Publications by authors named "Renwick"

1,001 Publications

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The potential developmental neurotoxicity of calcium cyclamate in CD rats.

Food Chem Toxicol 2021 Apr 30;153:112236. Epub 2021 Apr 30.

The Coca-Cola Company, GA, USA.

The developmental neurotoxicity of calcium cyclamate was evaluated in Sprague Dawley [Crl:CD(SD)] rats, administered in drinking water, in comparison to a concurrent control group (water) and a positive control group given propylthiouracil (PTU). Calcium cyclamate was administered to F0 females for 4 weeks prior to pairing, throughout mating, gestation and lactation and to F1 offspring from weaning to 12 weeks of age, PTU was administered by gavage to F0 females from Day 6 of gestation up to Day 20 of lactation. Target calcium cyclamate doses were 0, 250, 500 and 1,000 mg/kg bw/day, while the PTU dose was 0.5 mg/kg bw/day. No treatment-related effects of cyclamate were observed in either the F0 or F1 generations on reproductive performance or neurobehavioral development. In comparison, PTU exposure resulted in developmental delays, memory impairment and a number of neuropathological and morphometric outcomes. The results from the unique developmental neurotoxicity study design, corroborate the absence of hyperactivity and any other neurotoxic effects following cyclamate administration at levels up to 878 mg/kg bw/day in F0 females and 784 mg/kg bw/day in F1 animals. This demonstrates the suitability of PTU as a positive control and confirms the safe use of cyclamate as a no-calorie sweetener.
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http://dx.doi.org/10.1016/j.fct.2021.112236DOI Listing
April 2021

Improving health behaviors in patients with peripheral arterial disease - A pilot study of supported self-management.

J Vasc Nurs 2021 Mar 3;39(1):11-16. Epub 2020 Nov 3.

Vascular Department, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN Scotland, United Kingdom.

Purpose Of The Research: This pilot study reports the feasibility of a future randomized controlled trial (RCT) investigating the effect of supported self-management through low-intensity psychological intervention in patients with peripheral arterial disease (PAD) resulting in claudication. The study protocol, measurement instrument, data collection, and analysis were evaluated. Clinical outcome measures include depression and anxiety scores, smoking cessation, activity (step count), weight, and quality of life. Both Quantitative and Qualitative data were collected to evaluate participant experience and the clinical impact of a supported self-management intervention delivered in a routine clinical setting.

Methods: Participants received an initial one to one assessment with a health psychologist. Demographic data and baseline clinical outcome measures were recorded. These included Hospital Anxiety and Depression Scale score (HADS), health-related quality of life questionnaire (EQ-5D-3 L), number of cigarettes smoked daily, weight/BMI, and daily step count. Participants each received an activity tracker to record daily step count and were followed up weekly to provide psychological input, including goal setting, overcoming barriers, and preventing relapse. Quantitative data collection was scheduled at baseline, 3 and 6 months (final follow-up). At the final follow-up, participants provided qualitative feedback reflecting upon their experience of the intervention and its impact. Descriptive statistical analysis and simple paired samples t-test were employed in data evaluation.

Results: The sample size was small (n = 30). Twenty-three participants were followed up to 6 months. Depression scores improved with statistical significance from baseline to 6-month follow-up. Eight participants stopped smoking (47% reduction); a further 9 greatly reduced their intake. A borderline statistically significant increase of daily step count was achieved between baseline and 6-month follow-up. In addition, positive weight loss trends were observed in a predominantly obese or overweight cohort. The qualitative feedback highlighted participants understood and embraced the information delivered regarding the importance of health behavior change. Participants were able to link tailored action plans with what mattered to them with the help of the Health Psychologist.

Conclusion: This study embraces the contemporary ideology of enabling self-management of long-term conditions to improve clinical outcomes. As a pilot study, we have shown that an expanded, randomized controlled trial is both safe and feasible. A positive trend in clinical outcomes suggests this patient group may benefit from supported self-management through low-intensity psychological intervention, where other forms of early intervention have historically faltered.
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http://dx.doi.org/10.1016/j.jvn.2020.10.001DOI Listing
March 2021

Early Interleukin-22 and Neutrophil Proteins Are Correlated to Future Lung Damage in Children With Cystic Fibrosis.

