, Melbourne, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Catherine Quinlan
- Department of Pediatric Nephrology, Royal Children's Hospital, Melbourne, Australia
- Department of Kidney Regeneration, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
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De Nunzio C, Lombardo R, Nacchia A, Cicione A, Turchi B, Gallo G, Gravina C, Guercio A, Stira J, Rivesti LM, Franco A, Guarnotta G, Mancini E, Voglino OA, Baldassarri V, D'Annunzio S, Riolo S, Carter S, Vicentini C, Tubaro A. PD39-03 POST-VOIDED RESIDUAL URINE RATIO IS A PREDICTOR OF BLADDER OUTLET OBSTRUCTION IN MEN WITH LOWER URINARY TRACT SYMPTOMS: DEVELOPMENT OF A CLINICAL NOMOGRAM. J Urol 2022. [DOI: 10.1097/ju.0000000000002597.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Speed E, Carter S, Green J. Pandemics, infection control and social justice: challenges for policy evaluation. Critical Public Health 2022. [DOI: 10.1080/09581596.2022.2029195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ewen Speed
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Simon Carter
- Department of Sociology, Walton Hall, Milton Keynes, the Open University, UK
| | - Judith Green
- Wellcome Centre for Cultures & Environments of Health, University of Exeter, Exeter, UK
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11
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Holroyd CR, Carter S, Crozier SR, D'Angelo S, Curtis EM, Moon RJ, Davies JH, Ward KA, Dennison EM, Inskip HM, Godfrey KM, Cooper C, Harvey NC. Differential relationships between parent-child DXA and pQCT bone measures: Results from the Southampton Women's Survey. Bone 2021; 153:116134. [PMID: 34332160 PMCID: PMC7611825 DOI: 10.1016/j.bone.2021.116134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/13/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
AIM To investigate the associations between indices of bone health in childhood and corresponding parental measures. METHODS The Southampton Women's Survey characterised 12,583 non-pregnant women aged 20-34 years; 3158 subsequently had singleton live births. In a subset, dual-energy X-ray absorptiometry (DXA) measurements of bone area (BA), bone mineral content (BMC) and areal bone mineral density (aBMD) lumbar spine and total hip were obtained in the parent/offspring (aged 8-9 years) trios. Another subset of children (aged 6-7 years), and their parents, had peripheral quantitative computed tomography (pQCT; 4% and 38% tibia) measures. Using multivariable linear regression we examined relationships between mother/father and offspring, adjusting for parental age, habitual walking speed and education; offspring age and sex; and the corresponding bone measure in the other parent (β-coefficients (95%CI) unit/unit for each bone measure). RESULTS Data were available for 260 trios with DXA and 99 with pQCT. There were positive associations for BA, BMC and aBMD between either parent and offspring. Mother-child associations were of greater magnitude than father-child; for example, mother-child aBMD (β = 0.26 g·cm-2/g·cm-2 (0.21,0.32)) and father-child aBMD (β = 0.16 g·cm-2/g·cm-2 (0.11,0.21)), P-difference in β = 0.007. In the subset with pQCT there was a positive association for mother-offspring 4% tibial total area (β = 0.33 mm2/mm2 (0.17,0.48)), but little evidence of a father-offspring association (β = -0.06 mm2/mm2 (-0.17,0.06)). In contrast offspring 38% cortical density was more strongly associated with this measure in fathers (β = 0.48 mg·cm-3/mg·cm-3 (0.15,0.82)) than mothers (β = 0.27 mg·cm-3/mg·cm-3 (-0.03,0.56)). In general mother-father differences were attenuated by adjustment for height. CONCLUSIONS Whilst offspring bone measures are independently associated with those of either parent, the magnitude of the association is often greater for maternal than paternal relationships. These findings are consistent with an in utero influence on offspring growth but might also reflect genetic and/or epigenetic parent of origin effects. SUMMARY In an established parent-offspring cohort, associations between parent and offspring bone indices were generally greater in magnitude for mother-offspring than father-offspring relationships.
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Affiliation(s)
- C R Holroyd
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Rheumatology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Carter S, van Rees CB, Hand BK, Muhlfeld CC, Luikart G, Kimball JS. Testing a Generalizable Machine Learning Workflow for Aquatic Invasive Species on Rainbow Trout ( Oncorhynchus mykiss) in Northwest Montana. Front Big Data 2021; 4:734990. [PMID: 34734177 PMCID: PMC8558495 DOI: 10.3389/fdata.2021.734990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Biological invasions are accelerating worldwide, causing major ecological and economic impacts in aquatic ecosystems. The urgent decision-making needs of invasive species managers can be better met by the integration of biodiversity big data with large-domain models and data-driven products. Remotely sensed data products can be combined with existing invasive species occurrence data via machine learning models to provide the proactive spatial risk analysis necessary for implementing coordinated and agile management paradigms across large scales. We present a workflow that generates rapid spatial risk assessments on aquatic invasive species using occurrence data, spatially explicit environmental data, and an ensemble approach to species distribution modeling using five machine learning algorithms. For proof of concept and validation, we tested this workflow using extensive spatial and temporal hybridization and occurrence data from a well-studied, ongoing, and climate-driven species invasion in the upper Flathead River system in northwestern Montana, USA. Rainbow Trout (RBT; Oncorhynchus mykiss), an introduced species in the Flathead River basin, compete and readily hybridize with native Westslope Cutthroat Trout (WCT; O. clarkii lewisii), and the spread of RBT individuals and their alleles has been tracked for decades. We used remotely sensed and other geospatial data as key environmental predictors for projecting resultant habitat suitability to geographic space. The ensemble modeling technique yielded high accuracy predictions relative to 30-fold cross-validated datasets (87% 30-fold cross-validated accuracy score). Both top predictors and model performance relative to these predictors matched current understanding of the drivers of RBT invasion and habitat suitability, indicating that temperature is a major factor influencing the spread of invasive RBT and hybridization with native WCT. The congruence between more time-consuming modeling approaches and our rapid machine-learning approach suggest that this workflow could be applied more broadly to provide data-driven management information for early detection of potential invaders.
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Affiliation(s)
- S Carter
- Numerical Terradynamic Simulation Group, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States
| | - C B van Rees
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States
| | - B K Hand
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States
| | - C C Muhlfeld
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States.,U.S. Geological Survey, Northern Rocky Mountain Science Center, Glacier National Park, West Glacier, MT, United States.,Department of Ecosystem and Conservation Sciences, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States
| | - G Luikart
- Flathead Lake Biological Station, Division of Biological Sciences, University of Montana, Polson, MT, United States
| | - J S Kimball
- Numerical Terradynamic Simulation Group, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States.,Department of Ecosystem and Conservation Sciences, WA Franke College of Forestry and Conservation, University of Montana, Missoula, MT, United States
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Kashetsky N, Mukovozov IM, Pereira J, Manion R, Carter S, Alhusayen R. Patient experiences with hidradenitis suppurativa: the Hidradenitis Patient Experience survey. Clin Exp Dermatol 2021; 47:72-79. [PMID: 34235774 DOI: 10.1111/ced.14826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/03/2021] [Accepted: 07/06/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Better understanding of the experience of people living with hidradenitis suppurativa (HS) is essential to identify gaps in current patient care and inform healthcare decision-making. AIM To describe the patient experience of individuals with HS, including their path to diagnosis, symptom control, treatments, healthcare utilization, patient needs and impact on quality of life. METHODS The Hidradenitis Suppurativa Patient Experience survey was created, extensively reviewed and disseminated through engaging HS-related patient organizations, physician groups and social media groups. RESULTS In total, 537 respondents completed the survey; the mean age was 38 years (range 14-73 years) and 95% (510 of 537) were female. The mean number of treatment types per respondent was 15, and included antibacterial soaps (93.3%; 431 of 462), avoidance of tight clothing (90.9%; 419 of 462), use of oral antibiotics (79.7%; 368 of 462), nonprescription drugs (79.7%; 368 of 462) and topical antibiotics (77.1%; 356 of 262). Pain was poorly controlled in 46% of respondents (184 of 401). HS had a negative impact on the ability to work and attend school for 81% of respondents (337 of 415), with 59% (245 of 415) missing at least 2 days of work a month and 16% (66 of 415) missing > 11 days of work. The mean number of misdiagnoses per respondent was three and the median time to diagnosis was 10 years. CONCLUSION Individuals with HS experience a delay in diagnosis and have suboptimal control of the disease. We propose 11 recommendations to improve diagnosis, treatment and quality of life for individuals living with HS.
