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Kenway S, Pamminger F, Yan G, Hall R, Lam K, Skinner R, Olsson G, Satur P, Allan J. Opportunities and challenges of tackling Scope 3 "Indirect" emissions from residential hot water. Water Res X 2023; 21:100192. [PMID: 37693826 PMCID: PMC10485153 DOI: 10.1016/j.wroa.2023.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023]
Abstract
The water sector could play a major role towards a Net Zero greenhouse gas (GHG) future if Scope 3 emissions were embraced and operationalised. Significant opportunities and challenges exist in tackling Scope 3 emissions including those associated with customer hot water use. Present GHG emission reduction practices predominantly focus on Scope 1 "within utility" and Scope 2 "purchased energy" emissions. In the urban water cycle, Scope 3 "indirect" emissions dominate, and water use is only one example of Scope 3 emissions. Over 90% of all water cycle GHG emissions can be attributed to water use in residential, industrial and commercial premises, collectively some 7% of global GHG emissions. One possibility is for water utilities to actively support efficient hot water use such as new ultra-low flow shower heads. Scope 3 opportunities also offer a range of cost-effective emissions-reduction opportunities, particularly when the wider perspective of "community value" is considered and not just a "business financial perspective". Hot water efficiency is additionally essential to Net Zero carbon futures, even with decarbonised grids, because most major Net Zero roadmaps require energy efficiency gains. Scientific and management advance needed includes: accounting methodologies, clear roles, collaboration, new business models, and clear definitions. The water sector has the opportunity to play a significant role in achieving Net Zero cities. The decision how much is yet to be made.
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Affiliation(s)
- S.J. Kenway
- Australian Centre for Water and Environmental Biotechnology, The University of Queensland, St. Lucia, QLD 4067, Australia
| | | | - G. Yan
- Australian Centre for Water and Environmental Biotechnology, The University of Queensland, St. Lucia, QLD 4067, Australia
| | - R. Hall
- Australian Centre for Water and Environmental Biotechnology, The University of Queensland, St. Lucia, QLD 4067, Australia
| | - K.L. Lam
- Division of Natural and Applied Sciences, Duke Kunshan University, Kunshan, Jiangsu 215316, China
| | - R. Skinner
- Monash Sustainable Development Institute, Monash University, Clayton, Australia
| | - G. Olsson
- Division of Industrial Electrical Engineering and Automation (IEA), Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - P. Satur
- Monash Sustainable Development Institute, Monash University, Clayton, Australia
| | - J. Allan
- Australian Centre for Water and Environmental Biotechnology, The University of Queensland, St. Lucia, QLD 4067, Australia
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Miller P, Patel SR, Skinner R, Dignan F, Richter A, Jeffery K, Khan A, Heath PT, Clark A, Orchard K, Snowden JA, de Silva TI. Joint consensus statement on the vaccination of adult and paediatric haematopoietic stem cell transplant recipients: Prepared on behalf of the British society of blood and marrow transplantation and cellular therapy (BSBMTCT), the Children's cancer and Leukaemia Group (CCLG), and British Infection Association (BIA). J Infect 2023; 86:1-8. [PMID: 36400155 DOI: 10.1016/j.jinf.2022.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
Haematopoietic stem cell transplant (HSCT) recipients have deficiencies in their adaptive immunity against vaccine preventable diseases. National and International guidance recommends that HSCT recipients are considered 'never vaccinated' and offered a comprehensive course of revaccination. This position statement aims to draw upon the current evidence base and existing guidelines, and align this with national vaccine availability and licensing considerations in order to recommend a pragmatic and standardised re-vaccination schedule for adult and paediatric HSCT recipients in the UK.
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Affiliation(s)
- Pde Miller
- British Society of Blood and Marrow Transplantation and Cellular Therapy, UK
| | - S R Patel
- Paediatric Department, Croydon Health Services NHS Trust, Croydon, UK
| | - R Skinner
- University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - F Dignan
- Department of Clinical Haematology, University of Manchester, Manchester, UK
| | - A Richter
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - K Jeffery
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A Khan
- St. James' Hospital, Leeds, UK
| | - P T Heath
- Vaccine Institute, Institute of Infection and Immunity, St. George's, University of London, London, UK
| | - A Clark
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - K Orchard
- Wessex Blood and Marrow Transplant and Cellular Therapy Program, Department of Haematology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Department of Oncology and Metabolism, Medical School, The University of Sheffield, Sheffield, UK
| | - T I de Silva
- Department of Infection, Immunity and Cardiovascular Disease, Medical School, The University of Sheffield, Sheffield, UK.
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Gebauer J, Skinner R, Haupt R, Kremer L, van der Pal H, Michel G, Armstrong GT, Hudson MM, Hjorth L, Lehnert H, Langer T. The chance of transition: strategies for multidisciplinary collaboration. Endocr Connect 2022; 11:e220083. [PMID: 35900792 PMCID: PMC9422248 DOI: 10.1530/ec-22-0083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/13/2022] [Indexed: 11/08/2022]
Abstract
Many long-term childhood cancer survivors suffer from treatment-related late effects, which may occur in any organ and include a wide spectrum of conditions. Long-term follow-up (LTFU) is recommended to facilitate early diagnosis and to ensure better health outcomes. Due to the heterogeneity of these sequelae, different specialists work together in the diagnosis and treatment of these conditions. Experts from both pediatric and internal medicine are involved in age-appropriate care by providing a transition process. Hence, LTFU of childhood cancer survivors is a prototypic example of multidisciplinary care for patients with complex needs treated in a specialized setting. International collaborations of healthcare professionals and scientists involved in LTFU of childhood cancer survivors, such as the International Guideline Harmonization Group, compile surveillance recommendations that can be clinically adopted all over the world. These global networks of clinicians and researchers make a joint effort to address gaps in knowledge, increase visibility and awareness of cancer survivorship and provide an excellent example of how progress in clinical care and scientific research may be achieved by international and multidisciplinary collaboration.
