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Bundy J, Shaw J, Hammel M, Nguyen J, Robbins C, Mercier I, Suryanarayanan A. Role of β3 subunit of the GABA type A receptor in triple negative breast cancer proliferation, migration, and cell cycle progression. Cell Cycle 2024:1-18. [PMID: 38623967 DOI: 10.1080/15384101.2024.2340912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/29/2024] [Indexed: 04/17/2024] Open
Abstract
Triple negative breast cancer (TNBC) is known for its heterogeneous nature and aggressive onset. The unresponsiveness to hormone therapies and immunotherapy and the toxicity of chemotherapeutics account for the limited treatment options for TNBC. Ion channels have emerged as possible therapeutic candidates for cancer therapy, but little is known about how ligand gated ion channels, specifically, GABA type A ligand-gated ion channel receptors (GABAAR), affect cancer pathogenesis. Our results show that the GABAA β3 subunit is expressed at higher levels in TNBC cell lines than non-tumorigenic cells, therefore contributing to the idea that limiting the GABAAR via knockdown of the GABAA β3 subunit is a potential strategy for decreasing the proliferation and migration of TNBC cells. We employed pharmacological and genetic approaches to investigate the role of the GABAA β3 subunit in TNBC proliferation, migration, and cell cycle progression. The results suggest that pharmacological antagonism or genetic knockdown of GABAA β3 subunit decreases TNBC proliferation and migration. In addition, GABAA β3 subunit knockdown causes cell cycle arrest in TNBC cell lines via decreased cyclin D1 and increased p21 expression. Our findings suggest that membrane bound GABAA receptors containing the β3 subunit can be further developed as a potential novel target for the treatment of TNBC.
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Affiliation(s)
- J Bundy
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, Saint Joseph's University, Pharmacology and Toxicology Center (PTC), Philadelphia, PA, USA
| | - J Shaw
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, Saint Joseph's University, Pharmacology and Toxicology Center (PTC), Philadelphia, PA, USA
| | - M Hammel
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, Saint Joseph's University, Pharmacology and Toxicology Center (PTC), Philadelphia, PA, USA
| | - J Nguyen
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, Saint Joseph's University, Pharmacology and Toxicology Center (PTC), Philadelphia, PA, USA
| | - C Robbins
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, Saint Joseph's University, Pharmacology and Toxicology Center (PTC), Philadelphia, PA, USA
| | | | - A Suryanarayanan
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, Saint Joseph's University, Pharmacology and Toxicology Center (PTC), Philadelphia, PA, USA
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2
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Thomas VJ, Shaw J, Tay N, Warburton NM. Comparative three-dimensional jaw muscle anatomy of marsupial carnivores (Dasyurus spp.) and the termite-eating numbat (Myrmecobius fasciatus). J Morphol 2024; 285:e21684. [PMID: 38439588 DOI: 10.1002/jmor.21684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 12/14/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024]
Abstract
Among marsupials, the endangered numbat (Myrmecobius fasciatus) is the only obligate myrmecophage with a diet comprised strictly of termites. Like many other specialised myrmecophagous mammals, numbats have a gracile and highly specialised skull morphology with an elongated rostrum and small braincase. Myrmecobiidae is one of four taxonomic families within the Australasian marsupial order Dasyuromorphia, and to date, the muscular anatomy of any member of this group is relatively poorly known. We utilised microdissection and contrast-enhanced microcomputed tomography scanning to provide the first comprehensive qualitative and quantitative descriptions of jaw muscle anatomy in numbats and quolls (Dasuyrus species). The arrangement of the jaw muscles across these species was conservative, both in gross anatomy and muscle proportions, corresponding to a 'generalised' mammalian pattern. In contrast to Dasyurus, the jaw muscles of the numbat were greatly reduced. Many aspects of the muscle anatomy of the numbat were similar to patterns reported in other myrmecophagous species, particularly a greatly reduced temporalis muscle. Unusually, the digastric muscle in the numbat was comprised of a single, large anterior belly while the posterior belly was absent. We propose that the enlarged anterior belly of the digastric may be linked to jaw stabilisation and coordination of tongue movements during feeding. The lateral insertion and fascial connection of the digastric to the tongue in numbats may also aid in distributing stress evenly across the jaw and minimise muscle fatigue. The muscle descriptions and three-dimensional models provided in this study will facilitate further analysis of musculoskeletal adaptation and evolution within the Dasyuromorphia.
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Affiliation(s)
- Vanessa J Thomas
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, Australia
| | - Jeremy Shaw
- Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, Australia
| | - Natasha Tay
- Centre for Terrestrial Ecosystem Science and Sustainability, Harry Butler Research Institute, Murdoch University, Murdoch, Australia
| | - Natalie M Warburton
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, Australia
- Centre for Terrestrial Ecosystem Science and Sustainability, Harry Butler Research Institute, Murdoch University, Murdoch, Australia
- Western Australian Museum, Welshpool, Australia
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Jessop AL, Millsteed AJ, Kirkensgaard JJK, Shaw J, Clode PL, Schröder-Turk GE. Composite material in the sea urchin Cidaris rugosa: ordered and disordered micrometre-scale bicontinuous geometries. J R Soc Interface 2024; 21:20230597. [PMID: 38471532 PMCID: PMC10932713 DOI: 10.1098/rsif.2023.0597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
The sponge-like biomineralized calcite materials found in echinoderm skeletons are of interest in terms of both structure formation and biological function. Despite their crystalline atomic structure, they exhibit curved interfaces that have been related to known triply periodic minimal surfaces. Here, we investigate the endoskeleton of the sea urchin Cidaris rugosa that has long been known to form a microstructure related to the Primitive surface. Using X-ray tomography, we find that the endoskeleton is organized as a composite material consisting of domains of bicontinuous microstructures with different structural properties. We describe, for the first time, the co-occurrence of ordered single Primitive and single Diamond structures and of a disordered structure within a single skeletal plate. We show that these structures can be distinguished by structural properties including solid volume fraction, trabeculae width and, to a lesser extent, interface area and mean curvature. In doing so, we present a robust method that extracts interface areas and curvature integrals from voxelized datasets using the Steiner polynomial for parallel body volumes. We discuss these very large-scale bicontinuous structures in the context of their function, formation and evolution.
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Affiliation(s)
- Anna-Lee Jessop
- School of Mathematics, Statistics, Chemistry and Physics, Murdoch University, Murdoch, Australia
| | - Allan J. Millsteed
- School of Mathematics, Statistics, Chemistry and Physics, Murdoch University, Murdoch, Australia
| | - Jacob J. K. Kirkensgaard
- Niels Bohr Institute, University of Copenhagen, Kobenhavn, Denmark
- Department of Food Science, University of Copenhagen, Kobenhavn, Denmark
| | - Jeremy Shaw
- Centre for Microscopy, Characterisation, and Analysis, University of Western Australia, Perth, Australia
| | - Peta L. Clode
- Centre for Microscopy, Characterisation, and Analysis, University of Western Australia, Perth, Australia
- School of Biological Sciences, University of Western Australia, Perth, Australia
| | - Gerd E. Schröder-Turk
- School of Mathematics, Statistics, Chemistry and Physics, Murdoch University, Murdoch, Australia
- Research School of Physics, The Australian National University, Canberra, Australia
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Lindenblatt N, Leuenberger NJ, Harder Y, Kappos EA, Pusic AL, Shaw J, Giovanoli P, Fontein DBY. Measuring quality of care in autologous breast reconstruction: a Delphi consensus. Eur J Surg Oncol 2024; 50:107254. [PMID: 38056020 DOI: 10.1016/j.ejso.2023.107254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 10/15/2023] [Accepted: 10/29/2023] [Indexed: 12/08/2023]
Abstract
Measuring and benchmarking quality of care in surgical oncology has been gaining popularity. In autologous breast reconstruction (ABR), a standardized set of indicators to assess quality of care is lacking. In this study, we defined a set of evidence-based quality indicators for autologous breast reconstruction. First, we performed a systematic review to identify factors related to quality of care in ABR. Variables were categorized depending on their function: indicators related to outcome, indicators related to process and case-mix variables. The review was followed by a 3-round Delphi Consensus to determine which indicators and case-mix-variables were considered relevant and feasible for inclusion in an ABR standard set of indicators. 932 unique articles were identified, of which 110 papers were included in the study. Indicators were categorized by function: outcome, process and case-mix variables. In total, 8 process indicators and 41 outcome indicators were extracted. 30 case-mix-variables were included. Following 3 rounds of questioning in the Delphi Consensus, all respondents agreed on type of ABR, oncological outcomes and patient satisfaction for the standard set. Indicators related to complications were consistently ranked highly. Most process indicators were not chosen after 3 rounds of questioning. 11 case-mix-variables were included in the final set. Following the Delphi Consensus, it was possible to identify 33 process and outcome indicators and 11 case-mix-variables for inclusion for a standard set of quality indicators. With the inclusion of both objective and patient-reported outcome measures, this set of indicators provides a multidimensional measurement tool for quality assessment for ABR.
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Affiliation(s)
- N Lindenblatt
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - N J Leuenberger
- Department of Hand and Plastic Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Y Harder
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland; Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - E A Kappos
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland
| | - A L Pusic
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - J Shaw
- Patient Advocacy Group, Oncoplastic Breast Consortium, University Hospital Basel, Basel, Switzerland
| | - P Giovanoli
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - D B Y Fontein
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
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Champenois F, George AD, McNamara KJ, Shaw J, Cherdantseva M. Contrasting morphology and growth habits of Frutexites in Late Devonian reef complexes of the Canning Basin, northwestern Australia. Geobiology 2024; 22:e12579. [PMID: 37984450 DOI: 10.1111/gbi.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/18/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
Frutexites-like microstructures are described from the exhumed Late Devonian reef complexes of the northern Canning Basin, Western Australia. Several high-resolution imaging techniques, including X-ray microcomputerised tomography, scanning electron microscopy and X-ray fluorescence microscopy, were used to investigate morphology and composition in two samples. Three types of Frutexites-like microstructures (Types I-III) have been identified. Type I, found lining an early marine cement-filled cavity in fore-reef grainstone facies, consists of dendritic structures formed primarily of coccoid bacteria with filamentous bacteria embedded in sheets of amorphous extracellular polymeric substances (EPS). These ferromanganiferous dendrites have laminated to spheroidal textures. Types II and III are from a toe-of-slope hardground. Type II grew in a crypt between two corals, is also dendritic and composed of bacilliform and filamentous bacteria embedded in an amorphous EPS sheet. The opaqueness of these ferriferous dendrites precludes more detailed description of textures. Type III grew as branching columnar microstromatolites and is composed of entwined filaments of Girvanella, Rothpletzella and Wetheredella with Fe-enriched outer walls that generate Frutexites-like microstructures. Types I and II resemble Frutexites sensu stricto as defined by Maslov (Stromatolites, Trudy Instituta geologicheskikh nauk Akademiya nauk SSR, 1960) and are the result of the consecutive growth and permineralisation of biofilms composed of mixed bacterial communities growing in cryptic habitats. Type III superficially resembles Frutexites sensu stricto based on macroscopic field observations, however, detailed microscopic analysis reveals that it is composed of Fe-enriched tubular walls surrounded by Mn-enriched calcite.
