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Donohue MP, Cao Z, Bowen T, Dickinson R, Zhang Y, Qian J. The CombE-IDMS Alternate Potency Method for H5N1 and H5N8 Cell-Based Vaccines. Vaccines (Basel) 2023; 11:1799. [PMID: 38140203 PMCID: PMC10747648 DOI: 10.3390/vaccines11121799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Assaying the potency of inactivated viral influenza vaccines is performed using single radial immunodiffusion, which is the globally accepted release method for potency. Under conditions of a rapidly emerging pandemic, such as the 2009 H1N1 influenza pandemic, a recognized obstacle in the delivery of vaccines to the public is the time needed for the distribution of calibrated SRID reagents (antisera and antigen standards) to vaccine manufacturers. Previously, we first described a novel streamlined MS-based assay, CombE-IDMS, which does not rely on antisera/antibodies or reference antigens, as a potential rapidly deployable alternate potency method through a comparison with SRID on adjuvanted seasonal quadrivalent vaccine cell-based (aQIVc) materials. In this report, we further demonstrate that the CombE-IDMS method can also be applied to measure the potency of pre-pandemic H5N1 and H5N8 monovalent vaccine materials, each subtype both unadjuvanted and adjuvanted, through a forced degradation study. Overall, CombE-IDMS results align with those of the gold standard SRID method on both H5N1 and H5N8 materials under conditions of thermal, pH, oxidative and freeze/thaw stress, lending further evidence for the CombE-IDMS method's suitability as an alternate assay for potency of both seasonal and pandemic influenza vaccines.
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Affiliation(s)
- Matthew P. Donohue
- Biopharmaceutical Product Development, CSL Seqirus, Holly Springs, NC 27540, USA; (Z.C.); (T.B.); (Y.Z.)
| | - Zhijun Cao
- Biopharmaceutical Product Development, CSL Seqirus, Holly Springs, NC 27540, USA; (Z.C.); (T.B.); (Y.Z.)
| | - Thomas Bowen
- Biopharmaceutical Product Development, CSL Seqirus, Holly Springs, NC 27540, USA; (Z.C.); (T.B.); (Y.Z.)
| | | | - Ying Zhang
- Biopharmaceutical Product Development, CSL Seqirus, Holly Springs, NC 27540, USA; (Z.C.); (T.B.); (Y.Z.)
| | - Jiang Qian
- Biopharmaceutical Product Development, CSL Seqirus, Holly Springs, NC 27540, USA; (Z.C.); (T.B.); (Y.Z.)
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Campos-Pires R, Ong BE, Koziakova M, Ujvari E, Fuller I, Boyles C, Sun V, Ko A, Pap D, Lee M, Gomes L, Gallagher K, Mahoney PF, Dickinson R. Repetitive, but Not Single, Mild Blast TBI Causes Persistent Neurological Impairments and Selective Cortical Neuronal Loss in Rats. Brain Sci 2023; 13:1298. [PMID: 37759899 PMCID: PMC10526452 DOI: 10.3390/brainsci13091298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Exposure to repeated mild blast traumatic brain injury (mbTBI) is common in combat soldiers and the training of Special Forces. Evidence suggests that repeated exposure to a mild or subthreshold blast can cause serious and long-lasting impairments, but the mechanisms causing these symptoms are unclear. In this study, we characterise the effects of single and tightly coupled repeated mbTBI in Sprague-Dawley rats exposed to shockwaves generated using a shock tube. The primary outcomes are functional neurologic function (unconsciousness, neuroscore, weight loss, and RotaRod performance) and neuronal density in brain regions associated with sensorimotor function. Exposure to a single shockwave does not result in functional impairments or histologic injury, which is consistent with a mild or subthreshold injury. In contrast, exposure to three tightly coupled shockwaves results in unconsciousness, along with persistent neurologic impairments. Significant neuronal loss following repeated blast was observed in the motor cortex, somatosensory cortex, auditory cortex, and amygdala. Neuronal loss was not accompanied by changes in astrocyte reactivity. Our study identifies specific brain regions particularly sensitive to repeated mbTBI. The reasons for this sensitivity may include exposure to less attenuated shockwaves or proximity to tissue density transitions, and this merits further investigation. Our novel model will be useful in elucidating the mechanisms of sensitisation to injury, the temporal window of sensitivity and the evaluation of new treatments.
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Affiliation(s)
- Rita Campos-Pires
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London SW7 2AZ, UK
| | - Bee Eng Ong
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Mariia Koziakova
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Eszter Ujvari
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Isobel Fuller
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Charlotte Boyles
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Valerie Sun
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Andy Ko
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Daniel Pap
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Matthew Lee
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Lauren Gomes
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Kate Gallagher
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - Peter F. Mahoney
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London SW7 2AZ, UK
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Robert Dickinson
- Anaesthetics, Pain Medicine and Intensive Care Division, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
- Royal British Legion Centre for Blast Injury Studies, Imperial College London, London SW7 2AZ, UK
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Liang M, Ahmad F, Dickinson R. Neuroprotection by the noble gases argon and xenon as treatments for acquired brain injury: a preclinical systematic review and meta-analysis. Br J Anaesth 2022; 129:200-218. [PMID: 35688658 PMCID: PMC9428918 DOI: 10.1016/j.bja.2022.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/28/2022] [Accepted: 04/12/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The noble gases argon and xenon are potential novel neuroprotective treatments for acquired brain injuries. Xenon has already undergone early-stage clinical trials in the treatment of ischaemic brain injuries, with mixed results. Argon has yet to progress to clinical trials as a treatment for brain injury. Here, we aim to synthesise the results of preclinical studies evaluating argon and xenon as neuroprotective therapies for brain injuries. METHODS After a systematic review of the MEDLINE and Embase databases, we carried out a pairwise and stratified meta-analysis. Heterogeneity was examined by subgroup analysis, funnel plot asymmetry, and Egger's regression. RESULTS A total of 32 studies were identified, 14 for argon and 18 for xenon, involving measurements from 1384 animals, including murine, rat, and porcine models. Brain injury models included ischaemic brain injury after cardiac arrest (CA), neurological injury after cardiopulmonary bypass (CPB), traumatic brain injury (TBI), and ischaemic stroke. Both argon and xenon had significant (P<0.001), positive neuroprotective effect sizes. The overall effect size for argon (CA, TBI, stroke) was 18.1% (95% confidence interval [CI], 8.1-28.1%), and for xenon (CA, TBI, stroke) was 34.1% (95% CI, 24.7-43.6%). Including the CPB model, only present for xenon, the xenon effect size (CPB, CA, TBI, stroke) was 27.4% (95% CI, 11.5-43.3%). Xenon, both with and without the CPB model, was significantly (P<0.001) more protective than argon. CONCLUSIONS These findings provide evidence to support the use of xenon and argon as neuroprotective treatments for acquired brain injuries. Current evidence suggests that xenon is more efficacious than argon overall.
