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Lim A, Walker S, Emery B, Ong E, Abeyaratne C, Galbraith K. Comparing the experiences of community and hospital pharmacy learners completing a pre-registrant research training program. Curr Pharm Teach Learn 2024:S1877-1297(24)00119-9. [PMID: 38688823 DOI: 10.1016/j.cptl.2024.04.016] [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] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/27/2024] [Accepted: 04/24/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND PURPOSE Research training programs in the community pharmacy sector have not been well established. This study showcases a year-long guided research training program undertaken in hospital and community workplaces by pre-registrant pharmacists, and compares the perceived impact on learners in both sectors. EDUCATIONAL ACTIVITY AND SETTING A two-year cohort study (2021-2022) of pre-registrant pharmacists enrolled in a research training program requiring them to undertake an individual project at their workplace over one year at either a community or hospital workplace. Outcome measures were pre-registrant perceptions of training impact and type of projects completed. FINDINGS The results of this study demonstrate that the year-long guided research training program delivered to 403 pre-registrant pharmacists was perceived to be impactful to both community and hospital pre-registrant pharmacists and gave them the confidence to pursue further research and see research skills as an important attribute for the profession. Barriers to research included lack of time for both sectors but workplace support and lack of project ideas were especially noted in the community sector. Research project designs were mainly cross-sectional surveys or retrospective audits. SUMMARY Programs seeking to adopt a similar model may wish to pay particular attention to supporting community pharmacy learners in providing a pre-selection of project ideas, offering training to workplace supervisors, ensuring enough academic support is given and having more check-in points/deliverables to ensure more feedback opportunities.
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Affiliation(s)
- Angelina Lim
- Lecturer, Pharmacy Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville 3052, Victoria, Australia.
| | - Steven Walker
- Associate Professor, Pharmacy Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville 3052, Victoria, Australia.
| | - Ben Emery
- Senior Lecturer, Pharmacy Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville 3052, Victoria, Australia.
| | - Eugene Ong
- Senior Lecturer, Pharmacy Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville 3052, Victoria, Australia.
| | - Carmen Abeyaratne
- Lecturer, Pharmacy Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville 3052, Victoria, Australia.
| | - Kirsten Galbraith
- Professor, Pharmacy Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville 3052, Victoria, Australia.
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Kaufmann A, Butcher P, Maden K, Walker S, Widmer M, Kaempf R. Improved method robustness and ruggedness in liquid chromatography-mass spectrometry by increasing the acid content of the mobile phase. J Chromatogr A 2024; 1717:464694. [PMID: 38306921 DOI: 10.1016/j.chroma.2024.464694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/04/2024]
Abstract
A routine multiresidue method developed for the detection and quantification of veterinary drug residues in animal-based food was used to analyze sheep (ovine) liver. Unlike when working with previously validated matrices (e.g., bovine liver), some of the analytes of interest chromatographed in the form of split- or even fully baseline separated peaks. In other cases a significantly longer retention times (tR) was observed. A detailed investigation led to the elucidation of taurocholic acid as the causative agent. This compound is present in sheep liver at significantly higher concentrations than in most other animal tissues. Taurocholic acid is a zwitterionic compound and likely acts as an ion pairing agent, which modifies the selectivity of the stationary phase in a highly spatial and dynamic way. Injecting smaller volumes of matrix extract or the use of a significantly higher formic acid concentration in the mobile phase reduced or even completely eliminated the peak splitting. A more detailed examination led to the observation that the problem is not restricted to this particular matrix and extraction procedure or the used stationary phase. In fact, a higher formic acid concentration (e.g., 1.0 % versus 0.1 %) significantly improves the peak shape of many analytes present in fortified matrix samples as well as in pure standard solutions. In addition, analytical column aging was observed as being slower with a higher formic acid concentration. Finally the peak shape of analytes interacting with the metallic parts along the flow path of the liquid chromatograph was also significantly improved. Use of 0.1 % acid in mobile phases is often taken for granted in LC-MS. Regardless of the stationary phase, a higher ionic strength better stabilizes the pH and reduces unwanted interactions, which ultimately improves the method robustness. Flow injection experiments often show that 0.1 % acid concentrations produce the highest analyte signals. Yet, the use of 1 % acid in the mobile phase often leads to narrower and therefore taller chromatographic peaks, which may lead to lower detection limits for many analytes and to an improved separation efficiency.
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Affiliation(s)
- A Kaufmann
- Official Food Control Authority of the Canton of Zurich, Kantonales Labor Zürich, Fehrenstrasse 15, 8032 Zürich, Switzerland.
| | - P Butcher
- Official Food Control Authority of the Canton of Zurich, Kantonales Labor Zürich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - K Maden
- Official Food Control Authority of the Canton of Zurich, Kantonales Labor Zürich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - S Walker
- Official Food Control Authority of the Canton of Zurich, Kantonales Labor Zürich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - M Widmer
- Official Food Control Authority of the Canton of Zurich, Kantonales Labor Zürich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - R Kaempf
- Official Food Control Authority of the Canton of Zurich, Kantonales Labor Zürich, Fehrenstrasse 15, 8032 Zürich, Switzerland
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Lifschitz C, Kozhevnikov O, Oesterling C, Anbar A, Walker S. Acute gastroenteritis-changes to the recommended original oral rehydrating salts: a review. Front Pediatr 2023; 11:1294490. [PMID: 38192370 PMCID: PMC10773804 DOI: 10.3389/fped.2023.1294490] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/14/2023] [Indexed: 01/10/2024] Open
Abstract
The World Health Organization recommended a formulation of oral rehydration salts as the intervention of choice for the treatment of acute gastroenteritis. While of value for the replacement of fluids and electrolytes, the formulation does not reduce stool volume, frequency, or symptom duration. This may prevent wide acceptance. To increase tolerability, shorten the duration of diarrhea and improve parental quality of life, several modifications to the original formula have been proposed. These include; low osmolarity, rice-based, glucose polymers as an alternative to glucose, the addition of probiotics, prebiotics and/or zinc, and various other ingredients. Here we summarize evidence regarding such changes and additions.
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Affiliation(s)
| | | | - Christine Oesterling
- Eastmead Surgery, Greenford, and Imperial College London, London, United Kingdom
| | | | - Steven Walker
- St. Gilesmedical (London & Berlin) & University of Applied Sciences, Bremen, Germany
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Shorthose M, Barton E, Walker S. The contemporary management of spontaneous pneumothorax in adults. Breathe (Sheff) 2023; 19:230135. [PMID: 38229681 PMCID: PMC10790175 DOI: 10.1183/20734735.0135-2023] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 01/18/2024] Open
Abstract
Spontaneous pneumothorax is a common presentation, and there has been a recent surge of research into the condition. With the recent publication of the new British Thoracic Society guidelines and the upcoming European Respiratory Society guidelines, we provide a concise up-to-date summary of clinical learning points. In particular we focus on the role of conservative or ambulatory management, as well as treatment options for persistent air leak and guidance for when to refer to thoracic surgeons for the prevention of the recurrence of pneumothorax. Educational aims To give up-to-date guidance on the acute management of spontaneous pneumothorax, including the role of conservative or ambulatory managementTo discuss the different treatment options for persistent air leak.To guide physicians on when to refer patients to thoracic surgeons for the prevention of the recurrence of pneumothorax.
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Affiliation(s)
| | - Eleanor Barton
- Academic Respiratory Unit, North Bristol NHS Trust, Bristol, UK
| | - Steven Walker
- Academic Respiratory Unit, North Bristol NHS Trust, Bristol, UK
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Lifschitz C, Walker S, Tookman A. Awareness of Tissue Disorders and Functional Gastrointestinal Diseases. J Pediatr Gastroenterol Nutr 2023; 77:e115. [PMID: 37771009 DOI: 10.1097/mpg.0000000000003947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Affiliation(s)
| | - Steven Walker
- St. Gilesmedical (London & Berlin) & University of Applied Sciences, Bremen, Germany
| | - Adrian Tookman
- Former Medical Director Marie Curie Hospice, Hampstead, London, United Kingdom
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Aung AK, Walker S, Lee JI, Graudins LV. An integrated scenario-based adverse drug reaction education programme. Med Educ 2023; 57:1163-1164. [PMID: 37705407 DOI: 10.1111/medu.15215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/15/2023] [Indexed: 09/15/2023]
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Walker S, Barton E, Maskell N. Intervening in primary spontaneous pneumothorax - Less is more. Respir Med Res 2023; 84:101039. [PMID: 37729672 DOI: 10.1016/j.resmer.2023.101039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/11/2023] [Accepted: 06/25/2023] [Indexed: 09/22/2023]
Affiliation(s)
- Steven Walker
- Academic Respiratory Unit, North Bristol NHS Trust, Southmead Road, Bristol BS10 5NB, United Kingdom
| | - Eleanor Barton
- Academic Respiratory Unit, North Bristol NHS Trust, Southmead Road, Bristol BS10 5NB, United Kingdom.
| | - Nick Maskell
- Academic Respiratory Unit, North Bristol NHS Trust, Southmead Road, Bristol BS10 5NB, United Kingdom
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Roberts ME, Rahman NM, Maskell NA, Bibby AC, Blyth KG, Corcoran JP, Edey A, Evison M, de Fonseka D, Hallifax R, Harden S, Lawrie I, Lim E, McCracken D, Mercer R, Mishra EK, Nicholson AG, Noorzad F, Opstad KS, Parsonage M, Stanton AE, Walker S. British Thoracic Society Guideline for pleural disease. Thorax 2023; 78:1143-1156. [PMID: 37553157 DOI: 10.1136/thorax-2023-220304] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Affiliation(s)
- Mark E Roberts
- Respiratory Medicine, Sherwood Forest Hospitals NHS Foundation Trust, Nottinghamshire, UK
| | - Najib M Rahman
- University of Oxford, Oxford Respiratory Trials Unit, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford, UK
- Oxford Pleural Unit, Churchill Hospital, Oxford, UK
| | - Nick A Maskell
- Academic Respiratory Unit, University of Brisol and North Bristol NHS Trust, UK
| | - Anna C Bibby
- Academic Respiratory Unit, University of Brisol and North Bristol NHS Trust, UK
| | - Kevin G Blyth
- Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cancer Sciences, University of Glasgow/Cancer Research UK Beatson Institute, Glasgow, UK
| | - John P Corcoran
- Interventional Pulmonology Service, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | - Matthew Evison
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Rob Hallifax
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Susan Harden
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Iain Lawrie
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Eric Lim
- Academic Division of Thoracic Surgery, The Royal Brompton Hospital and Imperial College London, London, UK
| | - David McCracken
- Regional Respiratory Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Rachel Mercer
- Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Eleanor K Mishra
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust and National Heart and Lung Institute, London, UK
| | - Farinaz Noorzad
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Maria Parsonage
- North Cumbria Integrated Care NHS Foundation Trust, Cumbria, UK
| | - Andrew E Stanton
- Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Steven Walker
- Academic Respiratory Unit, University of Brisol and North Bristol NHS Trust, UK
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Savolainen EHJ, Vänttinen T, Peltonen J, Ihalainen JK, Walker S. Average demands and most demanding passages of national-level female soccer matches: do small- and large-sided games replicate match demands? Front Sports Act Living 2023; 5:1236112. [PMID: 37886220 PMCID: PMC10598713 DOI: 10.3389/fspor.2023.1236112] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/08/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction This study aims to (1) determine the average and most demanding passage (MDP) load of national-level female soccer matches and (2) evaluate the relationship between average and MDP load during small-sided games (SSGs), large-sided games (LSGs), and matches. Methods A total of 37 national-level female soccer players from a single club senior team and the U18 team participated. The average and 1-, 3-, and 5-min MDP external (total, high-speed, and very-high-speed running distances, acceleration and deceleration distances, average metabolic power, and high-metabolic load distance) and internal loads (average heart rate, rate of perceived exertion) of the 29 league matches, ten 4 vs. 4 + goalkeepers SSGs, and six 8 vs. 8 + goalkeepers LSGs were analyzed by the Polar Team Pro player tracking system. Results In matches, the external load variables during 1-, 3-, and 5-min MDPs were 167%-1,165%, 135%-504%, and 126%-359%, of match average values, respectively. In LSGs, all external load variables reached higher average values compared with those during matches, except for the very-high-speed running distance; however, no variable reached higher values of 1-min MDP compared with those during the matches. In SSGs, the average acceleration and deceleration distances were higher compared with those during the matches. Discussion The findings from the present study suggest that LSGs and SSGs can be used to overload the average values of the selected external load variables compared with those during the matches; however, other training options must be explored to overload 1-min match MDPs.