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Affiliation(s)
- France Champenois
- School of Earth Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Annette D George
- School of Earth Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Kenneth J McNamara
- School of Earth Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Jeremy Shaw
- Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Crawley, Western Australia, Australia
| | - Maria Cherdantseva
- Centre for Exploration Targeting, School of Earth Sciences, University of Western Australia, Crawley, Western Australia, Australia
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Forsyth K, Daker-White G, Archer-Power L, Senior J, Edge D, Webb R, Shaw J. Silos and rigid processes: Barriers to the successful implementation of the Older prisoner Health and Social Care Assessment and Plan. Med Sci Law 2023; 63:272-279. [PMID: 36448196 PMCID: PMC10498653 DOI: 10.1177/00258024221141641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Older adults are the fastest growing sub-group in prisons. They have complex health, social care and custodial needs and often the support they receive is sub-optimal. The Older prisoner Health and Social Care Assessment and Plan (OHSCAP) aimed to better meet these inter-related needs. As part of a wider study, a randomised controlled trial was conducted to evaluate the OHSCAPs effectiveness in meeting older prisoners' health, social care and custodial needs in comparison to treatment as usual. This article describes the nested qualitative study which aimed to explore the barriers and facilitators to the effective implementation of the OHSCAP. Semi-structured interviews were conducted with older adults (n = 14) and staff members t (n = 12). Data was analysed using the framework method. Three overarching key themes were identified. These were: (1) balancing care and custodial requirements; (2) prison, health and social care silos; and (3) rigid prison processes. Prison is an important opportunity to engage residents and improve public health. Cultural and strategic change is required for health, social care and custodial interventions, such as the OHSCAP, to be successfully implemented into prison settings.
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Affiliation(s)
- K. Forsyth
- Health and Justice Research Network, The University of Manchester, Manchester, UK
| | - G. Daker-White
- Population Health, The University of Manchester, Manchester, UK
| | | | - J. Senior
- Health and Justice Research Network, The University of Manchester, Manchester, UK
| | - D. Edge
- Equality, Diversity and Inclusion Research Unit, The University of Manchester, Manchester, UK
| | - R.T. Webb
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - J. Shaw
- Health and Justice Research Network, The University of Manchester, Manchester, UK
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Butow P, Shaw J, Bartley N, Milch V, Sathiaraj R, Turnbull S, Der Vartanian C. Vaccine hesitancy in cancer patients: A rapid review. Patient Educ Couns 2023; 111:107680. [PMID: 36842287 PMCID: PMC9951090 DOI: 10.1016/j.pec.2023.107680] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Vaccination is a key strategy to limit the impact of the COVID-19 pandemic, among vulnerable groups such as cancer patients. However, COVID-19 vaccine hesitancy is limiting vaccination uptake in this population as in others. This study aimed to synthesise the emerging literature on vaccine hesitancy in this population and in Oncology health professionals, reasons for and factors associated with hesitancy, and interventions that address hesitancy. METHODS A rapid review was undertaken PubMed, Ovid and Google across all years up to October 2021 for articles in English, from any country or region, addressing the above issues. Individual case studies, opinion pieces, commentary articles and conference abstracts were excluded. Article screening, data extraction and bias assessment were conducted by two authors. A narrative synthesis of the data was undertaken. RESULTS Eighteen eligible articles were identified. Reported COVID-19 vaccine hesitancy rates varied from 76.7 % to 3.9 %, with a mean of 38.4 %. A large international study (n > 20,000) reported a more conservative hesitancy rate of 19 %. Six broad, common reasons for hesitancy were identified. Oncologist advice was valued by patients. DISCUSSION Vaccine hesitancy remains a significant concern in the oncology context. Oncologists are key to addressing hesitancy and providing tailored advice to cancer patients. PRACTICE IMPLICATIONS Where possible, patients appreciate personalised, tailored information about vaccination which addresses its interaction with cancer and its treatment. Education programmes for oncologists to support effective communication in this context are needed. Webinars and peer-to-peer counselling may be useful but remain to be proven.
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Affiliation(s)
- P Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006, Australia.
| | - J Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006, Australia
| | - N Bartley
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006, Australia
| | - V Milch
- Cancer Australia, Level 14, 300 Elizabeth St, Surry Hills, NSW 2010, Australia
| | - R Sathiaraj
- Cancer Australia, Level 14, 300 Elizabeth St, Surry Hills, NSW 2010, Australia
| | - Scott Turnbull
- Cancer Australia, Level 14, 300 Elizabeth St, Surry Hills, NSW 2010, Australia
| | - C Der Vartanian
- Cancer Australia, Level 14, 300 Elizabeth St, Surry Hills, NSW 2010, Australia
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Bayefsky MJ, Shaw J, Hamer D, Martel R, Reich J, Blakemore JK. A balancing act: sex selection after pre-implantation genetic testing for aneuploidy for first versus second baby. Hum Reprod 2023:7174313. [PMID: 37208860 DOI: 10.1093/humrep/dead101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
STUDY QUESTION How often do patients undergoing frozen embryo transfer (FET) after preimplantation genetic testing for aneuploidy (PGT-A) choose to select for sex and do sex selection rates differ before and after successful delivery of a first baby? SUMMARY ANSWER When a choice was available between male and female embryos, patients selected the sex more frequently when trying to conceive the second child (62%) as compared to the first child (32.4%) and most commonly selected for the opposite sex of the first child. WHAT IS KNOWN ALREADY Sex selection is widely available in US fertility clinics. However, the rate of sex selection for patients undergoing FET after PGT-A is unknown. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study of 585 patients that took place between January 2013 and February 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS The study took place at a single, urban academic fertility center in the USA. Patients were included if they had a live birth after single euploid FET and returned for at least one subsequent euploid FET. The primary outcomes were the rates of sex selection for first versus second baby. Secondary outcomes were rate of selection for same versus opposite sex as first live birth and overall rate of selection for males versus females. MAIN RESULTS AND THE ROLE OF CHANCE Five hundred and eighty-five patients underwent a total of 1560 single euploid FETs resulting in either one or two live births. A choice between male and female euploid embryos was available for 919 FETs (first child: 67.5% (519/769) versus second child: 50.6% (400/791), P < 0.01). When a choice was available, patients selected the sex more frequently when trying to conceive the second child (first child: 32.4% (168/519) versus second child: 62.0% (248/400), P < 0.01). When sex was selected after first live birth, the opposite sex of the first child was selected 81.8% (203/248 FETs) of the time. Of transfers that involved sex selection, rates of male and female selection were similar for the first child, but selection for females was greater for the second child (first child: 51.2% (86/168) male versus 48.9% (82/168) female, second child: 41.1% (102/248) male versus 58.9% (146/248) female, P < 0.04). LIMITATIONS, REASONS FOR CAUTION The study was performed at one urban academic medical center in the Northeastern US, which may limit generalizability to other settings where PGT-A may be performed less frequently, or sex selection may be limited or not permitted. In addition, we could not reliably account for whether patients or their partners had prior children and if so, of what sex. WIDER IMPLICATIONS OF THE FINDINGS Patients undergoing PGT-A with both male and female euploid embryos were more likely to select for sex when attempting a second child and usually selected for the opposite sex of their first child. These findings highlight the potential for family balancing for patients who undergo PGT-A in settings where sex selection is permitted. STUDY FUNDING/COMPETING INTEREST(S) This study received no funding. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M J Bayefsky
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, NY, USA
| | - J Shaw
- Langone Fertility Center, New York University, New York, NY, USA
| | - D Hamer
- Grossman School of Medicine, New York University, New York, NY, USA
| | - R Martel
- Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA, USA
| | - J Reich
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, NY, USA
| | - J K Blakemore
- Langone Fertility Center, New York University, New York, NY, USA
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Shaw J, Devlin JF, Rudolph D, Schillig P. Extended pilot test of a cross-injection in situ denitrification system for pre-emptive treatment of municipal well water. J Contam Hydrol 2023; 256:104196. [PMID: 37182507 DOI: 10.1016/j.jconhyd.2023.104196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023]
Abstract
Elevated groundwater nitrate concentrations have been linked to deleterious health and environmental effects. A significant source of the nitrate is nitrogen fertilizers applied to agricultural landscapes. Beneficial Management Practices (BMPs), including the optimization of fertilizer use and selective crop rotations, have proven to be effective in some cases. The city of Woodstock in southern Ontario relies on public wells for all of its municipal supply. Several of the wells have experienced chronic increases in nitrate concentrations exceeding the maximum allowable limit of 10 mg/L N-NO3-. While BMPs are established, an interim reduction plan based on enhanced in situ denitrification (Cross Injection System, CIS) in a 15 m thick zone of high nitrate mass flux within the aquifer zone was evaluated. Based in the results of preliminary acetate injection experiments, a C:N ratio of 2.35, (approximately 260 mg acetate/L), was selected to optimize the denitrification reaction. Injections were performed for six hours a day every day for a period of approximately two months. Dissolved oxygen (DO) and nitrate concentrations recorded over time indicated that reduction of both commenced within a few days of the beginning of the acetate injections and reduced levels were maintained for the remainder of the two-month injection period. Denitrification occurred throughout the profile although nitrate reduction was the highest in the lower groundwater velocity zones. An overall reduction of nitrate of 50% was achieved through the treated section of the aquifer. It is estimated that an upscaled treatment system utilizing a treatment width of only 70 m would be sufficient to reduce the nitrate concentrations to below the drinking water limit demonstrating the potential for the CIS method to functions as an interim groundwater nitrate reduction strategy.
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Affiliation(s)
- J Shaw
- Environmental Resources Management Ltd., Eaton House, North Hinksey Lane, Oxford OX20QS, UK
| | - J F Devlin
- Geology Department, University of Kansas, United States of America
| | - D Rudolph
- Department of Earth and Environmental Sciences, University of Waterloo, Waterloo, ON, Canada.
| | - P Schillig
- RSI Entech, Oak Ridge, TN, United States of America
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Paudel BB, Tan SF, Fox TE, Ung J, Shaw J, Dunton W, Lee I, Sharma A, Viny AD, Barth BM, Tallman MS, Cabot M, Garrett-Bakelman FE, Levine RL, Kester M, Claxton D, Feith DJ, Janes KA, Loughran TP. Acute myeloid leukemia stratifies as two clinically relevant sphingolipidomic subtypes. bioRxiv 2023:2023.04.13.536805. [PMID: 37131653 PMCID: PMC10153188 DOI: 10.1101/2023.04.13.536805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Acute myeloid leukemia (AML) is an aggressive disease with complex and heterogeneous biology. Although several genomic classifications have been proposed, there is a growing interest in going beyond genomics to stratify AML. In this study, we profile the sphingolipid family of bioactive molecules in 213 primary AML samples and 30 common human AML cell lines. Using an integrative approach, we identify two distinct sphingolipid subtypes in AML characterized by a reciprocal abundance of hexosylceramide (Hex) and sphingomyelin (SM) species. The two Hex-SM clusters organize diverse samples more robustly than known AML driver mutations and are coupled to latent transcriptional states. Using transcriptomic data, we develop a machine-learning classifier to infer the Hex-SM status of AML cases in TCGA and BeatAML clinical repositories. The analyses show that the sphingolipid subtype with deficient Hex and abundant SM is enriched for leukemic stemness transcriptional programs and comprises an unappreciated high-risk subgroup with poor clinical outcomes. Our sphingolipid-focused examination of AML identifies patients least likely to benefit from standard of care and raises the possibility that sphingolipidomic interventions could switch the subtype of AML patients who otherwise lack targetable alternatives.