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Affiliation(s)
- Min Liang
- Anaesthetics, Pain Medicine, and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Fatin Ahmad
- Anaesthetics, Pain Medicine, and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Robert Dickinson
- Anaesthetics, Pain Medicine, and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, UK,Royal British Legion Centre for Blast Injury Studies, Imperial College London, London, UK,Corresponding author
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Struthers S, Fiss T, Classen HL, Gomis S, Dickinson R, Crowe TG, Herwig E, Schwean-Lardner K. The effect of infrared beak treatment on the welfare of turkeys reared to 12 weeks of age. Poult Sci 2022; 101:101728. [PMID: 35192937 PMCID: PMC8866716 DOI: 10.1016/j.psj.2022.101728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/05/2022] [Accepted: 01/09/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- S Struthers
- Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG, Scotland; Monogastric Science Research Centre, Scotland's Rural College, Roslin Institute, EH25 9RG Scotland
| | - T Fiss
- Department and Animal and Poultry Science, University of Saskatchewan, Saskatoon, Canada S7N 5A8
| | - H L Classen
- Department and Animal and Poultry Science, University of Saskatchewan, Saskatoon, Canada S7N 5A8
| | - S Gomis
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada S7N 5B4
| | - R Dickinson
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada S7N 5B4
| | - T G Crowe
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, Canada S7N 5A9
| | - E Herwig
- Department and Animal and Poultry Science, University of Saskatchewan, Saskatoon, Canada S7N 5A8
| | - K Schwean-Lardner
- Department and Animal and Poultry Science, University of Saskatchewan, Saskatoon, Canada S7N 5A8.
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Zubair M, Dickinson R. Calculating the Effect of Ribs on the Focus Quality of a Therapeutic Spherical Random Phased Array. Sensors (Basel) 2021; 21:s21041211. [PMID: 33572208 PMCID: PMC7915479 DOI: 10.3390/s21041211] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 02/03/2023]
Abstract
The overlaying rib cage is a major hindrance in treating liver tumors with high intensity focused ultrasound (HIFU). The problems caused are overheating of the ribs due to its high ultrasonic absorption capability and degradation of the ultrasound intensity distribution in the target plane. In this work, a correction method based on binarized apodization and geometric ray tracing approach was employed to avoid heating the ribs. A detailed calculation of the intensity distribution in the focus plane was undertaken to quantify and avoid the effect on HIFU beam generated by a 1-MHz 256-element random phased array after the ultrasonic beam passes through the rib cage. Focusing through the ribs was simulated for 18 different idealized ribs-array configurations and 10 anatomically correct ribs-array configurations, to show the effect of width of the ribs, intercostal spacing and the relative position of ribs and array on the quality of focus, and to identify the positions that are more effective for HIFU applications in the presence of ribs. Acoustic simulations showed that for a single focus without beam steering and for the same total acoustic power, the peak intensity at the target varies from a minimum of 211 W/cm2 to a maximum of 293 W/cm2 for a nominal acoustic input power of 15 W, whereas the side lobe level varies from 0.07 Ipeak to 0.28 Ipeak and the separation between the main lobe and side lobes varies from 2.5 mm to 6.3 mm, depending on the relative positioning of the array and ribs and the beam alignment. An increase in the side lobe level was observed by increasing the distance between the array and the ribs. The parameters of focus splitting and the deterioration of focus quality caused by the ultrasonic propagation through the ribs were quantified in various possible different clinical scenarios. In addition to idealized rib topology, anatomical realistic ribs were used to determine the focus quality of the HIFU beam when the beam is steered both in axial and transverse directions and when the transducer is positioned at different depths from the rib cage.
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Affiliation(s)
- Muhammad Zubair
- Department of Radiation Oncology, University of California, San Francisco, CA 90007, USA
- Correspondence:
| | - Robert Dickinson
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK;
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Campos-Pires R, Onggradito H, Ujvari E, Karimi S, Valeo F, Aldhoun J, Edge CJ, Franks NP, Dickinson R. Xenon treatment after severe traumatic brain injury improves locomotor outcome, reduces acute neuronal loss and enhances early beneficial neuroinflammation: a randomized, blinded, controlled animal study. Crit Care 2020; 24:667. [PMID: 33246487 PMCID: PMC7691958 DOI: 10.1186/s13054-020-03373-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/04/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a major cause of morbidity and mortality, but there are no clinically proven treatments that specifically target neuronal loss and secondary injury development following TBI. In this study, we evaluate the effect of xenon treatment on functional outcome, lesion volume, neuronal loss and neuroinflammation after severe TBI in rats. METHODS Young adult male Sprague Dawley rats were subjected to controlled cortical impact (CCI) brain trauma or sham surgery followed by treatment with either 50% xenon:25% oxygen balance nitrogen, or control gas 75% nitrogen:25% oxygen. Locomotor function was assessed using Catwalk-XT automated gait analysis at baseline and 24 h after injury. Histological outcomes were assessed following perfusion fixation at 15 min or 24 h after injury or sham procedure. RESULTS Xenon treatment reduced lesion volume, reduced early locomotor deficits, and attenuated neuronal loss in clinically relevant cortical and subcortical areas. Xenon treatment resulted in significant increases in Iba1-positive microglia and GFAP-positive reactive astrocytes that was associated with neuronal preservation. CONCLUSIONS Our findings demonstrate that xenon improves functional outcome and reduces neuronal loss after brain trauma in rats. Neuronal preservation was associated with a xenon-induced enhancement of microglial cell numbers and astrocyte activation, consistent with a role for early beneficial neuroinflammation in xenon's neuroprotective effect. These findings suggest that xenon may be a first-line clinical treatment for brain trauma.
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Affiliation(s)
- Rita Campos-Pires
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
- Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, Bessemer Building, South Kensington, London, SW7 2AZ, UK
- Charing Cross Hospital Intensive Care Unit, Critical Care Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Haldis Onggradito
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
| | - Eszter Ujvari
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
| | - Shughoofa Karimi
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
| | - Flavia Valeo
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
| | - Jitka Aldhoun
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
| | - Christopher J Edge
- Department of Life Sciences, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
- Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust, London Road, Reading, RG1 5AN, UK
| | - Nicholas P Franks
- Department of Life Sciences, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK
| | - Robert Dickinson
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, Sir Ernst Chain Building, South Kensington, London, SW7 2AZ, UK.
- Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, Bessemer Building, South Kensington, London, SW7 2AZ, UK.
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Koziakova M, Harris K, Edge CJ, Franks NP, White IL, Dickinson R. Noble gas neuroprotection: xenon and argon protect against hypoxic-ischaemic injury in rat hippocampus in vitro via distinct mechanisms. Br J Anaesth 2019; 123:601-609. [PMID: 31470983 PMCID: PMC6871267 DOI: 10.1016/j.bja.2019.07.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 06/12/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 12/11/2022] Open
Abstract
Background Noble gases may provide novel treatments for neurological injuries such as ischaemic and traumatic brain injury. Few studies have evaluated the complete series of noble gases under identical conditions in the same model. Methods We used an in vitro model of hypoxia–ischaemia to evaluate the neuroprotective properties of the series of noble gases, helium, neon, argon, krypton, and xenon. Organotypic hippocampal brain slices from mice were subjected to oxygen-glucose deprivation, and injury was quantified using propidium iodide fluorescence. Results Both xenon and argon were equally effective neuroprotectants, with 0.5 atm of xenon or argon reducing injury by 96% (P<0.0001), whereas helium, neon, and krypton were devoid of any protective effect. Neuroprotection by xenon, but not argon, was reversed by elevated glycine. Conclusions Xenon and argon are equally effective as neuroprotectants against hypoxia–ischaemia in vitro, with both gases preventing injury development. Although xenon's neuroprotective effect may be mediated by inhibition of the N-methyl-d-aspartate receptor at the glycine site, argon acts via a different mechanism. These findings may have important implications for their clinical use as neuroprotectants.