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Affiliation(s)
- E. H. J. Savolainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - T. Vänttinen
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | | | - J. K. Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - S. Walker
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- NeuroMuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
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Duong QH, Pham TN, Reynolds L, Yeap Y, Walker S, Lyons K. A scoping review of therapeutic reasoning process research. Adv Health Sci Educ Theory Pract 2023; 28:1289-1310. [PMID: 37043070 PMCID: PMC10624714 DOI: 10.1007/s10459-022-10187-7] [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] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/09/2022] [Indexed: 06/19/2023]
Abstract
Therapeutic reasoning is when the purpose, task, or goal for engaging in reasoning is to determine the patient's management plan. As the field's understanding of the process of therapeutic reasoning is less well understood, we focused on studies that collected data on the process of therapeutic reasoning. To synthesize previous studies of therapeutic reasoning characteristics, methodological approaches, theoretical underpinnings, and results. We conducted a scoping review with systematic searching for English language articles with no date limits. Databases included MEDLINE, CINAHL Plus, Scopus, Embase, Proquest Dissertations and Theses Global, and ERIC. Search terms captured therapeutic reasoning in health professions education research. Initial search yielded 5450 articles. The title and abstract screening yielded 180 articles. After full-text review, 87 studies were included in this review. Articles were excluded if they were outside health professions education, did not collect data on the process of therapeutic reasoning, were not empirical studies, or not focused on therapeutic reasoning. We analyzed the included articles according to scoping questions using qualitative content analysis. 87 articles dated from 1987 to 2019 were included. Several study designs were employed including think-aloud protocol, interview and written documentation. More than half of the articles analyzed the data using qualitative coding. Authors often utilized several middle-range theories to explain therapeutic reasoning processes. The hypothetico-deductive model was most frequently mentioned. The included articles rarely built off the results from previous studies. Six key result categories were found: identifying themes, characterizing and testing previous local theory, exploring factors, developing new local theory, testing tools, and testing hypothesis. Despite the cast body of therapeutic reasoning research, individual study results remain isolated from previous studies. Our future recommendations include synthesizing pre-existing models, developing novel methodologies, and investigating other aspects of therapeutic reasoning.
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Affiliation(s)
- Quang Hung Duong
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Pde, Parkville, 3052, Australia
| | - To Nhu Pham
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Pde, Parkville, 3052, Australia
| | - Lorenna Reynolds
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Pde, Parkville, 3052, Australia
| | - Yan Yeap
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Pde, Parkville, 3052, Australia
| | - Steven Walker
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Pde, Parkville, 3052, Australia
| | - Kayley Lyons
- Centre for Digital Transformation of Health, University of Melbourne, 700 Swanston St, Carlton, 3053, Australia.
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Goo D, Gadde UD, Kim WK, Gay CG, Porta EW, Jones SW, Walker S, Lillehoj HS. Hyperimmune egg yolk antibodies developed against Clostridium perfringens antigens protect against necrotic enteritis. Poult Sci 2023; 102:102841. [PMID: 37480657 PMCID: PMC10393821 DOI: 10.1016/j.psj.2023.102841] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 07/24/2023] Open
Abstract
Necrotic enteritis (NE) is a widespread infectious disease caused by Clostridium perfringens that inflicts major economic losses on the global poultry industry. Due to regulations on antibiotic use in poultry production, there is an urgent need for alternative strategies to mitigate the negative effects of NE. This paper presents a passive immunization technology that utilizes hyperimmune egg yolk immunoglobulin Y (IgY) specific to the major immunodominant antigens of C. perfringens. Egg yolk IgYs were generated by immunizing hens with 4 different recombinant C. perfringens antigens, and their protective effects against NE were evaluated in commercial broilers. Six different spray-dried egg powders were produced using recombinant C. perfringens antigens: α-toxin, NE B-like toxin (NetB; EB), elongation factor-Tu (ET), pyruvate:ferredoxin oxidoreductase, a mixture of 4 antigens (EM-1), and a nonimmunized control (EC). The challenged groups were either provided with different egg powders at a 1% level or no egg powders (EN). The NE challenge model based on Eimeria maxima and C. perfringens dual infection was used. In Experiments 1 and 2, the EB and ET groups exhibited increased body weight gain (BWG; P < 0.01), decreased NE lesion scores (P < 0.001), and reduced serum NetB levels (P < 0.01) compared to the EN and EC groups. IgY against NetB significantly reduced Leghorn male hepatocellular cytotoxicity in an in vitro test (P < 0.01). In Experiment 3, the protective effect of the IgYs mixture (EM-2) against C. perfringens antigens (NetB and EFTu) and Eimeria antigens (elongation factor-1-alpha: EF1α and Eimeria profilin: 3-1E) was tested. The EM-2 group showed similar body weight, BWG, and feed intake from d 7 to 22 compared to the NC group (P < 0.05). On d 20, the EM-2 group showed comparable intestinal permeability, NE lesion scores, and jejunal NetB and collagen adhesion protein levels to the NC group (P < 0.05). In conclusion, dietary mixture containing antibodies to NetB and EFTu provides protection against experimental NE in chickens through passive immunization.
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Affiliation(s)
- D Goo
- Department of Poultry Science, University of Georgia, Athens, GA, USA
| | - U D Gadde
- Animal Bioscience and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA
| | - W K Kim
- Department of Poultry Science, University of Georgia, Athens, GA, USA
| | - C G Gay
- Office of National Program-Animal Health, Agricultural Research Service, USDA, Beltsville, MD, USA
| | - E W Porta
- Arkion Life Sciences, New Castle, DE, USA
| | - S W Jones
- Arkion Life Sciences, New Castle, DE, USA
| | - S Walker
- Arkion Life Sciences, New Castle, DE, USA
| | - H S Lillehoj
- Animal Bioscience and Biotechnology Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA.
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Ludikhuize J, Marshall D, Devchand M, Walker S, Talman A, Taylor C, McIntyre T, Trubiano J, Jones D. Improving the management of medical emergency team calls due to suspected infections: A before-after study. CRIT CARE RESUSC 2023; 25:136-139. [PMID: 37876370 PMCID: PMC10581256 DOI: 10.1016/j.ccrj.2023.06.004] [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: 10/26/2023]
Abstract
Objective To introduce a management guideline for sepsis-related MET calls to increase lactate and blood culture acquisition, as well as prescription of appropriate antibiotics. Design Prospective before (Jun-Aug 2018) and after (Oct-Dec 2018) study was designed. Setting A public university linked hospital in Melbourne, Australia. Participants Adult patients with MET calls related to sepsis/infection were included. Main outcome measures The primary outcome measure was the proportion of MET calls during which both a blood culture and lactate level were ordered. Secondary outcomes included the frequency with which new antimicrobials were commenced by the MET, and the presence and class of administered antimicrobials. Results There were 985 and 955 MET calls in the baseline and after periods, respectively. Patient features, MET triggers, limitations of treatment and disposition after the MET call were similar in both groups. Compliance with the acquisition of lactates (p = 0.101), respectively. There was a slight reduction in compliance with lactate acquisition in the after period (97% vs 99%; p = 0.06). In contrast, there was a significant increase in acquisition of blood cultures in the after period (69% vs 78%; p = 0.035). Conclusions Introducing a sepsis management guideline and enhanced linkage with an AMS program increased blood culture acquisition and decreased broad spectrum antimicrobial use but didn't change in-hospital mortality.
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Affiliation(s)
- Jeroen Ludikhuize
- Austin Health, Department of Intensive Care Medicine in Heidelberg, Australia
- HagaZiekenhuis, Department of Intensive Care Medicine in the Hague, the Netherlands
- University Medical Center Amsterdam Location VuMC, Department of Acute Internal Medicine in Amsterdam, the Netherlands
| | - David Marshall
- Austin Health, Department of Intensive Care Medicine in Heidelberg, Australia
| | - Misha Devchand
- Austin Health, Department of Infectious Diseases in Heidelberg, Australia
- Austin Health, Department of Pharmacy in Heidelberg, Australia
| | - Steven Walker
- Austin Health, Department of Infectious Diseases in Heidelberg, Australia
| | - Andrew Talman
- Austin Health, Department of Intensive Care Medicine in Heidelberg, Australia
| | - Carmel Taylor
- Austin Health, Department of Intensive Care Medicine in Heidelberg, Australia
| | - Tammie McIntyre
- Austin Health, Department of Intensive Care Medicine in Heidelberg, Australia
| | - Jason Trubiano
- Austin Health, Department of Infectious Diseases in Heidelberg, Australia
| | - Daryl Jones
- Austin Health, Department of Intensive Care Medicine in Heidelberg, Australia
- The University of Melbourne, Department of Surgery in Melbourne, Australia
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Foley J, Walker S, Carlton E. Large-bore versus small-bore chest drains in traumatic haemopneumothorax: an international survey of current practice. Emerg Med J 2023; 40:651-652. [PMID: 37348966 DOI: 10.1136/emermed-2023-213278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/24/2023]
Affiliation(s)
- James Foley
- Emergency Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | | | - Edward Carlton
- Emergency Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
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Ghomashi B, Walker S, Becker A. Enabling elliptically polarized high harmonic generation with short cross polarized laser pulses. Sci Rep 2023; 13:12843. [PMID: 37553388 PMCID: PMC10409740 DOI: 10.1038/s41598-023-39814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
Enabling elliptically polarized high-order harmonics overcomes a historical limitation in the generation of this highly nonlinear process in atomic, molecular and optical physics with applications in other branches. Here, we shed new light on a controversy between experimental observations and theoretical predictions on the possibility to generate harmonics with large ellipticity using two bichromatic laser pulses which are linearly polarized in orthogonal directions. Results of numerical calculations confirm the previous experimental data that in short laser pulses even harmonics with large ellipticity can be obtained for the interaction of such cross-polarized laser pulses with atoms initially in a s- or p-state, while odd harmonics have low ellipticity. The amount of the ellipticity can be controlled via the relative carrier-envelope phase of the pulses, their intensity ratio and the duration of the pulses.
