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Brown J, James K, Lisk S, Shearer J, Byford S, Stallard P, Deighton J, Saunders D, Yarrum J, Fonagy P, Weaver T, Sclare I, Day C, Evans C, Carter B. Clinical effectiveness and cost-effectiveness of a brief accessible cognitive behavioural therapy programme for stress in school-aged adolescents (BESST): a cluster randomised controlled trial in the UK. Lancet Psychiatry 2024:S2215-0366(24)00101-9. [PMID: 38759665 DOI: 10.1016/s2215-0366(24)00101-9] [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] [Received: 12/05/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Depression and anxiety are increasingly prevalent in adolescents. The Brief Educational Workshops in Secondary Schools Trial investigated the effectiveness of a brief accessible stress workshop programme for 16-18-year-olds. We aimed to investigate the clinical effectiveness and cost-effectiveness of the DISCOVER cognitive behavioural therapy (CBT) workshop on symptoms of depression in 16-18-year-olds at 6 months compared with treatment-as-usual. METHODS We conducted a multicentre, cluster randomised controlled trial in UK schools or colleges with sixth forms to evaluate clinical effectiveness and cost-effectiveness of a brief CBT workshop (DISCOVER) compared with treatment-as-usual. We planned to enrol 60 schools and 900 adolescents, using a self-referral system to recruit participants. Schools were randomised in a 1:1 ratio for participants to receive either the DISCOVER workshop or treatment-as-usual, stratified by site and balanced on school size and index of multiple deprivation. Participants were included if they were 16-18 years old, attending for the full school year, seeking help for stress, and fluent in English and able to provide written informed consent. The outcome assessors, senior health economist, senior statistician, and chief investigator were masked. People with lived experience were involved in the study. The primary outcome was depression symptoms measured with the Mood and Feelings Questionnaire (MFQ) at 6-month follow-up, in the intention-to-treat population of all participants with full covariate data. The trial was registered with the ISRCTN registry (ISRCTN90912799). FINDINGS 111 schools were invited to participate in the study, seven were deemed ineligible, and 47 did not provide consent. Between Oct 4, 2021, and Nov 10, 2022, 933 students at 57 schools were screened for eligibility, seven were not eligible for inclusion, and 26 did not attend the baseline meeting and assessment, resulting in 900 adolescents participating in the study. The DISCOVER group included 443 participants (295 [67%] female and 136 [31%] male) and the treatment-as-usual group included 457 participants (346 [76%] female and 92 [20%] male). 468 (52%) of the 900 participants were White, and the overall age of the participants was 17·2 years (SD 0·6). 873 (97%) adolescents were followed up in the intention-to-treat population. The primary intention-to-treat analysis (n=854) found an adjusted mean difference in MFQ of -2·06 (95% CI -3·35 to -0·76; Cohen's d=-0·17; p=0·0019) at the 6-month follow-up, indicating a clinical improvement in the DISCOVER group. The probability that DISCOVER is cost- effective compared with treatment-as-usual ranged from 61% to 78% at a £20 000 to £30 000 per quality-adjusted life-year threshold. Nine adverse events (two of which were classified as serious) were reported in the DISCOVER group and 14 (two of which were classified as serious) were reported in the treatment-as-usual group. INTERPRETATION Our findings indicate that the DISCOVER intervention is modestly clinically effective and economically viable and could be a promising early intervention in schools. Given the importance of addressing mental health needs early in this adolescent population, additional research is warranted to explore this intervention. FUNDING National Institute for Health and Care Research Health Technology Assessment Programme.
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Affiliation(s)
- June Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Kirsty James
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; King's Clinical Trials Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephen Lisk
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James Shearer
- Health Service & Population Research Department, King's College London, London, UK
| | - Sarah Byford
- Health Service & Population Research Department, King's College London, London, UK
| | | | - Jessica Deighton
- Anna Freud National Centre for Children and Families, London, UK
| | - David Saunders
- Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Jynna Yarrum
- Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, UK; Department of Clinical Educational and Health Psychology, University College London, London, UK
| | - Timothy Weaver
- Faculty of Health, Social Care & Education, Middlesex University, London, UK
| | - Irene Sclare
- Southwark CAMHS Clinical Academic Group, South London & Maudsley NHS Foundation Trust, London, UK
| | - Crispin Day
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Claire Evans
- Anna Freud National Centre for Children and Families, London, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; King's Clinical Trials Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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James K, Lisk S, Payne-Cook C, Farishta Z, Farrelly M, Sheikh A, Slusarczyk M, Byford S, Day C, Deighton J, Evans C, Fonagy P, Saunders D, Sclare I, Shearer J, Stallard P, Weaver T, Yarrum J, Carter B, Brown JSL. Brief Educational Workshops in Secondary Schools Trial (BESST trial), a school-based cluster randomised controlled trial of the DISCOVER workshop for 16-18-year-olds: recruitment and baseline characteristics. Trials 2024; 25:302. [PMID: 38702825 PMCID: PMC11069277 DOI: 10.1186/s13063-024-08116-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/15/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The Brief Educational Workshops in Secondary Schools Trial (BESST) is an England-wide school-based cluster randomised controlled trial assessing the clinical and cost-effectiveness of an open-access psychological workshop programme (DISCOVER) for 16-18-year-olds. This baseline paper describes the self-referral and other recruitment processes used in this study and the baseline characteristics of the enrolled schools and participants. METHOD We enrolled 900 participants from 57 Secondary schools across England from 4th October 2021 to 10th November 2022. Schools were randomised to receive either the DISCOVER day-long Stress workshop or treatment as usual which included signposting information. Participants will be followed up for 6 months with outcome data collection at baseline, 3-month, and 6-month post randomisation. RESULTS Schools were recruited from a geographically and ethnically diverse sample across England. To reduce stigma, students were invited to self-refer into the study if they wanted help for stress. Their mean age was 17.2 (SD = 0.6), 641 (71%) were female and 411 (45.6%) were from ethnic minority groups. The general wellbeing of our sample measured using the Mood and Feelings Questionnaire (MFQ) found 314 (35%) of students exhibited symptoms of depression at baseline. Eighty percent of students reported low wellbeing on the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) suggesting that although the overall sample mean is below the cut-off for depression, the self-referral approach used in this study supports distressed students in coming forward. CONCLUSION The BESST study will continue to follow up participants to collect outcome data and results will be analysed once all the data have been collected. TRIAL REGISTRATION ISRCTN registry ISRCTN90912799. Registered on 28 May 2020.
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Affiliation(s)
- Kirsty James
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
- Department of Biostatistics and Health Informatics, & King's Clinical Trials Unit (KCTU), Institute of Psychiatry Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Stephen Lisk
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | | | | | - Maria Farrelly
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Ayesha Sheikh
- Anna Freud Centre for Children and Families, London, UK
| | - Monika Slusarczyk
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Sarah Byford
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Crispin Day
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
- Southwark CAMHS Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Claire Evans
- Anna Freud Centre for Children and Families, London, UK
| | - Peter Fonagy
- Anna Freud Centre for Children and Families, London, UK
- Department of Clinical Educational and Health Psychology, University College London, London, UK
| | | | - Irene Sclare
- Southwark CAMHS Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - James Shearer
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | | | | | | | - Ben Carter
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
- Department of Biostatistics and Health Informatics, & King's Clinical Trials Unit (KCTU), Institute of Psychiatry Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK.
| | - June S L Brown
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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Goguet E, Olsen CH, Meyer WA, Ansari S, Powers JH, Conner TL, Coggins SA, Wang W, Wang R, Illinik L, Sanchez Edwards M, Jackson-Thompson BM, Hollis-Perry M, Wang G, Alcorta Y, Wong MA, Saunders D, Mohammed R, Balogun B, Kobi P, Kosh L, Bishop-Lilly K, Cer RZ, Arnold CE, Voegtly LJ, Fitzpatrick M, Luquette AE, Malagon F, Ortega O, Parmelee E, Davies J, Lindrose AR, Haines-Hull H, Moser MS, Samuels EC, Rekedal MS, Graydon EK, Malloy AMW, Tribble D, Burgess TH, Campbell W, Robinson S, Broder CC, O’Connell RJ, Weiss CD, Pollett S, Laing E, Mitre E. Immune and behavioral correlates of protection against symptomatic post-vaccination SARS-CoV-2 infection. Front Immunol 2024; 15:1287504. [PMID: 38566991 PMCID: PMC10985347 DOI: 10.3389/fimmu.2024.1287504] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction We sought to determine pre-infection correlates of protection against SARS-CoV-2 post-vaccine inzfections (PVI) acquired during the first Omicron wave in the United States. Methods Serum and saliva samples from 176 vaccinated adults were collected from October to December of 2021, immediately before the Omicron wave, and assessed for SARS-CoV-2 Spike-specific IgG and IgA binding antibodies (bAb). Sera were also assessed for bAb using commercial assays, and for neutralization activity against several SARS-CoV-2 variants. PVI duration and severity, as well as risk and precautionary behaviors, were assessed by questionnaires. Results Serum anti-Spike IgG levels assessed by research assay, neutralization titers against Omicron subvariants, and low home risk scores correlated with protection against PVIs after multivariable regression analysis. Commercial assays did not perform as well as research assay, likely due to their lower dynamic range. Discussion In the 32 participants that developed PVI, anti-Spike IgG bAbs correlated with lower disease severity and shorter duration of illness.
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Affiliation(s)
- Emilie Goguet
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Cara H. Olsen
- Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | | | - Sara Ansari
- Quest Diagnostics, Secaucus, NJ, United States
| | - John H. Powers
- Clinical Research Directorate, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Tonia L. Conner
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Si’Ana A. Coggins
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Wei Wang
- Division of Viral Products, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Richard Wang
- Division of Viral Products, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Luca Illinik
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Margaret Sanchez Edwards
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Belinda M. Jackson-Thompson
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Monique Hollis-Perry
- Clinical Trials Center, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, United States
| | - Gregory Wang
- Clinical Trials Center, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, United States
- General Dynamics Information Technology, Falls Church, VA, United States
| | - Yolanda Alcorta
- Clinical Trials Center, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, United States
- General Dynamics Information Technology, Falls Church, VA, United States
| | - Mimi A. Wong
- Clinical Trials Center, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, United States
- General Dynamics Information Technology, Falls Church, VA, United States
| | - David Saunders
- Translational Medicine Unit, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Roshila Mohammed
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Bolatito Balogun
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Priscilla Kobi
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Lakeesha Kosh
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Kimberly Bishop-Lilly
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
| | - Regina Z. Cer
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
| | - Catherine E. Arnold
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
- Defense Threat Reduction Agency, Fort Belvoir, VA, United States
| | - Logan J. Voegtly
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
- Leidos, Reston, VA, United States
| | - Maren Fitzpatrick
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
- Leidos, Reston, VA, United States
| | - Andrea E. Luquette
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
- Leidos, Reston, VA, United States
| | - Francisco Malagon
- Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, United States
- Leidos, Reston, VA, United States
| | - Orlando Ortega
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Edward Parmelee
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Julian Davies
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Alyssa R. Lindrose
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Hannah Haines-Hull
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Matthew S. Moser
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Emily C. Samuels
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Marana S. Rekedal
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Elizabeth K. Graydon
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Allison M. W. Malloy
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - David R. Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Timothy H. Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Wesley Campbell
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Sara Robinson
- Division of Infectious Diseases, Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Christopher C. Broder
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Robert J. O’Connell
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Carol D. Weiss
- Division of Viral Products, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Simon Pollett
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Eric D. Laing
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Edward Mitre
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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Chaorattanakawee S, Tachavarong W, Hananantachai H, Bunsermyos W, Chanarat N, Promsathaporn S, Tippayachai B, Sakolvaree J, Pitaksajjakul P, Benjathummarak S, Srinoppawan K, Saunders D, Lindroth EJ, Takhampunya R. Seasonal pattern of questing ticks and prevalence of pathogenic Rickettsia and Anaplasmataceae in Khao Yai national park, Thailand. Travel Med Infect Dis 2024; 58:102696. [PMID: 38360157 DOI: 10.1016/j.tmaid.2024.102696] [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: 10/12/2023] [Revised: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Tick-borne diseases (TBD) are considered neglected diseases in Thailand with disease burden likely underestimated. To assess risk for emerging TBD in Thailand, the seasonality of questing tick and pathogen prevalence were studied in Khao Yai National Park, a top tourist destination. METHODS During 2019, questing ticks around tourist attractions were systematically collected bimonthly and analyzed for Rickettsia and Anaplasmataceae bacterial species by polymerase chain reaction and DNA sequencing. RESULTS Larvae and nymphs of questing ticks peaked in Khao Yai National Park during the late rainy-winter season, though no specific trends were observed in adult ticks. Winter (November to February) was the highest risk for human tick-bites due to higher numbers of both ticks and visitors. Of the total 5916 ticks analyzed (651 pools), Anaplasma phagocytophilum, Neoehrlichia mikurensis, Ehrlichia ewingii, and Ehrlichia chaffeensis were detected at low rates (≤0.05%). There was a higher prevalence of human rickettsioses (0.2-7%) in ticks surveyed with Rickettsia tamurae, Rickettsia raoultii, and Rickettsia montana the major species. Amblyomma ticks had the highest prevalence of Rickettsia (85%, 35/44 Amblyomma adults), in which only R. tamurae and R. raoultii were found in Amblyomma with mixed species infections common. We report the first detection of R. africae-like and N. mikurensis in Ixodes granulatus adults in Thailand, suggesting I. granulatus as a potential vector for these pathogens. CONCLUSION This study demonstrated the risk of emerging TBD in Thailand and underscores the need for tick-bite prevention among tourists in Thailand.
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Affiliation(s)
- Suwanna Chaorattanakawee
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
| | - Wirunya Tachavarong
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Hathairad Hananantachai
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Watanyu Bunsermyos
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Nitima Chanarat
- Department of Entomology, Armed Forces Research Institute of Medical Sciences-United States Army Medical Directorate, Bangkok, Thailand
| | - Sommai Promsathaporn
- Department of Entomology, Armed Forces Research Institute of Medical Sciences-United States Army Medical Directorate, Bangkok, Thailand
| | - Bousaraporn Tippayachai
- Department of Entomology, Armed Forces Research Institute of Medical Sciences-United States Army Medical Directorate, Bangkok, Thailand
| | - Jira Sakolvaree
- Department of Entomology, Armed Forces Research Institute of Medical Sciences-United States Army Medical Directorate, Bangkok, Thailand
| | - Pannamthip Pitaksajjakul
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Center of Excellence for Antibody Research, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Surachet Benjathummarak
- Center of Excellence for Antibody Research, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kanchit Srinoppawan
- Department of National Parks, Wildlife and Plant Conservation, Bangkok, Thailand
| | - David Saunders
- Uniformed Services University School of Medicine, Bethesda, MD, USA
| | - Erica J Lindroth
- Department of Entomology, Armed Forces Research Institute of Medical Sciences-United States Army Medical Directorate, Bangkok, Thailand
| | - Ratree Takhampunya
- Department of Entomology, Armed Forces Research Institute of Medical Sciences-United States Army Medical Directorate, Bangkok, Thailand
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Hellwig LD, Turner C, Olsen C, Libbus J, Markos B, Koehlmoos T, Haigney M, De Castro M, Saunders D. Assessing Clinical Utility of Pharmacogenetic Testing in the Military Health System. Mil Med 2024; 189:e198-e204. [PMID: 37436924 PMCID: PMC11022329 DOI: 10.1093/milmed/usad254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/23/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Response to medications can differ widely among individual patients. Adverse drug reactions can lead to serious morbidity and mortality. Pharmacogenetic (PGx) testing can predict responses to medications and increased risks of adverse events where the genetic basis is understood. Several published manuscripts suggest positive impacts of systematic preemptive PGx testing. However, few studies have been conducted on PGx implementation in the Military Health System (MHS). MATERIAL AND METHODS A cross-sectional study of adult beneficiaries in a primary care clinic at a large military treatment facility was conducted in 2022. Participants underwent PGx genotyping of CYP2C19 and CYP2D6 genes at the Defense Health Agency Genetics Reference Laboratory. Participant medication lists were compared to the current Clinical Pharmacogenetic Implementation Consortium (CPIC) PGx gene-drug guidelines to assess potential actionability of these results. RESULTS Genotyping of CYP2C19 and CYP2D6 in 165 MHS beneficiaries (mean age: 65 years) revealed that 81.2% of participants had at least one abnormal PGx finding. Among those with an abnormal PGx result, 65% were taking a medication listed on the CPIC website with an association with the particular gene in which the finding was identified. In addition, 78% of all of the participants in the study were taking at least one medication that is metabolized by CYP2C19 or CYP2D6 with associated CPIC guidelines. CONCLUSIONS Pharmacogenetic testing for CYP2C19 and CYP2D6 identified a substantial proportion of MHS patients at a single center who could benefit from evaluation of current medication regimens based on the CPIC guidelines. Individualized medical management may be warranted to a greater degree than previously recognized based on the findings given possible differences in medication metabolism. Many MHS beneficiaries already take medications metabolized by CYP2C19 and CYP2D6, and a substantial proportion may be at risk for preventable adverse events for medications metabolized by these enzymes. While preliminary, a large number of actionable polymorphisms among a relatively small set of individuals taking at-risk medications suggest that implementing PGx testing in clinical practice may be beneficial in the MHS with appropriate clinical infrastructure.