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Affiliation(s)
- J Gebauer
- Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Campus Luebeck and Institute for Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany
| | - R Skinner
- Department of Paediatric and Adolescent Haematology and Oncology and Children’s BMT Unit, Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - R Haupt
- DOPO Clinic, Department of Hematology/Oncolgy, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - L Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Amsterdam UMC, Emma’s Children’s Hospital, Amsterdam, The Netherlands
| | - H van der Pal
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - G Michel
- Department of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - G T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - M M Hudson
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - L Hjorth
- Department of Clinical Sciences Lund, Paediatrics, Lund University, Skane University Hospital, Lund, Sweden
| | - H Lehnert
- Paris Lodron University of Salzburg, Salzburg, Austria
| | - T Langer
- Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
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Burgess T, Braunack-Mayer A, Tooher R, Collins J, O'Keefe M, Skinner R, Watson M, Ashmeade H, Proeve C, Marshall H. Optimizing intersectoral collaboration between health and education: the Health Bridges study. J Public Health (Oxf) 2018; 38:e430-e437. [PMID: 28158696 DOI: 10.1093/pubmed/fdv190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Burgess
- School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia
| | | | - R Tooher
- School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia
| | - J Collins
- School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - M O'Keefe
- School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | | | - M Watson
- Immunisation Section, Department for Health and Ageing, Adelaide, SA 5000, Australia
| | - H Ashmeade
- Department for Education and Child Development, South Australia, Australia
| | - C Proeve
- School of Public Health, University of Adelaide, Adelaide, SA 5005, Australia
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Lee VY, Booy R, Skinner R, Edwards KM. The effect of exercise on vaccine-related pain, anxiety and fear during HPV vaccinations in adolescents. Vaccine 2018; 36:3254-3259. [PMID: 29709446 DOI: 10.1016/j.vaccine.2018.04.069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 03/07/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION With increased school-based vaccinations for improved coverage rates and practicality, the World Health Organization (WHO) recently endorsed research to identify possible interventions to reduce vaccine-related pain in mass clinical and school-based settings. In particular, the lack of research in adolescents indicate a particular need in this population. Acute exercise has analgesic effects and has been used as a behavioural adjuvant to vaccination. Here, we examine the effect of exercise on vaccine-related pain, anxiety and fear in adolescents, during a school-based program for HPV vaccinations. METHODS 116 students (Female: 61, Male: 55) aged 11-13 years were randomly allocated to either an Exercise (n = 60) or Control (n = 56) group. All participants completed demographic and Trait-anxiety questionnaires prior to receiving the vaccine according to usual care. The Exercise group also performed upper body exercise for 15 min prior to receiving the vaccine. Immediately after the vaccine administration, all participants reported on pain, anxiety and fear at the time of receiving the vaccine. RESULTS Female adolescents in the Exercise group reported significantly less pain (3.64; 95% CI, 2.98-4.30) than Controls (4.58; 95% CI, 3.96-5.19; p = 0.04). Further, females reported greater pain and anxiety than males in the Control group but not the Exercise group. CONCLUSION This study supports the use of exercise prior to vaccine administration, especially in female adolescents who are particularly vulnerable to negative experiences during vaccination procedures. Furthermore, the ease of application, as well as the benefit of exercise, provides support for the use of simple exercise prior to vaccination in mass vaccination settings. Clinical trial registry: ANZCTR, ACTRN12614001185651.
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Affiliation(s)
- V Y Lee
- The University of Sydney, Faculty of Health Sciences & Charles Perkins Centre, Sydney, Australia.
| | - R Booy
- The University of Sydney, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
| | - R Skinner
- University of Sydney, Dept of Paediatrics & Adolescent Health, Children's Hospital at Westmead, Australia
| | - K M Edwards
- The University of Sydney, Faculty of Health Sciences & Charles Perkins Centre, Sydney, Australia
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Abstract
Results of treatment of end-stage renal failure (ESRF) in patients with primary hyperoxaluria have been generally poor, largely due to the inability of any treatment regime to match the endogenous overproduction of oxalate. The severity of the disease varies widely, as reflected by the differences in age at onset of ESRF. This variability may influence the results of treatment of ESRF in these patients. The longest reported survival on haemodialysis of a patient with primary hyperoxaluria is eight and a half years. We report a patient who survived for eleven years on haemodialysis after reaching ESRF due to primary hyperoxaluria, and suggest that this prolonged survival was due to relatively mild disease severity rather than exceptional treatment.
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Affiliation(s)
- R. Skinner
- Department of Renal Medicine, Freeman Hospital, Newcastle upon Tyne - U.K
| | - C.R.V. Tomson
- Department of Renal Medicine, Freeman Hospital, Newcastle upon Tyne - U.K
| | - J.S. Tapson
- Department of Renal Medicine, Freeman Hospital, Newcastle upon Tyne - U.K
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Flinn AM, Roberts CF, Slatter MA, Skinner R, Robson H, Lawrence J, Guest J, Gennery AR. Thymopoiesis following HSCT; a retrospective review comparing interventions for aGVHD in a pediatric cohort. Clin Immunol 2018; 193:33-37. [PMID: 29395846 DOI: 10.1016/j.clim.2018.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 01/31/2023]
Abstract
Acute graft-versus-host disease (aGVHD) complicates allogeneic hematopoietic stem cell transplantation (HSCT), and is treated with topical and/or systemic corticosteroids. Systemic corticosteroids and aGVHD damage thymic tissue. We compared thymopoietic effect of topical steroid therapy, corticosteroids and extracorporeal photopheresis (ECP) in 102 pediatric allogeneic HSCT patients. We categorized patients into 4 groups: - no aGVHD, aGVHD treated with topical or systemic steroid, or ECP. Naïve CD4+CD45RA+CD27+ T-lymphocyte values at 3, 6, 9, 12months post-HSCT were recorded: for ECP patients, values were recorded at 3, 6, 9, 12months during ECP. Differences were compared using the Kruskal-Wallis test. 41 patients had no aGVHD, 23 had aGVHD treated topically or systemically (25), 13 received ECP. Rate of thymopoiesis was significantly different between all groups at all time-points post-transplant (p=0.002, p<0.001, p<0.001, p=0.001 respectively). Even mild aGVHD impairs thymopoiesis. Worst recovery was in ECP patients. Earlier institution of ECP may speed thymic recovery.