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Affiliation(s)
- Mariia Koziakova
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Katie Harris
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Christopher J Edge
- Department of Life Sciences, Imperial College London, London, UK; Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust, London Road, Reading, UK
| | | | - Ian L White
- Department of Anaesthetics, St Peter's Hospital, Chertsey, UK
| | - Robert Dickinson
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London, London, UK; Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, London, UK.
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Campos-Pires R, Hirnet T, Valeo F, Ong BE, Radyushkin K, Aldhoun J, Saville J, Edge CJ, Franks NP, Thal SC, Dickinson R. Xenon improves long-term cognitive function, reduces neuronal loss and chronic neuroinflammation, and improves survival after traumatic brain injury in mice. Br J Anaesth 2019; 123:60-73. [PMID: 31122738 PMCID: PMC6676773 DOI: 10.1016/j.bja.2019.02.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 06/19/2018] [Revised: 02/07/2019] [Accepted: 02/23/2019] [Indexed: 12/13/2022] Open
Abstract
Background Xenon is a noble gas with neuroprotective properties that can improve short and long-term outcomes in young adult mice after controlled cortical impact. This follow-up study investigates the effects of xenon on very long-term outcomes and survival. Methods C57BL/6N young adult male mice (n=72) received single controlled cortical impact or sham surgery and were treated with either xenon (75% Xe:25% O2) or control gas (75% N2:25% O2). Outcomes measured were: (i) 24 h lesion volume and neurological outcome score; (ii) contextual fear conditioning at 2 weeks and 20 months; (iii) corpus callosum white matter quantification; (iv) immunohistological assessment of neuroinflammation and neuronal loss; and (v) long-term survival. Results Xenon treatment significantly reduced secondary injury (P<0.05), improved short-term vestibulomotor function (P<0.01), and prevented development of very late-onset traumatic brain injury (TBI)-related memory deficits. Xenon treatment reduced white matter loss in the contralateral corpus callosum and neuronal loss in the contralateral hippocampal CA1 and dentate gyrus areas at 20 months. Xenon's long-term neuroprotective effects were associated with a significant (P<0.05) reduction in neuroinflammation in multiple brain areas involved in associative memory, including reduction in reactive astrogliosis and microglial cell proliferation. Survival was improved significantly (P<0.05) in xenon-treated animals compared with untreated animals up to 12 months after injury. Conclusions Xenon treatment after TBI results in very long-term improvements in clinically relevant outcomes and survival. Our findings support the idea that xenon treatment shortly after TBI may have long-term benefits in the treatment of brain trauma patients.
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Affiliation(s)
- Rita Campos-Pires
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK; Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, UK; Charing Cross Hospital Intensive Care Unit, Critical Care Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Tobias Hirnet
- Department of Anaesthesiology, Medical Centre of Johannes Gutenberg University, Mainz, Germany
| | - Flavia Valeo
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK
| | - Bee Eng Ong
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK
| | - Konstantin Radyushkin
- Mouse Behavioural Outcome Unit, Focus Program Translational Neurosciences, Johannes Gutenberg University, Mainz, Germany
| | - Jitka Aldhoun
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK
| | - Joanna Saville
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK
| | - Christopher J Edge
- Department of Life Sciences, Imperial College London, UK; Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust, Reading, UK
| | | | - Serge C Thal
- Department of Anaesthesiology, Medical Centre of Johannes Gutenberg University, Mainz, Germany.
| | - Robert Dickinson
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, UK; Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London, UK.
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Dickinson R, Kennedy MC, Raynor DK, Knapp P, Thomas M, Adami E. What has been the impact of the Traditional Herbal Registration (THR) scheme in the UK on information provided with herbal products bought over the counter? Altern Ther Health Med 2019; 19:85. [PMID: 30975140 PMCID: PMC6460666 DOI: 10.1186/s12906-019-2494-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/28/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND In 2011 there was a strengthening of European Union (EU) legislation on the licencing of herbal products which, in the UK, resulted in the introduction of the Traditional Herbal Registration (THR) scheme. This scheme sets out standards for the safety and quality of herbal medicines and includes the provision of information to the customer on the safe use of the product. The aim of this study is to replicate a survey undertaken in 2011, prior to the implementation of the THR scheme, and evaluate the impact of this scheme on the information provided with herbal products bought over-the-counter. METHODS We undertook a survey on 5 herbal products commonly available over-the-counter (St John's wort, echinacea, Ginkgo biloba, Asian ginseng, garlic). The information was searched for key safety messages identified by the National Center for Complementary and Integrative Health (NCCIH). We also explored the presence of risk of harm information. RESULTS We recorded a rise in the number of products registered with the THR scheme (37% in 2016 compared to 7% in 2011). We also identified a reduction in the number of products that did not contain key safety information (75% in 2011 compared to 20% of products obtained in 2016). Risk of harm information was only communicated in products containing a PIL. We identified more products containing frequency of risk of harm information but this was not statistically significant. CONCLUSION The introduction of the THR scheme appears to be associated with an increase in the provision of information about key safety messages on the safe use of herbal products. However, it is important to note that at least half of the products on the market that are not included in the THR scheme do not contain any information about their safe use; this includes information about precautions, interactions and side effects. The use of NCCIH herbal monographs replicated the methods used in the previous study; we recognise that the use of a different resource might effect the appraisal of the information provided. We also acknowledge that surveying presence of information does not assure that the latter is effectively communicated to patients, for which a close textual analysis would be required. While it is promising that more information is available after the introduction of the THR scheme, the public needs to be informed about ways to optimise safe use of all herbal products.
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Johansen A, Liddicoat M, Hannaford J, Wakeman R, Boulton C, Dickinson R. 66INTRODUCING A NATIONAL PROGRAMME OF SCREENING WITH THE 4A TEST TO IDENTIFY DELIRIUM - THE COMMONEST COMPLICATION OF HIP FRACTURE SURGERY. Age Ageing 2019. [DOI: 10.1093/ageing/afy214.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Johansen
- National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London
| | - M Liddicoat
- National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London
| | - J Hannaford
- National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London
| | - R Wakeman
- National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London
| | - C Boulton
- National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London
| | - R Dickinson
- National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London
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Campos-Pires R, Yonis A, Macdonald W, Harris K, Edge CJ, Mahoney PF, Dickinson R. A Novel In Vitro Model of Blast Traumatic Brain Injury. J Vis Exp 2018. [PMID: 30614488 DOI: 10.3791/58400] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Traumatic brain injury is a leading cause of death and disability in military and civilian populations. Blast traumatic brain injury results from the detonation of explosive devices, however, the mechanisms that underlie the brain damage resulting from blast overpressure exposure are not entirely understood and are believed to be unique to this type of brain injury. Preclinical models are crucial tools that contribute to better understand blast-induced brain injury. A novel in vitro blast TBI model was developed using an open-ended shock tube to simulate real-life open-field blast waves modelled by the Friedlander waveform. C57BL/6N mouse organotypic hippocampal slice cultures were exposed to single shock waves and the development of injury was characterized up to 72 h using propidium iodide, a well-established fluorescent marker of cell damage that only penetrates cells with compromised cellular membranes. Propidium iodide fluorescence was significantly higher in the slices exposed to a blast wave when compared with sham slices throughout the duration of the protocol. The brain tissue injury is very reproducible and proportional to the peak overpressure of the shock wave applied.