Front Pediatr 2021 31;9:640184. Epub 2021 Mar 31.

Children's Health Ireland and Tallaght University Hospital, Dublin, Ireland.

Cystic Fibrosis (CF) lung damage begins early in life. Lung function decline is associated with pulmonary infections, neutrophil infiltration and inflammation. In CF, neutrophils have an altered phenotype. In this pilot study, we aimed to determine if signals of dysfunctional neutrophil responses were evident early in life and whether these signals may be associated with lung damage in later childhood. We examined the pulmonary protein profiles of 14 clinical stable infants and pre-school children with CF employing the aptamer-based affinity platform, SOMAscan®. High resolution computed tomography (HRCT) was performed on all children after age 6 years and Brody score calculated. A Spearman's rank order correlation analysis and Benjamini-Hochberg adjustment was used to correlate protein concentrations in early life to Brody scores in later childhood. Early life concentrations of azurocidin and myeloperoxidase, were positively correlated with Brody score after age 6 ( = 0.0041 and = 0.0182, respectively). Four other neutrophil associated proteins; Complement C3 ( = 0.0026), X-ray repair CCP 6 ( = 0.0059), C3a anaphylatoxin des Arginine ( = 0.0129) and cytokine receptor common subunit gamma ( = 0.0214) were all negatively correlated with Brody scores. Interestingly, patients with more severe lung damage after age 6 had significantly lower levels of IL-22 in early years of life ( = 0.0243). IL-22 has scarcely been reported to have implications in CF. Identification of early biomarkers that may predict more severe disease progression is particularly important for the future development of early therapeutic interventions in CF disease. We recommend further corroboration of these findings in prospective validation studies.
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http://dx.doi.org/10.3389/fped.2021.640184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044422PMC
March 2021

Laparoscopic Management of Hepatic Abscess From Ingested Chicken Bone.

Cureus 2021 Feb 17;13(2):e13403. Epub 2021 Feb 17.

General Surgery, Rockhampton Hospital, Rockhampton, AUS.

A 68-year-old man presented to the hospital with severe right upper abdominal pain, fevers, nausea and lethargy. He deteriorated into septic shock and was found to have a hepatic abscess on computer tomography imaging. After multiple investigations and continual deterioration, he underwent an exploratory laparoscopy which revealed a chicken bone within the liver parenchyma resulting in a large hepatic abscess. The patient required a second laparoscopic washout and prolonged antibiotics, subsequently recovering well. This rare case highlights the difficulty in diagnosing hepatic abscesses caused by gastrointestinal foreign bodies, and successful management with laparoscopic surgery.
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http://dx.doi.org/10.7759/cureus.13403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7978156PMC
February 2021

Mathematical modelling of respiratory syncytial virus (RSV) in low- and middle-income countries: A systematic review.

Epidemics 2021 Feb 22;35:100444. Epub 2021 Feb 22.

Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, United States.

Background: Due to high burden of respiratory syncytial virus (RSV) in low- and middle-income countries (LMIC), international funding organizations have prioritized the development of RSV vaccines. Mathematical models of RSV will play an important role in assessing the relative value of these interventions. Our objectives were to provide an overview of the existing RSV modelling literature in LMIC and summarize available results on population-level effectiveness and cost-effectiveness.

Methods: We searched MEDLINE from 2000 to 2020 for English language publications that employed a mathematical model of RSV calibrated to LMIC. Qualitative data were extracted on study and model characteristics. Quantitative data were collected on key model input assumptions and base case effectiveness and cost-effectiveness estimates for various immunization strategies.

Findings: Of the 283 articles reviewed, 15 met inclusion criteria. Ten studies used modelling techniques to explore RSV transmission and/or natural history, while eight studies evaluated RSV vaccines and/or monoclonal antibodies, three of which included cost-effectiveness analyses. Six studies employed deterministic compartmental models, five studies employed individual transmission models, and four studies used different types of cohort models. Nearly every model was calibrated to at least one middle-income country, while four were calibrated to low-income countries.