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Affiliation(s)
- Lydia D Hellwig
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
- Center for Military Precision Health (CMPH), Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Clesson Turner
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20894, USA
| | - Cara Olsen
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Joya Libbus
- Military Cardiovascular Outcomes Research, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Metis Foundation, San Antonio, TX 78216, USA
| | - Bethelhem Markos
- Military Cardiovascular Outcomes Research, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Metis Foundation, San Antonio, TX 78216, USA
| | - Tracey Koehlmoos
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Mark Haigney
- Military Cardiovascular Outcomes Research, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Uniformed Services University, Bethesda,, MD 20814, USA
| | - Mauricio De Castro
- Keesler Air Force Base, 81st Medical Operations Squadron, Biloxi, MS 39534, USA
| | - David Saunders
- Department of Medicine, Uniformed Services University of the Health Sciences, Uniformed Services University, Bethesda,, MD 20814, USA
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Collard M, Camenzuli L, Lyon D, Saunders D, Vallotton N, Curtis-Jackson P. "Persistence and mobility (defined as organic‑carbon partitioning) do not correlate to the detection of substances found in surface and groundwater: Criticism of the regulatory concept of persistent and mobile substances". Sci Total Environ 2024; 906:167355. [PMID: 37769732 DOI: 10.1016/j.scitotenv.2023.167355] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Affiliation(s)
| | | | - Delina Lyon
- Concawe, Brussels, Belgium, , Boulevard du Souverain 165, B-1160 Brussels, Belgium.
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Richard SA, Scher AI, Rusiecki J, Byrne C, Berjohn CM, Fries AC, Lalani T, Smith AG, Mody RM, Ganesan A, Huprikar N, Colombo RE, Colombo CJ, Schofield C, Lindholm DA, Mende K, Morris MJ, Jones MU, Flanagan R, Larson DT, Ewers EC, Bazan SE, Saunders D, Maves RC, Livezey J, Maldonado CJ, Edwards MS, Rozman JS, O’Connell RJ, Simons MP, Tribble DR, Agan BK, Burgess TH, Pollett SD. Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study. Open Forum Infect Dis 2023; 10:ofad579. [PMID: 38130596 PMCID: PMC10733205 DOI: 10.1093/ofid/ofad579] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Background The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain. Methods We compared survey responses in a 1-year study of US military service members with (n = 1923) and without (n = 1591) a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We fit Poisson regression models to estimate the association between history of SARS-CoV-2 infection and fitness impairment, adjusting for time since infection, demographics, and baseline health. Results The participants in this analysis were primarily young adults aged 18-39 years (75%), and 71.5% were male. Participants with a history of SARS-CoV-2 infection were more likely to report difficulty exercising (38.7% vs 18.4%; P < .01), difficulty performing daily activities (30.4% vs 12.7%; P < .01), and decreased fitness test (FT) scores (42.7% vs 26.2%; P < .01) than those without a history of infection. SARS-CoV-2-infected participants were at higher risk of these outcomes after adjusting for other factors (unvaccinated: exercising: adjusted risk ratio [aRR], 3.99; 95% CI, 3.36-4.73; activities: aRR, 5.02; 95% CI, 4.09-6.16; FT affected: aRR, 2.55; 95% CI, 2.19-2.98). Among SARS-CoV-2-positive participants, full vaccination before infection was associated with a lower risk of post-COVID-19 fitness impairment (fully vaccinated: exercise: aRR, 0.81; 95% CI, 0.70-0.95; activities: aRR, 0.76; 95% CI, 0.64-0.91; FT: aRR, 0.87; 95% CI, 0.76-1.00; boosted: exercise: aRR, 0.62; 95% CI, 0.51-0.74; activities: aRR, 0.52; 95% CI, 0.41-0.65; FT: aRR, 0.59; 95% CI, 0.49-0.70). Conclusions In this study of generally young, healthy military service members, SARS-CoV-2 infection was associated with lower self-reported fitness and exercise capacity; vaccination and boosting were associated with lower risk of self-reported fitness loss.
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Affiliation(s)
- Stephanie A Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Ann I Scher
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jennifer Rusiecki
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Celia Byrne
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Catherine M Berjohn
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Naval Medical Center San Diego, San Diego, California, USA
| | - Anthony C Fries
- US Air Force School of Aerospace Medicine, Wright-Patterson, Ohio, USA
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
- Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - Alfred G Smith
- Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - Rupal M Mody
- William Beaumont Army Medical Center, El Paso, Texas, USA
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Nikhil Huprikar
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Rhonda E Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Madigan Army Medical Center, Joint Base Lewis McChord, Washington, USA
| | - Christopher J Colombo
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Madigan Army Medical Center, Joint Base Lewis McChord, Washington, USA
| | | | - David A Lindholm
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Michael J Morris
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Milissa U Jones
- Department of Pediatrics, Translational Medicine Unit, Uniformed Services University, Bethesda, Maryland, USA
| | - Ryan Flanagan
- Department of Pediatrics, Translational Medicine Unit, Uniformed Services University, Bethesda, Maryland, USA
| | - Derek T Larson
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Naval Medical Center San Diego, San Diego, California, USA
- Alexander T. Augusta Military Medical Center, Fort Belvoir, Virginia, USA
| | - Evan C Ewers
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Alexander T. Augusta Military Medical Center, Fort Belvoir, Virginia, USA
| | | | - David Saunders
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Ryan C Maves
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jeffrey Livezey
- Department of Pediatrics, Clinical Pharmacology and Medical Toxicology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | | | - Margaret Sanchez Edwards
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Julia S Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Robert J O’Connell
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Mark P Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - David R Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Brian K Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Timothy H Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Simon D Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
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Phillips J, Fallon B, Majeed S, Meador K, Merlino J, Neely H, Nields J, Saunders D, Norko M. Undiagnosing St Joan: She Does Not Need a Medical or Psychiatric Diagnosis. J Nerv Ment Dis 2023; 211:559-565. [PMID: 37015107 PMCID: PMC10979324 DOI: 10.1097/nmd.0000000000001654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
ABSTRACT This article traces the history of Joan of Arc through her brief life that includes leading an army in defense of France at the age of 17 and ending with her death at the stake at the age of 19. In her activities, St Joan reported that she was guided by voices and visions in which she communicated with venerated spiritual figures such as St Michael and St Margaret. Questions have arisen about the nature of these experiences, and various medical and psychiatric diagnoses have been offered by contemporary experts. In our effort to evaluate the diagnostic proposals, we have examined the incidence of voices and visions in the Middle Ages, and we have followed that with a review of nonpathologic voice-hearing in our own era. We then move on to an analysis of some proposed medical and psychiatric diagnoses, all of which we find unconvincing. With this background, we argue that St Joan does not warrant a medical or psychiatric diagnosis. Such a conclusion, however, leaves us with another issue, that of Joan's achievements. How do we understand an adolescent being able to lead an army? Addressing this question proves more difficult than deciding whether St Joan warrants a diagnosis. In addition to her achievements in the war against Britain, Joan of Arc stands out as both the most documented person in Western civilization up until her era, and as the only person who has been both condemned and canonized by the Catholic Church.
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Affiliation(s)
- James Phillips
- Yale University School of Medicine, New Haven, Connecticut
| | - Brian Fallon
- Columbia University School of Medicine, New York, New York
| | - Salman Majeed
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | | | | | - Jenifer Nields
- Yale University School of Medicine, New Haven, Connecticut
| | - David Saunders
- Columbia University School of Medicine, New York, New York
| | - Michael Norko
- Yale University School of Medicine, New Haven, Connecticut
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Savard MF, Ibrahim M, Pond G, Saunders D, Vandermeer L, Fallowfield L, Ng T, Awan A, Sehdev S, Beltran-Bless A, Clemons M. P021 A pragmatic randomised, multicentre trial evaluating the dose timing (morning vs evening) of endocrine therapy for early breast cancer (REaCT-CHRONO Study). Breast 2023. [DOI: 10.1016/s0960-9776(23)00140-6] [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: 03/18/2023] Open
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10
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Chaorattanakawee S, Kosaisavee V, Bunsermyos W, Aonsri C, Imaram W, Suwannasin K, Kunasol C, Thamnurak C, Boonyalai N, Saunders D, Dondorp AM, Mungthin M, Imwong M. In vitro activity of rhinacanthin analogues against drug resistant Plasmodium falciparum isolates from Northeast Thailand. Malar J 2023; 22:105. [PMID: 36959593 PMCID: PMC10035203 DOI: 10.1186/s12936-023-04532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND New anti-malarial drugs are needed urgently to address the increasing challenges of drug-resistant falciparum malaria. Two rhinacanthin analogues containing a naphthoquinone moiety resembling atovaquone showed promising in-vitro activity against a P. falciparum laboratory reference strain (K1). The anti-malarial activity of these 2 compounds was further evaluated for P. falciparum field isolates from an area of multi-drug resistance in Northeast Thailand. METHODS Using a pLDH enzyme-linked immunosorbent assay, four P. falciparum isolates from Northeast Thailand in 2018 were tested for in vitro sensitivity to the two synthetic rhinacanthin analogues 1 and 2 as well as established anti-malarials. Mutations in the P. falciparum cytochrome b gene, a marker for atovaquone (ATQ) resistance, were genotyped in all four field isolates as well as 100 other clinical isolates from the same area using PCR-artificial Restriction Fragment Length Polymorphisms. Pfkelch13 mutations, a marker for artemisinin (ART) resistance, were also examined in all isolates. RESULTS The 50% inhibitory concentrations (IC50) of P. falciparum field isolates for rhinacanthin analogue 1 was 321.9-791.1 nM (median = 403.1 nM). Parasites were more sensitive to analogue 2: IC50 48.6-63.3 nM (median = 52.2 nM). Similar results were obtained against P. falciparum reference laboratory strains 3D7 and W2. The ART-resistant IPC-5202 laboratory strain was more sensitive to these compounds with a median IC50 45.9 and 3.3 nM for rhinacanthin analogues 1 and 2, respectively. The ATQ-resistant C2B laboratory strain showed high-grade resistance towards both compounds (IC50 > 15,000 nM), and there was a strong positive correlation between the IC50 values for these compounds and ATQ (r = 0.83-0.97, P < 0.001). There were no P. falciparum cytochrome b mutations observed in the field isolates, indicating that P. falciparum isolates from this area remained ATQ-sensitive. Pfkelch13 mutations and the ring-stage survival assay confirmed that most isolates were resistant to ART. CONCLUSIONS Two rhinacanthin analogues showed parasiticidal activity against multi-drug resistant P. falciparum isolates, although less potent than ATQ. Rhinacanthin analogue 2 was more potent than analogue 1, and can be a lead compound for further optimization as an anti-malarial in areas with multidrug resistance.
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Affiliation(s)
- Suwanna Chaorattanakawee
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Varakorn Kosaisavee
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Watanyu Bunsermyos
- Department of Parasitology and Entomology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Chaiyawat Aonsri
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Mahidol University, Bangkok, 10400, Thailand
| | - Witcha Imaram
- Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Kanokon Suwannasin
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chanon Kunasol
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chatchadaporn Thamnurak
- Department of Bacterial and Parasitic Diseases, Armed Forces Research Institute of Medical Science (AFRIMS), Bangkok, Thailand
| | - Nonlawat Boonyalai
- Department of Bacterial and Parasitic Diseases, Armed Forces Research Institute of Medical Science (AFRIMS), Bangkok, Thailand
| | - David Saunders
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Arjen M Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, 317 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Mallika Imwong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
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Collard M, Camenzuli L, Lyon D, Saunders D, Vallotton N, Curtis-Jackson P. Persistence and Mobility (defined as organic‑carbon partitioning) do not correlate to the detection of substances found in surface and groundwater: Criticism of the regulatory concept of Persistent and mobile substances. Sci Total Environ 2023; 865:161228. [PMID: 36586701 DOI: 10.1016/j.scitotenv.2022.161228] [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: 09/19/2022] [Revised: 12/23/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
The Chemical Strategy for Sustainability (CSS) includes actions to ensure the protection of drinking water resources from chemical pollution. To proactively identify potential pollutants, the German Environment Agency (UBA) proposed the Persistent and Mobile (PM) concept according to which Persistence (criteria of REACH Annex XIII) and Mobility (log Koc < 4) would be proxies for a substance's degradation potential and transport velocity, two processes believed to drive the potential for contamination of surface and groundwater as drinking water sources. Two studies identified hundreds of PM substances while three subsequent studies have selected some of these substances for monitoring in surface, ground- and/or drinking water to support the concept. In the present work, the Persistence of the aforementioned substances was reassessed based on all experimental data publicly available. Depending on the exact study examined, it was found that 15 % to 40 % of the substances were erroneously concluded as P. The reinterpretation of the data indicates that a PM substance does not have a higher likelihood to be detected in surface or groundwater than a non-PM substance. In addition, the PM properties do not have any influence on the level of contamination. Twenty-six to 75 % of the substances selected because they were identified as PM were not found in surface or ground water despite being selected for their high emission pattern. Regulations based primarily on the PM concept, like the CLP and possibly REACH and UN-GHS, are unlikely to appropriately identify substances of concern for drinking water sources. It is more likely that chemical presence in surface and groundwater is driven by emission patterns or local factors. The development of specific exposure models would better contribute to the protection of drinking water resources and consumers.
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Affiliation(s)
| | | | - Delina Lyon
- Concawe, Boulevard du Souverain 165, B-1160 Brussels, Belgium.
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12
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Hutton D, Booker P, Shuttleworth S, Hall T, Cain M, Murphy T, Woods L, Saunders D. The Patient's perspective: A review of the results from a radiotherapy patient experience survey in the North-West of England. Radiography (Lond) 2023; 29 Suppl 1:S59-S67. [PMID: 36934026 DOI: 10.1016/j.radi.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION A patient experience survey was undertaken for patients completing radiotherapy at the three Northwest of England Radiotherapy Providers. METHODS A previously reported National Radiotherapy Patient Experience Survey was adapted and undertaken in the Northwest of England. Quantitative data was analysed to establish trends. Frequency distribution was applied to appraise the number of participants selecting each of the pre-determined responses. Thematic analysis of free text responses was conducted. RESULTS The questionnaire received 653 responses from the 3 providers across seven departments. Thematic analysis revealed 3 themes; logistics, information and operational. CONCLUSION The results indicate that the majority of patients are satisfied with their treatment and care. Patients' responses indicate areas for improvements. Expectancy theory states that an individual's satisfaction is related to the difference between expected service and the service received. Consequently, when reviewing services and developing improvement it is important to understand patients' expectations. This regional survey starts to capture what people receiving radiotherapy expect from the service and the professionals delivering their treatment. IMPLICATIONS FOR PRACTICE This survey responses make a case for reviewing the information provision pre and post radiotherapy. This includes clarifying the understanding of consent for treatment including the intended benefits and potential late effects. There is an argument to offer information sessions prior to radiotherapy to achieve more relaxed and informed patients. A recommendation from this work is for the radiotherapy community undertake a national radiotherapy patient experience survey, facilitated via the 11 Radiotherapy ODNs. A national radiotherapy survey has multiple benefits to inform improvements in practice. This includes benchmarking services against national averages. This approach is aligned with the principles of the service specification in terms of reducing variation and increasing quality.
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Affiliation(s)
- D Hutton
- NW Radiotherapy ODN, United Kingdom.
| | - P Booker
- Lancashire Teaching Hospitals, United Kingdom
| | | | - T Hall
- NW Radiotherapy ODN, United Kingdom
| | - M Cain
- The Clatterbridge Cancer Centre NHS FT, United Kingdom
| | - T Murphy
- NW Radiotherapy ODN, United Kingdom
| | - L Woods
- The Clatterbridge Cancer Centre NHS FT, United Kingdom
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13
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Saunders D, Sussman T, Corbeil T, Canino G, Bird H, Alegria M, Duarte CS. Development, religious affiliation, and social context: Substance use disorders in Puerto Rican transitional age youth. Front Psychiatry 2023; 14:1076869. [PMID: 36873209 PMCID: PMC9978336 DOI: 10.3389/fpsyt.2023.1076869] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Transitional age youth (i. e., ages 16-24; TAY) use higher levels of substances than any age group in the United States. Understanding what factors increase substance use during TAY could suggest novel targets for prevention/intervention. Studies suggest that religious affiliation is inversely associated with substance use disorders (SUDs). However, the association of religious affiliation and SUD, including the role of gender and social context, has not been studied in TAY of Puerto Rican ethnicity. Methods Using data from N = 2,004 TAY of Puerto Rican ethnicity across two social contexts-Puerto Rico (PR) and the South Bronx, NY (SBx)-we tested the association of religious identity (Catholic, Non-Catholic Christian, Other/Mixed, and no religious affiliation, or "None"), and four SUD outcomes (alcohol use disorder, tobacco use disorder, illicit SUD, and any SUD). Logistic regression models were used to examine the association between religious identity and SUDs, then we tested for interaction by social context and gender. Result Half the sample identified as female; 30, 44, and 25% were 15-20, 21-24, and 25-29 years of age, respectively; 28% of the sample received public assistance. There was a statistically significant difference between sites for public assistance (22 and 33% in SBx/PR, respectively; p < 0.001); 29% of the sample endorsed None (38 and 21% in SBx/PR, respectively.) Compared to None, identifying as Catholic was associated with reduced risk of illicit SUD (OR = 0.51, p = 0.02), and identifying as Non-Catholic Christian with reduced risk for any SUD (OR = 0.68, p = 0.04). Additionally, in PR but not SBx, being Catholic or Non-Catholic Christian was protective for illicit SUD when compared to None (OR = 0.13 and 0.34, respectively). We found no evidence of an interaction between religious affiliation and gender. Discussion The percentage of PR TAY who endorse no affiliation is higher than the general PR population, reflective of increasing religious non-affiliation among TAY across cultures. Critically, TAY with no religious affiliation are twice as likely as Catholics to have illicit SUD, and 1.5 times as likely as Non-Catholic Christians to have any SUD. Endorsing no affiliation is more adverse for illicit SUD in PR than the SBx, underscoring the importance of social context.
