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Luyster FS, Baniak LM, Imes CC, Jeon B, Morris JL, Orbell S, Scott P. Association of comorbid obstructive sleep apnea and insomnia with risk of major adverse cardiovascular events in sleep medicine center patients. Sleep Health 2024:S2352-7218(24)00057-3. [PMID: 38704352 DOI: 10.1016/j.sleh.2024.03.001] [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: 07/24/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES To investigate the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events, including myocardial infarction, unstable angina, congestive heart failure, and stroke, in adults with suspected sleep disorders who underwent sleep apnea testing. METHODS We conducted a retrospective analysis of electronic medical records data from patients with clinical encounters at sleep medicine centers to identify patients with comorbid obstructive sleep apnea and insomnia, obstructive sleep apnea only, insomnia only, and patients without a diagnosis of obstructive sleep apnea or insomnia (i.e., controls). Obstructive sleep apnea, insomnia, comorbidities, and new-onset major adverse cardiovascular events were ascertained by ICD-9-CM and ICD-10-CM codes. Multivariable adjusted Cox proportional regression models evaluated the risk of major adverse cardiovascular events over a 10-year follow-up period. RESULTS A total of 3951 patients, 226 controls, 2107 with obstructive sleep apnea only, 276 with insomnia only, and 1342 with comorbid obstructive sleep apnea and insomnia, were included in the analysis. Compared to controls, comorbid obstructive sleep apnea and insomnia were associated with a significantly higher risk of developing major adverse cardiovascular events (hazard ratio 3.60, 95 CI%: 2.33-5.91) in unadjusted analyses. The relationship between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events remained after adjustment for demographic and behavioral factors, but not after further adjustment for comorbidities. The greatest risk of major adverse cardiovascular events was found among younger adults with comorbid obstructive sleep apnea and insomnia. Obstructive sleep apnea only was associated with greater risk of major adverse cardiovascular events in unadjusted analyses only (hazard ratio 2.77, 95% CI: 1.80-4.54). Insomnia only was not significantly associated with increased risk of major adverse cardiovascular events. CONCLUSIONS Comorbid obstructive sleep apnea and insomnia may be a high-risk group for major adverse cardiovascular events, particularly younger adults. Further research is needed to better understand the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events risk.
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Affiliation(s)
- Faith S Luyster
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
| | - Lynn M Baniak
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Christopher C Imes
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bomin Jeon
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Jonna L Morris
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Staci Orbell
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul Scott
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Meertens R, Lopez B, Crone B, Gundry M, Metcalfe-Smith E, Gibbard W, Jubb T, Manning F, Scott P, McWilliam R. Development of an opportunistic diagnostic prediction algorithm for osteoporosis and fragility fracture risk estimates from forearm radiographs (The OFFER1 Study). JBMR Plus 2024; 8:ziae020. [PMID: 38505820 PMCID: PMC10945724 DOI: 10.1093/jbmrpl/ziae020] [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] [Received: 08/04/2023] [Revised: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 03/21/2024] Open
Abstract
Osteoporosis and associated fractures are an increasingly prevalent concern with an ageing population. This study reports testing of IBEX Bone Health (IBEX BH) software, applied following acquisition of forearm radiographs. IBEX Bone Health analyses the radiograph to measure areal bone mineral density (aBMD) at the examination site. A non-randomized cross-sectional study design was performed involving 261 (254 after exclusions) participants (112/142 m/f; mean age 70.8 years (SD+/-9.0); 53 with osteoporosis). They underwent posterior-anterior distal forearm radiographs; dual X-ray absorptiometry (DXA) of the wrists, hips, and lumbar spine; and questionnaires exploring clinical risk factors. IBEX Bone Health automatically identifies regions of interest (ROI) at the ultra-distal (UD) and distal third (TD) regions of the radius. Analysis investigated area under the receiver operating characteristics curve performance of IBEX BH for prediction of (i) osteoporosis (based on clinical reporting of the hip and spine DXA) and (ii) treatment recommendations by Fracture Risk Assessment Tool (FRAX) inclusive of neck of femur (NoF) areal bone mineral density (aBMD) results following National Osteoporosis Guideline Group (NOGG) guidelines. Area under the receiver operating characteristics curve for osteoporosis prediction at the UD and TD ROIs were 0.86 (99% confidence interval (CI) [0.80, 0.91]) and 0.81 (99% CI [0.75, 0.88]), respectively. Area under the receiver operating characteristics curve for treatment recommendation using FRAX inclusive of NoF aBMD at the UD and TD ROIs were 0.95 (99% CI [0.91, 1.00]) and 0.97 (99% CI [0.93,1.00]), respectively. With a matched sensitivity to FRAX (without NoF aBMD) 0.93 (99% CI [0.78, 0.99]), IBEX BH predicted at the UD and TD ROIs recommended treatment outcomes by NOGG guidelines using FRAX (with NoF aBMD) with specificity 0.89 (99% CI 0.83, 0.94]) and 0.93 (99% CI [0.87, 0.97]), respectively. This is compared with 0.60 (99% CI [0.51, 0.69]) for FRAX (without NoF aBMD). Results demonstrate the potential clinical utility of IBEX BH as an opportunistic screening tool.
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Affiliation(s)
- Robert Meertens
- University of Exeter, Medical Imaging Exeter, EX1 2LU, United Kingdom
| | - Ben Lopez
- Ibex Innovations Ltd., Sedgefield, TS21 3FD, United Kingdom
| | - Ben Crone
- Ibex Innovations Ltd., Sedgefield, TS21 3FD, United Kingdom
| | - Mike Gundry
- University of Exeter, Medical Imaging Exeter, EX1 2LU, United Kingdom
| | | | - Warren Gibbard
- Ibex Innovations Ltd., Sedgefield, TS21 3FD, United Kingdom
| | - Thomas Jubb
- Ibex Innovations Ltd., Sedgefield, TS21 3FD, United Kingdom
| | - Fay Manning
- University of Exeter, Medical Imaging Exeter, EX1 2LU, United Kingdom
| | - Paul Scott
- Ibex Innovations Ltd., Sedgefield, TS21 3FD, United Kingdom
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Ferone E, Segev A, Tempo E, Gentile P, Elsanhoury A, Baggio C, Artico J, Bhatti P, Scott P, Bobbio E, Merlo M, Ameri P, Sinagra G, Tschöpe C, Bromage D, Cannata A. Current treatment and immunomodulation strategies in Acute Myocarditis. J Cardiovasc Pharmacol 2024; 83:00005344-990000000-00282. [PMID: 38335530 PMCID: PMC11067867 DOI: 10.1097/fjc.0000000000001542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/23/2023] [Indexed: 02/12/2024]
Abstract
Myocarditis is an inflammatory disease of the myocardium characterized by a great heterogeneity of presentation and evolution. Treatment of myocarditis is often supportive and the evidence for immunosuppression is scarce and debated. Conventional treatment is based on clinical presentation, ranging from conservative to advanced mechanical assist devices. In this setting, immunosuppression and immunomodulation therapies are mostly reserved for patients presenting with major clinical syndromes. In this review, we will summarise the current evidence and strategies for conventional and immunosuppressive treatments for patients presenting with acute myocarditis.
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Affiliation(s)
- Emma Ferone
- School of Cardiovascular Medicine and Sciences, King's College London, London, United Kingdom
| | - Amitai Segev
- Cardiovascular Division, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Erika Tempo
- Department of Internal Medicine, University of Genova, Genova, Italy
| | | | - Ahmed Elsanhoury
- Berlin Institute of Health (BIH) Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology, and Intensive Medicine (CVK), German Heart Center at Charite (DHZC), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Chiara Baggio
- CardioThoracoVascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy
| | - Jessica Artico
- Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Prashan Bhatti
- School of Cardiovascular Medicine and Sciences, King's College London, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Paul Scott
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Emanuele Bobbio
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marco Merlo
- CardioThoracoVascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy
| | - Pietro Ameri
- Department of Internal Medicine, University of Genova, Genova, Italy
- Cardiovascular Disease Unit, Cardiac, Thoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy; and
| | - Gianfranco Sinagra
- CardioThoracoVascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy
| | - Carsten Tschöpe
- Berlin Institute of Health (BIH) Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology, and Intensive Medicine (CVK), German Heart Center at Charite (DHZC), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Daniel Bromage
- School of Cardiovascular Medicine and Sciences, King's College London, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Antonio Cannata
- School of Cardiovascular Medicine and Sciences, King's College London, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
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Kotadia ID, O'Dowling R, Aboagye A, Crawley RJ, Bodagh N, Gharaviri A, O'Hare D, Solis‐Lemus JA, Roney CH, Sim I, Ramsey D, Newby D, Chiribiri A, Plein S, Sztriha L, Scott P, Masci P, Harrison J, Williams MC, Birns J, Somerville P, Bhalla A, Niederer S, O'Neill M, Williams SE. High Prevalence of New Clinically Significant Findings in Patients With Embolic Stroke of Unknown Source Evaluated by Cardiac Magnetic Resonance Imaging. J Am Heart Assoc 2024; 13:e031489. [PMID: 38240222 PMCID: PMC11056130 DOI: 10.1161/jaha.123.031489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/05/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Embolic stroke of unknown source (ESUS) accounts for 1 in 6 ischemic strokes. Current guidelines do not recommend routine cardiac magnetic resonance (CMR) imaging in ESUS, and beyond the identification of cardioembolic sources, there are no data assessing new clinical findings from CMR in ESUS. This study aimed to assess the prevalence of new cardiac and noncardiac findings and to determine their impact on clinical care in patients with ESUS. METHODS AND RESULTS In this prospective, multicenter, observational study, CMR imaging was performed within 3 months of ESUS. All scans were reported according to standard clinical practice. A new clinical finding was defined as one not previously identified through prior clinical evaluation. A clinically significant finding was defined as one resulting in further investigation, follow-up, or treatment. A change in patient care was defined as initiation of medical, interventional, surgical, or palliative care. From 102 patients recruited, 96 underwent CMR imaging. One or more new clinical findings were observed in 59 patients (61%). New findings were clinically significant in 48 (81%) of these patients. Of 40 patients with a new clinically significant cardiac finding, 21 (53%) experienced a change in care (medical therapy, n=15; interventional/surgical procedure, n=6). In 12 patients with a new clinically significant extracardiac finding, 6 (50%) experienced a change in care (medical therapy, n=4; palliative care, n=2). CONCLUSIONS CMR imaging identifies new clinically significant cardiac and noncardiac findings in half of patients with recent ESUS. Advanced cardiovascular screening should be considered in patients with ESUS. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT04555538.
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Affiliation(s)
- Irum D. Kotadia
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Robert O'Dowling
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Akosua Aboagye
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Richard J. Crawley
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Neil Bodagh
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Ali Gharaviri
- Centre for Cardiovascular Science, The University of EdinburghEdinburghUnited Kingdom
| | - Daniel O'Hare
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Jose Alonso Solis‐Lemus
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Caroline H. Roney
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Iain Sim
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | | | - David Newby
- Centre for Cardiovascular Science, The University of EdinburghEdinburghUnited Kingdom
| | - Amedeo Chiribiri
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Sven Plein
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | | | - Paul Scott
- King’s College HospitalLondonUnited Kingdom
| | - Pier‐Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | | | - Michelle C. Williams
- Centre for Cardiovascular Science, The University of EdinburghEdinburghUnited Kingdom
| | - Jonathan Birns
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Peter Somerville
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Ajay Bhalla
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Steven Niederer
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
| | - Mark O'Neill
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Guy’s and St Thomas’ National Health Service Foundation TrustLondonUnited Kingdom
| | - Steven E. Williams
- School of Biomedical Engineering and Imaging Sciences, King’s College LondonLondonUnited Kingdom
- Centre for Cardiovascular Science, The University of EdinburghEdinburghUnited Kingdom
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Morgan R, Haslam P, McCafferty I, Bryant T, Clarke C, McPherson S, Wells D, Gupta Y, See TC, Lakshminarayan R, Miller F, Scott P, Almazedi B, Bardgett H, Barnacle A, Shaida N, Manoharan D, Lewis M, Taylor J, Bhat R, Shaygi B, Ratnam L. Provision of Interventional Radiology Services 2023. Cardiovasc Intervent Radiol 2024; 47:3-25. [PMID: 37978066 PMCID: PMC10770229 DOI: 10.1007/s00270-023-03600-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Affiliation(s)
| | | | | | - Timothy Bryant
- University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | | | | | - David Wells
- University Hospitals of the North Midlands NHS Trust, Stoke-On-Trent, UK
| | - Yuri Gupta
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Teik Choon See
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Paul Scott
- Hull University Teaching Hospitals, Hull, UK
| | | | | | - Alex Barnacle
- Great Ormond Street Hospital for Children, London, UK
| | - Nadeem Shaida
- Cambridge University NHS Foundation Trust, Cambridge, UK
| | - Dinesh Manoharan
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Mark Lewis
- Norfolk and Norwich University Hospitals NHS Trust, Norwich, UK
| | - Jeremy Taylor
- Frimley Health Foundation Trust, Surrey, Frimley, UK
| | - Rajesh Bhat
- Ninewells Hospital and Medical School, Dundee, UK
| | - Behnam Shaygi
- London North West University Healthcare NHS Trust, London, UK
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6
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Parish O, Cannata A, Shamsi A, Jordan-Rios A, Albarjas M, Piper S, Scott P, Bromage D, McDonagh T. Prognostic Role of Contraindicated Drugs in Hospitalized Patients with Decompensated Heart Failure. J Pharmacol Exp Ther 2023; 386:205-211. [PMID: 37164369 DOI: 10.1124/jpet.122.001413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 03/24/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023] Open
Abstract
Due to the ageing population, patients often present to the hospital with a high burden of comorbidities and polypharmacy. For patients admitted with decompensated heart failure (HF), the evidence on the effects of contraindicated drugs on long-term mortality is scarce. Therefore, we aimed to investigate the effect of contraindicated medications on outcomes of patients admitted with decompensated HF. We analyzed all consecutive patients from the National Heart Failure Audit admitted to two tertiary centers with acutely decompensated HF between April 2020 and October 2021. We included medication classes listed as contraindicated (class III) in the most recent European and American guidelines on the management of HF. The primary outcome measure was in-hospital mortality. The secondary outcome measure was overall mortality. Overall, 716 patients admitted with acute HF were included. One-fifth (n = 156, 21.8%) were on at least one contraindicated medication at admission. The prevalence of comorbidities was comparable between medication groups. During hospitalization, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with increased in-hospital mortality (29% versus 9%, P = 0.013). On multivariable analyses, NSAID use was independently associated with worse in-hospital mortality (hazard ratio, 6.86; 95% confidence interval, 1.61-25.5; P = 0.005). However, other contraindicated medications were not associated with adverse outcomes. Postdischarge, the use of erythropoietin during admission was associated with increased mortality (54% versus 31%, P = 0.031). NSAID use is associated with increased in-hospital mortality for patients admitted with acute HF. However, inpatient use of other contraindicated medications was not associated with adverse in-hospital outcomes. Further studies are needed to confirm these results in larger and prospective cohorts. SIGNIFICANCE STATEMENT: Use of nonsteroidal anti-inflammatory drugs is associated with a worse in-hospital mortality in patients with decompensated heart failure. The prognostic role of other contraindicated medications remains still uncertain.