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Affiliation(s)
- N Kashetsky
- Faculty of Medicine, Memorial University of Newfoundland, St John's, NL, Canada
| | - I M Mukovozov
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - J Pereira
- JRL Research & Consulting Inc, Mississauga, ON, Canada
| | - R Manion
- Canadian Skin Patient Alliance, Ottawa, ON, Canada
| | | | - R Alhusayen
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
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Mansell S, Carter S. Martin Mansell. Assoc Med J 2021. [DOI: 10.1136/bmj.n927] [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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Bjorkman C, Carter S, Amin A, Joshi P. Moderate Association of Coronary Artery Calcium and Cardiac Allograft Vasculopathy in Heart Transplant Recipients on Non-Gated CT. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.600] [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] Open
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Pope CE, Vo AT, Hayden HS, Weiss EJ, Durfey S, McNamara S, Ratjen A, Grogan B, Carter S, Nay L, Parsek MR, Singh PK, McKone EF, Aitken ML, Rosenfeld MR, Hoffman LR. Changes in fecal microbiota with CFTR modulator therapy: A pilot study. J Cyst Fibros 2021; 20:742-746. [PMID: 33390317 DOI: 10.1016/j.jcf.2020.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Abstract
Studies have demonstrated that people with CF with pancreatic insufficiency (PI) have fecal dysbioses. Evidence suggests the causes of these dysbioses are multifactorial, and that important drivers include antibiotic exposure, dietary intake, and CF gastrointestinal tract dysfunction, including nutrient malabsorption. In this pilot study, we tested whether initiation of the CFTR modulator treatments ivacaftor (in a cohort of pancreatic sufficient (PS) people with CF and an R117H CFTR variant) or lumacaftor/ivacaftor (in a cohort of PI people with CF and an F508del variant) changed fecal measures of malabsorption or fecal microbiomes. While we identified no statistically significant fecal changes with either treatment, we detected trends in the PI cohort when initiating lumacaftor/ivacaftor towards decreased fecal fat content and towards fecal microbiomes that more closely resembled the fecal microbiota of people without PI. While these findings support a model in which nutrient malabsorption resulting from CF-induced PI drives fecal dysbiosis, they must be validated in future, larger studies of fecal microbiome and malabsorption outcomes with highly effective CFTR modulator therapies.
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Affiliation(s)
- C E Pope
- University of Washington, Seattle, USA
| | - A T Vo
- University of Washington, Seattle, USA
| | | | - E J Weiss
- University of Washington, Seattle, USA
| | - S Durfey
- University of Washington, Seattle, USA
| | | | - A Ratjen
- University of Washington, Seattle, USA
| | - B Grogan
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Carter
- St. Vincent's University Hospital, Dublin, Ireland
| | - L Nay
- University of Washington, Seattle, USA
| | | | - P K Singh
- University of Washington, Seattle, USA
| | - E F McKone
- St. Vincent's University Hospital, Dublin, Ireland
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Arrow P, Piggott S, Carter S, McPhee R, Atkinson D, Mackean T, Kularatna S, Tonmukayakul U, Brennan D, Nanda S, Palmer D, Jamieson L. Atraumatic Restorative Treatments in Australian Aboriginal Communities: A Cluster-randomized Trial. JDR Clin Trans Res 2020; 6:430-439. [PMID: 33016169 DOI: 10.1177/2380084420963949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The management of early childhood caries (ECC) is challenging. OBJECTIVES A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia. METHODS Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities. RESULTS A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group. CONCLUSION A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health. KNOWLEDGE TRANSFER STATEMENT This cluster-randomized trial tested a multi-component model of dental care to young children with ECC in remote Aboriginal communities in Australia. The intervention, based on the atraumatic approaches using minimally invasive techniques encompassing preventive care, Atraumatic Restorative Treatment and the Hall Technique (ART-HT), delivered more restorative care and reduced the incidence of caries. This model of care was more effective than available standard care and should be incorporated into mainstream service delivery programs.
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Affiliation(s)
- P Arrow
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Piggott
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - S Carter
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - R McPhee
- Kimberley Aboriginal Medical Services, Broome, Australia
| | - D Atkinson
- Rural Clinical School of Western Australia, University of Western Australia, Broome, Australia
| | - T Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - U Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Nanda
- Health Department Western Australia, Office of Chief Dental Officer, Perth, Australia
| | - D Palmer
- Community Development, Community Development, Murdoch University, Perth, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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Hernández-Vara J, Sáez-Francàs N, Lorenzo-Bosquet C, Corominas-Roso M, Cuberas-Borròs G, Lucas-Del Pozo S, Carter S, Armengol-Bellapart M, Castell-Conesa J. BDNF levels and nigrostriatal degeneration in “drug naïve” Parkinson's disease patients. An “in vivo” study using I-123-FP-CIT SPECT. Parkinsonism Relat Disord 2020; 78:31-35. [DOI: 10.1016/j.parkreldis.2020.06.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 01/01/2023]
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Logeman C, Guha C, Howell M, Hanson CS, Craig JC, Samuel S, Zappitelli M, Matsuda-Abedini M, Dart A, Furth S, Eddy A, Groothoff J, Yap HK, Bockenhauer D, Sinha A, Alexander SI, Goldstein SL, Gipson DS, Michael M, Walker A, Kausman J, Gaillard S, Bacchetta J, Rheault MN, Warady BA, Neu A, Christian M, McTaggart S, Liu I, Teo S, Sautenet B, Gutman T, Carter S, Teixeira-Pinto A, Tong A. Developing Consensus-Based Outcome Domains for Trials in Children and Adolescents With CKD: An International Delphi Survey. Am J Kidney Dis 2020; 76:533-545. [PMID: 32654889 DOI: 10.1053/j.ajkd.2020.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/08/2020] [Indexed: 12/11/2022]
Abstract
RATIONALE & OBJECTIVE The inconsistency in outcomes reported and lack of patient-reported outcomes across trials in children with chronic kidney disease (CKD) limits shared decision making. As part of the Standardized Outcomes in Nephrology (SONG)-Kids initiative, we aimed to generate a consensus-based prioritized list of critically important outcomes to be reported in all trials in children with CKD. STUDY DESIGN An online 2-round Delphi survey in English, French, and Hindi languages. SETTINGS & PARTICIPANTS Patients (aged 8-21 years), caregivers/family, and health care professionals (HCPs) rated the importance of outcomes using a 9-point Likert scale (7-9 indicating critical importance) and completed a Best-Worst Scale. ANALYTICAL APPROACH We assessed the absolute and relative importance of outcomes. Comments were analyzed thematically. RESULTS 557 participants (72 [13%] patients, 132 [24%] caregivers, and 353 [63%] HCPs) from 48 countries completed round 1 and 312 (56%) participants (28 [40%] patients, 64 [46%] caregivers, and 220 [56%] HCPs) completed round 2. Five outcomes were common in the top 10 for each group: mortality, kidney function, life participation, blood pressure, and infection. Caregivers and HCPs rated cardiovascular disease higher than patients. Patients gave lower ratings to all outcomes compared with caregivers/HCPs except they rated life participation (round 2 mean difference, 0.1), academic performance (0.1), mobility (0.4), and ability to travel (0.4) higher than caregivers and rated ability to travel (0.4) higher than HCPs. We identified 3 themes: alleviating disease and treatment burden, focusing on the whole child, and resolving fluctuating and conflicting goals. LIMITATIONS Most participants completed the survey in English. CONCLUSIONS Mortality, life participation, kidney function, and blood pressure were consistently highly prioritized by patients, caregivers, and HCPs. Patients gave higher priority to some lifestyle-related outcomes compared with caregivers/HCPs. Establishing critically important outcomes for all trials in children with CKD may improve consistent reporting of survival, kidney health, and clinical and life impact outcomes that are meaningful for decision making.
