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Katlama C, Bisshop F, Bogner J, Pérez Elías MJ, Di Giambenedetto S, Clarke E, Hodder S, Nwokolo N, Ait-Khaled M, Oyee J, Grove R, Wynne B, Okoli C, Jones B, Kisare M. Efficacy and safety of dolutegravir/lamivudine in virologically suppressed female participants: week 48 data from the pooled TANGO and SALSA studies. HIV Med 2024. [PMID: 38760011 DOI: 10.1111/hiv.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/24/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES Women represent >50% of people with HIV globally but have historically been underrepresented in clinical trials. We evaluated the efficacy and safety of switching to dolutegravir/lamivudine (DTG/3TC) vs continuing their current antiretroviral regimen (CAR) by sex assigned at birth (female and male) in virologically suppressed adults with HIV-1 without prior virological failure in a pooled analysis of two randomized controlled trials. METHODS This analysis included 48-week data from the phase 3 TANGO and SALSA studies. Primary and key secondary endpoints included proportions of participants with HIV-1 RNA ≥50 and <50 copies/mL at week 48, respectively. Safety was also assessed. RESULTS Of 1234 participants, 250 (DTG/3TC, n = 133; CAR, n = 117) were female at birth. Week 48 proportions of participants with Snapshot HIV-1 RNA ≥50 copies/mL were similar regardless of sex at birth (DTG/3TC vs CAR: female, <1% [1/133] vs 2% [2/117]; male, <1% [1/482] vs <1% [3/502]). Proportions with HIV-1 RNA <50 copies/mL were high across sexes and treatment groups (DTG/3TC vs CAR: female, 91% [121/133] vs 89% [104/117]; male, 94% [455/482] vs 94% [471/502]). Immunological response with DTG/3TC was slightly higher in female participants. Incidences of adverse events leading to withdrawal and serious adverse events were low and comparable between treatment groups and across sexes. Weight gain was higher with DTG/3TC than with CAR among female participants aged ≥50 years (treatment difference 2.08 kg [95% confidence interval 0.40-3.75]). CONCLUSIONS Results confirm the robustness of DTG/3TC as a switch option in virologically suppressed females with HIV-1, with outcomes similar to those in males.
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Affiliation(s)
- C Katlama
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, INSERM-Sorbonne Universités, Paris, France
| | - F Bisshop
- Holdsworth House Medical Brisbane, Fortitude Valley, Queensland, Australia
| | - J Bogner
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - S Di Giambenedetto
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Clarke
- Axess Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - S Hodder
- West Virginia Clinical and Translational Science Institute, Morgantown, West Virginia, USA
| | | | | | | | | | - B Wynne
- ViiV Healthcare, Durham, North Carolina, USA
| | - C Okoli
- ViiV Healthcare, Brentford, UK
| | - B Jones
- ViiV Healthcare, Brentford, UK
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Doran N, Murphy R, Clarke E, Quigley S, Kiernan S, Malone A. 275 “MOVING ON UP”: FEASIBILITY OF A WARD-BASED THERAPY INITIATIVE TO IMPROVE PATIENT ACTIVITY LEVELS IN NEUROLOGICAL REHABILITATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients admitted for neurological rehabilitation are not receiving sufficient dosage of activity to facilitate optimal recovery. Previous research has reported issues with feasibility and patient adherence to intensity programs.
Methods
Mixed methods were employed for this feasibility study. The “Moving On Up” program encompassed “Activitea” structured practice of sit to stands prompted by mealtimes, “Step It Up” a gradual walking program using pedometers and “Weekend Workout” increasing practice of exercise programs. These activities were in addition to daily therapy sessions over a four-week intervention period. Primary feasibility outcomes investigated recruitment, retention, adherence, adverse events, facilitators, barriers and acceptability of the program and preliminarily assessed changes in activity levels using the ActivPAL accelerometer. Functional tests assessed mobility, health-related quality of life and fear of falls. Descriptive statistics were used for analysing quantitative data. Braun and Clarke’s thematic analysis was adopted when reviewing qualitative data.
Results
Ten participants were recruited with zero dropouts. Median age was 72 years and five had a diagnosis of brain tumour excision. Eight participants demonstrated excellent adherence with completion of daily activity logs. There was one participant non-injurious fall, no other adverse events. Clinical outcomes demonstrated improvement in median daily step count, stepping and standing time. The median daily step count for the group increased from 1,375 steps (IQR 2,867, range 82-4,248) to 1,724 steps (IQR 2,914, range 80-8,207). All functional tests improved. Seven participants and three therapists completed semi-structured interviews. Five themes emerged; motivation to move more, empowerment, barriers to increasing activity, weekends long and boring and job satisfaction.
Conclusion
The “Moving On Up” program was feasible to implement without additional staffing and was accepted by key stakeholders. Future research is warranted into the program's effectiveness, incorporating a larger sample and randomised pilot trial. Inclusion of a follow-up of participants after discharge would be desirable to investigate long-term effects on activity.
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Affiliation(s)
- N Doran
- Clontarf Hospital , Dublin, Ireland
- Royal College of Surgeons in Ireland , Dublin, Ireland
| | - R Murphy
- Clontarf Hospital , Dublin, Ireland
| | - E Clarke
- Clontarf Hospital , Dublin, Ireland
| | | | | | - A Malone
- Royal College of Surgeons in Ireland , Dublin, Ireland
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Clarke E, Hamilton J, Dickinson S. POS1503-HPR THE VALUE OF REMOTE CONSULTATIONS WITH A PHYSIOTHERAPIST, SPECIALISED IN AXIAL SPONDYLOARTHRITIS DURING THE COVID 19 PANDEMIC: EVALUATION OF A MEMBER-SUPPORT PROJECT WITH THE NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundCOVID-19 caused significant disruption to Axial Spondyloarthritis (AxSpA) services during the intial 2020 lockdown1. In response, The National Axial Spondyloarthritis Society (NASS) piloted provision of remote consultations with a physiotherapist specialised in the management of AxSpA to their members in urgent need. This project was funded by the UK National Lottery FundObjectivesTo provide a total of 130 hrs of remote consultation to members of NASS, unable to access specialist care and in need of self-management advice for their conditionMethodsRemote consultations were offered to NASS members from Sept 2020 to Feb 2021. The preferred format being 1hr assessment and 2 x 30 min at 1 and 3 weeks from assessment. Participants consented to video consultations via Zoom and the inclusion of anonymised outcomes and comments in the project evaluation.Patient Reported Outcomes (BASDAI and BASFI) were collected immediately prior to assessment, at final consultation and in April 2021, between 8- 16 weeks from final consultContent was individually tailored, centring on self-management (pacing, sleep management), education (AxSpA pathology, medication) and individualised exercise plans.Exercise plans were formulated through “Rehab My Patient” software, including links to YouTube video references and daily exercise log sheets.Results67 members received online consultations, 63 receiving the full 3 sessions. Missed appointment rate = 2.5%Participants represented a wide geographical area across England and a spread in time since diagnosis.Patient Reported Outcomes Measures (PROMs) on assessment:● Mean BASDAI score (n=55) on assessment = 5.8● Mean BASFI score on assessment (n=56) = 5.524 participants returned PROMS at final consultation, 10 at longer follow-up (8-16 weeks).Results for complete data set (n=10):Table 1.PROMSAssessmentFinal consultationFollow-upMean BASDAI5.04.34.0Mean BASFI5.14.04.1Satisfaction:60 members completed an online feedback survey provided by NASS:9 Feedback to questions were asked, with a satisfaction scale of 1-5 (ascending positivity)99.6% of all scores were 3 or above.Example responses:● How would you rate the overall experience: 92% = 5, 100% = 3-5● To what extent do you feel more confident to manage your condition: 40% = 5, 100% = 3-5● How useful was it to be in direct contact with a Physiotherapist: 93% = 5, 100% = 3-546 members chose to leave additional, overwhelmingly positive comments, with 2 obvious themes arising: 1)The value of the experience and knowledge of the therapist. “was great to have the guidance and support of a professional who knows what they are talking about when it comes to AxSpA”2)The value of education in condition management “set me back on track”, ”very helpful for my mental strength in dealing with this enduring disease”, “I learned so much about my AS and ways to keep mobile”ConclusionA set of 1-3 sessions per person achieved desirable patient reported outcomes with modest and enduring improvements seen in disease activity and function.This pilot project enabled those living with Axial SpA across England access to a Physiotherapist highly experienced in treatment of their condition. The majority of participants reported having no previous experience of seeing a therapist with specialised knowledge of their condition. The knowledge and experience of the clinician was a key theme in the positive nature of feedback linking to another key theme of improved confidence to manage their condition. These results highlight the value to patients of specialised knowledge amongst health professionals. Remote consultations may provide access to specialist knowledge “out of area” and may be an efficient method of delivering self-management adviceReferences[1]Marzo-Ortega M, et al. COVID-19 in Axial Spondyloarthritis care provision: helping to straighten the long and winding road. Lancet Rheumatology. 2021. Jan 3(1) e11-13Disclosure of InterestsEmily Clarke Speakers bureau: Has previously received speaker fees from Novartis Pharmaceutical UK, Jill Hamilton: None declared, Sally Dickinson: None declared
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Mistry P, Leach Z, Hollingworth T, Clarke E, Mirenzami A, Smith T. Is early parenteral nutrition necessary following pelvic exenteration surgery? Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Davies S, Clarke E, Hardy E, Hepworth C. COVID-19, child inactivity and the introduction of an online exercise class. Physiotherapy 2022. [PMCID: PMC8848158 DOI: 10.1016/j.physio.2021.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Allan PJ, Ambrose T, Mountford C, Bond A, Donnellan C, Boyle R, Calvert C, Cernat E, Clarke E, Cooper SC, Donnelly S, Evans B, Glynn M, Hewett R, Holohan AS, Leitch EF, Louis-Auguste J, Mehta S, Naik S, Nightingale J, Rafferty G, Rodrigues A, Sharkey L, Small M, Teubner A, Urs A, Wyer N, Lal S. COVID-19 infection in patients with intestinal failure: UK experience. JPEN J Parenter Enteral Nutr 2021; 45:1369-1375. [PMID: 33586170 PMCID: PMC8013499 DOI: 10.1002/jpen.2087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The direct effect of the coronavirus disease 2019 (COVID-19) pandemic on patients with intestinal failure (IF) has not been described. METHODS We conducted a nationwide study of UK IF centers to evaluate the infection rates, presentations, and outcomes in patients with types 2 and 3 IF. RESULTS A total of 45 patients with IF contracted COVID-19 between March and August 2020; this included 26 of 2191 (1.2%) home parenteral nutrition (HPN)-dependent adults and 19 of 298 (6.4%) adults hospitalized with type 2 IF. The proportion of patients receiving nursing care for HPN administration was higher in those with community-acquired COVID-19 (66.7%) than the proportion in the entire HPN cohort (26.1%; P < .01). Two HPN-dependent and 1 hospitalized patient with type 2 IF died as a direct consequence of the virus (6.7% of 45 patients with types 2 or 3 infected). CONCLUSION This is the first study to describe the outcomes of COVID-19 in a large cohort of patients requiring long-term PN. Methods to reduce hospital and community nosocomial spread would likely be beneficial.
