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Lutchka J, Vercnocke J, Fisher E, Radoiu C, Jeberaeel J, Lucas S, Dhar N. Treatment of chronic post-radiation cystitis with trans-urethral amniotic bladder therapy appears durable at 9 months: A clinical study. Urologia 2024:3915603241248014. [PMID: 38646941 DOI: 10.1177/03915603241248014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE Chronic radiation cystitis (CRC) develops after radiation therapy and can present with symptoms like urinary frequency, urgency, pelvic pain, and nocturia. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory CRC patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months. MATERIALS AND METHODS CRC patients recalcitrant to previous treatments received ABT comprised of intra-detrusor injections of 100 mg micronized AM diluted in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder (OAB) Assessment Tool, SF-12 Health Survey) were repeated at pre-op and 2, 4, 8, 12, 16, 20, 24, and 36 weeks post-injection. RESULTS Five consecutive patients with a mean age of 64.4 ± 20.1 years with a median CRC duration of 10 years were included and followed for 6 months. After ABT, the lower urinary tract symptoms improved as early as 2 weeks and were maintained up to 20 weeks. BPIC significantly improved from 36.6 ± 1.1 at baseline to 12.6 ± 1.5 at 16 weeks and 13.8 ± 2.9 at 20 weeks. At 24 and 36 weeks, the improvement was maintained in four (80%) of the five patients (BPIC = 13.8 ± 1.0). Uroflow assessment showed voiding volume improved two-fold in four of the five patients at 24 weeks compared to baseline. CONCLUSION Our data suggest that a significant number of CRC patients may have durable benefit after ABT. Despite this, some of them can show symptoms rebound at 24 weeks.
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Affiliation(s)
| | - Jack Vercnocke
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Emily Fisher
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Codrut Radoiu
- Wayne State University School of Medicine, Detroit, MI, USA
| | | | - Steven Lucas
- Wayne State University School of Medicine, Detroit, MI, USA
- John D. Dingell VA Medical Center, Detroit, MI, USA
| | - Nivedita Dhar
- John D. Dingell VA Medical Center, Detroit, MI, USA
- Detroit Medical Center, Detroit, MI, USA
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Buthelezi TE, Venkatakrishna SSB, Lucas S, Workman L, Dheda K, Nicol MP, Zar HJ, Andronikou S. A comparison of chest radiographic findings in human immunodeficiency virus-positive and -negative children with pulmonary tuberculosis. Clin Radiol 2024; 79:e317-e324. [PMID: 38065775 DOI: 10.1016/j.crad.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 01/02/2024]
Abstract
AIM To compare chest radiography (CXR) findings in human immunodeficiency virus (HIV)-positive and HIV-negative children who had microbiologically confirmed pulmonary tuberculosis (PTB). MATERIALS AND METHODS Retrospective analysis of CXRs from children with known HIV status and microbiologically confirmed PTB (culture or GeneXpert Xpert MTB/RIF positive), who were hospitalised or seen at a primary healthcare centre over a 5-year period. Radiological findings were compared according to HIV and nutritional status. RESULTS CXRs of 130 children were analysed from 35 (27%) HIV- positive and 95 (73%) HIV-negative children with confirmed PTB, median age 45.7 months (interquartile range [IQR] 18-81.3 months). CXR changes consistent with PTB were reported in 21/35 (60%) of HIV-positive and 59/95 (62%) of HIV-negative patients, (p=0.81). Normal CXR was identified in 3/35 (8.6%) of HIV-positive and 5/95 (5.3%) of HIV-negative patients (p=0.81). Airway compression was present in 3/35 (8.6%) of HIV-positive and 7/95 (7.4%) of HIV-negative patients (p>0.99). Overall, lymphadenopathy was identified in 42/130 (32.3%) of patients, 11/35 (31.4 %) were HIV-positive compared with 31/95 (32.6%) HIV-negative patients. Airspace consolidation was present in 60% of both HIV-positive (21/35) and HIV-negative patients (57/95). Pleural effusion was present in 2/35 (5.7 %) of HIV-negative and 9/95 (9.5 %) of HIV-negative patients. There were no statistically significant radiological differences by HIV group. CONCLUSION There were no significant differences in the CXR findings between the HIV-positive and HIV-negative children with confirmed PTB.
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Affiliation(s)
- T E Buthelezi
- Department of Diagnostic Radiology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, South Africa
| | - S S B Venkatakrishna
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - S Lucas
- Department of Diagnostic Radiology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, South Africa
| | - L Workman
- Department of Paediatrics & Child Health, Red Cross Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - K Dheda
- Lung Infection and Immunity Unit, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - M P Nicol
- Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Australia; Division of Medical Microbiology, University of Cape Town and National Health Laboratory Services, South Africa
| | - H J Zar
- Department of Paediatrics & Child Health, Red Cross Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - S Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Græsholt-Knudsen T, Rask CU, Lucas S, Bech BH. Exploratory assessment of parental physical disease categories as predictors of documented physical child abuse. Eur J Pediatr 2024; 183:663-675. [PMID: 37955746 PMCID: PMC10912441 DOI: 10.1007/s00431-023-05317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023]
Abstract
Improved prediction of physical child abuse could aid in developing preventive measures. Parental physical disease has been tested previously as a predictor of documented physical child abuse but in broad categories and with differing results. No prior studies have tested clinically recognizable categories of parental disease in a high-powered dataset. Using Danish registries, data on children and their parents from the years 1997-2018 were used to explore several parental physical disease categories' associations with documented physical child abuse. For each disease category, survival analysis using pseudovalues was applied. When a parent of a child was diagnosed or received medication that qualified for a category, this family and five comparison families not in this disease category were included, creating separate cohorts for each category of disease. Multiple analyses used samples drawn from 2,705,770 children. Estimates were produced for 32 categories of physical diseases. Using Bonferroni-corrected confidence intervals (CIc), ischemic heart disease showed a relative risk (RR) of 1.44 (CIc 1.13-1.84); peripheral artery occlusive disease, RR 1.39 (CIc 1.01-1.90); stroke, RR 1.19 (1.01-1.41); chronic pulmonary disease, RR 1.33 (CIc 1.18-1.51); ulcer/chronic gastritis, RR 1.27 (CIc 1.08-1.49); painful condition, 1.17 (CIc 1.00-1.37); epilepsy, RR 1.24 (CIc 1.00-1.52); and unspecific somatic symptoms, RR 1.37 (CIc 1.21-1.55). Unspecific somatic symptoms were present in 71.87% of families at some point during the study period. CONCLUSION Most parental physical disease categories did not show statistically significant associations, but some showed predictive ability. Further research is needed to explore preventive potential. WHAT IS KNOWN • Few and broad categories of parental physical disease have been examined as risk factors for severe physical child abuse; no prior study has used several categories as predictors. WHAT IS NEW • Unspecific symptoms, ischemic heart disease, peripheral artery occlusive disease, stroke, chronic pulmonary disease, stomach ulcer/chronic gastritis, painful condition, and epilepsy all showed to be potential predictors, with unspecific symptoms being the most prevalent.
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Affiliation(s)
- Troels Græsholt-Knudsen
- Research Unit for Mental Public Health, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
- Department of Forensic Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul Jensens Boulevard 175, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Olof Palmes Allé 43, 8200, Aarhus N, Denmark
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Akademiska Sjukhuset, 751 85, Uppsala, Sweden
| | - Bodil Hammer Bech
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
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Græsholt-Knudsen T, Rask CU, Lucas S, Obel C, Bech BH. Parental physical disease severity and severe documented physical child abuse: a prospective cohort study. Eur J Pediatr 2024; 183:357-369. [PMID: 37889291 PMCID: PMC10857964 DOI: 10.1007/s00431-023-05291-8] [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: 04/17/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Abstract
Successful prevention of physical child abuse is dependent on improvements in risk assessment. The risk of abuse is assumed to increase when family stressors overcome resources. Severe physical disease can increase stress, and parental physical disease has been studied as a risk factor for physical child abuse, but with heterogeneous definitions. This study evaluated the relation between parental physical disease severity and severe documented physical child abuse. Models were based on data on children aged 0-17 years in Denmark between 1997 and 2018, and their parents. Severe documented physical child abuse was modeled as violence against a child registered by either health authorities in treatment or mortality registries, or police authorities in cases confirmed by the courts. Parental physical disease severity was modeled as the sum of Charlson Comorbidity Index scores for the child's parents. The causal connection was examined in two model types: a survival model comparing exposed with non-exposed children, adjusted for covariates at baseline, and a G-model, taking time-varying covariates, including income and parental psychiatric disease into account. Neither model showed an association between parental physical disease severity and severe documented physical child abuse, with RR 0.99 and 95% CI (0.93-1.05) for the survival model and RR 1.08 for the G-model (CI not calculated). Conclusion: In the model studied, parental physical disease severity was not a risk factor for severe documented physical child abuse. Individual categories of physical disease remain to be examined. Trial registration: The study was pre-registered on Open Science Framework, https://osf.io/fh2sr . What is Known: • Parental physical disease severity has been studied previously as a risk indicator of physical child abuse, but based on heterogeneous definitions. • Previous studies have not studied parental physical disease severity preceding physical child abuse. What is New: • Parental severe physical disease was not prospectively associated with severe documented physical child abuse in a survival model, a G-model and a number of sensitivity analyses, respectively. • Results should be replicated in samples from populations without universal health care, and using different categories of disease.
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Affiliation(s)
- Troels Græsholt-Knudsen
- Research Unit for Mental Public Health, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Aarhus, Denmark.
- Department of Forensic Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University, 8200, Aarhus N, Aaurhus, Denmark.
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200, Aarhus N, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Olof Palmes Allé 43, 8200, Aarhus N, Aarhus, Denmark
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, 751 85, Uppsala, Sweden
| | - Carsten Obel
- Research Unit for Mental Public Health, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Aarhus, Denmark
| | - Bodil Hammer Bech
- Research Unit for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Aarhus, Denmark
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Wittenberg S, Vercnocke J, Chancellor M, Dhar S, Liaw A, Lucas S, Dhar N. Prolonged impacts of COVID-19-associated cystitis: A study on long-term consequences. World J Clin Cases 2023; 11:7987-7993. [DOI: 10.12998/wjcc.v11.i33.7987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/06/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 virus is an international health concern with substantial morbidity and mortality. COVID-associated cystitis (CAC), presents as new onset or exacerbated urinary symptoms, resembling overactive bladder (OAB) symptoms.