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Affiliation(s)
- Charlotte Logeman
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Camilla S Hanson
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Susan Samuel
- Department of Pediatrics, Section of Nephrology, University of Calgary, Calgary, AB, Canada
| | - Michael Zappitelli
- Department of Pediatrics, Division of Nephrology, Toronto Hospital for Sick Children, Toronto, Canada
| | - Mina Matsuda-Abedini
- Department of Pediatrics, Division of Nephrology, Toronto Hospital for Sick Children, Toronto, Canada
| | - Allison Dart
- Department of Pediatrics and Child Health, The Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Susan Furth
- Department of Pediatrics, Perelman School of Medicine, Philadelphia, PA; Department of Epidemiology, Perelman School of Medicine, Philadelphia, PA; Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Allison Eddy
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Jaap Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Hui-Kim Yap
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Detlef Bockenhauer
- UCL Department of Renal Medicine and Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Aditi Sinha
- Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Stephen I Alexander
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Stuart L Goldstein
- Center for Acute Care Nephrology, Cincinnati Children's Hospital, Cincinnati, OH
| | - Debbie S Gipson
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Mini Michael
- Renal Section, Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Amanda Walker
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Nephrology and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Joshua Kausman
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Nephrology and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Segolene Gaillard
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacologie Clinique, Bron, France
| | - Justine Bacchetta
- Department of Pediatric Nephrology, Reference Center for Rare Renal Diseases, Hospices civils de Lyon, Lyon, France
| | - Michelle N Rheault
- Division of Nephrology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | | | - Alicia Neu
- Division of Pediatric Nephrology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Steven McTaggart
- Child and Adolescent Renal Service, Queensland Children's Hospital and University of Queensland, Brisbane, Australia
| | - Isaac Liu
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | - Sharon Teo
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | - Benedicte Sautenet
- Department of Nephrology Hypertension, dialysis, kidney transplantation, Tours Hospital, SPHERE - INSERM 1246, University of Tours and Nantes, Tours, France
| | - Talia Gutman
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Simon Carter
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
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Trappe A, Useckaite Z, Ward M, Davage H, Lennon J, Carter S, McKone E, Donnelly S, McNally P, Coppinger J. ePS3.02 Increased extracellular vesicles mediate inflammatory signalling in cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Litwic AE, Westbury LD, Carter S, Ward KA, Cooper C, Dennison EM. Self-perceived Fracture Risk in the Global Longitudinal Study of Osteoporosis in Women: Its Correlates and Relationship with Bone Microarchitecture. Calcif Tissue Int 2020; 106:625-636. [PMID: 32140759 PMCID: PMC7188698 DOI: 10.1007/s00223-020-00680-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/21/2020] [Indexed: 11/13/2022]
Abstract
The purpose of this study is to examine correlates of self-perceived fracture risk (SPR) and relationships between SPR and subsequent bone density and microarchitecture in the UK arm of the Global Longitudinal Study of Osteoporosis in Women. 3912 women completed baseline questionnaires detailing medical history and SPR; 492 underwent HRpQCT scans of the radius and tibia and DXA scans of total body, hip, femoral neck and lumbar spine a median of 7.5 years later. Correlates of SPR were examined and a cluster analysis of potential predictors of SPR performed. SPR in relation to HRpQCT and aBMD parameters was examined using linear regression with and without adjustment for anthropometric, demographic and lifestyle covariates. Mean (SD) baseline age was 69.0 (9.0) years; 56.6% reported a similar SPR; 28.6% lower SPR; 14.9% higher SPR compared to women of similar age. In mutually-adjusted analysis, higher SPR was associated (p < 0.05) with: lower physical activity and educational attainment; use of anti-osteoporosis medications (AOM) and calcium supplements; greater number of falls in the previous year; history of fracture since aged 45; family history of hip fracture; and increased comorbidity. Higher SPR, history of fracture, and use of AOM, calcium and vitamin D clustered together. Even after adjustments that included AOM use, higher SPR was associated with: lower radial trabecular volumetric density and number, and higher trabecular separation; lower tibial cortical area and trabecular volumetric density; and lower aBMD at the femoral neck. Despite greater AOM use, women with higher baseline SPR had poorer subsequent bone health.
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Affiliation(s)
- A E Litwic
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - L D Westbury
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S Carter
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- Victoria University of Wellington, Wellington, New Zealand.
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De Nunzio C, Lombardo R, Cicione A, Trucchi A, Carter S, Tema G, Nacchia A, Vicentini C, Tubaro A. The role of bladder wall thickness in the evaluation of detrusor underactivity: Development of a clinical nomogram. Neurourol Urodyn 2020; 39:1115-1123. [PMID: 32110842 DOI: 10.1002/nau.24327] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/31/2020] [Indexed: 11/09/2022]
Abstract
AIMS The aim of our study was to investigate noninvasive predictors for detrusor underactivity (DUA) in male patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE). METHODS A consecutive series of patients aged 45 years or older with non-neurogenic LUTS were prospectively enrolled. Patients underwent standard diagnostic assessment including International Prostatic Symptoms Score, uroflowmetry, urodynamic studies (cystometry and pressure-flow studies), transrectal ultrasound of the prostate, and ultrasound measurements of the bladder wall thickness (BWT). Logistic regression analysis was used to investigate predictors of DUA, defined as a bladder contractility index < 100 mm H2 O. A nomogram was developed based on the multivariable logistic regression model. RESULTS Overall 448 patients with a mean age of 66 ± 11 years were enrolled. In a multivariable logistic age-adjusted regression model BWT (odds ratio [OR]: 0.50 per mm; 95% confidence interval [CI], 0.30-0-66; P = .001) and Qmax (OR: 0.75 per mL/s; 95% CI, 0.70-0.81; P = .001) were significant predictors for DUA. The nomogram based on the model presented good discrimination (area under the curve [AUC]: 0.82), good calibration (Hosmer-Lemeshow test, P > .05) and a net benefit in the range of probabilities between 10% and 80%. CONCLUSIONS According to our results, BWT and Qmax can noninvasively predict the presence of DUA in patients with LUTS and BPE. Although our study should be confirmed in a larger prospective cohort, we present the first available nomogram for the prediction of DUA in patients with LUTS.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Cicione
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alberto Trucchi
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Simon Carter
- Department of Urology, London Clinic, London, UK
| | - Giorgia Tema
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Nacchia
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Carlo Vicentini
- Department of Surgical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Peacock M, Paterson J, Reed L, Davies S, Carter S, Coe A, Clarkson J. Innovation in Fischer–Tropsch: Developing Fundamental Understanding to Support Commercial Opportunities. Top Catal 2020. [DOI: 10.1007/s11244-020-01239-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractIn this contribution we provide details of the BP-Johnson Matthey proprietary Fischer–Tropsch technology and the advanced CANS reactor and catalyst system. The advanced CANS catalyst carrier reactor provides superior heat transfer, reduced pressure drop and higher productivity that lead to major economic savings. Fundamental understanding of catalyst behaviour is also key to obtaining a catalyst that is stable over the lifetime of its use. Synthesis, calcination and reduction steps introduce changes in the catalyst properties prior to syngas introduction. In particular, the presence of water can affect the final catalyst performance. The activity of a good catalyst can be significantly reduced by a sub-optimal activation or start-up. Similarly, stable operation and minimising deactivation are vital for long and stable catalyst life, with years of operation without requiring regeneration. In this report we also share a fundamental study on the catalyst activation across different catalyst supports. This combines advanced in situ techniques with reactor testing to explore the role of the support on catalyst performance. The results illustrate the critical need for a logical and systematic catalyst development programme to explore these effects to optimise the whole FT process. The combination of a joint approach in development plays a key role in a long term success in a process. The fundamental catalyst understanding, optimisation and improvements in combination with the novel CANS reactor design maximise their potential and offer the potential for a world leading technology.