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Affiliation(s)
- B. Bishal Paudel
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Su-Fern Tan
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
| | - Todd E. Fox
- Department of Pharmacology, University of Virginia, Charlottesville, VA
| | - Johnson Ung
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
- Department of Microbiology, Immunology & Cancer Biology, University of Virginia, Charlottesville, VA
| | - Jeremy Shaw
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
| | - Wendy Dunton
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
| | - Irene Lee
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
| | - Arati Sharma
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA
- Penn State Cancer Institute, Hershey, PA
| | - Aaron D. Viny
- Departments of Medicine, Division of Hematology & Oncology, and of Genetics & Development, Columbia Stem Cell Initiative, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Brian M. Barth
- Department of Chemistry, Biology, and Health Sciences, South Dakota School of Mines and Technology, Rapid City, SD
| | - Martin S. Tallman
- Northwestern University Feinberg School of Medicine Robert H. Lurie Comprehensive Cancer Center Chicago, IL
| | - Myles Cabot
- Department of Biochemistry & Molecular Biology, Brody School of Medicine, and the East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC
| | - Francine E. Garrett-Bakelman
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA
- University of Virginia Comprehensive Cancer Center, Charlottesville, VA
| | - Ross L. Levine
- Human Oncology and Pathogenesis Program and Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mark Kester
- Department of Pharmacology, University of Virginia, Charlottesville, VA
- University of Virginia Comprehensive Cancer Center, Charlottesville, VA
| | - David Claxton
- Penn State Cancer Institute, Hershey, PA
- Department of Medicine, Division of Hematology and Oncology, Pennsylvania State University College of Medicine, Hershey, PA
| | - David J. Feith
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
- University of Virginia Comprehensive Cancer Center, Charlottesville, VA
| | - Kevin A. Janes
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA
- University of Virginia Comprehensive Cancer Center, Charlottesville, VA
| | - Thomas P. Loughran
- Department of Medicine, Division of Hematology & Oncology, University of Virginia, Charlottesville, VA
- University of Virginia Comprehensive Cancer Center, Charlottesville, VA
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11
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Mok PLH, Walter F, Carr MJ, Antonsen S, Kapur N, Steeg S, Shaw J, Pedersen CB, Webb RT. Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care. Eur Psychiatry 2023; 66:e13. [PMID: 36649931 PMCID: PMC9970150 DOI: 10.1192/j.eurpsy.2022.2352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. METHODS Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967-2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. RESULTS Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. CONCLUSIONS Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.
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Affiliation(s)
- P L H Mok
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy & Optometry, The University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
| | - F Walter
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, United Kingdom
| | - M J Carr
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy & Optometry, The University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom
| | - S Antonsen
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.,National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - N Kapur
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| | - S Steeg
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| | - J Shaw
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| | - C B Pedersen
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.,National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - R T Webb
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
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12
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Modjtahedi BS, Do D, Shaw J. Correspondence Regarding Changes in the Incidence of Retinal Vascular Occlusions After COVID-19 Diagnosis-Reply. JAMA Ophthalmol 2022; 140:1143-1144. [PMID: 36074443 DOI: 10.1001/jamaophthalmol.2022.3479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Bobeck S Modjtahedi
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena.,Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.,Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park
| | - Duy Do
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena
| | - Jeremy Shaw
- Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park.,South Bay Medical Center, Department of Ophthalmology, Southern California Permanente Medical Group, Harbor City
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13
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Counter C, Owen R, Sinha S, Muthusamy A, Drage M, Callaghan C, Elker D, Harper S, Sutherland A, Van Dellen D, Johnson P, Manas D, Shaw J, Forsythe J, Wilson C, Hughes S, Casey J, White S. O007 Pancreas and islet transplantation in the United Kingdom during the COVID-19 era. Br J Surg 2022; 109:znac242.007. [PMCID: PMC9384530 DOI: 10.1093/bjs/znac242.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction Methods Results Conclusion Take-home message
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Affiliation(s)
| | - R Owen
- NHSBT Pancreas Advisory Group
| | - S Sinha
- NHSBT Pancreas Advisory Group
| | | | - M Drage
- NHSBT Pancreas Advisory Group
| | | | - D Elker
- NHSBT Pancreas Advisory Group
| | | | | | | | | | - D Manas
- NHSBT Pancreas Advisory Group
| | - J Shaw
- NHSBT Pancreas Advisory Group
| | | | | | | | - J Casey
- NHSBT Pancreas Advisory Group
| | - S White
- NHSBT Pancreas Advisory Group
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14
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Butow P, Havard PE, Butt Z, Juraskova, Sharpe L, Dhillon H, Beatty L, Beale P, Cigolini M, Kelly B, Chan RJ, Kirsten L, Best M, Shaw J. The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study. Patient Educ Couns 2022; 105:2397-2403. [PMID: 35120797 PMCID: PMC8801619 DOI: 10.1016/j.pec.2022.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 09/06/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged. METHODS In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety and Stress Scale (carers and HPs) to assess emotional morbidity. Thematic analysis was undertaken on qualitative data. RESULTS 32 patients, 16 carers and 29 HPs participated. Qualitative analysis yielded three shared themes: fear and death anxiety, isolation, and uncertainty. For HPs, uncertainty incorporated the potential for moral distress and work-stress. Patients and carers scoring high on anxiety/depression measures were more likely to have advanced disease, expressed greater death anxiety, talked about taking more extreme precautionary measures, and felt more impacted by isolation. CONCLUSION Cancer and COVID-19 can have compounding psychological impacts on all those receiving or giving care. PRACTICE IMPLICATIONS Screening for distress in patients, and burnout in HPs, is recommended. Increased compassionate access and provision of creative alternatives to face-to-face support are warrented.
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Affiliation(s)
- P Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia.
| | - P E Havard
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - Z Butt
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - Juraskova
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - L Sharpe
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - H Dhillon
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
| | - L Beatty
- Flinders University, Órama Institute, College of Education, Psychology & Social Work, Adelaide, Australia
| | - P Beale
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, NSW 2006 Australia
| | - M Cigolini
- Department of Palliative Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - B Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan NSW 2308, Australia
| | - R J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
| | - L Kirsten
- Nepean Cancer Care Centre, Penrith, NSW 2751, Australia
| | - M Best
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW 2007, Australia
| | - J Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, NSW 2006 Australia
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Mckinnon JE, Santiaguel J, Murta C, Yu D, Khursheed M, Moreau F, Klopp-Schulze L, Shaw J, Roy S, Kao A. POS1268 PHASE II TRIAL OF ENPATORAN IN PATIENTS HOSPITALIZED WITH COVID-19 PNEUMONIA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4528] [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: 11/03/2022]
Abstract
BackgroundEnpatoran is a selective and potent dual toll-like receptor (TLR) 7/8 inhibitor in development for the treatment of cutaneous and systemic lupus erythematosus (CLE/SLE). Enpatoran inhibits TLR7/8 activation in vitro and suppresses disease activity in lupus mouse models.1 Enpatoran was well tolerated and had linear pharmacokinetic (PK) parameters in healthy volunteers.2 As TLR7/8 mediate immune responses to single-stranded RNA viruses, including SARS-CoV-2, it was postulated that enpatoran may prevent hyperinflammation and cytokine storm in COVID-19.ObjectivesIn response to the COVID-19 pandemic, we conducted an exploratory Phase II trial to assess safety and determine whether enpatoran prevents clinical deterioration in patients (pts) hospitalized with COVID-19 pneumonia. PK and pharmacodynamics (PD) of enpatoran were also evaluated.MethodsANEMONE was a randomized, double-blind, placebo (PBO)-controlled study conducted in Brazil, the Philippines, and the USA (NCT04448756). Pts aged 18–75 years, hospitalized with COVID-19 pneumonia (WHO 9-point scale score =4) but not mechanically ventilated, with SpO2 <94% and PaO2/FiO2 ≥150 (FiO2 maximum 0.4) were eligible. Those with a history of uncontrolled illness, active/unstable cardiovascular disease and SARS-CoV-2 vaccination were excluded. Pts received PBO or enpatoran (50 or 100 mg twice daily [BID]) for 14 days, with monitoring to Day 28 and safety follow-up to Day 60. Primary outcomes were safety and time to recovery (WHO 9-point scale ≤3). Clinical deterioration (time to clinical status >4, WHO 9-point scale) was a secondary outcome. Exploratory endpoints were enpatoran and biomarker concentrations (cytokines, C-reactive protein [CRP], D-dimer and interferon gene signature [IFN-GS] scores) assessed over time.Results149 pts received either PBO (n=49), or enpatoran 50 mg (n=54) or 100 mg (n=46) BID; 88% completed treatment and 86% received concomitant steroids. Median age was 50 years (77% <60 years old), 66% were male, and 50% had ≥1 comorbidity (40% hypertension, 24% diabetes). Overall, 59% pts reported a treatment-emergent adverse event (TEAE) with three non-treatment-related deaths; 11% reported a treatment-related TEAE. The proportion of pts in the enpatoran group reporting serious TEAEs was low (50 mg BID 9%; 100 mg BID 2%) vs PBO (18%). Gastrointestinal disorders were most common (PBO 8%; 50 mg BID 28%; 100 mg BID 9%). The primary outcome of time to recovery with enpatoran vs PBO was not met; medians were 3.4–3.9 days. A positive signal in time to clinical deterioration from Day 1 through Day 28 was observed; hazard ratios [95% CI] for enpatoran vs PBO were 0.39 [0.13, 1.15] (50 mg BID) and 0.30 [0.08, 1.08] (100 mg BID). Mean enpatoran exposure was dose-proportional, and PK properties were within expectations. The median (quartile [Q]1– Q3) interleukin 6 (IL-6), CRP and D-dimer baseline concentration across the groups were 5.7 (4.0–13.5) pg/mL, 30.04 (11.40–98.02) and 0.62 (0.39–1.01) mg/L, respectively. Baseline IFN-GS scores were similar across groups.ConclusionThe ANEMONE trial was the first to evaluate the safety and efficacy of a TLR7/8 inhibitor in an infectious disease for preventing cytokine storm. Enpatoran up to 100 mg BID for 14 days was well tolerated by patients acutely ill with COVID-19 pneumonia. Time to recovery was not improved with enpatoran, perhaps due to the younger age of patients who had fewer comorbidities compared to those in similar COVID-19 trials. However, there was less likelihood for clinical deterioration with enpatoran than placebo. This trial provides important safety, tolerability, PK and PD data supporting continued development of enpatoran in SLE and CLE (NCT04647708, NCT05162586).References[1]Vlach, et al. J Pharmacol Exp Ther 2021;376:397–409;[2]Port, et al. Pharmacol Res Perspect 2021;9:e00842.AcknowledgementsWe would like to thank those who took part in the the ANEMONE trial. This study was sponsored by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945), who funded medical writing support by Bioscript Stirling Ltd.Disclosure of InterestsJohn E. McKinnon Consultant of: EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA, Joel Santiaguel Speakers bureau: Merck Healthcare KGaA, Claudia Murta Speakers bureau: Pfizer/Wyeth, Dongzi Yu Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Mukhy Khursheed Employee of: Merck Serono Ltd (an affiliate of Merck KGaA), Flavie Moreau Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Lena Klopp-Schulze Employee of: Merck Healthcare KGaA, Jamie Shaw Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA), Sanjeev Roy Employee of: Ares Trading SA (an affiliate of Merck KGaA), Amy Kao Employee of: EMD Serono Research & Development institute (an affiliate of Merck KGaA)
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16
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Shaw J. T113 Are repeat measurements required for critically high POCT glucose results? Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.581] [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: 11/03/2022]
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Abstract
Importance COVID-19 is associated with systemic vascular damage; however, the risk posed to the retinal vasculature remains incompletely understood. Objective To assess if there is a change in the incidence of retinal vascular occlusions after COVID-19 infection. Design, Setting, and Participants This cohort study at an integrated health care organization (Kaiser Permanente Southern California) included patients without a history of retinal vascular occlusion who were diagnosed with COVID-19 infection between January 20, 2020, and May 31, 2021. Patients were excluded if they had a history of retinal artery occlusions (RAOs) or retinal vein occlusions (RVOs) more than 6 months before their COVID-19 diagnosis or if they were enrolled in Kaiser Permanente Southern California for less than 6 months before COVID-19 diagnosis. Exposures COVID-19 infection. Main Outcomes and Measures The change in the average biweekly incidence of new RAOs and RVOs after COVID-19 diagnosis. Adjusted incidence rate ratios (IRRs) were calculated to compare the incidence of retinal vascular occlusions before and after COVID-19 diagnosis after accounting for baseline demographic characteristics, medical history, and hospitalization. Results A total of 432 515 patients diagnosed with COVID-19 infection were included in this study. The mean (SD) age was 40.9 (19.2) years, and 231 767 patients (53.6%) were women. Sixteen patients had an RAO (crude incidence rate, 3.00 per 1 000 000 patients), and 65 had an RVO (crude incidence rate, 12.20 per 1 000 000 patients) in the 6 months after COVID-19 diagnosis. The incidence of new RVOs was higher in the 6 months after COVID-19 infection compared with the 6 months before infection after adjusting for age; sex; self-reported race and ethnicity; body mass index; history of diabetes, hypertension, or hyperlipidemia; and hospitalization (adjusted IRR, 1.54; 95% CI, 1.05-2.26; P = .03). There was a smaller increase in the incidence of RAOs after COVID-19 diagnosis (IRR, 1.35; 95% CI, 0.64-2.85; P = .44). The peak incidence of RAOs and RVOs occurred 10 to 12 weeks and 6 to 8 weeks after COVID-19 diagnosis, respectively. Conclusions and Relevance The findings of this study suggest that there was an increase in the incidence of RVOs after COVID-19 infection; however, these events remain rare, and in the absence of randomized controls, a cause-and-effect relationship cannot be established. Further large, epidemiologic studies are warranted to better define the association between retinal thromboembolic events and COVID-19 infection.