AIM To examines the long-term outcomes of patients with CAC in the context of Long COVID.
METHODS A cohort of 350 patients admitted to Detroit Hospitals with COVID-19 between May and December 2020, displaying CAC symptoms following discharge, was prospectively followed. Initial urologic evaluations occurred at 10-14 wk and were repeated at 21-28 mo post-discharge. Symptoms were managed conservatively, employing behavioral modifications and standard OAB medications. Participants completed surveys assessing urinary symptoms and quality of life (QoL) at both time points. The primary outcome was the Urology Care Foundation Overactive Bladder Assessment Tool.
RESULTS 87% of the final cohort (n = 310) reported symptom improvement at 21-28 mo post-discharge. Patients with new onset CAC symptoms showed a median decrease of 9-10 points in OAB and QoL scores, while those with existing symptoms experienced a decrease of 6 points. Overall, 95.4% of patients with new onset symptoms reported symptom improvement at follow-up, contrasting with 60.7% among those with existing symptoms.
CONCLUSION This study presents the first long-term follow-up of adult patients with CAC, revealing a promising prognosis with conservative management measures in the context of Long COVID. These findings provide reassurance to patients regarding symptom resolution and underscore the need for further research into this evolving aspect of COVID-19's impact on urological health.
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Affiliation(s)
- Sophie Wittenberg
- Department of Urology, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Jack Vercnocke
- Department of Urology, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Michael Chancellor
- Department of Urology, Beaumont Hospital, Royal Oak, MI 48067, United States
| | - Sorabh Dhar
- Infectious Disease, Wayne State University School of Medicine, Detroit, MI 48201, United States
- Infectious Disease, John D. Dingell VA Medical Center, Detroit, MI 48201, United States
- Infectious Disease, Detroit Medical Center, Detroit, MI 48201, United States
| | - Aron Liaw
- Department of Urology, Wayne State University School of Medicine, Detroit, MI 48201, United States
- Department of Urology, John D. Dingell VA Medical Center, Detroit, MI 48201, United States
| | - Steven Lucas
- Department of Urology, Wayne State University School of Medicine, Detroit, MI 48201, United States
- Department of Urology, John D. Dingell VA Medical Center, Detroit, MI 48201, United States
| | - Nivedita Dhar
- Department of Urology, John D. Dingell VA Medical Center, Detroit, MI 48201, United States
- Department of Urology, Detroit Medical Center, Detroit, MI 48201, United States
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Wittenberg S, Madan R, Liaw A, Lucas S, Hamada A, Dhar N. Amniotic bladder therapy in patients with recalcitrant interstitial cystitis and bladder pain syndrome. Can Urol Assoc J 2023; 17:E402-E404. [PMID: 37549350 PMCID: PMC10657225 DOI: 10.5489/cuaj.8441] [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: 08/09/2023]
Affiliation(s)
- Sophie Wittenberg
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Raghav Madan
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Aron Liaw
- Wayne State University School of Medicine, Detroit, MI, United States
- John D. Dingell VA Medical Center, Detroit, MI, United States
| | - Steven Lucas
- Wayne State University School of Medicine, Detroit, MI, United States
- John D. Dingell VA Medical Center, Detroit, MI, United States
| | - Alaa Hamada
- John D. Dingell VA Medical Center, Detroit, MI, United States
| | - Nivedita Dhar
- John D. Dingell VA Medical Center, Detroit, MI, United States
- Detroit Medical Center, Detroit, MI, United States
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Engström M, Lindqvist S, Janson S, Feldman I, Dubowitz H, Lucas S. Validation of the Swedish version of the safe environment for every kid (SEEK) parent screening questionnaire. BMC Public Health 2023; 23:1989. [PMID: 37828478 PMCID: PMC10571478 DOI: 10.1186/s12889-023-16792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Psychosocial risk factors in the home may impair children's health and development and increase the risk of maltreatment. The Safe Environment for Every Kid (SEEK) model was developed to provide pediatric primary care professionals with a structured way to identify common psychosocial problems. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, discussion with parents about their responses and, when indicated, referral to relevant services. The SEEK-PSQ has not previously been available in Swedish. The aim of the present study was to evaluate the psychometric properties of an adapted Swedish version of the SEEK-PSQ (PSQ-S). METHODS This study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n = 852) with children 0-18 months of age were invited to complete a survey including the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors: economic worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence (IPV). Baseline data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor. RESULTS As a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81-99%) and PPV values were low to moderate (22-69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% for mothers, 27% for fathers). CONCLUSION The SEEK-PSQ-S demonstrated good psychometric properties for identifying economic worries, depressive symptoms, parental stress and alcohol misuse but low sensitivity for IPV. The PSQ-S as a whole showed high sensitivity and NPV, indicating that most parents with or without the targeted psychosocial risk factors were correctly identified. TRIAL REGISTRATION ISRCTN registry, study record 14,429,952 ( https://doi.org/10.1186/ISRCTN14429952 ) Registration date 27/05/2020.
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Affiliation(s)
- Maria Engström
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
| | - Sara Lindqvist
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Staffan Janson
- Division of Public Health Sciences, Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Howard Dubowitz
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden
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Venkatakrishna SSB, Krim AOA, Calle-Toro J, Lucas S, Bester D, Goussard P, Andronikou S. Comparison of single coronal thick-slab minimum intensity projection with flexible bronchoscopy for airway compression in children with lymphobronchial tuberculosis. Clin Radiol 2023; 78:576-583. [PMID: 37308350 DOI: 10.1016/j.crad.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/01/2023] [Accepted: 03/27/2023] [Indexed: 06/14/2023]
Abstract
AIM To generate standardised coronal minimum intensity projection (MinIP) computed tomography (CT) reconstructions, and compare these with flexible bronchoscopy in children with lymphobronchial tuberculosis (LBTB). MATERIALS AND METHODS Standardised coronal MinIP reconstructions were performed from CT images in children with LBTB and the findings of three readers were compared with the reference standard, flexible bronchoscopy (FB), regarding airway narrowing. Intraluminal lesions, the site of the stenosis, and the degree of stenosis were also evaluated. The length of stenosis was evaluated by CT MinIP only. RESULTS Sixty-five children (38 males; 58.5% and 27 females; 41.5%), with ages ranging from 2.5 to 144 months were evaluated. Coronal CT MinIP demonstrated a sensitivity of 96% and specificity of 89% against FB. The most common site of stenosis was the bronchus intermedius (91%), followed by the left main bronchus (85%), the right upper lobe bronchus RUL (66%), and the trachea (60%). CONCLUSION Coronal CT MinIP reconstruction is useful in demonstrating airway stenosis in children with lymphobronchial TB, with high sensitivity and specificity. CT MinIP had additional advantages over FB in that it allowed objective measurement of the diameter of stenosis, measurement of the length of stenosis, and evaluation of post-stenotic segments of the airways and lung parenchymal abnormalities.
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Affiliation(s)
- S S B Venkatakrishna
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - A O A Krim
- Waikato District Health Board, Waikato Hospital, 183 Pembroke Street, Hamilton 3204, New Zealand
| | - J Calle-Toro
- Department of Radiology, University of Texas Health Science Center at San Antonio - UT Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA
| | - S Lucas
- Department of Diagnostic Radiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - D Bester
- Department of Diagnostic Radiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - P Goussard
- Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - S Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Madan R, Radoiu C, Liaw A, Lucas S, Hamada A, Dhar N. Early three-month report of amniotic bladder therapy in patients with interstitial cystitis/bladder pain syndrome. Int Urol Nephrol 2023:10.1007/s11255-023-03652-8. [PMID: 37273012 DOI: 10.1007/s11255-023-03652-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by symptomatic frequency and urgency, as well as chronic pelvic pain. Disruption of the urothelial barrier is closely associated with IC/BPS. As amniotic membranes (AM) offer capabilities of wound healing in many other fields of medicine, likewise amniotic bladder therapy (ABT) may offer capability of urothelial healing in IC/BPS. METHODS Under general anesthesia, 10 consecutive IC/BPS patients received intra-detrusor injections of 100 mg micronized AM (Clarix Flo) diluted in 10 ml 0.9% preservative-free sodium chloride. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/ Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder Assessment Tool, and SF-12 Health Survey) were repeated at pre-op and 2, 4, 8 and 12 weeks post-op. RESULTS Ten females (47.4 ± 14.4 years) who had recalcitrant IC/BPS for 7.8 years (5.2-12.1 years) received injection of micronized AM uneventful in all cases. After treatment, voiding symptoms and bladder pain significantly improved from pre-injection to 3 months. BPIC-SS significantly decreased from 37.4 ± 0.70 at baseline to 12.2 ± 2.90 at 3 months (p < 0.001). This corresponded to a significant improvement in their overall physical and mental quality of life. No adverse events occurred related to micronized AM injections, such as UTIs or acute urinary retention. CONCLUSION ABT could be an innovative treatment option for IC/BPS patients in terms of improving clinical symptoms based on preliminary outcomes at 3 months. Further studies are warranted to confirm the usefulness of ABT in patients with IC/BPS and to determine the duration of the effect.
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Affiliation(s)
- Raghav Madan
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Codrut Radoiu
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Aron Liaw
- Wayne State University School of Medicine, Detroit, MI, USA
- John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI, 48201, USA
| | - Steven Lucas
- Wayne State University School of Medicine, Detroit, MI, USA
- John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI, 48201, USA
| | - Alaa Hamada
- John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI, 48201, USA
| | - Nivedita Dhar
- John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI, 48201, USA.
- Detroit Medical Center, Detroit, MI, USA.