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Affiliation(s)
- B Ghomashi
- JILA and Department of Physics, University of Colorado, Boulder, CO, 80309-0440, USA.
| | - S Walker
- JILA and Department of Physics, University of Colorado, Boulder, CO, 80309-0440, USA
| | - A Becker
- JILA and Department of Physics, University of Colorado, Boulder, CO, 80309-0440, USA
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Lim AS, Walker S, Bothe T, Gray H, Liu E, Ong E. Investigating How Preregistrant Pharmacists Respond in Job Interviews. Am J Pharm Educ 2023; 87:100107. [PMID: 37597913 DOI: 10.1016/j.ajpe.2023.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 08/21/2023]
Abstract
OBJECTIVE To investigate what competencies and attributes preregistrant pharmacists draw upon in job interviews. METHODS We used a virtual mock job interview assessment asking preregistrant pharmacists to apply for an entry-level pharmacist position. Data were analyzed using a team-based framework analysis using an inductive and deductive approach and mapping responses to the National Competency Standards. RESULTS A total of 143 interview transcripts were included in the analysis. The top skills mentioned were leadership of self (98.6%) and communication and collaboration (96.5%). Despite graduating from a course with an integrated research curriculum, participants rarely reflected on research skills (31.5%) and no participant discussed any expertise in clinical topics or knowledge of specific professional services. Responses generally lacked specific skills and skills were spoken about broadly without relating to evidence/experience and were often not targeted to the job description. A proposal for educators aligned with competency standards was also developed based on the findings. CONCLUSION Preregistrant pharmacists perceive experience within the workforce and communication and collaboration as the most desired by employers for entry-level pharmacy positions. Education and research competencies were seen as least useful to the job. There was a disconnect between skills gained in university and translation to practice. Academics could enhance the better preregistrant pharmacists' reflection of the skills and competencies they have developed employability by (1) providing portfolio management from the beginning of the course that collects evidence and maps to competencies; (2) integrating learning opportunities across all competencies; and (3) regular skills coaching/mentoring from practicing pharmacists to ensure students are aware of current needs in the job market.
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Affiliation(s)
- Angelina S Lim
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
| | - Steven Walker
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Tahlia Bothe
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Hamilton Gray
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Esther Liu
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Eugene Ong
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia; Pharmacy Department, Monash Health, Melbourne, Victoria, Australia
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Roberts ME, Rahman NM, Maskell NA, Bibby AC, Blyth KG, Corcoran JP, Edey A, Evison M, de Fonseka D, Hallifax R, Harden S, Lawrie I, Lim E, McCracken DJ, Mercer R, Mishra EK, Nicholson AG, Noorzad F, Opstad K, Parsonage M, Stanton AE, Walker S. British Thoracic Society Guideline for pleural disease. Thorax 2023; 78:s1-s42. [PMID: 37433578 DOI: 10.1136/thorax-2022-219784] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Affiliation(s)
- Mark E Roberts
- Respiratory Medicine, Sherwood Forest Hospitals NHS Foundation Trust, Nottinghamshire, UK
| | - Najib M Rahman
- University of Oxford, Oxford Respiratory Trials Unit, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford, UK
- Oxford Pleural Unit, Churchill Hospital, Oxford, UK
| | - Nick A Maskell
- Academic Respiratory Unit, University of Bristol and North Bristol NHS Trust, Bristol, UK
| | - Anna C Bibby
- Academic Respiratory Unit, University of Bristol and North Bristol NHS Trust, Bristol, UK
| | - Kevin G Blyth
- Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK
- School of Cancer Sciences, University of Glasgow/Cancer Research UK Beatson Institute, Glasgow, UK
| | - John P Corcoran
- Interventional Pulmonology Service, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | - Matthew Evison
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Rob Hallifax
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Susan Harden
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Iain Lawrie
- Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Eric Lim
- Academic Division of Thoracic Surgery, The Royal Brompton Hospital and Imperial College London, London, UK
| | - David J McCracken
- Regional Respiratory Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Rachel Mercer
- Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Eleanor K Mishra
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, UK
| | - Farinaz Noorzad
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Maria Parsonage
- North Cumbria Integrated Care NHS Foundation Trust, Cumbria, UK
| | - Andrew E Stanton
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Steven Walker
- Academic Respiratory Unit, University of Bristol and North Bristol NHS Trust, Bristol, UK
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Walker S, Ojha S, Mitchell EJ. Parents and healthcare professionals' attitudes to Kangaroo Care for preterm infants in the UK. Acta Paediatr 2023. [PMID: 37073107 DOI: 10.1111/apa.16795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/01/2023] [Accepted: 04/18/2023] [Indexed: 04/20/2023]
Abstract
AIM To explore the attitudes of parents and healthcare professionals (HCPs), and facilitators and barrier to implementation of Kangaroo Care (KC) in the UK. METHODS Online cross-sectional survey; distributed via the British Association of Perinatal Medicine, Bliss (UK-based charity), social media. RESULTS Sixty HCPs responded. 37 (62%) were nurses/nurse practitioners. 57 (95%) regularly implement KC. The most important factor that supported KC implementation was the team's belief in benefits of KC. Increased workload, staff shortage, and fear about safely of KC in unwell infants were recognised as the challenges preventing implementation. 518 parents responded. 421 (81%) had a preterm baby within three years. 338 (80%) were familiar with KC. The main facilitator was the belief that their baby enjoyed it. Excess noise and crowding on the unit were the most frequently reported barriers. Lack of opportunity and limited staff support were the main reasons why they had been unable to practice KC. CONCLUSION We found that most HCPs and parents believe that KC is beneficial and would like to practice it. Lack of resources to enable effective implementation is the main barrier. Service development and implementation research is required to ensure that KC is delivered in all UK neonatal units.
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Affiliation(s)
- S Walker
- Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - S Ojha
- Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - E J Mitchell
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
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Henderson LM, St Clair M, Knowland V, van Rijn E, Walker S, Gaskell MG. Stronger Associations Between Sleep and Mental Health in Adults with Autism: A UK Biobank Study. J Autism Dev Disord 2023; 53:1543-1559. [PMID: 34860312 PMCID: PMC10066094 DOI: 10.1007/s10803-021-05382-1] [Citation(s) in RCA: 1] [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] [Accepted: 11/22/2021] [Indexed: 12/26/2022]
Abstract
This study examined sleep and its cognitive and affective correlates in adults with and without autism spectrum disorder (ASD), utilizing UK Biobank data. There were no group differences in subjective sleep duration [n = 220 ASD; n = 2200 general population (GP)]. Accelerometer measures of sleep duration or nighttime activity did not differ by group, but sleep efficiency was marginally lower in ASD (n = 83 ASD; n = 824 GP). Sleep efficiency was associated with wellbeing and mental health, and pathways between accelerometer sleep measures and wellbeing and mental health were significantly stronger for adults with ASD (who also reported substantially poorer wellbeing and > 5 × likelihood of experiencing mental distress). These findings highlight the need to monitor sleep to maintain good mental health in adult ASD.
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Affiliation(s)
- Lisa M Henderson
- Department of Psychology, University of York, York, YO10 5DD, UK.
| | - M St Clair
- Department of Psychology, University of Bath, Bath, UK
| | - V Knowland
- Department of Speech and Language Sciences, University of Newcastle, Newcastle, Australia
| | - E van Rijn
- Department of Psychology, University of York, York, YO10 5DD, UK
| | - S Walker
- Department of Psychology, University of York, York, YO10 5DD, UK
| | - M G Gaskell
- Department of Psychology, University of York, York, YO10 5DD, UK
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20
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Walker S, Pham TN, Duong QH, Brock TP, Lyons KM. Cognitive and Metacognitive Processes Demonstrated by Pharmacy Students When Making Therapeutic Decisions. Am J Pharm Educ 2023; 87:ajpe8817. [PMID: 35272985 PMCID: PMC10159031 DOI: 10.5688/ajpe8817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 03/07/2022] [Indexed: 05/03/2023]
Abstract
Objective. To characterize the types of cognitive and metacognitive processes demonstrated by third-year pharmacy students during a therapeutic reasoning activity.Methods. A qualitative, descriptive study following a think-aloud protocol was used to analyze the cognitive (analytical) and metacognitive processes observed by third-year pharmacy students as they completed a 25-minute therapeutic reasoning activity. Using a deductive codebook developed from literature about reasoning, two independent coders characterized processes from students' audio-recorded, transcribed think-aloud episodes while making therapeutic decisions about simulated clinical cases.Results. A total of 40 think-aloud episodes were transcribed among the cohort. Categorization of the think-aloud transcriptions revealed a series of cognitive analytical and metacognitive processes demonstrated by students during the therapeutic decision-making activity. A total of 1792 codes were categorized as analytical processes, falling into six major themes: 69% gathering information (1232/1792), 13% processing information (227/1792), 7% making assessments (133/1792), 1% synthesizing information (19/1792), 7% articulating evidence (117/1792), and 4% making a recommendation (64/1792). In comparison to gathering information, a much lower frequency of processing and assessment was observed for students, particularly for those that were unable to resolve the case. Students' movement between major analytical processes co-occurred commonly with metacognitive processes. Of the 918 codes categorized as metacognitive processes, two major themes arose: 28% monitoring for knowledge or emotions (257/918) and 72% controlling the planning of next steps or verification of correct information (661/918). Sequencing the codes and co-occurrences of processes allowed us to propose an integrated cognitive/metacognitive model of therapeutic reasoning for students.Conclusion. This study categorizes the cognitive (analytical) and metacognitive processes engaged during pharmacy students' therapeutic reasoning process. The findings can inform current instructional practices and further research into educational activities that can strengthen pharmacy students' therapeutic reasoning skills.
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Affiliation(s)
- Steven Walker
- Monash University, Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, VIC, Australia
| | - To Nhu Pham
- Monash University, Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, VIC, Australia
| | - Quang Hung Duong
- Monash University, Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, VIC, Australia
| | - Tina P Brock
- Monash University, Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, VIC, Australia
| | - Kayley M Lyons
- University of Melbourne, Centre for Digital Transformation of Health, Parkville, VIC, Australia
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Edwards N, Walker S, Paddick SM, Prina AM, Chinnasamy M, Reddy N, Mboya IB, Mtei M, Varghese M, Nakkasuja N, Guerra M, Sapkota N, Dotchin C. Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis. J Affect Disord 2023; 325:656-674. [PMID: 36681304 DOI: 10.1016/j.jad.2023.01.068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted. METHODS Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression. RESULTS One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings. LIMITATIONS The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis. DISCUSSION A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.
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Affiliation(s)
- N Edwards
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-Upon-Tyne, UK.
| | - S Walker
- Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - S-M Paddick
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Population Health Sciences Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - A M Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Chinnasamy
- Bradford Primary Care NHS Foundation Trust, Bradford, UK
| | - N Reddy
- Newcastle University, Newcastle-Upon-Tyne, UK
| | - I B Mboya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Mtei
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - N Nakkasuja
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - M Guerra
- Memory and Depression Centre, Cayetano Heredia Peruvian University, Peru
| | - N Sapkota
- B.P Koirala Institute of Health Sciences, Dhahran, Eastern Nepal, Nepal
| | - C Dotchin
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
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22
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Eastwood MC, Busby J, Jackson DJ, Pavord ID, Hanratty CE, Djukanovic R, Woodcock A, Walker S, Hardman TC, Arron JR, Choy DF, Bradding P, Brightling CE, Chaudhuri R, Cowan D, Mansur AH, Fowler SJ, Howarth P, Lordan J, Menzies-Gow A, Harrison T, Robinson DS, Holweg CTJ, Matthews JG, Heaney LG. A randomised trial of a T2-composite-biomarker strategy adjusting corticosteroidtreatment in severe asthma, a post- hoc analysis by sex. J Allergy Clin Immunol Pract 2023; 11:1233-1242.e5. [PMID: 36621603 DOI: 10.1016/j.jaip.2022.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Approximately 5-10% of patients with asthma have severe disease with a consistent preponderance in females. Current asthma guidelines recommend stepwise treatment to achieve symptom control with no differential treatment considerations for either sex. OBJECTIVES To examine whether patient sex affects outcomes when using a composite T2-biomarker score to adjust corticosteroid treatment in patients with severe asthma compared to standard care. METHODS Post-hoc analysis stratifying patient outcomes by sex of a 48-week, multicentre, randomised controlled clinical trial comparing a biomarker-defined treatment algorithm with standard care. The primary outcome was the proportion of patients with a reduction in corticosteroid treatment (inhaled (ICS) and oral (OCS) corticosteroids). Secondary outcomes included exacerbation rates, hospital admissions and lung function. RESULTS Of 301 patients randomised; 194 (64.5%) were females and 107 (35.5%) were males. The biomarker algorithm led to a greater proportion of females being on a lower corticosteroid dose vs standard care which was not seen in males (effects estimate females: 3.57, 95% CI: 1.14, 11.18 vs. males 0.54, 95% CI: 0.16, 1.80). In T2-biomarker low females, reducing corticosteroid dose was not associated with increased exacerbations. Females scored higher in all ACQ-7 domains, but with no difference when adjusted for BMI/ anxiety and/or depression. Dissociation between symptoms and T2-biomarkers were noted in both sexes, with a higher proportion of females being symptom high/T2-biomarker low (22.8% vs. 15.6%; p=0.0002), whereas males were symptom low/T2-biomarker high (11.4% vs. 22.3%; p<0.0001). CONCLUSION This exploratory post-hoc analysis identified females achieved a greater benefit from biomarker-directed corticosteroid optimisation versus symptom-directed treatment.