Interpretation: The mathematical modelling literature in LMIC has demonstrated the potential effectiveness of RSV vaccines and monoclonal antibodies. This review has demonstrated the importance of accounting for seasonality, social contact rates, immunity from prior infection and maternal antibody transfer. Future models should consider incorporating individual-level risk factors, subtype-specific effects, long-term sequelae of RSV infections, and out-of-hospital mortality.
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http://dx.doi.org/10.1016/j.epidem.2021.100444DOI Listing
February 2021

The Lung Microbiome in Young Children with Cystic Fibrosis: A Prospective Cohort Study.

Microorganisms 2021 Feb 26;9(3). Epub 2021 Feb 26.

National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin D12 N512, Ireland.

The cystic fibrosis (CF) lung harbours a diverse microbiome and reduced diversity in the CF lung has been associated with advancing age, increased inflammation and poorer lung function. Data suggest that the window for intervention is early in CF, yet there is a paucity of studies on the lung microbiome in children with CF. The objective of this study was to thoroughly characterise the lower airway microbiome in pre-school children with CF. Bronchoalveolar lavage (BAL) samples were collected annually from children attending the three clinical centres. Clinical and demographic data were collated on all subjects alongside BAL inflammatory markers. 16S rRNA gene sequencing was performed on the Illumina MiSeq platform. Bioinformatics and data analysis were performed using Qiime and R project software. Data on 292 sequenced BALs from 101 children with CF and 51 without CF show the CF lung microbiome, while broadly similar to that in non-CF children, is distinct. Alpha diversity between the two cohorts was indistinguishable at this early age. The CF diagnosis explained only 1.1% of the variation between the cohort microbiomes. However, several key genera were significantly differentially abundant between the groups. While the non-CF lung microbiome diversity increased with age, diversity reduced in CF with age. and were more abundant with age, while genera such as and were less abundant with age. There was a negative correlation between alpha diversity and interleukin-8 and neutrophil elastase in the CF population. Neither current flucloxacillin or azithromycin prophylaxis, nor previous oral or IV antibiotic exposure, was correlated with microbiome diversity. Consecutive annual BAL samples over 5 years from a subgroup of children demonstrated diverse patterns of development in the first years of life.
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http://dx.doi.org/10.3390/microorganisms9030492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996874PMC
February 2021

Socio-demographic and clinical characteristics of migrants to Ireland presenting with a first episode of psychosis.

Ir J Psychol Med 2021 Feb 26:1-7. Epub 2021 Feb 26.

DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland.

Objectives: When presenting with a first episode of psychosis (FEP), migrants can have different demographic and clinical characteristics to the native-born population and this was examined in an Irish Early Intervention for Psychosis service.

Methods: All cases of treated FEP from three local mental health services within a defined catchment area were included. Psychotic disorder diagnoses were determined using the SCID and symptom and functioning domains were measured using validated and reliable measures.

Results: From a cohort of 612 people, 21.1% were first-generation migrants and there was no difference in the demographic characteristics, diagnoses, symptoms or functioning between migrants and those born in the Republic of Ireland, except that migrants from Africa presented with less insight. Of those admitted, 48.6% of admissions for migrants were involuntary compared to 37.7% for the native-born population (p = 0.09).

Conclusions: First-generation migrants now make up a significant proportion of people presenting with a FEP to an Irish EI for psychosis service. Broadly the demographic and clinical characteristics of migrants and those born in the Republic of Ireland are similar, except for less insight in migrants from Africa and a trend for a higher proportion of involuntary admissions in the total migrant group.
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http://dx.doi.org/10.1017/ipm.2020.132DOI Listing
February 2021

Environmental sustainability in anaesthesia and critical care. Response to Br J Anaesth 2021; 126: e195-e197.

Br J Anaesth 2021 Jun 22;126(6):e193-e195. Epub 2021 Jan 22.

Western Health, Footscray, Victoria, Australia; School of Public Health, University of Sydney, Sydney, Australia; Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2020.12.025DOI Listing
June 2021

Cost-effectiveness of cancer drugs: Comparative analysis of the United States and England.