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Affiliation(s)
- A M Flinn
- Institute of Cellular Medicine, Newcastle University, United Kingdom.
| | - C F Roberts
- Institute of Cellular Medicine, Newcastle University, United Kingdom
| | - M A Slatter
- Institute of Cellular Medicine, Newcastle University, United Kingdom; Great North Childrens' Hospital, Newcastle-upon-Tyne, United Kingdom
| | - R Skinner
- Great North Childrens' Hospital, Newcastle-upon-Tyne, United Kingdom
| | - H Robson
- Great North Childrens' Hospital, Newcastle-upon-Tyne, United Kingdom
| | - J Lawrence
- Great North Childrens' Hospital, Newcastle-upon-Tyne, United Kingdom
| | - J Guest
- Great North Childrens' Hospital, Newcastle-upon-Tyne, United Kingdom
| | - A R Gennery
- Institute of Cellular Medicine, Newcastle University, United Kingdom; Great North Childrens' Hospital, Newcastle-upon-Tyne, United Kingdom
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Skinner R, McFaull S, Draca J, Frechette M, Kaur J, Pearson C, Thompson W. Suicide and self-inflicted injury hospitalizations in Canada (1979 to 2014/15). Health Promot Chronic Dis Prev Can 2017; 36:243-251. [PMID: 27882859 DOI: 10.24095/hpcdp.36.11.02] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The purpose of this paper is to describe the trends and patterns of self-inflicted injuries, available from Canadian administrative data between 1979 and 2014/15, in order to inform and improve suicide prevention efforts. METHODS Suicide mortality and hospital separation data were retrieved from the Public Health Agency of Canada (PHAC) holdings of Statistics Canada's Canadian Vital Statistics: Death Database (CVS:D) (1979 to 2012); Canadian Socio-Economic Information Management System (CANSIM 2011, 2012); the Hospital Morbidity Database (HMDB) (1994/95 to 2010/11); and the Discharge Abstract Database (2011/12 to 2014/15). Mortality and hospitalization counts and rates were reported by sex, 5-year age groups and method. RESULTS The Canadian suicide rate (males and females combined, all ages, age-sex standardized rate) has decreased from 14.4/100 000 (n = 3355) in 1979 to 10.4/100 000 (n = 3926) in 2012, with an annual percent change (APC) of -1.2% (95% CI: -1.3 to -1.0). However, this trend was not observed in both sexes: female suicide rates stabilized around 1990, while male rates continued declining over time-yet males still accounted for 75.7% of all suicides in 2012. Suffocation (hanging and strangulation) was the primary method of suicide (46.9%) among Canadians of all ages in 2012, followed by poisoning at 23.3%. In the 2014/15 fiscal year, there were 13 438 hospitalizations in Canada (excluding Quebec) associated with self-inflicted injuries-over 3 times the number of suicides. Over time females have displayed consistently higher rates of hospitalization for self-inflicted injury than males, with 63% of the total. Poisoning was reported as the most frequent means of self-inflicted harm in the fiscal year 2014/15, at 86% of all hospitalizations. CONCLUSION Suicides and self-inflicted injuries continue to be a serious - but preventable - public health problem that requires ongoing surveillance.
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Affiliation(s)
- R Skinner
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - S McFaull
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - J Draca
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - M Frechette
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - J Kaur
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - C Pearson
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - W Thompson
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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Brown A, Carlson K, Culp W, Lowery J, Hellman M, Skinner R. Only large numbers of animals show sex differences in a rabbit stroke model. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1033] [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: 11/25/2022] Open
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Miller PDE, de Silva TI, Skinner R, Gilleece M, Peniket A, Hamblin A, Greenfield D, Anthias C, Peggs K, Madrigal A, Snowden JA. Routine vaccination practice after adult and paediatric allogeneic haematopoietic stem cell transplant: a survey of UK NHS programmes. Bone Marrow Transplant 2017; 52:775-777. [DOI: 10.1038/bmt.2016.362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Crain J, McFaull S, Thompson W, Skinner R, Do MT, Fréchette M, Mukhi S. Status report - The Canadian Hospitals Injury Reporting and Prevention Program: a dynamic and innovative injury surveillance system. Health Promot Chronic Dis Prev Can 2016; 36:112-117. [PMID: 27284703 PMCID: PMC4910447 DOI: 10.24095/hpcdp.36.6.02] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
This status report on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), an emergency department-based injury and poisoning surveillance system, describes the result of migrating from a centralized data entry and coding process to a decentralized process, the web-based eCHIRPP system, in 2011. This secure system is improving the CHIRPP's overall flexibility and timeliness, which are key attributes of an effective surveillance system. The integrated eCHIRPP platform enables near real-time data entry and access, has user-friendly data management and analysis tools, and allows for easier communication and connectivity across the CHIRPP network through an online collaboration centre. Current pilot testing of automated data monitoring and trend analysis tools-designed to monitor and flag incoming data according to predefined criteria (for example, a new consumer product)-is revealing eCHIRPP's potential for providing early warnings of new hazards, issues and trends.
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Affiliation(s)
- J Crain
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - S McFaull
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - W Thompson
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - R Skinner
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - M T Do
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - M Fréchette
- Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - S Mukhi
- Canadian Network for Public Health Intelligence, Public Health Agency of Canada, Ottawa, Ontario, Canada
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12
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Carlson K, Arthur M, Brown A, Skinner R, Culp W. Posterior occlusions limit effectiveness of dodecafluoropentane emulsion (DDFPe) neuroprotection. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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13
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Brown M, Pearce M, Bailey S, Skinner R. The long-term psychosocial impact of cancer: the views of young adult survivors of childhood cancer. Eur J Cancer Care (Engl) 2015; 25:428-39. [DOI: 10.1111/ecc.12380] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 11/28/2022]
Affiliation(s)
- M.C. Brown
- Institute of Health & Society; Newcastle University; Newcastle upon Tyne UK
| | - M.S. Pearce
- Institute of Health & Society; Newcastle University; Newcastle upon Tyne UK
| | - S. Bailey
- Great North Children's Hospital; The Royal Victoria Infirmary; Newcastle upon Tyne UK
- Northern Institute for Cancer Research; Newcastle University; Newcastle upon Tyne UK
| | - R. Skinner
- Great North Children's Hospital; The Royal Victoria Infirmary; Newcastle upon Tyne UK
- Northern Institute for Cancer Research; Newcastle University; Newcastle upon Tyne UK
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Affiliation(s)
- A Razavi
- Singleton Hospital, Swansea SA2 8QA, UK
| | - A Farboud
- Singleton Hospital, Swansea SA2 8QA, UK
| | | | - K Saw
- Singleton Hospital, Swansea SA2 8QA, UK
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Abstract
Graft-versus-host disease (GvHD) remains a significant hurdle in overcoming the morbidity and mortality associated with haemopoietic stem cell transplantation in children. Better understanding of its pathobiology is facilitating the development of biomarkers for the severity of acute GvHD and treatment response, and has led to the introduction of a more prognostically relevant grading system for chronic GvHD. These enable stratification of appropriate prophylactic and treatment strategies according to the risk profiles of individual patients. Steroid-refractory acute GvHD has a poor prognosis, but early reports of the use of new immunosuppressive drugs and especially cellular treatments with extracorporeal photopheresis and mesenchymal stem cells suggest improved short-term outcomes and offer the promise of increased longer-term survival rates.