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Affiliation(s)
- Bobeck S. Modjtahedi
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena,Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California,Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park
| | - Duy Do
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena
| | - Tiffany Q. Luong
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena
| | - Jeremy Shaw
- Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park,Department of Ophthalmology, South Bay Medical Center, Southern California Permanente Medical Group, Harbor City, California
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18
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Beemer RD, Li L, Leonti A, Shaw J, Fonseca J, Valova I, Iskander M, Pilskaln CH. Comparison of 2D Optical Imaging and 3D Microtomography Shape Measurements of a Coastal Bioclastic Calcareous Sand. J Imaging 2022; 8:jimaging8030072. [PMID: 35324627 PMCID: PMC8949309 DOI: 10.3390/jimaging8030072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 02/01/2023] Open
Abstract
This article compares measurements of particle shape parameters from three-dimensional (3D) X-ray micro-computed tomography (μCT) and two-dimensional (2D) dynamic image analysis (DIA) from the optical microscopy of a coastal bioclastic calcareous sand from Western Australia. This biogenic sand from a high energy environment consists largely of the shells and tests of marine organisms and their clasts. A significant difference was observed between the two imaging techniques for measurements of aspect ratio, convexity, and sphericity. Measured values of aspect ratio, sphericity, and convexity are larger in 2D than in 3D. Correlation analysis indicates that sphericity is correlated with convexity in both 2D and 3D. These results are attributed to inherent limitations of DIA when applied to platy sand grains and to the shape being, in part, dependent on the biology of the grain rather than a purely random clastic process, like typical siliceous sands. The statistical data has also been fitted to Johnson Bounded Distribution for the ease of future use. Overall, this research demonstrates the need for high-quality 3D microscopy when conducting a micromechanical analysis of biogenic calcareous sands.
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Affiliation(s)
- Ryan D. Beemer
- Department of Civil and Environmental Engineering, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA
- Correspondence: ; Tel.: +1-(508)-999-8416
| | - Linzhu Li
- Department of Civil and Urban Engineering, New York University, New York, NY 10012, USA; (L.L.); (M.I.)
| | - Antonio Leonti
- Department of Computer and Information Science, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA; (A.L.); (I.V.)
| | - Jeremy Shaw
- Centre for Microscopy, Characterisation & Analysis, University of Western Australia, Crawley 6009, Australia;
| | - Joana Fonseca
- Department of Civil Engineering, City, University of London, London EC1V 0HB, UK;
| | - Iren Valova
- Department of Computer and Information Science, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA; (A.L.); (I.V.)
| | - Magued Iskander
- Department of Civil and Urban Engineering, New York University, New York, NY 10012, USA; (L.L.); (M.I.)
| | - Cynthia H. Pilskaln
- School for Marine Science and Technology, University of Massachusetts Dartmouth, Dartmouth, MA 02747, USA;
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Rendon D, Thomson R, Van Citters D, Shaw J. Optimization of suture attachment for fascia sacral colpopexy using an animal model. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shaw J, McGraw Z, Bruno O, Storelvmo T, Hofer S. Using Satellite Observations to Evaluate Model Microphysical Representation of Arctic Mixed-Phase Clouds. Geophys Res Lett 2022; 49:e2021GL096191. [PMID: 35845251 PMCID: PMC9285086 DOI: 10.1029/2021gl096191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/16/2021] [Accepted: 01/12/2022] [Indexed: 06/15/2023]
Abstract
Mixed-phase clouds play an important role in determining Arctic warming, but are parametrized in models and difficult to constrain with observations. We use two satellite-derived cloud phase metrics to investigate the vertical structure of Arctic clouds in two global climate models that use the Community Atmosphere Model version 6 (CAM6) atmospheric component. We report a model error limiting ice nucleation, produce a set of Arctic-constrained model runs by adjusting model microphysical variables to match the cloud phase metrics, and evaluate cloud feedbacks for all simulations. Models in this small ensemble uniformly overestimate total cloud fraction in the summer, but have variable representation of cloud fraction and phase in the winter and spring. By relating modeled cloud phase metrics and changes in low-level liquid cloud amount under warming to longwave cloud feedback, we show that mixed-phase processes mediate the Arctic climate by modifying how wintertime and springtime clouds respond to warming.
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Affiliation(s)
- J. Shaw
- Department of GeosciencesUniversity of OsloOsloNorway
- Now at Department of Atmospheric and Oceanic SciencesUniversity of Colorado at BoulderBoulderCOUSA
| | - Z. McGraw
- Department of GeosciencesUniversity of OsloOsloNorway
- Now at Department of Applied Physics and Applied MathematicsColumbia University and NASA Goddard Institute for Space StudiesNew YorkNYUSA
| | - O. Bruno
- Karlsruhe Institute of TechnologyInstitute of Meteorology and Climate ResearchKarlsruheGermany
| | - T. Storelvmo
- Department of GeosciencesUniversity of OsloOsloNorway
- School of BusinessNord UniversityBodøNorway
| | - S. Hofer
- Department of GeosciencesUniversity of OsloOsloNorway
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Sharpe L, Michalowski M, Richmond B, Menzies RE, Shaw J. Fear of Progression in chronic illnesses other than cancer: A systematic review and meta-analysis of a transdiagnostic construct. Health Psychol Rev 2022; 17:301-320. [PMID: 35132937 DOI: 10.1080/17437199.2022.2039744] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has been studied outside of the cancer context. This review aimed to: (1) meta-synthesize qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e. seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses.
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Affiliation(s)
- Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - M Michalowski
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - B Richmond
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - R E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006
| | - J Shaw
- School of Psychology, Faculty of Science, The University of Sydney, NSW 2006.,Psycho-Oncology Co-operative Group (POCOG), The University of Sydney, NSW 2006
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Zheng W, Dinh D, Noaman S, Bloom J, Lefkovits J, Brennan A, Reid C, Al-Mukhtar O, Shaw J, Yang Y, Stub D, Kaye D, Cox N, Chan W. Effect of Concomitant Cardiac Arrest on Outcomes in Patients With Cardiogenic Shock Secondary to Acute Coronary Syndrome (ACS). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Zheng W, Noaman S, Batchelor R, Bloom J, Hanson L, Stub D, Cox N, Walton A, Shaw J, French C, Yang Y, Chan W. Comparison of Resuscitation, Treatment and Outcomes following Out-of-Hospital Cardiac Arrest (OHCA) and Shockable Rhythm in Three Different Age Groups. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Cohen NS, Dinh D, Ajani A, Clark D, Brennan A, Nan Tie E, Dagan M, Hamilton G, Sebastian M, Shaw J, Oqueli E, Freeman M, Reid C, Stub D, Duffy SJ. Outcomes after percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass grafting (cabg). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In patients with prior CABG requiring subsequent PCI there is uncertainty whether bypass grafts or native coronary arteries should be targeted.
Methods
We analysed data from 2,764 patients with prior CABG in the Melbourne Interventional Group registry (2005–2018), divided into two groups: those undergoing PCI to a native vessel (n=1,928) and those with PCI to a graft vessel (n=836).
Results
Patients with a graft vessel PCI were older, had more high-risk clinical characteristics (prior MI, heart failure, ejection fraction <50%, renal impairment, peripheral and cerebrovascular disease), and high-risk procedural features (ACC/AHA types B2/C lesions). However, patients in the native vessel group were more likely to have PCI to a chronic total occlusion. The majority of graft PCI were to saphenous vein grafts (84%), with 10% to radial and 6% to LIMA/RIMA grafts. Distal embolic protection devices were used in 30% of graft PCI. Patients with graft PCI had higher rates of no reflow (6.3% vs. 1.5%; p<0.001), coronary perforation (p=0.016) and inpatient stent thrombosis (p=0.028). However, 30-day mortality and major adverse cardiovascular and cerebrovascular events (MACCE) were similar. Unadjusted long-term mortality (median follow up 4.8 years) was higher in patients who had undergone a graft PCI (44% vs. 32%, p<0.001), but following Cox proportional hazards modelling, PCI vessel type was not a predictor of long-term mortality (HR 1.13; 95% CI 0.96–1.33, p=0.14).
Conclusions
Early clinical outcomes and risk-adjusted long-term mortality are similar for patients with prior CABG undergoing PCI to a native vessel or a bypass graft.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): The Alfred Hospital
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Affiliation(s)
- N S Cohen
- The Alfred Hospital, Melbourne, Australia
| | - D Dinh
- Monash University, Melbourne, Australia
| | - A Ajani
- Royal Melbourne Hospital, Melbourne, Australia
| | - D Clark
- Austin Hospital, Melbourne, Australia
| | - A Brennan
- Monash University, Melbourne, Australia
| | - E Nan Tie
- The Alfred Hospital, Melbourne, Australia
| | - M Dagan
- The Alfred Hospital, Melbourne, Australia
| | | | | | - J Shaw
- The Alfred Hospital, Melbourne, Australia
| | - E Oqueli
- Ballarat Health Services, Ballarat, Australia
| | - M Freeman
- Eastern Health, Melbourne, Australia
| | - C Reid
- Monash University, Melbourne, Australia
| | - D Stub
- The Alfred Hospital, Melbourne, Australia
| | - S J Duffy
- The Alfred Hospital, Melbourne, Australia
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Nan Tie E, Fernando H, Nehme Z, Dinh D, Andrew E, Brennan A, Zaman S, Liew D, Stephenson M, Lefkovits J, Peter K, Duffy SJ, Shaw J, Smith K, Stub D. Sex differences in pre-hospital analgesia and outcomes in patients presenting with acute coronary syndromes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Opioid analgesia remains the mainstay of pain management in acute coronary syndromes (ACS). Significant sex differences persist in ACS presentation, management and outcomes, but the impact of sex-differences on pre-hospital pain management of ACS with opioids is unknown. There is increasing awareness of the importance of pre-hospital factors in ACS, as well as emerging concerns with opioid use impairing the gastrointestinal absorption of oral P2Y12 inhibitors.
Purpose
This study examined if sex-differences in pre-hospital pain scores, opioid administration and clinical outcomes exist in ACS patients.
Methods
Patients presenting with ACS via ambulance (2014–2018) that underwent percutaneous coronary intervention (PCI) were prospectively collected via the Victorian Cardiac Outcomes Registry (VCOR), the Melbourne Interventional Group (MIG), and linked to the Ambulance Victoria database. The primary outcome was 30-day major adverse cardiac events (MACE). Secondary outcomes were descriptive analyses of pre-hospital pain score, intravenous morphine equivalent analgesic dosing, plus predictors of MACE and Thrombolysis In Myocardial Infarction (TIMI) 0–1 flow pre-PCI using logistic regression.