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Tong B, Rollo C, Carter S, Carberry J, Martins R, Osman A, Eckert D. An investigation into the differences in the phenotypic causes of obstructive sleep apnoea in obese versus non-obese people. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Carter S, Carberry J, Grunstein R, Eckert D. High dose zopiclone does not change OSA severity, the respiratory arousal threshold, genioglossus muscle responsiveness or next-day sleepiness and alertness in selected people with OSA. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hanson CS, Gutman T, Craig JC, Bernays S, Raman G, Zhang Y, James LJ, Ralph AF, Ju A, Manera KE, Teixeira-Pinto A, Viecelli AK, Alexander SI, Blydt-Hansen TD, Dionne J, McTaggart S, Michael M, Walker A, Carter S, Wenderfer SE, Winkelmayer WC, Bockenhauer D, Dart A, Eddy AA, Furth SL, Gipson DS, Goldstein SL, Groothoff J, Samuel S, Sinha A, Webb NJ, Yap HK, Zappitelli M, Currier H, Tong A. Identifying Important Outcomes for Young People With CKD and Their Caregivers: A Nominal Group Technique Study. Am J Kidney Dis 2019; 74:82-94. [DOI: 10.1053/j.ajkd.2018.12.040] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/23/2018] [Indexed: 11/11/2022]
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Carter S, Keogan B, O'Reilly P, Coughlan S, Cooke G, De Gascun C, Gallagher C, McKone E. P176 Detection of respiratory viruses in cystic fibrosis: comparison of nasal FLOQ Swabs™ and sputum using the FilmArray® platform. J Cyst Fibros 2019. [PMCID: PMC7129069 DOI: 10.1016/s1569-1993(19)30470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carter S, Clifton PM, Keogh JP. Flash glucose monitoring for the safe use of a 2-day intermittent energy restriction in patients with type 2 diabetes at risk of hypoglycaemia: An exploratory study. Diabetes Res Clin Pract 2019; 151:138-145. [PMID: 30959146 DOI: 10.1016/j.diabres.2019.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022]
Abstract
AIMS Two medication change protocols were tested, both based on haemoglobin A1c (HbA1c), with one protocol also accounting for hypoglycaemic events. The aim was to compare the two protocols during intermittent energy restriction (5:2 diet). METHODS Forty-two adults with type 2 diabetes (HbA1c ≥ 7% [53 mmol/mol], BMI of ≥27 kg/m2) treated with sulphonylureas and/or insulin were recruited and randomised 1:1 to fixed or adjusted medication protocols. Participants experiencing hypoglycaemia during a 2-week usual diet period then followed the 5:2 diet for 2 weeks (2 non-consecutive very-low-calorie days [500-600 kcal] and 5 habitual eating days/week), following the allocated medication protocol. The primary outcome was to determine if the adjusted protocol was superior to the fixed protocol at reducing hypoglycaemic events during the 5:2 diet. Flash glucose monitoring was used throughout to detect hypoglycaemia. RESULTS There was a significant difference in change in the number of hypoglycaemic events between fixed and adjusted protocols (-1.0 vs. -3.5; P = 0.04). Over 60% of participants on the adjusted protocol had no hypoglycaemic events. CONCLUSIONS This pilot study demonstrates the importance of assessing the risk of hypoglycaemia before starting a 5:2 diet and that the adjusted medication protocol is likely the best option for patients at risk. CLINICAL TRIAL REGISTRY This study has been registered with the Australia New Zealand Clinical Trial Registry (ANZCTR) www.anzctr.org.au and given the registration number ACTRN12617000512325.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia.
| | - J P Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
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Carter S, Clifton PM, Keogh JB. The effect of intermittent compared with continuous energy restriction on glycaemic control in patients with type 2 diabetes: 24-month follow-up of a randomised noninferiority trial. Diabetes Res Clin Pract 2019; 151:11-19. [PMID: 30902672 DOI: 10.1016/j.diabres.2019.03.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/11/2019] [Accepted: 03/14/2019] [Indexed: 11/23/2022]
Abstract
AIMS We investigated the effects of intermittent compared to continuous energy restriction on glycaemic control in patients with type 2 diabetes mellitus. METHODS Adults (N = 137) with type 2 diabetes (mean [SD] HbA1c level, 7.3% (56 mmol/mol) [1.3%] [14.2 mmol/mol]) were randomised to one of two diets for 12 months. The intermittent group (n = 70) followed a 2100-2500 kJ (500-600 kcal) diet 2 non-consecutive days/week and their usual diet for 5 days/week. The continuous group (n = 67) followed a 5000-6300 kJ (1200-1500 kcal) diet for 7 days/week. Follow-up occurred at 24 months, 12 months after the completed intervention. The primary outcome was change in HbA1c and the secondary outcome was weight loss. RESULTS Intention-to-treat analysis showed an increase in mean [SEM] HbA1c level at 24 months in both the continuous and intermittent groups (0.4% [0.3%] vs 0.1% [0.2%] respectively; P = 0.32) (4.4 [3.3 mmol/mol] vs 1.1 [2.2 mmol/mol]; P = 0.32), with a between-group difference of 0.3% (90% CI, -0.31 to 0.83%) (3.3 mmol/mol [90% CI, -3.2 to 9.1 mmol/mol]) outside the prespecified boundary of ± 0.5% (5.5 mmol/mol), so statistical equivalence was not shown. Weight loss was maintained (P < 0.001) at -3.9 kg [1.1 kg] in both groups at 24 months, with a between-group difference of 0.07 kg (90% CI, -2.5 to 2.6 kg) outside the prespecified boundary of ±2.5 kg. There were no significant differences between groups in body composition, fasting glucose levels, lipid levels, or total medication effect score at 24 months, which remained less than baseline. CONCLUSIONS In this prospective analysis weight loss was maintained but despite this HbA1c increased to above baseline levels in both groups.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Australia
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van Zwieten A, Caldwell P, Howard K, Tong A, Craig JC, Alexander S, Howell M, Armando TP, Hawley C, Jesudason S, Walker A, Mackie F, Kennedy S, McTaggart S, McCarthy H, Carter S, Kim S, Crafter S, Woodleigh R, Guha C, Wong G. NAV-KIDS 2 trial: protocol for a multi-centre, staggered randomised controlled trial of a patient navigator intervention in children with chronic kidney disease. BMC Nephrol 2019; 20:134. [PMID: 30999884 PMCID: PMC6471999 DOI: 10.1186/s12882-019-1325-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a devastating illness associated with increased mortality, reduced quality of life, impaired growth, neurocognitive impairment and psychosocial maladjustment in children. There is growing evidence of socioeconomic disparities in health outcomes among children with CKD. Patient navigators are trained non-medical personnel who assist patients with chronic conditions journey through the continuum of care and transit across different care settings. They help vulnerable and underserved populations to better understand their diagnosis, treatment options, and available resources, guide them through complex medical systems, and help them to overcome barriers to health care access. Given the complexity and chronicity of the disease process and concerns that current models of care may not adequately support the provision of high-level care in children with CKD from socioeconomically disadvantaged backgrounds, a patient navigator program may improve the provision of care and overall health of children with CKD. Methods The NAV-KIDS2 trial is a multi-centre, staggered entry, waitlisted randomised controlled trial assessing the health benefits and costs of a patient navigator program in children with CKD (stages 3–5, on dialysis, and with kidney transplants), who are of low socioeconomic backgrounds. Across 5 sites, 210 patients aged from 3 to 17 years will be randomised to immediate receipt of a patient navigator intervention for 24 weeks or waitlisting with standard care until receipt of a patient navigator at 24 weeks. The primary outcome is child self-rated health (SRH) 6-months after completion of the intervention. Other outcomes include utility-based quality of life, caregiver SRH, satisfaction with healthcare, progression of kidney dysfunction, other biomarkers, missed school days, hospitalisations and mortality. The trial also includes an economic evaluation and process evaluation, which will assess the cost-effectiveness, fidelity and barriers and enablers of implementing a patient navigator program in this setting. Discussion This study will provide clear evidence on the effectiveness and cost-effectiveness of a new intervention aiming to improve overall health and well-being for children with CKD from socioeconomically disadvantaged backgrounds, through a high quality, well-powered clinical trial. Trial registration Prospectively registered (12/07/2018) on the Australian New Zealand Clinical Trials Registry (ACTRN12618001152213).