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Affiliation(s)
- M C Eastwood
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
| | - J Busby
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
| | | | - I D Pavord
- Oxford Respiratory, NIHR BRC, Nuffield Department of Medicine, The University of Oxford, Oxford, UK.
| | - C E Hanratty
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
| | - R Djukanovic
- University of Southampton, NIHR Southampton Biomedical Research Centre, Southampton, UK.
| | - A Woodcock
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.
| | - S Walker
- Asthma UK 18 Mansell Street, London, UK.
| | - T C Hardman
- Niche Science & Technology Unit 26, Falstaff House, Bardolph Road, Richmond TW9 2LH.
| | - J R Arron
- Genentech Inc., South San Francisco, California, USA.
| | - D F Choy
- Genentech Inc., South San Francisco, California, USA.
| | - P Bradding
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, UK.
| | - C E Brightling
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, UK.
| | - R Chaudhuri
- NHS Greater Glasgow and Clyde Health Board, Gartnavel Hospital, Glasgow, UK NHS Greater Glasgow and Clyde, Stobhill Hospital, Glasgow, UK.
| | - D Cowan
- NHS Greater Glasgow and Clyde, Stobhill Hospital, Glasgow, UK.
| | - A H Mansur
- University of Birmingham and Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UK.
| | - S J Fowler
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.
| | - P Howarth
- School of Clinical and Experimental Sciences, University of Southampton, NIHR, Southampton Biomedical Research Centre, Southampton, UK.
| | - J Lordan
- The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne.
| | - A Menzies-Gow
- Royal Brompton & Harefield NHS Foundation Trust, London, UK.
| | - T Harrison
- UK Nottingham Respiratory NIHR Biomedical Research Centre ,University of Nottingham, Nottingham, UK School of Clinical and Experimental Sciences.
| | - D S Robinson
- University College Hospitals NHS Foundation Trust, London, UK.
| | - C T J Holweg
- Genentech Inc., South San Francisco, California, USA.
| | - J G Matthews
- Peter Gorer Department of Immunobiology, Kings College, London; 23andMe, Sunnyvale, California, USA.
| | - L G Heaney
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Jha A, Ward T, Walker S, Goodwin AT, Chalmers JD. Review of the British Thoracic Society Winter Meeting 2021, 24-26 November 2021. Thorax 2022; 77:1030-1035. [PMID: 35907640 DOI: 10.1136/thorax-2022-219150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/13/2022] [Indexed: 11/04/2022]
Abstract
The Winter Meeting of the British Thoracic Society (BTS) is a platform for the latest clinical and scientific research in respiratory medicine. This review summarises the key symposia and presentations from the BTS Winter Meeting 2021 held online due to the COVID-19 pandemic.
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Affiliation(s)
- Akhilesh Jha
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Tom Ward
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Steven Walker
- School of Clinical Sciences, University of Bristol Academic Respiratory Unit, Westbury on Trym, UK
| | - Amanda T Goodwin
- Nottingham NIHR Respiratory Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
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Kennedy A, Vollenhoven B, Hiscock R, Stern C, Walker S, Cheong J, Quach J, Hastie R, Wilkinson D, McBain J, Gurrin L, Tong S, Lindquist A. O-085 School-Age Outcomes Among IVF-Conceived Children: A Causal Inference Analysis Using Linked Population-Wide Data. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.099] [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: 11/13/2022] Open
Abstract
Abstract
Study question
To determine the causal effect of in-vitro fertilisation (IVF) on primary school-age childhood developmental and educational outcomes, compared with outcomes following spontaneous conception.
Summary answer
The school-age developmental and educational outcomes for children conceived by IVF are equivalent to those of spontaneously conceived peers.
What is known already
More than 8 million children have been conceived globally with the assistance of in-vitro fertilization (IVF). Large cohort studies have suggested an increase in the frequency of congenital abnormalities, autism spectrum disorder, developmental-delay and intellectual disability in children conceived via IVF. Educational and cognitive outcomes following IVF conception have not yet been adequately established. Two large Scandinavian studies (Norrman et al 2018 and Wienecke et al 2020) found poorer educational outcomes in children born after IVF-conception.
Study design, size, duration
Causal inference methods (based on the potential outcomes approach) were used to analyse observation data in a way that emulates the results of a target randomised clinical trial. The study cohort comprised state-wide linked maternal and childhood administrative data from Victoria, Australia.
Participants/materials, setting, methods
The study included singleton infants conceived spontaneously or via IVF and born between 2005-2014. The exposure of interest was conception via IVF, with those born after spontaneous conception as the control group. Two separate measures of childhood outcome were examined: The Australian Early Developmental Consensus (AEDC), (age 4-6); and the National Assessment Program – Literacy and Numeracy (NAPLAN) at age 7-9. We combined inverse probability weighting with regression adjustment to estimate population average causal effects.
Main results and the role of chance
The final cohort included 412,713 children across the two outcome cohorts. Linked records were available for 4,697 IVF-conceived cases and 168,503 controls for AEDC outcome data, and 8,976 cases and 333,335 controls for NAPLAN data. The mothers of IVF-conceived children were older, more highly educated mothers, who lived in more socio-economic advantaged areas and were less likely to be from non-English speaking backgrounds. There was no causal effect of IVF-conception on the on the risk of developmental vulnerability at school-entry compared to spontaneously conceived children, as defined by AEDC metrics; with an adjusted risk difference of -0.3% (95% CI -3.7% to 3.1%) and an adjusted risk ratio of 0.97 (95% CI 0.77 to 1.25). At age 7-9 years, there was no causal effect of IVF-conception on the NAPLAN overall z-score, adjusted mean difference of 0.030 (95% CI -0.018 to 0.077) between IVF-conceived and spontaneously conceived children.
Given the use of observational data, there were missing data and inherent differences in the covariate profile of the exposure cohorts. Multiple imputation and doubly robust inverse probability weighting regression adjustment modelling was utilised to allow a causal interpretation of results.
Limitations, reasons for caution
Children who did not attend school due to severe disability were not included, possibly leading to selection bias. It is possible that unmeasured common cause confounders could have led to bias in estimating the average treatment effects.
Wider implications of the findings
This study, in contrast to previous evidence, suggests that conception via IVF does not affect early childhood developmental and educational outcomes. These findings provide important reassurance for current and prospective parents, and clinicians alike.
Trial registration number
Not applicable
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Affiliation(s)
- A Kennedy
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - B Vollenhoven
- Monash University, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - R Hiscock
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - C Stern
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - S Walker
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - J Cheong
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - J Quach
- University of Melbourne, Graduate School of Education, Melbourne , Australia
| | - R Hastie
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - D Wilkinson
- City Fertility Centre, Clinical Services, Melbourne , Australia
| | - J McBain
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - L Gurrin
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne , Australia
| | - S Tong
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
| | - A Lindquist
- University of Melbourne, Department of Obstetrics and Gynaecology, Melbourne , Australia
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Laundal KM, Reistad JP, Hatch SM, Madelaire M, Walker S, Hovland AØ, Ohma A, Merkin VG, Sorathia KA. Local Mapping of Polar Ionospheric Electrodynamics. J Geophys Res Space Phys 2022; 127:e2022JA030356. [PMID: 35860288 PMCID: PMC9285517 DOI: 10.1029/2022ja030356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
An accurate description of the state of the ionosphere is crucial for understanding the physics of Earth's coupling to space, including many potentially hazardous space weather phenomena. To support this effort, ground networks of magnetometer stations, optical instruments, and radars have been deployed. However, the spatial coverage of such networks is naturally restricted by the distribution of land mass and access to necessary infrastructure. We present a new technique for local mapping of polar ionospheric electrodynamics, for use in regions with high data density, such as Fennoscandia and North America. The technique is based on spherical elementary current systems (SECS), which were originally developed to map ionospheric currents. We expand their use by linking magnetic field perturbations in space and on ground, convection measurements from space and ground, and conductance measurements, via the ionospheric Ohm's law. The result is a technique that is similar to the Assimilative Mapping of Ionospheric Electrodynamics (AMIE) technique, but tailored for regional analyses of arbitrary spatial extent and resolution. We demonstrate our technique on synthetic data, and with real data from three different regions. We also discuss limitations of the technique and potential areas for improvement.
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Affiliation(s)
- K M Laundal
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - J P Reistad
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - S M Hatch
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - M Madelaire
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - S Walker
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - A Ø Hovland
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - A Ohma
- Department of Physics and Technology Birkeland Centre for Space Science University in Bergen Bergen Norway
| | - V G Merkin
- Applied Physics Laboratory Johns Hopkins University Laurel MD USA
| | - K A Sorathia
- Applied Physics Laboratory Johns Hopkins University Laurel MD USA
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Al‐Diery T, Page AT, Johnson JL, Walker S, Sandulache D, Wilby KJ. Evidence for the development of skills for education, leadership and innovation through experiential‐based foundational pharmacy residency programs: a narrative review. Pharmacy Practice and Res 2022. [DOI: 10.1002/jppr.1804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tarik Al‐Diery
- Pharmacy Department Alfred Health Melbourne Australia
- School of Pharmacy University of Otago Dunedin New Zealand
| | - Amy Theresa Page
- Pharmacy Department Alfred Health Melbourne Australia
- Centre for Medicine Use and Safety Clayton Monash University Clayton Australia
| | - Jacinta Lee Johnson
- UniSA Clinical and Health Sciences University of South Australia Adelaide Australia
- SA Health SA Pharmacy Adelaide Australia
| | - Steven Walker
- Pharmacy Department Alfred Health Melbourne Australia
| | | | - Kyle John Wilby
- College of Pharmacy, Faculty of Health Dalhousie University Halifax Nova Scotia Canada
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Rissanen J, Walker S, Pareja-Blanco F, Häkkinen K. Velocity-based resistance training: do women need greater velocity loss to maximize adaptations? Eur J Appl Physiol 2022; 122:1269-1280. [PMID: 35258681 PMCID: PMC9012837 DOI: 10.1007/s00421-022-04925-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/19/2022] [Indexed: 11/26/2022]
Abstract
Purpose Men and women typically display different neuromuscular characteristics, force–velocity relationships, and differing strength deficit (upper vs. lower body). Thus, it is not clear how previous recommendations for training with velocity-loss resistance training based on data in men will apply to women. This study examined the inter-sex differences in neuromuscular adaptations using 20% and 40% velocity-loss protocols in back squat and bench press exercises. Methods The present study employed an 8-week intervention (2 × week) comparing 20% vs. 40% velocity-loss resistance training in the back squat and bench press exercises in young men and women (~ 26 years). Maximum strength (1-RM) and submaximal-load mean propulsive velocity (MPV) for low- and high-velocity lifts in squat and bench press, countermovement jump and vastus lateralis cross-sectional area were measured at pre-, mid-, and post-training. Surface EMG of quadriceps measured muscle activity during performance tests. Results All groups increased 1-RM strength in squat and bench press exercises, as well as MPV using submaximal loads and countermovement jump height (P < 0.05). No statistically significant between-group differences were observed, but higher magnitudes following 40% velocity loss in 1-RM (g = 0.60) and in low- (g = 1.42) and high-velocity (g = 0.98) lifts occurred in women. Training-induced improvements were accompanied by increases in surface EMG amplitude and vastus lateralis cross-sectional area. Conclusion Similar increases in strength and power performance were observed in men and women over 8 weeks of velocity-based resistance training. However, some results suggest that strength and power gains favor using 40% rather than 20% velocity loss in women.