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Affiliation(s)
- S Dhir
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK
| | - M Slatter
- Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK
| | - R Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle upon Tyne, UK Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK
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16
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Slade M, Byford S, Barrett B, Lloyd-Evans B, Gilburt H, Osborn DPJ, Skinner R, Leese M, Thornicroft G, Johnson S. Alternatives to standard acute in-patient care in England: short-term clinical outcomes and cost-effectiveness. Br J Psychiatry 2014; 53:s14-9. [PMID: 20679274 DOI: 10.1192/bjp.bp.110.081059] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 11/23/2022]
Abstract
BACKGROUND Outcomes following admission to residential alternatives to standard in-patient mental health services are underresearched. AIMS To explore short-term outcomes and costs of admission to alternative and standard services. METHOD Health of the Nation Outcome Scales (HoNOS), Threshold Assessment Grid (TAG), Global Assessment of Functioning (GAF) and admission cost data were collected for six alternative services and six standard services. RESULTS All outcomes improved during admission for both types of service (n = 433). Adjusted improvement was greater for standard services in scores on HoNOS (difference 1.99, 95% CI 1.12-2.86), TAG (difference 1.40, 95% CI 0.39-2.51) and GAF functioning (difference 4.15, 95% CI 1.08-7.22) but not GAF symptoms. Admissions to alternatives were 20.6 days shorter, and hence cheaper (UK pound3832 v. pound9850). Standard services cost an additional pound2939 per unit HoNOS improvement. CONCLUSIONS The absence of clear-cut advantage for either type of service highlights the importance of the subjective experience and longer-term costs.
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Affiliation(s)
- M Slade
- Health Service and Population Research Department, Box PO29, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.
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Smith LW, Guy R, Degenhardt L, Richters J, Robbins S, Kaldor J, Lumby C, Skinner R, Liu B. P4.024 Do New Media Affect Adolescent Sexual Attitudes and Behaviours? A Systematic Review. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Wade M, Tucker I, Cunningham P, Skinner R, Bell F, Lyons T, Patten K, Gonzalez L, Wess T. Investigating the origins of nanostructural variations in differential ethnic hair types using X-ray scattering techniques. Int J Cosmet Sci 2013; 35:430-41. [DOI: 10.1111/ics.12061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 04/27/2013] [Indexed: 11/27/2022]
Affiliation(s)
- M. Wade
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
| | - I. Tucker
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - P. Cunningham
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - R. Skinner
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - F. Bell
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - T. Lyons
- Unilever Research & Development Port Sunlight; Quarry Rd East; Bebington Wirral; CH63 3JW; U.K
| | - K. Patten
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
| | - L. Gonzalez
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
| | - T. Wess
- School of Optometry & Vision Sciences; Cardiff University; Maindy Road; Cardiff CF24 4LU; U.K
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Gibson F, Chisholm J, Blandford E, Donachie P, Hartley J, Lane S, Selwood K, Skinner R, Phillips R. Developing a national ‘low risk’ febrile neutropenia framework for use in children and young people's cancer care. Support Care Cancer 2012; 21:1241-51. [DOI: 10.1007/s00520-012-1653-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 10/29/2012] [Indexed: 11/24/2022]
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21
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McFaull SR, Fréchette M, Skinner R. Emergency department surveillance of injuries associated with bunk beds: the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990-2009. Chronic Dis Inj Can 2012; 33:38-46. [PMID: 23294920] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Due to space constraints, bunk beds are a common sleeping arrangement in many homes. The height and design of the structure can present a fall and strangulation hazard, especially for young children. The primary purpose of this study was to describe bunk bed-related injuries reported to the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990-2009. METHODS CHIRPP is an injury and poisoning surveillance system operating in 11 pediatric and 4 general emergency departments across Canada. Records were extracted using CHIRPP product codes and narratives. RESULTS Over the 20-year surveillance period, 6002 individuals presented to Canadian emergency departments for an injury associated with a bunk bed. Overall, the frequency of bunk bed-related injuries in CHIRPP has remained relatively stable with an average annual percent change of 21.2% (21.8% to 20.5%). Over 90% of upper bunk-related injuries were due to falls and children 3-5 years of age were most frequently injured (471.2/100 000 CHIRPP cases). CONCLUSION Children with bunk bed-related injuries continue to present to Canadian emergency departments, many with significant injuries. Injury prevention efforts should focus on children under 6 years of age.
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Affiliation(s)
- S R McFaull
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada.
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McFaull SR, Frechette M, Skinner R. Emergency department surveillance of injuries associated with bunk beds: the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990–2009. ACTA ACUST UNITED AC 2012. [DOI: 10.24095/hpcdp.33.1.05] [Citation(s) in RCA: 4] [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: 11/20/2022]
Abstract
Introduction
Due to space constraints, bunk beds are a common sleeping arrangement in many homes. The height and design of the structure can present a fall and strangulation hazard, especially for young children. The primary purpose of this study was to describe bunk bed-related injuries reported to the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 1990–2009.
Methods
CHIRPP is an injury and poisoning surveillance system operating in 11 pediatric and 4 general emergency departments across Canada. Records were extracted using CHIRPP product codes and narratives.
Results
Over the 20-year surveillance period, 6002 individuals presented to Canadian emergency departments for an injury associated with a bunk bed. Overall, the frequency of bunk bed-related injuries in CHIRPP has remained relatively stable with an average annual percent change of 21.2% (21.8% to 20.5%). Over 90% of upper bunk-related injuries were due to falls and children 3–5 years of age were most frequently injured (471.2/100 000 CHIRPP cases).
Conclusion
Children with bunk bed-related injuries continue to present to Canadian emergency departments, many with significant injuries. Injury prevention efforts should focus on children under 6 years of age.
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Affiliation(s)
- SR McFaull
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - M Frechette
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - R Skinner
- Injury and Child Maltreatment Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Cardinal M, Crain J, Do MT, Fréchette M, McFaull S, Skinner R, Thompson W. Report summary - Injury in Review, 2012 Edition: Spotlight on Road and Transport Safety. ACTA ACUST UNITED AC 2012. [DOI: 10.24095/hpcdp.32.4.08] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Injury in Review, 2012 Edition: Spotlight on Road and Transport Safety, the first national public health report of its kind, synthesizes road- and transport-related injury statistics from a variety of sources. It profiles injury patterns among Canadians aged up to 24 years, explains risks and protective factors, and makes recommendations for action. The findings inform the development of targeted injury prevention efforts.