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Affiliation(s)
- Anita van Zwieten
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Patrina Caldwell
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Kirsten Howard
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Allison Tong
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Adelaide, South Australia
| | - Stephen Alexander
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Martin Howell
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Teixeira-Pinto Armando
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Carmel Hawley
- Faculty of Medicine, Princess Alexandra Hospital Southside Clinical Unit, Queensland, Australia
| | - Shilpa Jesudason
- Department of Renal Medicine, Royal Adelaide Hospital, Adelaide, South Australia
| | - Amanda Walker
- Department of Renal Medicine, Royal Children's Hospital in Melbourne, Victoria, Australia
| | - Fiona Mackie
- Department of Renal Medicine, Sydney Children's Hospital, Sydney, Randwick, New South Wales, Australia
| | - Sean Kennedy
- Department of Renal Medicine, Sydney Children's Hospital, Sydney, Randwick, New South Wales, Australia
| | - Steve McTaggart
- Department of Renal Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Hugh McCarthy
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Department of Renal Medicine, Sydney Children's Hospital, Sydney, Randwick, New South Wales, Australia
| | - Simon Carter
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Siah Kim
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sam Crafter
- Department of Renal Medicine, Women's and Children's Hospital, Adelaide, South Australia
| | | | - Chandana Guha
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Germaine Wong
- Centre for Kidney Research at The Children's Hospital at Westmead, Westmead, New South Wales, Australia. .,Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
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Roberts S, Miter S, Shukrullah B, Keller B, Lee M, Yurjevic T, Carter S, Pope-Harman A, Lee P, Whitson B. Impact of Lung Allograft Oversizing on Pleural Cavity Expansion in Transplant Recipients with Idiopathic Pulmonary Fibrosis. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.455] [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] Open
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32
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Duncanson L, Armston J, Disney M, Avitabile V, Barbier N, Calders K, Carter S, Chave J, Herold M, Crowther TW, Falkowski M, Kellner JR, Labrière N, Lucas R, MacBean N, McRoberts RE, Meyer V, Næsset E, Nickeson JE, Paul KI, Phillips OL, Réjou-Méchain M, Román M, Roxburgh S, Saatchi S, Schepaschenko D, Scipal K, Siqueira PR, Whitehurst A, Williams M. The Importance of Consistent Global Forest Aboveground Biomass Product Validation. Surv Geophys 2019; 40:979-999. [PMID: 31395994 PMCID: PMC6647371 DOI: 10.1007/s10712-019-09538-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/27/2019] [Indexed: 05/17/2023]
Abstract
Several upcoming satellite missions have core science requirements to produce data for accurate forest aboveground biomass mapping. Largely because of these mission datasets, the number of available biomass products is expected to greatly increase over the coming decade. Despite the recognized importance of biomass mapping for a wide range of science, policy and management applications, there remains no community accepted standard for satellite-based biomass map validation. The Committee on Earth Observing Satellites (CEOS) is developing a protocol to fill this need in advance of the next generation of biomass-relevant satellites, and this paper presents a review of biomass validation practices from a CEOS perspective. We outline the wide range of anticipated user requirements for product accuracy assessment and provide recommendations for the validation of biomass products. These recommendations include the collection of new, high-quality in situ data and the use of airborne lidar biomass maps as tools toward transparent multi-resolution validation. Adoption of community-vetted validation standards and practices will facilitate the uptake of the next generation of biomass products.
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Affiliation(s)
- L. Duncanson
- Department of Geographical Sciences, University of Maryland, College Park, 2181 Lefrak Hall, College Park, MD 20742 USA
| | - J. Armston
- Department of Geographical Sciences, University of Maryland, College Park, 2181 Lefrak Hall, College Park, MD 20742 USA
| | - M. Disney
- Department of Geography, University College London, Gower Street, London, WC1E 6BT UK
| | - V. Avitabile
- European Commission, Joint Research Centre (JRC), Via E. Fermi 2749, 21027 Ispra, Italy
| | - N. Barbier
- AMAP, IRD, CIRAD,
CNRS, INRA, Montpellier University, TA A51/PS2, 34398 Montpellier cedex 5, France
| | - K. Calders
- CAVElab – Computational and Applied Vegetation Ecology, Ghent University, Room A2.089, Coupure Links 653, 9000 Ghent, Belgium
| | - S. Carter
- Laboratory of Geo-Information Science and Remote Sensing, Wageningen University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - J. Chave
- Laboratoire Evolution et Diversit. Biologique, UMR 5174, CNRS, Universit. Toulouse Paul Sabatier, 118 route de Narbonne, 31062 Toulouse cedex 9, France
| | - M. Herold
- Laboratory of Geo-Information Science and Remote Sensing, Wageningen University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - T. W. Crowther
- Institute of Integrative Biology, ETH Zürich, Univeritätstrasse 16, 8006 Zurich, Switzerland
| | - M. Falkowski
- Department of Ecosystem Science and Sustainability, Colorado State University, Fort Collins, CO 80523 USA
| | - J. R. Kellner
- Institute at Brown for Environment and Society, Brown University, Providence, RI 02912 USA
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI 02912 USA
| | - N. Labrière
- Laboratoire Evolution et Diversit. Biologique, UMR 5174, CNRS, Universit. Toulouse Paul Sabatier, 118 route de Narbonne, 31062 Toulouse cedex 9, France
| | - R. Lucas
- Earth Observation and Ecosystem Dynamics Research Group, Department of Geography and Earth Sciences (DGES), Aberystwyth University, Aberystwyth, Wales SY23 3DB UK
| | - N. MacBean
- Department of Geography, Indiana University, 701 E. Kirkwood Ave., Bloomington, IN 47405 USA
| | - R. E. McRoberts
- USDA Forest Service, Northern Research Station, Saint Paul, 1992 Folwell Ave, St Paul, MN 55108 USA
| | - V. Meyer
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - E. Næsset
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, NMBU, P.O. Box 5003, 1432 Ås, Norway
| | - J. E. Nickeson
- NASA Goddard Space Flight Center/Science Systems and Applications Inc., 10210 Greenbelt Rd #600, Lanham, MD 20706 USA
| | - K. I. Paul
- CSIRO Land and Water, GPO Box 1700, Canberra, ACT 2601 Australia
| | - O. L. Phillips
- School of Geography, University of Leeds, Leeds, LS2 9JT UK
| | - M. Réjou-Méchain
- AMAP, IRD, CIRAD,
CNRS, INRA, Montpellier University, TA A51/PS2, 34398 Montpellier cedex 5, France
| | - M. Román
- Earth from Space Institute, Universities Space Research Association, Columbia, MD USA
| | - S. Roxburgh
- CSIRO Land and Water, GPO Box 1700, Canberra, ACT 2601 Australia
| | - S. Saatchi
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - D. Schepaschenko
- International Institute for Applied Systems Analysis, Schlossplatz 1, 2361 Laxenburg, Austria
| | - K. Scipal
- European Space Agency, ESTEC, Keplerlaan 1, 2201 AZ Noordwijk, The Netherlands
| | - P. R. Siqueira
- Department of Electrical and Computer Engineering, 201 Marcus Hall, University of Massachusetts, 100 Natural Resources Road, Amherst, MA 01003 USA
| | - A. Whitehurst
- Arctic Slope Federal Technical Services, 7000 Muirkirk Meadows Dr #100, Laurel, MD 20707 USA
| | - M. Williams
- School of GeoScience, University of Edinburgh, Drummond St, Edinburgh, EH8 9XP UK
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McLaughlin T, Abbasi F, Lamendola C, Yee G, Carter S, Cushman SW. Dietary weight loss in insulin-resistant non-obese humans: Metabolic benefits and relationship to adipose cell size. Nutr Metab Cardiovasc Dis 2019; 29:62-68. [PMID: 30497926 PMCID: PMC6410738 DOI: 10.1016/j.numecd.2018.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Overweight and obesity increase risk for diabetes and cardiovascular disease, largely through development of insulin resistance. Benefits of dietary weight loss are documented for obese individuals with insulin resistance. Similar benefits have not been shown in overweight individuals. We sought to quantify whether dietary weight loss improves metabolic risk profile in overweight insulin-resistant individuals, and evaluated potential mediators between weight loss and metabolic response. METHODS AND RESULTS Healthy volunteers with BMI 25-29.9 kg/m2 underwent detailed metabolic phenotyping including insulin-mediated-glucose disposal, fasting/daylong glucose, insulin, triglycerides, FFA, and cholesterol. Subcutaneous fat biopsies were performed for measurement of adipose cell size. After 14 weeks of hypocaloric diet and 2 weeks of weight maintenance, cardiometabolic measures and biopsies were repeated. Changes in weight, % body fat, waist circumference, adipose cell size and FFA were evaluated as predictors of change in insulin resistance. Weight loss (4.3 kg) yielded significant improvements in insulin resistance and all cardiovascular risk markers except glucose, HDL-C, and LDL-C. Improvement in insulin sensitivity was greater among those with <2 vs >2 cardiovascular risk factors at baseline. Decrease in adipose cell size and waist circumference, but not weight or body fat, independently predicted improvement in insulin resistance. CONCLUSIONS Weight loss yields metabolic health benefits in insulin-resistant overweight adults, even in the absence of classic cardiovascular risk factors. Weight loss-related improvement in insulin sensitivity may be mediated through changes in adipose cell size and/or central distribution of body fat. The insulin-resistant subgroup of overweight individuals should be identified and targeted for dietary weight loss. CLINICAL TRIALS IDENTIFIER NCT00186459.