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Lucas S. Child health professionals can play an integral role in identifying and preventing intimate partner violence. Acta Paediatr 2023; 112:340-341. [PMID: 36529980 DOI: 10.1111/apa.16619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Steven Lucas
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden
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Engström M, Randell E, Lucas S. Child health nurses' experiences of using the Safe Environment for Every Kid (SEEK) model or current standard practice in the Swedish child health services to address psychosocial risk factors in families with young children - A mixed-methods study. Child Abuse Negl 2022; 132:105820. [PMID: 35932659 DOI: 10.1016/j.chiabu.2022.105820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/27/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child maltreatment (CM) is often hidden, and the youngest children are often those most exposed. CM can be prevented through programs that address risk factors, but few primary prevention strategies have been evaluated. OBJECTIVE To examine the experiences of nurses using the Safe Environment for Every Kid (SEEK) model compared to nurses using current standard practice in the Swedish child health services (CHS) to address psychosocial risk factors in the family environment. PARTICIPANTS AND SETTING Nurses at 27 child health centers in the CHS in the county of Dalarna, Sweden participated in the study. A survey was answered by 55 nurses and 18 nurses participated in focus-group interviews. METHODS A convergent mixed methods research design with focus-group interviews and survey data was used. Qualitative Content Analysis was used to analyze the interview data and Mann Whitney U test was used to analyze the survey data. RESULTS The qualitative analysis identified four categories - "Framing the prerequisites for successful practice"; "Managing the mission of the CHS"; "Meeting the family as a professional"; and "Working with psychosocial risk factors can be emotional" - under the overarching theme "Universal application of a structured method adds value to experience-based knowledge when addressing psychosocial risk factors". Survey data showed that SEEK nurses rated to a greater degree that they possessed adequate knowledge, competence and sense of security to address psychosocial risk factors in their work. CONCLUSIONS This study indicates that using SEEK can strengthen the nurses in identifying and responding to families in need of psychosocial support.
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Affiliation(s)
- Maria Engström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Eva Randell
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Cheng V, Rallabandi R, Gorusupudi A, Lucas S, Rognon G, Bernstein PS, Rainier JD, Conboy JC. Influence of very-long-chain polyunsaturated fatty acids on membrane structure and dynamics. Biophys J 2022; 121:2730-2741. [PMID: 35711144 DOI: 10.1016/j.bpj.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/24/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022] Open
Abstract
The unique attributes of very-long-chain polyunsaturated fatty acids (VLC-PUFAs), their long carbon chains (n > 24) and high degree of unsaturation, impart unique chemical and physical properties to this class of fatty acids. The changes imparted by VLC-PUFA 32:6 n-3 on lipid packing and the compression moduli of model membranes were evaluated from π-A isotherms of VLC-PUFA in 1,2-distearoyl-sn-3-glycero-phosphocholine (DSPC) lipid monolayers. To compare the attractive or repulsive forces between VLC-PUFA and DSPC lipid monolayers, the measured mean molecular areas (MMAs) were compared with the calculated MMAs of an ideal mixture of VLC-PUFA and DSPC. The presence of 0.1, 1, and 10 mol % VLC-PUFA shifted the π-A isotherm to higher MMAs of the lipids comprising the membrane and the observed positive deviations from ideal behavior of the mixed VLC-PUFA:DSPC monolayers correspond to repulsive forces between VLC-PUFAs and DSPC. The MMA of the VLC-PUFA component was estimated using the measured MMAs of DSPC of 47.1 ± 0.7 Å2/molecule, to be 15,000, 1100, and 91 Å2/molecule at 0.1, 1, and 10 mol % VLC-PUFA:DSPC mixtures, respectively. The large MMAs of VLC-PUFA suggest that the docosahexaenoic acid tail reinserts into the membrane and adopts a nonlinear structure in the membrane, which is most pronounced at 0.1 mol % VLC-PUFA. The presence of 0.1 mol % VLC-PUFA:DSPC also significantly increased the compression modulus of the membrane by 28 mN/m compared with a pure DSPC membrane. The influence of VLC-PUFA on lipid "flip-flop" was investigated by sum-frequency vibrational spectroscopy. The incorporation of 0.1 mol % VLC-PUFA increased the DSPC flip-flop rate fourfold. The fact that VLC-PUFA promotes lipid translocation is noteworthy as retinal membranes require a high influx of retinoids which may be facilitated by lipid flip-flop.
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Affiliation(s)
- Victoria Cheng
- Department of Chemistry, University of Utah, Salt Lake City, Utah
| | | | - Aruna Gorusupudi
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Steven Lucas
- Department of Chemistry, University of Utah, Salt Lake City, Utah
| | - Gregory Rognon
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Paul S Bernstein
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Jon D Rainier
- Department of Chemistry, University of Utah, Salt Lake City, Utah
| | - John C Conboy
- Department of Chemistry, University of Utah, Salt Lake City, Utah.
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13
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Stamis SA, Heath EI, Lucas S, Boerner J, Slusher LB. Alcohol dehydrogenase expression patterns in normal prostate, benign prostatic hyperplasia, and prostatic adenocarcinoma in African American and Caucasian men. Prostate 2022; 82:666-675. [PMID: 35133686 DOI: 10.1002/pros.24310] [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: 03/15/2021] [Revised: 01/09/2022] [Accepted: 01/14/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND In situ metabolism of ethanol by alcohol dehydrogenases (ADHs) contributes to oxidative damage of cells and DNA and has been linked to carcinogenesis in numerous epithelial tissues. The goal of this study was to determine expression patterns of ADH1 and ADH7 isozymes in normal, hyperplastic (benign prostatic hyperplasia [BPH]) and neoplastic (prostate cancer [PCa]) prostate. Furthermore, racial differences in ADH expression between African Americans and Caucasians were investigated. METHODS ADH expression patterns were characterized by density analysis of ADH immunohistochemistry (n = 21) and real-time RT-PCR of total RNAs by laser-capture microdissection (n = 10) and whole tissue formalin-fixed paraffin embedded prostate biopsies (n = 63). RESULTS ADH protein is found in normal prostate and is primarily associated with glandular epithelium. Transcripts of ADH1B are suppressed in PCa compared to BPH (p = 0.0095). Racial differences in ADH7 transcripts exist between African American and Caucasian men. A total of 57.6% of biopsies from African American prostates have detectable ADH7 messenger RNA (mRNA) transcripts compared to the 13.3% of Caucasian prostate biopsies with detectable transcripts (p = 0.0005). This increased frequency of detection contributes to higher mean ADH7 mRNA transcript levels in African Americans (p = 0.001). CONCLUSIONS To our knowledge this study is the first to report downregulation of ADH1B in neoplastic prostate at the transcriptional level, suggesting protective regulatory functions. ADH7 transcripts were not detectable in all samples and was found in higher frequency and amount in our African American samples. Racial differences in ADH7 within the prostate is a novel finding and should be investigated further.
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Affiliation(s)
- Sarah A Stamis
- Department of Biology, West Chester University of Pennsylvania, West Chester, Pennsylvania, USA
| | - Elisabeth I Heath
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Steven Lucas
- Department of Urology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Julie Boerner
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Leslie B Slusher
- Department of Biology, West Chester University of Pennsylvania, West Chester, Pennsylvania, USA
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Schoenauen L, Lucas S. EXPERIMENTAL FLASH SET-UP USING A LOW ENERGY PROTON BEAM FOR IN-VITRO IRRADIATION. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01671-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Servagent N, Koumeir C, Blain G, Bongrand A, Chiavassa S, Deffet S, Delpon G, Guertin A, Lucas S, Metivier V, Mouchard Q, Poirier F, Potiron V, Schoenauen L, Sterpin E, Villoing D, Labarbe R, Rossomme S, Haddad F. FLASH Modalities Track (Oral Presentations) PROTON BEAM FLASH ONLINE MONITORING AT ARRONAX CYCLOTRON. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01529-0] [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: 10/19/2022] Open
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16
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Moore P, Wiggen T, Kent L, Arif S, Lucas S, O’Grady S, Hunter R. 414: Anaerobic microbiota facilitate Pseudomonas aeruginosa access to the airway epithelium in a novel co-culture model of colonization. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01838-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Bodart J, Dufeys C, Senis YA, Nagy Z, Bertrand L, Beauloye C, Lucas S, Horman S. Role of platelet GARP in TGFB activation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Transforming growth factor (TGF)β is known to be a central player in the control of cardiac fibroblast properties and fibrosis. However, cellular and molecular mechanisms that trigger its activation remain poorly understood. Platelets are considered as a major source of TGFβ and recent evidence suggest that they are involved in TGFβ activation via Glycoprotein A Repetitions Predominant (GARP) present on their surface.
Purpose
The present study sought to evaluate the role of platelet GARP in TGFβ activation using platelet specific GARP knockout mice.
Methods
We generated a new Cre transgenic mouse strain that allowed Megakaryocyte/platelet specific invalidation of GARP (GpIba-Cre x GARPfl/fl). The impact of GARP deficiency on platelet function was measured in vitro by flow cytometry using thrombin and CRP. Serum production of total and active TGFβ was assessed by ELISA.
Results
Platelet count and other hematological parameters were normal in platelet specific GARP knockout mice, except platelet volume, which was increased by 10.3%, as compared to wild-type platelets. Stimulation by thrombin and CRP increased GARP exposure at platelet surface. However, platelets without GARP displayed normal agonist induced activation, as reflected by CD62P and αIIbβ3 exposure. Interestingly, the generation of active TGFβ was drastically impaired in the serum of platelet specific GARP knockout mice, while the amount of total TGFβ was not affected.