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Affiliation(s)
- Olivia Parish
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Antonio Cannata
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Aamir Shamsi
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Antonio Jordan-Rios
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Mohammad Albarjas
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Susan Piper
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Paul Scott
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Daniel Bromage
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
| | - Theresa McDonagh
- Department of Cardiology, King's College Hospital, London, United Kingdom (O.P., A.C., A.S., A.J.-R., S.P., P.S., D.B., T.M.) and Department of Cardiology, Princess Royal University Hospital, London, United Kingdom (M.A.)
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El-Bialy T, Aizenbud D, Sadeghi H, Scott P, Aizenbud I. Cloning, purification and characterization of human dentine matrix protein 1(DMP1). Saudi Dent J 2023; 35:553-558. [PMID: 37520603 PMCID: PMC10373089 DOI: 10.1016/j.sdentj.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/07/2023] [Accepted: 05/10/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Human teeth are composed mainly of dentin, formed by the odontoblasts. Dentin matrix protein 1 (DMP1) is one of odontoblast differentiation's most important growth factors. Human DMP1 has yet to be completely identified or studied. This study aimed to clone and characterize human DMP1. Materials and methods The DMP1 gene sequence was prepared and cloned by transfection of human 293 cells. Results The recombinant DMP1 was purified and characterized. Conclusion The results suggested its future use in dental tissue regeneration and tissue engineering.
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Affiliation(s)
- Tarek El-Bialy
- Division Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Dror Aizenbud
- Department of Orthodontics and Craniofacial Anomalies, School of Graduate Dentistry, Rambam Health Care Center and Technion Haifa, Israel
| | - Hamid Sadeghi
- Department of Dentistry, University of Alberta, Edmonton, Canada
| | - Paul Scott
- Department of Biochemistry, University of Alberta, Edmonton Canada
| | - Itay Aizenbud
- Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University, Jerusalem; Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel
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Coverdale JPC, Kostrhunova H, Markova L, Song H, Postings M, Bridgewater HE, Brabec V, Rogers NJ, Scott P. Triplex metallohelices have enantiomer-dependent mechanisms of action in colon cancer cells. Dalton Trans 2023; 52:6656-6667. [PMID: 37114730 DOI: 10.1039/d3dt00948c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Self-assembled enantiomers of an asymmetric di-iron metallohelix differ in their antiproliferative activities against HCT116 colon cancer cells such that the compound with Λ-helicity at the metals becomes more potent than the Δ compound with increasing exposure time. From concentration- and temperature-dependent 57Fe isotopic labelling studies of cellular accumulation we postulate that while the more potent Λ enantiomer undergoes carrier-mediated efflux, for Δ the process is principally equilibrative. Cell fractionation studies demonstrate that both enantiomers localise in a similar fashion; compound is observed mostly within the cytoskeleton and/or genomic DNA, with significant amounts also found in the nucleus and membrane, but with negligible concentration in the cytosol. Cell cycle analyses using flow cytometry reveal that the Δ enantiomer induces mild arrest in the G1 phase, while Λ causes a very large dose-dependent increase in the G2/M population at a concentration significantly below the relevant IC50. Correspondingly, G2-M checkpoint failure as a result of Λ-metallohelix binding to DNA is shown to be feasible by linear dichroism studies, which indicate, in contrast to the Δ compound, a quite specific mode of binding, probably in the major groove. Further, spindle assembly checkpoint (SAC) failure, which could also be responsible for the observed G2/M arrest, is established as a feasible mechanism for the Λ helix via drug combination (synergy) studies and the discovery of tubulin and actin inhibition. Here, while the Λ compound stabilizes F-actin and induces a distinct change in tubulin architecture of HCT116 cells, Δ promotes depolymerization and more subtle changes in microtubule and actin networks.
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Affiliation(s)
- J P C Coverdale
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
| | - H Kostrhunova
- The Czech Academy of Sciences, Institute of Biophysics, Kralovopolska 135, CZ-61265 Brno, Czech Republic
| | - L Markova
- The Czech Academy of Sciences, Institute of Biophysics, Kralovopolska 135, CZ-61265 Brno, Czech Republic
| | - H Song
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
- Beijing Area Major Laboratory of Peptide and Small Molecular Drugs, School of Pharmaceutical Sciences, Capital Medical University, Beijing, 100069, China
| | - M Postings
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
| | - H E Bridgewater
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
- Centre of Exercise, Sport and Life Science, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, UK
| | - V Brabec
- The Czech Academy of Sciences, Institute of Biophysics, Kralovopolska 135, CZ-61265 Brno, Czech Republic
| | - N J Rogers
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
| | - P Scott
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
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Kang H, Upton B, Scott P, Lewis M, Nagy J, Triche T. Abstract 825: Targeted nanospheres for the treatment of cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Conventional cancer therapy exploits sensitivity of dividing cells to DNA damage leading to apoptosis and tumor kill. Off-target normal tissue toxicity limits the maximum tolerated dose (MTD) and potential tumor ablation. We developed a targeted nanoparticle therapeutic platform that maximizes delivery of small molecules to tumor cells, including across the blood-brain barrier that normally prevents effective therapy with such agents. The core technology is a novel nanoparticle formulation that maximizes bioavailability and preferentially targets tumor cells while minimizing delivery to normal cells. Plasma irinotecan levels remain readily detectable for at least 48 hours, while free irinotecan is no longer detectable at 2 hours. Nanoparticles are readily imaged in tumor cells when virtually none are detectable in normal tissues. Targeting is achieved with antibodies that cause the nanoparticles to preferentially bind to tumor cells versus normal by a factor of at least 10. Levels of drug by quantitative mass spectroscopy are at least 15-fold greater in tumor vs normal tissue. As a result, the minimum effective dose (MED) is typically reduced ten-fold. Typical payloads include irinotecan, doxorubicin, and gemcitabine. Targeting antibodies include CD276 (B7H3) and CD99 (MIC2) for solid tumors. Compared to antibody-drug conjugates (ADCs), far greater drug doses per antibody molecule are delivered. In addition, the nanoparticles readily pass through the blood-brain barrier at least 15 times better than free drug alone. Consequently, the platform technology shows promise for treatment of both extra-cranial and intra-cranial tumors. In pre-clinical animal studies, survival of human PDX glioblastoma (GBM) bearing mice was prolonged by at least three-fold compared to free-drug treated animals when treated at a sub-optimal dose of 10mg/kg of irinotecan thrice weekly. Ewing sarcoma bearing mice showed indefinite survival at 2 mg/kg bi-weekly dosing, even for relapsed, treatment-resistant tumors. Treatment of hepatocellular carcinoma bearing mice biweekly at 5mg/kg resulted in no detectable tumor and 100% survival at 80 days, when all free irinotecan treated mice at the same dose were dead, with control animals dead at 50 days. Similarly, prostate cancer bearing mice treated at the same dose and regimen were all alive at 58 days when all untreated tumor bearing mice were dead. A similar result was obtained with ovarian cancer and the same treatment regimen, but tumor growth in treated animals was observed at 58 days when all untreated animals were dead. Perhaps most significantly, treated mice bearing pancreatic cancer showed 100 % survival at 80 days when all untreated animals were dead at day 59. At no time did any animal show evidence of treatment-related toxicity. Taken together, these results support a non-toxic cancer treatment approach with existing small molecule therapy that preferentially delivers drug to tumor with markedly improved efficacy.
Citation Format: HyungGyoo Kang, Bryon Upton, Paul Scott, Mark Lewis, Jon Nagy, Timothy Triche. Targeted nanospheres for the treatment of cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 825.
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Affiliation(s)
| | | | | | - Mark Lewis
- 2NanoValent Pharmaceuticals, Bozeman, MT
| | - Jon Nagy
- 2NanoValent Pharmaceuticals, Bozeman, MT
| | - Timothy Triche
- 4Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA
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10
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Whinnett ZI, Shun‐Shin MJ, Tanner M, Foley P, Chandrasekaran B, Moore P, Adhya S, Qureshi N, Muthumala A, Lane R, Rinaldi A, Agarwal S, Leyva F, Behar J, Bassi S, Ng A, Scott P, Prasad R, Swinburn J, Tomson J, Sethi A, Shah J, Lim PB, Kyriacou A, Thomas D, Chuen J, Kamdar R, Kanagaratnam P, Mariveles M, Burden L, March K, Howard JP, Arnold A, Vijayaraman P, Stegemann B, Johnson N, Falaschetti E, Francis DP, Cleland JG, Keene D. Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial. Eur J Heart Fail 2023; 25:274-283. [PMID: 36404397 PMCID: PMC10946926 DOI: 10.1002/ejhf.2736] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022] Open
Abstract
AIMS Excessive prolongation of PR interval impairs coupling of atrio-ventricular (AV) contraction, which reduces left ventricular pre-load and stroke volume, and worsens symptoms. His bundle pacing allows AV delay shortening while maintaining normal ventricular activation. HOPE-HF evaluated whether AV optimized His pacing is preferable to no-pacing, in a double-blind cross-over fashion, in patients with heart failure, left ventricular ejection fraction (LVEF) ≤40%, PR interval ≥200 ms and either QRS ≤140 ms or right bundle branch block. METHODS AND RESULTS Patients had atrial and His bundle leads implanted (and an implantable cardioverter-defibrillator lead if clinically indicated) and were randomized to 6 months of pacing and 6 months of no-pacing utilizing a cross-over design. The primary outcome was peak oxygen uptake during symptom-limited exercise. Quality of life, LVEF and patients' holistic symptomatic preference between arms were secondary outcomes. Overall, 167 patients were randomized: 90% men, 69 ± 10 years, QRS duration 124 ± 26 ms, PR interval 249 ± 59 ms, LVEF 33 ± 9%. Neither peak oxygen uptake (+0.25 ml/kg/min, 95% confidence interval [CI] -0.23 to +0.73, p = 0.3) nor LVEF (+0.5%, 95% CI -0.7 to 1.6, p = 0.4) changed with pacing but Minnesota Living with Heart Failure quality of life improved significantly (-3.7, 95% CI -7.1 to -0.3, p = 0.03). Seventy-six percent of patients preferred His bundle pacing-on and 24% pacing-off (p < 0.0001). CONCLUSION His bundle pacing did not increase peak oxygen uptake but, under double-blind conditions, significantly improved quality of life and was symptomatically preferred by the clear majority of patients. Ventricular pacing delivered via the His bundle did not adversely impact ventricular function during the 6 months.
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Affiliation(s)
- Zachary I. Whinnett
- National Heart and Lung InstituteImperial College LondonLondonUK
- Imperial College Healthcare NHS TrustLondonUK
| | - Matthew J. Shun‐Shin
- National Heart and Lung InstituteImperial College LondonLondonUK
- Imperial College Healthcare NHS TrustLondonUK
| | - Mark Tanner
- West Sussex Hospitals NHS TrustWest SussexUK
| | - Paul Foley
- Great Western Hospitals NHS Foundation TrustSwindonUK
| | | | - Philip Moore
- West Hertfordshire Hospitals NHS TrustHertfordshireUK
- Barts Health NHS TrustLondonUK
| | | | | | - Amal Muthumala
- Barts Health NHS TrustLondonUK
- North Middlesex University HospitalLondonUK
| | | | - Aldo Rinaldi
- Guy's and St. Thomas's NHS Foundation TrustLondonUK
| | | | | | | | - Sukh Bassi
- Sherwood Forest Hospitals NHS Foundation TrustUK
| | - Andre Ng
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | | | | | | | | | - Amarjit Sethi
- London North West University Healthcare NHS TrustLondonUK
| | - Jaymin Shah
- London North West University Healthcare NHS TrustLondonUK
| | - Phang Boon Lim
- National Heart and Lung InstituteImperial College LondonLondonUK
| | | | - Dewi Thomas
- Morriston Hospital Regional Cardiac CentreWalesUK
| | - Jenny Chuen
- Nottingham University Hospitals NHS TrustNottinghamUK
| | | | | | | | - Leah Burden
- Imperial College Healthcare NHS TrustLondonUK
| | | | - James P. Howard
- National Heart and Lung InstituteImperial College LondonLondonUK
| | - Ahran Arnold
- National Heart and Lung InstituteImperial College LondonLondonUK
- Imperial College Healthcare NHS TrustLondonUK
| | | | | | | | | | | | | | - Daniel Keene
- National Heart and Lung InstituteImperial College LondonLondonUK
- Imperial College Healthcare NHS TrustLondonUK
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11
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Farran D, Bean D, Wang T, Msosa Y, Casetta C, Dobson R, Teo JT, Scott P, Gaughran F. Corrigendum "Anticoagulation for atrial fibrillation in people with serious mental illness in the general hospital setting" [J. Psychiatr. Res. 153 (2022) 167-173]. J Psychiatr Res 2022; 162:228. [PMID: 36581539 DOI: 10.1016/j.jpsychires.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Dina Farran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Daniel Bean
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Health Data Research UK London, Institute of Health Informatics, University College London, London, UK
| | - Tao Wang
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yamiko Msosa
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Cecilia Casetta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Health Sciences, ASST Santi Paolo Carlo, Milano, Italy
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Health Data Research UK London, Institute of Health Informatics, University College London, London, UK; NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - James T Teo
- Department of Neurosciences, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
| | - Paul Scott
- Department of Cardiology, King's College Hospital, Denmark Hill, London, UK
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
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12
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Baggio C, Cannatà A, Scott P, Bromage D, Piper S, Mcdonagh T, Merlo M, Sinagra G. 130 PROGNOSTIC IMPLICATION OF NEUTROPHIL-LYMPHOCYTE RATIO (NLR) IN MYOCARDITIS: RESULTS FROM A MULTICENTRE, MULTINATIONAL STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Neutrophil–lymphocyte ratio (NLR) is an easily obtained inflammatory biomarker. Recently it has emerged as baseline NLR is independently associated with incident cardiovascular (CV) events and all-cause mortality. However, its role in acute myocarditis (AM) has not been evaluated.