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Affiliation(s)
- T McLaughlin
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - F Abbasi
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - C Lamendola
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - G Yee
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - S Carter
- Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - S W Cushman
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
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Bay V, Griffiths B, Carter S, Evans NJ, Lenzi L, Bicalho RC, Oikonomou G. 16S rRNA amplicon sequencing reveals a polymicrobial nature of complicated claw horn disruption lesions and interdigital phlegmon in dairy cattle. Sci Rep 2018; 8:15529. [PMID: 30341326 PMCID: PMC6195575 DOI: 10.1038/s41598-018-33993-9] [Citation(s) in RCA: 23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/08/2018] [Indexed: 11/08/2022] Open
Abstract
Lameness represents an intractable problem for the dairy industry. Complicated claw horn disruption lesions, interdigital hyperplasia, and interdigital phlegmon are important lameness causing foot lesions. Their aetiology is multifactorial, but infectious processes are likely implicated in disease pathogenesis. Our aim was to investigate the bacterial profiles of these lesions using 16S rRNA gene sequencing of samples obtained from 51 cattle across ten farms in the UK. In this study, interdigital hyperplasia, interdigital hyperplasia with signs of interdigital dermatitis, interdigital phlegmon, complicated sole ulcers, complicated toe ulcers lesions, and complicated white line lesions were investigated; corresponding healthy skin control samples were also analysed. All diseased tissues displayed reduced microbial richness and diversity (as described by Chao1, Shannon, and Simpson alpha-diversity indices) compared to their healthy skin control samples. Our results confirm the association of Treponema spp with some of these disorders. Other anaerobic bacteria including Fusobacterium spp., Fastidiosipila spp. and Porphyromonas spp. were implicated in the aetiology of all these lesions with the exception of interdigital hyperplasia. Complicated claw horn disruption lesions, and interdigital phlegmon were found to have similar bacterial profiles. Such sharing of bacterial genera suggests many of the infectious agents detected in these foot lesions are acting opportunistically; this finding could contribute towards future treatment and control strategies.
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Affiliation(s)
- V Bay
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - B Griffiths
- Department of Livestock Health and Welfare, Institute of Veterinary Sciences, University of Liverpool, Liverpool, UK
| | - S Carter
- Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - N J Evans
- Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - L Lenzi
- Centre for Genomic Research, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - R C Bicalho
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, USA
| | - G Oikonomou
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
- Department of Livestock Health and Welfare, Institute of Veterinary Sciences, University of Liverpool, Liverpool, UK.
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Gutman T, Hanson CS, Bernays S, Craig JC, Sinha A, Dart A, Eddy AA, Gipson DS, Bockenhauer D, Yap HK, Groothoff J, Zappitelli M, Webb NJ, Alexander SI, Goldstein SL, Furth S, Samuel S, Blydt-Hansen T, Dionne J, Michael M, Wenderfer SE, Winkelmayer WC, Currier H, McTaggart S, Walker A, Ralph AF, Ju A, James LJ, Carter S, Tong A. Child and Parental Perspectives on Communication and Decision Making in Pediatric CKD: A Focus Group Study. Am J Kidney Dis 2018; 72:547-559. [DOI: 10.1053/j.ajkd.2018.05.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/02/2018] [Indexed: 11/11/2022]
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Zimmer AS, Gril B, Steinberg S, Smart D, Gilbert M, Armstrong T, Xiao L, Houston N, Biassou N, Brastianos P, Carter S, Lyden DC, Lipkowitz S, Steeg P. Abstract OT2-06-01: Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-Positive breast cancer brain metastases following stereotactic radiosurgery. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-06-01] [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: Brain metastases occur in up to 25-40% of HER2+ breast cancer patients. Standard treatment is limited to surgery or stereotactic radiosurgery (SRS) and/or whole brain radiation therapy (WBRT), with high levels of recurrence or progression, limiting survival and quality of life in most patients. Our group has demonstrated that low doses of temozolomide (TMZ) administered in a prophylactic, metronomic fashion can significantly prevent development of brain metastases in murine models of breast cancer. Based on these findings, we propose a secondary-prevention clinical trial.
Trial Design: Phase I/II open label study. Phase I will follow a standard 3+3 design: T-DM1 3.6 mg/kg IV every 21 days plus TMZ 30, 40 or 50 mg/m2 daily. Phase II: randomization T-DM1 3.6 mg/kg versus T-DM1 3.6mg/kg plus TMZ at recommended phase 2 dose (RP2D). Patients will undergo radiology guided lumbar puncture at baseline and after 6 weeks of treatment (C3D1) for correlative studies, brain MRI, systemic restaging CTs, and questionnaires for evaluation of symptoms and quality of life (MDASI-BT and PROMIS®) every 6 weeks.
Eligibility: HER2+ breast cancer with ≤3 brain metastases, treated with SRS and/or resection ≤6 weeks before enrollment, no leptomeningeal metastases, no previous WBRT, able to complete brain MRI with contrast evaluations, willing to undergo lumbar puncture, ECOG ≤2 and adequate organ and marrow function. HBV, HCV or HIV-positive patients are ineligible.
Specific Aims: Phase I: to identify the maximum tolerated dose (MTD) of TMZ combined with T-DM1. Phase II: to determine if the combination regimen of T-DM1 and TMZ improves the recurrence-free incidence from distant new brain metastases at one year as compared to T-DM1 alone. Biomarkers, including cell free DNA sequencing from CSF, serum and tumor block, serum markers for neuroinflammation, and patient reported outcomes, will be analyzed in an exploratory fashion.
Statistical Methods: Phase I, MTD will be identified based on the dose level at which 0 or 1 patient in 6 has a DLT. Phase II, to test whether TMZ will increase RFS from 50% to 65% at 12 months. RFS Kaplan-Meier curves will be created for each of the randomized arms and compared using a one-tailed log-rank test, with a one-sided 0.10 significance level of interest to be detected. Patients will be stratified for number of brain lesions and status of systemic metastases (controlled or not).
Target Accrual: 49 evaluable patients per arm (total 98), plus 9 to 18 patients during phase I. Trial will open in Summer 2017, at NIH in Bethesda, MD.