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Affiliation(s)
- Rita Campos-Pires
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London; Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London
| | - Amina Yonis
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London
| | - Warren Macdonald
- Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London; Department of Bioengineering, Imperial College London
| | - Katie Harris
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London
| | - Christopher J Edge
- Department of Life Sciences, Imperial College London; Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust
| | - Peter F Mahoney
- Royal Centre for Defence Medicine, Medical Directorate Joint Force Command
| | - Robert Dickinson
- Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London; Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London;
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Dadarwal D, González-Cano P, Dickinson R, Griebel P, Palmer C. Characterization of cytokine gene expression in uterine cytobrush samples of non-endometritic versus endometritic postpartum dairy cows. Theriogenology 2018; 126:128-139. [PMID: 30551019 DOI: 10.1016/j.theriogenology.2018.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/03/2018] [Accepted: 12/04/2018] [Indexed: 12/31/2022]
Abstract
To better understand uterine inflammation in postpartum dairy cows we collected sequential cytobrush samples at 29-35 and at 49-55 d in milk (DIM). Based on the uterine cytology, cows were classified as Non-endometritic (n = 23; <18% neutrophils) or Endometritic (n = 12; ≥18% neutrophils) at 29-35 DIM and Non-endometritic (n = 17; <10% neutrophils) or Endometritic (n = 9; ≥10% neutrophils) at 49-55 DIM. Cows defined as Sham Controls (n = 6) were examined by vaginoscopy at 29-35 DIM and identified as Non-endometritic (<10% neutrophils) at 49-55 DIM. Cytokine gene expression in cytobrush samples was assessed using qRT-PCR. Sham Controls did not differ significantly (P > 0.17) from Non-endometritic cows at 49-55 DIM and these data were combined (n = 23). Uterine cytology-based classification using the aforementioned thresholds effectively separated cows into groups with Endometritic cows having significantly higher expression of pro-inflammatory (interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-17A CSF-1; P < 0.01) and regulatory (IL-1RA and IL-10; P < 0.03) cytokines, relative to Non-endometritic cows. Furthermore, Non-endometritic cows showed a significant decline (P < 0.03) in the expression of pro-inflammatory (IL-1α, IL-6, IL-8) and regulatory (IL-10) cytokine genes as the postpartum period progressed; whereas Endometritic cows exhibited a sustained elevation in transcript abundance throughout the sample period for both pro-inflammatory and regulatory cytokine genes. Expression of transforming growth factor (TGF) genes was more complex with TGF-β3 expression significantly (P < 0.01) lower at 29-35 DIM and TGF-β1 gene expression significantly (P < 0.03) increased at 49-55 DIM in Endometritic versus Non-endometritic cows. Expression of TGF-β2 gene was 2.7-fold higher (P < 0.01) at 29-35 DIM in cows that remained Endometritic when compared to cows recovering by 49-55 DIM. Some Non-endometritic cows (n = 4) at 29-35 DIM were reclassified as Endometritic at 49-55 DIM. The sampling procedures at 29-35 DIM did not alter either the cellular response (P > 0.43) or cytokine gene expression (P > 0.17) at 49-55 DIM. In conclusion, normal uterine involution is characterized by a progressive decline in pro-inflammatory and regulatory cytokine gene expression, while cows with endometritis show a dysregulated inflammatory process characterized by a sustained elevation in pro-inflammatory and regulatory cytokine gene expression. This analysis also shows that decreased TGF-β2 gene expression at 29-35 DIM may be an indicator of recovery from endometritis.
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Affiliation(s)
- D Dadarwal
- Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, S7N 5B4, Canada.
| | - P González-Cano
- Instituto de Farmacobiología, Universidad de la Cañada, Oaxaca, CP.68540, Mexico
| | - R Dickinson
- Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, S7N 5B4, Canada
| | - P Griebel
- Vaccine and Infectious Disease Organization-InterVac, University of Saskatchewan, 120 Veterinary Rd, Saskatoon, SK, S7N 5E3, Canada; School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - C Palmer
- Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, S7N 5B4, Canada
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Campos-Pires R, Armstrong S, Sebastiani A, Luh C, Gruss M, Radyushkin K, Hirnet T, Werner C, Engelhard K, Franks N, Thal S, Dickinson R. Xenon treatment improves short-term and long-term outcomes in a rodent model of traumatic brain injury. Br J Anaesth 2018. [DOI: 10.1016/j.bja.2018.05.022] [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: 12/01/2022] Open
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Abstract
During a one-year period, 206 of 245 patients referred directly to a single-visit dyspepsia clinic underwent gastroscopy after clinical consultation. Endoscopic findings enabled diagnosis in the majority and no complications occurred. In 12 patients with positive endoscopies there was an unrelated clinical diagnosis, and 23 with normal endoscopies had organic disease. Such a clinic has advantages both for patients in providing single-visit diagnosis and management for the majority, and for the hospital in reducing the load on outpatient services. Prior consultation may prevent both unwarranted use of endoscopy facilities and inappropriate diagnosis.
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Affiliation(s)
- A Lobo
- Department of Medicine, Hinchingbrooke Hospital, Huntingdon, Cambridgeshire
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15
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Campos-Pires R, Koziakova M, Yonis A, Pau A, Macdonald W, Harris K, Edge CJ, Franks NP, Mahoney PF, Dickinson R. Xenon Protects against Blast-Induced Traumatic Brain Injury in an In Vitro Model. J Neurotrauma 2018; 35:1037-1044. [PMID: 29285980 PMCID: PMC5899289 DOI: 10.1089/neu.2017.5360] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/22/2022] Open
Abstract
The aim of this study was to evaluate the neuroprotective efficacy of the inert gas xenon as a treatment for patients with blast-induced traumatic brain injury in an in vitro laboratory model. We developed a novel blast traumatic brain injury model using C57BL/6N mouse organotypic hippocampal brain-slice cultures exposed to a single shockwave, with the resulting injury quantified using propidium iodide fluorescence. A shock tube blast generator was used to simulate open field explosive blast shockwaves, modeled by the Friedlander waveform. Exposure to blast shockwave resulted in significant (p < 0.01) injury that increased with peak-overpressure and impulse of the shockwave, and which exhibited a secondary injury development up to 72 h after trauma. Blast-induced propidium iodide fluorescence overlapped with cleaved caspase-3 immunofluorescence, indicating that shock-wave–induced cell death involves apoptosis. Xenon (50% atm) applied 1 h after blast exposure reduced injury 24 h (p < 0.01), 48 h (p < 0.05), and 72 h (p < 0.001) later, compared with untreated control injury. Xenon-treated injured slices were not significantly different from uninjured sham slices at 24 h and 72 h. We demonstrate for the first time that xenon treatment after blast traumatic brain injury reduces initial injury and prevents subsequent injury development in vitro. Our findings support the idea that xenon may be a potential first-line treatment for those with blast-induced traumatic brain injury.