Conclusion
We provided evidence that platelet GARP is a crucial contributor to the systemic activation of TGFβ. Future work will aim to determine its role in cardiac fibroblast myodifferentiation and fibrosis.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): FRIA
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Affiliation(s)
- J Bodart
- Universite Catholique de Louvain, Brussels, Belgium
| | - C Dufeys
- Universite Catholique de Louvain, Brussels, Belgium
| | - Y A Senis
- Institut National de la Santé et de la Recherche Médicale, Strasbourg, France
| | - Z Nagy
- Université de Würzburg, Würzburg, Germany
| | - L Bertrand
- Universite Catholique de Louvain, Brussels, Belgium
| | - C Beauloye
- Universite Catholique de Louvain, Brussels, Belgium
| | - S Lucas
- Universite Catholique de Louvain, Brussels, Belgium
| | - S Horman
- Universite Catholique de Louvain, Brussels, Belgium
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18
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Brink HM, Rubin G, Benn CA, Lucas S. An audit of patients clinically deemed as high risk for malignant breast pathology at the Helen Joseph Hospital Breast Clinic. S AFR J SURG 2021; 59:102-107. [PMID: 34515426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Helen Joseph Hospital Breast Clinic has implemented a clinical triage system for patients presenting with a variety of breast concerns. The goal of this system is to expedite the process from initial presentation to radiological assessment of patients with suspected breast malignancy or breast abscess in a resource limited setting. The objective was to assess the clinical, imaging and histological diagnoses of breast disease in these patients with malignancy and sepsis. METHODS A retrospective audit of patients clinically deemed high risk for malignant breast pathology referred to the breast imaging unit (BIU) in 2018. Patients were triaged based on strict clinical criteria: presence of a breast mass with or without lymph nodes or a breast abscess. Patients that were subsequently referred for mammography/ultrasound were identified using the patient files in the BIU. Results were recorded on Microsoft Excel and analysed using SAS version 9.2. RESULTS Three hundred and twenty-five patients were included in this study. Eighty-seven (26.8%) were diagnosed with breast cancer and 236 (72.6%) with benign disease. The most common presenting complaint was a palpable mass (n = 227; 69.9%). Ninety-five per cent of patients characterised as BI-RADS 5 had malignant disease. 55.8% of malignancies diagnosed on ultrasound had locally advanced disease. The most common histological diagnosis of malignancy was invasive ductal carcinoma (n = 67, 77%). The most commonly diagnosed benign disease was breast abscess (n = 42, 17.8%). CONCLUSION BI-RADS findings correspond to similar studies, however, a large number of benign breast disease was diagnosed. This may indicate heightened clinical awareness of breast cancer diagnosis and early detection. A significant percentage of malignancies presented as locally advanced. Except for a lower number of invasive lobular carcinoma, the histological spectrum of malignant disease is similar to comparative studies.
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Affiliation(s)
- H-M Brink
- Department of Diagnostic Radiology, University of the Witwatersrand, South Africa
| | - G Rubin
- Department of Radiology, Helen Joseph Hospital, South Africa
| | - C-A Benn
- Breast Surgical Unit, Helen Joseph Hospital, South Africa
| | - S Lucas
- Department of Radiology, Chris Hani Baragwanath Academic Hospital, South Africa
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19
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Wade A, Rallabandi R, Lucas S, Oberg C, Gorusupudi A, Bernstein PS, Rainier JD. The synthesis of the very long chain polyunsaturated fatty acid (VLC-PUFA) 32:6 n-3. Org Biomol Chem 2021; 19:5563-5566. [PMID: 34080605 DOI: 10.1039/d1ob00491c] [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] [Indexed: 12/15/2022]
Abstract
This article describes the synthesis of VLC-PUFA 32:6 n-3, D2-labeled 32:6 n-3, and the uptake of 32:6 n-3 into mouse retinal tissue.
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Affiliation(s)
- Alexander Wade
- Department of Chemistry, University of Utah, 315 South, 1400 East, Salt Lake City, UT 84112, USA.
| | - Rameshu Rallabandi
- Department of Chemistry, University of Utah, 315 South, 1400 East, Salt Lake City, UT 84112, USA.
| | - Steven Lucas
- Department of Chemistry, University of Utah, 315 South, 1400 East, Salt Lake City, UT 84112, USA.
| | - Catrina Oberg
- Department of Chemistry, University of Utah, 315 South, 1400 East, Salt Lake City, UT 84112, USA.
| | - Aruna Gorusupudi
- Department of Ophthalmology and Visual Sciences, 65 Mario Capecchi Drive, Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA
| | - Paul S Bernstein
- Department of Ophthalmology and Visual Sciences, 65 Mario Capecchi Drive, Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA
| | - Jon D Rainier
- Department of Chemistry, University of Utah, 315 South, 1400 East, Salt Lake City, UT 84112, USA.
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20
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Abstract
AIMS The aim of the present study was to examine the prevalence of childhood experiences of physical violence (CPV) and emotional violence (CEV) at the hands of parents over a 57-year period among adults born between 1937 and 1993. METHODS In 2012, a survey among women and men aged 18-74 years in Sweden was undertaken to examine the lifetime prevalence of physical, psychological and sexual violence and associations with current health in adulthood. Questionnaires were based on the Adverse Childhood Experiences study and a previous national survey of violence exposure. Descriptive statistics were used to analyse the frequency of exposure to CPV and CEV, and changes over time were analysed using analysis of variance and logistic regression. RESULTS A total of 10,337 individuals participated (response rates: 56% for women and 48% for men). CPV decreased significantly over the time period studied, particularly for those born after 1983. This decrease was more evident for male respondents. Throughout the time period studied, the proportion of women reporting CEV was higher than for men. Among both genders there was a steady rise in CEV rates from those born in the late 1930s to those born in the mid-1980s, after which there was a decline that was more marked for men. CONCLUSIONS A significant group of children in Sweden experience violence at the hands of parents. However, our data corroborate previous national studies that children's exposure to violence has decreased. Clear gender differences indicate that these changes have affected girls and boys differently.
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Affiliation(s)
- Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Sweden
| | - Staffan Janson
- Department of Women's and Children's Health, Uppsala University, Sweden
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21
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Sharma R, Lee S, Bhatti P, Lucas S. Proximal Migration of Ureteral Stent With Ureteric Obstruction After Kidney Transplant. EXP CLIN TRANSPLANT 2021; 20:687-690. [PMID: 34142937 DOI: 10.6002/ect.2021.0040] [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: 11/05/2022]
Abstract
In this case report, we present the rare complication of proximal migration of ureteral stent after kidney transplant, and we describe our approach for its diagnosis and treatment. Although endoscopic management is the treatment of choice for retrieval of migrated stents, we reexplored the transplant in response to erroneous reporting of ureteral stent lying in an extravesicular position on a pelvic computed tomography scan. Subsequent exploration disproved the original interpretation of the image. Proximal stent migration may result from retrograde peristalsis and is generally related to suboptimal stent length.
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Affiliation(s)
- Rajeev Sharma
- From the Department of Surgery, Wayne State University School of Medicine, Detroit Medical Center-Harper University Hospital, Detroit, Michigan, USA
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22
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Fäldt A, Fabian H, Dahlberg A, Thunberg G, Durbeej N, Lucas S. Infant-Toddler Checklist identifies 18-month-old children with communication difficulties in the Swedish child healthcare setting. Acta Paediatr 2021; 110:1505-1512. [PMID: 33251672 PMCID: PMC8247056 DOI: 10.1111/apa.15696] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/17/2020] [Accepted: 11/25/2020] [Indexed: 11/30/2022]
Abstract
Aim At present, there is no reliable method to screen for communication difficulties at age 18‐months in the Swedish child health care. This study examined the psychometric properties of the Communication and Symbolic Behavior Scales Developmental Profile Infant‐Toddler Checklist (ITC) when used at the 18‐month visit in the child healthcare setting. Methods Children aged 16–20 months (n = 679) were screened. Children were referred for an assessment if they screened positive screen or if the parent or nurse was concerned about the child's communicative development. Two groups of positive screens were used in the analysis (n = 78 children), one based on the ITC result, and one combining the ITC with contradicting information from the nurses' informal clinical assessment. Results The AUC ranged from 0.68 to 0.84. The sensitivity was 0.85, and the specificity was 0.59. When the ITC result was combined with the nurses' information, sensitivity increased to 0.88 and specificity to 0.63. The internal consistency was moderate to high, and fit indices were satisfactory. Conclusion The results suggest that the ITC can be used to identify children in need of interventions to enhance communication at 18 months of age, especially in combination with the nurse's assessment.
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Affiliation(s)
- Anna Fäldt
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Helena Fabian
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Anton Dahlberg
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Gunilla Thunberg
- Department of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Dart Centre for Augmentative and Alternative Communication and Assistive Technology Sahlgrenska University Hospital Gothenburg Sweden
| | - Natalie Durbeej
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Steven Lucas
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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Affiliation(s)
- Steven Lucas
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden
| | - Gun Heimer
- Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden
- National Centre for Knowledge on Men's Violence against Women, Uppsala University, Uppsala, Sweden
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Engström M, Hiltunen J, Wallby T, Lucas S. Child Health Nurses' experiences of addressing psychosocial risk factors with the families they meet. Acta Paediatr 2021; 110:574-583. [PMID: 32716528 PMCID: PMC7891612 DOI: 10.1111/apa.15492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/12/2020] [Accepted: 07/21/2020] [Indexed: 12/02/2022]
Abstract
Aim To examine how child health nurses perceive the routine assessment of psychosocial risk factors in the family environment as well as their self‐reported competence and the present organisational conditions in this context. Method A mixed‐methods design was used, including three focus group interviews and a web‐based survey. Qualitative data were analysed using systematic text condensation. Quantitative data were analysed at the descriptive level. Results Nurses expressed that identifying psychosocial risk factors was both important and relevant to their work. They had little formal training and education on most psychosocial risk factors, and they lacked structured methods to address them. In areas where nurses reported more formal education and a structured methodology (depression, parental stress), they rated to a higher degree that they possessed sufficient skills and sense of security. The nurses perceived that they seldom came into contact with families with financial problems, hazardous alcohol use or intimate partner violence. Conclusions There is a gap between the nurses’ attitudes regarding the importance of helping families in need and their ability to do so with the current level of training and methodological support. The results suggest that, in many cases, psychosocial problems remain undetected.