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Affiliation(s)
- M Cardinal
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
| | - J Crain
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
| | - MT Do
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
| | - M Fréchette
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
| | - S McFaull
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
| | - R Skinner
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
| | - W Thompson
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
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24
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Cardinal M, Crain J, Do MT, Fréchette M, McFaull S, Skinner R, Thompson W. Report summary - injury in review, 2012 edition: spotlight on road and transport safety. Chronic Dis Inj Can 2012; 32:229-230. [PMID: 23046806] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Injury in Review, 2012 Edition: Spotlight on Road and Transport Safety, the first national public health report of its kind, synthesizes road- and transport-related injury statistics from a variety of sources. It profiles injury patterns among Canadians aged up to 24 years, explains risks and protective factors, and makes recommendations for action. The findings inform the development of targeted injury prevention efforts.
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Affiliation(s)
- M Cardinal
- Injury Section, Health Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention and Control, Ottawa, Ontario, Canada
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25
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Westley S, Skinner R, Bridle C, Collier J. Ocular assessment in patients with maxillofacial injury: snapshot from a major trauma centre. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.085] [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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26
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Wiersma YF, Skinner R. Predictive distribution model for the boreal felt lichen Erioderma pedicellatum in Newfoundland, Canada. ENDANGER SPECIES RES 2011. [DOI: 10.3354/esr00374] [Citation(s) in RCA: 21] [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] [Indexed: 11/23/2022] Open
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27
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Haupt R, Pisani P, Garwicz S, Hawkins M, Skinner R, Hjorth L. 21 INVITED The Epidemiology of Childhood Cancer Survivors. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70236-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Clarke SA, Skinner R, Guest J, Darbyshire P, Cooper J, Vora A, Urquhart T, Jenney M, Powell J, Eiser C. Clinical outcomes and health-related quality of life (HRQOL) following haemopoietic stem cell transplantation (HSCT) for paediatric leukaemia. Child Care Health Dev 2011; 37:571-80. [PMID: 21143268 DOI: 10.1111/j.1365-2214.2010.01182.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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: 11/28/2022]
Abstract
BACKGROUND Haemopoietic stem cell transplantation (HSCT) is a life-saving but intensive procedure associated with potentially severe adverse late effects. We aimed to determine morbidity and health-related quality of life (HRQOL) in a sample of survivors aged 8-18 years at least 1 year post HSCT for paediatric acute leukaemia, compared with a non-transplanted group of survivors matched for age, gender, initial disease and time since treatment. METHODS Families (N = 54; HSCT n= 29) recruited from four UK centres completed measures of child behaviour and school attendance, HRQOL and finances. Mothers completed measures of their own well-being. Clinical outcome data were extracted from medical records. RESULTS Children in the HSCT group had significantly more late effects and had received more tests for vision, bone, dental and skin health, and thyroid, lung, and gonadal function than the non-transplanted group. HRQOL scores for the HSCT group were significantly lower in all domains compared with the non-transplanted group and population norms, but were not significantly related to clinical indices. Mothers in the HSCT group had significantly poorer mental well-being than population norms. CONCLUSION Significant morbidity and compromised HRQOL was found in survivors of HSCT. The burden of caring for a child after HSCT has a continuing toll on mothers' well-being.The importance of counselling families about possible long-term consequences is emphasized.
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Affiliation(s)
- S-A Clarke
- Department of Psychology, University of Sheffield, Sheffield, UK.
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29
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Millar M, Zhou W, Skinner R, Pizer B, Hennessy E, Wilks M, Gilbert RE. Accuracy of bacterial DNA testing for central venous catheter-associated bloodstream infection in children with cancer. Health Technol Assess 2011; 15:1-114. [PMID: 21294989 DOI: 10.3310/hta15070] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Central venous catheters (CVCs) are widely used for children with cancer and are a major risk factor for bloodstream infection. Early and specific diagnosis of CVC-associated bloodstream infection allows early targeted treatment, reducing the risk of CVC removal and avoiding the operative risks and trauma of reinsertion, but peripheral vein sampling, as used in adults, improves specificity but is not usually acceptable in children. OBJECTIVE To improve the detection and treatment of CVC-associated bloodstream infection in children (aged 0-18 years) with cancer admitted with fever. METHODS There were four main studies: (1) evaluation of the diagnostic accuracy of a quantitative molecular method for the detection of bacterial deoxyribonucleic acid (DNA), based solely on blood samples drawn through the CVC; (2) analysis of the prognostic risk of CVC removal and duration of intravenous (i.v.) antibiotic treatment days in relation to presenting clinical features, blood culture results and bacterial DNA test results; (3) systematic reviews of treatment options for CVC-associated infection and a questionnaire survey of current practice in paediatric oncology centres; (4) evaluation of the clinical effectiveness of different test-treatment strategies to reduce i.v. antibiotic treatment days and unnecessary CVC removals. RESULTS (1) The bacterial DNA test detected two-thirds [95% confidence interval (CI) 44% to 83%] of children classified with probable CVC-associated infection - specificity was 88% (95% CI 84% to 92%). Although high bacterial DNA concentrations were associated with subsequent CVC removal and long duration of i.v. antibiotic treatment, the test did not improve the prediction of these outcomes over and above clinical signs of CVC-associated infection combined with blood culture results. (2) High DNA load was predictive of CVC removal and i.v. treatment duration, before blood culture results became available at 48 hours after sampling. (3) There was limited evidence that antibiotic lock treatment reduces the risk of recurrent CVC-associated infection or CVC removal (pooled relative risk 0.7, 95% CI 0.47 to 1.05), but prophylactic use of antimicrobial locks halved the risk of bloodstream infection (pooled incidence rate ratio 0.43, 95% CI 0.36 to 0.51). Contrary to this, the national survey of paediatric oncology centres found that locks are being used for treatment rather than prevention and that problems related to the formulation of lock solutions currently impede a shift to their prophylactic use in children. (4) Most i.v. treatment days would be saved by early stopping of treatment for children at low risk of infection. LIMITATIONS The accuracy study was limited primarily by the lack of an adequate reference standard, and the main limitation of the series of systematic reviews was the poor quality of included studies and lack of randomised controlled trials of CVC removal or antimicrobial locks for treatment of infection. CONCLUSIONS There is strong evidence to support the use of antimicrobial locks for prevention of CVC-associated infection; however, few of these studies involved children with cancer. The analysis does not support routine bacterial DNA testing on admission to detect CVC-associated infection, but repeated testing (as a marker of microbial load) should be evaluated in high-risk groups. Further research should determine the effectiveness of antibiotic locks for treating CVC-associated infection. TRIAL REGISTRATION Current Controlled Trials ISRCTN68138140. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 15, No. 7. See the HTA programme website for further project information.