Contact Information: Principal Investigator: Alexandra S Zimmer, MD alexandra.zimmer@nih.gov
Citation Format: Zimmer AS, Gril B, Steinberg S, Smart D, Gilbert M, Armstrong T, Xiao L, Houston N, Biassou N, Brastianos P, Carter S, Lyden DC, Lipkowitz S, Steeg P. Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-Positive breast cancer brain metastases following stereotactic radiosurgery [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-06-01.
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Affiliation(s)
- AS Zimmer
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - B Gril
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Steinberg
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - D Smart
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - M Gilbert
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - T Armstrong
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - L Xiao
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - N Houston
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - N Biassou
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - P Brastianos
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Carter
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - DC Lyden
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Lipkowitz
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - P Steeg
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
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Raine R, Carter S, Sensky T, Black N. ‘Referral into a Void': Opinions of General Practitioners and Others on Single Point of Access to Mental Health Care. J R Soc Med 2017; 98:153-7. [PMID: 15805555 PMCID: PMC1079438 DOI: 10.1177/014107680509800404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/16/2022] Open
Abstract
In the past, British general practitioners (GPs) have referred patients to individual consultants. There is now a trend towards generic referral, whereby the specialist team is consulted via a single point of access. We examined the impact of this innovation on the relationship between GPs and specialists in mental health care. Sixteen groups of randomly selected GPs and mental health professionals (MHPs) in England discussed clinical scenarios involving the use of mental health interventions for patients with functional somatic symptoms. The meetings were audiotaped, transcribed and analysed to the point at which no major new themes were emerging. The final analysis was confined to a purposive sample of six of the sixteen groups, comprising 54 GPs and 15 MHPs. Although the rationale for the single point of access was clear to both GPs and MHPs, the approach erected boundaries because it impeded the establishment of professional relationships and transfer of knowledge. GPs thought the system reduced their capacity to be accountable to their patients and limited the potential for their own professional development. MHPs did not seem to be aware of GPs’ concerns. Effective interprofessional management of individual patients depends upon confidence in colleagues’ skills and good communication. Factors that hamper these must be addressed in the development of this system of referral.
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Affiliation(s)
- Rosalind Raine
- Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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Carter S, Channon A, Berrington A, Carter S. Variations in the Risk of Labour Induction Across Hospitals and NHS Trusts in the United Kingdom. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Channon
- University of Southampton, Southampton, UK
| | | | - S Carter
- University of Southampton, Southampton, UK
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Chua ME, Ming JM, Carter S, El Hout Y, Koyle MA, Noone D, Farhat WA, Lorenzo AJ, Bägli DJ. Impact of Adjuvant Urinary Diversion versus Valve Ablation Alone on Progression from Chronic to End Stage Renal Disease in Posterior Urethral Valves: A Single Institution 15-Year Time-to-Event Analysis. J Urol 2017; 199:824-830. [PMID: 29061539 DOI: 10.1016/j.juro.2017.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Long-term progression to end stage renal disease of valve ablation alone vs ablation followed by additional urinary diversion were compared among children with stage 3 chronic kidney disease due to posterior urethral valves. MATERIALS AND METHODS We performed a retrospective study of children with posterior urethral valves and stage 3 chronic kidney disease treated at a single institution between 1986 and 2011. The 3 treatment groups were classified as group 1-valve ablation alone, group 2-ablation plus subsequent vesicostomy and group 3-ablation followed by ureterostomies and/or pyelostomies. Baseline demographic characteristics were analyzed. Statistical analyses compared the incidence of time to end stage renal disease among the intervention groups using the Fisher-Freeman-Halton exact test and Kaplan-Meier analysis with the log rank test. Cox regression was used to determine predictors of end stage renal disease progression. RESULTS A total of 40 eligible patients were included in the study (group 1-14 patients, group 2-13 patients, group 3-13 patients). Baseline characteristics and post-intervention estimated glomerular filtration rate revealed no significant between-group differences. A statistically significant difference in progression to end stage renal disease was noted within 1 year after diagnosis of stage 3 chronic kidney disease among the treatment groups (log rank test p=0.02). However, cumulative end stage renal disease incidence at 15-year followup showed no statistical difference (log rank test p=0.628). Cox regression analysis determined that bilateral renal dysplasia (HR 2.76, 95% CI 1.21-6.30) and estimated glomerular filtration rate 60 ml/minute/1.73 m2 or greater after intervention (HR 0.23, 95% CI 0.09-0.61) were predictive of the likelihood of progression to end stage renal disease. CONCLUSIONS Urinary diversion following valve ablation in children with stage 3 chronic kidney disease associated with posterior urethral valves may temporarily delay progression to end stage renal disease. However, no long-term benefit was noted from diversion in the ultimate incidence of end stage renal disease, suggesting that these interventions should be seen as a temporizing measure. Bilateral renal dysplasia and post-intervention estimated glomerular filtration rate are independent variables predicting overall chronic kidney disease progression.
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Affiliation(s)
- Michael E Chua
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jessica M Ming
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Simon Carter
- Division of Nephrology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Yaser El Hout
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Urology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Martin A Koyle
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Damien Noone
- Division of Nephrology, The Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Walid A Farhat
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Armando J Lorenzo
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Darius J Bägli
- Division of Urology, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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Buckley R, Reilly CM, Kelly S, Ward E, O'Connor C, Carter S, Gallagher CG, McKone EF. Corrigendum to "WS04.1 The effect of Orkambi® on exercise capacity and muscle strength" [J Cyst Fibros, volume 16, supplement 1, June 2017, pages S6-S7]. J Cyst Fibros 2017; 16:S1569-1993(17)30771-3. [PMID: 28826587 DOI: 10.1016/j.jcf.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Buckley
- St. Vincent's University Hospital, Dublin, Ireland.
| | - C M Reilly
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Kelly
- St. Vincent's University Hospital, Dublin, Ireland
| | - E Ward
- St. Vincent's University Hospital, Dublin, Ireland
| | - C O'Connor
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Carter
- St. Vincent's University Hospital, Dublin, Ireland
| | | | - E F McKone
- St. Vincent's University Hospital, Dublin, Ireland
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Chadi N, Carter S, Loung RPY, Gould M, Hick K. Nephrocalcinosis in a young male with anorexia nervosa. CEN Case Rep 2017; 6:164-168. [PMID: 28669007 DOI: 10.1007/s13730-017-0267-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/27/2017] [Indexed: 11/27/2022] Open
Abstract
Nephrocalcinosis (NC) has been described as a long-term complication of anorexia nervosa (AN). This is the first report of this complication in an adolescent male patient. We describe the case of a 12-year-old male with AN who presented with acute food restriction and excessive exercising leading to three inpatient admissions. The patient experienced an isolated episode of dysuria and hematuria while on calcium and vitamin D supplementation. Investigations revealed hypophosphatemia, hypercalciuria and mild NC. Follow-up confirmed the presence of NC and possible nephrolithiasis (NL). We discuss the pathophysiology and risk factors of NC and NL in the context of an early presentation of AN. We suggest fluid intake should be liberalized under observation and calcium and vitamin D supplementation should be initiated with caution in patients presenting with AN and risk factors for NC and NL.
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Affiliation(s)
- Nicholas Chadi
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
| | - Simon Carter
- Division of Nephrology, Department of Pediatrics, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Robert P Y Loung
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Michelle Gould
- Department of Pediatrics, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Katherine Hick
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
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Tsagozis P, Stevenson JD, Grimer R, Carter S. Outcome of surgery for primary and recurrent desmoid-type fibromatosis. A retrospective case series of 174 patients. Ann Med Surg (Lond) 2017; 17:14-19. [PMID: 28386395 PMCID: PMC5374757 DOI: 10.1016/j.amsu.2017.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The best management of relapsing desmoid-type fibromatosis, a benign but locally infiltrative soft-tissue tumour, is largely undecided. Our aim was to investigate the incidence and the factors influencing local relapse after surgery for primary and recurrent disease of the trunk and extremities. PATIENTS AND METHODS Retrospective analysis of 174 patients who had surgical treatment for desmoid-type fibromatosis. The quality of the surgical margins and use of adjuvant radiotherapy or chemotherapy were analysed regarding local recurrences in primary and recurrent disease. RESULTS Clear margins were achieved in 41% of cases. 10-year local control rate was 58% for clear primary resections as compared to 37% with intralesional primary resections (p = 0.030). Extremity tumours had a higher risk of local recurrence compared to trunk and pelvic ones (p < 0.001). Attempted resection of recurrent disease was associated with an approximately 90% incidence of relapse after each procedure, despite the quality of the surgical margins being equivalent to primary resections. Quality of surgical margins was not important for local control of recurrent lesions. Adjuvant treatments (radiotherapy and chemotherapy) had a no significant effect on the local control rate of recurrent disease (odds ratio 0.693 and 0.969 respectively). CONCLUSIONS A complete primary excision is the best window of opportunity to achieve local control of desmoid-type fibromatosis. Once the disease relapses, surgical intervention is accompanied with a high risk of failure, irrespective of the quality of the margins and adjuvant treatment given.