Purpose
The aim of the present study was to investigate the prognostic value of NLR in patients with AM.
Methods
All consecutive patients with a diagnosis of AM admitted to two tertiary referral cardiac centres (King's College Hospital, London, UK and Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy) between October 2006 and June 2020 were included in the study. Diagnosis was confirmed by either cardiac magnetic resonance or endomyocardial biopsy. The outcome measure was all-cause mortality. Patients were divided into two groups according to NLR value defined in previous studies (i.e, 2.5).
Results
A total of 260 patients with AM were included in the study. Baseline characteristics were comparable in both groups. Approximately two thirds of patients were males (n=175, 67%) with a mean age of 45±16 years. Main clinical presentation was predominantly infarct-like (n=189, 73%), followed by heart failure (HF) (n=46, 18%) and arrhythmic (n=25, 10%). Patients admitted with a HF presentation were more prevalent in the group with elevated NLR, while no difference was found in the other clinical presentations. For all patients, ECG features were comparable between groups. However, patients with elevated NLR presented with slightly lower LVEF (54±11% vs 49±13% respectively, p=0.001). Higher NLR was associated with worse prognosis (Figure 1, p=0.02).
Conclusions
The NLR is a promising and accessible inflammatory biomarker. In patients with AM, elevated NLR is associated with worse prognosis. Further research is advocated to confirm these data in larger populations.
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Affiliation(s)
- Chiara Baggio
- Center For Diagnosis And Treatment Of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Giuliano-Isontina (Asugi), University Of Trieste , Trieste , Italy
| | - Antonio Cannatà
- Department Of Cardiovascular Sciences - Faculty Of Life Sciences And Medicine, King’s College London , London , UK
- Department Of Cardiology, King’s College Hospital Nhs Foundation Trust , London , UK
| | - Paul Scott
- Department Of Cardiovascular Sciences - Faculty Of Life Sciences And Medicine, King’s College London , London , UK
| | - Daniel Bromage
- Department Of Cardiovascular Sciences - Faculty Of Life Sciences And Medicine, King’s College London , London , UK
- Department Of Cardiology, King’s College Hospital Nhs Foundation Trust , London , UK
| | - Susan Piper
- Department Of Cardiology, King’s College Hospital Nhs Foundation Trust , London , UK
| | - Theresa Mcdonagh
- Department Of Cardiovascular Sciences - Faculty Of Life Sciences And Medicine, King’s College London , London , UK
- Department Of Cardiology, King’s College Hospital Nhs Foundation Trust , London , UK
| | - Marco Merlo
- Center For Diagnosis And Treatment Of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Giuliano-Isontina (Asugi), University Of Trieste , Trieste , Italy
| | - Gianfranco Sinagra
- Center For Diagnosis And Treatment Of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Giuliano-Isontina (Asugi), University Of Trieste , Trieste , Italy
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13
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Cannata A, Badawy L, Anyu AT, Samways J, Sweeney M, Zackeri R, Scott P, Piper S, Plymen C, Mcdonagh T, Bromage D. 522 THE IMPACT OF SPECIALIST CARDIOLOGY INPUT ON OUTCOMES IN PATIENTS ADMITTED FOR HEART FAILURE WITH NORMAL EJECTION FRACTION. A MULTICENTRE STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Aims
Specialist cardiology care is associated with a prognostic benefit in patients with HF with reduced ejection fraction (HFrEF) admitted with decompensated heart failure (HF). However, up to one third of patients admitted with HF and normal ejection fraction (HFnEF) do not receive specialist cardiology input. Whether this has prognostic implications is unknown.
Methods
Data on patients hospitalised with HFnEF from two tertiary centres were analysed. The primary outcome measure was all-cause mortality during follow-up. The secondary outcome was in-hospital mortality.
Results
A total of 1,413 patients were included in the study. Of these, 23% (n=322) did not receive in-hospital specialist cardiology input. Patients seen by a cardiologist were less likely to have hypertension (73% vs 79%, p=0.03) and respiratory comorbidities (25% vs 31%, p=0.02) compared to those who did not receive specialist input. Similarly, clinical presentation was more severe for those who received specialist input (NYHA III/IV 83% vs 75% respectively, p=0.003; moderate-to-severe peripheral oedema 65% vs 54%, p<0.001). Medical management was similar, except for a higher use of diuretics (90% vs 86%, p=0.04) and a longer length of stay for patients who received specialist input (9 vs 4 days, p<0.001). Long-term outcomes were comparable between patients who received specialist input and those who did not. However, specialist input was independently associated with lower in-hospital mortality (HR 0.19, CI 0.09-0.43, p<0.001).
Conclusion
In-hospital cardiology specialist input has no long-term prognostic advantage in patients with HFnEF but it is independently associated with reduced in-hospital mortality.
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Schor NF, Scott P, Litvina EY, Torborg C, Kim JL, Zalutsky R, Adams AB. Planning and Implementing Strategically: Year 1 of the NINDS 2021-2026 Strategic Plan. Neurology 2022; 99:1099-1107. [PMID: 36257710 PMCID: PMC9757872 DOI: 10.1212/wnl.0000000000201380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/24/2022] [Indexed: 12/27/2022] Open
Abstract
At the end of 2020, the National Institute of Neurological Disorders and Stroke, an institute of the NIH, completed an 18-month-long strategic planning process that involved and engaged diverse internal and external biomedical and general stakeholders. The institute published and disseminated its 2021-2026 Strategic Plan online in December 2020. Now, 1 year into its implementation, this progress report presents accomplishments to date, new initiatives and opportunities, and a preview of the metrics and benchmarks we will use to gauge the future progress of the strategic plan's implementation.
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Affiliation(s)
- Nina F Schor
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD.
| | - Paul Scott
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Elizabeth Y Litvina
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Christine Torborg
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Jenny L Kim
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Robert Zalutsky
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Amy Bany Adams
- From the National Institute of Neurological Disorders and Stroke, Bethesda, MD
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15
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Davis JA, Glasser M, Spatz DL, Scott P, Demirci JR. First Feed Type Is Associated With Birth/Lactating Parent's Own Milk Use During NICU Stay Among Infants Who Require Surgery. Adv Neonatal Care 2022; 22:578-588. [PMID: 35421040 PMCID: PMC9556699 DOI: 10.1097/anc.0000000000000981] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Early exclusive birth/lactating parent's own milk (B/LPOM) feeds have been associated with longer duration of B/LPOM use for infant feedings in healthy term and hospitalized preterm infants. This relationship has not been explored in infants undergoing neonatal surgery (surgical infants). PURPOSE To evaluate the relationship between early exclusive B/LPOM feeds and cumulative B/LPOM patterns during surgical infants' neonatal intensive care unit (NICU) hospitalization. METHODS A secondary cross-sectional analysis was performed using the electronic health record data of surgical infants admitted to a level IV NICU between January 2014 and March 2015. Multiple linear regression and Fisher's exact test were used to examine the associations between first NICU feed type and total percentage of diet composed of B/LPOM during NICU stay and continuation of any or exclusive B/LPOM feedings at NICU discharge, respectively. RESULTS The analysis included 59 infants who required surgery for gastrointestinal, cardiac, or multisystem defects or pregnancy-related complications. Receipt of B/LPOM as the first NICU feed was associated with higher percentage of B/LPOM feeds ( P < .001) throughout NICU stay, as well as continuation of any or exclusive B/LPOM feedings at NICU discharge ( P = .03). IMPLICATIONS FOR PRACTICE Early exclusive B/LPOM feeds may be an important predictor for continuation of any B/LPOM use throughout the NICU stay and at NICU discharge. Continued efforts to identify and address gaps in prenatal and postpartum lactation support for parents of surgical infants are needed. IMPLICATIONS FOR RESEARCH Powered studies are needed to corroborate these findings and to explore the potential impact of other factors on duration and exclusivity of B/LPOM use. VIDEO ABSTRACT AVAILABLE AT https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx .
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Affiliation(s)
- Jessica A Davis
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (Ms Davis and Drs Glasser, Scott, and Demirci); and University of Pennsylvania School of Nursing, Philadelphia, and The Children's Hospital of Philadelphia (CHOP), Philadelphia, and Children's Hospital of Philadelphia's Mothers' Milk Bank, Philadelphia, Pennsylvania (Dr Spatz)
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16
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Mazzotti D, Scott P, Morris J. Obstructive Sleep Apnea Symptom Subtype Transitions over Five Years are Associated with Increased Cardiovascular Disease Incidence Risk. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Roy R, Cannata A, Bhatti P, Daniel A, Rosmini S, Birkenshaw A, Rind I, Sado D, Piper S, Scott P, McDonagh T, Bromage D. Accuracy of ICD-10 codes for patients with acute myocarditis: a retrospective study at a large tertiary centre in London, UK. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1704] [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
Acute myocarditis (AM) is an inflammatory disease of the myocardium that is associated with heterogenous clinical presentations, which may be non-specific. Furthermore, several cardiac diseases can mimic its clinical phenotype. Research in AM frequently utilises ICD-10 codes from hospital admissions for case identification. We retrospectively confirmed or refuted a diagnosis of AM according to ESC Position Statement criteria in patients with an ICD-10 code for AM.
Methods
We performed a single-centre retrospective analysis of all unique admissions with ICD-10 codes corresponding to myocarditis or myopericarditis in the first three coding positions at King's College Hospital, London, United Kingdom. The diagnosis was classified as “confirmed” if proven by cardiac magnetic resonance imaging (CMR) or endomyocardial biopsy (EMB) or “suspected” in the absence of CMR or EMB if other ESC Position Statement criteria were met. To identify additional cases, we used an open-source retrieval system for unstructured clinical data (CogStack). We searched hospital and Intensive Care Unit (ICU) discharge summaries for inpatients discharged alive containing the keywords “myocarditis” or “myopericarditis”. We also searched for patients who died during the study period where the keywords “myocarditis” or “myopericarditis” were included on the death notification.
Results
We identified 308 unique admissions with an ICD-10 code for myocarditis or myopericarditis in this study, presenting between 2008 and 2020 (Figure 1). Overall, 26.0% of patients (n=80/308) could be excluded from a diagnosis of AM on review of the clinical summary. A total of 16.2% of patients (n=50/308) had insufficient evidence of AM, 1.9% (n=6/308) had not had coronary artery disease excluded as a culprit for the presentation, and 10.1% (n=31/308) had an alternative diagnosis. Only 45.8% (n=141/308) of all patients met criteria for suspected or confirmed AM. Of those, 86.5% (n=122/141) of cases were confirmed by CMR. Overall, 39.6% of patients with an ICD-10 code indicating AM had a confirmed diagnosis. An additional 46 suspected and 197 confirmed cases were identified using open-source retrieval from unstructured clinical data.
Conclusion
AM has heterogenous and sometimes non-specific clinical presentations, which may be compounded by limited access to CMR and EMB. We identified significant misclassification using ICD-10 codes. It is crucial to ensure that studies investigating AM include only patients meeting appropriate diagnostic criteria, thereby ensuring a high-quality evidence base in this disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Roy
- King's College London , London , United Kingdom
| | - A Cannata
- King's College London , London , United Kingdom
| | - P Bhatti
- King's College London , London , United Kingdom
| | - A Daniel
- King's College London , London , United Kingdom
| | - S Rosmini
- King's College London , London , United Kingdom
| | | | - I Rind
- King's College London , London , United Kingdom
| | - D Sado
- King's College London , London , United Kingdom
| | - S Piper
- King's College London , London , United Kingdom
| | - P Scott
- King's College London , London , United Kingdom
| | - T McDonagh
- King's College London , London , United Kingdom
| | - D Bromage
- King's College London , London , United Kingdom
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18
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Sadler M, Cannata A, Baggio CHIARA, Monzo L, Scott P, Piper S, Sinagra G, McDonagh T, Merlo M, Bromage D. Prognostic implication of neutrophil-lymphocyte ratio (NLR) in myocarditis: results from a multicentre, multinational study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Neutrophil–lymphocyte ratio (NLR) is an accessible inflammatory biomarker. Recently, baseline NLR has been shown to be independently associated with incident cardiovascular (CV) events and all-cause mortality. However, whether this applies to acute myocarditis (AM) has not been evaluated. The aim of the present study was to investigate the prognostic value of NLR in patients with AM.
Methods
All consecutive patients with a diagnosis of AM admitted to three tertiary referral cardiac centres in two countries between October 2006 and June 2020 were included in the study. Diagnosis was confirmed by either cardiac magnetic resonance or endomyocardial biopsy. The outcome measure was all-cause mortality. Patients were divided into two groups according to NLR value defined in previous studies (i.e., 2.5).
Results
A total of 287 patients with AM were included in the study. Baseline characteristics were comparable in both groups. Approximately two thirds of patients were males (n=194, 68%) with a mean age of 39±16 years. The main clinical presentation was predominantly infarct-like (n=215, 75%), followed by heart failure (HF) (n=46, 16%) and arrhythmic (n=26, 9%). Patients admitted with a HF presentation were more prevalent in the group with elevated NLR, while no difference was found in the other clinical presentations. For all patients, ECG features were comparable between groups. However, patients with elevated NLR presented with slightly higher LVEF (55±11% vs 50±13% respectively, p=0.003). Over a median follow-up of 54 months, higher NLR was associated with worse prognosis (Figure 1, p=0.02). Patients with high NLR have a 7-fold higher risk of adverse events during follow-up (Hazard Ratio 7.83, 95% confidence interval 1.02–59.89, p=0.047).