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Affiliation(s)
- J Rissanen
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Room VIV225, 40014, Jyväskylä, Finland
| | - S Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Room VIV225, 40014, Jyväskylä, Finland.
| | - F Pareja-Blanco
- Department of Sports and Computer Sciences, Physical Performance and Sports Research Center, Universidad Pablo de Olavide, Seville, Spain
| | - K Häkkinen
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Room VIV225, 40014, Jyväskylä, Finland
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Kuhn M, Gonzalez E, Weil L, Izguttinov A, Walker S. Effectiveness of Child-Focused Interventions for Externalizing Behavior: a Rapid Evidence Review. Res Child Adolesc Psychopathol 2022; 50:987-1009. [PMID: 35212851 DOI: 10.1007/s10802-022-00904-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
Parent behavior management training (BMT) is well established as an effective, evidence-based treatment for children with externalizing behavior. Despite the wealth of data supporting BMT, many community providers use a variety of child-focused and non-directive interventions to target behavior problems. There is lack of clarity as to whether the evidence supporting child-focused externalizing treatments is sufficiently compelling to support offering these treatments rather than or in addition to BMT. This rapid evidence review compares the effectiveness of BMT with several common child-focused interventions for externalizing behavior including cognitive behavioral (CBT), social skill (SS), and play/dynamic (PT) approaches. PubMed, PsychINFO, and Web of Science were searched for English-language articles from year 2000 onwards for each intervention type. Inclusion criteria were child age (12 and under), presence of a child-focused behavioral treatment condition, and externalizing behavior as an outcome variable. A total of 30 studies met inclusion criteria and were coded (13 CBT, 10 SS, 7 PT). Results supported social skills interventions with accompanying BMT as effective in improving externalizing problems, with generally moderate effect sizes. Individual social skills interventions were promising but needing further evaluation compared to treatment as usual. CBT treatments with and without accompanying BMT showed moderate effects over waitlist but produced less consistently significant effects compared to more robust controls. Play therapy approaches showed inconsistent effects and require further evaluation. This review supports social skills plus BMT treatments as a child-focused intervention with probable efficacy for child externalizing problems. Implications for policy and community practice are discussed.
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Affiliation(s)
- M Kuhn
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA. .,University of Washington Child and Adolescent Psychiatry, Seattle, WA, USA.
| | - E Gonzalez
- Seattle Children's Hospital and Research Institute, Seattle, WA, USA.,University of Washington Child and Adolescent Psychiatry, Seattle, WA, USA
| | - L Weil
- University of Washington Evidence Based Practice Institute, Seattle, WA, USA
| | - A Izguttinov
- University of Washington Evidence Based Practice Institute, Seattle, WA, USA
| | - S Walker
- University of Washington Evidence Based Practice Institute, Seattle, WA, USA
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Aung AK, Walker S, Khu YL, Tang MJ, Lee JI, Graudins LV. Adverse drug reaction management in hospital settings: review on practice variations, quality indicators and education focus. Eur J Clin Pharmacol 2022; 78:781-791. [PMID: 35171316 PMCID: PMC9005418 DOI: 10.1007/s00228-022-03287-1] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/31/2022] [Indexed: 11/28/2022]
Abstract
Purpose Adverse drug reactions (ADRs) contribute significantly to healthcare burden. However, they are largely preventable through appropriate management processes. This narrative review aims to identify the quality indicators that should be considered for routine monitoring of processes within hospital ADR management systems. It also examines the potential reasons behind variation in ADR management practices amongst HCPs, and explores possible solutions, focusing on targeted education programmes, to improve both the quality and quantity indicators of ADR management processes. Methods A comprehensive literature review was conducted to explore relevant themes and topics concerning ADR management, quality indicators and educational interventions. Results Substantial variability exists in ADR management amongst healthcare professionals (HCPs) with regard to reporting rates, characteristics of ADRs reported, quality of assessment, completeness of reports and, most importantly, risk communication practices. These variable practices not only threaten patient safety but also undermine pharmacovigilance processes. To date, quality indicators to monitor ADR management practices within hospital settings remain ill-defined. Furthermore, evidence behind effective interventions, especially in the form of targeted education strategies, to improve the quality of ADR management remains limited. Conclusions The focus of ADR management in hospitals should be to promote patient safety through comprehensive assessment, risk communication and safe prescribing. There is a need to develop a system to define, measure and monitor the quality of ADR management. Educational strategies may help improve the quality of ADR management processes.
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Affiliation(s)
- Ar Kar Aung
- Department of General Medicine, Alfred Hospital, Melbourne, Australia. .,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Steven Walker
- Department of Pharmacy, Alfred Hospital, Melbourne, Australia
| | - Yin Li Khu
- Department of General Medicine, Alfred Hospital, Melbourne, Australia
| | - Mei Jie Tang
- Department of General Medicine, Alfred Hospital, Melbourne, Australia
| | - Jennifer I Lee
- Department of Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, USA.,Quality Improvement Academy, Weill Cornell Medicine, New York, USA
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Gao S, Porumb M, Mumith A, Parker A, Walker S, Jones G, Chartsias A, Oliveira J, Hawkes W, Sarwar R, Leeson P, Woodward G, Beqiri A. Fully automated quantification of LV regional wall motion from echocardiograms to detect myocardial infarction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Ultromics Ltd
Background
Myocardial wall motion analysis from echocardiography allows precise assessment of cardiac contractile function. Strain, which assesses myocardial deformation, has been shown to enable earlier detection of myocardial disease [1]. Current analysis software packages [2] use semi-automated methods to compute strain, which frequently require manual endocardial delineation and iterative contour adjustment based on tracking results, respectively, causing significant variability.
Purpose
We present a fully automated pipeline for tracking left ventricular (LV) wall motion to quantify global and segmental longitudinal strain from 2D echocardiograms, and go on to validate the pipeline with an openly available myocardial infarction (MI) dataset.
Methods
We applied our existing deep learning-based automated contouring method [3] to delineate the endocardial border in the A4C, A2C and A3C views and combined this with spline-based elastic image registration to track LV motion through time. We sampled points from a region of interest initiated from the endocardial border at the end-diastolic (ED) frame, and tracked subsequent motion by recomputing updated positions of all sample points based on each frame‘s displacement field, enabling us to both track the myocardium throughout the cardiac cycle and calculate longitudinal strain relative to the ED frame. The automated endocardial contour was used to regularise the process. The pipeline was independently tested on the HMC-QU dataset [4] which was downloaded from Kaggle and consists of a single cardiac cycle from the A4C view from 160 patients who were diagnosed with an acute MI and underwent echocardiography either prior to percutaneous coronary intervention or within 24 hours of undergoing the procedure; the dataset includes the labels of ED and end-systolic (ES) frames, as well as the presence of an MI in 6 segments excluding the apical cap (Fig 1a), as determined by the consensus of cardiologists from HMC Hospital in Qatar. The Wilcoxon signed-rank test was used to compare peak strain between the MI and non-MI segments; ROC curves were computed to compare the performance of the automatically derived peak longitudinal strain against the MI labels.
Results
Fig 1b shows ROC curves of peak segmental longitudinal strain for detecting MI, with the best performance in the mid-anterolateral segment (AUC 0.84), and a lower performance for basal segments than mid and apical segments, consistent with known variation in clinical practice [5]. Fig 2 shows that peak longitudinal strain computed from our pipeline was statistically significantly more positive in segments with an MI.
Conclusions
We present a fully automated pipeline for calculating segmental strain across a cardiac cycle to identify infarcted segments without any observer variability. Clinical application of this method has the potential to identify and monitor regional myocardial function and benefit patient management. Abstract Figure. Fig1. ROC of peak longitudinal strains Abstract Figure. Fig2.Boxplot of peak longitudinal strain
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Affiliation(s)
- S Gao
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - M Porumb
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A Mumith
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A Parker
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Walker
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - G Jones
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A Chartsias
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J Oliveira
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - W Hawkes
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - R Sarwar
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - P Leeson
- John Radcliffe Hospital, Cardiovascular Clinical Research Facility, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - G Woodward
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A Beqiri
- Ultromics Ltd, Oxford, United Kingdom of Great Britain & Northern Ireland
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Rees G, Brough L, Orsatti GM, Lodge A, Walker S. Do Micronutrient and Omega-3 Fatty Acid Supplements Affect Human Maternal Immunity during Pregnancy? A Scoping Review. Nutrients 2022; 14:367. [PMID: 35057548 PMCID: PMC8781537 DOI: 10.3390/nu14020367] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
Maternal dietary micronutrients and omega-3 fatty acids support development of the fetal and neonatal immune system. Whether supplementation is similarly beneficial for the mother during gestation has received limited attention. A scoping review of human trials was conducted looking for evidence of biochemical, genomic, and clinical effects of supplementation on the maternal immune system. The authors explored the literature on PubMed, Cochrane Library, and Web of Science databases from 2010 to the present day using PRISMA-ScR methodology. Full-length human trials in English were searched for using general terms and vitamin A, B12, C, D, and E; choline; iodine; iron; selenium; zinc; and docosahexaenoic/eicosapentaenoic acid. Of 1391 unique articles, 36 were eligible for inclusion. Diverse biochemical and epigenomic effects of supplementation were identified that may influence innate and adaptive immunity. Possible clinical benefits were encountered in malaria, HIV infections, anemia, Type 1 diabetes mellitus, and preventing preterm delivery. Only limited publications were identified that directly explored maternal immunity in pregnancy and the effects of micronutrients. None provided a holistic perspective. It is concluded that supplementation may influence biochemical aspects of the maternal immune response and some clinical outcomes, but the evidence from this review is not sufficient to justify changes to current guidelines.
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Affiliation(s)
- Gail Rees
- School of Biomedical Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK
| | - Louise Brough
- School of Food and Advanced Technology, Massey University, Palmerston North 4442, New Zealand
| | | | - Anna Lodge
- St Gilesmedical, London WC2H 8LG, UK; (A.L.); (S.W.)
| | - Steven Walker
- St Gilesmedical, London WC2H 8LG, UK; (A.L.); (S.W.)