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Affiliation(s)
- P J Allan
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - T Ambrose
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C Mountford
- Department of Gastroenterology, Freeman Hospital, Newcastle, UK
| | - A Bond
- Department of Gastroenterology, Royal Liverpool and Broadgreen Hospitals, Liverpool, UK
| | - C Donnellan
- St James' and Leeds Gastroenterology Institute, St James' Hospital, Leeds, UK
| | - R Boyle
- Department of Biochemistry, Aberdeen Royal Infirmary, Aberdeen, UK
| | - C Calvert
- Department of Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK
| | - E Cernat
- Department of Paediatric Gastroenterology, Leeds General Infirmary, Leeds, UK
| | - E Clarke
- Department of Gastroenterology, Southampton University Hospital, Southampton, UK
| | - S C Cooper
- GI Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Donnelly
- Leonard Jones' Intestinal Rehabilitation Unit, St Mark's Hospital, Harrow, UK
| | - B Evans
- Department of Gastroenterology, Bristol Royal Infirmary, Bristol, UK
| | - M Glynn
- Centre for Digestive Diseases, Royal London Hospital, London, UK
| | - R Hewett
- Department of Gastroenterology, University of Wales Hospital, Cardiff, UK
| | - A S Holohan
- Nutrition, Leicester Royal Infirmary, Leicester, UK
| | - E F Leitch
- Intestinal Failure Surgery, Glasgow Royal Infirmary, Glasgow, UK
| | | | - S Mehta
- Intestinal Failure Unit, University College London Hospitals, London, UK
| | - S Naik
- Department of Paediatric Gastroenterology, Royal London Children's Hospital, London, UK
| | | | - G Rafferty
- Department of Gastroenterology, Belfast City Hospital, Belfast, UK
| | - A Rodrigues
- Department of Paediatric Gastroenterology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - L Sharkey
- Intestinal Failure and Transplant, Cambridge University Hospitals, Cambridge, UK
| | - M Small
- Leonard Jones' Intestinal Rehabilitation Unit, St Mark's Hospital, Harrow, UK
| | - A Teubner
- Intestinal Failure Unit, Salford Royal Hospital, Salford, UK
| | - A Urs
- Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, UK
| | - N Wyer
- Intestinal Failure and Nutrition Support, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - S Lal
- Intestinal Failure Unit, Salford Royal Hospital, Salford, UK.,Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
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Clarke E, Skrzat J, Mazur M, Musiał A, Sienkiewicz J, Radek M, Polguj M, Wysiadecki G. Anatomical variations of the superficial ulnar artery: case series observed on historical specimens prepared by Ludwik Karol Teichmann. Folia Morphol (Warsz) 2021; 81:227-233. [PMID: 33577075 DOI: 10.5603/fm.a2021.0014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND In this report we present a series of cases representing variant origin and course of the ulnar artery, namely the superficial ulnar artery, observed during the review of collection of historical specimens prepared in the 19th century by the prominent Polish anatomist Ludwik Karol Teichmann and his collaborators, exhibited in the Anatomy Museum of Jagiellonian University Medical College. RESULTS Three distinct variants of the superficial ulnar artery were found on anatomical specimens of the upper limb with arteries injected by using Teichmann's method. In case No. 1, the superficial ulnar artery originated from the brachial artery slightly above the interepicondylar line of the humerus. This aberrant vessel gave off the common interosseous artery in the upper half of the cubital fossa and then ran superficially to the bicipital aponeurosis and over the muscles arising from the medial epicondyle of the humerus. The cases No. 2 and 3 involved two similar variants of the superficial artery in which the common interosseous artery arose from the radial artery. In the unique case No. 4, the superficial ulnar artery arose from the radial artery. CONCLUSIONS The superficial ulnar artery shows diverse anatomy regarding its topography and blood supply territory. Orthopedic, hand, and plastic surgeons should be aware of anatomic variations of the SUA both in planning and in conducting surgeries of the upper limb.
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Affiliation(s)
- E Clarke
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - J Skrzat
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - M Mazur
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - A Musiał
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - J Sienkiewicz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - M Radek
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, University Hospital WAM-CSW, Łódź, Poland
| | - M Polguj
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - G Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland.
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Chu H, Brailey R, Clarke E, Sen SK. Reducing pain through distraction therapy in small acute paediatric burns. Burns 2021; 47:1635-1638. [PMID: 33972148 DOI: 10.1016/j.burns.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The majority of patients who sustained small (low % total body surface area [TBSA]) burns are assessed in an outpatient setting. This can be a traumatic experience, particularly, for paediatric patients. During the initial assessment pharmacological and non-pharmacological adjuncts, such as distraction therapy, can be employed to provide an environment that may reduce and minimise distress. In this study, we investigated whether distraction therapy reduces objective pain scores during the outpatient assessment of small acute burns in children. METHODS Two cohorts of patients were formed. In the first group (group A), the children received analgesia and routine nursing care. In the second group (group B), the children received specialist distraction therapy in addition to the same analgesia and nursing care. We recorded patient demographics, TBSA, anatomical sites and mechanism of burn. The Wong Baker™ visual analogue scale (VAS) was used to convert perceived pain, as reported by the patient or parent, into a numerical value at three set intervals during the consultation. RESULTS 50 patients were recruited with 32 patients in group A and 18 in group B. A larger TBSA positively correlated with higher pain scores (p < 0.05). At the start of the consultation the mean pain score without distraction therapy was 1.55 and with specialist distraction therapy was 0.33 (p < 0.05). The mean peak pain score during dressing change without distraction therapy was 6.80 and with specialist distraction was 4.47 (p < 0.05). At the end of the procedure, the mean pain score was 2.12 without distraction therapy and with specialist distraction 1.75. CONCLUSION This study of pain scores in small acute paediatric burns has shown that distraction therapy provided by a qualified play specialist can reduce maximal pain by over 2 points on the Wong-Baker™ VAS. Consideration should be given to ensure that distraction therapy is available at all times during initial consultations for children who have sustained small burns.
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Affiliation(s)
- H Chu
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom.
| | - R Brailey
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
| | - E Clarke
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
| | - S K Sen
- Department of Burns, Plastic and Reconstructive Surgery, Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, United Kingdom
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Clarke E, Rahme J, Rajkomar A, Smart P, Warrier S. Standardizing robotic transanal minimally invasive surgery in lithotomy using the Xi platform - a video vignette. Colorectal Dis 2020; 22:1799-1800. [PMID: 32619056 DOI: 10.1111/codi.15224] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/10/2020] [Indexed: 02/08/2023]
Affiliation(s)
- E Clarke
- Austin Health, Heidelberg, Victoria, Australia
| | - J Rahme
- Austin Health, Heidelberg, Victoria, Australia
| | - A Rajkomar
- Epworth Eastern Hospital, Box Hill, Victoria, Australia
| | - P Smart
- Austin Health, Heidelberg, Victoria, Australia.,Epworth Eastern Hospital, Box Hill, Victoria, Australia
| | - S Warrier
- Epworth Eastern Hospital, Box Hill, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Clarke E, Tubbs RS, Radek M, Haładaj R, Tomaszewski M, Wysiadecki G. Unusual formation of the musculocutaneous and median nerves: a case report refined by intraneural dissection and literature review. Folia Morphol (Warsz) 2020; 80:1020-1026. [PMID: 33084011 DOI: 10.5603/fm.a2020.0121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022]
Abstract
This report presents a detailed anatomical investigation of an upper limb specimen showing an atypical formation of the musculocutaneous (MCN) and median (MN) nerves. The study was refined by intraneural dissection, which supplements earlier descriptions of similar anatomical variations and allows for revision of the accepted classification. The case described in this report was an incidental finding during routine dissection of a fixed isolated upper limb. Intraneural dissection revealed partial fusion between the MCN and aberrant bundles of the MN. Those aberrant bundles joined the main steam of the MN at the level at which the MCN branched off as an independent nerve. The procedure allowed the aberrant fibers of the MN to be differentiated from the MCN. The presence of separate bundles in a territory corresponding to the MCN was confirmed, although those bundles and the aberrant MN bundles were covered by a common epineurium. The aberrant MN bundles running within the MCN did not contribute to innervation of the forearm muscles. They rejoined the main nerve trunk in the arm. A comprehensive understanding of the diverse anatomical variations of the upper limb nerves could be crucial for the safety and success of surgical procedures, especially procedures for reconstructing the brachial plexus or its branches.