Conclusions
NLR is a promising and accessible inflammatory biomarker. In patients with AM, elevated NLR is associated with worse prognosis. Further research is advocated to confirm these data in larger populations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Sadler
- King's College London , London , United Kingdom
| | - A Cannata
- King's College London , London , United Kingdom
| | | | - L Monzo
- Polyclinic Casilino , Rome , Italy
| | - P Scott
- King's College London , London , United Kingdom
| | - S Piper
- King's College London , London , United Kingdom
| | - G Sinagra
- Integrated University Health Authority of Trieste , Trieste , Italy
| | - T McDonagh
- King's College London , London , United Kingdom
| | - M Merlo
- Integrated University Health Authority of Trieste , Trieste , Italy
| | - D Bromage
- King's College London , London , United Kingdom
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19
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Porcari A, Merlo M, Baggio C, Gagno G, Cittar M, Barbati G, Paldino A, Castrichini M, Vitrella G, Pagnan L, Cannatà A, Andreis A, Cecere A, Cipriani A, Raafs A, Bromage DI, Rosmini S, Scott P, Sado D, Di Bella G, Nucifora G, Marra MP, Heymans S, Imazio M, Sinagra G. Global longitudinal strain by CMR improves prognostic stratification in acute myocarditis presenting with normal LVEF. Eur J Clin Invest 2022; 52:e13815. [PMID: 35598175 DOI: 10.1111/eci.13815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/21/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prognostic stratification of acute myocarditis (AM) presenting with normal left ventricular ejection fraction (LVEF) relies mostly on late gadolinium enhancement (LGE) characterization. Left ventricular peak global longitudinal strain (LV-GLS) measured by feature tracking analysis might improve prognostication of AM presenting with normal LVEF. METHODS Data of patients undergoing cardiac magnetic resonance (CMR) for clinically suspected AM in seven European Centres (2013-2020) were retrospectively analysed. Patients with AM confirmed by CMR and LVEF ≥50% were included. LGE was visually characterized: localized versus. non-localized, subepicardial versus midwall. LV-GLS was measured by dedicated software. The primary outcome was the first occurrence of an adverse cardiovascular event (ACE) including cardiac death, life-threatening arrhythmias, development of heart failure or of LVEF <50%. RESULTS Of 389 screened patients, 256 (66%) fulfilled inclusion criteria: median age 36 years, 71% males, median LVEF 60%, median LV-GLS -17.3%. CMR was performed at 4 days from hospitalization. At 27 months, 24 (9%) patients experienced ≥1 ACE (71% developed LVEF <50%). Compared to the others, they had lower median LV-GLS values (-13.9% vs. -17.5%, p = .001). At Kaplan-Meier analysis, impaired LV-GLS (both considered as > -20% or quartiles), non-localized and midwall LGE were associated with ACEs. Patients with LV-GLS ≤-20% did not experience ACEs. LV-GLS remained associated with ACEs after adjustment for non-localized and midwall LGE. CONCLUSION In AM presenting with LVEF ≥50%, LV-GLS provides independent prognostic value over LGE characterization, improving risk stratification and representing a rationale for further studies of therapy in this cohort.
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Affiliation(s)
- Aldostefano Porcari
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Marco Merlo
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Chiara Baggio
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Giulia Gagno
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Marco Cittar
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy
| | - Alessia Paldino
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Matteo Castrichini
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Giancarlo Vitrella
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Lorenzo Pagnan
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
| | - Antonio Cannatà
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy.,Department of Cardiovascular Sciences - Faculty of Life Sciences & Medicine, King's College London, London, UK.,Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Alessandro Andreis
- University Cardiology A.O.U., Città della Salute e della Scienza di Torino, Turin, Italy
| | - Annagrazia Cecere
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Anne Raafs
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Daniel I Bromage
- Department of Cardiovascular Sciences - Faculty of Life Sciences & Medicine, King's College London, London, UK.,Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Stefania Rosmini
- Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Paul Scott
- Department of Cardiovascular Sciences - Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Daniel Sado
- Department of Cardiovascular Sciences - Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - Gaetano Nucifora
- NorthWest Cardiac Imaging Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Stephane Heymans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Gianfranco Sinagra
- Centre for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and University of Trieste, Trieste, Italy
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Mandel D, Scott P, Lamoreaux B. AB1038 PEGLOTICASE URATE-LOWERING RESPONSE FOLLOWING COVID-RELATED GAP IN THERAPY: EXPERIENCES OF ONE RHEUMATOLOGIST. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundWhen uncontrolled gout cannot be managed with oral urate-lowering therapies, pegloticase is one of the few remaining treatment options. Patients receiving infusion therapies experienced treatment interruptions due to the COVID-19 pandemic. As with other biologic therapies, patients can develop anti-drug antibodies (ADAs) against pegloticase, and longer infusion intervals can result in higher rates of pegloticase immunogenicity.1 The literature suggests that co-administering an immunomodulator with pegloticase can markedly decrease the proportion of patients who develop ADAs,2 increasing the proportion with sustained urate-lowering response.3ObjectivesThis case series reports one rheumatologists’ experience with a gap in pegloticase therapy during the COVID-19 pandemic.MethodsUncontrolled gout patients who underwent pegloticase treatment during 2019/2020 and had a gap in therapy of ≥28 days were identified. Patient, clinical, and treatment (number post-gap infusions, immunomodulation co-therapy) characteristics were retrospectively examined, along with urate-lowering response following therapy interruption. Patients who had a serum urate (SU) <6 mg/dL after the last post-gap pegloticase infusion were considered to have recaptured response.Results7 patients (5 men, 64.3±13.5 years, pretherapy sUA: 7.76±2.47 mg/dL, 6 had tophi) were included with 2 remaining on therapy at data collection. Eleven gaps were noted with an average gap duration of 11.4±9.3 weeks (median: 9 weeks). For the last gap in therapy, patients received 13.9±7.0 infusions (range: 4-22) before the gap and 7.0±4.1 infusions (range: 2-14) after (Figure 1). Four patients (57%; Patients 1, 2, 5, 7) had recaptured urate-lowering at last pegloticase infusion, all of whom began immunomodulation (3 methotrexate, 1 mycophenolate mofetil/hydroxychloroquine) prior to resuming pegloticase. Of the 3 patients without response recapture, 2 initiated MTX after resuming pegloticase. 4 patients (57%) experienced ≥1 AE, including mild infusion reaction (n=1), acute gout flare (n=2), clinically meaningful decrease in eGFR (14.8 ml/min/1.73m2, n=1), heart attack (n=1), and anemia (n=1).ConclusionThese cases suggest that it may be possible to recapture urate-lowering response to pegloticase in some patients, particularly in the presence of immunomodulation. These preliminary findings are important to this vulnerable patient population, particularly during the COVID-19 pandemic. Further study is needed to confirm our findings.References[1]Sundy JS, et al. JAMA 201;306:711-20.[2]Song Y, et al. Arthritis Rheum 2020;72[3]Keenan RT, et al. Semin Arthritis Rheum 2021, 51:347-52.AcknowledgementsMedical writing support provided by Lissa Padnick-Silver PhD, an employee of and stockholder in Horizon.Disclosure of InterestsDavid Mandel: None declared, Patricia Scott: None declared, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
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Mazzotti D, Scott P, Morris J. 0717 Obstructive Sleep Apnea Symptom Subtype Transitions over Five Years are Associated with Increased Cardiovascular Disease Incidence Risk. Sleep 2022. [DOI: 10.1093/sleep/zsac079.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Efforts to characterize clinical heterogeneity of obstructive sleep apnea (OSA) resulted in the identification and replication of symptom-based subtypes. Individuals with moderate-severe OSA that are excessively sleepy are at increased risk of cardiovascular disease (CVD). There is limited evidence about whether OSA patients that worsen their symptom presentation over time are at increased cardiovascular burden. This study aimed to assess the association between five-year transitions among OSA symptom subtypes and incidence of CVD in a community-based cohort.
Methods
Participants of the Sleep Heart Health Study with complete baseline and 5-year follow-up data on symptom presentation, polysomnographic data and CVD outcomes were included (N=2,643). We used latent transition analysis on 14 symptom items to determine symptom subtype transitions in participants diagnosed with OSA (apnea-hypopnea index [AHI]≥5) across both visits. The primary outcome was incidence of CVD, defined as first occurrence of a composite of coronary heart disease, heart failure or stroke after the follow-up visit (median CV follow-up: 6.7 years). Cox proportional hazards models were used to assess the association between symptom subtype transitions and CVD incidence, adjusted by relevant demographic and cardiovascular risk factors.
Results
Four OSA symptom subtypes were identified at baseline and follow-up visits: minimally symptomatic, disturbed sleep, moderately sleepy and excessively sleepy. When compared to participants without OSA at baseline and follow-up visits, those with OSA that transitioned from moderately sleepy to excessively sleepy had increased CVD incidence risk (HR=2.09; 95%CI=1.27-3.45; p=0.004), independent of other CV risk factors. Increased CVD incidence risk was also observed in participants who transitioned from moderately sleepy to excessively sleepy when compared to those that remained moderately sleepy (HR=2.02; 95%CI=1.20-3.40; p=0.008) and in participants who transitioned from disturbed sleep to excessively sleepy when compared to those that remained with disturbed sleep (HR=3.25; 95%CI=1.03-10.23; p=0.044).
Conclusion
Five-year transitions across OSA symptom subtypes are associated with increased CVD incidence risk when adjusted by other relevant cardiovascular risk factors. Participants that transitioned from moderately sleepy or from disturbed sleep to excessively sleepy were at higher CVD risk. Results of this study might inform the role of symptom progression on CVD risk in OSA.
Support (If Any)
American Heart Association (20CDA35310360), National Institutes of Health (U01HL53916, U01HL53931, U01HL53934, U01HL53937, U01HL53938, U01HL53940, U01HL53941, U01HL64360 R24 HL114473, 75N92019R002).
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22
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Orbell S, Chasens E, Scott P, Luyster F, Morris J. 0710 Validation of the Predictive Utility of the Multivariable Apnea Index for Obstructive Sleep Apnea in Women. Sleep 2022. [DOI: 10.1093/sleep/zsac079.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The Multivariable Apnea Prediction (MAP) index is a commonly used screening tool for obstructive sleep apnea (OSA). Previous analyses have demonstrated higher sensitivity of the MAP in predicting OSA in men versus women and in post-menopausal versus pre-menopausal women with type 2 diabetes (T2DM) and an apnea-hypopnea index (AHI) ≥10. The purpose of this secondary analysis was to validate previous findings by comparing women with and without T2DM across all categories of OSA severity including mild (AHI ≥5).
Methods
The sample (N=386) was comprised of participants from the Diabetes Sleep Treatment Trial who were recruited because of risk for OSA with T2DM (n=279), and the EMPOWER study which examined triggers for lapses or relapse after intentional weight loss in overweight but otherwise healthy participants (n=115). AHI was assessed by in-home sleep study, ApneaLink Plus®. Descriptive statistics and binomial logistic regression and receiver operating characteristic analyses were conducted to evaluate classification of OSA diagnosis, defined as AHI ≥5 or ≥10, by MAP between sexes and by menopause status.
Results
Participants were middle aged (mean 54.09 years + 10.63), obese (mean BMI of 34.79 + 6.52 kg/m2), primarily female (67%), and white (64%). Compared to men, women were younger (52.99 years + 10.15 vs. 56.26 years + 11.25, p=0.004) and had a lower AHI (9.10 + 18.94 vs. 17.25 + 18.94, p<0.001). No significant differences, except for age, were noted between pre- and post-menopausal women. Sensitivity of MAP on OSA diagnosis was higher for men than women (AHI ≥5: 94.7% vs. 76%; AHI ≥10: 84.2% vs 29.6%). Sensitivity of MAP on OSA diagnosis was lower for pre-menopausal than post-menopausal women using AHI ≥5 (74.0% vs. 98.8%) and AHI ≥10 (19.0% vs. 32.1%).
Conclusion
This validation study corroborates previous findings that the MAP index was better at identifying OSA in men than women, and in post- versus pre-menopausal women using AHI values across all categories of OSA severity. Improved screening methods are needed to detect women at high risk for OSA.
Support (If Any)
This study was funded by the National Institutes of Health (R01-DK090628, R01-HL107370).
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Affiliation(s)
| | | | - Paul Scott
- University of Pittsburgh, School of Nursing
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23
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Luyster F, Scott P, Chasens E, Imes C, Jeon B, Shi X, Strollo P, Baniak L. 0571 Associations Between Sleep Problems and Cardiovascular Disease and All-Cause Mortality in Asthma-COPD Overlap. Sleep 2022. [DOI: 10.1093/sleep/zsac079.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Sleep problems (i.e., short and long sleep duration and sleep disorders) are common in persons with either asthma or chronic obstructive pulmonary disease (COPD) and have been linked to increased cardiovascular risk and mortality. This study determined whether sleep problems are associated with increased cardiovascular disease (CVD) prevalence and all-cause mortality in adults with asthma-COPD overlap (ACO).
Methods
Cross-sectional analysis of the 2007-2012 National Health and Nutrition Examination Survey (NHANES) and 2015 National Death Index. Participants (n=7616) were stratified into four groups, using self-report and spirometry data: asthma (n=483), COPD (n=1006), ACO (n=398), and those without asthma or COPD (controls; n=5729). Sleep duration hours were categorized as short (≤5), normal (6-8), and long (≥9). Self-report of physician diagnosis of a sleep disorder (Yes/No) and cardiovascular disease (angina, congestive heart failure, coronary heart disease, hypertension or myocardial infarction) were collected. Logistic and Cox regression models adjusted for covariates were employed.
Results
Prevalence of sleep disorders in ACO (24.7%) was roughly two times higher than rates in the asthma (10.7%) and COPD (13.5%) groups and 5 times higher than controls (4.6%). The ACO group had a higher proportion of short sleepers (27.6%) compared to COPD (19.2%) and controls (11.7%) and higher proportion of long sleepers (6.9%) compared to COPD (5.5%). Short sleepers had higher odds for CVD (OR=1.70, 95% CI, 1.34–2.15) compared to normal sleepers. Relative to ACO with normal sleep, long sleepers in the other groups had lower odds for CVD (all P-values <0.05). Both short and long sleepers in the control (HR=0.19, 95% CI 0.07–0.47, and HR=0.07, 95% CI 0.02–0.35, respectively) or COPD (HR=0.38, 95% C, 0.19–0.77, and HR=0.24, 95% CI 0.12–0.51, respectively) groups had lower hazards of all-cause mortality compared to ACO with normal sleep. The influence of presence of sleep disorders on CVD and mortality did not vary between groups.
Conclusion
Associations between sleep duration and increased risk of CVD and all-cause mortality were stronger in ACO as compared to COPD and controls. Persons with ACO may represent a high-risk group that should be targeted for assessment and treatment of sleep problems.