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Affiliation(s)
- M Millar
- Barts and the London NHS Trust, London, UK
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Abstract
OBJECTIVE To explore the relationship between cannabis use and self-reported dimensions of psychosis in a population of university students presenting for any reason to primary care. METHOD One thousand and forty-nine students attending the Student Health Unit, National University of Ireland, Galway, completed self-report questionnaires on alcohol and substance misuse, non-clinical dimensions of psychosis [Community Assessment of Psychic Experiences (CAPE)], anxiety and depression [Hospital Anxiety and Depression Scale (HADS)]. Association of cannabis use with psychiatric symptoms was explored whilst controlling for confounds. RESULTS More frequent cannabis use was independently associated with greater intensity of positive, negative and depressive psychotic symptoms. The earlier the age of onset of cannabis use, the more positive psychotic symptoms were reported. CONCLUSION These findings support the hypotheses that cannabis use increases the risk of developing psychotic symptoms and that this risk is further increased in those individuals who use cannabis more heavily and commence it at a younger age.
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Affiliation(s)
- R Skinner
- Department of Psychiatry, National University of Ireland, Galway, Ireland
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31
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McFaull S, Skinner R, Herbert M. Emergency Department presentations for injuries related to cribs. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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32
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Woods AJ, Philbeck J, Chelette K, Mennemeier M, Skinner R, Garcia-Rill E, Chichka D, Potolicchio S. Cortical arousal influences early but not late visual perception. J Vis 2010. [DOI: 10.1167/9.8.1113] [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: 11/24/2022] Open
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33
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Skinner R, Conlon L, Gibbons D, MacDonald C. PW01-194 - Cannabis use and non-clinical dimensions of psychosis in university students presenting to primary care. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71601-1] [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: 12/01/2022] Open
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34
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Clarke SA, Skinner R, Guest J, Darbyshire P, Cooper J, Shah F, Roberts I, Eiser C. Health-related quality of life and financial impact of caring for a child with Thalassaemia Major in the UK. Child Care Health Dev 2010; 36:118-22. [PMID: 19961496 DOI: 10.1111/j.1365-2214.2009.01043.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [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: 12/01/2022]
Abstract
BACKGROUND Thalassaemia Major (TM) is a serious condition characterized by life-long dependence on blood transfusions and chelation therapy. Our aim was to determine health-related quality of life (HRQOL) in children with TM living in the UK, and the impact of caring for a child receiving National Health Service treatment on family finances. METHODS This was a cross-sectional assessment of HRQOL in children (n= 22) with TM aged 8-18 years. Children were recruited from three UK Paediatric Haematology and Bone Marrow Transplant centres. Mothers completed measures of their child's HRQOL [PedsQL 4.0 (Measurement Model for the Pediatric Quality of Life Inventory, James W. Varni PhD, PedMetrics, Quantifying the Qualitative SM, Copyright 1998-2009)] and behaviour (Strengths and Difficulties questionnaire), and the impact of caring for the child on family finances. RESULTS Child behaviour was within the normal range but child HRQOL was significantly lower than population norms. Family financial concerns associated with TM were associated with poorer child HRQOL (P= 0.020). CONCLUSIONS Thalassaemia Major poses a considerable challenge to child HRQOL, well documented in areas of the world where TM is prevalent. Despite the availability of National Health Service care and financial benefits our study suggests a similar burden in the UK.
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Affiliation(s)
- S A Clarke
- Department of Psychology, University of Sheffield, Sheffield S102TP, UK.
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35
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Grenier D, Ugnat AM, Skinner R, Laffin Thibodeau M. Travel-Related Illnesses and Conditions. Paediatr Child Health 2009. [DOI: 10.1093/pch/14.suppl_a.24a] [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: 11/14/2022] Open
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36
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Yule SM, Skinner R, English MW, Cole M, Pearson AD, Lucraft HH, Craft AW. Outcome and toxicity of an Ifosfamide-based soft tissue sarcoma treatment protocol in children. The importance of local therapy. Sarcoma 2008; 2:171-7. [PMID: 18521250 PMCID: PMC2395403 DOI: 10.1080/13577149877939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. Although the survival of children with soft tissue sarcoma (STS) has improved considerably, the outcome of patients with metastatic disease, and those with primary tumours of the extremities or parameningeal sites remains disappointing. We describe the clinical outcome of an ifosfamide-based regimen with local therapy directed only to children who failed to achieve a complete response to initial chemotherapy. Patients and Methods. Twenty-one children with STS (16 rhabdomyosarcoma) who presented with
unresectable tumours were treated with five courses of ifosfamide (9 g/m2) and etoposide
(600 mgm2). Patients who did not achieve a complete response then received local therapy. Chemotherapy
with ifosfamide combined with etoposide, vincristine (1.5 mg/m2 and doxorubicin (60 mg/m2) or
vincristine and actinomycin D (1.5 mg/m2) was continued for one year. Results and Discussion. Objective responses to five courses of ifosfamide and etoposide were seen in all patients. Disease free survival (DFS) at a median follow up of 59 months was 57% (95% CI 29–75%). The DFS of children who received local therapy was 89% compared with 33% in those who received chemotherapy alone (p=0.027). Locoregional recurrences did not occur in children who received radiotherapy to the site of the primary tumour. Ifosfamide-based chemotherapy does not reduce the incidence of loco-regional recurrence in children who do not receive local therapy.
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Affiliation(s)
- S M Yule
- Department of Child Health The University of Newcastle upon Tyne UK
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Abstract
An 8-year-old male relapsed with refractory anemia with excess blasts (RAEB) and monosomy 7 and mixed chimerism (MC) 21 months after HLA-matched unrelated donor bone marrow transplant (BMT). He received three donor lymphocyte infusions (DLI) using an escalating dose schedule. He developed grade II acute graft-versus-host disease (GVHD) 9 days after the third DLI, but continued to deteriorate for 2 months with decreasing marrow cellularity but persisting blasts, MC, and monosomy 7, before exhibiting a delayed but complete response which has persisted for 5 years. This case suggests that DLI and graft-versus-myelodysplasia (GVMDS) may be beneficial in post-transplant relapse of pediatric myelodysplasia.