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Affiliation(s)
- E Clarke
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - R S Tubbs
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA, United States.,Department of Anatomical Sciences, St. George's University, Grenada
| | - M Radek
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, University Hospital WAM-CSW, Łódź, Poland
| | - R Haładaj
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - M Tomaszewski
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - G Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland.
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Clarke E, Levien AS, Bennett RA, Perry S, Daniel G. Clinical utility of liver biopsies in dogs undergoing splenectomy. J Small Anim Pract 2020; 61:684-688. [PMID: 33035380 DOI: 10.1111/jsap.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/25/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence of neoplasia detected on liver biopsy obtained at the time of splenectomy in dogs with splenic masses. MATERIALS AND METHODS Retrospective study of medical records of dogs with splenic masses from which liver biopsies were taken following splenectomy. RESULTS Malignant splenic neoplasia was detected in 50 of 113 (44.2%) of the dogs undergoing splenectomy. Neoplastic liver disease was detected on biopsy from 1 of 40 (2.5%) dogs with a grossly normal liver and from 20 of 69 (28.9%) dogs with a grossly abnormal liver. Dogs with a grossly abnormal liver had a ~ 16 times (95% CI: 2.5-170) higher chance of being diagnosed with liver neoplasia on biopsy. Haemoabdomen was also associated with an increased likelihood of liver neoplasia on biopsy at the time of splenectomy. CLINICAL SIGNIFICANCE A liver biopsy taken from grossly normal liver is a low-yield diagnostic test but liver biopsy is recommended following splenectomy if the liver appears abnormal at surgery.
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Affiliation(s)
- E Clarke
- Louisiana State University Veterinary Teaching Hospital, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - A S Levien
- The Animal Medical Center, 510 E 62nd St. New York, NY, 10065, USA.,Veterinary Specialists of Sydney, PO BOX 197, Padstow, NSW, 2211, Australia
| | - R A Bennett
- Louisiana State University Veterinary Teaching Hospital, Skip Bertman Drive, Baton Rouge, LA, 70803, USA.,The Animal Medical Center, 510 E 62nd St. New York, NY, 10065, USA
| | - S Perry
- Louisiana State University Veterinary Teaching Hospital, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - G Daniel
- The Animal Medical Center, 510 E 62nd St. New York, NY, 10065, USA.,Friendship Hospital for Animals, 4105 Brandywine St NW, Washington, DC, 20016, USA
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Ahmed N, Giorgakoudi K, Usuf E, Okomo U, Clarke E, Kampmann B, Le Doare K, Trotter C. Potential cost-effectiveness of a maternal Group B streptococcal vaccine in The Gambia. Vaccine 2020; 38:3096-3104. [PMID: 32147298 DOI: 10.1016/j.vaccine.2020.02.071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/18/2020] [Accepted: 02/24/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To estimate neonatal health benefits and healthcare provider costs of a theoretical Group B streptococcal (GBS) hexavalent maternal vaccination programme in The Gambia, a low-income setting in West Africa. METHODS A static decision analytic cost-effectiveness model was developed from the healthcare provider perspective. Demographic data and acute care costs were available from studies in The Gambia undertaken in 2012-2015. Further model parameters were taken from United Nations and World Health Organisation sources, supplemented by data from a global systematic review of GBS and literature searches. As vaccine efficacy is not known, we simulated vaccine efficacy estimates of 50-90%. Costs are reported in US dollars. Cost-effectiveness thresholds of one (US$473, very cost effective) and three (US$1420, cost effective) times Gambian GDP were used. RESULTS Vaccination with a hexavalent vaccine would avert 24 GBS disease cases (55%) and 768 disability adjusted life years compared to current standard of care (no interventions to prevent GBS disease). At vaccine efficacy of 70%, the programme is cost-effective at a maximum vaccine price per dose of 12 US$ (2016 US$), and very cost-effective at a maximum of $3/dose. The total costs of vaccination at $12 is $1,056,962 for one annual cohort of Gambian pregnant women. One-way sensitivity analysis showed that GBS incidence was the most influential parameter on the cost effectiveness ratio. CONCLUSION The introduction of a hexavalent vaccine would considerably reduce the current burden of GBS disease in The Gambia but to be cost-effective, the vaccine price per dose would need to be $12/dose or less.
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Affiliation(s)
- N Ahmed
- Imperial College London, London, UK
| | - K Giorgakoudi
- School of Health Sciences, City, University of London, London, UK; NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust, Insititute of Cancer Research, London, UK
| | - E Usuf
- Medical Research Council Unit The Gambia (MRCG) @LSHTM, Fajara, Gambia
| | - U Okomo
- Medical Research Council Unit The Gambia (MRCG) @LSHTM, Fajara, Gambia
| | - E Clarke
- Medical Research Council Unit The Gambia (MRCG) @LSHTM, Fajara, Gambia
| | - B Kampmann
- Medical Research Council Unit The Gambia (MRCG) @LSHTM, Fajara, Gambia
| | - K Le Doare
- Medical Research Council Unit The Gambia (MRCG) @LSHTM, Fajara, Gambia; St George's University of London, London, UK; West African Global Health Alliance, Dakar, Senegal
| | - C Trotter
- University of Cambridge, Cambridge, UK.
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13
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Unemo M, Clarke E, Boiko I, Patel C, Patel R. Adherence to the 2012 European gonorrhoea guideline in the WHO European Region according to the 2018-19 International Union against Sexually Transmitted Infections European Collaborative Clinical Group gonorrhoea survey. Int J STD AIDS 2019; 31:69-76. [PMID: 31842695 DOI: 10.1177/0956462419879278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Gonorrhoea is a major public health problem globally. Increasing incidence in many particularly developed countries and the emergence of resistance to the extended-spectrum cephalosporin ceftriaxone, the last option for empiric first-line monotherapy, are of serious concern. This paper evaluates the results of the 2018–19 International Union against Sexually Transmitted Infections European Collaborative Clinical Group survey on the diagnosis and treatment of gonorrhoea in Europe. Although high quality clinical care was reported in many European settings, in several countries the testing, diagnostics, antimicrobial treatment, and follow-up of gonorrhoea patients were evidently suboptimal. Increased adherence to evidence-based European and/or nationally-adapted management guidelines is essential in controlling the increasing incidence of gonorrhoea in many European settings and the spread of ceftriaxone-resistant, multidrug-resistant, and extensively drug-resistant gonorrhoea.
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Affiliation(s)
- M Unemo
- Department of Laboratory Medicine, Faculty of Medicine and Health, World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Örebro University, Örebro, Sweden
| | - E Clarke
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - I Boiko
- Department of Laboratory Medicine, Faculty of Medicine and Health, World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Örebro University, Örebro, Sweden.,Department of Functional and Laboratory Diagnostics, I. Horbachevsky Ternopil State Medical University, Ternopil, Ukraine
| | - C Patel
- University of Liverpool, Liverpool, UK
| | - R Patel
- Department of Genitourinary Medicine, Southampton Medical School, University of Southampton, Southampton, UK.,Solent NHS Trust, Southampton, UK
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14
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Clarke E, Patel C, Patel R, Unemo M. The 2018-19 International Union against Sexually Transmitted Infections European Collaborative Clinical Group report on the diagnosis and treatment of gonorrhoea in Europe. Int J STD AIDS 2019; 31:77-81. [PMID: 31793388 DOI: 10.1177/0956462419879270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The European Collaborative Clinical Group (ECCG) has been surveying clinical management of sexually transmitted infections (STIs) in Europe since its inauguration in 2011. The ECCG is a network of nearly 130 STI specialists from 34 European countries who conduct questionnaire-based research across the European region. The research of ECCG focuses on providing data regarding clinical practice to inform European STI guideline development and revisions. The present paper describes the results of the 2018–19 ECCG survey regarding diagnosis and treatment of gonorrhoea in Europe.
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Affiliation(s)
- E Clarke
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - C Patel
- Solihull Hospital, Solihull, UK
| | - R Patel
- Department of Genitourinary Medicine, Southampton Medical School, University of Southampton, Southampton, UK.,Solent NHS Trust, Southampton, UK
| | - M Unemo
- Department of Laboratory Medicine, Faculty of Medicine and Health, World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Örebro University, Örebro, Sweden
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15
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Clarke E, Jantrachotechatchawan C, Buhidma Y, Broadstock M, Yu L, Howlett D, Aarsland D, Ballard C, Francis PT. Age-related neurochemical and behavioural changes in D409V/WT GBA1 mouse: Relevance to lewy body dementia. Neurochem Int 2019; 129:104502. [PMID: 31299418 DOI: 10.1016/j.neuint.2019.104502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/21/2019] [Accepted: 07/08/2019] [Indexed: 12/13/2022]
Abstract
Heterozygous mutations in GBA1, the gene which encodes the lysosomal enzyme glucocerebrosidase (GCase), are a strong genetic risk factor for the development of Lewy body dementia (LBD). Until this point however, recapitulation of the symptoms and pathology of LBD has been limited to a homozygous GBA1 mouse model which genetically and enzymatically reflects the lysosomal storage disorder Gaucher's disease. This study reports for the first time cognitive impairment by two independent behavioural tests in heterozygous GBA1 mutant mice (D409V/WT) which demonstrate significant cognitive impairment by the age of 12 months. Furthermore, reductions in GBA1 GCase enzyme activity within the brain reflects levels seen in sporadic and GBA1 mutant LBD patients. While there is no overt deposition of Lewy bodies within the hippocampus, alterations to cholinergic machinery and glial proliferation are evident, both pathological features of LBD. Interestingly, we also describe the novel finding of significantly reduced GBA2 GCase enzyme activity specifically within the hippocampus. This suggests that reduced GBA1 GCase enzyme activity dis-equilibrates the finely balanced glycosphingolipid metabolism pathway and that reductions in GBA2 GCase enzyme could contribute to the pathological and behavioural effects seen. Overall, this study presents evidence to suggest that pathological hallmarks associated with LBD specifically affecting brain regions intrinsically linked with cognition are present in the D409V/WT mice. In the absence of Lewy body deposition, the D409V/WT mice could be considered an early pre-clinical model of LBD with potential for drug discovery. Since few robust pre-clinical models of LBD currently exist, with further characterization, the mouse model described here may contribute significantly to developments in the LBD field.