Support (If Any)
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Affiliation(s)
| | - Paul Scott
- University of Pittsburgh School of Nursing
| | | | | | - Bomin Jeon
- University of Pittsburgh School of Nursing
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24
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Kunz A, Moodley A, Colby DJ, Soltis M, Robb-McGrath W, Fairchok A, Faestel P, Jungels A, Bender AA, Kamau E, Wingood G, DiClemente R, Scott P. Feasibility, acceptability, and short-term impact of a brief sexually transmitted infection intervention targeting U.S. Military personnel and family members. BMC Public Health 2022; 22:640. [PMID: 35366848 PMCID: PMC8977033 DOI: 10.1186/s12889-022-13096-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Over the past 10 years, incidence of sexually transmitted infections (STIs) has increased to record numbers in the United States, with the most significant increases observed among adolescents and young adults. The US military, where the majority of active duty personnel are 18–30 years old, has seen similar increases. However, the US military does not yet have a standardized, service-wide program for STI education and prevention. Methods The KISS intervention (Knocking out Infections through Safer-sex and Screening) was adapted from an evidence-based intervention endorsed by the US Centers for Disease Control and Prevention and consisted of a one-time, small group session. Content included STI/HIV knowledge and prevention, condom use skills, and interpersonal communication techniques. The intervention was pilot tested for feasibility and acceptability among a population of service members and medical beneficiaries at Joint Base Lewis-McChord in Washington state. Results A total of 79 participants aged 18–30 years were consented to participate in the pilot study and met entry criteria, 66/79 (82.5%) attended the intervention session, and 46/66 (69.7%) returned at 3 months for the final follow-up assessment. The intervention sessions included 31 male (47.0%) and 35 female (53.0%) participants. Almost all participants felt comfortable discussing sexual issues in the group sessions, reported that they intended to practice safer sex after the intervention, and would also recommend the intervention to friends. Knowledge about STI/HIV prevention significantly increased after the intervention, and intervention effects were maintained at 3 months. About one-fifth of participants tested positive for N. gonorrhea or C. trachomatis infection at enrollment, while none had recurrent STIs at the final visit. Use of both male and female condoms increased after the intervention. Conclusions The KISS intervention was feasible to implement in the military setting and was acceptable to the active duty service members and other medical beneficiaries who participated in the pilot project. Further studies are needed to determine if the KISS intervention, or others, effectively decrease STI incidence in active duty personnel and would be appropriate for more widespread implementation. Trial Registration Retrospectively registered as the pilot phase of clinicaltrials.gov NCT04547413, “Prospective Cohort Trial to Assess Acceptability and Efficacy of an Adapted STI/HIV Intervention Behavioral Intervention Program in a Population of US Army Personnel and Their Medical Beneficiaries—Execution Phase.” Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13096-x.
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25
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Duque-Correa MA, Goulding D, Rodgers FH, Gillis JA, Cormie C, Rawlinson KA, Bancroft AJ, Bennett HM, Lotkowska ME, Reid AJ, Speak AO, Scott P, Redshaw N, Tolley C, McCarthy C, Brandt C, Sharpe C, Ridley C, Moya JG, Carneiro CM, Starborg T, Hayes KS, Holroyd N, Sanders M, Thornton DJ, Grencis RK, Berriman M. Defining the early stages of intestinal colonisation by whipworms. Nat Commun 2022; 13:1725. [PMID: 35365634 PMCID: PMC8976045 DOI: 10.1038/s41467-022-29334-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
Whipworms are large metazoan parasites that inhabit multi-intracellular epithelial tunnels in the large intestine of their hosts, causing chronic disease in humans and other mammals. How first-stage larvae invade host epithelia and establish infection remains unclear. Here we investigate early infection events using both Trichuris muris infections of mice and murine caecaloids, the first in-vitro system for whipworm infection and organoid model for live helminths. We show that larvae degrade mucus layers to access epithelial cells. In early syncytial tunnels, larvae are completely intracellular, woven through multiple live dividing cells. Using single-cell RNA sequencing of infected mouse caecum, we reveal that progression of infection results in cell damage and an expansion of enterocytes expressing of Isg15, potentially instigating the host immune response to the whipworm and tissue repair. Our results unravel intestinal epithelium invasion by whipworms and reveal specific host-parasite interactions that allow the whipworm to establish its multi-intracellular niche. Whipworms are large parasites causing chronic disease in humans and other mammals. Here, the authors show how larvae create tunnels inside the gut lining and reveal the early host response to infection via Isg15 in mice and murine caecaloids.
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Affiliation(s)
- María A Duque-Correa
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK. .,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, CB2 0AW, UK.
| | - David Goulding
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Faye H Rodgers
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Mogrify Ltd, 25 Cambridge Science Park, Milton Road, Cambridge, CB4 0FW, UK
| | - J Andrew Gillis
- Department of Zoology, University of Cambridge, Cambridge, CB2 3EJ, UK
| | - Claire Cormie
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, CB2 0AW, UK
| | - Kate A Rawlinson
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Allison J Bancroft
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK
| | - Hayley M Bennett
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Genentech, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Magda E Lotkowska
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Adam J Reid
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.,Wellcome/Cancer Research UK Gurdon Institute, University of Cambridge, Cambridge, CB2 1QN, UK
| | - Anneliese O Speak
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Paul Scott
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Nicholas Redshaw
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Charlotte Tolley
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Catherine McCarthy
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Cordelia Brandt
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Catherine Sharpe
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK.,InstilBio, UMIC Bio-Incubator, Manchester, M13 9XX, UK
| | - Caroline Ridley
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK.,Prime Global Medical Communications, Knutsford, WA16 8GP, UK
| | - Judit Gali Moya
- Faculty of Biology, University of Barcelona, Barcelona, 08028, Spain
| | - Claudia M Carneiro
- Immunopathology Laboratory, NUPEB, Federal University of Ouro Preto, Campus Universitario Morro do Cruzeiro, Ouro Preto, MG, 35400-000, Brazil
| | - Tobias Starborg
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK.,Rosalind Franklin Institute, Harwell Campus, Didcot, OX11 0FA, UK
| | - Kelly S Hayes
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK
| | - Nancy Holroyd
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Mandy Sanders
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - David J Thornton
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK
| | - Richard K Grencis
- Lydia Becker Institute of Immunology and Inflammation, Wellcome Trust Centre for Cell Matrix Research and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PT, UK
| | - Matthew Berriman
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK.
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Kotadia ID, O’Dowling R, Aboagye A, Sim I, O’Hare D, Lemus-Solis JA, Roney CH, Dweck M, Chiribiri A, Plein S, Sztriha L, Scott P, Harrison J, Ramsay D, Birns J, Somerville P, Bhalla A, Niederer S, O’Neill M, Williams SE. Atrial CARdiac Magnetic resonance imaging in patients with embolic stroke of unknown source without documented Atrial Fibrillation (CARM-AF): Study design and clinical protocol. Heart Rhythm O2 2022; 3:196-203. [PMID: 35496458 PMCID: PMC9043416 DOI: 10.1016/j.hroo.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Initiation of anticoagulation therapy in ischemic stroke patients is contingent on a clinical diagnosis of atrial fibrillation (AF). Results from previous studies suggest thromboembolic risk may predate clinical manifestations of AF. Early identification of this cohort of patients may allow early initiation of anticoagulation and reduce the risk of secondary stroke. Objective This study aims to produce a substrate-based predictive model using cardiac magnetic resonance imaging (CMR) and baseline noninvasive electrocardiographic investigations to improve the identification of patients at risk of future thromboembolism. Methods CARM-AF is a prospective, multicenter, observational cohort study. Ninety-two patients will be recruited following an embolic stroke of unknown source (ESUS) and undergo atrial CMR followed by insertion of an implantable loop recorder (ILR) as per routine clinical care within 3 months of index stroke. Remote ILR follow-up will be used to allocate patients to a study or control group determined by the presence or absence of AF as defined by ILR monitoring. Results Baseline data collection, noninvasive electrocardiographic data analysis, and imaging postprocessing will be performed at the time of enrollment. Primary analysis will be performed following 12 months of continuous ILR monitoring, with interim and delayed analyses performed at 6 months and 2 and 3 years, respectively. Conclusion The CARM-AF Study will use atrial structural and electrocardiographic metrics to identify patients with AF, or at high risk of developing AF, who may benefit from early initiation of anticoagulation.
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Affiliation(s)
- Irum D. Kotadia
- King’s College London, London, United Kingdom
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Robert O’Dowling
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Akosua Aboagye
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Iain Sim
- King’s College London, London, United Kingdom
| | | | | | | | - Marc Dweck
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, United Kingdom
| | | | - Sven Plein
- King’s College London, London, United Kingdom
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Paul Scott
- King’s College Hospital, London, United Kingdom
| | - James Harrison
- Princess Royal University Hospital, London, United Kingdom
| | - Deborah Ramsay
- Princess Royal University Hospital, London, United Kingdom
| | - Jonathan Birns
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Peter Somerville
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Ajay Bhalla
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | | | - Mark O’Neill
- King’s College London, London, United Kingdom
- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Steven E. Williams
- King’s College London, London, United Kingdom
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, United Kingdom
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27
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Patterson BK, Francisco EB, Yogendra R, Long E, Pise A, Rodrigues H, Hall E, Herrera M, Parikh P, Guevara-Coto J, Triche TJ, Scott P, Hekmati S, Maglinte D, Chang X, Mora-Rodríguez RA, Mora J. Persistence of SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-Acute Sequelae of COVID-19 (PASC) up to 15 Months Post-Infection. Front Immunol 2022; 12:746021. [PMID: 35082777 PMCID: PMC8784688 DOI: 10.3389/fimmu.2021.746021] [Citation(s) in RCA: 107] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/06/2021] [Indexed: 12/27/2022] Open
Abstract
The recent COVID-19 pandemic is a treatment challenge in the acute infection stage but the recognition of chronic COVID-19 symptoms termed post-acute sequelae SARS-CoV-2 infection (PASC) may affect up to 30% of all infected individuals. The underlying mechanism and source of this distinct immunologic condition three months or more after initial infection remains elusive. Here, we investigated the presence of SARS-CoV-2 S1 protein in 46 individuals. We analyzed T-cell, B-cell, and monocytic subsets in both severe COVID-19 patients and in patients with post-acute sequelae of COVID-19 (PASC). The levels of both intermediate (CD14+, CD16+) and non-classical monocyte (CD14Lo, CD16+) were significantly elevated in PASC patients up to 15 months post-acute infection compared to healthy controls (P=0.002 and P=0.01, respectively). A statistically significant number of non-classical monocytes contained SARS-CoV-2 S1 protein in both severe (P=0.004) and PASC patients (P=0.02) out to 15 months post-infection. Non-classical monocytes were sorted from PASC patients using flow cytometric sorting and the SARS-CoV-2 S1 protein was confirmed by mass spectrometry. Cells from 4 out of 11 severe COVID-19 patients and 1 out of 26 PASC patients contained ddPCR+ peripheral blood mononuclear cells, however, only fragmented SARS-CoV-2 RNA was found in PASC patients. No full length sequences were identified, and no sequences that could account for the observed S1 protein were identified in any patient. That non-classical monocytes may be a source of inflammation in PASC warrants further study.
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Affiliation(s)
- Bruce K Patterson
- Department of Research and Development, IncellDx Inc, San Carlos, CA, United States
| | - Edgar B Francisco
- Department of Research and Development, IncellDx Inc, San Carlos, CA, United States
| | - Ram Yogendra
- Department of Anesthesia, Lawrence General Hospital, Lawrence, MA, United States
| | - Emily Long
- Department of Research and Development, IncellDx Inc, San Carlos, CA, United States
| | - Amruta Pise
- Department of Research and Development, IncellDx Inc, San Carlos, CA, United States
| | - Hallison Rodrigues
- Department of Research and Development, IncellDx Inc, San Carlos, CA, United States
| | - Eric Hall
- Department of Molecular Diagnostics, Bio-Rad Laboratories, Hercules, CA, United States
| | - Monica Herrera
- Department of Molecular Diagnostics, Bio-Rad Laboratories, Hercules, CA, United States
| | - Purvi Parikh
- Department of Allergy and Immunology, New York University (NYU) Langone Health, New York, NY, United States
| | - Jose Guevara-Coto
- Lab of Tumor Chemosensitivity, Research Center on Tropical Diseases (CIET)/Research Center on Surggery and Cancer (DC) Lab, Faculty of Microbiology, Universidad de Costa Rica, San Jose, Costa Rica.,Department of Computer Science and Informatics (ECCI), Universidad de Costa Rica, San Jose, Costa Rica
| | - Timothy J Triche
- Department of Molecular Biology, Avrok Laboratories, Inc., Azusa, CA, United States
| | - Paul Scott
- Department of Molecular Biology, Avrok Laboratories, Inc., Azusa, CA, United States
| | - Saboor Hekmati
- Department of Molecular Biology, Avrok Laboratories, Inc., Azusa, CA, United States
| | - Dennis Maglinte
- Department of Molecular Biology, Avrok Laboratories, Inc., Azusa, CA, United States
| | - Xaiolan Chang
- Vaccine & Gene Therapy Institute and Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, United States
| | - Rodrigo A Mora-Rodríguez
- Lab of Tumor Chemosensitivity, Research Center on Tropical Diseases (CIET)/Research Center on Surggery and Cancer (DC) Lab, Faculty of Microbiology, Universidad de Costa Rica, San Jose, Costa Rica
| | - Javier Mora
- Lab of Tumor Chemosensitivity, Research Center on Tropical Diseases (CIET)/Research Center on Surggery and Cancer (DC) Lab, Faculty of Microbiology, Universidad de Costa Rica, San Jose, Costa Rica
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28
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Porcari A, Merlo M, Baggio C, Gagno G, Cittar M, Barbati G, Paldino A, Castrichini M, Vitrella G, Pagnan L, Cannata A, Andreis A, Cecere A, Cipriani A, Raafs A, Bromage DI, Rosmini S, Scott P, Sado D, Di Bella G, Nucifora G, Marra MP, Heymans S, Imazio M, Sinagra G. 100 Global longitudinal strain by CMR improves prognostic stratification in acute myocarditis presenting with normal LVEF. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab132.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Prognostic stratification of acute myocarditis (AM) presenting with normal left ventricular (LV) ejection fraction (EF) relies mostly on late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) imaging. In this specific AM population, LV peak global longitudinal strain (LV-GLS) measured by feature tracking (FT) analysis might provide further prognostic information.