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Affiliation(s)
- Rita Campos-Pires
- 1 Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London , London, United Kingdom .,2 Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London , London, United Kingdom
| | - Mariia Koziakova
- 1 Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London , London, United Kingdom .,2 Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London , London, United Kingdom
| | - Amina Yonis
- 1 Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London , London, United Kingdom
| | - Ashni Pau
- 1 Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London , London, United Kingdom
| | - Warren Macdonald
- 2 Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London , London, United Kingdom .,3 Department of Bioengineering, Imperial College London , London, United Kingdom
| | - Katie Harris
- 1 Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London , London, United Kingdom
| | - Christopher J Edge
- 4 Department of Life Sciences, Imperial College London , London, United Kingdom .,5 Department of Anaesthetics, Royal Berkshire Hospital NHS Foundation Trust , Reading, United Kingdom
| | - Nicholas P Franks
- 4 Department of Life Sciences, Imperial College London , London, United Kingdom
| | - Peter F Mahoney
- 6 Royal Centre for Defence Medicine , Medical Directorate Joint Force Command, ICT Centre, Birmingham, United Kingdom
| | - Robert Dickinson
- 1 Anaesthetics, Pain Medicine and Intensive Care Section, Department of Surgery and Cancer, Imperial College London , London, United Kingdom .,2 Royal British Legion Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London , London, United Kingdom
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Rodgers H, Scott O, Beckett P, Navani N, Dickinson R. Development of the first patient-level National Lung Cancer Audit 2016 key findings for patient and carers. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30148-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Harden S, Khakwani A, Dickinson R, Navani N, Hubbard R, Beckett P. Curative intent treatment for small cell lung cancer (SCLC) in England. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Khakwani A, Harden S, Baldwin D, Foweraker K, Navani N, Dickinson R, West D, Beckett P, Hubbard R. P1.05-010 Curative Treatment Rates for Patients Diagnosed with Early Stage Non-Small Cell Lung Cancer (NSCLC) in England. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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West D, Beckett P, Khakwani A, Hubbard R, Dickinson R, Woolhouse I. S60 Lung cancer surgical survival and volume in england. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.66] [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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Beckett P, Khakwani A, Hubbard R, Vernon S, Jack R, Wood N, Plewa B, McAndrew N, Dickinson R, Navani N, Harden S, Woolhouse I. P104 Results of the first analysis of national lung cancer audit data based on cancer registration data. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khakwani A, Hubbard R, Jack R, Wood N, Vernon S, Beckett P, Navani N, Harden S, Dickinson R, Woolhouse I. P103 Apples and pears? a comparison of two sources of lung cancer data in england. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.246] [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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22
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Williams SP, Dickinson R, Walmsley SR. S44 Pseudomonas aeruginosa induces neutrophil cell death which is reversed by hypoxia. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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23
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Cvijovic M, Höfer T, Aćimović J, Alberghina L, Almaas E, Besozzi D, Blomberg A, Bretschneider T, Cascante M, Collin O, de Atauri P, Depner C, Dickinson R, Dobrzynski M, Fleck C, Garcia-Ojalvo J, Gonze D, Hahn J, Hess HM, Hollmann S, Krantz M, Kummer U, Lundh T, Martial G, dos Santos VM, Mauer-Oberthür A, Regierer B, Skene B, Stalidzans E, Stelling J, Teusink B, Workman CT, Hohmann S. Strategies for structuring interdisciplinary education in Systems Biology: an European perspective. NPJ Syst Biol Appl 2016; 2:16011. [PMID: 28725471 PMCID: PMC5516850 DOI: 10.1038/npjsba.2016.11] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 03/10/2016] [Accepted: 03/14/2016] [Indexed: 11/08/2022] Open
Abstract
Systems Biology is an approach to biology and medicine that has the potential to lead to a better understanding of how biological properties emerge from the interaction of genes, proteins, molecules, cells and organisms. The approach aims at elucidating how these interactions govern biological function by employing experimental data, mathematical models and computational simulations. As Systems Biology is inherently multidisciplinary, education within this field meets numerous hurdles including departmental barriers, availability of all required expertise locally, appropriate teaching material and example curricula. As university education at the Bachelor's level is traditionally built upon disciplinary degrees, we believe that the most effective way to implement education in Systems Biology would be at the Master's level, as it offers a more flexible framework. Our team of experts and active performers of Systems Biology education suggest here (i) a definition of the skills that students should acquire within a Master's programme in Systems Biology, (ii) a possible basic educational curriculum with flexibility to adjust to different application areas and local research strengths, (iii) a description of possible career paths for students who undergo such an education, (iv) conditions that should improve the recruitment of students to such programmes and (v) mechanisms for collaboration and excellence spreading among education professionals. With the growing interest of industry in applying Systems Biology approaches in their fields, a concerted action between academia and industry is needed to build this expertise. Here we present a reflection of the European situation and expertise, where most of the challenges we discuss are universal, anticipating that our suggestions will be useful internationally. We believe that one of the overriding goals of any Systems Biology education should be a student's ability to phrase and communicate research questions in such a manner that they can be solved by the integration of experiments and modelling, as well as to communicate and collaborate productively across different experimental and theoretical disciplines in research and development.
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Affiliation(s)
- Marija Cvijovic
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Thomas Höfer
- Division of Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jure Aćimović
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Lilia Alberghina
- University of Milano-Bicocca, Department of Biotechnology and Biosciences, Milano, Italy
| | - Eivind Almaas
- Department of Biotechnology, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Daniela Besozzi
- Department of Informatics, Systems and Communication, University of Milano-Bicocca and SYSBIO Centre of Systems Biology, Milano, Italy
| | - Anders Blomberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - Marta Cascante
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | | | - Pedro de Atauri
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Cornelia Depner
- Division of Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Christian Fleck
- Laboratory for Systems and Synthetic Biology, Wageningen UR, Wageningen, Netherlands
| | - Jordi Garcia-Ojalvo
- Universitat Pompeu Fabra, Department of Experimental and Health Sciences, Barcelona, Spain
| | - Didier Gonze
- Unité de Chronobiologie Théorique, Faculté des Sciences, CP 231 and Interuniversity Institute of Bioinformatics in Brussels (IB)2, Université Libre de Bruxelles, Brussels, Belgium
| | - Jens Hahn
- Theoretical Biophysics, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | | | - Marcus Krantz
- Theoretical Biophysics, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Torbjörn Lundh
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Gifta Martial
- BioQuant Center, University of Heidelberg, Heidelberg, Germany
| | | | | | | | | | - Egils Stalidzans
- Institute of Microbiology and Biotechnology, University of Latvia, Riga, Latvia
| | | | - Bas Teusink
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Stefan Hohmann
- Department of Biology and Bioengineering, Chalmers University of Technology, Göteborg, Sweden
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Bertaccini EJ, Dickinson R, Trudell JR, Franks NP. Molecular modeling of a tandem two pore domain potassium channel reveals a putative binding site for general anesthetics. ACS Chem Neurosci 2014; 5:1246-52. [PMID: 25340635 PMCID: PMC4306477 DOI: 10.1021/cn500172e] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 11/28/2022] Open
Abstract
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Anesthetics are thought
to mediate a portion of their activity
via binding to and modulation of potassium channels. In particular,
tandem pore potassium channels (K2P) are transmembrane ion channels
whose current is modulated by the presence of general anesthetics
and whose genetic absence has been shown to confer a level of anesthetic
resistance. While the exact molecular structure of all K2P forms remains
unknown, significant progress has been made toward understanding their
structure and interactions with anesthetics via the methods of molecular
modeling, coupled with the recently released higher resolution structures
of homologous potassium channels to act as templates. Such models
reveal the convergence of amino acid regions that are known to modulate
anesthetic activity onto a common three- dimensional cavity that forms
a putative anesthetic binding site. The model successfully predicts
additional important residues that are also involved in the putative
binding site as validated by the results of suggested experimental
mutations. Such a model can now be used to further predict other amino
acid residues that may be intimately involved in the target-based
structure–activity relationships that are necessary for anesthetic
binding.