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Affiliation(s)
- E Clarke
- King's College London, Wolfson Centre for Age-Related Diseases, UK.
| | | | - Y Buhidma
- King's College London, Wolfson Centre for Age-Related Diseases, UK
| | - M Broadstock
- King's College London, Wolfson Centre for Age-Related Diseases, UK
| | - L Yu
- King's College London, Wolfson Centre for Age-Related Diseases, UK
| | - D Howlett
- King's College London, Wolfson Centre for Age-Related Diseases, UK
| | - D Aarsland
- King's College London, Department of Old Age Psychiatry, UK
| | | | - P T Francis
- King's College London, Wolfson Centre for Age-Related Diseases, UK; University of Exeter, UK
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16
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Foster AP, Hallett D, Iorsh IV, Sheldon SJ, Godsland MR, Royall B, Clarke E, Shelykh IA, Fox AM, Skolnick MS, Itskevich IE, Wilson LR. Tunable Photon Statistics Exploiting the Fano Effect in a Waveguide. Phys Rev Lett 2019; 122:173603. [PMID: 31107076 DOI: 10.1103/physrevlett.122.173603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Indexed: 06/09/2023]
Abstract
A strong optical nonlinearity arises when coherent light is scattered by a semiconductor quantum dot coupled to a nanophotonic waveguide. We exploit the Fano effect in such a waveguide to control the phase of the quantum interference underpinning the nonlinearity, experimentally demonstrating a tunable quantum optical filter which converts a coherent input state into either a bunched or an antibunched nonclassical output state. We show theoretically that the generation of nonclassical light is predicated on the formation of a two-photon bound state due to the interaction of the input coherent state with the quantum dot. Our model demonstrates that the tunable photon statistics arise from the dependence of the sign of two-photon interference (either constructive or destructive) on the detuning of the input relative to the Fano resonance.
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Affiliation(s)
- A P Foster
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - D Hallett
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - I V Iorsh
- ITMO University, St. Petersburg 197101, Russia
| | - S J Sheldon
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - M R Godsland
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - B Royall
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - E Clarke
- EPSRC National Epitaxy Facility, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - I A Shelykh
- ITMO University, St. Petersburg 197101, Russia
- Science Institute, University of Iceland, Dunhagi 3, IS-107 Reykjavik, Iceland
| | - A M Fox
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - M S Skolnick
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
- ITMO University, St. Petersburg 197101, Russia
| | - I E Itskevich
- Department of Engineering, University of Hull, Hull HU6 7RX, United Kingdom
| | - L R Wilson
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
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17
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Gangloff DA, Éthier-Majcher G, Lang C, Denning EV, Bodey JH, Jackson DM, Clarke E, Hugues M, Le Gall C, Atatüre M. Quantum interface of an electron and a nuclear ensemble. Science 2019; 364:62-66. [DOI: 10.1126/science.aaw2906] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/08/2019] [Indexed: 11/02/2022]
Abstract
Coherent excitation of an ensemble of quantum objects underpins quantum many-body phenomena and offers the opportunity to realize a memory that stores quantum information. Thus far, a deterministic and coherent interface between a spin qubit and such an ensemble has remained elusive. In this study, we first used an electron to cool the mesoscopic nuclear spin ensemble of a semiconductor quantum dot to the nuclear sideband–resolved regime. We then implemented an all-optical approach to access individual quantized electronic-nuclear spin transitions. Lastly, we performed coherent optical rotations of a single collective nuclear spin excitation—a spin wave. These results constitute the building blocks of a dedicated local memory per quantum-dot spin qubit and promise a solid-state platform for quantum-state engineering of isolated many-body systems.
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18
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Oliver E, Pope C, Clarke E, Langton Hewer C, Ogunniyi AD, Paton JC, Mitchell T, Malley R, Finn A. Th17 responses to pneumococcus in blood and adenoidal cells in children. Clin Exp Immunol 2019; 195:213-225. [PMID: 30325010 PMCID: PMC6330644 DOI: 10.1111/cei.13225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 11/30/2022] Open
Abstract
Pneumococcal infections cause a large global health burden, and the search for serotype-independent vaccines continues. Existing conjugate vaccines reduce nasopharyngeal colonization by target serotypes. Such mucosal effects of novel antigens may similarly be important. CD4+ Th17 cell-dependent, antibody-independent reductions in colonization and enhanced clearance have been described in mice. Here we describe the evaluation of T helper type 17 (Th17) cytokine responses to candidate pneumococcal protein vaccine antigens in human cell culture, using adenoidal and peripheral blood mononuclear cells. Optimal detection of interleukin (IL)-17A was at day 7, and of IL-22 at day 11, in these primary cell cultures. Removal of CD45RO+ memory T cells abolished these responses. Age-associated increases in magnitude of responses were evident for IL-17A, but not IL-22, in adenoidal cells. There was a strong correlation between individual IL-17A and IL-22 responses after pneumococcal antigen stimulation (P < 0·015). Intracellular cytokine staining following phorbol myristate acetate (PMA)/ionomycin stimulation demonstrated that > 30% CD4+ T cells positive for IL-22 express the innate markers γδT cell receptor and/or CD56, with much lower proportions for IL-17A+ cells (P < 0·001). Responses to several vaccine candidate antigens were observed but were consistently absent, particularly in blood, to PhtD (P < 0·0001), an antigen recently shown not to impact colonization in a clinical trial of a PhtD-containing conjugate vaccine in infants. The data presented and approach discussed have the potential to assist in the identification of novel vaccine antigens aimed at reducing pneumococcal carriage and transmission, thus improving the design of empirical clinical trials.
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Affiliation(s)
- E. Oliver
- School of Cellular and Molecular Medicine, Biomedical Sciences BuildingUniversity of BristolBristolUK
| | - C. Pope
- School of Cellular and Molecular Medicine, Biomedical Sciences BuildingUniversity of BristolBristolUK
| | - E. Clarke
- Vaccines and Immunity Theme, MRC Unit The GambiaFajaraThe Gambia
| | | | - A. D. Ogunniyi
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary SciencesThe University of AdelaideAdelaideAustralia
| | - J. C. Paton
- Research Centre for Infectious Diseases, Department of Molecular and Biomedical ScienceUniversity of AdelaideAdelaideAustralia
| | - T. Mitchell
- Institute of Microbiology and InfectionUniversity of BirminghamBirminghamUK
| | - R. Malley
- Division of Infectious Diseases, Department of MedicineChildren’s Hospital and Harvard Medical SchoolBostonMAUSA
| | - A. Finn
- School of Cellular and Molecular Medicine, Biomedical Sciences BuildingUniversity of BristolBristolUK
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19
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Wysiadecki G, Clarke E, Polguj M, Haładaj R, Żytkowski A, Topol M. Klingler's method of brain dissection: review of the technique including its usefulness in practical neuroanatomy teaching, neurosurgery and neuroimaging. Folia Morphol (Warsz) 2018; 78:455-466. [PMID: 30536356 DOI: 10.5603/fm.a2018.0113] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 11/25/2022]
Abstract
Klingler's technique was discovered in the 1930s. It is a modified method of brain fixation and dissection, based on freezing and thawing of the brain tissue, subsequent peeling away of white matter fibres and the gradual exposure of white matter tracts. The added value of this technique is that it is carried out in a stratigraphic manner. This fact makes it an invaluable tool for an in-depth understanding of the complex anatomical organisation of the cerebral hemispheres. The purpose of this paper is to provide a review of Klingler's method while taking into account the original description of the technique and its value for medical training. The historical background, the concise outline of white matter organisation, as well as our own experience in using this procedure for research and teaching activities were also included. The fibre dissection technique may still be considered an excellent complementary research tool for neuroanatomical studies. Numerous detailed observations about the white matter topography and spatial organisation have been recently made by applying this method. Using this technique may also improve understanding of the three-dimensional intrinsic structure of the brain, which is particularly important both in under- and postgraduate training in the field of neuroanatomy.
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Affiliation(s)
- G Wysiadecki
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland.
| | - E Clarke
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - M Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - R Haładaj
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - A Żytkowski
- Department of Biomechanics and Prosthetic-Orthopaedic Supply, Medical University of Lodz, Poland
| | - M Topol
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland
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20
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Hurst DL, Price DM, Bentham C, Makhonin MN, Royall B, Clarke E, Kok P, Wilson LR, Skolnick MS, Fox AM. Nonreciprocal Transmission and Reflection of a Chirally Coupled Quantum Dot. Nano Lett 2018; 18:5475-5481. [PMID: 30080970 DOI: 10.1021/acs.nanolett.8b01869] [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] [Indexed: 06/08/2023]
Abstract
We report strongly nonreciprocal behavior for quantum dot exciton spins coupled to nanophotonic waveguides under resonant laser excitation. A clear dependence of the transmission spectrum on the propagation direction is found for a chirally coupled quantum dot, with spin up and spin down exciton spins coupling to the left and right propagation directions, respectively. The reflection signal shows an opposite trend to the transmission, which a numerical model indicates is due to direction-selective saturation of the quantum dot. The chiral spin-photon interface we demonstrate breaks reciprocity of the system and opens the way to spin-based quantum optical components such as optical diodes and circulators in a chip-based solid-state environment.