Methods and results
Data of patients undergoing CMR for clinically suspected AM in seven European Centres, between January 2013 and August 2020, were retrospectively analysed. Those patients fulfilling CMR Lake Louise Criteria (LLC) for the diagnosis of AM and presenting with normal LVEF (≥50%) were included. Patients presenting with heart failure (HF) or significant arrhythmic events, LVEF <50% or haemodynamic instability were excluded. CMR-LGE extent (localized vs. diffuse), localization (subepicardial vs. mid-wall), and distribution (anteroseptal vs. inferolateral) were visually assessed. LV-GLS was measured by dedicated software. The primary outcome was the first occurrence of an adverse cardiovascular event (ACE) including a composite of cardiac death, development of heart failure, life-threatening arrhythmias, or development of LVEF <50%. In patients experiencing more than one event, the first one was considered for the outcome analysis. Of 389 patients with clinically suspected AM, 256 (66%) had confirmed AM with LVEF ≥50% and were included. Median age was 36 years, 71% were males, median LVEF was 60%, and median LV-GLS −17.3%. CMR was performed at a median time of 4 (IQR: 2–12) days from hospital admission. At a median follow-up of 27 months, 24 (9%) patients experienced at least one ACE with development of LVEF <50% accounting for 17 [71%]. Compared to the others, patients experiencing ACEs had lower median LV-GLS values at baseline (−13.9% vs. −17.5%, P = 0.001). At Kaplan–Meier analysis, impaired LV-GLS (both considered as >-20% or quartiles), diffuse and mid-wall LGE were associated with a significantly higher rate of ACEs. LV-GLS remained independently associated with ACEs after adjustment for diffuse or mid-wall LGE as covariate at bivariable analysis.
Conclusions
In AM with LVEF ≥50%, LV-GLS provides independent prognostic value over LGE, improving risk stratification and providing a rationale for further studies of therapy in this cohort.
100 Figure
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Affiliation(s)
- Aldostefano Porcari
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Marco Merlo
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Chiara Baggio
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Giulia Gagno
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Marco Cittar
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Biosatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Alessia Paldino
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Matteo Castrichini
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Giancarlo Vitrella
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
| | - Lorenzo Pagnan
- Department of Radiology, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy
| | - Antonio Cannata
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
- Department of Cardiovascular Sciences, Faculty of Life Sciences and Medicine, King’s College, London, UK
- Department of Cardiology, King’s College Hospital NHS Foundation Trust, London, UK
| | - Alessandro Andreis
- University Cardiology, A.O.U. Città della Salute e Della Scienza di Torino, Turin, Italy
| | - Annagrazia Cecere
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Anne Raafs
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Daniel I Bromage
- Department of Cardiovascular Sciences, Faculty of Life Sciences and Medicine, King’s College, London, UK
- Department of Cardiology, King’s College Hospital NHS Foundation Trust, London, UK
| | - Stefania Rosmini
- Department of Cardiology, King’s College Hospital NHS Foundation Trust, London, UK
| | - Paul Scott
- Department of Cardiovascular Sciences, Faculty of Life Sciences and Medicine, King’s College, London, UK
| | - Daniel Sado
- Department of Cardiovascular Sciences, Faculty of Life Sciences and Medicine, King’s College, London, UK
| | | | - Gaetano Nucifora
- Northwest Cardiac Imaging Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Stephane Heymans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Massimo Imazio
- University Cardiology, A.O.U. Città della Salute e Della Scienza di Torino, Turin, Italy
| | - Gianfranco Sinagra
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina and University of Trieste, Trieste, Italy
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29
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Burgess T, Edwards J, Drenth A, Massenbauer T, Cunnington J, Mostowfizadeh-Ghalamfarsa R, Dinh Q, Liew E, White D, Scott P, Barber P, O’Gara E, Ciampini J, McDougall K, Tan Y. Current status of Phytophthora in Australia. Persoonia 2021; 47:151-177. [PMID: 37693794 PMCID: PMC10486634 DOI: 10.3767/persoonia.2021.47.05] [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] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/26/2021] [Indexed: 11/25/2022]
Abstract
Among the most economically relevant and environmentally devastating diseases globally are those caused by Phytophthora species. In Australia, production losses in agriculture and forestry result from several well-known cosmopolitan Phytophthora species and infestation of natural ecosystems by Phytophthora cinnamomi have caused irretrievable loss to biodiversity especially in proteaceous dominated heathlands. For this review, all available records of Phytophthora in Australia were collated and curated, resulting in a database of 7 869 records, of which 2 957 have associated molecular data. Australian databases hold records for 99 species, of which 20 are undescribed. Eight species have no records linked to molecular data, and their presence in Australia is considered doubtful. The 99 species reside in 10 of the 12 clades recognised within the complete phylogeny of Phytophthora. The review includes discussion on each of these species' status and additional information provided for another 29 species of concern. The first species reported in Australia in 1900 was Phytophthora infestans. By 2000, 27 species were known, predominantly from agriculture. The significant increase in species reported in the subsequent 20 years has coincided with extensive surveys in natural ecosystems coupled with molecular taxonomy and the recognition of numerous new phylogenetically distinct but morphologically similar species. Routine and targeted surveys within Australian natural ecosystems have resulted in the description of 27 species since 2009. Due to the new species descriptions over the last 20 years, many older records have been reclassified based on molecular identification. The distribution of records is skewed toward regions with considerable activity in high productivity agriculture, horticulture and forestry, and native vegetation at risk from P. cinnamomi. Native and exotic hosts of different Phytophthora species are found throughout the phylogeny; however, species from clades 1, 7 and 8 are more likely to be associated with exotic hosts. One of the most difficult challenges to overcome when establishing a pest status is a lack of reliable data on the current state of a species in any given country or location. The database compiled here for Australia and the information provided for each species overcomes this challenge. This review will aid federal and state governments in risk assessments and trade negotiations by providing a comprehensive resource on the current status of Phytophthora species in Australia. Citation: Burgess TI, Edwards J, Drenth A, et al. 2021. Current status of Phytophthora in Australia. Persoonia 47: 151-177. https://doi.org/10.3767/persoonia.2021.47.05.
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Affiliation(s)
- T.I. Burgess
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - J. Edwards
- Agriculture Victoria, Department of Jobs, Precincts and Regions, Bundoora, VIC 3083, Australia; La Trobe University, Bundoora, VIC 3083, Australia
| | - A. Drenth
- Centre for Horticultural Science, The University of Queensland, Ecosciences Precinct, Dutton Park QLD, 4102, Brisbane, Australia
| | - T. Massenbauer
- TiloMass Environmental Services, PO Box 1148, Esperance WA, 6450, Australia
| | - J. Cunnington
- Department of Agriculture, Water and the Environment, 7 London Circuit, Canberra ACT 2600 Australia
| | | | - Q. Dinh
- Agriculture Victoria, Department of Jobs, Precincts and Regions, Bundoora, VIC 3083, Australia; La Trobe University, Bundoora, VIC 3083, Australia
| | - E.C.Y. Liew
- Research Centre for Ecosystem Resilience, Royal Botanic Gardens and Domain Trust, Mrs Macquaries Rd, Sydney NSW 2000, Australia
| | - D. White
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - P. Scott
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
- Plant Pathologist, DPIRD Diagnostics and Laboratory Services, Sustainability and Biosecurity, Department of Primary Industries and Regional Development, 3 Baron-Hay Court, Kennsington WA 6151, Australia
| | - P.A. Barber
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
- Arbor Carbon P/L, ROTA Compound off Discovery Way, Murdoch University, Murdoch 6150, Australia
| | - E. O’Gara
- Department of Biodiversity, Conservation and Attractions, 17 Dick Perry Ave, Kensington WA 6151, Australia
| | - J. Ciampini
- Department of Biodiversity, Conservation and Attractions, 17 Dick Perry Ave, Kensington WA 6151, Australia
| | - K.L. McDougall
- Department of Ecology, Environment and Evolution, School of Life Sciences, La Trobe University, Bundoora VIC 3083, Australia
| | - Y.P. Tan
- Department of Agriculture and Fisheries, Ecosciences Precinct, Dutton Park QLD 4102; Centre for Crop Health, University of Southern Queensland, Toowoomba, QLD 4350, Australia
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30
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Bou-Samra P, Scott P, Cheng H, Kallem C, Pathak R, Geller DA, Marsh W, Wang Y, Antoni M, Penedo F, Tsung A, Steel JL. Social Support is Associated with Survival in Patients Diagnosed with Gastrointestinal Cancer. J Gastrointest Cancer 2021; 53:854-861. [PMID: 34806126 DOI: 10.1007/s12029-021-00741-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to examine the link between psychological, behavioral, and social factors and survival in patients diagnosed with gastrointestinal cancer. METHODS A cohort of gastrointestinal cancer patients were administered a battery of questionnaires that assessed trauma, depression, social support, sleep, diet, exercise, quality of life, tobacco and alcohol use, pain, and fatigue. Analyses included Pearson's correlations, analyses of variance, Kaplan Meier survival, and Cox regression analyses. RESULTS Of the 568 patients, the majority were male (57.9%) and Caucasian (91.9%), with a mean age of 61 (S.D. = 10.7). The level of perceived social support was comparable to patients with other medical conditions. Sociodemographic predictors of social support included the number of years of education (r = 0.109, p = 0.05), marital status (F(6,387) = 5.465, p ≤ 0.001), and whether the patients' income met the family's basic needs (F(1,377) = 25.531, p < 0.001). Univariate analyses revealed that older age (p < 0.001), male gender (p = 0.007), being black (p = 0.005), diagnosis of hepatocellular carcinoma (p = 0.046), higher body mass index (p = 0.022), larger tumor size (p = 0.032), initial treatment including chemotherapy rather than surgery (p < 0.001), and lower level of perceived social support (p = 0.037) were associated with poorer survival. Using multivariate Cox regression and adjusting for all factors found to be significant in univariate survival analyses, older age (p = 0.024) and lower perceived social support (HR = 0.441, 95% CI = 0.233, 0.833; p = 0.012) were the factors that remained significantly associated with poorer survival. CONCLUSION There are several biological and psychosocial factors that predict cancer mortality. Social support appears to be a robust factor affecting mortality in gastrointestinal cancer patients.
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Affiliation(s)
- Patrick Bou-Samra
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Paul Scott
- Department of Psychology, School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hannah Cheng
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Cramer Kallem
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ritambhara Pathak
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - David A Geller
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wallis Marsh
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Yisi Wang
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Michael Antoni
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Frank Penedo
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. .,Department of Psychiatry, University of Pittsburgh, 3459 Fifth Avenue; Montefiore 7S, Pittsburgh, PA, 15213, USA. .,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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31
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Scott P, Anderson K, Cormier R. 656: Impact of high-fat diet on intestinal tumorigenesis in a CFTR-deficient mouse model. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Burgess T, Edwards J, Drenth A, Massenbauer T, Cunnington J, Mostowfizadeh-Ghalamfarsa R, Dinh Q, Liew E, White D, Scott P, Barber P, O’Gara E, Ciampini J, McDougall K, Tan Y. Current status of Phytophthora in Australia. Persoonia 2021; 47:151-177. [PMID: 38352973 PMCID: PMC10784666 DOI: 10.3767/persoonia.2023.47.05] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/26/2021] [Indexed: 02/16/2024]
Abstract
Among the most economically relevant and environmentally devastating diseases globally are those caused by Phytophthora species. In Australia, production losses in agriculture and forestry result from several well-known cosmopolitan Phytophthora species and infestation of natural ecosystems by Phytophthora cinnamomi have caused irretrievable loss to biodiversity especially in proteaceous dominated heathlands. For this review, all available records of Phytophthora in Australia were collated and curated, resulting in a database of 7 869 records, of which 2 957 have associated molecular data. Australian databases hold records for 99 species, of which 20 are undescribed. Eight species have no records linked to molecular data, and their presence in Australia is considered doubtful. The 99 species reside in 10 of the 12 clades recognised within the complete phylogeny of Phytophthora. The review includes discussion on each of these species' status and additional information provided for another 29 species of concern. The first species reported in Australia in 1900 was Phytophthora infestans. By 2000, 27 species were known, predominantly from agriculture. The significant increase in species reported in the subsequent 20 years has coincided with extensive surveys in natural ecosystems coupled with molecular taxonomy and the recognition of numerous new phylogenetically distinct but morphologically similar species. Routine and targeted surveys within Australian natural ecosystems have resulted in the description of 27 species since 2009. Due to the new species descriptions over the last 20 years, many older records have been reclassified based on molecular identification. The distribution of records is skewed toward regions with considerable activity in high productivity agriculture, horticulture and forestry, and native vegetation at risk from P. cinnamomi. Native and exotic hosts of different Phytophthora species are found throughout the phylogeny; however, species from clades 1, 7 and 8 are more likely to be associated with exotic hosts. One of the most difficult challenges to overcome when establishing a pest status is a lack of reliable data on the current state of a species in any given country or location. The database compiled here for Australia and the information provided for each species overcomes this challenge. This review will aid federal and state governments in risk assessments and trade negotiations by providing a comprehensive resource on the current status of Phytophthora species in Australia. Citation: Burgess TI, Edwards J, Drenth A, et al. 2021. Current status of Phytophthora in Australia. Persoonia 47: 151-177. https://doi.org/10.3767/persoonia.2021.47.05.