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Affiliation(s)
- Edward J. Bertaccini
- Department
of Anesthesia and Perioperative Medicine, Palo Alto VA Health Care System, Palo Alto, California 94304, United States
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Stewart B, Kanal K, Dickinson R, Zamora D. MO-F-16A-06: Implementation of a Radiation Exposure Monitoring System for Surveillance of Multi-Modality Radiation Dose Data. Med Phys 2014. [DOI: 10.1118/1.4889177] [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: 11/07/2022] Open
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Kanal K, Hoff M, Dickinson R, Zamora D, Stewart B. SU-E-E-01: ABR Diagnostic Radiology Core Exam: Was Our Redesigned Physics Course Successful in Teaching Physics to Radiology Residents? Med Phys 2014. [DOI: 10.1118/1.4887932] [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: 11/07/2022] Open
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28
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Yip GMS, Chen ZW, Edge CJ, Smith EH, Dickinson R, Hohenester E, Townsend RR, Fuchs K, Sieghart W, Evers AS, Franks NP. A propofol binding site on mammalian GABAA receptors identified by photolabeling. Nat Chem Biol 2013; 9:715-20. [PMID: 24056400 PMCID: PMC3951778 DOI: 10.1038/nchembio.1340] [Citation(s) in RCA: 169] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 08/08/2013] [Indexed: 11/09/2022]
Abstract
Propofol is the most important intravenous general anesthetic in current clinical use. It acts by potentiating GABAA (γ-aminobutyric acid type A) receptors, but where it binds to this receptor is not known and has been a matter of some debate. We synthesized a new propofol analog photolabeling reagent whose biological activity is very similar to that of propofol. We confirmed that this reagent labeled known propofol binding sites in human serum albumin that have been identified using X-ray crystallography. Using a combination of protiated and deuterated versions of the reagent to label mammalian receptors in intact membranes, we identified a new binding site for propofol in GABAA receptors consisting of both β3 homopentamers and α1β3 heteropentamers. The binding site is located within the β subunit at the interface between the transmembrane domains and the extracellular domain and lies close to known determinants of anesthetic sensitivity in the transmembrane segments TM1 and TM2.
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Affiliation(s)
- Grace M S Yip
- 1] Department of Life Sciences, Imperial College, London, UK. [2]
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Mizandari M, Pai M, Xi F, Valek V, Tomas A, Quaretti P, Golfieri R, Mosconi C, Guokun A, Kyriakides C, Dickinson R, Nicholls J, Habib N. Percutaneous intraductal radiofrequency ablation is a safe treatment for malignant biliary obstruction: feasibility and early results. Cardiovasc Intervent Radiol 2012; 36:814-9. [PMID: 23232859 DOI: 10.1007/s00270-012-0529-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [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] [Received: 08/10/2012] [Accepted: 11/03/2012] [Indexed: 02/06/2023]
Abstract
PURPOSE Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. METHODS Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. RESULTS Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14-260) days and median stent patency of 84.5 (range 14-260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14-260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38-210) days. CONCLUSIONS In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies.
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Affiliation(s)
- Malkhaz Mizandari
- Department of Radiology, Tbilisi State Medical University, Tbilisi, Georgia
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Yang X, Han R, Guo Y, Bradley J, Cox B, Dickinson R, Kitney R. Modelling and performance analysis of clinical pathways using the stochastic process algebra PEPA. BMC Bioinformatics 2012; 13 Suppl 14:S4. [PMID: 23095226 PMCID: PMC3439723 DOI: 10.1186/1471-2105-13-s14-s4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Hospitals nowadays have to serve numerous patients with limited medical staff and equipment while maintaining healthcare quality. Clinical pathway informatics is regarded as an efficient way to solve a series of hospital challenges. To date, conventional research lacks a mathematical model to describe clinical pathways. Existing vague descriptions cannot fully capture the complexities accurately in clinical pathways and hinders the effective management and further optimization of clinical pathways. Method Given this motivation, this paper presents a clinical pathway management platform, the Imperial Clinical Pathway Analyzer (ICPA). By extending the stochastic model performance evaluation process algebra (PEPA), ICPA introduces a clinical-pathway-specific model: clinical pathway PEPA (CPP). ICPA can simulate stochastic behaviours of a clinical pathway by extracting information from public clinical databases and other related documents using CPP. Thus, the performance of this clinical pathway, including its throughput, resource utilisation and passage time can be quantitatively analysed. Results A typical clinical pathway on stroke extracted from a UK hospital is used to illustrate the effectiveness of ICPA. Three application scenarios are tested using ICPA: 1) redundant resources are identified and removed, thus the number of patients being served is maintained with less cost; 2) the patient passage time is estimated, providing the likelihood that patients can leave hospital within a specific period; 3) the maximum number of input patients are found, helping hospitals to decide whether they can serve more patients with the existing resource allocation. Conclusions ICPA is an effective platform for clinical pathway management: 1) ICPA can describe a variety of components (state, activity, resource and constraints) in a clinical pathway, thus facilitating the proper understanding of complexities involved in it; 2) ICPA supports the performance analysis of clinical pathway, thereby assisting hospitals to effectively manage time and resources in clinical pathway.
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Affiliation(s)
- Xian Yang
- Department of Computing, Imperial College London, London, SW7 2AZ, UK
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Zamora D, Dickinson R, Kanal K, Stewart B. MO-F-213CD-07: Implementation of Dose Monitoring in a Cardiology Department with Independent Medical Reporting Systems. Med Phys 2012. [DOI: 10.1118/1.4735832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Zamora D, Kanal K, Dickinson R, Shuman W, Stewart B. TU-G-217BCD-09: Integration of Recent NEMA (MITA) XR-25 CT Dose-Check Standard into Clinical Practice. Med Phys 2012. [DOI: 10.1118/1.4736023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dickinson R, Kanal K, Zamora D, Stewart B. SU-E-I-34: Air Kerma to Estimated Entrance Skin Dose Look-Up Tables: A Tool to Improve Dose Awareness in the Angiography Suite. Med Phys 2012; 39:3632. [PMID: 28519524 DOI: 10.1118/1.4734749] [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] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Although air kerma (AK) is displayed during a case, often it does not represent the entrance skin dose (ESD), which can be estimated. The purpose of this work is to develop and provide system-customized AK-to- ESD look-up tables (LUTs) for immediate reference so that physicians can better evaluate the likelihood of deterministic skin reactions to weigh the risk-versus-benefit of continuing high-dose procedures. METHODS Four correction factors are applied to estimate ESD from AK: inverse square correction from the interventional reference point to the average entrance table position, backscatter factor, mean energy absorption coefficient ratio, and measured table attenuation. Correction factors are room and service specific; therefore, room-specific AK-to-ESD LUTs are posted for easy reference. LUTs also list corresponding tissue reactions and their approximate time-of-onset. Protocols can be established for nurse or technology staff to provide verbal AK dose notifications during the case at crucial skin reaction dose thresholds (e.g. 2Gy indicating possible skin erythema and 5Gy indicating potentially prolonged recovery or permanent skin damage). Patient follow-up protocols can be established if the estimated ESD exceeds a set trigger level (e.g. 5Gy). Staff and physicians surveys evaluate usefulness and impact of dose awareness by system users. RESULTS Two surveys report feedback on LUTs from physicians and technologists with 14 years median experience (range: 3-24 years). Over three-quarters of all angiography system users identify the LUTs and verbal dose notifications as positively affecting the institution's 'Patient First' initiative and roughly one-half of the imaging system users indicate that the LUTs and site-specific dose trigger level improves the dose awareness of care providers. CONCLUSIONS Our efforts have focused on educating care providers about the differences between displayed AK and the estimated ESD. LUTs provide physicians and staff an immediate reference for estimated ESD and the associated deterministic skin effects at specific dose levels.