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Affiliation(s)
- D L Hurst
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - D M Price
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - C Bentham
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - M N Makhonin
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - B Royall
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - E Clarke
- EPSRC National Epitaxy Facility, Department of Electronic and Electrical Engineering , University of Sheffield , Sheffield S1 3JD , United Kingdom
| | - P Kok
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - L R Wilson
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - M S Skolnick
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
| | - A M Fox
- Department of Physics and Astronomy , University of Sheffield , Hounsfield Road , Sheffield , S3 7RH , United Kingdom
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21
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Bishop ZK, Foster AP, Royall B, Bentham C, Clarke E, Skolnick MS, Wilson LR. Electro-mechanical control of an on-chip optical beam splitter containing an embedded quantum emitter. Opt Lett 2018; 43:2142-2145. [PMID: 29714766 DOI: 10.1364/ol.43.002142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/29/2018] [Indexed: 05/28/2023]
Abstract
We demonstrate electro-mechanical control of an on-chip GaAs optical beam splitter containing a quantum dot single-photon source. The beam splitter consists of two nanobeam waveguides, which form a directional coupler (DC). The splitting ratio of the DC is controlled by varying the out-of-plane separation of the two waveguides using electromechanical actuation. We reversibly tune the beam splitter between an initial state, with emission into both output arms, and a final state with photons emitted into a single output arm. The device represents a compact and scalable tuning approach for use in III-V semiconductor integrated quantum optical circuits.
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22
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Arundel C, Fairhurst C, Corbacho-Martin B, Buckley H, Clarke E, Cullum N, Dixon S, Dumville J, Firth A, Henderson E, Lamb K, McGinnis E, Oswald A, Saramago Goncalves P, Soares MO, Stubbs N, Chetter I. Pilot feasibility randomized clinical trial of negative-pressure wound therapy versus usual care in patients with surgical wounds healing by secondary intention. BJS Open 2018; 2:99-111. [PMID: 29951633 PMCID: PMC5989956 DOI: 10.1002/bjs5.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/13/2017] [Indexed: 01/09/2023] Open
Abstract
Background Surgical wounds healing by secondary intention (SWHSI) are increasingly being treated with negative-pressure wound therapy (NPWT) despite a lack of high-quality research evidence regarding its clinical and cost-effectiveness. This pilot feasibility RCT aimed to assess the methods for and feasibility of conducting a future definitive RCT of NPWT for the treatment of SWHSI. Methods Eligible consenting adult patients receiving care at the study sites (2 acute and 1 community) and with a SWHSI appropriate for NPWT or wound dressing treatment were randomized 1 : 1 centrally to receive NPWT or usual care (no NPWT). Participants were followed up every 1-2 weeks for 3 months. Feasibility (recruitment rate, time to intervention delivery) and clinical (time to wound healing) outcomes were assessed. Results A total of 248 participants were screened for eligibility; 40 (16·1 per cent) were randomized, 19 to NPWT and 21 to usual care. Twenty-four of the 40 wounds were located on the foot. Participants received NPWT for a median of 18 (range 0-72) days. Two participants in the NPWT group never received the intervention and 14 received NPWT within 48 h of randomization. Five participants in the usual care group received NPWT during the study. Ten of the 40 wounds were deemed to have healed during the study. Conclusion A full-scale RCT to investigate the clinical and cost-effectiveness of NPWT for SWHSI is feasible. This study identified crucial information on recruitment rates and data collection methods to consider during the design of a definitive RCT. Registration number: ISRCTN12761776 (http://www.iscrtn.com).
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Affiliation(s)
- C Arundel
- York Trials Unit, Department of Health Sciences University of York York UK
| | - C Fairhurst
- York Trials Unit, Department of Health Sciences University of York York UK
| | - B Corbacho-Martin
- York Trials Unit, Department of Health Sciences University of York York UK
| | - H Buckley
- York Trials Unit, Department of Health Sciences University of York York UK
| | - E Clarke
- Academic Vascular Surgical Unit Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | - N Cullum
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK.,Research and Innovation Division, Central Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK
| | - S Dixon
- Patient and Public Involvement Group Hull UK
| | - J Dumville
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
| | - A Firth
- Academic Vascular Surgical Unit Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | - E Henderson
- Outpatient Services Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | - K Lamb
- Leeds Wound Research Unit Leeds Community Healthcare NHS Trust Leeds UK
| | - E McGinnis
- Department for Tissue Viability Leeds Teaching Hospitals NHS Trust Leeds UK
| | - A Oswald
- Academic Vascular Surgical Unit Hull and East Yorkshire Hospitals NHS Trust Hull UK
| | | | - M O Soares
- Centre for Health Economics University of York York UK
| | - N Stubbs
- Leeds Wound Research Unit Leeds Community Healthcare NHS Trust Leeds UK
| | - I Chetter
- Centre for Health Economics University of York York UK.,Research Office Hull York Medical School Hull UK
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23
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Sich M, Chana JK, Egorov OA, Sigurdsson H, Shelykh IA, Skryabin DV, Walker PM, Clarke E, Royall B, Skolnick MS, Krizhanovskii DN. Transition from Propagating Polariton Solitons to a Standing Wave Condensate Induced by Interactions. Phys Rev Lett 2018; 120:167402. [PMID: 29756939 DOI: 10.1103/physrevlett.120.167402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Indexed: 06/08/2023]
Abstract
We explore phase transitions of polariton wave packets, first, to a soliton and then to a standing wave polariton condensate in a multimode microwire system, mediated by nonlinear polariton interactions. At low excitation density, we observe ballistic propagation of the multimode polariton wave packets arising from the interference between different transverse modes. With increasing excitation density, the wave packets transform into single-mode bright solitons due to effects of both intermodal and intramodal polariton-polariton scattering. Further increase of the excitation density increases thermalization speed, leading to relaxation of the polariton density from a solitonic spectrum distribution in momentum space down to low momenta, with the resultant formation of a nonequilibrium condensate manifested by a standing wave pattern across the whole sample.
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Affiliation(s)
- M Sich
- Department of Physics and Astronomy, The University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - J K Chana
- Department of Physics and Astronomy, The University of Sheffield, Sheffield S3 7RH, United Kingdom
- Base4 Innovation, Ltd., Cambridge CB3 0FA, United Kingdom
| | - O A Egorov
- Technische Physik der Universität Würzburg, Am Hubland 97074, Würzburg, Germany
| | - H Sigurdsson
- Science Institute, University of Iceland, Dunhagi-3, IS-107 Reykjavik, Iceland
| | - I A Shelykh
- Science Institute, University of Iceland, Dunhagi-3, IS-107 Reykjavik, Iceland
- Department of Nanophotonics and Metamaterials, ITMO University, St. Petersburg 197101, Russia
| | - D V Skryabin
- Department of Nanophotonics and Metamaterials, ITMO University, St. Petersburg 197101, Russia
- Department of Physics, University of Bath, Bath BA2 7AY, United Kingdom
| | - P M Walker
- Department of Physics and Astronomy, The University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - E Clarke
- EPSRC National Centre for III-V Technologies, The University of Sheffield, Sheffield S1 4DE, United Kingdom
| | - B Royall
- Department of Physics and Astronomy, The University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - M S Skolnick
- Department of Physics and Astronomy, The University of Sheffield, Sheffield S3 7RH, United Kingdom
- Department of Nanophotonics and Metamaterials, ITMO University, St. Petersburg 197101, Russia
| | - D N Krizhanovskii
- Department of Physics and Astronomy, The University of Sheffield, Sheffield S3 7RH, United Kingdom
- Department of Nanophotonics and Metamaterials, ITMO University, St. Petersburg 197101, Russia
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Whittaker CE, Cancellieri E, Walker PM, Gulevich DR, Schomerus H, Vaitiekus D, Royall B, Whittaker DM, Clarke E, Iorsh IV, Shelykh IA, Skolnick MS, Krizhanovskii DN. Exciton Polaritons in a Two-Dimensional Lieb Lattice with Spin-Orbit Coupling. Phys Rev Lett 2018; 120:097401. [PMID: 29547302 DOI: 10.1103/physrevlett.120.097401] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/09/2017] [Indexed: 05/04/2023]
Abstract
We study exciton polaritons in a two-dimensional Lieb lattice of micropillars. The energy spectrum of the system features two flat bands formed from S and P_{x,y} photonic orbitals, into which we trigger bosonic condensation under high power excitation. The symmetry of the orbital wave functions combined with photonic spin-orbit coupling gives rise to emission patterns with pseudospin texture in the flat band condensates. Our Letter shows the potential of polariton lattices for emulating flat band Hamiltonians with spin-orbit coupling, orbital degrees of freedom, and interactions.