Results
10,547 patients were included (female: 2,775 [26.3%]). Opioids were administered to 1,585 (57%) females and 5,068 (65%) males (p<0.001). Adjusted 30-day MACE was similar between opioid groups in both sexes (female: OR 1.21, CI 0.82–1.79, p=0.34; male: OR 0.89, 0.68–1.16, p=0.40). Median pain score at presentation was 6 (IQR 4,8) for both sexes. Median opioid dose was 2.5 mg (IQR 0,10) in females and 5 mg (IQR 0,10) in males (p<0.001), with similar pain relief achieved. Adjusted rates of TIMI 0–1 pre-PCI were higher in patients administered opioids (female: OR 2.83, CI 2.14–3.56, p<0.001; male: OR 2.95, CI 2.49–3.49, p<0.001).
Conclusions
Female patients undergoing PCI received less opioid analgesia, but no sex-differences in pre-hospital pain scores were seen. Opioid administration was associated with impaired antegrade flow in the culprit artery in both sexes, but not short-term MACE. Randomised trials evaluating the clinical implications of opioid administration in ACS with sex subgroup analyses are needed to guide clinical practice.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Melbourne Interventional GroupVictorian Cardiac Outcomes Registry
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Affiliation(s)
- E Nan Tie
- Monash University, Melbourne, Australia
| | - H Fernando
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - Z Nehme
- Monash University, Melbourne, Australia
| | - D Dinh
- Monash University, Melbourne, Australia
| | - E Andrew
- Monash University, Melbourne, Australia
| | - A Brennan
- Monash University, Melbourne, Australia
| | - S Zaman
- Westmead Hospital, Sydney, Australia
| | - D Liew
- Monash University, Melbourne, Australia
| | | | - J Lefkovits
- Royal Melbourne Hospital, Melbourne, Australia
| | - K Peter
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - S J Duffy
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - J Shaw
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - K Smith
- Monash University, Melbourne, Australia
| | - D Stub
- The Alfred Hospital, Cardiology, Melbourne, Australia
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Nan Tie E, Dinh D, Clark D, Ajani AE, Brennan A, Cohen N, Dagan M, Shaw J, Sebastian M, Freeman M, Oqueli E, Reid C, Kaye D, Stub D, Duffy SJ. Trends in intra-aortic balloon pump use in cardiogenic shock in the post-SHOCK II trial era. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Myocardial infarction complicated by cardiogenic shock (MI-CS) has a poor prognosis, even with early revascularisation. Previously, intra-aortic balloon pump (IABP) use was thought to improve outcomes, but the SHOCK-II trial in 2012 found no survival benefit.
Purpose
This study aimed to determine the trends in IABP use in patients with MI-CS undergoing percutaneous intervention (PCI) over time and characteristics associated with use.
Methods
Between 2005–2018, patients presenting with MI-CS that underwent percutaneous coronary intervention (PCI) at a hospital participating in the Melbourne Interventional Group Registry were included. The primary outcome was the trend in IABP use over time. Secondary outcomes included mortality, 30-day MACCE (major adverse cardiovascular and cerebrovascular events) and predictors of outcome, determined via logistic regression.
Results
Of the 1,110 patients identified, IABP was used in 478 (43%). IABP was used more in patients with left main and left anterior descending culprit lesions (62% vs. 46%), lower ejection fraction (<35%; 18% vs. 11%), and pre-procedural inotrope use (81% vs. 73%), all p<0.05. IABP use was associated with higher inpatient bleeding (18% vs. 13%) and 30-day MACCE (58% vs. 51%), both p<0.05. The rate of MI-CS increased over time, but after 2012 there was a decline in IABP use (Figure 1). IABP use was a predictor of 30-day MACCE (OR 1.6, 95% CI 1.18–2.29, p=0.003). However, IABP was not associated with in-hospital, 30-day or long-term mortality (45% vs. 47%, p=0.44; 46% vs. 50%, p=0.25; 60% vs. 62%, p=0.39).
Conclusions
Consistent with the SHOCK II trial, IABP use is not associated with reduced short- or long-term mortality, but in this study was associated with increased short-term adverse events. IABP use is declining, but is still used in sicker patients with greater myocardium at risk, given limited alternatives.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Melbourne interventional group
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Affiliation(s)
- E Nan Tie
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - D Dinh
- Monash University, Melbourne, Australia
| | - D Clark
- Austin Hospital, Melbourne, Australia
| | - A E Ajani
- Royal Melbourne Hospital, Melbourne, Australia
| | - A Brennan
- Monash University, Melbourne, Australia
| | - N Cohen
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - M Dagan
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - J Shaw
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | | | - M Freeman
- Eastern Health, Melbourne, Australia
| | - E Oqueli
- Ballarat Health Services, Ballarat, Australia
| | - C Reid
- Monash University, Melbourne, Australia
| | - D Kaye
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - D Stub
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - S J Duffy
- The Alfred Hospital, Cardiology, Melbourne, Australia
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Fernando H, Duong T, Huynh K, Noonan J, Shaw J, Duffy S, Nehme Z, Smith K, Myles P, Meikle P, Peter K, Stub D. Lignocaine versus opioids in coronary intervention: assessing antiplatelet activity and ticagrelor levels (LOCAL) study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Opioid analgesia impairs the bioavailability and antiplatelet effect of oral P2Y12 inhibitors prompting investigation of mitigation strategies including identifying alternative analgesic agents.
Purpose
To assess the impact of intravenous fentanyl and lignocaine on the bioavailability and antiplatelet effect of ticagrelor in patients with unstable angina and non-ST elevation myocardial infarction, as well as their procedural analgesic efficacy and safety.
Methods
The LOCAL trial was a prospective, single centre, double-blind, randomized, controlled trial where intravenous lignocaine was the experimental analgesic agent assessed in this trial compared to intravenous fentanyl as procedural analgesia during coronary angiography and percutaneous coronary intervention. Patients with an indication for dual antiplatelet therapy and no contraindication were given 180mg of ticagrelor orally as integral tablets with 250 mL of tap water at the end of the case. Blood was sampled at time 0, 0.5, 1, 2 and 4 hours post administration of ticagrelor for pharmacokinetic and comprehensive pharmacodynamic analysis.
Results
Seventy patients undergoing coronary angiography with an indication for ticagrelor loading were included in the pharmacokinetic and pharmacodynamic analysis. Plasma ticagrelor levels at 2 h post loading dose were significantly lower in the fentanyl compared to lignocaine treatment arm (476 vs. 792 ng/mL, p=0.02, see figure 1). The area under the plasma-time curves for ticagrelor (987 vs. 2189 ng.h/mL, p=0.001) and its active metabolite (173 vs. 394 ng.h/mL, p<0.001) were both significantly lower in the fentanyl arm. Platelet reactivity assessed by the VerifyNow assay was higher at all time points after baseline in the fentanyl compared to lignocaine arm. The VASP flow cytometry assay demonstrated higher platelet reactivity at 2 hours in the fentanyl group (40% vs. 22% platelet reactivity index, p=0.001). The Multiplate Analyzer demonstrated higher platelet reactivity in the fentanyl arm at 60 minutes (43 vs. 26 area under the curve units, p=0.001) as did expression of activated platelet GpIIb/IIIa receptor (2829 vs. 1426 geometric mean fluorescence intensity (GMFI), p=0.006) and P-selectin (439 vs. 211 GMFI, p=0.001). High on-treatment platelet reactivity (HPR) was significantly higher in the fentanyl arm at 60 min using the MPA (41% vs. 9%, p=0.002) and 120 min using the VFN (30% vs. 3%, p=0.003) and VASP (37% vs. 6%, p=0.002) assays (see figure 2). Both drugs were well tolerated with a high level of patient satisfaction (fentanyl 94% vs. lignocaine 97%, p=0.56).
Conclusion(s)
Unlike fentanyl, lignocaine does not impair the bioavailability or delay the antiplatelet effect of ticagrelor. Both drugs were well tolerated and effective with a high level of patient satisfaction for procedural analgesia. Systemic pain medication during PCI should be reconsidered and if performed, lignocaine is a beneficial alternative to fentanyl.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): TBA Figure 1. Ticagrelor and AM pharmacokineticsFigure 2. Ticagrelor pharmacodynamics
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Affiliation(s)
- H Fernando
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - T Duong
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - K Huynh
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - J Noonan
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - J Shaw
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - S Duffy
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - Z Nehme
- Monash University, Melbourne, Australia
| | - K Smith
- Monash University, Melbourne, Australia
| | - P Myles
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - P Meikle
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - K Peter
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - D Stub
- The Alfred Hospital, Cardiology, Melbourne, Australia
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Morgan R, Clamp A, Ryder W, Wheeler C, Buckley E, Truelove J, Murphy A, Hasan J, Mitchell C, Burghel G, White D, Price M, Bhaskar S, Shaw J, Dive C, Wallace A, O'Connor J, Rothwell D, Edmondson R, Jayson G. 731P Multi-maintenance olaparib in relapsed, platinum-sensitive BRCA-mutant high-grade serous ovarian carcinoma (MOLTO): A phase II feasibility study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1174] [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] Open
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29
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Murphy M, Newby J, Butow P, Joubert A, Kirsten L, Shaw J, Shepherd H, Andrews G. A mixed methods pilot and feasibility open trial of internet-delivered cognitive behaviour therapy ( iCanADAPT Advanced) for people with advanced cancer with depression and/or anxiety. Internet Interv 2021; 26:100449. [PMID: 34504779 PMCID: PMC8416957 DOI: 10.1016/j.invent.2021.100449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Evaluate the feasibility, acceptability and potential efficacy of a form of online therapy for clinical depression and/or anxiety in people living with advanced cancer. METHODS A single-arm open trial of a six-lesson clinician-supervised, internet-delivered cognitive behavioural therapy (iCBT) transdiagnostic intervention (iCanADAPT Advanced) was undertaken. Qualitative (semi-structured telephone interview conducted at 3-months) and quantitative data (questionnaires collected at pre-, post-, and 3-month follow-up) were analysed. RESULTS 27 participants partook (26 women, 56% breast cancer, mean age 56yo; average number of mental health diagnoses 1.8, with majority (81%) meeting criteria for generalised anxiety disorder). Feasibility - Unanticipated numbers (48%) of participants had physical health deterioration (cancer progression or death). iCBT had high adherence overall (completion rates: 37% did 6 lessons; 70% did 4 lessons) but adherence was higher for those whose cancer remained stable (completion rates: 43% did 6 lessons; 85% did 4 lessons). Acceptability - the intervention was acceptable to the majority of participants, with high treatment satisfaction. Advisory data was achieved regarding future versions. Potential efficacy - regardless of physical health status, participants who completed the iCBT showed a significant decrease over time in anxiety and depression symptoms. CONCLUSIONS Online therapies may be useful in assisting those living with advanced cancer dealing with clinical depression and anxiety disorders. The specific modality of clinician supervised iCBT has significant potential to be a suitable modality of online therapy.