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Affiliation(s)
| | - K Kanal
- University of Washington, Seattle, WA
| | - D Zamora
- University of Washington, Seattle, WA
| | - B Stewart
- University of Washington, Seattle, WA
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Stewart B, Zamora D, Dickinson R, Rohrmann C, Kanal K. MO-F-213CD-06: Implementation of Fluoroscopy Dose Mining and Analysis Process for Continuous Quality Assurance. Med Phys 2012. [DOI: 10.1118/1.4735831] [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: 11/07/2022] Open
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Kanal K, Dickinson R, Zamora D, Cohen W, Valji K, Stewart B. MO-F-213CD-05: Establishing a Follow-Up Process for Angiographic Patients Receiving an Estimated Entrance Skin Dose in Excess of 5 Gy. Med Phys 2012. [DOI: 10.1118/1.4735830] [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: 11/07/2022] Open
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Dickinson R, Kanal K, Zamora D, Stewart B. MO-F-110-01: Analysis of Distribution of Procedure Time and Dose in Interventional Radiography (IR): Setting Thresholds for Case Review. Med Phys 2011. [DOI: 10.1118/1.3613023] [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: 11/07/2022] Open
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Kanal K, Dickinson R, Zamora D, Stewart B. SU-E-E-06: The New ABR Exam: What Have We Done to Change the Way We Teach Physics to Residents? Med Phys 2011. [DOI: 10.1118/1.3611560] [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: 11/07/2022] Open
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Abstract
In the past decade there has been a resurgence of interest in the clinical use of inert gases. In the present paper we review the use of inert gases as anesthetics and neuroprotectants, with particular attention to the clinical use of xenon. We discuss recent advances in understanding the molecular pharmacology of xenon and we highlight specific pharmacological targets that may mediate its actions as an anesthetic and neuroprotectant. We summarize recent in vitro and in vivo studies on the actions of helium and the other inert gases, and discuss their potential to be used as neuroprotective agents.
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Affiliation(s)
- Robert Dickinson
- Biophysics Section, Blackett Laboratory, Imperial College London, South Kensington, London SW7 2AZ, UK.
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Kanal K, Gunn M, Dickinson R, Stewart B. TH-C-201B-03: Computed Tomography Dose Data Mining and Surveillance as an Ongoing Quality Assurance Improvement Process. Med Phys 2010. [DOI: 10.1118/1.3469520] [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: 11/07/2022] Open
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41
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Barber ND, Alldred DP, Raynor DK, Dickinson R, Garfield S, Jesson B, Lim R, Savage I, Standage C, Buckle P, Carpenter J, Franklin B, Woloshynowych M, Zermansky AG. Care homes' use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people. Qual Saf Health Care 2009; 18:341-6. [PMID: 19812095 PMCID: PMC2762085 DOI: 10.1136/qshc.2009.034231] [Citation(s) in RCA: 187] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2009] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Care home residents are at particular risk from medication errors, and our objective was to determine the prevalence and potential harm of prescribing, monitoring, dispensing and administration errors in UK care homes, and to identify their causes. METHODS A prospective study of a random sample of residents within a purposive sample of homes in three areas. Errors were identified by patient interview, note review, observation of practice and examination of dispensed items. Causes were understood by observation and from theoretically framed interviews with home staff, doctors and pharmacists. Potential harm from errors was assessed by expert judgement. RESULTS The 256 residents recruited in 55 homes were taking a mean of 8.0 medicines. One hundred and seventy-eight (69.5%) of residents had one or more errors. The mean number per resident was 1.9 errors. The mean potential harm from prescribing, monitoring, administration and dispensing errors was 2.6, 3.7, 2.1 and 2.0 (0 = no harm, 10 = death), respectively. Contributing factors from the 89 interviews included doctors who were not accessible, did not know the residents and lacked information in homes when prescribing; home staff's high workload, lack of medicines training and drug round interruptions; lack of team work among home, practice and pharmacy; inefficient ordering systems; inaccurate medicine records and prevalence of verbal communication; and difficult to fill (and check) medication administration systems. CONCLUSIONS That two thirds of residents were exposed to one or more medication errors is of concern. The will to improve exists, but there is a lack of overall responsibility. Action is required from all concerned.
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Affiliation(s)
- N D Barber
- Department of Practice and Policy, School of Pharmacy, Tavistock House, Tavistock Square, London WC1H 9JP, UK.
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Sykes J, Lindsay R, Fairfoul J, Emmens D, Dickinson R, Thwaites D. DEVELOPMENT OF A CLINICALLY REALISTIC TEST FOR EVALUATION OF X-RAY TOMOGRAPHIC IGRT SYSTEMS. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72930-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lindsay R, Sykes J, Stanley S, Dickinson R, Thwaites D. A TECHNICAL EVALUATION AND IMPLEMENTATION SURVEY OF THREE IGRT SYSTEMS AT ELEVEN UK CENTRES. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72931-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ayav A, Jiao L, Dickinson R, Nicholls J, Milicevic M, Pellicci R, Bachellier P, Habib N. Liver resection with a new multiprobe bipolar radiofrequency device. ACTA ACUST UNITED AC 2008; 143:396-401; discussion 401. [PMID: 18427028 DOI: 10.1001/archsurg.143.4.396] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
HYPOTHESIS Liver resection can be associated with marked blood loss. A novel multiprobe bipolar radiofrequency device (Habib 4X; RITA Medical Systems Inc, Fremont, California) has been developed to assist in liver resection and to reduce intraoperative blood loss. DESIGN Prospective study. SETTING Tertiary referral unit. PATIENTS Sixty-two patients requiring liver resection between November 1, 2004, and February 28, 2006, primarily for metastatic cancer. INTERVENTION Liver resection with the radiofrequency device. MAIN OUTCOME MEASURES Intraoperative blood loss, liver parenchyma transection time, and complications. RESULTS There were 51 minor and 11 major hepatectomies. Mean (SD) transection time was 39 (27) seconds per square centimeter. Mean (SD) blood loss was 4.8 (5.6) mL per square centimeter. No patient required hepatic inflow occlusion. One patient required blood transfusion. There were no deaths, and the morbidity rate was 18%. Mean (SD) hospital stay was 8 (3) days. CONCLUSIONS This new bipolar radiofrequency device allows minor and major hepatectomies to be performed with minimal blood loss, low blood transfusion requirement, and reduced mortality and morbidity rates.