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Affiliation(s)
- C E Whittaker
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - E Cancellieri
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
- Department of Physics, Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - P M Walker
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | | | - H Schomerus
- Department of Physics, Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - D Vaitiekus
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - B Royall
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - D M Whittaker
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - E Clarke
- EPSRC National Centre for III-V Technologies, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - I V Iorsh
- ITMO University, St. Petersburg 197101, Russia
| | - I A Shelykh
- ITMO University, St. Petersburg 197101, Russia
- Science Institute, University of Iceland, Dunhagi 3, IS-107, Reykjavik, Iceland
| | - M S Skolnick
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
- ITMO University, St. Petersburg 197101, Russia
| | - D N Krizhanovskii
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
- ITMO University, St. Petersburg 197101, Russia
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25
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Éthier-Majcher G, Gangloff D, Stockill R, Clarke E, Hugues M, Le Gall C, Atatüre M. Improving a Solid-State Qubit through an Engineered Mesoscopic Environment. Phys Rev Lett 2017; 119:130503. [PMID: 29341723 DOI: 10.1103/physrevlett.119.130503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Indexed: 06/07/2023]
Abstract
A controlled quantum system can alter its environment by feedback, leading to reduced-entropy states of the environment and to improved system coherence. Here, using a quantum-dot electron spin as a control and probe, we prepare the quantum-dot nuclei under the feedback of coherent population trapping and observe their evolution from a thermal to a reduced-entropy state, with the immediate consequence of extended qubit coherence. Via Ramsey interferometry on the electron spin, we directly access the nuclear distribution following its preparation and measure the emergence and decay of correlations within the nuclear ensemble. Under optimal feedback, the inhomogeneous dephasing time of the electron, T_{2}^{*}, is extended by an order of magnitude to 39 ns. Our results can be readily exploited in quantum information protocols utilizing spin-photon entanglement and represent a step towards creating quantum many-body states in a mesoscopic nuclear-spin ensemble.
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Affiliation(s)
- G Éthier-Majcher
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - D Gangloff
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - R Stockill
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - E Clarke
- EPSRC National Centre for III-V Technologies, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - M Hugues
- Université Côte d'Azur, CNRS, CRHEA, rue Bernard Gregory, 06560 Valbonne, France
| | - C Le Gall
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - M Atatüre
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
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26
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Stockill R, Stanley MJ, Huthmacher L, Clarke E, Hugues M, Miller AJ, Matthiesen C, Le Gall C, Atatüre M. Phase-Tuned Entangled State Generation between Distant Spin Qubits. Phys Rev Lett 2017; 119:010503. [PMID: 28731764 DOI: 10.1103/physrevlett.119.010503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Indexed: 05/13/2023]
Abstract
Quantum entanglement between distant qubits is an important feature of quantum networks. Distribution of entanglement over long distances can be enabled through coherently interfacing qubit pairs via photonic channels. Here, we report the realization of optically generated quantum entanglement between electron spin qubits confined in two distant semiconductor quantum dots. The protocol relies on spin-photon entanglement in the trionic Λ system and quantum erasure of the Raman-photon path information. The measurement of a single Raman photon is used to project the spin qubits into a joint quantum state with an interferometrically stabilized and tunable relative phase. We report an average Bell-state fidelity for |ψ^{(+)}⟩ and |ψ^{(-)}⟩ states of 61.6±2.3% and a record-high entanglement generation rate of 7.3 kHz between distant qubits.
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Affiliation(s)
- R Stockill
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - M J Stanley
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - L Huthmacher
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - E Clarke
- EPSRC National Centre for III-V Technologies, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - M Hugues
- Université Côte d'Azur, CNRS, CRHEA, rue Bernard Grégory, Valbonne 06560, France
| | - A J Miller
- Quantum Opus, LLC, 45211 Helm St., Plymouth, Michigan 48170, USA
| | - C Matthiesen
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - C Le Gall
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - M Atatüre
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
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Alexander C, Lum I, Reid S, Clarke E, Stannage K, El-Sallam Abd A, Herbert R, Donnelly C. A simple but reliable method for measuring 3D Achilles tendon moment arm geometry from a single, static magnetic resonance scan. J Biomech 2017; 55:134-138. [DOI: 10.1016/j.jbiomech.2017.01.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 11/03/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
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Dufferwiel S, Li F, Cancellieri E, Giriunas L, Trichet AAP, Whittaker DM, Walker PM, Fras F, Clarke E, Smith JM, Skolnick MS, Krizhanovskii DN. Publisher's Note: Spin Textures of Exciton-Polaritons in a Tunable Microcavity with Large TE-TM Splitting [Phys. Rev. Lett. 115, 246401 (2015)]. Phys Rev Lett 2017; 118:089901. [PMID: 28282162 DOI: 10.1103/physrevlett.118.089901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Indexed: 06/06/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.115.246401.
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Konishi T, Clarke E, Burrows CW, Bomphrey JJ, Murray R, Bell GR. Spatial regularity of InAs-GaAs quantum dots: quantifying the dependence of lateral ordering on growth rate. Sci Rep 2017; 7:42606. [PMID: 28211899 PMCID: PMC5304192 DOI: 10.1038/srep42606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/11/2017] [Indexed: 11/21/2022] Open
Abstract
The lateral ordering of arrays of self-assembled InAs-GaAs quantum dots (QDs) has been quantified as a function of growth rate, using the Hopkins-Skellam index (HSI). Coherent QD arrays have a spatial distribution which is neither random nor ordered, but intermediate. The lateral ordering improves as the growth rate is increased and can be explained by more spatially regular nucleation as the QD density increases. By contrast, large and irregular 3D islands are distributed randomly on the surface. This is consistent with a random selection of the mature QDs relaxing by dislocation nucleation at a later stage in the growth, independently of each QD’s surroundings. In addition we explore the statistical variability of the HSI as a function of the number N of spatial points analysed, and we recommend N > 103 to reliably distinguish random from ordered arrays.
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Affiliation(s)
- T Konishi
- Centre for Collaborative Research, National Institute of Technology, Anan College, Anan, Tokushima, Japan
| | - E Clarke
- EPSRC National Centre for III-V Technologies, Department of Electronic and Electrical Engineering, University of Sheffield, Mappin Street, Sheffield, S1 3JD, United Kingdom
| | - C W Burrows
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - J J Bomphrey
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - R Murray
- Department of Physics, Imperial College London, South Kensington Campus, London, SW7 2AZ, United Kingdom
| | - G R Bell
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
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Chevalier A, Coxon K, Chevalier AJ, Clarke E, Rogers K, Brown J, Boufous S, Ivers R, Keay L. Predictors of older drivers' involvement in rapid deceleration events. Accid Anal Prev 2017; 98:312-319. [PMID: 27810673 DOI: 10.1016/j.aap.2016.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 05/17/2016] [Revised: 09/27/2016] [Accepted: 10/08/2016] [Indexed: 06/06/2023]
Abstract
Rapid deceleration occurs when substantial force slows the speed of a vehicle. Rapid deceleration events (RDEs) have been proposed as a surrogate safety measure. As there is concern about crash involvement of older drivers and the effect of age-related declining visual and cognitive function on driving performance, we examined the relationship between RDEs and older driver's vision, cognitive function and driving confidence, using naturalistic driving measures. Participants aged 75 to 94 years had their vehicle instrumented for 12 months. To minimise the chance of identifying false positives, accelerometer data was processed to identify RDEs with a substantial deceleration of >750 milli-g (7.35m/s2). We examined the incidence of RDEs amongst older drivers, and how this behaviour is affected by differences in age; sex; visual function, cognitive function; driving confidence; and declines over the 12 months. Almost two-thirds (64%) of participants were involved in at least one RDE, and 22% of these participants experienced a meaningful decline in contrast sensitivity during the 12 months. We conducted regression modelling to examine associations between RDEs and predictive measures adjusted for (i) duration of monitoring and (ii) distance driven. We found the rate of RDEs per distance increased with age; although, this did not remain in the multivariate model. In the multivariate model, we found older drivers who experienced a decline in contrast sensitivity over the 12 months and those with lower baseline driving confidence were at increased risk of involvement in RDEs adjusted for distance driven. In other studies, contrast sensitivity has been associated with increased crash involvement for older drivers. These findings lend support for the use of RDEs as a surrogate safety measure, and demonstrate an association between a surrogate safety measure and a decline in contrast sensitivity of older drivers.
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Affiliation(s)
- A Chevalier
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, PO Box M201, Missenden Rd, Camperdown, NSW, 2050, Australia.
| | - K Coxon
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, PO Box M201, Missenden Rd, Camperdown, NSW, 2050, Australia; School of Science and Health, The University of Western Sydney, Penrith, NSW, 2751, Australia.
| | - A J Chevalier
- Safer Roads Consulting, 53 Lachlan St, Thirroul, NSW, 2515, Australia.
| | - E Clarke
- Kolling Institute of Medical Research, Sydney Medical School, The University of Sydney, Level 10, Kolling Building 6, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
| | - K Rogers
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, PO Box M201, Missenden Rd, Camperdown, NSW, 2050, Australia.
| | - J Brown
- Neuroscience Research Australia (NeuRA), Margarete Ainsworth Building, Barker St, Randwick, NSW, 2031, Australia.
| | - S Boufous
- Transport and Road Safety Research (TARS), Level 1, West Wing, Old Main Building, University of NSW, Sydney, NSW, 2052, Australia.
| | - R Ivers
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, PO Box M201, Missenden Rd, Camperdown, NSW, 2050, Australia.
| | - L Keay
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, PO Box M201, Missenden Rd, Camperdown, NSW, 2050, Australia.
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31
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Leamy M, Clarke E, Le Boutillier C, Bird V, Choudhury R, MacPherson R, Pesola F, Sabas K, Williams J, Williams P, Slade M. Recovery practice in community mental health teams: national survey. Br J Psychiatry 2016; 209:340-346. [PMID: 27340113 PMCID: PMC5046739 DOI: 10.1192/bjp.bp.114.160739] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 03/07/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is consensus about the importance of 'recovery' in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. AIMS To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. METHOD In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). RESULTS Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31-0.85, P<0.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. CONCLUSIONS Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery.