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Affiliation(s)
- Panagiotis Tsagozis
- The Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B31 2AP, UK
- Section of Orthopaedics, Department of Molecular Medicine and Surgery, Karolinska University Hospital, Solna, 17176, Stockholm, Sweden
- Corresponding author. Present address: Section of Orthopaedics, Department of Molecular Medicine and Surgery, Karolinska University Hospital, Stockholm, Sweden.Section of OrthopaedicsDepartment of Molecular Medicine and SurgeryKarolinska University HospitalStockholmSweden
| | | | - Robert Grimer
- The Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B31 2AP, UK
| | - Simon Carter
- The Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B31 2AP, UK
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Affiliation(s)
- Simon Carter
- ESRC Management Teaching Fellow at Cardiff Business School in the University of Wales, Cardiff, UK
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Abstract
The understanding of the role of complement dysregulation in atypical haemolytic uraemic syndrome (aHUS) has led to major changes in therapeutic approaches and outcomes. Eculizumab is a humanized anti-C5 monoclonal antibody that inhibits the terminal complement pathway and has revolutionized the treatment and prognosis of aHUS. However, published reports to date have had relatively short-term follow-up. We report two paediatric cases of aHUS successfully treated with eculizumab longer than 6 years with no serious adverse events and preservation of renal function.
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Affiliation(s)
- Simon Carter
- The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ian Hewitt
- Princess Margaret Hospital, Perth, Western Australia, Australia
| | - Joshua Kausman
- The Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
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Abstract
There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of 'the doctor' in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of 'the doctor' is discursively deployed to act as the moral compass at the centre of the programme narrative. Our analysis highlights that the qualities, norms and ethics represented by doctors in space (ships) are intertwined with issues of gender equality, speciesism and posthuman ethics. We explore the signifying practices and political articulations that are played out through these cultural imaginaries. For example, the ways in which 'the simple country doctor' is deployed to help establish hegemonic formations concerning potentially destabilising technoscientific futures involving alternative sexualities, or military dystopia. Doctors mostly function to provide the ethical point of narrative stability within a world in flux, referencing a nostalgia for the traditional, attentive, humanistic family physician. The science fiction doctor facilitates the personalisation of technological change and thus becomes a useful conduit through which societal fears and anxieties concerning medicine, bioethics and morality in a 'post 9/11' world can be expressed and explored.
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Affiliation(s)
- Lesley Henderson
- Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
| | - Simon Carter
- Department of Sociology, The Open University, Milton Keynes, UK
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Carter S, Clifton PM, Keogh JB. The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial. Diabetes Res Clin Pract 2016; 122:106-112. [PMID: 27833048 DOI: 10.1016/j.diabres.2016.10.010] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/12/2016] [Indexed: 01/06/2023]
Abstract
AIMS Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups. METHOD Sixty-three overweight or obese participants (BMI 35.2±5kg/m2) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks. RESULTS At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite. CONCLUSIONS In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy.
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Affiliation(s)
- S Carter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
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De Nunzio C, Presicce F, Lombardo R, Carter S, Vicentini C, Tubaro A. Detrusor overactivity increases bladder wall thickness in male patients: A urodynamic multicenter cohort study. Neurourol Urodyn 2016; 36:1616-1621. [PMID: 27778388 DOI: 10.1002/nau.23166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 10/04/2016] [Indexed: 11/10/2022]
Abstract
AIMS To evaluate the role of Bladder wall thickness (BWT) as a predictor of Detrusor overactivity (DO) in patients with Lower urinary tract symptoms (LUTS)/Benign prostatic enlargement without Bladder Outlet Obstruction. METHODS From January 1996 to December 2000, each new patient, aged 45 years or older with LUTS, underwent standard diagnostic assessment, urodynamic studies (cystometry and pressure flow studies), and ultrasound measurements of the bladder wall thickness (BWT) in two centers. In order to exclude the possible effect of benign prostatic obstruction (BPO) on detrusor thickness, patients with a Schaefer class was ≥2 were excluded from the study. The area under the receiver operating characteristics curve (AUC) quantified the predictive accuracy (PA) of BWT for the diagnosis of DO. RESULTS Overall 195 patients were enrolled. DO was observed in 98/195 patients (50%). The BWT presented an AUC of 0.70; 95% CI: 0.62-0.77 for the diagnosis of DO. At the best cut-off value of 3.85 mm sensitivity was 73%; specificity was 59%; positive predictive value (64%, PPV). Negative predictive value (69%, NPV). CONCLUSIONS Our study firstly showed, how BWT in male patients may be a consequence of DO other than BPO. Our finding, if confirmed in further studies, could limit the accuracy of BWT in patients with DO and BPO.
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Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Presicce
- Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy
| | - Simon Carter
- Department of Urology, London Clinic, London, United Kingdom
| | - Carlo Vicentini
- Department of Surgical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Andrea Tubaro
- Department of Urology, Ospedale Sant'Andrea, Sapienza University of Rome, Rome, Italy
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Carter S, Scott E. Impact of Three G-CSF Mobilzation/Collection Schedules and Total Blood Volume Processed on the Yield of CD34+ Cells From Leukaphereses Collected From Normal Healthy Subjects Using the COBE Spectra. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.076] [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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Headland M, Pedersen E, Carter S, Clifton P, Keogh J. The on/off diet: Effects of week-on, week-off energy restriction compared to continuous energy restriction. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.230] [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: 10/21/2022] Open
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Shahid M, Albergo N, Purvis T, Heron K, Gaston L, Carter S, Grimer R, Jeys L. Management of sarcomas possibly involving the knee joint when to perform extra-articular resection of the knee joint and is it safe? Eur J Surg Oncol 2016; 43:175-180. [PMID: 27266818 DOI: 10.1016/j.ejso.2016.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/07/2016] [Accepted: 05/13/2016] [Indexed: 12/18/2022] Open
Abstract
We reviewed the oncological and functional outcomes of patients treated for a primary sarcoma possibly involving the knee joint and present an algorithm to guide treatment. The records of 76 patients who had a primary bone or soft tissue sarcoma possibly invading the knee between 1996 and 2012 were identified. Mean age and follow-up was 32 years (9-74) and 64 months (12-195), respectively. Patients were grouped according to the resection (Intra-articular [IAR] vs. Extra-articular [EAR] vs. Amputation/rotationplasty) for survival and functional outcomes. Overall 5 and 10 year survival was 61% and 53%, respectively. No differences in survival were found between the 3 groups (p = 0.55). Sixteen patients developed local recurrence with no difference between the groups. Mean MSTS score was 24.5 (12-30). Mean flexion at final follow-up was 106° (70-130°). We conclude that EAR of the knee allows for good oncologic and functional outcomes but with an increased risk of complications compared to IAR. Intra-operative assessment of joint involvement can be done in patients where joint infiltration by the tumour is not clear to avoid an unnecessary EAR. For chondrosarcoma patients with joint involvement, an EAR should be carefully considered because they present a significantly higher local recurrence risk.
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Affiliation(s)
- M Shahid
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
| | - N Albergo
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - T Purvis
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - K Heron
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - L Gaston
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - S Carter
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - R Grimer
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - L Jeys
- Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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