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Affiliation(s)
- Maria Engström
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | | | - Thomas Wallby
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | - Steven Lucas
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
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25
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Brink HM, Rubin G, Benn CA, Lucas S. An audit of patients clinically deemed as high risk for malignant breast pathology at the Helen Joseph Hospital Breast Clinic. S AFR J SURG 2021. [DOI: 10.17159/2078-5151/2021/v59n3a3474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACT BACKGROUND: The Helen Joseph Hospital Breast Clinic has implemented a clinical triage system for patients presenting with a variety of breast concerns. The goal of this system is to expedite the process from initial presentation to radiological assessment of patients with suspected breast malignancy or breast abscess in a resource limited setting. The objective was to assess the clinical, imaging and histological diagnoses of breast disease in these patients with malignancy and sepsis METHODS: A retrospective audit of patients clinically deemed high risk for malignant breast pathology referred to the breast imaging unit (BIU) in 2018. Patients were triaged based on strict clinical criteria: presence of a breast mass with or without lymph nodes or a breast abscess. Patients that were subsequently referred for mammography/ultrasound were identified using the patient files in the BIU. Results were recorded on Microsoft Excel and analysed using SAS version 9.2 RESULTS: Three hundred and twenty-five patients were included in this study. Eighty-seven (26.8%) were diagnosed with breast cancer and 236 (72.6%) with benign disease. The most common presenting complaint was a palpable mass (n = 227; 69.9%). Ninety-five per cent of patients characterised as BI-RADS 5 had malignant disease. 55.8% of malignancies diagnosed on ultrasound had locally advanced disease. The most common histological diagnosis of malignancy was invasive ductal carcinoma (n = 67, 77%). The most commonly diagnosed benign disease was breast abscess (n = 42, 17.8% CONCLUSION: BI-RADS findings correspond to similar studies, however, a large number of benign breast disease was diagnosed. This may indicate heightened clinical awareness of breast cancer diagnosis and early detection. A significant percentage of malignancies presented as locally advanced. Except for a lower number of invasive lobular carcinoma, the histological spectrum of malignant disease is similar to comparative studies Keywords: malignant breast pathology, high risk patient, Helen Joseph Hospital Breast Clinic
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Lucas S. Daunting but not impossible-Addressing child maltreatment in Bangladesh. Acta Paediatr 2021; 110:10-11. [PMID: 32935382 PMCID: PMC7821125 DOI: 10.1111/apa.15558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Steven Lucas
- Department of Women's and Children's Health Uppsala University Children's Hospital Uppsala Sweden
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27
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Fäldt A, Fabian H, Thunberg G, Lucas S. “All of a sudden we noticed a difference at home too”: parents’ perception of a parent-focused early communication and AAC intervention for toddlers. Augment Altern Commun 2020; 36:143-154. [DOI: 10.1080/07434618.2020.1811757] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Anna Fäldt
- Department of Women’s and Children’s Health, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Helena Fabian
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Gunilla Thunberg
- DART - Centre for AAC and Assisitve Technology, Gothenburg, Sweden
| | - Steven Lucas
- Department of Women’s and Children’s Health, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Dhar N, Dhar S, Timar R, Lucas S, Lamb LE, Chancellor MB. De Novo Urinary Symptoms Associated With COVID-19: COVID-19-Associated Cystitis. J Clin Med Res 2020; 12:681-682. [PMID: 33029276 PMCID: PMC7524562 DOI: 10.14740/jocmr4294] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nivedita Dhar
- Detroit Medical Center, Detroit, MI, USA.,John D. Dingell VA Medical Center, Detroit, MI, USA
| | - Sorabh Dhar
- John D. Dingell VA Medical Center, Detroit, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - Ryan Timar
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Steven Lucas
- John D. Dingell VA Medical Center, Detroit, MI, USA.,Wayne State University School of Medicine, Detroit, MI, USA
| | - Laura E Lamb
- Department of Urology, Beaumont Health System, Royal Oak, MI, USA.,Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA
| | - Michael B Chancellor
- Department of Urology, Beaumont Health System, Royal Oak, MI, USA.,Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA
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Abstract
Aims: The aims of this cross-sectional study were to examine the prevalence of lifetime exposure to sexual, physical and psychological violence among a representative sample of women and men in Sweden, and to analyze if there were gender differences regarding the types of violence the participants were exposed to and by whom it was perpetrated. Methods: A survey containing questions about lifetime experiences of sexual, physical and psychological violence was sent to a national sample of 10,000 women and 10,000 men aged 18-74; 56.8% of the women and 46.5% of the men agreed to participate. Results: Sexual violence in childhood was reported by 26.4% of women and 22.1% experienced sexual violence in adulthood. Among men, 11% disclosed experiences of sexual violence in childhood and 4.5% in adulthood. Physical violence was experienced by 39.3% of women in childhood and by 18.8% as adults, often by a present or former partner. Among men, 59.3% were exposed to physical violence during childhood, often by a peer, and 20.4% as adults. Psychological violence in childhood was experienced by 58.1% of women in childhood and by 21.8% in adulthood. Among male respondents, 69.2% reported experiences of physiological violence in childhood, often by a peer, and 9.4% in adulthood. Conclusions: Lifetime violence exposure is common in the Swedish population. Though it affects both women and men, the patterns of type of violence and perpetrators are different. The results suggest that violence prevention early in life is important to target.
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Affiliation(s)
- Mariella Öberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gun Heimer
- National Centre for Knowledge on Men's Violence Against Women, Uppsala University, Uppsala, Sweden
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Öberg M, Skalkidou A, Heimer G, Lucas S. Sexual violence against women in Sweden: Associations with combined childhood violence and sociodemographic factors. Scand J Public Health 2020; 49:292-300. [PMID: 32720565 DOI: 10.1177/1403494820939015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/26/2023]
Abstract
Aims: This cross-sectional, population-based study aimed to investigate the prevalence of violence polyvictimization during childhood and sexual violence in adulthood among women, and how childhood violence exposure and sociodemographic factors associate with women's risk of experiencing sexual violence in adulthood. Methods: A survey regarding lifetime experiences of sexual, physical and psychological violence was sent to a national sample of 10,000 women aged 18-74 years, of which 56% participated. Data were analysed using Chi-square analyses and logistic regression. Results: Sexual violence before 18 years of age was reported by 16.3% and rape/attempted rape in adulthood by 10.2% of the women. In univariate analyses, sexual, physical, and psychological violence during childhood was associated with rape/attempted rape in adulthood (odds ratio 4.5, confidence interval 3.2-6.2; odds ratio 2.5, confidence interval 1.3-4.6; and odds ratio 2.5, confidence interval 1.8-3.2, respectively). Associations were stronger for combined exposure to sexual and physical (odds ratio 5.5, confidence interval 2.5-12.3), sexual and psychological (odds ratio 9.2, confidence interval 6.7-12.8) or sexual, physical, and psychological violence (odds ratio 14.1, confidence interval 10.4-19.2) during childhood. Rape/attempted rape after 18 years of age was more common among women who were single, those with college-level education and those who had been unemployed or had received social welfare payments. Most associations remained relatively unchanged when including all exposure and background variables in multivariate analyses. Conclusions: Although several of the sociodemographic factors studied showed significant associations, multiple exposure to violence during childhood was found to be the most potent risk factor for sexual violence in adulthood among adult women.
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Affiliation(s)
- Mariella Öberg
- Department of Women's and Children's Health, Uppsala University, Sweden
| | | | - Gun Heimer
- National Centre for Knowledge on Men's Violence Against Women, Uppsala University, Sweden
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Sweden
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Lucas S, Kumar D, Leach D, Phillips D. Complementary and alternative medicine use in Australian children with acute respiratory tract infection - A cross-sectional survey of parents. Complement Ther Clin Pract 2020; 39:101171. [DOI: 10.1016/j.ctcp.2020.101171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/02/2020] [Indexed: 12/18/2022]
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Lucas S, Kumar S, Leach MJ, Phillips A. Parent use of complementary medicine remedies and services for the management of respiratory tract infection in children: a qualitative study. J Multidiscip Healthc 2019; 12:749-766. [PMID: 31571893 PMCID: PMC6750007 DOI: 10.2147/jmdh.s216687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/22/2019] [Accepted: 08/15/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) is increasing globally, in both adults and children. A common condition where CAM is used in children is acute respiratory tract infection (ARTI). However, limited information exists regarding specific CAM modalities used in children, and the factors that influence a parent's decision to use CAM for ARTI in children. This research aimed to address this knowledge gap. METHOD This research used a qualitative descriptive approach. Parents residing in Greater Melbourne, Australia, who had children aged from 0-12 years, and had used CAM for treating ARTI in their children in the last 12 months, were eligible to participate. Parents' perspectives were captured using individual semi-structured interviews, which were then transcribed verbatim. Data were analysed using content analysis. RESULTS Twenty-four families were interviewed. Several strategies to improve trustworthiness were implemented. Three themes underpinning the parents' decision to use CAM emerged from the data: safety, internal drivers and external drivers. Parents used a breadth of different treatments, predominantly food as medicine, followed by aromatherapy and other CAM remedies typically found in the kitchen, to manage ARTI in their children. Parents often used both CAM practitioners and mainstream medicine to manage ARTI in their children. While mainstream medicine was typically used to rule out any sinister pathology, CAM was often used as a frontline treatment option, with food as medicine (e.g. soups) dominating. This was due in part to concerns regarding the negative aspects of pharmaceutical use. Parents utilised a diverse range of information sources to inform their decision-making, including friends, families and the internet; traditional sources of research evidence were generally not used. CONCLUSION Child safety was a major factor influencing a primary carer's decision to utilise CAM for ARTI. The safety and effectiveness of remedies utilised by parents now warrants further investigation.
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Affiliation(s)
- S Lucas
- School of Health Sciences, Department of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - S Kumar
- School of Health Sciences, Department of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - MJ Leach
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - A Phillips
- School of Health Sciences, Department of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Nayeb L, Lagerberg D, Westerlund M, Sarkadi A, Lucas S, Eriksson M. Modifying a language screening tool for three-year-old children identified severe language disorders six months earlier. Acta Paediatr 2019; 108:1642-1648. [PMID: 30896050 DOI: 10.1111/apa.14790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 03/13/2019] [Accepted: 03/18/2019] [Indexed: 12/19/2022]
Abstract
AIM We examined if routine Swedish language screening for developmental language disorder (DLD) carried out at three years of age could be performed as effectively six months earlier. METHODS This study observed 105 monolingual Swedish-speaking children (53% boys) aged 29-31 months at three Swedish child health centres. We compared their ability to combine three words, as per the existing protocol, and two words. They also underwent a comprehension task. Speech and language pathologists clinically assessed the children for DLD and their results were compared with the nurse-led screening. RESULTS The results for the three-word and two-word criterion were the following: sensitivity (100% versus 91%) specificity (81% versus 91%), positive predictive (38% versus 56%) and negative predictive value (100% versus 99%). The three-word criterion identified 29 children with possible DLD, including 11 cases later confirmed, and the two-word criterion identified 18 possible cases, including 10 confirmed cases. DLD was overrepresented in the 10% of children who did not cooperate with the nurse-led screening. CONCLUSION Changing the required word combinations from three to two words worked well. The three-word test identified one extra confirmed case, but resulted in 10 more false positives. Lack of cooperation during screening constituted an increased risk for DLD.