EClinicalMedicine 2020 Dec 5;29-30:100625. Epub 2020 Nov 5.

Department of Health Policy, London School of Economics and Political Science, London, UK.

Background: England's National Institute for Health and Care Excellence (NICE) and the US' Institute for Clinical and Economic Review (ICER) both conduct cost-effectiveness evaluations for new cancer drugs to help payers make drug coverage decisions. However, NICE and ICER assessments have been noted to reach different conclusions. We aim to better understand the degree to which their recommendations diverge and what drives these apparent differences.

Methods: We compared the methods and results of publicly available cost-effectiveness evaluations performed by ICER and NICE of similarly assessed cancer drugs. Assessments were compared based on incremental cost-effectiveness ratio, comparator treatment, price, recommendation, and the design of the economic evaluation.

Findings: Among 11 commonly assessed cancer drugs, ICER and NICE were in concordance for 7 evaluations and in discordance on the cost-effectiveness and coverage decisions for 4 drugs. Most new cancer drugs were not cost-effective in either the US (7/11) or England (7/11). Furthermore, NICE's capacity to negotiate price discounts and access schemes result in much lower cost per QALY valuations and more favourable recommendations than those of ICER for similarly assessed cancer drugs.

Interpretations: NICE and ICER employ similar health technology assessment (HTA) methodologies and were aligned with most recommendations, finding that many new and expensive cancer drugs are cost ineffective. Growing use of ICER assessments will continue to send stronger price signals to manufacturers that cancer drugs with low value for money will be viewed less favourably by private insurers. NICE provides an important reminder of how much lower other countries pay for drugs when comparative effectiveness and value-based pricing are integrated into public drug coverage decisions.
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http://dx.doi.org/10.1016/j.eclinm.2020.100625DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788430PMC
December 2020

Analysis of adoption trends of in-parlor technologies over a 10-year period for labor saving and data capture on pasture-based dairy farms.

J Dairy Sci 2021 Jan 6;104(1):431-442. Epub 2020 Nov 6.

Department of Global Value Chains and Trade, Faculty of Agribusiness and Commerce, Lincoln University, Lincoln 7647, New Zealand.

The use of precision technology is increasingly seen as an option to improve productivity, animal welfare, resource use efficiency, and workplace features on dairy farms. There is limited research related to longitudinal adoption patterns of precision dairy technologies and reasons for any patterns. The aim of this analysis was to investigate trends in technology adoption regarding both the amount (number of farms with a technology) and intensity (number of technologies per farm) of adoption. Surveys of parlor technology adoption were conducted on New Zealand dairy farms in 2008, 2013, and 2018, with 532, 500, and 500 respondents, respectively. Technologies were grouped into labor-saving (LS, such as automatic cluster removers) or data-capture (DC, such as in-line milk meters) categories. Trends were examined for farms that had only LS, only DC, or LS+DC technologies. Technology adoption increased over time; the likelihood of technology adoption in 2018 (and 2013 in parentheses) increased by 21 (22), 7 (68), and 378% (165) for LS, DC, and LS+DC technology groups, respectively, compared to 2008. Farms with LS+DC technologies also had a greater proportion of LS technologies compared to non-LS+DC farms, although this relationship declined over the 10-yr period. The use of a rotary versus herringbone parlor was estimated to be associated with 356 and 470% increase in the likelihood of adopting LS technologies and LS+DC, respectively, from 2008 to 2018. Regional differences in adoption were also found, with the likelihood of adopting DC and LS+DC technologies found to be 46 and 59% greater, respectively, in the South Island of New Zealand, compared to the base region of Waikato. The results highlight the importance of understanding spatial and temporal farm characteristics when considering future effect and adoption of precision dairy technologies. For example, the analysis indicates the occurrence of 2 trajectories to technology investment on farms, where larger farms are able to take advantage of technology opportunities, but smaller farms may be constrained by factors such as lack of economies of scale, limited capital to invest, and inability to retrofit technology into aging parlor infrastructure.
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http://dx.doi.org/10.3168/jds.2020-18726DOI Listing
January 2021

Cost-Effectiveness of Cardiovascular, Obesity, and Diabetes Mellitus Drugs: Comparative Analysis of the United States and England.