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Hallifax RJ, Walker S, Walters J, Maskell N, Rahman NM. Management of primary spontaneous pneumothorax: less is more - Authors' reply. Lancet 2021; 396:1973-1974. [PMID: 33341133 DOI: 10.1016/s0140-6736(20)32676-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Rob J Hallifax
- Oxford Centre for Respiratory Medicine, University of Oxford, Oxford OX3 7LE, UK.
| | - Steven Walker
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - James Walters
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Nick Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - Najib M Rahman
- Oxford Centre for Respiratory Medicine, University of Oxford, Oxford OX3 7LE, UK
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Walker S, Froehlich A. Contained Transvaginal Specimen Removal: A Simple Technique Using Materials Readily Available in the MIGS Operating Room. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lawton E, Antczak P, Walker S, Germain-Cripps E, Falciani F, Routledge EJ. An investigation into the biological effects of indirect potable reuse water using zebrafish embryos. Sci Total Environ 2021; 789:147981. [PMID: 34323829 DOI: 10.1016/j.scitotenv.2021.147981] [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] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 06/13/2023]
Abstract
Advanced treatment technologies are being assessed as a proactive measure to assist with the transformation of treated wastewater into a source of water for potable water production. We investigated the biological effects along an advanced water treatment pilot plant, using zebrafish embryos throughout early development. The study compared phenotypic observations with global transcriptome responses, enabling us to keep an open mind about the chemicals that might influence the biological activity. There was no evidence of acute toxicity at any treatment stage, but skeletal, cardiovascular and pigmentation changes occurred in a small proportion of embryos along the treatment process, and in a tap water; not detected in the aquarium water control. Reverse osmosis (RO) reduced the concentration of measured chemical contaminants in the water the most, while eliminating the occurrence of abnormalities detected in fish embryos. Conversely, advanced oxidation reversed the benefits of RO treatment by increasing the frequency of teratogenic and sub-lethal abnormalities seen. Using the molecular responses of zebrafish embryos to different IPR water, we report the bioactivity within the water at different stages of advanced treatment and associate these to perturbed biological functions. Transcriptomic analysis revealed alterations to the retinoid system, which was consistent with the observed teratogenic effects. Changes to tryptophan metabolism (associated with the production of melatonin required for the control of normal circadian rhythms) and somatolactin-beta (associated with normal pigmentation in fish) were also found. We show that underexplored forms of biological activity occur in treated wastewater effluent, and/or may be created depending on the type of advanced treatment process used. By integrating the available analytical chemistry we highlight chemical groups associated to this response. Our study shows that more detailed and in-depth characterisation of chemicals and biological pathways associated with advanced treatment water systems are needed to mitigate possible risks to downstream organisms.
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Affiliation(s)
- E Lawton
- Brunel University London, Institute for Environment Health and Societies, UB8 3PH, UK
| | - P Antczak
- University of Liverpool, Institute of Systems, Molecular and Integrative Biology, L69 7ZB, UK; University of Cologne, Faculty of Medicine and Cologne University Hospital, Center for Molecular Medicine Cologne, 50931 Cologne, Germany
| | - S Walker
- Brunel University London, Institute for Environment Health and Societies, UB8 3PH, UK
| | | | - F Falciani
- University of Liverpool, Institute of Systems, Molecular and Integrative Biology, L69 7ZB, UK
| | - E J Routledge
- Brunel University London, Institute for Environment Health and Societies, UB8 3PH, UK.
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36
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Walker S, Reiff R, Jaron-Becker A, Becker A. Characterization of vacuum and deep ultraviolet pulses via two-photon autocorrelation signals. Opt Lett 2021; 46:3083-3086. [PMID: 34197386 DOI: 10.1364/ol.427200] [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] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
Characterization of ultrashort vacuum and deep ultraviolet pulses is important in view of applications of those pulses for spectroscopic and dynamical imaging of atoms, molecules, and materials. We present an extension of the autocorrelation technique, applied for measurement of the pulse duration via a single Gaussian function. Analytic solutions for two-photon ionization of atoms by Gaussian pulses are used along with an expansion of the pulse to be characterized using multiple Gaussians at multi-color central frequencies. This approach allows one to use two-photon autocorrelation signals to characterize isolated ultrashort pulses and pulse trains, i.e., the time-dependent amplitude and phase variation of the electric field. The potential of the method is demonstrated using vacuum and deep ultraviolet pulses and pulse trains obtained from numerical simulations of macroscopic high harmonic spectra.
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Whiteman J, Maiden N, Wylie E, McGoldrick V, Walker S, Liggett N, Neville LA, McAteer C, Boyce T, McWilliams LA. P008 Improving patient care cost-effectively through a virtual rheumatology biologic clinic. Rheumatology (Oxford) 2021. [DOI: 10.1093/rheumatology/keab247.007] [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: 11/14/2022] Open
Abstract
Abstract
Background/Aims
There are currently around 1,000 rheumatology patients on biologic therapy in the Southern Health and Social Care Trust (SHSCT) with annual growth of > 15%. Challenges facing the Rheumatology Biologics Service include: Continued increase in demand for biologics which makes timely review and management of patients difficult to maintain; Increased availability of approved treatments for inflammatory disease which makes drug choice difficult; Regional budget constraints and the need to comply with regional efficiency savings. Expenditure in SHSCT for rheumatology biologics in 2019 was over £5.5 million. A new service model, the multidisciplinary Virtual Rheumatology Biologics Clinic (VRBC) was established to address some of the challenges facing the Rheumatology Biologics Service.
Methods
The VRBC was introduced in May 2019 after a successful ‘Invest to Save’ proposal to the Health and Social Care Board by the lead clinician (NM). Detailed biologic drug pathways reflective of drug cost, current guidelines and patient factors and a drug tapering protocol were agreed by the rheumatology team. Each week appropriate patients were identified who were either stable and 'in remission’, had grumbling disease and needed a treatment consideration or could be switched to a biosimilar drug. Treatment recommendations were made and communicated to the clinicians seeing these patients in clinic the following week. The aim of the VRBC was to: Improve the care provided to patients by facilitating multidisciplinary review of patients; Facilitate medicines optimisation enabling a minimum 5% reduction in 2019 expenditure on biologic drugs; Introduce tapering of the biologic doses of patients in stable remission for 10% of patients.
Results
In the first 24 weeks of the VRBC, 928 patients attended biologic review clinics. Treatment recommendations were implemented in 283 (30%) patients. 172 patients were switched to biosimilar drug, 56 patients had their biologic drug changed to an alternative and 50 had their dose of biologic tapered. Going forward, switching of these 172 patients will lead to savings of £30,078 per month on biologic spend. Optimisation of biologic drugs will lead to savings of £4,592/month in 56 patients and tapering of drug dose will lead to savings of approximately £11,335/month in 50 patients going forward.
Conclusion
Regular virtual clinics have facilitated multidisciplinary review of biologic patients and medicines optimisation within Rheumatology. Clinicians choose biologic drug based on safety, evidence-based guidelines, patient factors and cost. Drug dose tapering was achieved in 5.4% (n = 50) of patients seen at clinic. This number will increase as the clinic progresses because patients newly switched to biosimilar drugs were not considered for tapering. A 5% reduction in expenditure on biologic drugs last year is achievable through dose tapering and choice of cost-effective drugs.
Disclosure
J. Whiteman: None. N. Maiden: None. E. Wylie: None. V. McGoldrick: None. S. Walker: None. N. Liggett: None. L. Neville: None. C. McAteer: None. T. Boyce: None. L. McWilliams: None.
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Affiliation(s)
- J Whiteman
- Pharmacy Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - N Maiden
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - E Wylie
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - V McGoldrick
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - S Walker
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - N Liggett
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - L-A Neville
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - C McAteer
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - T Boyce
- Pharmacy Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
| | - L-A McWilliams
- Rheumatology Department, Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UNITED KINGDOM
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Awan MA, Grierson DJ, Walker S. Bilateral macular sub‐retinal fluid and retinal pigment epithelial detachment associated with type 2 membrano‐proliferative glomerulonephritis. Clin Exp Optom 2021; 91:476-9. [DOI: 10.1111/j.1444-0938.2008.00268.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Muhammad Amer Awan
- Hairmyres Hospital, Glasgow, United Kingdom
- Gartnavel General Hospital, Glasgow, United Kingdom
E‐mail:
| | | | - S Walker
- Gartnavel General Hospital, Glasgow, United Kingdom
E‐mail:
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39
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Walker S, Paterson C. Keep Calm and Carry on: Safety, Feasibility and Early Outcomes of Head and Neck Cancer Treatment During the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2021; 33:e223-e224. [PMID: 33549462 PMCID: PMC7817453 DOI: 10.1016/j.clon.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/20/2022]
Affiliation(s)
- S Walker
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Paterson
- Beatson West of Scotland Cancer Centre, Glasgow, UK
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40
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Fitzgerald DB, Muruganandan S, Tsim S, Ip H, Asciak R, Walker S, Uribe Becerra JP, Majid A, Ahmed L, Rahman NM, Maskell NA, Blyth KG, Lee YCG. Intrapleural Fibrinolytics and Deoxyribonuclease for Treatment of Indwelling Pleural Catheter-Related Pleural Infection: A Multi-Center Observational Study. Respiration 2021; 100:452-460. [PMID: 33784710 DOI: 10.1159/000514643] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Indwelling pleural catheters (IPC) are increasingly used for management of recurrent (especially malignant) effusions. Pleural infection associated with IPC use remains a concern. Intrapleural therapy with tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) significantly reduces surgical referrals in non-IPC pleural infection, but data on its use in IPC-related pleural infection are scarce. OBJECTIVE To assess the safety and efficacy of intrapleural tPA and DNase in IPC-related pleural infection. METHODS Patients with IPC-related pleural infection who received intrapleural tPA/DNase in five Australian and UK centers were identified from prospective databases. Outcomes on feasibility of intrapleural tPA/DNase delivery, its efficacy and safety were recorded. RESULTS Thirty-nine IPC-related pleural infections (predominantly Staphylococcus aureus and gram-negative organisms) were treated in 38 patients; 87% had malignant effusions. In total, 195 doses (median 6 [IQR = 3-6]/patient) of tPA (2.5 mg-10 mg) and DNase (5 mg) were instilled. Most (94%) doses were delivered via IPCs using local protocols for non-IPC pleural infections. The mean volume of pleural fluid drained during the first 72 h of treatment was 3,073 (SD = 1,685) mL. Most (82%) patients were successfully treated and survived to hospital discharge without surgery; 7 required additional chest tubes or therapeutic aspiration. Three patients required thoracoscopic surgery. Pleurodesis developed post-infection in 23/32 of successfully treated patients. No major morbidity/mortality was associated with tPA/DNase. Four patients received blood transfusions; none had systemic or significant pleural bleeding. CONCLUSION Treatment of IPC-related pleural infection with intrapleural tPA/DNase instillations via the IPC appears feasible and safe, usually without additional drainage procedures or surgery. Pleurodesis post-infection is common.
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Affiliation(s)
- Deirdre B Fitzgerald
- Sir Charles Gairdner Hospital, Perth, Washington, Australia.,Institute for Respiratory Health, Perth, Washington, Australia.,University of Western Australia, Perth, Washington, Australia
| | - Sanjeevan Muruganandan
- Sir Charles Gairdner Hospital, Perth, Washington, Australia.,University of Western Australia, Perth, Washington, Australia.,Northern Hospital, Epping, Victoria, Australia
| | - Selina Tsim
- Queen Elizabeth University Hospital, Glasgow, United Kingdom.,Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Hugh Ip
- Guy's and St. Thomas' Hospital, London, United Kingdom
| | - Rachelle Asciak
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Steven Walker
- Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | | | - Adnan Majid
- Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, Massachusetts, USA
| | - Liju Ahmed
- Guy's and St. Thomas' Hospital, London, United Kingdom
| | - Najib M Rahman
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Nick A Maskell
- Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Kevin G Blyth
- Queen Elizabeth University Hospital, Glasgow, United Kingdom.,Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Y C Gary Lee
- Sir Charles Gairdner Hospital, Perth, Washington, Australia.,Institute for Respiratory Health, Perth, Washington, Australia.,University of Western Australia, Perth, Washington, Australia
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41
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Kosmicki JA, Horowitz JE, Banerjee N, Lanche R, Marcketta A, Maxwell E, Bai X, Sun D, Backman JD, Sharma D, Kang HM, O'Dushlaine C, Yadav A, Mansfield AJ, Li AH, Watanabe K, Gurski L, McCarthy SE, Locke AE, Khalid S, O'Keeffe S, Mbatchou J, Chazara O, Huang Y, Kvikstad E, O'Neill A, Nioi P, Parker MM, Petrovski S, Runz H, Szustakowski JD, Wang Q, Wong E, Cordova-Palomera A, Smith EN, Szalma S, Zheng X, Esmaeeli S, Davis JW, Lai YP, Chen X, Justice AE, Leader JB, Mirshahi T, Carey DJ, Verma A, Sirugo G, Ritchie MD, Rader DJ, Povysil G, Goldstein DB, Kiryluk K, Pairo-Castineira E, Rawlik K, Pasko D, Walker S, Meynert A, Kousathanas A, Moutsianas L, Tenesa A, Caulfield M, Scott R, Wilson JF, Baillie JK, Butler-Laporte G, Nakanishi T, Lathrop M, Richards JB, Jones M, Balasubramanian S, Salerno W, Shuldiner AR, Marchini J, Overton JD, Habegger L, Cantor MN, Reid JG, Baras A, Abecasis GR, Ferreira MA. A catalog of associations between rare coding variants and COVID-19 outcomes. medRxiv 2021:2020.10.28.20221804. [PMID: 33655273 PMCID: PMC7924298 DOI: 10.1101/2020.10.28.20221804] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19), a respiratory illness that can result in hospitalization or death. We investigated associations between rare genetic variants and seven COVID-19 outcomes in 543,213 individuals, including 8,248 with COVID-19. After accounting for multiple testing, we did not identify any clear associations with rare variants either exome-wide or when specifically focusing on (i) 14 interferon pathway genes in which rare deleterious variants have been reported in severe COVID-19 patients; (ii) 167 genes located in COVID-19 GWAS risk loci; or (iii) 32 additional genes of immunologic relevance and/or therapeutic potential. Our analyses indicate there are no significant associations with rare protein-coding variants with detectable effect sizes at our current sample sizes. Analyses will be updated as additional data become available, with results publicly browsable at https://rgc-covid19.regeneron.com.