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Affiliation(s)
- Laleh Nayeb
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Dagmar Lagerberg
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Monica Westerlund
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Steven Lucas
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Mårten Eriksson
- Department of Social work and Psychology Faculty of Health and Occupational Studies University of Gävle Gävle Sweden
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Hespeels F, Heuskin AC, Tabarrant T, Scifoni E, Kraemer M, Chêne G, Strivay D, Lucas S. Backscattered electron emission after proton impact on gold nanoparticles with and without polymer shell coating. Phys Med Biol 2019; 64:125007. [PMID: 30986778 DOI: 10.1088/1361-6560/ab195f] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This work aims at measuring experimentally proton induced secondary electron energy spectra after interaction with gold nano particles (GNPs) and polymer-coated GNPs. Backscattered electron energy spectra were collected over a 0 to 1000 eV energy range using a retarding field analyzer (RFA). This paper presents the spectra obtained for proton beam energies of 0.5 and 2 MeV and diameter 2.5 and 3.8 nm GNPs. The spectra were also measured for 3.8 nm GNPs after 5 and 10 MeV proton irradiations. GNPs were deposited on a 100 nm carbon film. Each experimental spectrum was compared with dedicated simulations based on existing numerical models used in the TRAX and Geant4 Monte Carlo codes. For 100 nm carbon target, good agreement between experimental, TRAX and Geant4 simulation results can be observed. For 3.8 nm GNPs, the TRAX simulations reproduce with good agreement the electron energy spectra produced after 0.5, 2, 5 and 10 MeV proton irradiations, while Geant4 spectra display a lower secondary electron yield at low energy (<600 eV) for all the studied energies. This underestimation can mostly be explained by the 790 eV threshold applied in the condensed history model used by Geant4 which impacts the secondary electron energy distribution. Results obtained for carbon and gold targets highlight the impact of the secondary electron production threshold for proton ionization process considered in condensed history models. The experimental results demonstrate that the single interaction approach used in TRAX is adapted to reproduce secondary electron emission from GNPs. On the other hand, the standard electron generation threshold implement in G4BetheBlochModel and G4BraggModel condensed-history models used in Geant4 is not adapted to reproduce low energy electron emission in gold targets. Finally, the results highlight that the GNP coating leads to a decrease of the electron yield and mostly affects low energy electrons (<500 eV) emitted from GNPs.
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Affiliation(s)
- F Hespeels
- University of Namur, PMR, 61 rue de Bruxelles, 5000 Namur, Belgium
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Valentini T, Lucas S, Cameron L, Dunitz J, Hunter R. WS19-6 Bioorthogonal non-canonical amino acid tagging reveals translationally active subpopulations of the cystic fibrosis lung microbiota. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fäldt A, Fabian H, Thunberg G, Lucas S. The study design of ComAlong Toddler: a randomised controlled trial of an early communication intervention. Scand J Public Health 2019; 48:391-399. [PMID: 31068096 DOI: 10.1177/1403494819834755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/26/2023]
Abstract
Aims: This study design article aims to describe a research study focused on evaluating the use of the Infant-Toddler Checklist to identify children at 18 months with early communication difficulties, and to study the ComAlong Toddler intervention for parents to support their child's communication development. Background: Communication disorders are a common public health problem affecting up to 20% of children. Evidence points to the importance of early detection and intervention to improve young children's communicative abilities and decrease developmental delay. Early identification of communication difficulties is possible with instruments such as Infant-Toddler Checklist. The ComAlong Toddler intervention is tailored to the needs of parents of young children with communication delay before definitive diagnosis. The parents are provided with guidance in communication enhancing strategies during home visit and five group sessions. Methods: The study uses a prospective cohort design. Children were consecutively recruited during 2015-2017, and data will be collected 2015-2023. The screening was performed at the child health centre through use of the Infant-Toddler Checklist. An assessment and first consultation were then performed by a speech and language therapist for children with suspected communication delay according to the screen as well as for children referred for other reasons before the age of 2.5 years. Children with confirmed communication delay were randomised between two interventions: the ComAlong Toddler parental course or a telephone follow-up. Outcome measures include child communication and language skills and use of augmentative and alternative communication. To gain insight into the participants' perspectives, surveys have been collected from parents. Conclusion: The study will provide information regarding identification and intervention for 18-month old children with communication delay. Trial registration: ISRCTN13330627.
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Affiliation(s)
- Anna Fäldt
- Department of Women's and Children's Health, Uppsala University, Sweden
| | - Helena Fabian
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Gunilla Thunberg
- Dart Centre for Augmentative and Alternative Communication (AAC) and Assistive Technology (AT), Sahlgrenska University Hospital, Sweden
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Sweden
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Fäldt A, Nordlund H, Holmqvist U, Lucas S, Fabian H. Nurses' experiences of screening for communication difficulties at 18 months of age. Acta Paediatr 2019; 108:662-669. [PMID: 30153364 DOI: 10.1111/apa.14557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/20/2018] [Accepted: 08/23/2018] [Indexed: 01/22/2023]
Abstract
AIM Early identification of communication disorders is important and may be possible through screening in the child health services. The aim of the study was to investigate nurses' experiences and sense of competence when using the Infant-Toddler Checklist (ITC) communication screening at the 18-month health visit. METHODS A mixed-methods design including three focus group interviews (n = 14) and a web-based survey (n = 22) among nurses using the ITC or the standard method. Interview data were analysed through systematic text condensation and a deductive analysis based on implementation theory. Groups were compared using Mann-Whitney tests. RESULT Three themes emerged: Using a structured evaluation of communication changes, the dynamic, ITC is a beneficial tool and Implementation of the ITC faces a few challenges. Nurses who used the ITC perceived to a greater extent that they used a structured method (p = 0.003, r = 0.9) and felt more secure in describing the child's communication and language development to parents (p = 0.006, r = 0.83) compared to the standard method group. CONCLUSION Using the ITC supported the nurses in their assessment of communication at 18 months. Nurses' sense of competence was higher when using the ITC, both in their assessment and in communicating with parents.
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Affiliation(s)
- A Fäldt
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - H Nordlund
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - U Holmqvist
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - S Lucas
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - H Fabian
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
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Escamilla-Rivera V, Solorio-Rodríguez A, Uribe-Ramírez M, Lozano O, Lucas S, Chagolla-López A, Winkler R, De Vizcaya-Ruiz A. Plasma protein adsorption on Fe 3O 4-PEG nanoparticles activates the complement system and induces an inflammatory response. Int J Nanomedicine 2019; 14:2055-2067. [PMID: 30988608 PMCID: PMC6438142 DOI: 10.2147/ijn.s192214] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Understanding of iron oxide nanoparticles (IONP) interaction with the body milieu is crucial to guarantee their efficiency and biocompatibility in nanomedicine. Polymer coating to IONP, with polyethyleneglycol (PEG) and polyvinylpyrrolidone (PVP), is an accepted strategy to prevent toxicity and excessive protein binding. AIM The aim of this study was to investigate the feature of IONP adsorption of complement proteins, their activation and consequent inflammatory response as a strategy to further elucidate their biocompatibility. METHODS Three types of IONP with different surface characteristics were used: bare (IONP-bare), coated with PVP (IONP-PVP) and PEG-coated (IONP-PEG). IONPs were incubated with human plasma and adsorbed proteins were identified. BALB/c mice were intravenously exposed to IONP to evaluate complement activation and proinflammatory response. RESULTS Protein corona fingerprinting showed that PEG surface around IONP promoted a selective adsorption of complement recognition molecules which would be responsible for the complement system activation. Furthermore, IONP-PEG activated in vitro, the complement system and induced a substantial increment of C3a and C4a anaphylatoxins while IONP-bare and IONP-PVP did not. In vivo IONP-PEG induced an increment in complement activation markers (C5a and C5b-9), and proinflammatory cytokines (IL-1β, IL-6, TNF-α). CONCLUSION The engineering of nanoparticles must incorporate the association between complement proteins and nanomedicines, which will regulate the immunostimulatory effects through a selective adsorption of plasma proteins and will enable a safer application of IONP in human therapy.
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Affiliation(s)
- V Escamilla-Rivera
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV-IPN), Ciudad de México, México,
| | - A Solorio-Rodríguez
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV-IPN), Ciudad de México, México,
| | - M Uribe-Ramírez
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV-IPN), Ciudad de México, México,
| | - O Lozano
- Namur Nanosafety Centre, Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
- Research Centre for the Physics of Matter and Radiation, University of Namur, Namur, Belgium
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Monterrey, México
| | - S Lucas
- Namur Nanosafety Centre, Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
- Research Centre for the Physics of Matter and Radiation, University of Namur, Namur, Belgium
| | - A Chagolla-López
- Departmento de Biotecnología y Bioquímica, CINVESTAV-IPN, Unidad Irapuato, Irapuato, México
| | - R Winkler
- Departmento de Biotecnología y Bioquímica, CINVESTAV-IPN, Unidad Irapuato, Irapuato, México
- Max Planck Institute for Chemical Ecology, Mass Spectrometry Group, Beutenberg Campus, Jena, Germany
| | - A De Vizcaya-Ruiz
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV-IPN), Ciudad de México, México,
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Hespeels F, Lucas S, Tabarrant T, Scifoni E, Kraemer M, Chêne G, Strivay D, Tran HN, Heuskin AC. Experimental measurements validate the use of the binary encounter approximation model to accurately compute proton induced dose and radiolysis enhancement from gold nanoparticles. Phys Med Biol 2019; 64:065014. [PMID: 30731439 DOI: 10.1088/1361-6560/ab0516] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In protontherapy, it has been suggested that nanoparticles of high-Z material like gold (GNP) could be used as radiosensitizers. The origin of this enhancement phenomenon for proton radiation is not yet well understood and additional mechanistic insights are required. Previous works have highlighted the good capabilities of TRAX to reproduce secondary electron emission from gold material. Therefore, TRAX cross sections obtained with the binary encounter approximation (BEA) model for proton ionization were implemented within Geant4 for gold material. Based on the TRAX cross sections, improved Geant4 simulations have been developed to investigate the energy deposition and radical species production around a spherical gold nanoparticle (5 and 10 nm in diameter) placed in a water volume during proton irradiation. Simulations were performed for incident 2 MeV proton. The dose enhancement factor and the radiolysis enhancement factor were quantified. Results obtained with the BEA model were compared with results obtained with condensed-history models. Experimental irradiation of 200 nm gold films were performed to validate the secondary electron emission reproduction capabilities of physical models used in Monte Carlo (MC) simulations. TRAX simulations reproduced the experimental backscattered electron energy spectrum from gold film with better agreement than Geant4. Results on gold film obtained with the BEA model enabled to estimate the electron emission from GNPs. Results obtained in our study tend to support that the use of the BEA discrete model leads to a significant increase of the dose in the near vicinity of GNPs (<20 nm), while condensed history models used in Geant4 seem to overestimate the dose and the number of chemical species for increasing distances from the GNP. Based on discrete BEA model results, no enhancement effect due to secondary electron emitted from the GNP is expected if the GNP is not in close proximity to key cellular functional elements (DNA, mitochondria…).