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Affiliation(s)
- Ahmet Ayav
- ChM, Department of Surgery, Hammersmith Hospital, Imperial College School of Medicine, Du Cane Road, London W120NN, England
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Rhodes JM, Robinson R, Beales I, Pugh S, Dickinson R, Dronfield M, Speirs CJ, Wilkinson P, Wilkinson SP. Clinical trial: oral prednisolone metasulfobenzoate (Predocol) vs. oral prednisolone for active ulcerative colitis. Aliment Pharmacol Ther 2008; 27:228-40. [PMID: 17988236 DOI: 10.1111/j.1365-2036.2007.03569.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [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: 12/28/2022]
Abstract
BACKGROUND Systemic corticosteroids are effective in ulcerative colitis but commonly cause side effects. AIM To compare the safety and efficacy of a sparingly absorbed formulation of prednisolone metasulfobenzoate (Predocol) with a conventional tapering course of oral prednisolone. METHOD In a double-blind randomized study, 59 active ulcerative colitis patients received Predocol 40 mg/day for 6 months, 61 received Predocol 60 mg/day for 6 months and 61 received prednisolone 40 mg/day for 2 weeks, tapered to week 8, followed by placebo until 6 months. RESULTS Steroid-related side effects assessed using a 10-cm visual analogue scale were fewer at 2 months with Predocol 40 mg [VAS 8.1 cm (2.6), mean (s.d.)], or 60 mg [8.1 (2.1)] compared with prednisolone [6.7 (2.7); P = 0.01]. Mood changes affected 43% receiving prednisolone at 4 weeks vs. 8% for Predocol 40 mg (P = 0.001). Remission rates (Powell-Tuck < or =2) at 2 months were Predocol 40 mg 46%, Predocol 60 mg 28% and tapering prednisolone 41% (P = 0.13). Visual analogue scale for efficacy also showed non-inferiority for Predocol 40 mg/day. Remission rates at 6 months were Predocol 40 mg 51%, Predocol 60 mg 38% and tapering prednisolone 32% (P = 0.08). CONCLUSION Predocol 40 mg/day has similar efficacy but markedly fewer side effects than a conventional tapering prednisolone regimen (ISRCTN14133410).
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Affiliation(s)
- J M Rhodes
- School of Clinical Science, University of Liverpool, Liverpool, UK.
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Waring JF, Yang Y, Healan-Greenberg CH, Adler AL, Dickinson R, McNally T, Wang X, Weitzberg M, Xu X, Lisowski A, Warder SE, Gu YG, Zinker BA, Blomme EA, Camp HS. Gene Expression Analysis in Rats Treated with Experimental Acetyl-Coenzyme A Carboxylase Inhibitors Suggests Interactions with the Peroxisome Proliferator-Activated Receptor α Pathway. J Pharmacol Exp Ther 2007; 324:507-16. [DOI: 10.1124/jpet.107.126938] [Citation(s) in RCA: 18] [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] [Indexed: 12/31/2022] Open
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Andres-Enguix I, Caley A, Yustos R, Schumacher MA, Spanu PD, Dickinson R, Maze M, Franks NP. Determinants of the Anesthetic Sensitivity of Two-pore Domain Acid-sensitive Potassium Channels. J Biol Chem 2007; 282:20977-90. [PMID: 17548360 DOI: 10.1074/jbc.m610692200] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [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: 11/06/2022] Open
Abstract
Certain two-pore domain K(+) channels are plausible targets for volatile general anesthetics, yet little is known at the molecular level about how these simple agents cause channel activation. The first anesthetic-activated K(+) current I(K(An)) that was characterized was discovered in the mollusk Lymnaea stagnalis and is remarkable for both its sensitivity to general anesthetics and its stereoselective responses to anesthetic enantiomers (Franks, N. P., and Lieb, W. R. (1988) Nature 333, 662-664 and Franks, N. P., and Lieb, W. R. (1991) Science 254, 427-430). Here we report the molecular cloning of a two-pore domain K(+) channel LyTASK from L. stagnalis and show that, when expressed in HEK-293 cells, it displays the same biophysical characteristics as the anesthetic-activated K(+) current I(K(An)). Sequence analysis and functional properties show it to be a member of the TASK family of channels with approximately 47% identity at the amino acid level when compared with human TASK-1 and TASK-3. By using chimeric channel constructs and site-directed mutagenesis we have identified the specific amino acid 159 to be a critical determinant of anesthetic sensitivity, which, when mutated to alanine, essentially eliminates anesthetic activation in the human channels and greatly reduces activation in LyTASK. The L159A mutation in LyTASK disrupts the stereoselective response to isoflurane while having no effect on the pH sensitivity of the channel, suggesting this critical amino acid may form part of an anesthetic binding site.
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Affiliation(s)
- Isabelle Andres-Enguix
- Biophysics Section, Blackett Laboratory, and Division of Biology, Imperial College, South Kensington, London SW7 2AZ
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Dickinson R, Erwin W, Bidaut L, Vija A, Williams C, Wendt R. SU-FF-I-107: Improving the Accuracy of CT Topograms for Node Localization in Breast Lymphoscintigraphy. Med Phys 2007. [DOI: 10.1118/1.2760484] [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: 11/07/2022] Open
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49
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Dickinson R, Stevens D, Williams C, Wendt R. SU-FF-I-105: Dosimetric Comparison of Planar and 3-Dimensional Methods of Anatomic Localization for Breast Lymphoscintigraphy. Med Phys 2007. [DOI: 10.1118/1.2760482] [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: 11/07/2022] Open
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Cool B, Zinker B, Chiou W, Kifle L, Cao N, Perham M, Dickinson R, Adler A, Gagne G, Iyengar R, Zhao G, Marsh K, Kym P, Jung P, Camp HS, Frevert E. Identification and characterization of a small molecule AMPK activator that treats key components of type 2 diabetes and the metabolic syndrome. Cell Metab 2006; 3:403-16. [PMID: 16753576 DOI: 10.1016/j.cmet.2006.05.005] [Citation(s) in RCA: 698] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 12/01/2005] [Accepted: 05/17/2006] [Indexed: 12/25/2022]
Abstract
AMP-activated protein kinase (AMPK) is a key sensor and regulator of intracellular and whole-body energy metabolism. We have identified a thienopyridone family of AMPK activators. A-769662 directly stimulated partially purified rat liver AMPK (EC50 = 0.8 microM) and inhibited fatty acid synthesis in primary rat hepatocytes (IC50 = 3.2 microM). Short-term treatment of normal Sprague Dawley rats with A-769662 decreased liver malonyl CoA levels and the respiratory exchange ratio, VCO2/VO2, indicating an increased rate of whole-body fatty acid oxidation. Treatment of ob/ob mice with 30 mg/kg b.i.d. A-769662 decreased hepatic expression of PEPCK, G6Pase, and FAS, lowered plasma glucose by 40%, reduced body weight gain and significantly decreased both plasma and liver triglyceride levels. These results demonstrate that small molecule-mediated activation of AMPK in vivo is feasible and represents a promising approach for the treatment of type 2 diabetes and the metabolic syndrome.
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Affiliation(s)
- Barbara Cool
- Department of Metabolic Disease Research, Abbott Laboratories, 100 Abbott Park Road, Abbott Park, Illinois 60064, USA.
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