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Affiliation(s)
- David Saunders
- Center for Intergenerational Psychiatry, Division of Child Psychiatry, New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, NY, United States
| | - Tamara Sussman
- Center for Intergenerational Psychiatry, Division of Child Psychiatry, New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, NY, United States
| | - Thomas Corbeil
- Center for Intergenerational Psychiatry, Division of Child Psychiatry, New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, NY, United States
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan, PR, United States
| | - Hector Bird
- Center for Intergenerational Psychiatry, Division of Child Psychiatry, New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, NY, United States
| | - Margarita Alegria
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Cristiane S. Duarte
- Center for Intergenerational Psychiatry, Division of Child Psychiatry, New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, NY, United States
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Abdel Hamid MM, Abdelraheem MH, Acheampong DO, Ahouidi A, Ali M, Almagro-Garcia J, Amambua-Ngwa A, Amaratunga C, Amenga-Etego L, Andagalu B, Anderson T, Andrianaranjaka V, Aniebo I, Aninagyei E, Ansah F, Ansah PO, Apinjoh T, Arnaldo P, Ashley E, Auburn S, Awandare GA, Ba H, Baraka V, Barry A, Bejon P, Bertin GI, Boni MF, Borrmann S, Bousema T, Bouyou-Akotet M, Branch O, Bull PC, Cheah H, Chindavongsa K, Chookajorn T, Chotivanich K, Claessens A, Conway DJ, Corredor V, Courtier E, Craig A, D'Alessandro U, Dama S, Day N, Denis B, Dhorda M, Diakite M, Djimde A, Dolecek C, Dondorp A, Doumbia S, Drakeley C, Drury E, Duffy P, Echeverry DF, Egwang TG, Enosse SMM, Erko B, Fairhurst RM, Faiz A, Fanello CA, Fleharty M, Forbes M, Fukuda M, Gamboa D, Ghansah A, Golassa L, Goncalves S, Harrison GLA, Healy SA, Hendry JA, Hernandez-Koutoucheva A, Hien TT, Hill CA, Hombhanje F, Hott A, Htut Y, Hussein M, Imwong M, Ishengoma D, Jackson SA, Jacob CG, Jeans J, Johnson KJ, Kamaliddin C, Kamau E, Keatley J, Kochakarn T, Konate DS, Konaté A, Kone A, Kwiatkowski DP, Kyaw MP, Kyle D, Lawniczak M, Lee SK, Lemnge M, Lim P, Lon C, Loua KM, Mandara CI, Marfurt J, Marsh K, Maude RJ, Mayxay M, Maïga-Ascofaré O, Miotto O, Mita T, Mobegi V, Mohamed AO, Mokuolu OA, Montgomery J, Morang’a CM, Mueller I, Murie K, Newton PN, Ngo Duc T, Nguyen T, Nguyen TN, Nguyen Thi Kim T, Nguyen Van H, Noedl H, Nosten F, Noviyanti R, Ntui VNN, Nzila A, Ochola-Oyier LI, Ocholla H, Oduro A, Omedo I, Onyamboko MA, Ouedraogo JB, Oyebola K, Oyibo WA, Pearson R, Peshu N, Phyo AP, Plowe CV, Price RN, Pukrittayakamee S, Quang HH, Randrianarivelojosia M, Rayner JC, Ringwald P, Rosanas-Urgell A, Rovira-Vallbona E, Ruano-Rubio V, Ruiz L, Saunders D, Shayo A, Siba P, Simpson VJ, Sissoko MS, Smith C, Su XZ, Sutherland C, Takala-Harrison S, Talman A, Tavul L, Thanh NV, Thathy V, Thu AM, Toure M, Tshefu A, Verra F, Vinetz J, Wellems TE, Wendler J, White NJ, Whitton G, Yavo W, van der Pluijm RW. Pf7: an open dataset of Plasmodium falciparum genome variation in 20,000 worldwide samples. Wellcome Open Res 2023; 8:22. [PMID: 36864926 PMCID: PMC9971654 DOI: 10.12688/wellcomeopenres.18681.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
We describe the MalariaGEN Pf7 data resource, the seventh release of Plasmodium falciparum genome variation data from the MalariaGEN network. It comprises over 20,000 samples from 82 partner studies in 33 countries, including several malaria endemic regions that were previously underrepresented. For the first time we include dried blood spot samples that were sequenced after selective whole genome amplification, necessitating new methods to genotype copy number variations. We identify a large number of newly emerging crt mutations in parts of Southeast Asia, and show examples of heterogeneities in patterns of drug resistance within Africa and within the Indian subcontinent. We describe the profile of variations in the C-terminal of the csp gene and relate this to the sequence used in the RTS,S and R21 malaria vaccines. Pf7 provides high-quality data on genotype calls for 6 million SNPs and short indels, analysis of large deletions that cause failure of rapid diagnostic tests, and systematic characterisation of six major drug resistance loci, all of which can be freely downloaded from the MalariaGEN website.
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Affiliation(s)
| | | | - Mohamed Hassan Abdelraheem
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
- Nuclear Applications In Biological Sciences, Sudan Atomic Energy Commission, Khartoum, Sudan
| | - Desmond Omane Acheampong
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ambroise Ahouidi
- Health Research Epidemiological Surveillance and Training Institute (IRESSEF), Université Cheikh Anta Diop, Dakar, Senegal
| | - Mozam Ali
- Wellcome Sanger Institute, Hinxton, UK
| | | | - Alfred Amambua-Ngwa
- Wellcome Sanger Institute, Hinxton, UK
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Chanaki Amaratunga
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Lucas Amenga-Etego
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Ben Andagalu
- United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Tim Anderson
- Texas Biomedical Research Institute, San Antonio, USA
| | | | | | - Enoch Aninagyei
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health & Allied Sciences, Ho, Ghana
| | - Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Patrick O Ansah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | | | - Paulo Arnaldo
- Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | - Elizabeth Ashley
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Sarah Auburn
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Nuffield Department of Medicine, University of Oxford, UK
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Hampate Ba
- Institut National de Recherche en Santé Publique, Nouakchott, Mauritania
| | - Vito Baraka
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Department of Epidemiology, International Health Unit, Universiteit Antwerpen, Antwerp, Belgium
| | - Alyssa Barry
- Walter and Eliza Hall Institute, Melbourne, Australia
- Deakin University, Geelong, Australia
- Burnet Institute, Melbourne, Australia
| | - Philip Bejon
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Maciej F Boni
- Nuffield Department of Medicine, University of Oxford, UK
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Steffen Borrmann
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Teun Bousema
- London School of Hygiene and Tropical Medicine, London, UK
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marielle Bouyou-Akotet
- Department of Parasitology-Mycology, Université des Sciences de la Santé, Libreville, Gabon
| | - Oralee Branch
- NYU School of Medicine Langone Medical Center, New York, USA
| | - Peter C Bull
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Huch Cheah
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | | | | | - Antoine Claessens
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- LPHI, MIVEGEC, INSERM, CNRS, IRD, University of Montpellier, Montpellier, France
| | - David J Conway
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Alister Craig
- Liverpool School of Tropical Medicine, Liverpool, UK
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Souleymane Dama
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Nicholas Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Brigitte Denis
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
| | - Mehul Dhorda
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- WorldWide Antimalarial Resistance Network – Asia Regional Centre, Bangkok, Thailand
| | - Mahamadou Diakite
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Arjen Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Seydou Doumbia
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), Bamako, Mali
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Patrick Duffy
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Diego F Echeverry
- Departamento de Microbiología, Universidad del Valle, Cali, Colombia
- Centro Internacional de Entrenamiento e Investigaciones Médicas - CIDEIM, Cali, Colombia
| | | | | | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Caterina A Fanello
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Mark Fleharty
- Broad Institute of Harvard and MIT and Harvard, Cambridge, MA, USA
| | | | - Mark Fukuda
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | - Dionicia Gamboa
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Anita Ghansah
- Nogouchi Memorial Institute for Medical Research, Legon-Accra, Ghana
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Sara Anne Healy
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Jason A Hendry
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Tran Tinh Hien
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Catherine A Hill
- Department of Entomology, Purdue University, West Lafayette, USA
| | - Francis Hombhanje
- Centre for Health Research & Diagnostics, Divine Word University, Madang, Papua New Guinea
| | | | - Ye Htut
- Department of Medical Research, Yangon, Myanmar
| | - Mazza Hussein
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Deus Ishengoma
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- East African Consortium for Clinical Research (EACCR), Dar es Salaam, Tanzania
| | - Scott A Jackson
- Center for Applied Genetic Technologies, University of Georgia, Athens, GA, USA
| | | | | | | | - Claire Kamaliddin
- Institute of Research for Development (IRD), Paris, France
- The University of Calgary, Calgary, Canada
| | - Edwin Kamau
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | - Drissa S Konate
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Aminatou Kone
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Myat P Kyaw
- Myanmar Oxford Clinical Research Unit, University of Oxford, Yangon, Myanmar
- University of Public Health, Yangon, Myanmar
| | - Dennis Kyle
- University of South Florida, Tampa, USA
- University of Georgia, Athens, USA
| | | | - Samuel K Lee
- Broad Institute of Harvard and MIT and Harvard, Cambridge, MA, USA
| | - Martha Lemnge
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Pharath Lim
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
- Medical Care Development International, Maryland, USA
| | - Chanthap Lon
- National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Kovana M Loua
- University Gamal Abdel Nasser of Conakry, Conakry, Guinea
- Institut National de Santé Publique, Conakry, Guinea
| | - Celine I Mandara
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Jutta Marfurt
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kevin Marsh
- Nuffield Department of Medicine, University of Oxford, UK
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Richard James Maude
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA
| | - Mayfong Mayxay
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Oumou Maïga-Ascofaré
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Research in Tropical Medicine, Kwame Nkrumah University of Sciences and Technology, Kumasi, Ghana
| | - Olivo Miotto
- Wellcome Sanger Institute, Hinxton, UK
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- MRC Centre for Genomics and Global Health, Big Data Institute, Oxford University, Oxford, UK
| | | | - Victor Mobegi
- Department of Biochemistry and Centre for Biotechnology and Bioinformatics, University of Nairobi, Nairobi, Kenya
| | | | - Olugbenga A Mokuolu
- Department of Paediatrics and Child Health, University of Ilorin, Ilorin, Nigeria
| | - Jaqui Montgomery
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
- World Mosquito Program, Monash University, Melbourne, Australia
| | - Collins Misita Morang’a
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Ivo Mueller
- Walter and Eliza Hall Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | | | - Paul N Newton
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Thang Ngo Duc
- National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | | | - Thuy-Nhien Nguyen
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | | | - Hong Nguyen Van
- National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Harald Noedl
- MARIB - Malaria Research Initiative Bandarban, Bandarban, Bangladesh
- Medical University of Vienna, Vienna, Austria
| | - Francois Nosten
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | | | - Alexis Nzila
- King Fahid University of Petroleum and Minerals (KFUMP), Dhahran, Saudi Arabia
| | | | - Harold Ocholla
- KEMRI Centres for Disease Control and Prevention (CDC) Research Program, Kisumu, Kenya
- Centre for Bioinformatics and Biotechnology, University of Nairobi, Nairobi, Kenya
| | - Abraham Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Irene Omedo
- Wellcome Sanger Institute, Hinxton, UK
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marie A Onyamboko
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo, Democratic Republic
| | | | - Kolapo Oyebola
- Nigerian Institute of Medical Research, Lagos, Nigeria
- Parasitology and Bioinformatics Unit, Faculty of Science, University of Lagos, Lagos, Nigeria
| | | | | | - Norbert Peshu
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Aung P Phyo
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Shoklo Malaria Research Unit, Bangkok, Thailand
| | | | - Ric N Price
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | - Huynh Hong Quang
- Institute of Malariology, Parasitology, and Entomology (IMPE) Quy Nhon, Ministry of Health, Quy Nhon, Vietnam
| | - Milijaona Randrianarivelojosia
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Universités d'Antananarivo et de Mahajanga, Antananarivo, Madagascar
| | - Julian C Rayner
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | | | | | | | | | - Lastenia Ruiz
- Universidad Nacional de la Amazonia Peruana, Iquitos, Peru
| | - David Saunders
- Department of Medicine, Uniformed Services University, Bethesda, MD, USA
| | - Alex Shayo
- Nelson Mandela Institute of Science and Technology, Arusha, Tanzania
| | - Peter Siba
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | | | - Mahamadou S. Sissoko
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Xin-zhuan Su
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | | | - Shannon Takala-Harrison
- Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Arthur Talman
- MIVEGEC, Université de Montpellier, IRD, CNRS, Montpellier, France
| | - Livingstone Tavul
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ngo Viet Thanh
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Vandana Thathy
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA
| | - Aung Myint Thu
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Mahamoudou Toure
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | | | - Joseph Vinetz
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
- Yale School of Medicine, New Haven, CT, USA
| | - Thomas E Wellems
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Jason Wendler
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
- Seattle Children’s Hospital, Seattle, USA
| | - Nicholas J White
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - William Yavo
- University Félix Houphouët-Boigny, Abidjan, Cote d'Ivoire
- Malaria Research and Control Center of the National Institute of Public Health, Abidjan, Cote d'Ivoire
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Richard SA, Pollett SD, Fries AC, Berjohn CM, Maves RC, Lalani T, Smith AG, Mody RM, Ganesan A, Colombo RE, Lindholm DA, Morris MJ, Huprikar N, Colombo CJ, Madar C, Jones M, Larson DT, Bazan SE, Mende K, Saunders D, Livezey J, Lanteri CA, Scher AI, Byrne C, Rusiecki J, Ewers E, Epsi NJ, Rozman JS, English C, Simons MP, Tribble DR, Agan BK, Burgess TH. Persistent COVID-19 Symptoms at 6 Months After Onset and the Role of Vaccination Before or After SARS-CoV-2 Infection. JAMA Netw Open 2023; 6:e2251360. [PMID: 36652247 PMCID: PMC9857077 DOI: 10.1001/jamanetworkopen.2022.51360] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
IMPORTANCE Understanding the factors associated with post-COVID conditions is important for prevention. OBJECTIVE To identify characteristics associated with persistent post-COVID-19 symptoms and to describe post-COVID-19 medical encounters. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases With Pandemic Potential (EPICC) study implemented in the US military health system (MHS); MHS beneficiaries aged 18 years or older who tested positive for SARS-CoV-2 from February 28, 2020, through December 31, 2021, were analyzed, with 1-year follow-up. EXPOSURES SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The outcomes analyzed included survey-reported symptoms through 6 months after SARS-CoV-2 infection and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis categories reported in medical records 6 months following SARS-CoV-2 infection vs 3 months before infection. RESULTS More than half of the 1832 participants in these analyses were aged 18 to 44 years (1226 [66.9%]; mean [SD] age, 40.5 [13.7] years), were male (1118 [61.0%]), were unvaccinated at the time of their infection (1413 [77.1%]), and had no comorbidities (1290 [70.4%]). A total of 728 participants (39.7%) had illness that lasted 28 days or longer (28-89 days: 364 [19.9%]; ≥90 days: 364 [19.9%]). Participants who were unvaccinated prior to infection (risk ratio [RR], 1.39; 95% CI, 1.04-1.85), reported moderate (RR, 1.80; 95% CI, 1.47-2.22) or severe (RR, 2.25; 95% CI, 1.80-2.81) initial illnesses, had more hospitalized days (RR per each day of hospitalization, 1.02; 95% CI, 1.00-1.03), and had a Charlson Comorbidity Index score of 5 or greater (RR, 1.55; 95% CI, 1.01-2.37) were more likely to report 28 or more days of symptoms. Among unvaccinated participants, postinfection vaccination was associated with a 41% lower risk of reporting symptoms at 6 months (RR, 0.59; 95% CI, 0.40-0.89). Participants had higher risk of pulmonary (RR, 2.00; 95% CI, 1.40-2.84), diabetes (RR, 1.46; 95% CI, 1.00-2.13), neurological (RR, 1.29; 95% CI, 1.02-1.64), and mental health-related medical encounters (RR, 1.28; 95% CI, 1.01-1.62) at 6 months after symptom onset than at baseline (before SARS-CoV-2 infection). CONCLUSIONS AND RELEVANCE In this cohort study, more severe acute illness, a higher Charlson Comorbidity Index score, and being unvaccinated were associated with a higher risk of reporting COVID-19 symptoms lasting 28 days or more. Participants with COVID-19 were more likely to seek medical care for diabetes, pulmonary, neurological, and mental health-related illness for at least 6 months after onset compared with their pre-COVID baseline health care use patterns. These findings may inform the risk-benefit ratio of COVID-19 vaccination policy.