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Affiliation(s)
- J A Kosmicki
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - J E Horowitz
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - N Banerjee
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - R Lanche
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A Marcketta
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - E Maxwell
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - X Bai
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - D Sun
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - J D Backman
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - D Sharma
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - H M Kang
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - C O'Dushlaine
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A Yadav
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A J Mansfield
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A H Li
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - K Watanabe
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - L Gurski
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - S E McCarthy
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A E Locke
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - S Khalid
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - S O'Keeffe
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - J Mbatchou
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - O Chazara
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - Y Huang
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - E Kvikstad
- Bristol Myers Squibb, Route 206 and Province Line Road, Princeton, NJ 08543, USA
| | - A O'Neill
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - P Nioi
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - M M Parker
- Alnylam Pharmaceuticals, 675 West Kendall St, Cambridge, MA 02142, USA
| | - S Petrovski
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - H Runz
- Biogen, 300 Binney St, Cambridge, MA 02142, USA
| | - J D Szustakowski
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - Q Wang
- Centre for Genomics Research, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - E Wong
- Biogen, 300 Binney St, Cambridge, MA 02142, USA
| | | | - E N Smith
- Takeda California Inc., 9625 Towne Centre Dr, San Diego, CA 92121, USA
| | - S Szalma
- Takeda California Inc., 9625 Towne Centre Dr, San Diego, CA 92121, USA
| | - X Zheng
- AbbVie, Inc., 1 N. Waukegan Rd, North Chicago, IL 60064, USA
| | - S Esmaeeli
- AbbVie, Inc., 1 N. Waukegan Rd, North Chicago, IL 60064, USA
| | - J W Davis
- AbbVie, Inc., 1 N. Waukegan Rd, North Chicago, IL 60064, USA
| | - Y-P Lai
- Pfizer, Inc., 1 Portland Street, Cambridge MA 02139, USA
| | - X Chen
- Pfizer, Inc., 1 Portland Street, Cambridge MA 02139, USA
| | | | | | | | | | - A Verma
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - G Sirugo
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - M D Ritchie
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - D J Rader
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - G Povysil
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - D B Goldstein
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
- Department of Genetics & Development, Columbia University, New York, NY 10032, USA
| | - K Kiryluk
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA
- Division of Nephrology, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY 10032, USA
| | - E Pairo-Castineira
- Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - K Rawlik
- Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK
| | - D Pasko
- Genomics England, London EC1M 6BQ, UK
| | - S Walker
- Genomics England, London EC1M 6BQ, UK
| | - A Meynert
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | | | | | - A Tenesa
- Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, Teviot Place, Edinburgh EH8 9AG, UK
| | - M Caulfield
- Genomics England, London EC1M 6BQ, UK
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
| | - R Scott
- Genomics England, London EC1M 6BQ, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - J F Wilson
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, Teviot Place, Edinburgh EH8 9AG, UK
| | - J K Baillie
- Roslin Institute, University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
- Intensive Care Unit, Royal Infirmary of Edinburgh, 54 Little France Drive, Edinburgh, EH16 5SA, UK
| | - G Butler-Laporte
- Lady Davis Institute, Jewish General Hospital, Montréal, Québec H3T 1E2, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec H3A 0G4, Canada
| | - T Nakanishi
- Lady Davis Institute, Jewish General Hospital, Montréal, Québec H3T 1E2, Canada
- Department of Human Genetics, McGill University, Montréal, Québec H3A 0G4, Canada
- Kyoto-McGill International Collaborative School in Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Research Fellow, Japan Society for the Promotion of Science
| | - M Lathrop
- Department of Human Genetics, McGill University, Montréal, Québec H3A 0G4, Canada
- Canadian Centre for Computational Genomics, McGill University, Montréal, Québec H3A 0G4, Canada
| | - J B Richards
- Lady Davis Institute, Jewish General Hospital, Montréal, Québec H3T 1E2, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec H3A 0G4, Canada
- Department of Human Genetics, McGill University, Montréal, Québec H3A 0G4, Canada
- Department of Twins Research, King's College London, London WC2R 2LS, UK
| | - M Jones
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - S Balasubramanian
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - W Salerno
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A R Shuldiner
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - J Marchini
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - J D Overton
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - L Habegger
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - M N Cantor
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - J G Reid
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - A Baras
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - G R Abecasis
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
| | - M A Ferreira
- Regeneron Genetics Center, 777 Old Saw Mill River Rd., Tarrytown, NY 10591, USA
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Masoudi S, Harmon S, Mehralivand S, Walker S, Ning H, Choyke P, Turkbey B, Citrin D. Cross Modality Domain Adaptation To Generate Pelvic Magnetic Resonance Images From Computed Tomography Simulation For More Accurate Prostate Delineation In Radiotherapy Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kaufmann A, Butcher P, Maden K, Walker S, Widmer M. Optimized multimatrix calibration concept for liquid chromatography mass spectrometry-based bioanalysis methods. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1159:122393. [PMID: 33137679 DOI: 10.1016/j.jchromb.2020.122393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/05/2020] [Accepted: 09/19/2020] [Indexed: 10/23/2022]
Abstract
In this paper, a calibration procedure for LC/MS-based bioanalysis methods, termed "A/B fortification", is proposed. The concept relies on the post-extraction fortification (B-spike) of an aliquot of the injection-ready sample extract for the determination and compensation of specific signal suppression or enhancement effects compared to matrix-free extract prepared in buffer or mobile phase. Conventional analyte recovery, observed due to the incomplete extraction of analytes from the sample or losses during a cleanup, is determined by the conventional pre-extraction fortification (A-spike) of a blank sample that belongs to the same type of matrix as the sample with the unknown analyte concentration. This approach permits a higher throughput than conventional sample fortification strategies. The results obtained by utilizing the A/B fortification concept were extensively compared against conventional methods (representative bank matrix fortification, sample fortification and internal standard). The proposed concept (based on the pre-fortification of a reference matrix and post-fortification of the sample) was found to be significantly less biased than internal standard-based techniques. The A/B fortification indicated a better accuracy than the sample fortification or representative blank matrix fortification approach and, most importantly, produced significantly fewer outliers. This was linked to the fact that in the case of the A/B fortification, the uncertainty of the subtraction of two peak areas (fortified minus unfortified sample) is reduced, because fortifications are not made prior to the extraction step but are made into the final injection-ready sample extract. Fortification into an injection-ready aliquot eliminates all sample processing-related differences (procedural errors), which can affect conventional sample fortification-based quantifications.
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Affiliation(s)
- A Kaufmann
- Official Food Control Authority of the Canton of Zurich, Fehrenstrasse 15, 8032 Zürich, Switzerland.
| | - P Butcher
- Official Food Control Authority of the Canton of Zurich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - K Maden
- Official Food Control Authority of the Canton of Zurich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - S Walker
- Official Food Control Authority of the Canton of Zurich, Fehrenstrasse 15, 8032 Zürich, Switzerland
| | - M Widmer
- Official Food Control Authority of the Canton of Zurich, Fehrenstrasse 15, 8032 Zürich, Switzerland
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Ward L, Jackowski S, Ma J, Scharke M, Konji V, Jaremko J, Koujok K, Matzinger M, Shenouda N, Walker S, McMillan H, Siminoski K, Bista P, Mancini M, Donovan J. DMD – BIOMARKERS & OUTCOME MEASURES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Russell E, Walker S, McPherson T. Diagnosis of mycoplasma aetiology in Stevens-Johnson syndrome/toxic epidermal necrolysis. Br J Dermatol 2020; 184:176-178. [PMID: 32757268 DOI: 10.1111/bjd.19458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 11/28/2022]
Affiliation(s)
- E Russell
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Walker
- Release Life Sciences and Diagnostics Ltd (RLS), Oxford, UK
| | - T McPherson
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Hallifax RJ, McKeown E, Sivakumar P, Fairbairn I, Peter C, Leitch A, Knight M, Stanton A, Ijaz A, Marciniak S, Cameron J, Bhatta A, Blyth KG, Reddy R, Harris MC, Maddekar N, Walker S, West A, Laskawiec-Szkonter M, Corcoran JP, Gerry S, Roberts C, Harvey JE, Maskell N, Miller RF, Rahman NM. Ambulatory management of primary spontaneous pneumothorax: an open-label, randomised controlled trial. Lancet 2020; 396:39-49. [PMID: 32622394 PMCID: PMC7607300 DOI: 10.1016/s0140-6736(20)31043-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Primary spontaneous pneumothorax occurs in otherwise healthy young patients. Optimal management is not defined and often results in prolonged hospitalisation. Data on efficacy of ambulatory options are poor. We aimed to describe the duration of hospitalisation and safety of ambulatory management compared with standard care. METHODS In this open-label, randomised controlled trial, adults (aged 16-55 years) with symptomatic primary spontaneous pneumothorax were recruited from 24 UK hospitals during a period of 3 years. Patients were randomly assigned (1:1) to treatment with either an ambulatory device or standard guideline-based management (aspiration, standard chest tube insertion, or both). The primary outcome was total length of hospital stay including re-admission up to 30 days after randomisation. Patients with available data were included in the primary analysis and all assigned patients were included in the safety analysis. The trial was prospectively registered with the International Standard Randomised Clinical Trials Number, ISRCTN79151659. FINDINGS Of 776 patients screened between July, 2015, and March, 2019, 236 (30%) were randomly assigned to ambulatory care (n=117) and standard care (n=119). At day 30, the median hospitalisation was significantly shorter in the 114 patients with available data who received ambulatory treatment (0 days [IQR 0-3]) than in the 113 with available data who received standard care (4 days [IQR 0-8]; p<0·0001; median difference 2 days [95% CI 1-3]). 110 (47%) of 236 patients had adverse events, including 64 (55%) of 117 patients in the ambulatory care arm and 46 (39%) of 119 in the standard care arm. All 14 serious adverse events occurred in patients who received ambulatory care, eight (57%) of which were related to the intervention, including an enlarging pneumothorax, asymptomatic pulmonary oedema, and the device malfunctioning, leaking, or dislodging. INTERPRETATION Ambulatory management of primary spontaneous pneumothorax significantly reduced the duration of hospitalisation including re-admissions in the first 30 days, but at the expense of increased adverse events. This data suggests that primary spontaneous pneumothorax can be managed for outpatients, using ambulatory devices in those who require intervention. FUNDING UK National Institute for Health Research.