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Affiliation(s)
- M.J. Murphy
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW, Sydney, NSW 2010, Australia
- Corresponding author.
| | - J.M. Newby
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW, Sydney, NSW 2010, Australia
- School of Psychology, UNSW, NSW 2052, Australia
| | - P. Butow
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, NSW 2006, Australia
| | - A. Joubert
- School of Psychology, UNSW, NSW 2052, Australia
| | - L. Kirsten
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, NSW 2006, Australia
- Nepean Cancer Care Centre, NSW 2747, Australia
| | - J. Shaw
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, NSW 2006, Australia
| | - H.L. Shepherd
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, NSW 2006, Australia
| | - G. Andrews
- Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW, Sydney, NSW 2010, Australia
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Shaw J, Scotchman E, Chandler N, Chitty LS. PREIMPLANTATION GENETIC TESTING: Non-invasive prenatal testing for aneuploidy, copy-number variants and single-gene disorders. Reproduction 2021; 160:A1-A11. [PMID: 32130205 DOI: 10.1530/rep-19-0591] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/02/2020] [Indexed: 12/11/2022]
Abstract
The discovery of cell-free fetal DNA (cffDNA) in maternal plasma has enabled a paradigm shift in prenatal testing, allowing for safer, earlier detection of genetic conditions of the fetus. Non-invasive prenatal testing (NIPT) for fetal aneuploidies has provided an alternative, highly efficient approach to first-trimester aneuploidy screening, and since its inception has been rapidly adopted worldwide. Due to the genome-wide nature of some NIPT protocols, the commercial sector has widened the scope of cell-free DNA (cfDNA) screening to include sex chromosome aneuploidies, rare autosomal trisomies and sub-microscopic copy-number variants. These developments may be marketed as 'expanded NIPT' or 'NIPT Plus' and bring with them a plethora of ethical and practical considerations. Concurrently, cfDNA tests for single-gene disorders, termed non-invasive prenatal diagnosis (NIPD), have been developed for an increasing array of conditions but are less widely available. Despite the fact that all these tests utilise the same biomarker, cfDNA, there is considerable variation in key parameters such as sensitivity, specificity and positive predictive value depending on what the test is for. The distinction between diagnostics and screening has become blurred, and there is a clear need for the education of physicians and patients regarding the technical capabilities and limitations of these different forms of testing. Furthermore, there is a requirement for consistent guidelines that apply across health sectors, both public and commercial, to ensure that tests are validated and robust and that careful and appropriate pre-test and post-test counselling is provided by professionals who understand the tests offered.
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Affiliation(s)
- J Shaw
- London North Genomic Laboratory Hub, Great Ormond Street NHS Foundation Trust, London, UK
| | - E Scotchman
- London North Genomic Laboratory Hub, Great Ormond Street NHS Foundation Trust, London, UK
| | - N Chandler
- London North Genomic Laboratory Hub, Great Ormond Street NHS Foundation Trust, London, UK
| | - L S Chitty
- London North Genomic Laboratory Hub, Great Ormond Street NHS Foundation Trust, London, UK.,Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London, UK
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31
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Wyber BW, Dougherty LR, McNamara K, Mehnert A, Shaw J, Tomkins JL, Simmons LW. Quantifying variation in female internal genitalia: no evidence for plasticity in response to sexual conflict risk in a seed beetle. Proc Biol Sci 2021; 288:20210746. [PMID: 34229488 PMCID: PMC8261201 DOI: 10.1098/rspb.2021.0746] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/09/2021] [Indexed: 11/12/2022] Open
Abstract
Sexually antagonistic coevolution can drive the evolution of male traits that harm females, and female resistance to those traits. While males have been found to vary their harmfulness to females in response to social cues, plasticity in female resistance traits remains to be examined. Here, we ask whether female seed beetles Callosobruchus maculatus are capable of adjusting their resistance to male harm in response to the social environment. Among seed beetles, male genital spines harm females during copulation and females might resist male harm via thickening of the reproductive tract walls. We develop a novel micro computed tomography imaging technique to quantify female reproductive tract thickness in three-dimensional space, and compared the reproductive tracts of females from populations that had evolved under high and low levels of sexual conflict, and for females reared under a social environment that predicted either high or low levels of sexual conflict. We find little evidence to suggest that females can adjust the thickness of their reproductive tracts in response to the social environment. Neither did evolutionary history affect reproductive tract thickness. Nevertheless, our novel methodology was capable of quantifying fine-scale differences in the internal reproductive tracts of individual females, and will allow future investigations into the internal organs of insects and other animals.
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Affiliation(s)
- Blake W. Wyber
- Centre for Evolutionary Biology, School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Liam R. Dougherty
- Centre for Evolutionary Biology, School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 7RB, UK
| | - Kathryn McNamara
- Centre for Evolutionary Biology, School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
- School of BioSciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew Mehnert
- Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, Western Australia 6009, Australia
- National Imaging Facility, Brisbane, Queensland, Australia
| | - Jeremy Shaw
- Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, Western Australia 6009, Australia
- National Imaging Facility, Brisbane, Queensland, Australia
| | - Joseph L. Tomkins
- Centre for Evolutionary Biology, School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Leigh W. Simmons
- Centre for Evolutionary Biology, School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
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Stenson C, Menne T, Osborne W, Publicover A, Kennedy H, Shaw J, Dewhurst F, Stocker R, Vidrine J. THE PATIENT AND CARER EXPERIENCE OF CHIMERIC ANTIGEN RECEPTOR T‐CELL THERAPY FOR RELAPSED/REFRACTORY B‐CELL LYMPHOMA AT A UK REGIONAL CENTRE. Hematol Oncol 2021. [DOI: 10.1002/hon.93_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C. Stenson
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - T. Menne
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - W. Osborne
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - A. Publicover
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - H. Kennedy
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - J. Shaw
- Newcastle University Faculty of Medical Sciences Newcastle upon Tyne UK
| | - F. Dewhurst
- Newcastle University Faculty of Medical Sciences Newcastle upon Tyne UK
| | - R. Stocker
- Newcastle University Faculty of Medical Sciences Newcastle upon Tyne UK
| | - J. Vidrine
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
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33
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Li H, Rajan GP, Shaw J, Rohani SA, Ladak HM, Agrawal S, Rask-Andersen H. A Synchrotron and Micro-CT Study of the Human Endolymphatic Duct System: Is Meniere's Disease Caused by an Acute Endolymph Backflow? Front Surg 2021; 8:662530. [PMID: 34136526 PMCID: PMC8200827 DOI: 10.3389/fsurg.2021.662530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The etiology of Meniere's disease (MD) and endolymphatic hydrops believed to underlie its symptoms remain unknown. One reason may be the exceptional complexity of the human inner ear, its vulnerability, and surrounding hard bone. The vestibular organ contains an endolymphatic duct system (EDS) bridging the different fluid reservoirs. It may be essential for monitoring hydraulic equilibrium, and a dysregulation may result in distension of the fluid spaces or endolymphatic hydrops. Material and Methods: We studied the EDS using high-resolution synchrotron phase contrast non-invasive imaging (SR-PCI), and micro-computed tomography (micro-CT). Ten fresh human temporal bones underwent SR-PCI. One bone underwent micro-CT after fixation and staining with Lugol's iodine solution (I2KI) to increase tissue resolution. Data were processed using volume-rendering software to create 3D reconstructions allowing orthogonal sectioning, cropping, and tissue segmentation. Results: Combined imaging techniques with segmentation and tissue modeling demonstrated the 3D anatomy of the human saccule, utricle, endolymphatic duct, and sac together with connecting pathways. The utricular duct (UD) and utriculo-endolymphatic valve (UEV or Bast's valve) were demonstrated three-dimensionally for the first time. The reunion duct was displayed with micro-CT. It may serve as a safety valve to maintain cochlear endolymph homeostasis under certain conditions. Discussion: The thin reunion duct seems to play a minor role in the exchange of endolymph between the cochlea and vestibule under normal conditions. The saccule wall appears highly flexible, which may explain occult hydrops occasionally preceding symptoms in MD on magnetic resonance imaging (MRI). The design of the UEV and connecting ducts suggests that there is a reciprocal exchange of fluid among the utricle, semicircular canals, and the EDS. Based on the anatomic framework and previous experimental data, we speculate that precipitous vestibular symptoms in MD arise from a sudden increase in endolymph pressure caused by an uncontrolled endolymphatic sac secretion. A rapid rise in UD pressure, mediated along the fairly wide UEV, may underlie the acute vertigo attack, refuting the rupture/K+-intoxication theory.
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Affiliation(s)
- Hao Li
- Department of Surgical Sciences, Section of Otolaryngology and Head and Neck Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Gunesh P. Rajan
- Department of Otolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- Department of Otolaryngology, Head and Neck Surgery Division of Surgery, Medical School, University of Western Australia, Perth, WA, Australia
| | - Jeremy Shaw
- Centre for Microscopy, Characterisation and Analysis, Perth, WA, Australia
| | - Seyed Alireza Rohani
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Hanif M. Ladak
- Department of Medical Biophysics and Department of Electrical and Computer Engineering, Western University, London, ON, Canada
| | - Sumit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Helge Rask-Andersen
- Department of Surgical Sciences, Section of Otolaryngology and Head and Neck Surgery, Uppsala University Hospital, Uppsala, Sweden
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Li H, Schart-Moren N, Rajan G, Shaw J, Rohani SA, Atturo F, Ladak HM, Rask-Andersen H, Agrawal S. Vestibular Organ and Cochlear Implantation-A Synchrotron and Micro-CT Study. Front Neurol 2021; 12:663722. [PMID: 33897611 PMCID: PMC8058461 DOI: 10.3389/fneur.2021.663722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Reports vary on the incidence of vestibular dysfunction and dizziness in patients following cochlear implantation (CI). Disequilibrium may be caused by surgery at the cochlear base, leading to functional disturbances of the vestibular receptors and endolymphatic duct system (EDS) which are located nearby. Here, we analyzed the three-dimensional (3D) anatomy of this region, aiming to optimize surgical approaches to limit damage to the vestibular organ. Material and Methods: A total of 22 fresh-frozen human temporal bones underwent synchrotron radiation phase-contrast imaging (SR-PCI). One temporal bone underwent micro-computed tomography (micro-CT) after fixation and staining with Lugol's iodine solution (I2KI) to increase tissue contrast. We used volume-rendering software to create 3D reconstructions and tissue segmentation that allowed precise assessment of anatomical relationships and topography. Macerated human ears belonging to the Uppsala collection were also used. Drilling and insertion of CI electrodes was performed with metric analyses of different trajectories. Results and Conclusions: SR-PCI and micro-CT imaging demonstrated the complex 3D anatomy of the basal region of the human cochlea, vestibular apparatus, and EDS. Drilling of a cochleostomy may disturb vestibular organ function by injuring the endolymphatic space and disrupting fluid barriers. The saccule is at particular risk due to its proximity to the surgical area and may explain immediate and long-term post-operative vertigo. Round window insertion may be less traumatic to the inner ear, however it may affect the vestibular receptors.
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Affiliation(s)
- Hao Li
- Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Nadine Schart-Moren
- Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
- Section of Otolaryngology, Head and Neck Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Gunesh Rajan
- Department of Otolaryngology, Head & Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- Department of Otolaryngology, Head & Neck Surgery, Division of Surgery, Medical School, University of Western Australia, Perth, WA, Australia
| | - Jeremy Shaw
- Centre for Microscopy, Characterization and Analysis, Perth, WA, Australia
| | - Seyed Alireza Rohani
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Francesca Atturo
- Department of Otolaryngology, University of Sapienza, Rome, Italy
| | - Hanif M. Ladak
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
- Department of Medical Biophysics and Department of Electrical and Computer Engineering, Western University, London, ON, Canada
| | - Helge Rask-Andersen
- Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Sumit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
- Department of Medical Biophysics and Department of Electrical and Computer Engineering, Western University, London, ON, Canada
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LeVasseur CM, Pitcairn S, Shaw J, Donaldson WF, Lee JY, Anderst WJ. The effects of age, pathology, and fusion on cervical neural foramen area. J Orthop Res 2021; 39:671-679. [PMID: 32167190 PMCID: PMC7487021 DOI: 10.1002/jor.24663] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/17/2019] [Accepted: 03/06/2020] [Indexed: 02/06/2023]
Abstract
Cervical radiculopathy is a relatively common neurological disorder, often resulting from mechanical compression of the nerve root within the neural foramen. Anterior cervical discectomy and fusion (ACDF) is a common treatment for radicular symptoms that do not resolve after conservative treatment. One mechanism by which ACDF is believed to resolve symptoms is by replacing degenerated disc tissue with bone graft to increase the neural foramen area, however in vivo evidence demonstrating this is lacking. The aim of this study was to evaluate the effects of age, pathology, and fusion on bony neural foramen area. Participants included 30 young adult controls (<35 years old), 23 middle-aged controls (36 to 60 years old), and 36 cervical arthrodesis patients tested before and after ACDF surgery. Participants' cervical spines were imaged in the neutral, full flexion, and full extension positions while seated within a biplane radiography system. A validated model-based tracking technique determined three-dimensional vertebral position and orientation and automated software identified the neural foramen area in each head position. The neural foramen area decreased throughout the entire sub-axial cervical spine with age and pathology, however, no changes in neural foramen area were observed due solely to replacing degenerated disc tissue with bone graft. The neural foramen area was not associated with disc height in young adult controls, but moderate to strong associations were observed in middle-aged controls. The results provide evidence to inform the debate regarding localized versus systemic spinal degeneration and provide novel insight into the mechanism of pain relief after ACDF.