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Affiliation(s)
- Stephanie A. Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Simon D. Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | | | - Catherine M. Berjohn
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Naval Medical Center San Diego, San Diego, California
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Ryan C. Maves
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Naval Medical Center San Diego, San Diego, California
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Naval Medical Center Portsmouth, Portsmouth, Virginia
| | | | - Rupal M. Mody
- William Beaumont Army Medical Center, Fort Bliss, Texas
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Rhonda E. Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington
| | - David A. Lindholm
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
| | - Michael J. Morris
- Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
| | - Nikhil Huprikar
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Christopher J. Colombo
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington
| | | | - Milissa Jones
- Tripler Army Medical Center, Honolulu, Hawaii
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Derek T. Larson
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | | | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
| | - David Saunders
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jeffrey Livezey
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Charlotte A. Lanteri
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | | | | | - Evan Ewers
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | - Nusrat J. Epsi
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Julia S. Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Caroline English
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Mark P. Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David R. Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Brian K. Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
| | - Timothy H. Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Richard SA, Scher A, Rusiecki J, Byrne C, Berjohn CM, Fries AC, Lalani T, Smith AG, Mody R, Ganesan A, Huprikar N, Colombo RE, Colombo C, Lindholm DA, Mende K, Jones M, Larson D, Ewers EC, Bazan S, Lanteri C, Saunders D, Maves RC, Livezey J, Edwards MS, Rozman JS, Tribble DR, Agan B, Pollett S, Simons MP, Burgess T. 80. SARS-CoV-2 infection is associated with decreased reported physical fitness in a US military longitudinal cohort. Open Forum Infect Dis 2022. [PMCID: PMC9751972 DOI: 10.1093/ofid/ofac492.005] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background COVID-19 may have deleterious effects on the fitness of active duty US military service members. We seek to understand the long-term functional consequences of SARS-CoV-2 infection in this critical population, and in other military healthcare beneficiaries. Methods The Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential (EPICC) study is a longitudinal cohort study to describe the outcomes of SARS-CoV-2 infection in US Military Health System beneficiaries. Subjects provided information about difficulties experienced with daily activities, exercise, and physical fitness performance via electronic surveys. Subjects completed surveys at enrollment and at 1, 3, 6, 9, and 12 months. Results 5,910 subjects completed survey fitness questions, 3,244 (55%) of whom tested SARS-CoV-2 positive at least once during the period of observation. Over 75% of subjects were young adults and over half were male (Table 1). 1,093 (34.3%) of SARS-CoV-2-positive subjects reported new or increased difficulty exercising compared to 393 (14.8%) SARS-CoV-2 negative subjects (p < 0.01) (Table 2). The most commonly reported symptoms related to problems with exercise and activities were dyspnea and fatigue. Among the active-duty members who answered the question about their service-mandated physical fitness test scores, 43.2% of SARS-CoV-2-positive participants reported that their scores had worsened in the study period, compared with 24.3% of SARS-CoV-2 negative participants. Among SARS-CoV-2-positive subjects, reports of difficulty exercising and performing daily activities were highest within one month of the first positive test, decreasing in prevalence among the cohort only slightly to 24% and 18%, respectively, at 12 months (Figure 1).
Conclusion A substantial proportion of military service-members in this cohort have reported impairment of their service-mandated physical fitness scores after COVID-19; this proportion is significantly higher than those who are SARS-CoV-2 negative and persists to 12 months in many; similar complaints were reported among non-active duty. Further objective evaluation of post-COVID fitness impairment in this population is warranted. Disclosures Ryan C. Maves, MD, AiCuris: Grant/Research Support|Sound Pharmaceuticals: Grant/Research Support|Trauma Insights, LLC: Advisor/Consultant Julia S. Rozman, n/a, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response David R. Tribble, DrPH, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Simon Pollett, MBBS, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Mark P. Simons, PhD, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Timothy Burgess, MD, MPH, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response.
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Affiliation(s)
- Stephanie A Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, MD
| | - Ann Scher
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jennifer Rusiecki
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Celia Byrne
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Catherine M Berjohn
- Naval Medical Center San Diego Division of Infectious Diseases, Infectious Disease Clinical Research Program, San Diego, CA
| | | | | | - Alfred G Smith
- Division of Infectious Diseases, Naval Medical Center, Portsmouth, Virginia, USA, Portsmouth, Virginia
| | - Rupal Mody
- William Beaumont Army Medical Center, El Paso, Texas
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Nikhil Huprikar
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Rhonda E Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Madigan Army Medical Center Division of Infectious Diseases, Tacoma, Washington
| | | | | | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, MD
| | | | - Derek Larson
- Naval Medical Center San Diego, san diego, California
| | - Evan C Ewers
- Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | | | - Charlotte Lanteri
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David Saunders
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Ryan C Maves
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jeffrey Livezey
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Margaret Sanchez Edwards
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health SciencesHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Julia S Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, MD
| | - David R Tribble
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Brian Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, MD
| | - Simon Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, MD
| | - Mark P Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, MD
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Goguet E, Weiss CD, Olsen C, Powers JH, Coggins SA, Tribble D, Davies J, Illinik L, Lusvarghi S, Edwards MS, Jackson-Thompson B, Hollis-Perry M, Pollett S, Wang G, Alcorta Y, Wong M, Saunders D, Mohammed R, Ortega O, Parmelee E, Lindrose AR, Haines-Hull H, Moser MS, Samuels EC, Tso MS, Graydon E, Malloy AM, Schully K, Burgess T, Broder CC, Laing ED, Mitre E. 1047. Asymptomatic SARS-CoV-2 Infections, BNT162b2 mRNA COVID 19 Vaccine-Related Symptoms, and Correlates of Immunity in Post-Vaccination Breakthrough Infections in the Prospective Assessment of SARS-CoV-2 Seroconversion (PASS) Study. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.888] [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: 12/23/2022] Open
Abstract
Abstract
Background
We sought to determine the frequency of asymptomatic SARS-CoV-2 infections, the BNT162b2 mRNA COVID 19 vaccine-related symptoms, and the correlates of immunity in post-vaccination breakthrough infections in a prospective cohort of healthcare workers.
Methods
We have been conducting a single-center, observational cohort study of healthcare workers. 271 participants were enrolled since August 25, 2020. Testing for SARS-CoV-2 spike (S)-specific IgG antibodies is conducted using a microsphere-based multiplex immunoassay interpolated against an internal standard curve for binding antibody (bAb) units (BAU) and has been performed on serum samples collected at monthly visits between September 2020 to August of 2021, and quarterly since then. Neutralizing antibody titers against wild-type (WT) virus are determined by microneutralization assays and against Delta and Omicron variants by lentiviral pseudovirus neutralization assays. For the first 6 months, participants completed a symptoms questionnaire every day they had any symptoms.
Results
12 participants were diagnosed with SARS-CoV-2, with at least mild symptoms. Of 206 participants evaluated for adverse effects after 1st and 2nd vaccine doses, no relationship was observed between vaccine-associated symptom scores and antibody titers 1 month after the 2nd dose. Longitudinal studies demonstrate that anti-S IgG bAbs decrease from a geometric mean (GM) of 1929 BAU/mL at 1 month post-vaccination to a GM of 442 BAU/mL at 6 months post-vaccination (P< 0.001, n=187), and that boosting increases S-specific IgG BAU. While only 5 of 39 participants had detectable anti-Omicron neutralizing activity 1 month after 2 vaccinations, booster vaccination resulted in detectable neutralizing activity for all participants.
Conclusion
Asymptomatic infection is likely rare, that there is no relationship between vaccine-associated symptom severity and antibody titers 1 month after the 2nd vaccination, and that booster results in better protection against the Omicron variant. Ongoing studies are evaluating serological and cellular immune responses immediately prior to 38 breakthrough infections in an attempt to identify immune correlates of protection and will be reported at the conference.
Disclosures
John H. Powers, III, MD, Arrevus: Advisor/Consultant|Eicos: Advisor/Consultant|Evofem: Advisor/Consultant|Eyecheck: Advisor/Consultant|Gilead: Advisor/Consultant|GlaxoSmithKline: Advisor/Consultant|OPKO: Advisor/Consultant|Resolve: Advisor/Consultant|Romark: Advisor/Consultant|SpineBioPharma: Advisor/Consultant|UTIlity: Advisor/Consultant|Vir: Advisor/Consultant David Tribble, MD, DrPH, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Simon Pollett, MBBS, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Timothy Burgess, MD, MPH, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response.
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Affiliation(s)
| | - Carol D Weiss
- U.S. Food and Drug Administration , Silver Spring, Maryland
| | - Cara Olsen
- Uniformed Services University , Bethesda, Maryland
| | | | | | - David Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | - Julian Davies
- Infectious Diseases Clinical Research Program, Henry M. Jackson Foundation , Bethesda, Maryland
| | - Luca Illinik
- Henry M. Jackson Foundation for the Advancement of Military Medicine , Portsmouth, Virginia
| | - Sabrina Lusvarghi
- Division of Viral Products, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Admninistration , Silver Spring, Maryland
| | - Margaret Sanchez Edwards
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health SciencesHenry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland
| | | | | | - Simon Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | - Gregory Wang
- Naval Medical Research Center , Bethesda, Maryland
| | - Yolanda Alcorta
- CTC, NMRC , General Dynamics Information Technology, Bethesda, Maryland
| | - Mimi Wong
- CTC, NMRC , General Dynamics Information Technology, Bethesda, Maryland
| | - David Saunders
- Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | | | - Orlando Ortega
- HJF, Infectious Diseases Clinical Research Program , Bethesda, Maryland
| | - Edward Parmelee
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | | | | | | | | | | | | | - Allison M Malloy
- Department of Pediatrics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | | | - Timothy Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | - Christopher C Broder
- Department of Microbiology and Immunology, Uniformed Services University , Bethesda, MD, Bethesda, Maryland
| | - Eric D Laing
- Department of Microbiology and Immunology, Uniformed Services University , Bethesda, MD, Bethesda, Maryland
| | - Edward Mitre
- Uniformed Services University , Bethesda, Maryland
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18
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Pollett S, Richard SA, Fries AC, Malloy AM, Ganesan A, Livezey J, Saunders D, Huprikar N, Mody R, Mende K, Lindholm DA, Berjohn CM, Rozman JS, Jones M, Colombo C, Colombo RE, Tribble D, Simons MP, Agan B, Burgess T. 1056. Correlates of Omicron SARS-CoV-2 viral load: diagnostic and clinical implications. Open Forum Infect Dis 2022. [PMCID: PMC9752607 DOI: 10.1093/ofid/ofac492.897] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Omicron SARS-CoV-2 infections are associated with less frequent olfactory sensory loss and a predominance of pharyngitis symptoms compared to prior variants, with proposed diagnostic implications. We examined whether such symptomology predicts a higher RNA abundance in the oropharynx. We further investigated how age, symptom-day, vaccination history and clinical severity correlate with viral load to inform clinical prognostication and transmission modeling. Methods The EPICC study is a longitudinal cohort of COVID-19 cases enrolled through U.S military medical treatment facilities. Demographic and clinical characteristics were measured with interviews and surveys. Nasopharyngeal (NP), oropharyngeal (OP) and nasal swabs (NS) were collected for SARS-CoV-2 qPCR and sequence genotyping. Multivariable linear regression models were fit to estimate the effect of anatomical site on SARS-CoV-2 RNA abundance (a proxy for viral load), adjusting for sampling time, vaccine history and host age. Results We analyzed 77 sequence-confirmed Omicron cases; no BA.2 cases were detected. The median age was 38.8 years. 81.8% were vaccinated and 15.6% cases were hospitalized. 80.0%, 21.8%, and 65.5% reported nasal congestion, loss of smell or taste, and sore throat, respectively. The median RNA abundance was lowest in OP swabs (p < 0.001) (Fig 1). Linear regression confirmed that OP sampling was associated with lower viral load (p < 0.001). We further noted that greater age and symptom-day were independent correlates of viral load (Table 1). By bivariate analysis there was a trend toward lower RNA abundance in vaccinated subjects (p = 0.35). RNA abundance (at any site) was substantially higher in hospitalized (10634 N2 genome equivalents [GE]/reaction) versus outpatient cases (1419 N1 GE/reaction) but this was not statistically significant (p = 0.26).
RNA abundance by upper respiratory swab anatomical location of collection (n = 142 swabs from n = 77 subjects) ![]() ![]() Conclusion We noted prevalent sore throat symptoms and infrequent sensory loss in Omicron cases. Despite this, viral load was highest in NP/NS collected swabs as has been noted in prior variants. We note an age correlation with RNA abundance, and provide a viral load decay rate which may be useful for transmission modeling. Vaccination and clinical severity may also correlate with Omicron viral load, as noted with prior SARS-CoV-2 variants. Disclosures Simon Pollett, MBBS, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Julia S. Rozman, n/a, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response David Tribble, MD, DrPH, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Mark P. Simons, PhD, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Timothy Burgess, MD, MPH, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response.
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Affiliation(s)
- Simon Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Stephanie A Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | | | - Allison M Malloy
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Jeffrey Livezey
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - David Saunders
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Nikhil Huprikar
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Rupal Mody
- William Beaumont Army Medical Center, El Paso, Texas
| | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | | | - Catherine M Berjohn
- Naval Medical Center San Diego Division of Infectious Diseases, Infectious Disease Clinical Research Program, San Diego, CA
| | - Julia S Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | | | | | - Rhonda E Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Madigan Army Medical Center Division of Infectious Diseases, Tacoma, Washington
| | - David Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Mark P Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
| | - Brian Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Bethesda, Maryland
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19
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Parsons E, Richard SA, Laing ED, Fries AC, Livezey J, Jones M, Lindholm DA, Mende K, Rozman JS, Ganesan A, Huprikar N, Lalani T, Smith AG, Mody R, Bazan S, Saunders D, Colombo RE, Colombo C, Ewers EC, Larson D, Maves RC, Berjohn CM, Maldonado C, Simons MP, Tribble D, Agan B, Burgess T, Pollett S, Malloy AM. 1102. The Host Response to SARS-CoV-2 Infection Differs by Age. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.941] [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: 12/23/2022] Open
Abstract
Abstract
Background
Infection with SARS-CoV-2 and the resulting host immune response has been primarily characterized in middle and older aged populations due to a higher incidence of symptoms in these age groups. Due to reduced severity of disease, children were poorly studied and assumed to be less frequently infected compared to older age groups. We measured the viral load and adaptive immune response across the age-spectrum to define the age-dependent viral and host responses.
Methods
From March 2020-March 2022, we enrolled individuals across the age spectrum who presented to U.S. military medical treatment facilities with COVID-19-like symptoms. In this longitudinal cohort study, demographic and clinical data were collected in addition to nasopharyngeal swabs and peripheral blood. Magnitude of viral RNA was measured by quantitative PCR (qPCR) from nasopharyngeal samples and SARS-CoV-2-specific IgG antibodies were measured from blood with multiplex microsphere immunoassays.
Results
4,768 SARS-CoV-2 positive participants were enrolled, among whom 42, 64, 89, 380, 948 and 245 individuals were in age brackets 0-4y, 5-11y, 12-17y, 18-44, 45-64y, and >65y, respectively. Viral load as measured by qPCR was determined to be similar across age groups within the first week post symptom onset. The magnitude of the IgG antibody response against the spike protein was also compared across age groups at early and convalescent time points and was higher in those over the age of 65 years.
Conclusion
Early viral load during acute infection did not correlate with age in individuals who experienced COVID-19. These findings diverge from other respiratory viruses, such as respiratory syncytial virus and influenza where children tend to have higher viral loads. In contrast, the magnitude of the antibody response against the spike protein correlated with older age at acute and convalescent time points. Together our data suggest that the host response against SAR-CoV-2 differs with age and is not associated with the acute viral load. Defining age-dependent immunity against SARS-CoV-2 has the potential to identify key immunologic responses that can be used to optimize treatment and vaccine strategies.
Disclosures
Julia S. Rozman, n/a, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Ryan C. Maves, MD, AiCuris: Grant/Research Support|Sound Pharmaceuticals: Grant/Research Support|Trauma Insights, LLC: Advisor/Consultant Mark P. Simons, PhD, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response David Tribble, MD, DrPH, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Timothy Burgess, MD, MPH, AstraZeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response Simon Pollett, MBBS, Astra Zeneca: The HJF, in support of the USU IDCRP, was funded to conduct or augment unrelated Phase III Mab and vaccine trials as part of US Govt. COVID19 response.