J Am Heart Assoc 2020 11 30;9(21):e018281. Epub 2020 Oct 30.

Department of Health Policy London School of Economics and Political Science London United Kingdom.

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http://dx.doi.org/10.1161/JAHA.120.018281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763410PMC
November 2020

Descriptive analysis of Thoroughbred horses born in Victoria, Australia, in 2010; barriers to entering training and outcomes on exiting training and racing.

PLoS One 2020 28;15(10):e0241273. Epub 2020 Oct 28.

Asia-Pacific Centre for Animal Health, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia.

The reasons for Thoroughbred (TB) horses not entering training or exiting the racing industry, are of interest to regulators, welfare groups and the broader community. Speculation about the outcomes of these horses threatens the community acceptance, or social license, of the TB breeding and racing industries. A representative survey of the 2010 Victorian born TB foal crop was used to determine the outcomes and reasons for exit for horses that had not entered training, or had exited training and racing by eight years of age. Horses exported for racing or breeding (4%), or that were still actively racing (7%) at the start of the follow up period were excluded from the study. An online questionnaire was sent to breeders or trainers of 3,176 TB horses eligible for enrolment in the study. Of the 2,005 (63%) responses received, the two most frequent outcomes were that the horse had either been retired or rehomed (65%), or deceased (16%). For the 1,637 TB horses that had entered training, the majority of retirements were voluntary (59%), followed by involuntary retirements due to health disorders (28%). For TBs that did not have an industry record of entering training (n = 368), death (34%), or retirement or being rehomed (27%), were the most frequent barriers to entering training. The median age of retirement for TBs that raced was five (Q1 4; Q3 6) years regardless of sex, or whether their first race start was at two, three or four years of age. Relatively large numbers of horses voluntarily retiring at five-years of age suggests that industry-level, rather than individual horse-level factors are the predominant influences on racing career duration.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241273PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592779PMC
December 2020

A rapidly enlarging neck swelling.

BMJ 2020 10 22;371:m3395. Epub 2020 Oct 22.

Epsom & St Helier University Hospitals NHS Trust, Carshalton, UK.

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http://dx.doi.org/10.1136/bmj.m3395DOI Listing
October 2020

Belonging through sport participation for young adults with intellectual and developmental disabilities: A scoping review.

J Appl Res Intellect Disabil 2021 Mar 21;34(2):402-420. Epub 2020 Oct 21.

Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.

Background: Research suggests that sport facilitates belonging for diverse athletes. This scoping review characterizes literature on sport participation and belonging for young adults with intellectual and developmental disabilities.

Materials And Methods: A search of five databases identified 17,497 articles. Selected articles (N = 39) underwent data extraction and analysis guided by a theoretical framework of belonging, outlining four processes through which belonging is experienced by individuals with intellectual and developmental disabilities.

Results: Articles originated from developed countries and in the context of Special Olympics (N = 17). Studies commonly used qualitative interviews with proxy respondents. While all studies described at least one belonging process, only 11 studies applied the term "belonging," and no study defined the construct.

Conclusion: Belonging is not well-conceptualized in sports literature for athletes with intellectual and developmental disabilities. Understanding belonging through sport participation for this population may inform sport-based policies and programming.
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http://dx.doi.org/10.1111/jar.12817DOI Listing
March 2021

Towards a bioeconomic vision for New Zealand - Unlocking barriers to enable new pathways and trajectories.

N Biotechnol 2021 Jan 10;60:138-145. Epub 2020 Oct 10.

Lincoln University, P O Box 85084, Lincoln, 7647, Christchurch, New Zealand.

There has been significant national interest and movement towards bioeconomic policy over the past decade. Through an examination of the current bioeconomic pathways in New Zealand, this paper outlines key barriers that transition pathways will need to overcome and factors needing development within the country's bioeconomic environment. New Zealand's strength in primary production, coupled with a market-led economy and recent green growth with low carbon policies, provide an excellent platform for bioeconomic development. However, the strength in established biological industries and lack of clearly defined vision or cohesive support for bioeconomic development provide sufficient inertia to realising the full potential. For a bioeconomy in New Zealand to flourish, a primary sector model that is cohesive and more integrated is needed to develop new niche industries and attract finance, while providing an overarching governance system to the primary industries.
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http://dx.doi.org/10.1016/j.nbt.2020.09.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547829PMC
January 2021

Fibulin-3 knockout mice demonstrate corneal dysfunction but maintain normal retinal integrity.