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Affiliation(s)
- T.I. Burgess
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - J. Edwards
- Agriculture Victoria, Department of Jobs, Precincts and Regions, Bundoora, VIC 3083, Australia; La Trobe University, Bundoora, VIC 3083, Australia
| | - A. Drenth
- Centre for Horticultural Science, The University of Queensland, Ecosciences Precinct, Dutton Park QLD, 4102, Brisbane, Australia
| | - T. Massenbauer
- TiloMass Environmental Services, PO Box 1148, Esperance WA, 6450, Australia
| | - J. Cunnington
- Department of Agriculture, Water and the Environment, 7 London Circuit, Canberra ACT 2600 Australia
| | | | - Q. Dinh
- Agriculture Victoria, Department of Jobs, Precincts and Regions, Bundoora, VIC 3083, Australia; La Trobe University, Bundoora, VIC 3083, Australia
| | - E.C.Y. Liew
- Research Centre for Ecosystem Resilience, Royal Botanic Gardens and Domain Trust, Mrs Macquaries Rd, Sydney NSW 2000, Australia
| | - D. White
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - P. Scott
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
- Plant Pathologist, DPIRD Diagnostics and Laboratory Services, Sustainability and Biosecurity, Department of Primary Industries and Regional Development, 3 Baron-Hay Court, Kennsington WA 6151, Australia
| | - P.A. Barber
- Phytophthora Science and Management, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
- Arbor Carbon P/L, ROTA Compound off Discovery Way, Murdoch University, Murdoch 6150, Australia
| | - E. O’Gara
- Department of Biodiversity, Conservation and Attractions, 17 Dick Perry Ave, Kensington WA 6151, Australia
| | - J. Ciampini
- Department of Biodiversity, Conservation and Attractions, 17 Dick Perry Ave, Kensington WA 6151, Australia
| | - K.L. McDougall
- Department of Ecology, Environment and Evolution, School of Life Sciences, La Trobe University, Bundoora VIC 3083, Australia
| | - Y.P. Tan
- Department of Agriculture and Fisheries, Ecosciences Precinct, Dutton Park QLD 4102; Centre for Crop Health, University of Southern Queensland, Toowoomba, QLD 4350, Australia
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Chaudhury S, Hutter J, Bolton JS, Hakre S, Mose E, Wooten A, O’Connell W, Hudak J, Krebs SJ, Darden JM, Regules JA, Murray CK, Modjarrad K, Scott P, Peel S, Bergmann-Leitner ES. Serological profiles of pan-coronavirus-specific responses in COVID-19 patients using a multiplexed electro-chemiluminescence-based testing platform. PLoS One 2021; 16:e0252628. [PMID: 34081747 PMCID: PMC8174743 DOI: 10.1371/journal.pone.0252628] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/19/2021] [Indexed: 01/15/2023] Open
Abstract
Serological assessment of SARS-CoV-2 specific responses are an essential tool for determining the prevalence of past SARS-CoV-2 infections in the population especially when testing occurs after symptoms have developed and limited contact tracing is in place. The goal of our study was to test a new 10-plex electro-chemiluminescence-based assay to measure IgM and IgG responses to the spike proteins from multiple human coronaviruses including SARS-CoV-2, assess the epitope specificity of the SARS-CoV-2 antibody response against full-length spike protein, receptor-binding domain and N-terminal domain of the spike protein, and the nucleocapsid protein. We carried out the assay on samples collected from three sample groups: subjects diagnosed with COVID-19 from the U.S. Army hospital at Camp Humphreys in Pyeongtaek, South Korea; healthcare administrators from the same hospital but with no reported diagnosis of COVID-19; and pre-pandemic samples. We found that the new CoV-specific multiplex assay was highly sensitive allowing plasma samples to be diluted 1:30,000 with a robust signal. The reactivity of IgG responses to SARS-CoV-2 nucleocapsid protein and IgM responses to SARS-CoV-2 spike protein could distinguish COVID-19 samples from non-COVID-19 and pre-pandemic samples. The data from the three sample groups also revealed a unique pattern of cross-reactivity between SARS-CoV-2 and SARS-CoV-1, MERS-CoV, and seasonal coronaviruses HKU1 and OC43. Our findings show that the CoV-2 IgM response is highly specific while the CoV-2 IgG response is more cross-reactive across a range of human CoVs and also showed that IgM and IgG responses show distinct patterns of epitope specificity. In summary, this multiplex assay was able to distinguish samples by COVID-19 status and characterize distinct trends in terms of cross-reactivity and fine-specificity in antibody responses, underscoring its potential value in diagnostic or serosurveillance efforts.
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Affiliation(s)
- Sidhartha Chaudhury
- Center Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Jack Hutter
- Clinical Trials Center, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Jessica S. Bolton
- Immunology Core, Malaria Biologics Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- Henry M. Jackson Foundation for The Advancement of Military Medicine, Bethesda, MD, United States of America
| | - Shilpa Hakre
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Evelyn Mose
- Brian D. Allgood Army Community Hospital, Camp Humphreys, Pyeongtaek, South Korea
| | - Amy Wooten
- Brian D. Allgood Army Community Hospital, Camp Humphreys, Pyeongtaek, South Korea
| | - William O’Connell
- Brian D. Allgood Army Community Hospital, Camp Humphreys, Pyeongtaek, South Korea
| | - Joseph Hudak
- Brian D. Allgood Army Community Hospital, Camp Humphreys, Pyeongtaek, South Korea
| | - Shelly J. Krebs
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Janice M. Darden
- Henry M. Jackson Foundation for The Advancement of Military Medicine, Bethesda, MD, United States of America
| | - Jason A. Regules
- Immunology Core, Malaria Biologics Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | | | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Paul Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Sheila Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
| | - Elke S. Bergmann-Leitner
- Immunology Core, Malaria Biologics Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
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Dance S, Dack C, Lasheras C, McMahon C, Scott P, Adams S. Exploring the use of workplaces to recruit "hard-to-reach" male drinkers to a survey on alcohol use and awareness of health messages. BMC Public Health 2021; 21:623. [PMID: 33789645 PMCID: PMC8011195 DOI: 10.1186/s12889-021-10697-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Lower socioeconomic status (SES) groups, particularly lower SES males, are at greater risk of alcohol-related harm than higher SES groups, despite drinking at the same level or less. However, they are rarely recruited for research through typical recruitment strategies. Consequently, limited evidence exists on patterns of alcohol use and effectiveness of public health messages for these groups. Using workplaces to recruit male drinkers from lower SES backgrounds may provide a feasible and accessible approach to research participation and enable improved understanding of alcohol use, drinking motives and acceptance of alcohol-related public health messages in this underrepresented and high-risk group. We investigated workplace-based strategies to recruit male drinkers from lower SES backgrounds. We also investigated their experiences and motivations for alcohol use, and acceptance of alcohol-related public health messages. Methods A feasibility element investigated the effectiveness of workplace-based strategies to recruit male drinkers from lower SES backgrounds in the south west of England. A pilot element investigated this population’s experiences and motivations for alcohol use, and acceptance of alcohol-related public health messages, through a mixed-methods survey. Results Feasibility results indicated that workplace-based recruitment strategies, including recruiting participants in person at their workplace and providing a financial incentive, effectively led to the recruitment of 84 male drinkers (70% recruitment rate), predominately from lower SES backgrounds, to a survey. Pilot results indicated that more than half of participants were at increasing risk of alcohol-related harm, and approximately one fifth engaged in weekly heavy episodic drinking. Participation in campaigns aimed at reducing alcohol use, and knowledge of government alcohol consumption guidelines, were low. Participants reported negative beliefs about alcohol including health effects, dependency and excess use, and financial and occupational effects. Positive beliefs about alcohol included relaxation, socialising, and enjoyment. Conclusions Workplace-based recruitment, using in-person recruitment and a financial incentive, may be a feasible strategy to recruit male drinkers from lower SES backgrounds. Pilot results may direct larger scale research aiming to understand alcohol use in this population and inform targeted public health messages. Workplace-based recruitment may represent a promising avenue for future research aiming to tackle inequalities in participation in alcohol research.
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Affiliation(s)
- Sarah Dance
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK
| | - Charlotte Dack
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK
| | - Celia Lasheras
- Public Health Department, Bath & North East Somerset Council, Bath, BA2 5RP, UK
| | - Cathy McMahon
- Public Health Department, Bath & North East Somerset Council, Bath, BA2 5RP, UK
| | - Paul Scott
- Public Health Department, Bath & North East Somerset Council, Bath, BA2 5RP, UK
| | - Sally Adams
- Department of Psychology, University of Bath, Bath, BA2 7AY, UK.
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Garnick L, Massarsky A, Mushnick A, Hamaji C, Scott P, Monnot A. An evaluation of health-based federal and state PFOA drinking water guidelines in the United States. Sci Total Environ 2021; 761:144107. [PMID: 33360549 DOI: 10.1016/j.scitotenv.2020.144107] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 08/04/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
Perfluorooctanoic acid (PFOA) is a synthetic, perfluorinated organic acid previously used in fluoropolymer production in the United States. PFOA has been a recent focal point for regulation because of its ubiquitous presence in drinking water throughout the United States. In 2016, the United States Environmental Protection Agency (US EPA) issued a lifetime drinking water Health Advisory (HA) for PFOA of 0.07 μg/L; several states have also implemented their own drinking water guidelines for PFOA. The current study aimed to evaluate the basis and derivation of state and federal guidelines for PFOA in drinking water, with particular emphasis on the exposure parameters utilized. Twelve distinct PFOA drinking water standards were identified ranging from 0.0051 to 2 μg/L. The US EPA HA assumptions were evaluated using a Monte Carlo analysis that included distributions for drinking water intake (DWI) rate and the relative source contribution (RSC). We determined that US EPA's HA of 0.07 μg/L is protective of 99% of the population of lactating women. We also demonstrated that the health-based guidelines were highly variable across states and that the actual RSC of PFOA from drinking water is likely greater than 20%, based on studies of actual PFOA exposures from dust, water, and food. A sensitivity analysis was performed using the same equations as the US EPA, while substituting the RSC and DWI variables; resulting in HAs ranging from 0.074 to 0.346 μg/L. We also evaluated the contribution of PFOA in drinking water to the systemic PFOA body burden of the general population using an available biokinetic model. We conclude that more rigorous efforts are warranted to establish consistent health-based drinking water guidelines for PFOA, given that drinking water is a primary source of human exposure to PFOA in the United States.
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Affiliation(s)
- Lindsey Garnick
- Cardno ChemRisk, San Francisco, CA 94104, United States of America
| | - Andrey Massarsky
- Cardno ChemRisk, Aliso Viejo, CA 92656, United States of America
| | - Adam Mushnick
- Cardno ChemRisk, San Francisco, CA 94104, United States of America; Duke University Nicholas School of the Environment, Durham, NC 27705, United States of America
| | - Claire Hamaji
- Cardno ChemRisk, San Francisco, CA 94104, United States of America
| | - Paul Scott
- Cardno ChemRisk, Pittsburgh, PA 15222, United States of America
| | - Andrew Monnot
- Cardno ChemRisk, San Francisco, CA 94104, United States of America.
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Harding I, Murgatroyd F, Scott P. Broad complex tachycardia and paroxysmal atrial fibrillation: What is the diagnosis? J Cardiovasc Electrophysiol 2020; 31:1229-1231. [PMID: 32202016 DOI: 10.1111/jce.14451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Idris Harding
- Department of Cardiology, King's College Hospital, London, UK
| | | | - Paul Scott
- Department of Cardiology, King's College Hospital, London, UK
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Joyce MG, Sankhala RS, Chen WH, Choe M, Bai H, Hajduczki A, Yan L, Sterling SL, Peterson CE, Green EC, Smith C, de Val N, Amare M, Scott P, Laing ED, Broder CC, Rolland M, Michael NL, Modjarrad K. A Cryptic Site of Vulnerability on the Receptor Binding Domain of the SARS-CoV-2 Spike Glycoprotein. bioRxiv 2020:2020.03.15.992883. [PMID: 32511298 PMCID: PMC7217142 DOI: 10.1101/2020.03.15.992883] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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] [Indexed: 01/25/2023]
Abstract
SARS-CoV-2 is a zoonotic virus that has caused a pandemic of severe respiratory disease-COVID-19-within several months of its initial identification. Comparable to the first SARS-CoV, this novel coronavirus's surface Spike (S) glycoprotein mediates cell entry via the human ACE-2 receptor, and, thus, is the principal target for the development of vaccines and immunotherapeutics. Molecular information on the SARS-CoV-2 S glycoprotein remains limited. Here we report the crystal structure of the SARS-CoV-2 S receptor-binding-domain (RBD) at a the highest resolution to date, of 1.95 Å. We identified a set of SARS-reactive monoclonal antibodies with cross-reactivity to SARS-CoV-2 RBD and other betacoronavirus S glycoproteins. One of these antibodies, CR3022, was previously shown to synergize with antibodies that target the ACE-2 binding site on the SARS-CoV RBD and reduce viral escape capacity. We determined the structure of CR3022, in complex with the SARS-CoV-2 RBD, and defined a broadly reactive epitope that is highly conserved across betacoronaviruses. This epitope is inaccessible in the "closed" prefusion S structure, but is accessible in "open" conformations. This first-ever resolution of a human antibody in complex with SARS-CoV-2 and the broad reactivity of this set of antibodies to a conserved betacoronavirus epitope will allow antigenic assessment of vaccine candidates, and provide a framework for accelerated vaccine, immunotherapeutic and diagnostic strategies against SARS-CoV-2 and related betacoronaviruses.
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Affiliation(s)
- M. Gordon Joyce
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rajeshwer S. Sankhala
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Wei-Hung Chen
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Misook Choe
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Hongjun Bai
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Agnes Hajduczki
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Lianying Yan
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA, Bethesda, MD, USA
| | - Spencer L. Sterling
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA, Bethesda, MD, USA
| | - Caroline E. Peterson
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Ethan C. Green
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Clayton Smith
- Center for Molecular Microscopy, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
- Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Natalia de Val
- Center for Molecular Microscopy, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
- Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, USA
| | - Mihret Amare
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Paul Scott
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Eric D. Laing
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA, Bethesda, MD, USA
| | - Christopher C. Broder
- Department of Microbiology and Immunology, Uniformed Services University, Bethesda, MD, USA, Bethesda, MD, USA
| | - Morgane Rolland
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Nelson L. Michael
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Kayvon Modjarrad
- Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Center for Infectious Diseases Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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Das S, Ng W, Wheelahan A, Scott P. 537 Rapid Access Chest Pain Clinic Utilisation and Outcomes: Calvary Hospital Experience. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Barakat MF, Sunderland N, Chehab O, Kaura A, Hayat S, Amin-Youssef G, Scott P, Okonko DO. P5975Diminished LV systolic velocity on tissue Doppler imaging is linked to an amplified risk of lethal arrhythmias independently of LV ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0696] [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
Life threatening arrhythmias (LTA) can trigger sudden cardiac death, or provoke implantable cardioverter defibrillator (ICD) discharges that escalate morbidity and mortality. Longitudinal myofibrils predominate in the subendocardium which is uniquely sensitive to arrhythmogenic triggers.
Objectives
To test the hypothesis that mitral annular systolic velocity (S'), a tissue Doppler index of LV long-axis systolic function, might predict lethal arrhythmias irrespective of LVEF.
Methods
We analysed data from diverse ICD and cardiac resynchronization therapy defibrillator (CRT-D) patients at 2 London centres. Channelopathies were excluded. S' was averaged from medial and lateral mitral annuli velocities. Primary outcome was time to sustained ventricular tachycardia (VT) or fibrillation (VF) needing device therapy.