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Affiliation(s)
| | - Stephanie A Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Eric D Laing
- Department of Microbiology and Immunology, Uniformed Services University , Bethesda, MD, Bethesda, Maryland
| | | | - Jeffrey Livezey
- Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | | | - David A Lindholm
- Uniformed Services University of the Health Sciences , San Antonio, Texas
| | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Julia S Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, Walter Reed National Military Medical Center , Bethesda, Maryland
| | - Nikhil Huprikar
- Walter Reed National Military Medical Center , Bethesda, Maryland
| | | | - Alfred G Smith
- Division of Infectious Diseases, Naval Medical Center , Portsmouth, Virginia, USA, Portsmouth, Virginia
| | - Rupal Mody
- William Beaumont Army Medical Center , El Paso, Texas
| | | | - David Saunders
- Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
| | - Rhonda E Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Madigan Army Medical Center Division of Infectious Diseases , Tacoma, Washington
| | | | - Evan C Ewers
- Fort Belvoir Community Hospital , Fort Belvoir, Virginia
| | - Derek Larson
- Naval Medical Center San Diego , san diego, California
| | - Ryan C Maves
- Wake Forest University School of Medicine , Winston-Salem, North Carolina
| | - Catherine M Berjohn
- Naval Medical Center San Diego Division of Infectious Diseases, Infectious Disease Clinical Research Program , San Diego, CA
| | | | - Mark P Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - David Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Brian Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Timothy Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Simon Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, MD
| | - Allison M Malloy
- Department of Pediatrics, Uniformed Services University of the Health Sciences , Bethesda, MD, USA, Bethesda, Maryland
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20
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Wang W, Lusvarghi S, Subramanian R, Epsi NJ, Wang R, Goguet E, Fries AC, Echegaray F, Vassell R, Coggins SA, Richard SA, Lindholm DA, Mende K, Ewers EC, Larson DT, Colombo RE, Colombo CJ, Joseph JO, Rozman JS, Smith A, Lalani T, Berjohn CM, Maves RC, Jones MU, Mody R, Huprikar N, Livezey J, Saunders D, Hollis-Perry M, Wang G, Ganesan A, Simons MP, Broder CC, Tribble DR, Laing ED, Agan BK, Burgess TH, Mitre E, Pollett SD, Katzelnick LC, Weiss CD. Antigenic cartography of well-characterized human sera shows SARS-CoV-2 neutralization differences based on infection and vaccination history. Cell Host Microbe 2022; 30:1745-1758.e7. [PMID: 36356586 PMCID: PMC9584854 DOI: 10.1016/j.chom.2022.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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: 07/03/2022] [Revised: 08/31/2022] [Accepted: 10/18/2022] [Indexed: 01/26/2023]
Abstract
The rapid emergence of SARS-CoV-2 variants challenges vaccination strategies. Here, we collected 201 serum samples from persons with a single infection or multiple vaccine exposures, or both. We measured their neutralization titers against 15 natural variants and 7 variants with engineered spike mutations and analyzed antigenic diversity. Antigenic maps of primary infection sera showed that Omicron sublineages BA.2, BA.4/BA.5, and BA.2.12.1 are distinct from BA.1 and more similar to Beta/Gamma/Mu variants. Three mRNA COVID-19 vaccinations increased neutralization of BA.1 more than BA.4/BA.5 or BA.2.12.1. BA.1 post-vaccination infection elicited higher neutralization titers to all variants than three vaccinations alone, although with less neutralization to BA.2.12.1 and BA.4/BA.5. Those with BA.1 infection after two or three vaccinations had similar neutralization titer magnitude and antigenic recognition. Accounting for antigenic differences among variants when interpreting neutralization titers can aid the understanding of complex patterns in humoral immunity that informs the selection of future COVID-19 vaccine strains.
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Affiliation(s)
- Wei Wang
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Sabrina Lusvarghi
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Rahul Subramanian
- Office of Data Science and Emerging Technologies, Office of Science Management and Operations, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nusrat J Epsi
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Richard Wang
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Emilie Goguet
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA; Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Anthony C Fries
- U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Fairborn, OH, USA
| | - Fernando Echegaray
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Russell Vassell
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Si'Ana A Coggins
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA; Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Stephanie A Richard
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - David A Lindholm
- Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Katrin Mende
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Evan C Ewers
- Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | | | - Rhonda E Colombo
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Madigan Army Medical Center, Tacoma, WA, USA
| | - Christopher J Colombo
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Madigan Army Medical Center, Tacoma, WA, USA
| | - Janet O Joseph
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Julia S Rozman
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Alfred Smith
- Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - Tahaniyat Lalani
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA; Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - Catherine M Berjohn
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Naval Medical Center San Diego, San Diego, CA, USA
| | - Ryan C Maves
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Section of Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Rupal Mody
- William Beaumont Army Medical Center, El Paso, TX, USA
| | - Nikhil Huprikar
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Jeffrey Livezey
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David Saunders
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Monique Hollis-Perry
- Clinical Trials Center, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, MD, USA
| | - Gregory Wang
- General Dynamics Information Technology, Falls Church, VA, USA
| | - Anuradha Ganesan
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Mark P Simons
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Christopher C Broder
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David R Tribble
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Eric D Laing
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Brian K Agan
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Timothy H Burgess
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Edward Mitre
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Simon D Pollett
- Infectious Diseases Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
| | - Leah C Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Carol D Weiss
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
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21
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Kalra N, Livermore J, Spink S, Boyer G, O'Malley L, Flatley M, Maguire M, Fairclough S, Wright E, Armstrong C, Stephenson E, Ewan S, Cooper S, Guy D, Saunders D, Igra M, Macmullen-Price J, Currie S, Zaman A, Derbyshire C, Chakrabarty A, Gooden J, Chumas P, Mathew R. NCOG-28. LEEDS LOW GRADE GLIOMA SERVICE 2010-2022: A 12-YEAR EXPERIENCE. Neuro Oncol 2022. [PMCID: PMC9660792 DOI: 10.1093/neuonc/noac209.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
INTRODUCTION
We present our 12-year experience of the surgical management of lower-grade gliomas (LGGs) by a multidisciplinary team in a large tertiary UK brain tumour centre.
METHODS
Retrospective analysis of all adult patients who underwent surgery in the Leeds Low Grade Glioma Service between January 2010 and January 2022. Data collected included demographics, procedure type, extent of resection, histological diagnosis, morbidity, mortality, tumour location, seizure control, adjuvant therapy, cognitive outcomes, progression-free survival (PFS) and overall survival (OS). Results were statistically analysed by Kaplan-Meier and Log Rank (Cox Proportional Regression Hazard) Testing (p< 0.05).
RESULTS
254 patients underwent surgery between 2010-2022. Of these, 77 patients underwent a second resection surgery, 9 a third, and 1 patient had a total of 4 resections. 184 operations were carried out awake, 115 asleep and 42 patients underwent biopsy only. The most common histology at initial surgery was astrocytoma, IDH1m, WHO Grade 2 (41.7%) with oligodendroglioma, IDH1m, WHO Grade 2 being the second most common. The majority of tumors were located in the right frontal lobe (24%) followed by the left frontal lobe (18%). 32% of tumors were on the left side. The median time between diagnosis and first surgery was 36.5 months. 8 patients died during this time frame, 7 who had resection, 1 had biopsy.
CONCLUSION
Our experience of the surgical management of LGG over the last 12 years shows that maximal safe surgical resection remains important as first-line treatment. Greater extent of resection (EOR) can delay transformation, control seizures and improve survival. Awake surgery is well tolerated and can preserve eloquent function. A multidisciplinary team approach achieves the best outcomes, and is appreciated by our patients
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Affiliation(s)
- Neeraj Kalra
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - James Livermore
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Suzanne Spink
- Department of Speech and Language Therapy, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Gillian Boyer
- Department of Neuro-Oncology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Lianne O'Malley
- Department of Neuro-Oncology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Michael Flatley
- Department of Neuro-Oncology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Melissa Maguire
- Department of Neurology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Sam Fairclough
- Department of Neurology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Elizabeth Wright
- Department of Neurology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Caroline Armstrong
- Department of Neurology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Elisa Stephenson
- Department of Physiotherapy, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Seonaid Ewan
- Department of Physiotherapy, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Sara Cooper
- Department of Physiotherapy, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Danielle Guy
- Department of Orthoptics, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - David Saunders
- Department of Neuro-Radiology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Mark Igra
- Department of Neuro-Radiology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Jeremy Macmullen-Price
- Department of Neuro-Radiology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Stuart Currie
- Department of Neuro-Radiology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Arshad Zaman
- Department of Neuro-Radiology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Catherine Derbyshire
- Department of Neuropsychology, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Arundhati Chakrabarty
- Department of Histopathology, Leeds Teaching Hospitals NHS Trust, Leeds , England , United Kingdom
| | - John Gooden
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Paul Chumas
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Ryan Mathew
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds , England , United Kingdom
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22
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Anderson C, Lee C, Kelley J, Walker G, Dunlap N, Bar-Ad V, Miller D, King V, Peddada A, Ciuba D, Vincent F, Muzyka B, Gillespie-Twardy A, Sonis S, Holmlund J, Saunders D. Tumor Outcomes for ROMAN: Phase 3 Trial of Avasopasem Manganese (GC4419) for Severe Oral Mucositis (SOM) in Patients Receiving Chemoradiotherapy (CRT) for Locally Advanced Head and Neck Cancer (LAHNC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.518] [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: 10/31/2022]
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23
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Vitulano LA, Mitchell JT, Vitulano ML, Leckman JF, Saunders D, Davis N, Woodward D, Goodhue B, Artukoglu B, Kober H. Parental perspectives on attention-deficit/hyperactivity disorder treatments for children. Clin Child Psychol Psychiatry 2022; 27:1019-1032. [PMID: 35695509 DOI: 10.1177/13591045221108836] [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] [Indexed: 11/16/2022]
Abstract
This study investigated parental perspectives and experiences on the evaluation and treatment process associated with attention-deficit/hyperactivity disorder (ADHD). Five hundred sixty-eight parents of youth 2-28 years-old (M = 9.37; SD = 4.11) diagnosed with ADHD responded to a 14-item online survey about their child's diagnosis and treatment. Parents reported that they had tried an average of 4.49 interventions (SD = 2.63). Parents further shared factors in treatment selection, most helpful parenting strategies, and preferences for types of treatments and treatment targets. A majority of parents reported incorporating many non-traditional strategies (e.g., exercise, healthy eating, outdoor activities) with goals of improving their child's coping skills, study habits, and anger management. The findings show that treatment choices were often selected based on trust in the provider, research support, and the child's preference. Given parental preferences for non-traditional strategies, treatment development efforts should consider these strategies as a component of a broader multimodal treatment approach to ADHD.
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Affiliation(s)
| | | | | | | | - David Saunders
- Yale Child Study Center.,5798Columbia University, New York, NY, USA
| | | | | | | | | | - Hedy Kober
- Yale University Department of Psychiatry
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24
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Bejarano AC, Hughes SA, Saunders D. Hazard assessment of chemical constituents in biocide formulations used in offshore oil and gas operations. Mar Pollut Bull 2022; 183:114076. [PMID: 36057157 DOI: 10.1016/j.marpolbul.2022.114076] [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: 01/26/2022] [Revised: 08/11/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Biocides used in offshore oil and gas operations could be present in water discharges, and thus identifying such chemicals and their hazard could help address concerns regarding non-target organisms. Aquatic toxicity data, queried from different sources and augmented with predictive models, were used to develop species sensitivity distributions and their corresponding 5th percentile hazard concentrations (HC5s). Curated data, including over 1000 empirical records for 137 species, indicated no evidence of bias when comparing sensitivity between marine and freshwater species, even when predicted data were used. HC5s facilitated estimation of an acute-to-chronic ratio (ACR = 10), appropriate for most chemicals and useful in filling data gaps. Comparison of chronic-HC5s with the default approach for deriving predicted no effect concentrations showed that the latter systematically overstates aquatic hazard. The present approach shows promise of using acute-to-chronic HC5 ratios for defining assessment factors for different chemical classes, instead of the use of generic assessment factors.
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Affiliation(s)
| | | | - David Saunders
- Shell Global Solutions International, The Hague, the Netherlands
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25
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Lek D, Rachmat A, Harrison D, Chin G, Chaoratanakawee S, Saunders D, Menard D, Rogers WO. Efficacy of three anti-malarial regimens for uncomplicated Plasmodium falciparum malaria in Cambodia, 2009-2011: a randomized controlled trial and brief review. Malar J 2022; 21:259. [PMID: 36071520 PMCID: PMC9450427 DOI: 10.1186/s12936-022-04279-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/28/2022] [Indexed: 11/26/2022] Open
Abstract
Background Anti-malarial resistance remains an important public health challenge in Cambodia. The effectiveness of three therapies for uncomplicated falciparum malaria was evaluated in Oddar Meanchey province in Northern Cambodia from 2009 to 2011. Methods In this randomized, open-label, parallel group-controlled trial, 211 subjects at least 5 years old with uncomplicated falciparum malaria were treated with 3 days of directly observed therapy: 63 received artesunate–mefloquine (AS/MQ), 77 received dihydroartemisinin–piperaquine (DHA/PPQ), and 71 received atovaquone–proguanil (ATQ/PG). The subjects were followed for 42 days or until recurrent parasitaemia. Genotyping of msp1, msp2, and glurp among individual parasite isolates distinguished recrudescence from reinfection. Pfmdr1 copy number was measured by real-time PCR and half-maximal parasite inhibitory concentrations (IC50) were measured in vitro by 48-h isotopic hypoxanthine incorporation assay. Results The per-protocol PCR-adjusted efficacy (95% confidence interval) at 42 days was 80.6% (70.8–90.5%) for AS/MQ, 97.2% (93.3–100%) for DHA/PPQ, and 92.9% (86.1–99.6%) for ATQ/PG. On day 3, 57.9% remained parasitaemic in the AS/MQ and DHA/PPQ arms. At baseline, 46.9% had microscopic Plasmodium falciparum gametocytaemia. Both recurrences in the DHA/PPQ arm lost Pfmdr1 copy number amplification at recrudescence. All four recurrences in the ATQ/PG arm were wild-type for cytochrome bc1. One subject withdrew from the ATQ/PG arm due to drug allergy. Conclusions This study was conducted at the epicentre of substantial multi-drug resistance that emerged soon thereafter. Occurring early in the national transition from AS/MQ to DHA/PPQ, both DHA/PPQ and ATQ/PG had acceptable efficacy against uncomplicated falciparum malaria. However, efficacy of AS/MQ was only 80% with apparent mefloquine resistance based on elevated Pfmdr1 copy number and IC50. By 2009, there was already significant evidence of artemisinin resistance not previously reported at the Northern Cambodia–Thai border. This study suggests the basis for early development of significant DHA/PPQ failures within 3 years of introduction. Artemisinin resistance likely occurred on the Northern border concurrently with that reported along the Western border in Pailin. Trial registration This legacy trial was conducted prior to International Committee of Medical Journal Editors’ requirements for preregistration on ClinicalTrials.gov. The full protocol has been provided. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04279-3.
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Affiliation(s)
- Dysoley Lek
- National Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
| | - Agus Rachmat
- U.S. Naval Medical Research Unit 2, Phnom Penh, Cambodia
| | | | - Geoffrey Chin
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - David Saunders
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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26
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Saunders D, Carrillo JC, Gundlach ER, Iroakasi O, Visigah K, Zabbey N, Bonte M. Analysis of polycyclic aromatic hydrocarbons (PAHs) in surface sediments and edible aquatic species in an oil-contaminated mangrove ecosystem in Bodo, Niger Delta, Nigeria: Bioaccumulation and human health risk assessment. Sci Total Environ 2022; 832:154802. [PMID: 35346703 DOI: 10.1016/j.scitotenv.2022.154802] [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: 01/19/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 06/14/2023]
Abstract
This work investigated the occurrence and risks associated with polycyclic aromatic hydrocarbons (PAHs) in tissues from five commonly consumed aquatic species (swimming crabs, estuarine shrimp, tiger prawns, periwinkles, and tilapia) and sediment across six sites in the area around Bodo town, in the Niger Delta region of Nigeria. We aimed to establish a relationship between PAH concentrations in sediment and biota, and to derive biota-sediment accumulation factors (BSAFs). Risks to human health associated with consumption of impacted food sources were assessed based on measured biotic concentrations of PAHs. The average concentration of PAHs and the number of PAHs measured above the limit of quantification varied greatly between different biota, with the lowest average concentrations observed in tilapia, followed by tiger prawns, crabs, estuarine shrimp, and the highest concentrations were observed in periwinkles. Similar to biotic concentrations, BSAFs were found to vary greatly across species, sites, and PAHs, though BSAFs for all organisms except periwinkles were below a value of 1. In periwinkles, BSAFs exceeded a value of 1 for phenanthrene (BSAF = 1.7), pyrene (1.5) and benzo[k]fluoranthene (1.7). Risks to human health associated with consumption of these species were assessed using the BaP toxic-equivalent approach for cancer risks and the toxic unit approach which jointly considered carcinogenic but also non-cancer hazards. The BaP toxic-equivalent approach showed that the excess lifetime cancer risk resulting from daily consumption of 0.2 kg of seafood ranged between 1.3 × 10-6 for tiger prawn and tilapia to 4.1 × 10-6 for periwinkles, which is below the excess lifetime cancer risk of 10-4 used by Dutch and Nigerian authorities for sediment intervention values. This finding is supported by the results obtained from the toxic unit approach which indicates that the ratios of the estimated dose and the maximal permissible risk level for summed PAHs never exceeded 1.