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Affiliation(s)
- F Hespeels
- University of Namur, PMR, 61 rue de Bruxelles, 5000 Namur, Belgium
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Nisbet S, Mahalingam H, Gfeller CF, Biggs E, Lucas S, Thompson M, Cargill MR, Moore D, Bielfeldt S. Cosmetic benefit of a biomimetic lamellar cream formulation on barrier function or the appearance of fine lines and wrinkles in randomized proof-of-concept clinical studies. Int J Cosmet Sci 2019; 41:1-11. [PMID: 30414275 PMCID: PMC6849859 DOI: 10.1111/ics.12499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/22/2018] [Accepted: 11/05/2018] [Indexed: 12/21/2022]
Abstract
Objective Two studies were designed to evaluate the potential cosmetic benefit of a biomimetic, niacinamide‐containing moisturizing cream for the first time in humans. Methods In both studies, healthy women were randomized to use two treatments, one for the left side of the body and one for the right, from three options: the test cream, a positive control or no treatment (use of standard cleanser only). Treatments were applied twice daily for 4 weeks to the face and forearms (Study 1) or the face only (Study 2). Instrumental and clinical skin assessments were performed by trained technicians. Study 1 involved tape stripping and a 5‐day no‐treatment (‘regression’) period at the end of the 4 weeks. Independent lay graders were asked to grade the skin texture of subjects in Study 2 from high‐resolution photographs. Results In Study 1 (n = 66), the test cream significantly decreased the transepidermal water loss (TEWL) values on the forearm, and in the cheek area of the face, relative to baseline and compared to no treatment, and increased skin Corneometer values. The improvements were partially retained during a subsequent 5‐day period of no treatment. Increases in TEWL values on skin subjected to tape stripping were significantly lower after 4 weeks of using the test cream compared to no treatment. In Study 2 (n = 72 subjects with visible signs of ageing), there was a favourable trend in the change from baseline of a skin roughness parameter, Ra, for the test cream compared to no treatment. There were statistically significant improvements in the Fitzpatrick wrinkle score compared to no treatment, decreases in TEWL and increased Corneometer values and Cutometer values (R5 elasticity parameter). Grading of high‐resolution images failed to detect the improvements in skin texture (defined as pores, smoothness and unevenness) for the test cream vs. no treatment. No treatment‐related serious or severe adverse events were reported. Conclusion Twice daily application of the test cream over 4 weeks had beneficial effects on skin barrier function, moisturization, wrinkle dimensions and elasticity compared to no treatment. These studies provide proof‐of‐concept evidence and highlight the cosmetic benefit of the biomimetic lamellar cream formulation. Study registration: NCT03216265, NCT03180645.
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Affiliation(s)
- S Nisbet
- GlaxoSmithKline Consumer Healthcare, Medical Affairs - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - H Mahalingam
- GlaxoSmithKline Consumer Healthcare, Medical Affairs - Skin Health, 184 Liberty Corner Road, Warren, NJ 07059, U.S.A
| | - C F Gfeller
- GlaxoSmithKline Consumer Healthcare, Medical Affairs - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - E Biggs
- GlaxoSmithKline Consumer Healthcare, Research and Development - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - S Lucas
- GlaxoSmithKline Consumer Healthcare, Research and Development - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - M Thompson
- GlaxoSmithKline Consumer Healthcare, Research and Development - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - M R Cargill
- GlaxoSmithKline Consumer Healthcare, Research and Development - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - D Moore
- GlaxoSmithKline Consumer Healthcare, Research and Development - Skin Health, St George's Avenue, Weybridge, KT13 0DE, U.K
| | - S Bielfeldt
- proDERM Institute for Applied Dermatological Research, Kiebitzweg 2, Schenefeld/Hamburg, 22869, Germany
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Otterman G, Lahne K, Arkema EV, Lucas S, Janson S, Hellström‐Westas L. Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated. Acta Paediatr 2019. [PMID: 29520820 DOI: 10.1111/apa.14309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes, and this study examined the trends in Sweden. METHODS We analysed individual-level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000 to 2014, and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years. RESULTS Child deaths from all causes were 7914, and 2006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100 000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-17 (0.9%). CONCLUSION Childhood deaths showed a sustained decline from 2000 to 2014 in Sweden and a quarter were from external, ill-defined or unknown causes. Systematic, interagency death reviews could yield information that could prevent future deaths.
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Affiliation(s)
- Gabriel Otterman
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Klara Lahne
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Elizabeth V. Arkema
- Clinical Epidemiology Unit Department of Medicine Solna Karolinska Institutet Stockholm Sweden
| | - Steven Lucas
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Staffan Janson
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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Geary P, Lucas S. Contamination of estuaries from failing septic tank systems: difficulties in scaling up from monitored individual systems to cumulative impact. Environ Sci Pollut Res Int 2019; 26:2132-2144. [PMID: 29397513 DOI: 10.1007/s11356-018-1364-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/22/2018] [Indexed: 06/07/2023]
Abstract
Aquaculture in many coastal estuaries is threatened by diffuse sources of runoff from different land use activities. The poor performance of septic tank systems (STS), as well as runoff from agriculture, may contribute to the movement of contaminants through ground and surface waters to estuaries resulting in oyster contamination, and following their consumption, impacts to human health. In monitoring individual STS in sensitive locations, it is possible to show that nutrients and faecal contaminants are transported through the subsurface in sandy soils off-site with little attenuation. At the catchment scale however, there are always difficulties in discerning direct linkages between failing STS and water contamination due to processes such as effluent dilution, adsorption, precipitation and vegetative uptake. There is often substantial complexity in detecting and tracing effluent pathways from diffuse sources to water bodies in field studies. While source tracking as well as monitoring using tracers may assist in identifying potential pathways from STS to surface waters and estuaries, there are difficulties in scaling up from monitored individual systems to identify their contribution to the cumulative impact which may be apparent at the catchment scale. The processes which may be obvious through monitoring and dominate at the individual scale may be masked and not readily discernible at the catchment scale due to impacts from other land use activities.
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Affiliation(s)
- Phillip Geary
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Steven Lucas
- The Tom Farrell Institute for the Environment, University of Newcastle, Callaghan, NSW, 2308, Australia
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Vermeersch E, Liénart S, Collignon A, Lucas S, Gallimore A, Gysemans C, Unutmaz D, Vanhoorelbeke K, De Meyer SF, Maes W, Deckmyn H. Deletion of GARP on mouse regulatory T cells is not sufficient to inhibit the growth of transplanted tumors. Cell Immunol 2018; 332:129-133. [PMID: 30093071 DOI: 10.1016/j.cellimm.2018.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/13/2018] [Accepted: 07/29/2018] [Indexed: 12/17/2022]
Abstract
GARP is a transmembrane protein that presents latent TGF-β1 on the surface of regulatory T cells (Tregs). Neutralizing anti-GARP monoclonal antibodies that prevent the release of active TGF-β1, inhibit the immunosuppressive activity of human Tregs in vivo. In this study, we investigated the contribution of GARP on mouse Tregs to immunosuppression in experimental tumors. Unexpectedly, Foxp3 conditional garp knockout (KO) mice challenged orthotopically with GL261 tumor cells or subcutaneously with MC38 colon carcinoma cells did not show prolonged survival or delayed tumor growth. Also, the suppressive function of KO Tregs was similar to that of wild type Tregs in the T cell transfer model in allogeneic, immunodeficient mice. In conclusion, garp deletion in mouse Tregs is not sufficient to impair their immunosuppressive activity in vivo.
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Affiliation(s)
- E Vermeersch
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - S Liénart
- de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - A Collignon
- de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - S Lucas
- de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - A Gallimore
- Medical Biochemistry and Immunology, Henry Wellcome Building, Heath Park, Cardiff CF14 4XN, UK
| | - C Gysemans
- Laboratory of Clinical and Experimental Endocrinology (CEE), Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - D Unutmaz
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - K Vanhoorelbeke
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - S F De Meyer
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - W Maes
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - H Deckmyn
- Laboratory for Thrombosis Research, IRF Life Sciences, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.
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Dosani M, Lucas S, Wong J, Weir L, Lomas S, Cumayas C, Fisher C, Tyldesley S. Impact of the Spinal Instability Neoplastic Score on Surgical Referral Patterns and Outcomes. ACTA ACUST UNITED AC 2018; 25:53-58. [PMID: 29507484 DOI: 10.3747/co.25.3835] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 12/25/2022]
Abstract
Background The Spinal Instability Neoplastic Score (sins) was developed to identify patients with spinal metastases who may benefit from surgical consultation. We aimed to assess the distribution of sins in a population-based cohort of patients undergoing palliative spine radiotherapy (rt) and referral rates to spinal surgery pre-rt. Secondary outcomes included referral to a spine surgeon post-rt, overall survival, maintenance of ambulation, need for re-intervention, and presence of spinal adverse events. Methods We retrospectively reviewed ct simulation scans and charts of consecutive patients receiving palliative spine rt between 2012 and 2013. Data were analyzed using Student's t-test, Chi-squared, Fisher's exact, and Kaplan-Meier log-rank tests. Patients were stratified into low (<7) and high (≥7) sins groups. Results We included 195 patients with a follow-up of 6.1 months. The median sins was 7. The score was 0 to 6 (low, no referral recommended), 7 to 12 (intermediate, consider referral), and 13 to 18 (high, referral suggested) in 34%, 59%, and 7% of patients, respectively. Eleven patients had pre-rt referral to spine surgery, with a surgery performed in 0 of 1 patient with sins 0 to 6, 1 of 7 with sins 7 to 12, and 1 of 3 with sins 13 to 18. Seven patients were referred to a surgeon post-rt with salvage surgery performed in two of those patients. Primary and secondary outcomes did not differ between low and high sins groups. Conclusion Higher sins was associated with pre-rt referral to a spine surgeon, but most patients with high sins were not referred. Higher sins was not associated with shorter survival or worse outcome following rt.