Results
In 302 patients (mean age 68 years, LVEF 32%, 77% male, 52% ischemic, 35% primary prevention, and 53% CRT-D), median S' was 5.1 (IQR: 4.0–6.2) cm/s and lower in CRT-D than ICD subjects. After a median follow-up of 15 months, 56 (19%) subjects had LTA and those who did had a lower S' than those who did not (4.6±1.4 cm/s vs. 5.4±1.7 cm/s, P=0.003-Fig A). Each 1cm/s lower S' correlated to a 43% increased risk of LTA (HR: 0.70, 95% CI: 0.57–0.87, P=0.001) independently of age, gender, β-blocker use, centre, ICD use and LVEF. Adding S' to the baseline model improved net reclassification (P=0.02) implying incremental utility (Fig B). An S' ≤5.6cm/s was the best cut-off, conferring a 2.4-fold higher LTA risk than an S'>5.6 cm/s (95% CI: 1.17–4.37, P=0.02–Fig C).
Conclusion
A lower S' forecasts an enhanced probability of LTA in cardiac device recipients irrespective of LVEF, and could be used to titrate medical, device and ablative therapies to mitigate future arrhythmic risk.
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Affiliation(s)
- M F Barakat
- King's College London, London, United Kingdom
| | | | - O Chehab
- King's College London, London, United Kingdom
| | - A Kaura
- Kings College Hospital, London, United Kingdom
| | - S Hayat
- University Hospital, Cardiology, Coventry, United Kingdom
| | | | - P Scott
- Kings College Hospital, London, United Kingdom
| | - D O Okonko
- King's College London, London, United Kingdom
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Li H, Ji M, Scott P, Dunbar-Jacob JM. The Effect of Symptom Clusters on Quality of Life Among Patients With Type 2 Diabetes. Diabetes Educ 2019; 45:287-294. [DOI: 10.1177/0145721719837902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose The purpose of this study was to examine the collective effect of a symptom cluster (depression, anxiety, fatigue, and impaired sleep quality) at baseline on the quality of life (QOL) of patients with type 2 diabetes (T2DM) over time. Methods This was a secondary data analysis of 302 patients with T2DM who presented with both hypertension and hyperlipidemia. All of the participants were enrolled in a randomized controlled intervention study testing strategies to improve medication adherence. The psychological symptoms and QOL were assessed at baseline, 6 months, and 12 months. Cluster analysis was used to identify subgroups of patients based on the severity of symptoms at baseline. Results Hierarchical cluster analysis identified 4 patient subgroups: all low severity, mild, moderate, and all high severity. There were significant differences in patients’ QOL overall among the 4 subgroups. Compared with the all-low-severity subgroup, subgroups with higher severity of the 4 symptoms had poorer QOL across all 3 time points. QOL was most impacted by trait anxiety across the 3 time points. Conclusion QOL was significantly impacted by psychological symptom clusters among patients with T2DM. Healthcare providers should not neglect psychological symptoms that patients experience. It is important to assess and manage these symptoms to improve QOL among patients with diabetes.
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Affiliation(s)
- Hongjin Li
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Ms Li)
| | - Meihua Ji
- School of Nursing, Capital Medical University, Beijing, China (Dr Ji)
| | - Paul Scott
- Department of Health & Community Systems, Center for Research & Evaluation, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Dr Scott)
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Kaura A, Sunderland N, Murgatroyd F, Dhillon P, Scott P. META-ANALYSIS ON THE IMPACT OF CONTACT FORCE SENSING CATHETERS ON OUTCOMES IN ATRIAL FIBRILLATION ABLATION: A FOCUS ON RANDOMIZED CONTROLLED TRIAL VERSUS OBSERVATIONAL DATA. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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42
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Jaumdally H, Barakat MF, Charles-Edwards G, Amin-Youssef G, Shah AM, Scott P, Okonko DO. IRON ISOMALTOSIDE DIMINISHES ATRIAL ELECTRICAL INHOMOGENEITY IN CHRONIC HEART FAILURE WITHOUT ALTERING ATRIAL SIZE: A FERRIC-HF II SUBSTUDY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Salter SJ, Scott P, Page AJ, Tracey A, de Goffau MC, Cormie C, Ochoa-Montaño B, Ling CL, Tangmanakit J, Turner P, Parkhill J. 'Candidatus Ornithobacterium hominis': insights gained from draft genomes obtained from nasopharyngeal swabs. Microb Genom 2019; 5. [PMID: 30720420 PMCID: PMC6421346 DOI: 10.1099/mgen.0.000247] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
'Candidatus Ornithobacterium hominis' represents a new member of the Flavobacteriaceae detected in 16S rRNA gene surveys of people from South-East Asia, Africa and Australia. It frequently colonizes the infant nasopharynx at high proportional abundance, and we demonstrate its presence in 42 % of nasopharyngeal swabs from 12-month-old children in the Maela refugee camp in Thailand. The species, a Gram-negative bacillus, has not yet been cultured, but the cells can be identified in mixed samples by fluorescent hybridization. Here, we report seven genomes assembled from metagenomic data, two to improved draft standard. The genomes are approximately 1.9 Mb, sharing 62 % average amino acid identity with the only other member of the genus, the bird pathogen Ornithobacterium rhinotracheale. The draft genomes encode multiple antibiotic-resistance genes, competition factors, Flavobacterium johnsoniae-like gliding motility genes and a homologue of the Pasteurella multocida mitogenic toxin. Intra- and inter-host genome comparison suggests that colonization with this bacterium is both persistent and strain exclusive.
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Affiliation(s)
| | - Paul Scott
- 1Pathogen Genomics, Wellcome Sanger Institute, Hinxton, UK
| | - Andrew J Page
- 1Pathogen Genomics, Wellcome Sanger Institute, Hinxton, UK.,†Present address: Quadram Institute Bioscience, Norwich, UK
| | - Alan Tracey
- 1Pathogen Genomics, Wellcome Sanger Institute, Hinxton, UK
| | | | - Claire Cormie
- 1Pathogen Genomics, Wellcome Sanger Institute, Hinxton, UK
| | - Bernardo Ochoa-Montaño
- 2Department of Biochemistry, University of Cambridge, Cambridge, UK.,‡Present address: Illumina Cambridge Ltd, Little Chesterford, UK
| | - Clare L Ling
- 3Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,4Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jiraporn Tangmanakit
- 3Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Paul Turner
- 4Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,5Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
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Milligan-Saville J, Choi I, Deady M, Scott P, Tan L, Calvo RA, Bryant RA, Glozier N, Harvey SB. The impact of trauma exposure on the development of PTSD and psychological distress in a volunteer fire service. Psychiatry Res 2018; 270:1110-1115. [PMID: 30190167 DOI: 10.1016/j.psychres.2018.06.058] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/17/2018] [Accepted: 06/27/2018] [Indexed: 11/25/2022]
Abstract
Emergency service workers (ESWs) are at increased risk of trauma-related mental disorders. However, volunteer ESWs, who comprise the majority of firefighters in Western countries, have limited access to the necessary support services for mental health problems. This study aimed to examine the impact of the level and types of trauma exposure on the development of mental disorders in a volunteer fire service. Members of an Australian volunteer fire service (N = 459) completed a cross-sectional survey. Information on the number and types of distressing critical incidents involved within the last year was collected. Validated, self-report measures were used to determine probable post-traumatic stress disorder (PTSD) and psychological distress caseness. The risk of probable PTSD was significantly higher for those with the most frequent involvement with distressing incidents and the highest levels of cumulative trauma exposure. Being trapped in a dangerous situation or being assaulted by other people, resulted in the greatest odds of developing a mental disorder. Volunteer fire service members with the highest levels of trauma exposure and involvement with particular types of critical incidents are at elevated risk of mental health problems. The implications for the provision of psychological support measures amongst volunteer emergency services are discussed.
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Affiliation(s)
- Josie Milligan-Saville
- Black Dog Institute, Sydney, Australia; School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Isabella Choi
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Mark Deady
- Black Dog Institute, Sydney, Australia; School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Paul Scott
- NSW Rural Fire Service, Sydney, Australia
| | - Leona Tan
- Black Dog Institute, Sydney, Australia
| | - Rafael A Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | | | - Samuel B Harvey
- Black Dog Institute, Sydney, Australia; School of Psychiatry, University of New South Wales, Sydney, Australia.
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Nandhagopal R, Meftah D, Al-Kalbani S, Scott P. Recessive distal motor neuropathy with pyramidal signs in an Omani kindred: underlying novel mutation in the SIGMAR1 gene. Eur J Neurol 2018; 25:395-403. [PMID: 29115704 DOI: 10.1111/ene.13519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 06/25/2017] [Accepted: 11/02/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Distal hereditary motor neuropathy (dHMN) due to sigma non-opioid intracellular receptor 1 (SIGMAR1) gene mutation (OMIM 601978.0003) is a rare neuromuscular disorder characterized by prominent amyotrophic distal limb weakness and co-existing pyramidal signs initially described in a Chinese family recently. We report an extended consanguineous Omani family segregating dHMN with pyramidal signs in an autosomal recessive pattern and describe a novel mutation in the SIGMAR1 gene underlying this motor phenotype. We also provide an update on the reported phenotypic profile of SIGMAR1 mutations. METHODS We utilized homozygosity mapping and whole-exome sequencing of leucocyte DNA obtained from three affected members of an Omani family who manifested with a length-dependent motor neuropathy and pyramidal signs. RESULTS We identified a novel C>T transition at nucleotide position 238 (c.238C>T) in exon 2 of the SIGMAR1 gene. Sanger sequencing and segregation analysis confirmed the presence of two copies of the variant in the affected subjects, unlike the unaffected healthy parents/sibling who carried, at most, a single copy. The T allele is predicted to cause a truncating mutation (p.Gln80*), probably flagging the mRNA for nonsense-mediated decay leading to a complete loss of function, thereby potentially contributing to the disease process. CONCLUSIONS Our finding expands the spectrum of SIGMAR1 mutations causing recessive dHMN and indicates that this disorder is pan-ethnic. SIGMAR1 mutation should be included in the diagnostic panel of a dHMN, especially if there are co-existing pyramidal signs and autosomal recessive inheritance.
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Affiliation(s)
- R Nandhagopal
- Department of Medicine - Neurology Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - D Meftah
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - S Al-Kalbani
- Molecular Genetics and Genomics Laboratory, Sultan Qaboos University Hospital, Muscat, Oman
| | - P Scott
- Molecular Genetics and Genomics Laboratory, Sultan Qaboos University Hospital, Muscat, Oman
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Al-Shorbaji N, Hanmer L, Hussein R, Magrabi F, Moen A, Moura LA, Park HA, Scott P. Discussion of “Evidence-based Health Informatics: How Do We Know What We Know?”. Methods Inf Med 2018. [DOI: 10.3414/me14-02-0119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
SummaryThis article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper “Evidence-based Health Informatics: How Do We Know What We Know?” written by Elske Ammenwerth [1]. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Ammenwerth paper. In subsequent issues the discussion can continue through letters to the editor.With these comments on the paper “Evidence-based Health Informatics: How do we know what we know?”, written by Elske Ammenwerth [1], the journal seeks to stimulate a broad discussion on the challenges of evaluating information processing and information technology in health care. An international group of experts has been invited by the editor of Methods to comment on this paper. Each of the invited commentaries forms one section of this paper.
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Harbertson J, Jamerson M, Graf PCF, Kennemur L, House B, Michael NL, Scott P, Hale B. Population-based Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis prevalence using discarded, deidentified urine specimens previously collected for drug testing. Sex Transm Infect 2017; 94:123. [PMID: 29066630 PMCID: PMC5870458 DOI: 10.1136/sextrans-2017-053355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/18/2017] [Accepted: 09/23/2017] [Indexed: 11/21/2022] Open
Affiliation(s)
- Judith Harbertson
- US Military HIV Research Program, Walter Reed Army Institute of Research, San Diego, California, USA.,Health Sciences Business Unit, Leidos, Inc, San Diego, California, USA.,Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA
| | - Matthew Jamerson
- Navy Drug Screening Laboratory, US Navy, San Diego, California, USA
| | - Paul C F Graf
- Naval Medical Center, San Diego, California, USA.,Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California, USA
| | - Lisa Kennemur
- Navy Drug Screening Laboratory, US Navy, San Diego, California, USA
| | - Brent House
- Naval Medical Center, San Diego, California, USA
| | - Nelson L Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, San Diego, California, USA
| | - Paul Scott
- US Military HIV Research Program, Walter Reed Army Institute of Research, San Diego, California, USA
| | - Brad Hale
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, California, USA.,University of California, San Diego, California, USA
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Storey M, Forde K, Littlewood SJ, Scott P, Luther F, Kang J. Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 2: periodontal health outcomes after 12 months. Eur J Orthod 2017; 40:399-408. [DOI: 10.1093/ejo/cjx059] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Madeleine Storey
- Department of Orthodontics, Leeds Dental Institute, Clarendon Way, UK
| | | | | | - Paul Scott
- Department of Orthodontics, Montagu Hospital, Mexborough, Doncaster and Bassetlaw NHS Trust, UK
| | - Friedy Luther
- Department of Orthodontics, The Charles Clifford Dental Hospital, Sheffield, UK
| | - Jing Kang
- Department of Biostatistics, School of Dentistry, University of Leeds, UK
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Forde K, Storey M, Littlewood SJ, Scott P, Luther F, Kang J. Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 1: stability, retainer survival, and patient satisfaction outcomes after 12 months. Eur J Orthod 2017; 40:387-398. [DOI: 10.1093/ejo/cjx058] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Madeleine Storey
- Department of Orthodontics, Leeds Dental Institute, Clarendon Way, UK
| | | | - Paul Scott
- Department of Orthodontics, Montagu Hospital, Mexborough, Doncaster and Bassetlaw NHS Trust, UK
| | - Friedy Luther
- Sheffield Teaching Hospitals NHS Foundation Trust, Department of Orthodontics, The Charles Clifford Dental Hospital, Sheffield, UK
| | - Jing Kang
- Department of Biostatistics, School of Dentistry, University of Leeds, UK
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Mellor A, Bakker-Dyos J, Howard M, Boos C, Cooke M, Vincent E, Scott P, O'Hara J, Clarke SB, Barlow M, Matu J, Deighton K, Hill N, Newman C, Cruttenden R, Holdsworth D, Woods D. The British Services Dhaulagiri Medical Research Expedition 2016: a unique military and civilian research collaboration. J ROY ARMY MED CORPS 2017; 163:371-375. [DOI: 10.1136/jramc-2016-000700] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/17/2016] [Accepted: 01/26/2017] [Indexed: 11/04/2022]
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