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Affiliation(s)
| | | | | | - Ogonnaya Iroakasi
- Shell Petroleum Development Company of Nigeria Ltd, Port Harcourt, Nigeria
| | - Kabari Visigah
- Shell Petroleum Development Company of Nigeria Ltd, Port Harcourt, Nigeria
| | | | - Matthijs Bonte
- Shell Global Solutions International BV, Rijswijk, the Netherlands
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27
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Pilar A, Saunders D, Pan S, Gaito S, Charlwood F, Lowe M, Smith E, Mcpartlin A, Thorp N. PD-0167 Acute, late toxicities & early outcomes in children after proton therapy for head & neck malignancy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Kannikanti D, Charlwood F, Clarke M, Colaco R, Pan S, Saunders D, Sitch P, Thorp N, Whitfield G, Rasool M. PO-1161 Protons in posterior fossa ependymoma- a dosimetric comparison with photons. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03125-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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29
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Bruce SS, Saunders D, Mallouppa E. 699 EMBEDDING A FRAILTY TEAM AND UNIT INTO WYTHENSHAWE HOSPITAL’S EMERGENCY DEPARTMENT. Age Ageing 2022. [PMCID: PMC9383571 DOI: 10.1093/ageing/afac034.699] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Evaluation of Wythenshawe Hospital’s Acute Frailty Service in January–June 2019 demonstrated slow referrals times and poor identification of frail patients due to inaccurate Clinical Frailty Scoring (CFS) at emergency department triage. This project presents the results of ongoing quality assessment of our service between June 2019–January 2021, following two quality improvement (QI) interventions. Aims: To evaluate our service’s ability to deliver early identification and intervention for complex frail patients via Complex Geriatric Assessment (CGA), as set out in National and Regional Frailty standards.(1,2). -To improve and maintain better outcomes for patients accessing our frailty service. Method Intervention1 (July’19): Specialist frailty nurses relocated to ED. Dedicated frailty clinical fellows and Consultant geriatrician input 0900–1700 weekdays. Intervention2 (Sep’20): Short-stay frailty unit opened. Junior clinical fellow cover increased (0900–1900 weekdays and 0900–1700 weekends). 299 patients seen at intervals between Jun’19-Jan’21 analysed using electronic records and completed CGA proformas. Results Pre-intervention Intervention1 Intervention2 June’19(n = 22) July’19(n = 198) Nov’19(n = 25) Sep’20(n = 26) Jan’21(n = 28) Time from triage-to-CGA (mins) (CI 95%)* 372.0 ± 178.2 56.0 83.4 ± 31.0 72.9 ± 35.7 48.4 ± 20.0 Discharge(%): Same day 22.7 39.4 21.7 36.0 25.0 < 72 hr(cumulative) 72.7 63.6 47.8 68.0 57.1 Ave. length of stay(days)(CI95%) 10.4 ± 5.9 20.6 20.0 ± 8.7 7.1 ± 3.4 5.4 ± 2.1 Readmission <30 days(%) 30.0 9.0 17.4 12.5 25.0 CGA Quality(%) CFS completion 100 96.0100 89.3 ReSPECT discussion 29.3 64.0 61.5 67.9 Full medication review 46.5 96.0 80.8 89.3 Therapy assessment 85.5 92.0 92.3 89.3 *patients triaged between 0800–1700. Conclusion Since Intervention1, Wythenshawe frailty service has sustained a reduction in triage-to-CGA time, maintained high percentages of same-day and < 72 hr discharges, and sustained high rates of CFS completion and therapy assessments. Following intervention2, average length of stay reduced. Increased readmission rates in Jan’21 were impacted by COVID-19. Additional interventions targeted at reducing readmission rates and increasing ReSPECT discussions should be implemented. 1. Greater Manchester Frailty Collaborative and Network, 2019. 2. Same-day acute frailty service, NHS improvement, 2019.
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Affiliation(s)
- S S Bruce
- Wythenshawe Hospital, OPAL team, Manchester Foundation Trust
| | - D Saunders
- Wythenshawe Hospital, OPAL team, Manchester Foundation Trust
| | - E Mallouppa
- Wythenshawe Hospital, OPAL team, Manchester Foundation Trust
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30
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Saunders D. A Comparative Study of Circadian Rhythmicity and Photoperiodism in Closely Related Species of Blow Flies: External Coincidence, Maternal Induction, and Diapause at Northern Latitudes. J Biol Rhythms 2021; 36:532-547. [PMID: 34738497 PMCID: PMC8600581 DOI: 10.1177/07487304211054419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
This review compares adult locomotor activity rhythms and photoperiodic induction of diapause in 3 common species of blow fly, Calliphora vicina, Lucilia sericata, and Protophormia terraenovae. Activity rhythms were broadly similar in all 3 species, although P. terraenovae is much less sensitive to constant light inducing arrhythmicity. Photoperiodic induction of diapause, on the other hand, varies more widely between species. C. vicina and L. sericata overwinter in a larval diapause induced by autumnal short days (long nights) acting both maternally and directly upon the larvae. P. terraenovae, on the other hand, shows an adult (reproductive) diapause induced by short daylength and low temperature experienced by the larvae. In the Nanda-Hamner protocol, C. vicina shows 3 clear peaks of high diapause incidence in cycle lengths close to 24, 48, and 72 h, without dampening and therefore suggesting a photoperiodic mechanism based on a self-sustained circadian oscillator acting in a clock of the external coincidence type. Entrainment of the locomotor activity rhythm to extended Nanda-Hamner photocycles, as well as to LD cycles close to the limits of the primary range of entrainment, demonstrates that overt circadian rhythmicity may act as 'hands' of the otherwise covert photoperiodic system, as suggested by Bünning, nearly 8 decades ago. In 24 h LD cycles, both locomotor activity rhythms and the photoperiodic oscillator are set to constant phase (CT 12) at light-off, so that the photoperiodic clock measures changes in nightlength by the coincidence (or not) of dawn light with a 'photoinducible phase' late in the subjective night (at about CT 21.5 h) as photoperiod changes with the seasons. Apparent differences between quantitative and qualitative photoperiodic responses are discussed.
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Affiliation(s)
- David Saunders
- The University of Edinburgh (Professor
Emeritus), Edinburgh, UK
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31
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Hoegg S, Elsner B, Saunders D, van Wijck F, Mehrholz J. Resistive strength training for arm rehabilitation after stroke. Hippokratia 2021. [DOI: 10.1002/14651858.cd014279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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32
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Armitage JM, Toose L, Camenzuli L, Redman AD, Parkerton TF, Saunders D, Wheeler J, Martin A, Vaiopoulou E, Arnot JA. Acritical review and weight of evidence approach for assessing the bioaccumulation of phenanthrene in aquatic environments. Integr Environ Assess Manag 2021; 17:911-925. [PMID: 33620129 PMCID: PMC8451923 DOI: 10.1002/ieam.4401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/01/2020] [Accepted: 02/17/2021] [Indexed: 05/31/2023]
Abstract
Bioaccumulation (B) assessment is challenging because there are various B-metrics from laboratory and field studies, multiple criteria and thresholds for classifying bioaccumulative (B), very bioaccumulative (vB), and not bioaccumulative (nB) chemicals, as well as inherent variability and uncertainty in the data. These challenges can be met using a weight of evidence (WoE) approach. The Bioaccumulation Assessment Tool (BAT) provides a transparent WoE assessment framework that follows Organisation for Economic Co-operation and Development (OECD) principles for performing a WoE analysis. The BAT guides an evaluator through the process of data collection, generation, evaluation, and integration of various lines of evidence (LoE) (i.e., B-metrics) to inform decision-making. Phenanthrene (PHE) is a naturally occurring chemical for which extensive B and toxicokinetics data are available. A B assessment for PHE using the BAT is described that includes a critical evaluation of 74 measured in vivo LoE for fish and invertebrate species from laboratory and field studies. The number of LoE are reasonably well balanced across taxa (i.e., fish and invertebrates) and the different B-metrics. Additionally, in silico and in vitro biotransformation rate estimates and corresponding model-predicted B-metrics are included as corroborating evidence. Application of the BAT provides a consistent, coherent, and scientifically defensible WoE evaluation to conclude that PHE is not bioaccumulative (nB) because the overwhelming majority of the bioconcentration, bioaccumulation, and biomagnification metrics for both fish and invertebrates are below regulatory thresholds. An analysis of the relevant data using fugacity ratios is also provided, showing that PHE does not biomagnify in aquatic food webs. The critical review identifies recommendations to increase the consistency of B assessments, such as improved standardization of B testing guidelines, data reporting requirements for invertebrate studies, and consideration of temperature and salinity effects on certain B-metrics. Integr Environ Assess Manag 2021;17:911-925. © 2021 Concawe. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
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Affiliation(s)
- James M. Armitage
- ARC Arnot Research and Consulting Inc.TorontoOntarioCanada
- AES Armitage Environmental Science Inc.OttawaOntarioCanada
| | - Liisa Toose
- ARC Arnot Research and Consulting Inc.TorontoOntarioCanada
| | - Louise Camenzuli
- ExxonMobil Petroleum & Chemical B.V.MachelenBelgium
- Member of ConcaweBrusselsBelgium
| | - Aaron D. Redman
- ExxonMobil Petroleum & Chemical B.V.MachelenBelgium
- Member of ConcaweBrusselsBelgium
| | - Tom F. Parkerton
- ExxonMobil Biomedical Sciences Inc.SpringTexasUSA
- Member of ConcaweBrusselsBelgium
| | - David Saunders
- Shell Health, Shell International B.V.The Haguethe Netherlands
- Member of ConcaweBrusselsBelgium
| | - James Wheeler
- Shell Health, Shell International B.V.The Haguethe Netherlands
- Member of ConcaweBrusselsBelgium
| | | | | | - Jon A. Arnot
- ARC Arnot Research and Consulting Inc.TorontoOntarioCanada
- Department of Physical and Environmental SciencesUniversity of Toronto ScarboroughTorontoOntarioCanada
- Department of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada
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33
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Datta A, Forker L, McWilliam A, Mistry H, Zhong J, Wylie J, Coyle C, Saunders D, Kennedy S, O’Connor J, Hoskin P, West C, Choudhury A. PO-1415 Association of radiomic features with aggressive phenotypes in soft tissue sarcomas. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07866-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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Ahouidi A, Ali M, Almagro-Garcia J, Amambua-Ngwa A, Amaratunga C, Amato R, Amenga-Etego L, Andagalu B, Anderson TJC, Andrianaranjaka V, Apinjoh T, Ariani C, Ashley EA, Auburn S, Awandare GA, Ba H, Baraka V, Barry AE, Bejon P, Bertin GI, Boni MF, Borrmann S, Bousema T, Branch O, Bull PC, Busby GBJ, Chookajorn T, Chotivanich K, Claessens A, Conway D, Craig A, D'Alessandro U, Dama S, Day NPJ, Denis B, Diakite M, Djimdé A, Dolecek C, Dondorp AM, Drakeley C, Drury E, Duffy P, Echeverry DF, Egwang TG, Erko B, Fairhurst RM, Faiz A, Fanello CA, Fukuda MM, Gamboa D, Ghansah A, Golassa L, Goncalves S, Hamilton WL, Harrison GLA, Hart L, Henrichs C, Hien TT, Hill CA, Hodgson A, Hubbart C, Imwong M, Ishengoma DS, Jackson SA, Jacob CG, Jeffery B, Jeffreys AE, Johnson KJ, Jyothi D, Kamaliddin C, Kamau E, Kekre M, Kluczynski K, Kochakarn T, Konaté A, Kwiatkowski DP, Kyaw MP, Lim P, Lon C, Loua KM, Maïga-Ascofaré O, Malangone C, Manske M, Marfurt J, Marsh K, Mayxay M, Miles A, Miotto O, Mobegi V, Mokuolu OA, Montgomery J, Mueller I, Newton PN, Nguyen T, Nguyen TN, Noedl H, Nosten F, Noviyanti R, Nzila A, Ochola-Oyier LI, Ocholla H, Oduro A, Omedo I, Onyamboko MA, Ouedraogo JB, Oyebola K, Pearson RD, Peshu N, Phyo AP, Plowe CV, Price RN, Pukrittayakamee S, Randrianarivelojosia M, Rayner JC, Ringwald P, Rockett KA, Rowlands K, Ruiz L, Saunders D, Shayo A, Siba P, Simpson VJ, Stalker J, Su XZ, Sutherland C, Takala-Harrison S, Tavul L, Thathy V, Tshefu A, Verra F, Vinetz J, Wellems TE, Wendler J, White NJ, Wright I, Yavo W, Ye H. An open dataset of Plasmodium falciparum genome variation in 7,000 worldwide samples. Wellcome Open Res 2021; 6:42. [PMID: 33824913 PMCID: PMC8008441 DOI: 10.12688/wellcomeopenres.16168.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 02/02/2023] Open
Abstract
MalariaGEN is a data-sharing network that enables groups around the world to work together on the genomic epidemiology of malaria. Here we describe a new release of curated genome variation data on 7,000 Plasmodium falciparum samples from MalariaGEN partner studies in 28 malaria-endemic countries. High-quality genotype calls on 3 million single nucleotide polymorphisms (SNPs) and short indels were produced using a standardised analysis pipeline. Copy number variants associated with drug resistance and structural variants that cause failure of rapid diagnostic tests were also analysed. Almost all samples showed genetic evidence of resistance to at least one antimalarial drug, and some samples from Southeast Asia carried markers of resistance to six commonly-used drugs. Genes expressed during the mosquito stage of the parasite life-cycle are prominent among loci that show strong geographic differentiation. By continuing to enlarge this open data resource we aim to facilitate research into the evolutionary processes affecting malaria control and to accelerate development of the surveillance toolkit required for malaria elimination.