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MESH Headings
- Anemia, Refractory, with Excess of Blasts/drug therapy
- Anemia, Refractory, with Excess of Blasts/genetics
- Anemia, Refractory, with Excess of Blasts/surgery
- Anemia, Refractory, with Excess of Blasts/therapy
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Bone Marrow Transplantation
- Child
- Chromosomes, Human, Pair 7/genetics
- Combined Modality Therapy
- Humans
- Lymphocyte Transfusion
- Male
- Monosomy
- Recurrence
- Remission Induction
- Tissue Donors
- Transplantation Conditioning
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Affiliation(s)
- R Skinner
- Department of Paediatric and Adolescent Oncology, and Children's BMT Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
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Millar MR, Johnson G, Wilks M, Skinner R, Stoneham S, Pizer B, Hemsworth S, Fogarty A, Steward C, Gilbert R, Hennessy EM. Molecular diagnosis of vascular access device-associated infection in children being treated for cancer or leukaemia. Clin Microbiol Infect 2007; 14:213-20. [PMID: 18093238 DOI: 10.1111/j.1469-0691.2007.01909.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Blood samples were collected for quantitative 16S rDNA analysis from the vascular access device (VAD) of patients presenting with fever at participating centres of the UK Children's Cancer and Leukaemia Group. In total, 260 of 301 episodes of fever were evaluable and were classified as probable, possible, unlikely or unclassifiable VAD-associated infection. The sensitivity of the 16S rDNA assay declined concomitantly with delays from time of presentation to sampling. The sensitivity with >0.125 pg of bacterial DNA/microL of whole blood was 80% for the 20 probable VAD-associated infections diagnosed with samples collected on the day of or day following presentation. The specificity rose with increasing amounts of bacterial DNA, from 93% with >0.125 pg, to 98% with 0.25-0.5 pg, and to 100% with >0.5 pg/microL blood. The positive predictive value (for probable or possible) was 88% (95% CI 70-98%) with 0.25 pg/microL, and 100% (95% CI 83-100%) with >0.5 pg/microL. All 18 (6.8%) episodes with >0.5 pg of bacterial DNA/microL blood were associated with positive blood cultures. Identifications derived from the DNA sequence were consistent with the blood culture identifications for 15 of the 17 episodes with a DNA sequence identification. The VAD was removed because of suspected infection in six (2.8%) of 216 episodes with <0.125 pg of bacterial DNA/microL, in one (5%) of 20 episodes with 0.125-0.25 pg/microL, in one (16.7%) of six episodes with 0.25-0.5 pg/microL, and in nine (50%) of 18 episodes with >0.5 pg/microL. A bacterial DNA concentration of >0.5 pg/microL in blood drawn through a central venous catheter at the time of fever presentation had a high positive predictive value for VAD-associated infection and predicted an increased risk of VAD removal because of suspected infection.
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Affiliation(s)
- M R Millar
- Division of Infection, Barts and The London NHS Trust, London, UK.
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Henneman P, Garb J, Capraro G, Smithline H, Haiping L, Skinner R, Wait R. Geography and Travel Distance Impact ED Visits. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1293] [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: 11/10/2022]
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40
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Abstract
Some paediatric patients with cancer can be treated with antibiotic regimens of reduced intensity and duration
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Affiliation(s)
- R Phillips
- Department of Paediatric Oncology, St James's Hospital, Leeds, UK
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41
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Warren-Forward H, Arthur L, Hobson L, Skinner R, Watts A, Clapham K, Lou D, Cook A. An assessment of exposure indices in computed radiography for the posterior–anterior chest and the lateral lumbar spine. Br J Radiol 2007; 80:26-31. [PMID: 16916804 DOI: 10.1259/bjr/59538862] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Studies have indicated that computed radiography (CR) can increase radiation dose to the patient, leading to potential biological effects. Although manufacturers have set parameters to safeguard against overexposure, it is unclear whether these are being used by radiographers or if their recommended values are consistent with the ALARA principle. The research aims are to investigate (i) whether radiographers are producing images with exposure indices within the manufacturers recommended range (MRR); (ii) the phenomenon of exposure creep, and (iii) the relationship between exposure indices (EIs) and radiation dose. A retrospective analysis of exposure indices over an 18-month period for the posteroanterior (PA) chest and lateral (LAT) lumbar spine at two centres using Kodak 800 and 850 CR systems was conducted. A phantom study was performed to assess the relationship between EI and entrance surface dose (ESD) for fixed and varying tube potentials. Kodak recommends that images have EIs between 1700 and 1900. Thirty percent of LAT lumbar spine examinations at hospital B and 38% of PA chest examinations at hospital A were produced with EIs below 1700. In the phantom study, when using a varied tube potential (70-125 kVp) and maintaining a constant EI of 1550, ESD was reduced by 56%. All clinical and phantom images were assessed to be of a diagnostic quality. The retrospective results indicate that there is a potential to reduce the MRR and optimize patient dose. There is also evidence to suggest that EI is not a reliable indicator of patient dose. The authors recommend that staff training is essential on these newer systems.
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Affiliation(s)
- H Warren-Forward
- Medical Radiation Science, School of Health Sciences, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
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Ramalingam J, Pathan MS, Feril O, Ross K, Ma XF, Mahmoud AA, Layton J, Rodriguez-Milla MA, Chikmawati T, Valliyodan B, Skinner R, Matthews DE, Gustafson JP, Nguyen HT. Structural and functional analyses of the wheat genomes based on expressed sequence tags (ESTs) related to abiotic stresses. Genome 2006; 49:1324-40. [PMID: 17218960 DOI: 10.1139/g06-094] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To gain insights into the structure and function of the wheat (Triticum aestivum L.) genomes, we identified 278 ESTs related to abiotic stress (cold, heat, drought, salinity, and aluminum) from 7671 ESTs previously mapped to wheat chromosomes. Of the 278 abiotic stress related ESTs, 259 (811 loci) were assigned to chromosome deletion bins and analyzed for their distribution pattern among the 7 homoeologous chromosome groups. Distribution of abiotic stress related EST loci were not uniform throughout the different regions of the chromosomes of the 3 wheat genomes. Both the short and long arms of group 4 chromosomes showed a higher number of loci in their distal regions compared with proximal regions. Of the 811 loci, the number of mapped loci on the A, B, and D genomes were 258, 281, and 272, respectively. The highest number of abiotic stress related loci were found in homoeologous chromosome group 2 (142 loci) and the lowest number were found in group 6 (94 loci). When considering the genome-specific ESTs, the B genome showed the highest number of unique ESTs (7 loci), while none were found in the D genome. Similarly, considering homoeologous group-specific ESTs, group 2 showed the highest number with 16 unique ESTs (58 loci), followed by group 4 with 9 unique ESTs (33 loci). Many of the classified proteins fell into the biological process categories associated with metabolism, cell growth, and cell maintenance. Most of the mapped ESTs fell into the category of enzyme activity (28%), followed by binding activity (27%). Enzymes related to abiotic stress such as β-galactosidase, peroxidase, glutathione reductase, and trehalose-6-phosphate synthase were identified. The comparison of stress-responsive ESTs with genomic sequences of rice (Oryza sativa L.) chromosomes revealed the complexities of colinearity. This bin map provides insight into the structural and functional details of wheat genomic regions in relation to abiotic stress.