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Affiliation(s)
- M. Leamy
- Correspondence: Mary Leamy, King's College London, National Nursing Research Unit, Florence Nightingale School of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK.
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32
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Stockill R, Le Gall C, Matthiesen C, Huthmacher L, Clarke E, Hugues M, Atatüre M. Quantum dot spin coherence governed by a strained nuclear environment. Nat Commun 2016; 7:12745. [PMID: 27615704 PMCID: PMC5027245 DOI: 10.1038/ncomms12745] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/28/2016] [Indexed: 11/12/2022] Open
Abstract
The interaction between a confined electron and the nuclei of an optically active quantum dot provides a uniquely rich manifestation of the central spin problem. Coherent qubit control combines with an ultrafast spin–photon interface to make these confined spins attractive candidates for quantum optical networks. Reaching the full potential of spin coherence has been hindered by the lack of knowledge of the key irreversible environment dynamics. Through all-optical Hahn echo decoupling we now recover the intrinsic coherence time set by the interaction with the inhomogeneously strained nuclear bath. The high-frequency nuclear dynamics are directly imprinted on the electron spin coherence, resulting in a dramatic jump of coherence times from few tens of nanoseconds to the microsecond regime between 2 and 3 T magnetic field and an exponential decay of coherence at high fields. These results reveal spin coherence can be improved by applying large magnetic fields and reducing strain inhomogeneity. Spins confined to quantum dots are a possible qubit, but the mechanism that limits their coherence is unclear. Here, the authors use an all-optical Hahn-echo technique to determine the intrinsic coherence time of such spins set by its interaction with the inhomogeneously strained nuclear bath.
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Affiliation(s)
- R Stockill
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
| | - C Le Gall
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
| | - C Matthiesen
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
| | - L Huthmacher
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
| | - E Clarke
- EPSRC National Centre for III-V Technologies, University of Sheffield, Sheffield, S1 3JD, UK
| | - M Hugues
- CNRS-CRHEA, rue Bernard Grégory, Valbonne 06560, France
| | - M Atatüre
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
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33
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Bär Deucher A, Hengartner MP, Kawohl W, Konrad J, Puschner B, Clarke E, Slade M, Del Vecchio V, Sampogna G, Égerházi A, Süveges Á, Krogsgaard Bording M, Munk-Jørgensen P, Rössler W. Participation in medical decision-making across Europe: An international longitudinal multicenter study. Eur Psychiatry 2016; 35:39-46. [PMID: 27061376 DOI: 10.1016/j.eurpsy.2016.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/13/2016] [Accepted: 02/15/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The purpose of this paper was to examine national differences in the desire to participate in decision-making of people with severe mental illness in six European countries. METHODS The data was taken from a European longitudinal observational study (CEDAR; ISRCTN75841675). A sample of 514 patients with severe mental illness from the study centers in Ulm, Germany, London, England, Naples, Italy, Debrecen, Hungary, Aalborg, Denmark and Zurich, Switzerland were assessed as to desire to participate in medical decision-making. Associations between desire for participation in decision-making and center location were analyzed with generalized estimating equations. RESULTS We found large cross-national differences in patients' desire to participate in decision-making, with the center explaining 47.2% of total variance in the desire for participation (P<0.001). Averaged over time and independent of patient characteristics, London (mean=2.27), Ulm (mean=2.13) and Zurich (mean=2.14) showed significantly higher scores in desire for participation, followed by Aalborg (mean=1.97), where scores were in turn significantly higher than in Debrecen (mean=1.56). The lowest scores were reported in Naples (mean=1.14). Over time, the desire for participation in decision-making increased significantly in Zurich (b=0.23) and decreased in Naples (b=-0.14). In all other centers, values remained stable. CONCLUSIONS This study demonstrates that patients' desire for participation in decision-making varies by location. We suggest that more research attention be focused on identifying specific cultural and social factors in each country to further explain observed differences across Europe.
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Affiliation(s)
- A Bär Deucher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland.
| | - M P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Pfingstweidstrasse 96, PO Box 707, 8037 Zurich, Switzerland
| | - W Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland
| | - J Konrad
- Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - B Puschner
- Section Process-Outcome Research, Department of Psychiatry II, Ulm University, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - E Clarke
- Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - M Slade
- Kings College London, Section for Recovery, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, London SE5 8AF, UK
| | - V Del Vecchio
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
| | - G Sampogna
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
| | - A Égerházi
- Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt, 4012, Debrecen, Hungary
| | - Á Süveges
- Department of Psychiatry, Medical and Health Science Centre, University of Debrecen, 98, Nagyerdei krt, 4012, Debrecen, Hungary
| | - M Krogsgaard Bording
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, Aalborg, 9000, Denmark
| | - P Munk-Jørgensen
- Department M, Aarhus University Hospital, Skovagervej 2, 8240 Risskov, Denmark
| | - W Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021 Zurich, Switzerland
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Hurley-Sanders J, Harms C, Christiansen E, Clarke E, Law J. Exuberant granulation tissue response associated with Neobenedenia sp. (Monogenea: Capsalidae) infestation in two cobia, Rachycentron canadum (Linnaeus). J Fish Dis 2016; 39:277-283. [PMID: 25864868 DOI: 10.1111/jfd.12360] [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: 11/19/2014] [Revised: 01/22/2015] [Accepted: 01/22/2015] [Indexed: 06/04/2023]
Abstract
Monogenean parasite infestations are common in captive marine teleosts, and are generally found on the skin and gills. This report describes an unusual pathological presentation of exuberant granulation tissue of the gills, suspected to be related to Neobenedenia infestation in two cobia housed together at a North Carolina aquarium.
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Affiliation(s)
- J Hurley-Sanders
- Environmental Medicine Consortium, North Carolina State University, Raleigh, NC, USA
| | - C Harms
- Environmental Medicine Consortium, North Carolina State University, Raleigh, NC, USA
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Center for Marine Sciences and Technology, Morehead City, NC, USA
| | - E Christiansen
- Environmental Medicine Consortium, North Carolina State University, Raleigh, NC, USA
- Center for Marine Sciences and Technology, Morehead City, NC, USA
- North Carolina Aquariums, Raleigh, NC, USA
| | - E Clarke
- Environmental Medicine Consortium, North Carolina State University, Raleigh, NC, USA
- Center for Marine Sciences and Technology, Morehead City, NC, USA
- Audubon Nature Institute, New Orleans, LA, USA
| | - J Law
- Environmental Medicine Consortium, North Carolina State University, Raleigh, NC, USA
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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35
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Dufferwiel S, Li F, Cancellieri E, Giriunas L, Trichet AAP, Whittaker DM, Walker PM, Fras F, Clarke E, Smith JM, Skolnick MS, Krizhanovskii DN. Spin Textures of Exciton-Polaritons in a Tunable Microcavity with Large TE-TM Splitting. Phys Rev Lett 2015; 115:246401. [PMID: 26705642 DOI: 10.1103/physrevlett.115.246401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Indexed: 06/05/2023]
Abstract
We report an extended family of spin textures of zero-dimensional exciton-polaritons spatially confined in tunable open microcavity structures. The transverse-electric-transverse-magnetic (TE-TM) splitting, which is enhanced in the open cavity structures, leads to polariton eigenstates carrying quantized spin vortices. Depending on the strength and anisotropy of the cavity confining potential and of the TE-TM induced splitting, which can be tuned via the excitonic or photonic fractions, the exciton-polariton emissions exhibit either spin-vortex-like patterns or linear polarization, in good agreement with theoretical modeling.
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Affiliation(s)
- S Dufferwiel
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - Feng Li
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - E Cancellieri
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - L Giriunas
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - A A P Trichet
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - D M Whittaker
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - P M Walker
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - F Fras
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
- IPCMS UMR 7504, CNRS and Université de Strasbourg, 67200 Strasbourg, France
| | - E Clarke
- EPSRC National Centre for III-V Technologies, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - J M Smith
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - M S Skolnick
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
| | - D N Krizhanovskii
- Department of Physics and Astronomy, University of Sheffield, Sheffield S3 7RH, United Kingdom
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McGarvey A, Brugha R, Conroy RM, Clarke E, Byrne E. International students' experience of a western medical school: a mixed methods study exploring the early years in the context of cultural and social adjustment compared to students from the host country. BMC Med Educ 2015; 15:111. [PMID: 26134823 PMCID: PMC4488065 DOI: 10.1186/s12909-015-0394-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 06/12/2015] [Indexed: 05/10/2023]
Abstract
BACKGROUND Few studies have addressed the challenges associated with international students as they adapt to studying medicine in a new host country. Higher level institutions have increasing numbers of international students commencing programmes. This paper explores the experiences of a cohort of students in the early years of medical school in Ireland, where a considerable cohort are from an international background. METHODS A mixed exploratory sequential study design was carried out with medical students in the preclinical component of a five year undergraduate programme. Data for the qualitative phase was collected through 29 semi-structured interviews using the peer interview method. Thematic analysis from this phase was incorporated to develop an online questionnaire combined with components of the Student Adaptation to College Questionnaire and Student Integration Questionnaire. First year students were anonymously surveyed online. The Mokken Scaling procedure was used to investigate the students' experiences, both positive and negative. RESULTS Three main themes are identified; social adjustment, social alienation and cultural alienation. The response rate for the survey was 49% (467 Respondents). The Mokken Scaling method identified the following scales (i) Positive experience of student life; (ii) Social alienation, which comprised of negative items about feeling lonely, not fitting in, being homesick and (iii) Cultural alienation, which included the items of being uncomfortable around cultural norms of dress and contact between the sexes. With the threshold set to H = 0.4. Subscales of the positive experiences of student life scale are explored further. CONCLUSIONS Overall student adjustment to a western third level college was good. Students from regions where cultural distance is greatest reported more difficulties in adjusting. Students from these regions also demonstrate very good adaptation. Some students from the host country and more similar cultural backgrounds were also struggling. Acculturation is more complex than being associated with cultural distance and worthy of further exploration.