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Affiliation(s)
| | | | - Mozam Ali
- Wellcome Sanger Institute, Hinxton, UK
| | - Jacob Almagro-Garcia
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Alfred Amambua-Ngwa
- Wellcome Sanger Institute, Hinxton, UK,Medical Research Council Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Chanaki Amaratunga
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | - Roberto Amato
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Lucas Amenga-Etego
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana,West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Ben Andagalu
- United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | | | | | | | | | - Elizabeth A Ashley
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Sarah Auburn
- Menzies School of Health Research, Darwin, Australia,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Gordon A. Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana,University of Ghana, Legon, Ghana
| | - Hampate Ba
- Institut National de Recherche en Santé Publique, Nouakchott, Mauritania
| | - Vito Baraka
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania,Department of Epidemiology, International Health Unit, University of Antwerp, Antwerp, Belgium
| | - Alyssa E. Barry
- Deakin University, Geelong, Australia,Burnet Institute, Melbourne, Australia,Walter and Eliza Hall Institute, Melbourne, Australia
| | - Philip Bejon
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Maciej F. Boni
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Steffen Borrmann
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Teun Bousema
- London School of Hygiene and Tropical Medicine, London, UK,Radboud University Medical Center, Nijmegen, The Netherlands
| | - Oralee Branch
- NYU School of Medicine Langone Medical Center, New York, USA
| | - Peter C. Bull
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya,Department of Pathology, University of Cambridge, Cambridge, UK
| | - George B. J. Busby
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | | | - Antoine Claessens
- Medical Research Council Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia,LPHI, MIVEGEC, INSERM, CNRS, IRD, University of Montpellier, Montpellier, France
| | - David Conway
- London School of Hygiene and Tropical Medicine, London, UK
| | - Alister Craig
- Liverpool School of Tropical Medicine, Liverpool, UK,Malawi-Liverpool-Wellcome Trust Clinical Research, Blantyre, Malawi
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Souleymane Dama
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Nicholas PJ Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Brigitte Denis
- Malawi-Liverpool-Wellcome Trust Clinical Research, Blantyre, Malawi
| | - Mahamadou Diakite
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Abdoulaye Djimdé
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Arjen M Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Patrick Duffy
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | - Diego F. Echeverry
- Centro Internacional de Entrenamiento e Investigaciones Médicas - CIDEIM, Cali, Colombia,Universidad Icesi, Cali, Colombia
| | | | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | - Mark M. Fukuda
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | - Dionicia Gamboa
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Anita Ghansah
- Nogouchi Memorial Institute for Medical Research, Legon-Accra, Ghana
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - William L. Hamilton
- Wellcome Sanger Institute, Hinxton, UK,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Lee Hart
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Christa Henrichs
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Tran Tinh Hien
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | | | - Christina Hubbart
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Deus S. Ishengoma
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania,East African Consortium for Clinical Research (EACCR), Dar es Salaam, Tanzania
| | - Scott A. Jackson
- Center for Applied Genetic Technologies, University of Georgia, Athens, GA, USA
| | | | - Ben Jeffery
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Anna E. Jeffreys
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Kimberly J. Johnson
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | | | - Edwin Kamau
- Walter Reed Army Institute of Research, U.S. Military HIV Research Program, Silver Spring, MD, USA
| | | | - Krzysztof Kluczynski
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Theerarat Kochakarn
- Wellcome Sanger Institute, Hinxton, UK,Mahidol University, Bangkok, Thailand
| | | | - Dominic P. Kwiatkowski
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK,Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Myat Phone Kyaw
- The Myanmar Oxford Clinical Research Unit, University of Oxford, Yangon, Myanmar,University of Public Health, Yangon, Myanmar
| | - Pharath Lim
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA,Medical Care Development International, Maryland, USA
| | - Chanthap Lon
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | | | - Oumou Maïga-Ascofaré
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali,Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,Research in Tropical Medicine, Kwame Nkrumah University of Sciences and Technology, Kumasi, Ghana
| | | | | | - Jutta Marfurt
- Menzies School of Health Research, Darwin, Australia
| | - Kevin Marsh
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,African Academy of Sciences, Nairobi, Kenya
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Lao People's Democratic Republic,Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Alistair Miles
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Olivo Miotto
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK,Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Victor Mobegi
- School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Olugbenga A. Mokuolu
- Department of Paediatrics and Child Health, University of Ilorin, Ilorin, Nigeria
| | - Jacqui Montgomery
- Institute of Vector-Borne Disease, Monash University, Clayton, Victoria, 3800, Australia
| | - Ivo Mueller
- Walter and Eliza Hall Institute, Melbourne, Australia,Barcelona Centre for International Health Research, Barcelona, Spain
| | - Paul N. Newton
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Vientiane, Lao People's Democratic Republic
| | | | - Thuy-Nhien Nguyen
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Harald Noedl
- MARIB - Malaria Research Initiative Bandarban, Bandarban, Bangladesh
| | - Francois Nosten
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,Shoklo Malaria Research Unit, Bangkok, Thailand
| | | | - Alexis Nzila
- King Fahid University of Petroleum and Minerals (KFUMP), Dharhran, Saudi Arabia
| | | | - Harold Ocholla
- KEMRI - Centres for Disease Control and Prevention (CDC) Research Program, Kisumu, Kenya,Centre for Bioinformatics and Biotechnology, University of Nairobi, Nairobi, Kenya
| | - Abraham Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Irene Omedo
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marie A. Onyamboko
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo, Democratic Republic
| | | | - Kolapo Oyebola
- Nigerian Institute of Medical Research, Lagos, Nigeria,Parasitology and Bioinformatics Unit, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Richard D. Pearson
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Norbert Peshu
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Aung Pyae Phyo
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand,Shoklo Malaria Research Unit, Bangkok, Thailand
| | - Chris V. Plowe
- School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Ric N. Price
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand,Menzies School of Health Research, Darwin, Australia,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Milijaona Randrianarivelojosia
- Institut Pasteur de Madagascar, Antananarivo, Madagascar,Universités d'Antananarivo et de Mahajanga, Antananarivo, Madagascar
| | | | | | - Kirk A. Rockett
- Wellcome Sanger Institute, Hinxton, UK,Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Lastenia Ruiz
- Universidad Nacional de la Amazonia Peruana, Iquitos, Peru
| | - David Saunders
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | - Alex Shayo
- Nelson Mandela Institute of Science and Technology, Arusha, Tanzania
| | - Peter Siba
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Victoria J. Simpson
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | - Xin-zhuan Su
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | | | - Shannon Takala-Harrison
- Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Livingstone Tavul
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Vandana Thathy
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya,Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, New York, USA
| | | | | | - Joseph Vinetz
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru,Yale School of Medicine, New Haven, CT, USA
| | - Thomas E. Wellems
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | - Jason Wendler
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Nicholas J. White
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Ian Wright
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - William Yavo
- University Félix Houphouët-Boigny, Abidjan, Cote d'Ivoire,Malaria Research and Control Center of the National Institute of Public Health, Abidjan, Cote d'Ivoire
| | - Htut Ye
- Department of Medical Research, Yangon, Myanmar
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35
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Ahouidi A, Ali M, Almagro-Garcia J, Amambua-Ngwa A, Amaratunga C, Amato R, Amenga-Etego L, Andagalu B, Anderson TJC, Andrianaranjaka V, Apinjoh T, Ariani C, Ashley EA, Auburn S, Awandare GA, Ba H, Baraka V, Barry AE, Bejon P, Bertin GI, Boni MF, Borrmann S, Bousema T, Branch O, Bull PC, Busby GBJ, Chookajorn T, Chotivanich K, Claessens A, Conway D, Craig A, D'Alessandro U, Dama S, Day NPJ, Denis B, Diakite M, Djimdé A, Dolecek C, Dondorp AM, Drakeley C, Drury E, Duffy P, Echeverry DF, Egwang TG, Erko B, Fairhurst RM, Faiz A, Fanello CA, Fukuda MM, Gamboa D, Ghansah A, Golassa L, Goncalves S, Hamilton WL, Harrison GLA, Hart L, Henrichs C, Hien TT, Hill CA, Hodgson A, Hubbart C, Imwong M, Ishengoma DS, Jackson SA, Jacob CG, Jeffery B, Jeffreys AE, Johnson KJ, Jyothi D, Kamaliddin C, Kamau E, Kekre M, Kluczynski K, Kochakarn T, Konaté A, Kwiatkowski DP, Kyaw MP, Lim P, Lon C, Loua KM, Maïga-Ascofaré O, Malangone C, Manske M, Marfurt J, Marsh K, Mayxay M, Miles A, Miotto O, Mobegi V, Mokuolu OA, Montgomery J, Mueller I, Newton PN, Nguyen T, Nguyen TN, Noedl H, Nosten F, Noviyanti R, Nzila A, Ochola-Oyier LI, Ocholla H, Oduro A, Omedo I, Onyamboko MA, Ouedraogo JB, Oyebola K, Pearson RD, Peshu N, Phyo AP, Plowe CV, Price RN, Pukrittayakamee S, Randrianarivelojosia M, Rayner JC, Ringwald P, Rockett KA, Rowlands K, Ruiz L, Saunders D, Shayo A, Siba P, Simpson VJ, Stalker J, Su XZ, Sutherland C, Takala-Harrison S, Tavul L, Thathy V, Tshefu A, Verra F, Vinetz J, Wellems TE, Wendler J, White NJ, Wright I, Yavo W, Ye H. An open dataset of Plasmodium falciparum genome variation in 7,000 worldwide samples. Wellcome Open Res 2021; 6:42. [PMID: 33824913 PMCID: PMC8008441.2 DOI: 10.12688/wellcomeopenres.16168.2] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 02/02/2023] Open
Abstract
MalariaGEN is a data-sharing network that enables groups around the world to work together on the genomic epidemiology of malaria. Here we describe a new release of curated genome variation data on 7,000 Plasmodium falciparum samples from MalariaGEN partner studies in 28 malaria-endemic countries. High-quality genotype calls on 3 million single nucleotide polymorphisms (SNPs) and short indels were produced using a standardised analysis pipeline. Copy number variants associated with drug resistance and structural variants that cause failure of rapid diagnostic tests were also analysed. Almost all samples showed genetic evidence of resistance to at least one antimalarial drug, and some samples from Southeast Asia carried markers of resistance to six commonly-used drugs. Genes expressed during the mosquito stage of the parasite life-cycle are prominent among loci that show strong geographic differentiation. By continuing to enlarge this open data resource we aim to facilitate research into the evolutionary processes affecting malaria control and to accelerate development of the surveillance toolkit required for malaria elimination.
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Affiliation(s)
| | | | - Mozam Ali
- Wellcome Sanger Institute, Hinxton, UK
| | - Jacob Almagro-Garcia
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Alfred Amambua-Ngwa
- Wellcome Sanger Institute, Hinxton, UK,Medical Research Council Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Chanaki Amaratunga
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | - Roberto Amato
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Lucas Amenga-Etego
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana,West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Ben Andagalu
- United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | | | | | | | | | - Elizabeth A Ashley
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Sarah Auburn
- Menzies School of Health Research, Darwin, Australia,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Gordon A. Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana,University of Ghana, Legon, Ghana
| | - Hampate Ba
- Institut National de Recherche en Santé Publique, Nouakchott, Mauritania
| | - Vito Baraka
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania,Department of Epidemiology, International Health Unit, University of Antwerp, Antwerp, Belgium
| | - Alyssa E. Barry
- Deakin University, Geelong, Australia,Burnet Institute, Melbourne, Australia,Walter and Eliza Hall Institute, Melbourne, Australia
| | - Philip Bejon
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Maciej F. Boni
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Steffen Borrmann
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Teun Bousema
- London School of Hygiene and Tropical Medicine, London, UK,Radboud University Medical Center, Nijmegen, The Netherlands
| | - Oralee Branch
- NYU School of Medicine Langone Medical Center, New York, USA
| | - Peter C. Bull
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya,Department of Pathology, University of Cambridge, Cambridge, UK
| | - George B. J. Busby
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | | | - Antoine Claessens
- Medical Research Council Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia,LPHI, MIVEGEC, INSERM, CNRS, IRD, University of Montpellier, Montpellier, France
| | - David Conway
- London School of Hygiene and Tropical Medicine, London, UK
| | - Alister Craig
- Liverpool School of Tropical Medicine, Liverpool, UK,Malawi-Liverpool-Wellcome Trust Clinical Research, Blantyre, Malawi
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia, at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Souleymane Dama
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Nicholas PJ Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Brigitte Denis
- Malawi-Liverpool-Wellcome Trust Clinical Research, Blantyre, Malawi
| | - Mahamadou Diakite
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Abdoulaye Djimdé
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Arjen M Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Patrick Duffy
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | - Diego F. Echeverry
- Centro Internacional de Entrenamiento e Investigaciones Médicas - CIDEIM, Cali, Colombia,Universidad Icesi, Cali, Colombia
| | | | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | - Mark M. Fukuda
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | - Dionicia Gamboa
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Anita Ghansah
- Nogouchi Memorial Institute for Medical Research, Legon-Accra, Ghana
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - William L. Hamilton
- Wellcome Sanger Institute, Hinxton, UK,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Lee Hart
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Christa Henrichs
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Tran Tinh Hien
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | | | - Christina Hubbart
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Deus S. Ishengoma
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania,East African Consortium for Clinical Research (EACCR), Dar es Salaam, Tanzania
| | - Scott A. Jackson
- Center for Applied Genetic Technologies, University of Georgia, Athens, GA, USA
| | | | - Ben Jeffery
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Anna E. Jeffreys
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Kimberly J. Johnson
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | | | - Edwin Kamau
- Walter Reed Army Institute of Research, U.S. Military HIV Research Program, Silver Spring, MD, USA
| | | | - Krzysztof Kluczynski
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Theerarat Kochakarn
- Wellcome Sanger Institute, Hinxton, UK,Mahidol University, Bangkok, Thailand
| | | | - Dominic P. Kwiatkowski
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK,Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Myat Phone Kyaw
- The Myanmar Oxford Clinical Research Unit, University of Oxford, Yangon, Myanmar,University of Public Health, Yangon, Myanmar
| | - Pharath Lim
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA,Medical Care Development International, Maryland, USA
| | - Chanthap Lon
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | | | - Oumou Maïga-Ascofaré
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali,Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,Research in Tropical Medicine, Kwame Nkrumah University of Sciences and Technology, Kumasi, Ghana
| | | | | | - Jutta Marfurt
- Menzies School of Health Research, Darwin, Australia
| | - Kevin Marsh
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,African Academy of Sciences, Nairobi, Kenya
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Lao People's Democratic Republic,Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Alistair Miles
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Olivo Miotto
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK,Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Victor Mobegi
- School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Olugbenga A. Mokuolu
- Department of Paediatrics and Child Health, University of Ilorin, Ilorin, Nigeria
| | - Jacqui Montgomery
- Institute of Vector-Borne Disease, Monash University, Clayton, Victoria, 3800, Australia
| | - Ivo Mueller
- Walter and Eliza Hall Institute, Melbourne, Australia,Barcelona Centre for International Health Research, Barcelona, Spain
| | - Paul N. Newton
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Vientiane, Lao People's Democratic Republic
| | | | - Thuy-Nhien Nguyen
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Harald Noedl
- MARIB - Malaria Research Initiative Bandarban, Bandarban, Bangladesh
| | - Francois Nosten
- Nuffield Department of Medicine, University of Oxford, Oxford, UK,Shoklo Malaria Research Unit, Bangkok, Thailand
| | | | - Alexis Nzila
- King Fahid University of Petroleum and Minerals (KFUMP), Dharhran, Saudi Arabia
| | | | - Harold Ocholla
- KEMRI - Centres for Disease Control and Prevention (CDC) Research Program, Kisumu, Kenya,Centre for Bioinformatics and Biotechnology, University of Nairobi, Nairobi, Kenya
| | - Abraham Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Irene Omedo
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marie A. Onyamboko
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo, Democratic Republic
| | | | - Kolapo Oyebola
- Nigerian Institute of Medical Research, Lagos, Nigeria,Parasitology and Bioinformatics Unit, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Richard D. Pearson
- Wellcome Sanger Institute, Hinxton, UK,MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Norbert Peshu
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Aung Pyae Phyo
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand,Shoklo Malaria Research Unit, Bangkok, Thailand
| | - Chris V. Plowe
- School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Ric N. Price
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand,Menzies School of Health Research, Darwin, Australia,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - Milijaona Randrianarivelojosia
- Institut Pasteur de Madagascar, Antananarivo, Madagascar,Universités d'Antananarivo et de Mahajanga, Antananarivo, Madagascar
| | | | | | - Kirk A. Rockett
- Wellcome Sanger Institute, Hinxton, UK,Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Lastenia Ruiz
- Universidad Nacional de la Amazonia Peruana, Iquitos, Peru
| | - David Saunders
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | - Alex Shayo
- Nelson Mandela Institute of Science and Technology, Arusha, Tanzania
| | - Peter Siba
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Victoria J. Simpson
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | - Xin-zhuan Su
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | | | - Shannon Takala-Harrison
- Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Livingstone Tavul
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Vandana Thathy
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya,Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, New York, USA
| | | | | | - Joseph Vinetz
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru,Yale School of Medicine, New Haven, CT, USA
| | - Thomas E. Wellems
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, USA
| | - Jason Wendler
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Nicholas J. White
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Ian Wright
- MRC Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, UK
| | - William Yavo
- University Félix Houphouët-Boigny, Abidjan, Cote d'Ivoire,Malaria Research and Control Center of the National Institute of Public Health, Abidjan, Cote d'Ivoire
| | - Htut Ye
- Department of Medical Research, Yangon, Myanmar
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Saunders D, Svob C, Pan L, Abraham E, Posner J, Weissman M, Wickramaratne P. Differential Association of Spirituality and Religiosity With Rumination: Implications for the Treatment of Depression. J Nerv Ment Dis 2021; 209:370-377. [PMID: 33835955 PMCID: PMC8041060 DOI: 10.1097/nmd.0000000000001306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Recent studies have shown that religiosity (R) is associated with lower rates of depression, whereas spirituality (S) is associated with higher rates. Rumination has also been associated with higher rates of depression. Some have hypothesized that rumination mediates the differential association of religiosity and spirituality with depression. We empirically test this hypothesis in a longitudinal, multigenerational sample through associations between rumination and depression, R/S and depression, and R/S and rumination. Cross-sectionally, total rumination scores were predicted by spirituality (standardized β = 0.13; 95% confidence interval [CI], 0.00-0.26), with subscale (reflection, depression, and brooding) standardized betas ranging from 0.11 to 0.15 (95% CI, -0.03 to -0.29). Cross-sectionally, rumination was not predicted by religiosity. Longitudinally, and consistent with previous findings, religiosity, but not spirituality, predicted reduced depressive symptoms (standardized β = -0.3; 95% CI, -0.58 to -0.01). The association between spirituality and rumination was driven by millennials. Psychotherapies that target rumination for depression might therefore be especially effective in the millennial demographic.
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Affiliation(s)
| | | | - Lifang Pan
- Division of Translational Epidemiology, New York State Psychiatric Institute
| | - Eyal Abraham
- Division of Translational Epidemiology, New York State Psychiatric Institute
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Ng Cheong Chung J, Kamarajah SK, Mohammed AA, Sinclair RCF, Saunders D, Navidi M, Immanuel A, Phillips AW. Comparison of multimodal analgesia with thoracic epidural after transthoracic oesophagectomy. Br J Surg 2021; 108:58-65. [PMID: 33640920 DOI: 10.1093/bjs/znaa013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Thoracic epidural analgesia (TEA) has been regarded as the standard of care after oesophagectomy for pain control, but has several side-effects. Multimodal (intrathecal diamorphine, paravertebral and rectus sheath catheters) analgesia (MA) may facilitate postoperative mobilization by reducing hypotensive episodes and the need for vasopressors, but uncertainty exists about whether it provides comparable analgesia. This study aimed to determine whether MA provides comparable analgesia to TEA following transthoracic oesophagectomy. METHODS Consecutive patients undergoing oesophagectomy for cancer between January 2015 and December 2018 were grouped according to postoperative analgesia regimen. Propensity score matching (PSM) was used to account for treatment selection bias. Pain scores at rest and on movement, graded from 0 to 10, were used. The incidence of hypotensive episodes and the requirement for vasopressors were evaluated. RESULTS The study included 293 patients; 142 (48.5 per cent) received TEA and 151 (51.5 per cent) MA. After PSM, 100 patients remained in each group. Mean pain scores were significantly higher at rest in the MA group (day 1: 1.5 versus 0.8 in the TEA group, P = 0.017; day 2: 1.7 versus 0.9 respectively, P = 0.014; day 3: 1.2 versus 0.6, P = 0.047). Fewer patients receiving MA had a hypotensive episode (25 per cent versus 45 per cent in the TEA group; P = 0.003) and fewer required vasopressors (36 versus 53 per cent respectively; P = 0.016). There was no significant difference in the overall complication rate (71.0 versus 61.0 per cent; P = 0.136). CONCLUSION MA is less effective than TEA at controlling pain, but this difference may not be clinically significant. However, fewer patients experienced hypotension or required vasopressor support with MA; this may be beneficial within an enhanced recovery programme.