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Affiliation(s)
| | - Samuel Pitcairn
- Department of Orthopedic Surgery University of Pittsburgh Pittsburgh Pennsylvania
| | - Jeremy Shaw
- Department of Orthopedic Surgery University of Pittsburgh Pittsburgh Pennsylvania
| | - William F. Donaldson
- Department of Orthopedic Surgery University of Pittsburgh Pittsburgh Pennsylvania
| | - Joon Y. Lee
- Department of Orthopedic Surgery University of Pittsburgh Pittsburgh Pennsylvania
| | - William J. Anderst
- Department of Orthopedic Surgery University of Pittsburgh Pittsburgh Pennsylvania
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De Buitléir C, O' Connor E, Satti MM, Shaw J, Liew A. Efficacy and safety of a sodium-glucose co-transporter-2 inhibitor versus placebo as an add-on therapy for people with type 2 diabetes inadequately treated with metformin and a dipeptidyl peptidase-4 inhibitor: a systematic review and meta-analysis of randomised controlled trials. Diabet Med 2021; 38:e14409. [PMID: 32979231 DOI: 10.1111/dme.14409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022]
Abstract
AIMS To conduct a systematic review and meta-analysis to assess the efficacy, safety and tolerability of sodium-glucose co-transporter-2 inhibitors vs placebo as add-on therapy after metformin and dipeptidyl peptidase-4 inhibitor dual therapy in type 2 diabetes. METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number: CRD42018099398). A search was conducted via PubMed, www.clinicaltrials.gov and Cochrane Central Register of Controlled Trials of relevant randomised controlled trials up until 14 August 2020 that compared sodium-glucose co-transporter-2 inhibitors vs placebo as add-on therapy after metformin and dipeptidyl peptidase-4 inhibitor therapy. A random-effects model was used. RESULTS Six randomised controlled trials (1661 participants) met the inclusion criteria. Compared with placebo, sodium-glucose co-transporter-2 inhibitor treatment, as add-on to metformin and dipeptidyl peptidase-4 inhibitor therapy, was associated with a significant reduction in HbA1c level [mean difference -8 mmol/mol, 95% CI -10, -6 (-0.7%, 95% CI -0.9, -0.6); P < 0.00001], in fasting plasma glucose level [mean difference -1.70 mmol/l, 95% CI -1.91, -1.49; P < 0.00001], in weight (mean difference -1.76 kg, 95% CI -2.04, -1.48; P < 0.00001) and in blood pressure (systolic blood pressure: mean difference -3.6 mmHg, 95% CI -4.8, -2.4; P < 0.00001; diastolic blood pressure: mean difference -1.5 mmHg; 95% CI -2.4, -0.6; P = 0.002). Genital mycotic infections (odds ratio 7.37, 95% CI 3.06, 17.76; P < 0.00001) were more common with sodium-glucose co-transporter-2 inhibitors, but there was no significant statistical difference in urinary tract infections (odds ratio 1.16, 95% CI 0.63, 2.13; P = 0.64), in hypoglycaemia (odds ratio 1.36, 95% CI 0.61, 3.04; P = 0.45), or in discontinuation rates due to adverse events (odds ratio 1.52, 95% CI 0.78, 2.97; P = 0.22) between the two groups. CONCLUSIONS In comparison with placebo, add-on therapy with a sodium-glucose co-transporter-2 inhibitor is significantly more efficacious in lowering HbA1c , fasting plasma glucose and weight in people with type 2 diabetes following inadequate glycaemic control with metformin and a dipeptidyl peptidase-4 inhibitor. The rate of discontinuation due to adverse events was similar despite higher risk of genital mycotic infections.
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Affiliation(s)
- C De Buitléir
- Galway University Hospital, Galway, Ireland
- National University of Ireland, Galway, Ireland
| | - E O' Connor
- Portiuncula University Hospital, Ballinasloe, Ireland
| | - M M Satti
- National University of Ireland, Galway, Ireland
| | - J Shaw
- Newcastle University Translational and Clinical Research Institute, Newcastle-upon-Tyne, UK
| | - A Liew
- Galway University Hospital, Galway, Ireland
- National University of Ireland, Galway, Ireland
- Portiuncula University Hospital, Ballinasloe, Ireland
- Newcastle University Translational and Clinical Research Institute, Newcastle-upon-Tyne, UK
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Noaman S, Neil C, O'Brien J, Frenneaux M, Hare J, Shaw J, Gay A, Bloom J, Stub D, Walton A, Cox N, Wang B, Duffy S, Taylor A, Kaye D, Chan W. Effect of Upstream Doxycycline During Primary Percutaneous Coronary Intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI) on Infarct Size and Left Ventricular (LV) Remodelling: the SALVAGE MI Randomised Trial. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fernando H, Duong T, Huynh K, Noonan J, Shaw J, Duffy S, Nehme Z, Smith K, Myles P, Meikle P, Peter K, Stub D. Lignocaine Versus Opioids in Coronary Intervention: Assessing Antiplatelet Activity and Ticagrelor Levels (LOCAL) Study. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.007] [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: 11/28/2022]
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Zheng W, Noaman S, Batchelor R, Bloom J, Hanson L, Stub D, Cox N, Walton A, Shaw J, Duffy S, French C, Yang Y, Chan W. Characteristics and Predictors of Adverse Prognosis Among Patients Presenting With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Wong N, Dinh D, Brennan A, Batchelor R, Duffy S, Shaw J, Chan W, Layland J, Van GW, Reid C, Liew D, Stub D. Incidence, Predictors, and Clinical Implications of New Renal Impairment Following Percutaneous Coronary Intervention. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nan Tie E, Fernando H, Nehme Z, Dinh D, Andrew E, Brennan A, Zaman S, Liew D, Stephenson M, Lefkovits J, Peter K, Duffy S, Shaw J, Smith K, Stub D. Sex Differences in Pre-hospital Analgesia and Outcomes in Patients Presenting with Acute Coronary Syndromes. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Muzny C, Schwebke J, Nyirjesy P, Kaufman G, Mena L, Lazenby G, Van Gerwen O, Graves K, Arbuckle J, Carter B, McMahon C, Shaw J, Pandey B, Chavoustie S. A phase 3, multi-center, prospective, randomized, placebo-controlled, delayed treatment, double-blind study to evaluate the effectiveness and safety of a single oral dose of 2 grams of secnidazole for the treatment of trichomoniasis in women. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2020.08.129] [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: 11/28/2022]
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Coupal D, Amjad A, Sadikov E, Fay A, Glass L, Hordos J, Liu D, Lukowich K, Marchant K, McKenzie J, McVicar L, Otitoju C, Penna S, Shaw J, Thakur-Singh V, Smith A, Tremblay C, Leong N. An Analysis of Learning Curve Effect on the Speed and Quality of High Dose Rate Prostate Brachytherapy Procedures. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Geerligs L, Shepherd HL, Butow P, Shaw J, Masya L, Cuddy J, Rankin NM. What factors influence organisational readiness for change? Implementation of the Australian clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP). Support Care Cancer 2020; 29:3235-3244. [PMID: 33095356 DOI: 10.1007/s00520-020-05836-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/15/2020] [Indexed: 11/24/2022]
Abstract
AIMS Translation of evidence-based psycho-oncology interventions into routine care can significantly improve patient outcomes, yet effective implementation remains challenging due to numerous real-world barriers. A key factor that may influence implementation is organisational readiness for change. This mixed method study sought to identify factors associated with organisational readiness for implementing the Australian clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP). METHODS We collected data from multidisciplinary staff across six Australian cancer services who were preparing to implement the ADAPT CP. Services were categorised as having 'high' versus 'mid-range' organisational readiness based on a median split on the Organizational Readiness for Implementing Change (ORIC) questionnaire (score range = 12-60). Qualitative data from the semi-structured interviews based on the Promoting Action Research in Health Services (PARiHS) framework were analysed thematically and compared for services with high- versus mid-range organisational readiness. RESULTS Three services with high- (mean ORIC range, 52.25-56.88), and three with mid-range (range, 38.75-46.39) organisational readiness scores were identified. Staff at services reporting higher readiness described a more collaborative and proactive service culture, strong communication processes and greater role flexibility. They also reported greater confidence in overcoming anticipated barriers and clearer strategies for addressing issues. CONCLUSIONS Levels of organisational readiness were related to distinct qualitative themes. Targeting these issues in services where readiness is mid-range or low prior to full-scale roll-out may improve staff levels of confidence and efficacy in implementing psycho-oncology-focused interventions.
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Affiliation(s)
- L Geerligs
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia
| | - H L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-Making (CeMPED), The University of Sydney, Sydney, NSW, Australia
| | - P Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-Making (CeMPED), The University of Sydney, Sydney, NSW, Australia
| | - J Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-Making (CeMPED), The University of Sydney, Sydney, NSW, Australia
| | - L Masya
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia
| | - J Cuddy
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia
| | | | - N M Rankin
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. .,School of Public Health, Faculty of Medicine and Health, The University of Sydney, c/o Charles Perkins Centre Level 2 (D17), Sydney, NSW, 2006, Australia.
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Soobiah C, Desveaux L, Bhatia S, Shaw J. Identifying and Overcoming Policy‐Level Barriers to the Implementation of Digital Health Innovation in Ontario: Qualitative Study. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- C. Soobiah
- Womens' College Hospital Institute for Health System Solutions and Virtual Care Toronto ON Canada
| | | | - S. Bhatia
- Women's College Hospital Toronto ON Canada
| | - J. Shaw
- Women's College Hospital Toronto ON Canada
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Breton M, Ann Smithman M, Lamoureux‐Lamarche C, Dumas Pilon M, Keely E, Farrell G, Singer A, Woods P, Bibeau C, Nabelsi V, Gaboury I, Gagnon M, Steele Gray C, Shaw J, Hudon C, Aubrey‐Bassler K, Bush P, Côté‐Boileau É, Gagnon J, Visca R, Liddy C. DISSEMINATION, IMPLEMENTATION, AND IMPACT. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- M. Breton
- University of Sherbrooke Longueuil QC Canada
| | | | | | - M. Dumas Pilon
- Collège québécois des médecins de famille Laval QC Canada
| | - E. Keely
- Department of Medicine University of Ottawa Ottawa ON Canada
| | | | - A. Singer
- University of Manitoba Winnipeg MB Canada
| | | | | | - V. Nabelsi
- Université du Québec en Outaouais Gatineau QC Canada
| | - I. Gaboury
- University of Sherbrooke Longueuil QC Canada
| | | | | | - J. Shaw
- Women's College Hospital Toronto ON Canada
| | - C. Hudon
- University of Sherbrooke Sherbrooke QC Canada
| | | | - P. Bush
- McGill University Montréal QC Canada
| | | | - J. Gagnon
- McGill University Montréal QC Canada
| | - R. Visca
- McGill University Montréal QC Canada
| | - C. Liddy
- Family Medicine C.T. Lamont Primary Health Care Research Centre Bruyère Research Institute Ottawa ON Canada
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Allwood BW, van der Zalm MM, Amaral AFS, Byrne A, Datta S, Egere U, Evans CA, Evans D, Gray DM, Hoddinott G, Ivanova O, Jones R, Makanda G, Marx FM, Meghji J, Mpagama S, Pasipanodya JG, Rachow A, Schoeman I, Shaw J, Stek C, van Kampen S, von Delft D, Walker NF, Wallis RS, Mortimer K. Post-tuberculosis lung health: perspectives from the First International Symposium. Int J Tuberc Lung Dis 2020; 24:820-828. [PMID: 32912387 DOI: 10.5588/ijtld.20.0067] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
ALTHOUGH CURABLE, TB frequently leaves the individual with chronic physical and psycho-social impairment, but these consequences have been largely neglected. The 1st International Post-Tuberculosis Symposium (Stellenbosch, South Africa) was held to discuss priorities and gaps in addressing this issue. A barrier to progress has been the varied terminology and nomenclature, so the Delphi process was used to achieve consensus on definitions. Lack of sufficient evidence hampered definitive recommendations in most domains, including prevention and treatment of post-TB lung disease (PTLD), but the discussions clarified the research needed. A consensus was reached on a toolkit for future PTLD measurement and on PTLD patterns to be considered. The importance of extra-pulmonary consequences and progressive impairment throughout the life-course was identified, including TB recurrence and increased mortality. Patient advocates emphasised the need to address the psychological and social impacts post TB and called for clinical guidance. More generally, there is an urgent need for increased awareness and research into post-TB complications.