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Affiliation(s)
- M Dosani
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 W 10th Ave, Vancouver, BC
| | - S Lucas
- Department of Radiation Oncology, British Columbia Cancer Agency Centre for the Southern Interior, 399 Royal Ave, Kelowna, BC; and
| | - J Wong
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 W 10th Ave, Vancouver, BC
| | - L Weir
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 W 10th Ave, Vancouver, BC
| | - S Lomas
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 W 10th Ave, Vancouver, BC
| | - C Cumayas
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 W 10th Ave, Vancouver, BC
| | - C Fisher
- Division of Spine, Department of Orthopedics, University of British Columbia and Vancouver General Hospital, 899 W 12th Ave, Vancouver, BC
| | - S Tyldesley
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, 600 W 10th Ave, Vancouver, BC
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Lucas S, Leach M, Kumar S. Complementary and alternative medicine utilisation for the management of acute respiratory tract infection in children: A systematic review. Complement Ther Med 2018; 37:158-166. [PMID: 29609928 DOI: 10.1016/j.ctim.2018.03.001] [Citation(s) in RCA: 20] [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: 12/11/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION As many as one in two children across the globe use complementary and alternative medicine (CAM) to manage a health condition. Despite the high prevalence of use, there is still limited information on the types of CAM used in children, particularly for the management of one of the most common childhood health complaints - acute respiratory tract infection (ARTI). This systematic review was undertaken to address this knowledge gap. METHODS Eligible studies reporting the use of CAM in children with ARTI were identified using a targeted search of seven electronic databases and the grey literature. Data were extracted using a customised data extraction form and appraised using the McMaster critical review forms for quantitative and qualitative studies. Findings were synthesised in narrative form. RESULTS The search identified 2261 papers, of which 22 studies were eligible for inclusion. The 22 studies reported the use of 118 distinct CAM interventions for the management of ARTI in children. Most (53%, n = 63) of these interventions represented biologically-based therapies, followed by whole medical systems/alternative medical systems (46%, n = 55). No studies reported the use of energy therapies, or manipulative and body-based methods, or mind-body therapies. CONCLUSION A diverse range of CAM interventions are used in the management of ARTI in children. These interventions largely represent CAM use in the southern region of Asia - India, Pakistan and Bangladesh. Further research is needed to better understand the types of CAM used among children with ARTI in western countries.
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Affiliation(s)
- S Lucas
- School of Health Sciences, University of South Australia, Adelaide, South Australia, North Tce. Adelaide SA 5000, Australia.
| | - M Leach
- Department of Rural Health, University of South Australia Adelaide, South Australia, North Tce. Adelaide SA 5000, Australia.
| | - S Kumar
- School of Health Sciences, University of South Australia, Adelaide, South Australia, North Tce. Adelaide SA 5000, Australia.
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Montgomery C, Johansen K, Lucas S, Strömberg B, Persson K. The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients. Early Hum Dev 2017; 113:31-39. [PMID: 28728014 DOI: 10.1016/j.earlhumdev.2017.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/23/2017] [Accepted: 07/02/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The detection of motor problems in infancy requires a detailed assessment method that measures both the infants' level of motor development and movement quality. AIMS To evaluate the ability of the Structured Observation of Motor Performance in Infants (SOMP-I) to detect cerebral palsy (CP) in neonatal intensive care recipients. STUDY DESIGN Prospective cohort study analyzed retrospectively. SUBJECTS 212 (girls: 96) neonatal intensive care recipients (mean gestational age 34weeks, range: 23-43). Twenty infants were diagnosed with CP. OUTCOME MEASURES The infants were assessed using SOMP-I at 2, 4, 6 and 10months' corrected age. Accuracy measures were calculated for level of motor development, quality of motor performance and a combination of the two to detect CP at single and repeated assessments. RESULTS At 2months, 17 of 20 infants with CP were detected, giving a sensitivity of 85% (95% CI 62-97%) and a specificity of 48% (95% CI 40-55%), while the negative likelihood ratio was 0.3 (95% CI 0.1-0.9) and the positive likelihood ratio was 1.6 (95% CI 1.3-2.0). At 6months all infants with CP were detected using SOMP-I, and all infants had repeatedly been assessed outside the cut-offs. Specificity was generally lower for all assessment ages, however, for repeated assessments sensitivity reached 90% (95% CI 68-99%) and specificity 85% (95% CI 79-90%). CONCLUSIONS SOMP-I is sensitive for detecting CP early, but using the chosen cut-off can lead to false positives for CP. Assessing level and quality in combination and at repeated assessments improved predictive ability.
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Affiliation(s)
- Cecilia Montgomery
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden.
| | - Kine Johansen
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden.
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden
| | - Bo Strömberg
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden
| | - Kristina Persson
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden
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Affiliation(s)
- Ba Thanh Ho
- Faculty of Environment and Natural Resources, Nong Lam University, Ho Chi Minh City, Vietnam
| | - Timothy K. Roberts
- The Tom Farrell Institute for The Environment, University of Newcastle, Newcastle, NSW, Australia
| | - Steven Lucas
- The Tom Farrell Institute for The Environment, University of Newcastle, Newcastle, NSW, Australia
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Lucas S, Bärtås A, Bonamy AKE, Törnudd L, Wide P, Otterman G. The way forward in addressing abusive head trauma in infants - current perspectives from Sweden. Acta Paediatr 2017; 106:1033-1035. [PMID: 28422325 DOI: 10.1111/apa.13840] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Steven Lucas
- Department of Paediatrics; Uppsala University Children's Hospital; Uppsala Sweden
| | - Anna Bärtås
- Department of Paediatrics; Växjö Regional Hospital; Växjö Sweden
| | | | - Lisa Törnudd
- Department of Paediatrics; Linköping University Hospital; Linköping Sweden
| | - Peter Wide
- Department of Paediatrics; Linköping University Hospital; Linköping Sweden
| | - Gabriel Otterman
- Department of Paediatrics; Uppsala University Children's Hospital; Uppsala Sweden
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Lucas S, Grube K, Huang CL, Sakai A, Wunderlich S, Green EL, Wosnitza J, Fritsch V, Gegenwart P, Stockert O, V Löhneysen H. Entropy Evolution in the Magnetic Phases of Partially Frustrated CePdAl. Phys Rev Lett 2017; 118:107204. [PMID: 28339268 DOI: 10.1103/physrevlett.118.107204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Indexed: 06/06/2023]
Abstract
In the heavy-fermion metal CePdAl, long-range antiferromagnetic order coexists with geometric frustration of one-third of the Ce moments. At low temperatures, the Kondo effect tends to screen the frustrated moments. We use magnetic fields B to suppress the Kondo screening and study the magnetic phase diagram and the evolution of the entropy with B employing thermodynamic probes. We estimate the frustration by introducing a definition of the frustration parameter based on the enhanced entropy, a fundamental feature of frustrated systems. In the field range where the Kondo screening is suppressed, the liberated moments tend to maximize the magnetic entropy and strongly enhance the frustration. Based on our experiments, this field range may be a promising candidate to search for a quantum spin liquid.
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Affiliation(s)
- S Lucas
- Max-Planck-Institut für Chemische Physik fester Stoffe, 01187 Dresden, Germany
- Institut für Festkörperphysik, TU Dresden, 01062 Dresden, Germany
| | - K Grube
- Institut für Festkörperphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
| | - C-L Huang
- Max-Planck-Institut für Chemische Physik fester Stoffe, 01187 Dresden, Germany
- Institut für Festkörperphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
- Physikalisches Institut, Karlsruher Institut für Technologie, 76049 Karlsruhe, Germany
| | - A Sakai
- Experimentalphysik VI, Elektronische Korrelationen und Magnetismus, Universität Augsburg, 86159 Augsburg, Germany
| | - S Wunderlich
- Max-Planck-Institut für Chemische Physik fester Stoffe, 01187 Dresden, Germany
| | - E L Green
- Hochfeld-Magnetlabor Dresden (EMFL-HLD), Helmholtz-Zentrum Dresden-Rossendorf, 01314 Dresden, Germany
| | - J Wosnitza
- Institut für Festkörperphysik, TU Dresden, 01062 Dresden, Germany
- Hochfeld-Magnetlabor Dresden (EMFL-HLD), Helmholtz-Zentrum Dresden-Rossendorf, 01314 Dresden, Germany
| | - V Fritsch
- Experimentalphysik VI, Elektronische Korrelationen und Magnetismus, Universität Augsburg, 86159 Augsburg, Germany
| | - P Gegenwart
- Experimentalphysik VI, Elektronische Korrelationen und Magnetismus, Universität Augsburg, 86159 Augsburg, Germany
| | - O Stockert
- Max-Planck-Institut für Chemische Physik fester Stoffe, 01187 Dresden, Germany
| | - H V Löhneysen
- Institut für Festkörperphysik, Karlsruher Institut für Technologie, 76131 Karlsruhe, Germany
- Physikalisches Institut, Karlsruher Institut für Technologie, 76049 Karlsruhe, Germany
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Abstract
Central government assistance to local government in England is based on the Standard Spending Assessment (SSA), which is intended to reflect the spending needs of each local council. This paper is an evaluation of the methodology used in calculating SSA, with particular reference to the district-level service clement of the All Other Services block of SSA. This element accounts for the vast majority of SSA for nonmetropolitan district councils. The first section of the paper is concerned with the overall structure of the SSA methodology, and the second section is an examination of some of the details of how it was implemented. Barrow-in-Furness is used as an illustrative example. In the conclusion some specific problems are high-lighted and some potential improvements are suggested.
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Affiliation(s)
- R Flowerdew
- North West Regional Research Laboratory, Lancaster University, Lancaster LA1 4YD, England
| | - B Francis
- North West Regional Research Laboratory, Lancaster University, Lancaster LA1 4YD, England
| | - S Lucas
- North West Regional Research Laboratory, Lancaster University, Lancaster LA1 4YD, England
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