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Affiliation(s)
- J Ng Cheong Chung
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - S K Kamarajah
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - A A Mohammed
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - R C F Sinclair
- Department of Anaesthesia and Critical Care Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - D Saunders
- Department of Anaesthesia and Critical Care Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - M Navidi
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - A Immanuel
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - A W Phillips
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK.,School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
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Stojanovic D, McEvoy J, Alves F, Rayner L, Heinsohn R, Saunders D, Webb M. Parental care does not compensate for the effects of bad years on reproductive success of a vagile bird. J Zool (1987) 2021. [DOI: 10.1111/jzo.12888] [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: 11/28/2022]
Affiliation(s)
- D. Stojanovic
- Fenner School of Environment and Society Australian National University Canberra ACT Australia
| | - J. McEvoy
- Smithsonian Conservation Biology Institute National Zoological Park Front Royal VA USA
| | - F. Alves
- Fenner School of Environment and Society Australian National University Canberra ACT Australia
| | - L. Rayner
- Fenner School of Environment and Society Australian National University Canberra ACT Australia
| | - R. Heinsohn
- Fenner School of Environment and Society Australian National University Canberra ACT Australia
| | - D. Saunders
- Fenner School of Environment and Society Australian National University Canberra ACT Australia
| | - M. Webb
- Fenner School of Environment and Society Australian National University Canberra ACT Australia
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Hanrath AT, Schim van der Loeff I, Lendrem DW, Baker KF, Price DA, McDowall P, McDowall K, Cook S, Towns P, Schwab U, Evans A, Dixon J, Collins J, Burton-Fanning S, Saunders D, Harwood J, Samuel J, Schmid ML, Pareja-Cebrian L, Hunter E, Murphy E, Taha Y, Payne BAI, Duncan CJA. SARS-CoV-2 Testing of 11,884 Healthcare Workers at an Acute NHS Hospital Trust in England: A Retrospective Analysis. Front Med (Lausanne) 2021; 8:636160. [PMID: 33777979 PMCID: PMC7994756 DOI: 10.3389/fmed.2021.636160] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/16/2021] [Indexed: 11/13/2022] Open
Abstract
Healthcare workers (HCWs) are known to be at increased risk of infection with SARS-CoV-2, although whether these risks are equal across all roles is uncertain. Here we report a retrospective analysis of a large real-world dataset obtained from 10 March to 6 July 2020 in an NHS Foundation Trust in England with 17,126 employees. 3,338 HCWs underwent symptomatic PCR testing (14.4% positive, 2.8% of all staff) and 11,103 HCWs underwent serological testing for SARS-CoV-2 IgG (8.4% positive, 5.5% of all staff). Seropositivity was lower than other hospital settings in England but higher than community estimates. Increased test positivity rates were observed in HCWs from BAME backgrounds and residents in areas of higher social deprivation. A multiple logistic regression model adjusting for ethnicity and social deprivation confirmed statistically significant increases in the odds of testing positive in certain occupational groups, most notably domestic services staff, nurses, and health-care assistants. PCR testing of symptomatic HCWs appeared to underestimate overall infection levels, probably due to asymptomatic seroconversion. Clinical outcomes were reassuring, with only a small minority of HCWs with COVID-19 requiring hospitalization (2.3%) or ICU management (0.7%) and with no deaths. Despite a relatively low level of HCW infection compared to other UK cohorts, there were nevertheless important differences in test positivity rates between occupational groups, robust to adjustment for demographic factors such as ethnic background and social deprivation. Quantitative and qualitative studies are needed to better understand the factors contributing to this risk. Robust informatics solutions for HCW exposure data are essential to inform occupational monitoring.
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Affiliation(s)
- Aidan T. Hanrath
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ina Schim van der Loeff
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Dennis W. Lendrem
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre, Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Kenneth F. Baker
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre, Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - David A. Price
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Peter McDowall
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Kiera McDowall
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Susan Cook
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Peter Towns
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Ulrich Schwab
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Adam Evans
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jill Dixon
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jennifer Collins
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | | | - David Saunders
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jayne Harwood
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Julie Samuel
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Matthias L. Schmid
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lucia Pareja-Cebrian
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Ewan Hunter
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Elizabeth Murphy
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Yusri Taha
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Brendan A. I. Payne
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Christopher J. A. Duncan
- Immunity and Inflammation Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Abstract
AIM OF THE REVIEW This review aims to describe the current state of regenerative rehabilitation of severe military extremity injuries, and promising new therapies on the horizon. DISCUSSION The nature of warfare is rapidly shifting with information operations, autonomous weapons, and the threat of full-scale peer adversary conflicts threatening to create contested environments with delayed medical evacuation to definitive care. More destructive weapons will lead to more devastating injuries, creating new challenges for limb repair and restoration. Current paradigms of delayed rehabilitation following initial stabilization, damage control surgery, and prolonged antibiotic therapy will need to shift. Advances in regenerative medicine technologies offer the possibility of treatment along the continuum of care. Regenerative rehabilitation will begin at the point of injury and require a holistic, organ-systems approach. CONCLUSIONS Both technological improvements and a rapidly advancing understanding of injury pathophysiology will contribute to improved limb-salvage outcomes, and shift the calculus away from early limb amputation.
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Affiliation(s)
- David Saunders
- US Army Medical Material Development Activity, Fort Detrick, MD , USA
| | - Lloyd Rose
- US Army Medical Material Development Activity, Fort Detrick, MD , USA
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41
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Brothers TD, Fraser J, MacAdam E, Morgan B, Francheville J, Nidumolu A, Cheung C, Hickcox S, Saunders D, O'Donnell T, Genge L, Webster D. Implementation and evaluation of a novel, unofficial, trainee-organized hospital addiction medicine consultation service. Subst Abus 2020; 42:433-437. [PMID: 33332248 DOI: 10.1080/08897077.2020.1856291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND To evaluate a novel, unofficial, trainee-organized, hospital addiction medicine consultation service (AMCS), we aimed to assess whether it was (1) acceptable to hospital providers and patients, (2) feasible to organize and deliver, and (3) impacted patient care. Methods: We performed a retrospective descriptive study of all AMCS consultations over the first 16 months. We determined acceptability via the number of referrals received from admitting services, and the proportion of referred patients who consented to consultation. We evaluated feasibility via continuation/growth of the service over time, and the proportion of referrals successfully completed before hospital discharge. As most referrals related to opioid use disorder, we determined impact through the proportion of eligible patients offered and initiated on opioid agonist therapy (OAT) in hospital, and the proportion of patients who filled their outpatient prescription or attended their first visit with their outpatient OAT prescriber. Results: The unofficial AMCS grew to involve six hospital-based residents and five supervising community-based addiction physicians. The service received 59 referrals, primarily related to injection opioid use, for 50 unique patients from 12 different admitting services. 90% of patients were seen before discharge, and 98% agreed to addiction medicine consultation. Among 34 patients with active moderate-severe opioid use disorder who were not already on OAT, 82% initiated OAT in hospital and 89% of these patients continued after discharge. Conclusions: Established in response to identified gaps in patient care and learning opportunities, a novel, unofficial, trainee-organized AMCS was acceptable, feasible, and positively impacted patient care over the first 16 months. This trainee-organized, unofficial AMCS could be used as a model for other hospitals that do not yet have an official AMCS.
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Affiliation(s)
- Thomas D Brothers
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - John Fraser
- Mobile Outreach Street Health, North End Community Health Centre, Halifax, Nova Scotia, Canada
| | - Emily MacAdam
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Brendan Morgan
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Aditya Nidumolu
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Christopher Cheung
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samuel Hickcox
- Mental Health and Addictions, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - David Saunders
- Direction 180, Halifax, Nova Scotia, Canada.,The Open Door Clinic, Dartmouth, Nova Scotia, Canada
| | - Tiffany O'Donnell
- Hospitalist Medicine Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.,Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Leah Genge
- Mobile Outreach Street Health, North End Community Health Centre, Halifax, Nova Scotia, Canada.,Direction 180, Halifax, Nova Scotia, Canada.,Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Duncan Webster
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Division of Infectious Diseases, Saint John Regional Hospital, Saint John, New Brunswick, Canada
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Griffiths J, Kleinegesse S, Saunders D, Taylor R, Vacheret A. Pulse shape discrimination and exploration of scintillation signals using convolutional neural networks. Mach Learn : Sci Technol 2020. [DOI: 10.1088/2632-2153/abb781] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
We demonstrate the use of a convolutional neural network to perform neutron-gamma pulse shape discrimination, where the only inputs to the network are the raw digitised silicon photomultiplier signals from a dual scintillator detector element made of 6Li F:ZnS(Ag) scintillator and PVT plastic. A realistic labelled dataset was created to train the network by exposing the detector to an AmBe source, and a data-driven method utilising a separate photomultiplier tube was used to assign labels to the recorded signals. This approach is compared to the charge integration and continuous wavelet transform methods and a simpler artificial neural net. It is found to provide superior levels of discrimination, achieving an area under the curve of 0.996 ± 0.003. We find that the neural network is capable of extracting interpretable features directly from the raw data. In addition, by visualising the high-dimensional representations of the network with the t-SNE algorithm, we discover that not only is this method robust to minor mislabeling of the training dataset but that it is possible to identify an underlying substructure within the signals that goes beyond the original labelling. This technique could be utilised to explore and cluster complex, raw detector data in a novel way that may reveal more insights than standard analysis methods.
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Keshtkar-Jahromi M, Reisler RB, Haller JM, Clizbe DP, Rivard RG, Cardile AP, Pierson BC, Norris S, Saunders D, Pittman PR. The Western Equine Encephalitis Lyophilized, Inactivated Vaccine: An Update on Safety and Immunogenicity. Front Immunol 2020; 11:555464. [PMID: 33240257 PMCID: PMC7680781 DOI: 10.3389/fimmu.2020.555464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/24/2020] [Indexed: 11/13/2022] Open
Abstract
Background Western Equine Encephalitis (WEE) is a naturally acquired infection and potentially devastating bioweapon, with no specific human countermeasures. An experimental inactivated Western Equine Encephalitis Vaccine (WEEV; WEE TSI-GSD 210) has been used under an IND (investigational New Drug) protocol at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) since 1976. Methods Over 24 years from 1987 to 2011, 876 subjects received 3 primary vaccine doses under 3 studies with 1,537 booster doses administered (FY87-8, phase 2, laboratory workers, vaccine lots 1-81-1, 1-81-2, and 2-1-91; FY99-12, phase 2 laboratory workers, lot 2-1-91; and FY09-02, phase 1 healthy volunteer, lot 3-1-92). Post-vaccination safety and immunogenicity [plaque reduction neutralization test 80% (PRNT80) > 1:40] were analyzed. Results Overall PRNT80 response to the primary series in FY87-8 was 42% (326/770) but dropped to 16% (14/87) in FY99-12, prompting study FY09-02, which achieved 89% (17/19). The first booster response rate was 68% (814/1194) in FY87-8, 53% (171/324) in FY99-12, and 100% (10/10) in FY09-02. The majority of definitely related adverse reactions (AEs) were mild and local with no definitely related serious AEs. No laboratory acquired WEE infection was documented during this period despite 4 reported exposures in vaccinated subjects. Conclusion The TSI-GSD 210 WEE vaccine was immunogenic, safe and well tolerated. Use of this vaccine could be considered in an emergency setting. Despite decades of safe and effective use under IND, full licensure is not planned due to manufacturing constraints, and a strategic decision to develop alternatives. Clinical Trial Registration https://clinicaltrials.gov/, identifier NCT01159561.
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Affiliation(s)
- Maryam Keshtkar-Jahromi
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ronald B Reisler
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Jeannine M Haller
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Denise P Clizbe
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Robert G Rivard
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Anthony P Cardile
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Benjamin C Pierson
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Sarah Norris
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - David Saunders
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
| | - Phillip R Pittman
- Division of Medicine, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, United States
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Anderson C, Lee C, Saunders D, Curtis A, Dunlap N, Nangia C, Lee A, Gordon S, Kovoor P, Ad VB, Peddada A, Colvett K, Blakaj D, Bonomi M, Worden F, Holmlund J, Brill J, Downs M, Sonis S, Buatti J. 2-Year Outcomes Of Phase Iib, Randomized, Double-Blind Trial Of GC4419 Versus Placebo To Reduce Severe Oral Mucositis Due To Concurrent Radiotherapy And Cisplatin For Head And Neck Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Conlon MSC, Santi SA, Meigs ML, Davidson SM, Saunders D. Cigarette-smoking characteristics and interest in cessation in patients with head-and-neck cancer. Curr Oncol 2020; 27:e478-e485. [PMID: 33173387 PMCID: PMC7606046 DOI: 10.3747/co.27.6019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Many patients diagnosed with head-and-neck cancer are current or former smokers. Despite the well-known adverse effects of smoking, continuation of smoking during cancer treatment is associated with reduced efficacy of that treatment and with cancer recurrence. In the present study, we examined smoking characteristics in patients with head-and-neck cancer near the time of cancer treatment. Methods A prospective cohort of patients with head-and-neck cancer who attended a dental oncology clinic before receiving cancer treatment at a regional cancer centre were invited to participate in a study that involved completing an interviewer-administered questionnaire to assess smoking characteristics, intention to quit, motivation to quit, and strategies perceived to potentially aid in successful cessation. Results The study enrolled 493 ever-smokers, with a response rate of 96.1% and a self-reported current smoker rate of 37.1% (n = 183). Most of the current smokers reported high nicotine dependence, with 84.7% (n = 155) indicating a time to first cigarette of 30 minutes or less. Most had previously attempted to quit smoking (77.0%), and many had prior unsuccessful quit attempts before resuming smoking again. Most were interested in quitting smoking (85.8%), and many (70.5%) were seriously considering quitting smoking within the subsequent 30 days. Conclusions Patients with head-and-neck cancer reported high nicotine dependence and high interest in cessation opportunities near the time of treatment for cancer. Those results might provide support for provision of smoking cessation opportunities.
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Affiliation(s)
- M S C Conlon
- Health Sciences North Research Institute, Sudbury, ON
- Northeast Cancer Centre, Health Sciences North, Sudbury, ON
- Laurentian University, Sudbury, ON
| | - S A Santi
- Health Sciences North Research Institute, Sudbury, ON
| | - M L Meigs
- Health Sciences North Research Institute, Sudbury, ON
| | - S M Davidson
- Northeast Cancer Centre, Health Sciences North, Sudbury, ON
- Northern Ontario School of Medicine, Sudbury, ON
| | - D Saunders
- Northeast Cancer Centre, Health Sciences North, Sudbury, ON
- Northern Ontario School of Medicine, Sudbury, ON
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Saunders D, Ganjavi M. Perceived Distress and its Relationship to Cognition and Food Choice in College Students. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Berner A, Hughes D, Tharmalingam H, Baker T, Heyworth B, Banerjee S, Saunders D. 1614P LGBTQ+ cancer patients: Are UK oncologists being supported to develop essential knowledge, attitudes and behaviours to provide quality care? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1922] [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] Open
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Brown DM, Camenzuli L, Redman AD, Hughes C, Wang N, Vaiopoulou E, Saunders D, Villalobos A, Linington S. Is the Arrhenius-correction of biodegradation rates, as recommended through REACH guidance, fit for environmentally relevant conditions? An example from petroleum biodegradation in environmental systems. Sci Total Environ 2020; 732:139293. [PMID: 32438147 DOI: 10.1016/j.scitotenv.2020.139293] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/10/2020] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 04/15/2023]
Abstract
Biodegradation is a major determinant of chemical persistence in the environment and an important consideration for PBT and environmental risk assessments. It is influenced by several environmental factors including temperature and microbial community structure. According to REACH guidance, a temperature correction based on the Arrhenius equation is recommended for chemical persistence data not performed at the recommended EU mean surface water temperature. Such corrections, however, can lead to overly conservative P/vP assessments. In this paper, the relevance of this temperature correction is assessed for petroleum hydrocarbons, using measured surface water (marine and freshwater) degradation half-time (DT50) and degradation half-life (HL) data compiled from relevant literature. Stringent screening criteria were used to specifically select data from biodegradation tests containing indigenous microbes and conducted at temperatures close to their ambient sampling temperature. As a result, ten independent studies were identified, with 993 data points covering 326 hydrocarbon constituents. These data were derived from tests conducted with natural seawater, or freshwater, at temperatures ranging from 5 to 21 °C. Regressions were performed on the full hydrocarbon dataset and on several individual hydrocarbons. The results were compared to the trend as predicted by the Arrhenius equation and using the activation energy (Ea) as recommend in the REACH Guidance. The comparison shows that the correction recommended in REACH Guidance over predicts the effect of temperature on hydrocarbon biodegradation. These results contrast with temperature manipulated inocula where the test temperature is different from the ambient sampling temperature. In these manipulated systems, the effect of temperature follows the Arrhenius equation more closely. In addition, a more striking effect of temperature on the lag phase was observed with longer lag phases more apparent at lower temperatures. This indicates that the effect of temperature may indeed be even lower when considering hydrocarbon biodegradation without the initial lag phase.
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Affiliation(s)
| | - Louise Camenzuli
- ExxonMobil Petroleum & Chemical, Machelen, Belgium; Concawe, Brussels, Belgium
| | - Aaron D Redman
- ExxonMobil Petroleum & Chemical, Machelen, Belgium; Concawe, Brussels, Belgium
| | | | - Neil Wang
- Total, Paris, France; Concawe, Brussels, Belgium
| | | | - David Saunders
- Concawe, Brussels, Belgium; Shell International, The Hague, Netherlands
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Affiliation(s)
- David Saunders
- Clinical and Research Fellow, Child and Adult Psychiatry, Yale Child Study Center
| | - Hedy Kober
- Associate Professor, Department of Psychiatry, Department of Psychology, Cognitive Science Program, Interdepartmental Neuroscience Program, Yale University School of Medicine
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Giuliani M, Brual J, Cameron E, Chaiton M, Eng L, Haque M, Liu G, Mittmann N, Papadakos J, Saunders D, Truscott R, Evans W. Smoking Cessation in Cancer Care: Myths, Presumptions and Implications for Practice. Clin Oncol (R Coll Radiol) 2020; 32:400-406. [PMID: 32029357 DOI: 10.1016/j.clon.2020.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
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