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Affiliation(s)
- Rob J Hallifax
- Oxford Centre for Respiratory Medicine, University of Oxford, Oxford, UK.
| | - Edward McKeown
- Royal Berkshire National Health Service (NHS) Foundation Trust, Reading, UK
| | | | | | - Christy Peter
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Andrew Leitch
- Western General Hospital, NHS Lothian, Edinburgh, UK
| | | | - Andrew Stanton
- Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Asim Ijaz
- University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, UK
| | | | | | - Amrithraj Bhatta
- Blackpool Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, UK
| | - Kevin G Blyth
- Queen Elizabeth University Hospital, Glasgow, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Raja Reddy
- Kettering General Hospital, Kettering, UK
| | | | | | - Steven Walker
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - Alex West
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | | | - Stephen Gerry
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Corran Roberts
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Nick Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, UK
| | - Robert F Miller
- Institute for Global Health, University College London, London, UK
| | - Najib M Rahman
- Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
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Armstrong CWD, Coulter JA, Ong CW, Maxwell PJ, Walker S, Butterworth KT, Lyubomska O, Berlingeri S, Gallagher R, O'Sullivan JM, Jain S, Mills IG, Prise KM, Bristow RG, LaBonte MJ, Waugh DJJ. Clinical and functional characterization of CXCR1/CXCR2 biology in the relapse and radiotherapy resistance of primary PTEN-deficient prostate carcinoma. NAR Cancer 2020; 2:zcaa012. [PMID: 32743555 PMCID: PMC7380483 DOI: 10.1093/narcan/zcaa012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 01/20/2023] Open
Abstract
Functional impairment of the tumour suppressor PTEN is common in primary prostate cancer and has been linked to relapse post-radiotherapy (post-RT). Pre-clinical modelling supports elevated CXC chemokine signalling as a critical mediator of PTEN-depleted disease progression and therapeutic resistance. We assessed the correlation of PTEN deficiency with CXC chemokine signalling and its association with clinical outcomes. Gene expression analysis characterized a PTEN LOW/CXCR1HIGH/CXCR2HIGH cluster of tumours that associates with earlier time to biochemical recurrence [hazard ratio (HR) 5.87 and 2.65, respectively] and development of systemic metastasis (HR 3.51). In vitro, CXCL signalling was further amplified following exposure of PTEN-deficient prostate cancer cell lines to ionizing radiation (IR). Inhibition of CXCR1/2 signalling in PTEN-depleted cell-based models increased IR sensitivity. In vivo, administration of a CXCR1/2-targeted pepducin (x1/2pal-i3), or CXCR2-specific antagonist (AZD5069), in combination with IR to PTEN-deficient xenografts attenuated tumour growth and progression compared to control or IR alone. Post-mortem analysis confirmed that x1/2pal-i3 administration attenuated IR-induced CXCL signalling and anti-apoptotic protein expression. Interventions targeting CXC chemokine signalling may provide an effective strategy to combine with RT in locally advanced prostate cancer patients with known presence of PTEN-deficient foci.
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Affiliation(s)
- Chris W D Armstrong
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | | | - Chee Wee Ong
- Laboratory of Cancer Epigenome, Division of Medical Science, National Cancer Centre, Singapore, 169610
| | - Pamela J Maxwell
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Steven Walker
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Karl T Butterworth
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Oksana Lyubomska
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Silvia Berlingeri
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Rebecca Gallagher
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Joe M O'Sullivan
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Suneil Jain
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Ian G Mills
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Kevin M Prise
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - Robert G Bristow
- Movember FASTMAN Centre of Excellence, Manchester CRUK Institute, Manchester, SK10 4TG, UK
| | - Melissa J LaBonte
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
| | - David J J Waugh
- Movember FASTMAN Centre of Excellence, Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7AE, UK
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Bédard A, Antó JM, Fonseca JA, Arnavielhe S, Bachert C, Bedbrook A, Bindslev‐Jensen C, Bosnic‐Anticevich S, Cardona V, Cruz AA, Fokkens WJ, Garcia‐Aymerich J, Hellings PW, Ivancevich JC, Klimek L, Kuna P, Kvedariene V, Larenas‐Linnemann D, Melén E, Monti R, Mösges R, Mullol J, Papadopoulos NG, Pham‐Thi N, Samolinski B, Tomazic PV, Toppila‐Salmi S, Ventura MT, Yorgancioglu A, Bousquet J, Pfaar O, Basagaña X, Aberer W, Agache I, Akdis CA, Akdis M, Aliberti MR, Almeida R, Amat F, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto JM, Arnavielle S, Asayag E, Asarnoj A, Arshad H, Avolio F, Bacci E, Baiardini I, Barbara C, Barbagallo M, Baroni I, Barreto BA, Bateman ED, Bedolla‐Barajas M, Bewick M, Beghé B, Bel EH, Bergmann KC, Bennoor KS, Benson M, Bertorello L, Białoszewski AZ, Bieber T, Bialek S, Bjermer L, Blain H, Blasi F, Blua A, Bochenska Marciniak M, Bogus‐Buczynska I, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briedis V, Brightling CE, Brozek J, Bucca C, Buhl R, Buonaiuto R, Panaitescu C, Burguete Cabañas MT, Burte E, Bush A, Caballero‐Fonseca F, Caillaud D, Caimmi D, Calderon MA, Camargos PAM, Camuzat T, Canfora G, Canonica GW, Carlsen KH, Carreiro‐Martins P, Carriazo AM, Carr W, Cartier C, Casale T, Castellano G, Cecchi L, Cepeda AM, Chavannes NH, Chen Y, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciaravolo MM, Ciceran A, Cingi C, Ciprandi G, Carvalho Coehlo AC, Colas L, Colgan E, Coll J, Conforti D, Constantinidis J, Correia de Sousa J, Cortés‐Grimaldo RM, Corti F, Costa E, Costa‐Dominguez MC, Courbis AL, Cox L, Crescenzo M, Custovic A, Czarlewski W, Dahlen SE, D'Amato G, Dario C, da Silva J, Dauvilliers Y, Darsow U, De Blay F, De Carlo G, Dedeu T, de Fátima Emerson M, De Feo G, De Vries G, De Martino B, Motta Rubini NP, Deleanu D, Denburg JA, Devillier P, Di Capua Ercolano S, Di Carluccio N, Didier A, Dokic D, Dominguez‐Silva MG, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, El‐Gamal Y, Eklund P, Eller E, Emuzyte R, Farrell J, Farsi A, Ferreira de Mello J, Ferrero J, Fink‐Wagner A, Fiocchi A, Fontaine JF, Forti S, Fuentes‐Perez JM, Gálvez‐Romero JL, Gamkrelidze A, García‐Cobas CY, Garcia‐Cruz MH, Gemicioğlu B, Genova S, Christoff G, Gereda JE, Gerth van Wijk R, Gomez RM, Gómez‐Vera J, González Diaz S, Gotua M, Grisle I, Guidacci M, Guldemond NA, Gutter Z, Guzmán MA, Haahtela T, Hajjam J, Hernández L, Hourihane JO, Huerta‐Villalobos YR, Humbert M, Iaccarino G, Illario M, Ispayeva Z, Jares EJ, Jassem E, Johnston SL, Joos G, Jung KS, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Karjalainen J, Kardas P, Keil T, Keith PK, Khaitov M, Khaltaev N, Kleine‐Tebbe J, Kowalski ML, Kuitunen M, Kull I, Kupczyk M, Krzych‐Fałta E, Lacwik P, Laune D, Lauri D, Lavrut J, Le LTT, Lessa M, Levato G, Li J, Lieberman P, Lipiec A, Lipworth B, Lodrup Carlsen KC, Louis R, Lourenço O, Luna‐Pech JA, Magnan A, Mahboub B, Maier D, Mair A, Majer I, Malva J, Mandajieva E, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu‐Dupas E, Matta Campos JJ, Matos AL, Maurer M, Mavale‐Manuel S, Mayora O, Meco C, Medina‐Avalos MA, Melo‐Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica‐Martinez MD, Mohammad Y, Momas I, Montefort S, Mora Bogado D, Morais‐Almeida M, Morato‐Castro FF, Mota‐Pinto A, Moura Santo P, Münter L, Muraro A, Murray R, Naclerio R, Nadif R, Nalin M, Napoli L, Namazova‐Baranova L, Neffen H, Niedeberger V, Nekam K, Neou A, Nieto A, Nogueira‐Silva L, Nogues M, Novellino E, Nyembue TD, O'Hehir RE, Odzhakova C, Ohta K, Okamoto Y, Okubo K, Onorato GL, Ortega Cisneros M, Ouedraogo S, Pali‐Schöll I, Palkonen S, Panzner P, Park HS, Papi A, Passalacqua G, Paulino E, Pawankar R, Pedersen S, Pépin JL, Pereira AM, Persico M, Phillips J, Picard R, Pigearias B, Pin I, Pitsios C, Plavec D, Pohl W, Popov TA, Portejoie F, Potter P, Pozzi AC, Price D, Prokopakis EP, Puy R, Pugin B, Pulido Ross RE, Przemecka M, Rabe KF, Raciborski F, Rajabian‐Soderlund R, Reitsma S, Ribeirinho I, Rimmer J, Rivero‐Yeverino D, Rizzo JA, Rizzo MC, Robalo‐Cordeiro C, Rodenas F, Rodo X, Rodriguez Gonzalez M, Rodriguez‐Mañas L, Rolland C, Rodrigues Valle S, Roman Rodriguez M, Romano A, Rodriguez‐Zagal E, Rolla G, Roller‐Wirnsberger RE, Romano M, Rosado‐Pinto J, Rosario N, Rottem M, Ryan D, Sagara H, Salimäki J, Sanchez‐Borges M, Sastre‐Dominguez J, Scadding GK, Schunemann HJ, Scichilone N, Schmid‐Grendelmeier P, Sarquis Serpa F, Shamai S, Sheikh A, Sierra M, Simons FER, Siroux V, Sisul JC, Skrindo I, Solé D, Somekh D, Sondermann M, Sooronbaev T, Sova M, Sorensen M, Sorlini M, Spranger O, Stellato C, Stelmach R, Stukas R, Sunyer J, Strozek J, Szylling A, Tebyriçá JN, Thibaudon M, To T, Todo‐Bom A, Trama U, Triggiani M, Suppli Ulrik C, Urrutia‐Pereira M, Valenta R, Valero A, Valiulis A, Valovirta E, van Eerd M, van Ganse E, van Hage M, Vandenplas O, Vezzani G, Vasankari T, Vatrella A, Verissimo MT, Viart F, Viegi G, Vicheva D, Vontetsianos T, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Werfel T, Westman M, Wickman M, Williams DM, Williams S, Wilson N, Wright J, Wroczynski P, Yakovliev P, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zhang L, Zhong N, Zernotti ME, Zhanat I, Zidarn M, Zuberbier T, Zubrinich C, Zurkuhlen A. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App. Allergy 2020; 75:1672-1688. [PMID: 31995656 DOI: 10.1111/all.14204] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/23/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. METHODS All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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Welch H, Walker S, Maskell N. Current Management Strategies for Primary Spontaneous Pneumothorax. Curr Pulmonol Rep 2020. [DOI: 10.1007/s13665-020-00249-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Zwingelberg S, Hamrah P, Hamprecht A, Walker S, Bachmann B, Cursiefen C, Roters S. Der schmerzlose Fremdkörper. Ophthalmologe 2020; 117:575-578. [DOI: 10.1007/s00347-019-01017-0] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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