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Affiliation(s)
- A McGarvey
- Anatomy Department, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
| | - R Brugha
- Division of Population and Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
| | - R M Conroy
- Division of Population and Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
| | - E Clarke
- Health Professions Education Centre, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
| | - E Byrne
- Division of Population and Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
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Case R, Thomas E, Clarke E, Peat G. Prodromal symptoms in knee osteoarthritis: a nested case-control study using data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2015; 23:1083-9. [PMID: 25843364 PMCID: PMC4491193 DOI: 10.1016/j.joca.2014.12.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/27/2014] [Accepted: 12/29/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In order to gain a better understanding of the timing of emergent symptoms of osteoarthritis, we sought to investigate the existence, duration and nature of a prodromal symptomatic phase preceding incident radiographic knee osteoarthritis (ROA). DESIGN Data were from the incidence cohort of the Osteoarthritis Initiative (OAI) public use datasets. Imposing a nested case-control design, ten control knees were selected for each case of incident tibiofemoral ROA between 2004 and 2010 from participants aged 45-79 years. Candidate prodromal symptoms were Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscale scores and individual items, available up to 4 years prior to the time of incident ROA. Multi-level models were used to estimate the length of the prodromal phases. RESULTS The prodromal phase for subscale scores ranged from 29 months (KOOS Other Symptoms) to 37 months (WOMAC Pain). Pain and difficulty on activities associated with higher dynamic knee loading were associated with longer prodromal phases (e.g., pain on twisting/pivoting (39 months, 95% confidence interval: 13, 64) vs pain on standing (25 months: 7, 42)). CONCLUSIONS Our analysis found that incident ROA is preceded by prodromal symptoms lasting at least 2-3 years. This has potential implications for understanding phasic development and progression of osteoarthritis and for early recognition and management.
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Affiliation(s)
- R Case
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom.
| | - E Thomas
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom.
| | - E Clarke
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom.
| | - G Peat
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom.
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Clarke E, Puschner B, Jordan H, Williams P, Konrad J, Kawohl W, Bär A, Rössler W, Del Vecchio V, Sampogna G, Nagy M, Süveges A, Krogsgaard Bording M, Slade M. Empowerment and satisfaction in a multinational study of routine clinical practice. Acta Psychiatr Scand 2015; 131:369-78. [PMID: 25471821 DOI: 10.1111/acps.12365] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Decision-making between mental health clinicians and patients is under-researched. We tested whether mental health patients are more satisfied with a decision made (i) using their preferred decision-making style and (ii) with a clinician with the same decision-making style preference. METHOD As part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. RESULTS Patients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, P=0.005, 95% CI 1.32-4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, P=0.003, 95% CI 1.48-6.82). CONCLUSION More active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction.
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Affiliation(s)
- E Clarke
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Blair D, Brada M, Clarke E, Baker C, Reilly A, Baker A. EP-1327: The definition of an auditable and complete dataset for lung cancer patients - the RTTís role. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41319-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Meyer HM, Stockill R, Steiner M, Le Gall C, Matthiesen C, Clarke E, Ludwig A, Reichel J, Atatüre M, Köhl M. Direct photonic coupling of a semiconductor quantum dot and a trapped ion. Phys Rev Lett 2015; 114:123001. [PMID: 25860737 DOI: 10.1103/physrevlett.114.123001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Indexed: 06/04/2023]
Abstract
Coupling individual quantum systems lies at the heart of building scalable quantum networks. Here, we report the first direct photonic coupling between a semiconductor quantum dot and a trapped ion and we demonstrate that single photons generated by a quantum dot controllably change the internal state of a Yb^{+} ion. We ameliorate the effect of the 60-fold mismatch of the radiative linewidths with coherent photon generation and a high-finesse fiber-based optical cavity enhancing the coupling between the single photon and the ion. The transfer of information presented here via the classical correlations between the σ_{z} projection of the quantum-dot spin and the internal state of the ion provides a promising step towards quantum-state transfer in a hybrid photonic network.
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Affiliation(s)
- H M Meyer
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
- Physikalisches Institut, University of Bonn, Wegelerstrasse 8, 53115 Bonn, Germany
| | - R Stockill
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - M Steiner
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - C Le Gall
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - C Matthiesen
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - E Clarke
- EPSRC National Centre for III-V Technologies, University of Sheffield, Sheffield S1 3JD, United Kingdom
| | - A Ludwig
- Lehrstuhl für Angewandte Festkörperphysik, Ruhr-Universität, 44780 Bochum, Germany
| | - J Reichel
- Laboratoire Kastler Brossel, École Normale Supérieure, 24 Rue Lhomond, 75005 Paris, France
| | - M Atatüre
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - M Köhl
- Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
- Physikalisches Institut, University of Bonn, Wegelerstrasse 8, 53115 Bonn, Germany
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Minniti G, Esposito V, Clarke E, Enrici RM. P08.18 * FRACTIONATED STEREOTACTIC RADIOSURGERY FOR PATIENTS WITH SKULL BASE METASTASES INVOLVING THE ANTERIOR VISUAL PATHWAY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.206] [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: 11/13/2022] Open
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Minniti G, Clarke E, Scaringi C, Falco T, Osti M, Enrici RM. P08.17 * REPEAT STEREOTACTIC RADIOSURGERY (SRS) FOR RECURRENT BRAIN METASTASES. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.205] [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: 11/13/2022] Open
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Dyer B, Pollock L, Morar N, Clarke E, Kampmann B, Anderson S. ESSENTIAL ETAT: ONE-DAY PAEDIATRIC RESUSCITATION TRAINING IN A RESOURCE-LIMITED SETTING. Arch Emerg Med 2013. [DOI: 10.1136/emermed-2013-203113.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Clarke E, Drew O, Sundaram S, Baker A, Whale J, Rowen D, Patel R. A glimmer of hope? Evaluation of time for non-genitourinary medicine physicians to diagnose HIV infection in patients presenting with HIV-related illness. Int J STD AIDS 2013; 24:639-41. [PMID: 23970573 DOI: 10.1177/0956462413477555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A study conducted in 2002-2003 at three UK south coast hospitals measuring the length of time for non-genitourinary medicine physicians to diagnose HIV when patients presented with an HIV-related illness, found a median time to diagnosis of four days with 70% of diagnoses being made within seven days. This retrospective cohort study of all patients newly diagnosed with HIV between 1 January 2010 and 31 December 2011 was conducted at the same three hospitals. Thirty-seven patients were newly diagnosed with HIV in non-genitourinary (GU) medicine inpatient and outpatient settings (24 men, 13 women), with a mean age of 43 years. The median time to diagnosis was one day (interquartile range of 0-4 days), with 81% of diagnoses made within seven days of first presentation. Late diagnosis of HIV remains a significant challenge, but delayed diagnosis in a patient admitted with an HIV-related illness is reducing in this setting.
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Affiliation(s)
- E Clarke
- Department of Genitourinary Medicine, Royal South Hants Hospital, Brintons Terrace, Southampton SO14 0YG
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Bains M, Collister A, Jackson R, Clarke E, Patel R. P5.032* Do Fast-Track Asymptomatic Screening Pathways For Men Who Have Sex with Men (MSM) Lead to Missed or Delayed Diagnoses? Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.1077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Baker A, Fleury C, Clarke E, Foley E, Samraj S, Rowen D, Patel R. Increasing screening frequency in men who have sex with men: impact of guidance on risk profiling on workload and earlier diagnosis of sexually transmitted infection and HIV. Int J STD AIDS 2013; 24:613-7. [PMID: 23970570 DOI: 10.1177/0956462413477552] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increasing screening frequency in men who have sex with men (MSM) engaging in high-risk behaviours can reduce prevalence of sexually transmitted infections (STIs). This evaluation investigated the impact of applying stricter screening guidelines for MSM on service workload and earlier STI diagnoses. A validated risk assessment tool (RAT) was distributed to MSM attending a level 3 sexual health service over three months. Australian screening guidelines were applied to the data to identify MSM requiring more frequent screening and data projected to the larger MSM population. The RAT identified a 2-5-fold increase in the number of STI and HIV screenings required based on six- and three-monthly screening intervals, respectively, in the MSM cohort. When screening intervals are reduced from three-monthly to six-monthly there is a potential loss of 66.7% of earlier HIV diagnoses. The use of RATs will increase workload in sexual health services, but potentially diagnose a large proportion of disease earlier.
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Affiliation(s)
- A Baker
- School of Medicine, University of Southampton
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Clarke E, Mansour O, Foley E, Patel R. P2.152 Giving Patients What They Want: Disclosure Advice For Sexually Transmitted Infections and Information on Legal Redress Following Infection. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Clarke E, Shone E, Broad C, Baker A, Patel R, Rowen D. P5.034 British Co-Operative Clinical Group (BCCG) Project - How Often Are Men Who Have Sex with Men (MSM) Advised to Attend For Repeat Sexual Health Screening in the UK? Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Whale J, Clarke E, Patel N, Graham C, Ingham R, Patel R. O07.3 A Psychological Experiment to Examine the Global Impact of Stigma on Individuals Diagnosed with Type 1 Herpes Simplex Virus (HSV-1). Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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O’Shea DJ, Thomas A, Turner-Cobb J, Hill I, Clarke E, Groves S, France B, Sengupta R. AB0835-HPR Evaluating the impact of a specialist ankylosing spondylitis rehabilitation programme on patient’s quality of life. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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