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Affiliation(s)
- J Ramalingam
- Division of Plant Sciences, University of Missouri, Columbia, MO 65211, USA
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Mucoepidermoid/radiotherapy
- Follow-Up Studies
- Humans
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/therapy
- Male
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/radiotherapy
- Parotid Neoplasms/diagnosis
- Parotid Neoplasms/pathology
- Parotid Neoplasms/radiotherapy
- Recurrence
- Remission Induction
- Treatment Outcome
- Whole-Body Irradiation/adverse effects
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Skinner R, Velangi M, Bown N. Successful use of donor lymphocyte infusions in post-BMT relapse of RAEB (monosomy 7). Leuk Res 2006. [DOI: 10.1016/s0145-2126(06)80060-3] [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: 11/24/2022]
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Abstract
Adolescents are a growing area in paediatric practice in both hospital and community settings. They make up around one quarter of the practice of many paediatricians. Yet until recently there has been little formal interest in young people's health in the UK. The situation is now changing, particularly following the publication of the "National Service Framework for children, young people and maternity services", which places a major emphasis on adolescent health. Given that this area is relatively new to many paediatricians, this article aims to provide an overview of the range of health problems that affect young people, to provide practical advice for working with this group in paediatric practice, and to outline current and future opportunities for training in adolescent health in the UK.
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Affiliation(s)
- D Payne
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.
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Jasper MJ, Bromfield JJ, Skinner R, Robertson SA. 242. LIF expression is induced in the mouse oviduct following activation by seminal factors. Reprod Fertil Dev 2005. [DOI: 10.1071/srb05abs242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A precisely regulated sequence of molecular and cellular changes occurs in the female reproductive tract in early pregnancy to facilitate development of the embryo and its successful implantation. Cytokine–leukocyte networks are integral in the tissue remodelling and immuno-regulatory processes underpinning successful implantation. Seminal factors are implicated in activating expression of cytokine genes and inflammatory leukocyte recruitment in the uterus, but whether semen-induced effects extend to the oviduct to influence blastocyst development has not been examined. The aim of this study was to quantitate the expression of mRNA encoding epidermal growth factor (EGF), granulocyte-macrophage colony-stimulating factor (GM-CSF), heparin-binding epidermal growth factor-like growth factor (HB-EGF), insulin-like growth factor (IGFII), leukaemia inhibitory factor (LIF), tumour necrosis factor (TNFα), transforming growth factor (TGFα) and TGFβ from oviducts collected from mice at oestrus and on day 1 of pregnancy, after mating with intact, seminal plasma deficient (svx) and vasectomised (vas) mice. Total RNA was extracted, DNAse treated, reverse transcribed into cDNA, and quantified by real-time PCR using SYBR Green chemistry. All cytokine-specific primers were designed using GenBank sequences and data were normalised to β-actin mRNA expression. Expression of LIF mRNA was induced following mating with intact or vas males, but not svx males, showing that LIF mRNA is induced by factors present in seminal plasma. mRNAs encoding EGF, GM-CSF, HB EGF, IGFII, TNFα, TGFα and TGFβ were all detected in oviduct cDNA collected from oestrus and day 1 mice. These data support the proposal that cytokine-leukocyte networks shown previously to be operative in the uterus extend to the oviduct, and are influenced by exposure to seminal plasma at mating. The cytokines expressed in the oviduct during early pregnancy are likely to be key regulators of embryo growth and development.
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Skinner R, Ineson P, Hicks WK, Jones HE, Sleep D, Leith ID, Sheppard LJ. Correlating the Spatial Distribution of Atmospheric Ammonia with ?15N Values at an Ammonia Release Site. ACTA ACUST UNITED AC 2004. [DOI: 10.1007/s11267-004-3032-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Miftahudin, Ross K, Ma XF, Mahmoud AA, Layton J, Milla MAR, Chikmawati T, Ramalingam J, Feril O, Pathan MS, Momirovic GS, Kim S, Chema K, Fang P, Haule L, Struxness H, Birkes J, Yaghoubian C, Skinner R, McAllister J, Nguyen V, Qi LL, Echalier B, Gill BS, Linkiewicz AM, Dubcovsky J, Akhunov ED, Dvorák J, Dilbirligi M, Gill KS, Peng JH, Lapitan NLV, Bermudez-Kandianis CE, Sorrells ME, Hossain KG, Kalavacharla V, Kianian SF, Lazo GR, Chao S, Anderson OD, Gonzalez-Hernandez J, Conley EJ, Anderson JA, Choi DW, Fenton RD, Close TJ, McGuire PE, Qualset CO, Nguyen HT, Gustafson JP. Analysis of expressed sequence tag loci on wheat chromosome group 4. Genetics 2004; 168:651-63. [PMID: 15514042 PMCID: PMC1448824 DOI: 10.1534/genetics.104.034827] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [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: 12/05/2003] [Accepted: 06/01/2004] [Indexed: 12/16/2022] Open
Abstract
A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes (ESTs) from 26 Triticeae cDNA libraries, were mapped to wheat (Triticum aestivum L.) homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoeologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology (only 26 of the 119 consensus ESTs) was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases.
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Affiliation(s)
- Miftahudin
- Department of Agronomy, University of Missouri, Columbia, Missouri 65211, USA
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Bajwa RPS, Skinner R, Windebank KP, Reid MM. Demographic study of leukaemia presenting within the first 3 months of life in the Northern Health Region of England. J Clin Pathol 2004; 57:186-8. [PMID: 14747447 PMCID: PMC1770212 DOI: 10.1136/jcp.2003.12039] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To determine the incidence and outcome of congenital leukaemia. METHODS Retrospective population based study of putative leukaemia arising during the first 3 months of life over an 18 year period within the Northern Health Region of England. RESULTS Nine infants with putative leukaemia were identified. Five had acute leukaemia and four had transient myeloproliferative disorder (TMD). Trisomy 21, either as Down's syndrome or perhaps restricted to proliferating marrow cells, was present in all four infants with TMD. The incidence of congenital acute leukaemia was 8.6/10(6) live births/year, but would be less than half this value if only patients presenting within 4 weeks of birth were counted. Remission was induced in three of the five patients with acute leukaemia. One patient, who presented at birth, remains well five years after diagnosis. All four patients with TMD survive. CONCLUSIONS Congenital leukaemia is very rare but is not inevitably fatal. Finding trisomy 21 in spontaneously dividing blood or bone marrow cells of an infant with putative acute leukaemia, particularly within 3 months of birth, should encourage a cautious clinical approach and suggests that the diagnosis might be TMD.
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Affiliation(s)
- R P S Bajwa
- Department of Paediatric Oncology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
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