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Affiliation(s)
- B W Allwood
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg
| | - M M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - A F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - A Byrne
- Heart Lung Clinic, St Vincent´s Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - S Datta
- Department of Infectious Disease, Imperial College London, London, UK, Innovation For Health And Development, Laboratory for Research and Development, Universidad Peruana Cayetano Heredia, Lima, Innovacion por la Salud y el Desarollo, Asociación Benéfica Prisma, Lima, Peru
| | - U Egere
- IMPALA Consortium and Community Health Systems Group, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - C A Evans
- Department of Infectious Disease, Imperial College London, London, UK, Innovation For Health And Development, Laboratory for Research and Development, Universidad Peruana Cayetano Heredia, Lima, Innovacion por la Salud y el Desarollo, Asociación Benéfica Prisma, Lima, Peru
| | - D Evans
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - D M Gray
- Division of Paediatric Pulmonology, Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - G Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - O Ivanova
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany
| | - R Jones
- Faculty of Health, Plymouth University, Plymouth, UK
| | | | - F M Marx
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa, DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Faculty of Science, Stellenbosch University, Johannesburg, South Africa
| | - J Meghji
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - S Mpagama
- Kibong´oto Infectious Diseases Hospital, Kibong´oto, Tanzania
| | - J G Pasipanodya
- Center for Infectious Diseases Research & Experimental Therapeutics, Texas Tech University Health Sciences Center, Dallas, TX, USA
| | - A Rachow
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich, Munich, Germany, German Centre for Infection Research (DFIZ), Partner Site Munich, Munich, Germany
| | | | - J Shaw
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg
| | - C Stek
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - S van Kampen
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - N F Walker
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - R S Wallis
- Aurum Institute, Johannesburg, South Africa
| | - K Mortimer
- Liverpool School of Tropical Medicine, Liverpool, UK, International Union against Tuberculosis and Lung Disease, Paris, France
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Sun K, Zhang T, Tan L, Zhou D, Qian Y, Gao X, Song F, Bian H, Lu Z, Dang J, Gao H, Shaw J, Chen S, Chen G, Rao Y. Interface Catalysts of Ni/Co 2N for Hydrogen Electrochemistry. ACS Appl Mater Interfaces 2020; 12:29357-29364. [PMID: 32501672 DOI: 10.1021/acsami.0c06644] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The development of active, durable, and nonprecious electrocatalysts for hydrogen electrochemistry is highly desirable but challenging. In this work, we design and fabricate a novel interface catalyst of Ni and Co2N (Ni/Co2N) for hydrogen evolution reaction (HER) and hydrogen oxidation reaction (HOR). The Ni/Co2N interfacial catalysts not only achieve a current density of -10.0 mA cm-2 with an overpotential of 16.2 mV for HER but also provide a HOR current density of 2.35 mA cm-2 at 0.1 V vs reversible hydrogen electrode (RHE). Furthermore, the electrode couple made of the Ni/Co2N interfacial catalysts requires only a cell voltage of 1.57 V to gain a current density of 10 mA cm-2 for overall water splitting. Hybridizations in the three elements of Ni-3d, N-2p, and Co-3d result in charge transfer in the interfacial junction of the Ni and Co2N materials. Our density functional theory calculations show that both the interfacial N and Co sites of Ni/Co2N prefer to hydrogen adsorption in the hydrogen catalytic activities. This study provides a new approach for the construction of multifunctional catalysts for hydrogen electrochemistry.
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Affiliation(s)
- Kaixi Sun
- Key Laboratory of Pesticide & Chemical Biology Ministry of Education, College of Chemistry, Central China Normal University, Wuhan, Hubei 430079, China
- Department of Chemistry and Biochemistry, Utah State University, Logan, Utah 84322, United States
| | - Tong Zhang
- Department of Chemistry and Biochemistry, Utah State University, Logan, Utah 84322, United States
- Beijing National Laboratory for Molecular Sciences and State Key Laboratory of Molecular Reaction Dynamics, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Liming Tan
- Department of Chemistry and Biochemistry, Utah State University, Logan, Utah 84322, United States
| | - Dexia Zhou
- Key Laboratory of Applied Surface and Colloid Chemistry, Ministry of Education, School of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi'an 710119, China
| | - Yuqin Qian
- Department of Chemistry and Biochemistry, Utah State University, Logan, Utah 84322, United States
| | - Xiaoxia Gao
- Key Laboratory of Pesticide & Chemical Biology Ministry of Education, College of Chemistry, Central China Normal University, Wuhan, Hubei 430079, China
| | - Fahui Song
- Key Laboratory of Pesticide & Chemical Biology Ministry of Education, College of Chemistry, Central China Normal University, Wuhan, Hubei 430079, China
| | - Hongtao Bian
- Key Laboratory of Applied Surface and Colloid Chemistry, Ministry of Education, School of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi'an 710119, China
| | - Zhou Lu
- Anhui Province Key Laboratory of Optoelectronic Material Science and Technology, School of Physics of Electronic Information, Anhui Normal University, Wuhu, Anhui 241002, China
| | - Jingshuang Dang
- Key Laboratory of Applied Surface and Colloid Chemistry, Ministry of Education, School of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi'an 710119, China
| | - Hong Gao
- Beijing National Laboratory for Molecular Sciences and State Key Laboratory of Molecular Reaction Dynamics, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Jeremy Shaw
- Key Laboratory of Pesticide & Chemical Biology Ministry of Education, College of Chemistry, Central China Normal University, Wuhan, Hubei 430079, China
| | - Shutang Chen
- Honda Research Institute, USA, Inc., San Jose, California 95134, United States
| | - Gugang Chen
- Honda Research Institute, USA, Inc., San Jose, California 95134, United States
| | - Yi Rao
- Department of Chemistry and Biochemistry, Utah State University, Logan, Utah 84322, United States
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Borschmann R, Tibble H, Spittal MJ, Preen D, Pirkis J, Larney S, Rosen DL, Young JT, Love AD, Altice FL, Binswanger IA, Bukten A, Butler T, Chang Z, Chen CY, Clausen T, Christensen PB, Culbert GJ, Degenhardt L, Dirkzwager AJE, Dolan K, Fazel S, Fischbacher C, Giles M, Graham L, Harding D, Huang YF, Huber F, Karaminia A, Keen C, Kouyoumdjian FG, Lim S, Møller L, Moniruzzaman A, Morenoff J, O’Moore E, Pizzicato LN, Pratt D, Proescholdbell SK, Ranapurwala SI, Shanahan ME, Shaw J, Slaunwhite A, Somers JM, Spaulding AC, Stern MF, Viner KM, Wang N, Willoughby M, Zhao B, Kinner SA. The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis. Int J Popul Data Sci 2020; 5:1145. [PMID: 32935053 PMCID: PMC7473255 DOI: 10.23889/ijpds.v5i1.1145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. OBJECTIVES To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. METHODS We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. RESULTS The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. CONCLUSIONS The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. KEY WORDS Mortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.
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Affiliation(s)
- R Borschmann
- Justice Health Unit, Centre for Health Equity, The University of Melbourne, 207 Bouverie street, Carlton 3010, Melbourne, Victoria, AUSTRALIA
| | - H Tibble
- Usher Institute of Population Health Sciences and Informatics, Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
| | - MJ Spittal
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - D Preen
- The University of Western Australia, School of Population and Global Health, Nedlands, AUSTRALIA
| | - J Pirkis
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - S Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, AUSTRALIA
| | - DL Rosen
- University of North Carolina at Chapel Hill, North Carolina, USA
| | - JT Young
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - AD Love
- University of Melbourne, Melbourne School of Population Health, Melbourne, AUSTRALIA
| | - FL Altice
- Yale University School of Medicine and Public Health, New Haven, Connecticut, USA
| | - IA Binswanger
- Kaiser Permanente Colorado, Colorado Permanente Medical Group, USA
| | - A Bukten
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - T Butler
- University of New South Wales, Kirby Institute, Sydney, AUSTRALIA
| | - Z Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SWEDEN
| | - C-Y Chen
- National Yang-Ming University, Institute of Public Health, TAIWAN
| | - T Clausen
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - PB Christensen
- Department of Infectious Diseases, Odense University Hospital and Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, DENMARK
| | - GJ Culbert
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, USA
| | - L Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, AUSTRALIA
| | - AJE Dirkzwager
- Netherlands Institute for the Study of Crime and Law Enforcement (NSCR), Amsterdam, NETHERLANDS
| | - K Dolan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, AUSTRALIA
| | - S Fazel
- University of Oxford, Department of Psychiatry, Medical Sciences Division, Oxford, ENGLAND
| | - C Fischbacher
- NHS National Services, Information Services Division, Edinburgh, SCOTLAND
| | - M Giles
- Edith Cowan University, School of Arts and Humanities, Joondalup, AUSTRALIA
| | - L Graham
- NHS National Services, Information Services Division, Edinburgh, SCOTLAND
| | - D Harding
- University of California Berkeley, USA
| | - Y-F Huang
- Taiwan Centers for Disease Control, Taipei, TAIWAN
| | - F Huber
- Cayenne General Hospital, COREVIH Guyane, and Reseau Kikiwi, Cayenne, French Guiana, FRANCE
| | - A Karaminia
- University of New South Wales, Sydney, AUSTRALIA
| | - C Keen
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - FG Kouyoumdjian
- McMaster University, Department of Family Medicine, Hamilton, Ontario, CANADA
| | - S Lim
- New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Division of Epidemiology, New York, USA
| | - L Møller
- World Health Organization, Division of Noncommunicable Diseases and Promoting Health through the Life-course, Marmorvej, DENMARK
| | - A Moniruzzaman
- Somers Research Group, Simon Fraser University, Burnaby, British Columbia, CANADA
| | - J Morenoff
- University of Michigan, Department of Sociology, USA
| | - E O’Moore
- Public Health England, London, ENGLAND
| | - LN Pizzicato
- Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - D Pratt
- University of Manchester, Division of Psychology and Mental Health, School of Health Sciences, Manchester, ENGLAND
| | - SK Proescholdbell
- North Carolina Department of Health and Human Services, North Carolina, USA
| | - SI Ranapurwala
- Department of Epidemiology, University of North Carolina at Chapel Hill, USA
| | - ME Shanahan
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, USA
| | - J Shaw
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, Manchester, ENGLAND
| | - A Slaunwhite
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, British Columbia, CANADA
| | - JM Somers
- Somers Research Group, Simon Fraser University, Burnaby, British Columbia, CANADA
| | - AC Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - MF Stern
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - KM Viner
- Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - N Wang
- Institute of Public Health, National Yang-Ming University, TAIWAN
| | - M Willoughby
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - B Zhao
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, British Columbia, CANADA
| | - SA Kinner
- Murdoch Children’s Research Institute, Centre for Adolescent Health, Melbourne, Victoria, AUSTRALIA
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