J Mol Med (Berl) 2020 11 22;98(11):1639-1656. Epub 2020 Sep 22.

Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA.

Fibulin-3 (F3) is an extracellular matrix glycoprotein found in basement membranes across the body. An autosomal dominant R345W mutation in F3 causes a macular dystrophy resembling dry age-related macular degeneration (AMD), whereas genetic removal of wild-type (WT) F3 protects mice from sub-retinal pigment epithelium (RPE) deposit formation. These observations suggest that F3 is a protein which can regulate pathogenic sub-RPE deposit formation in the eye. Yet the precise role of WT F3 within the eye is still largely unknown. We found that F3 is expressed throughout the mouse eye (cornea, trabecular meshwork (TM) ring, neural retina, RPE/choroid, and optic nerve). We next performed a thorough structural and functional characterization of each of these tissues in WT and homozygous (F3) knockout mice. The corneal stroma in F3 mice progressively thins beginning at 2 months, and the development of corneal opacity and vascularization starts at 9 months, which worsens with age. However, in all other tissues (TM, neural retina, RPE, and optic nerve), gross structural anatomy and functionality were similar across WT and F3 mice when evaluated using SD-OCT, histological analyses, electron microscopy, scotopic electroretinogram, optokinetic response, and axonal anterograde transport. The lack of noticeable retinal abnormalities in F3 mice was confirmed in a human patient with biallelic loss-of-function mutations in F3. These data suggest that (i) F3 is important for maintaining the structural integrity of the cornea, (ii) absence of F3 does not affect the structure or function of any other ocular tissue in which it is expressed, and (iii) targeted silencing of F3 in the retina and/or RPE will likely be well-tolerated, serving as a safe therapeutic strategy for reducing sub-RPE deposit formation in disease. KEY MESSAGES: • Fibulins are expressed throughout the body at varying levels. • Fibulin-3 has a tissue-specific pattern of expression within the eye. • Lack of fibulin-3 leads to structural deformities in the cornea. • The retina and RPE remain structurally and functionally healthy in the absence of fibulin-3 in both mice and humans.
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http://dx.doi.org/10.1007/s00109-020-01974-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606609PMC
November 2020

Classifying Lung Neuroendocrine Neoplasms through MicroRNA Sequence Data Mining.

Cancers (Basel) 2020 Sep 17;12(9). Epub 2020 Sep 17.

Laboratory of Translational RNA Biology, Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON K7L 3N6, Canada.

Lung neuroendocrine neoplasms (NENs) can be challenging to classify due to subtle histologic differences between pathological types. MicroRNAs (miRNAs) are small RNA molecules that are valuable markers in many neoplastic diseases. To evaluate miRNAs as classificatory markers for lung NENs, we generated comprehensive miRNA expression profiles from 14 typical carcinoid (TC), 15 atypical carcinoid (AC), 11 small cell lung carcinoma (SCLC), and 15 large cell neuroendocrine carcinoma (LCNEC) samples, through barcoded small RNA sequencing. Following sequence annotation and data preprocessing, we randomly assigned these profiles to discovery and validation sets. Through high expression analyses, we found that miR-21 and -375 are abundant in all lung NENs, and that miR-21/miR-375 expression ratios are significantly lower in carcinoids (TC and AC) than in neuroendocrine carcinomas (NECs; SCLC and LCNEC). Subsequently, we ranked and selected miRNAs for use in miRNA-based classification, to discriminate carcinoids from NECs. Using miR-18a and -155 expression, our classifier discriminated these groups in discovery and validation sets, with 93% and 100% accuracy. We also identified miR-17, -103, and -127, and miR-301a, -106b, and -25, as candidate markers for discriminating TC from AC, and SCLC from LCNEC, respectively. However, these promising findings require external validation due to sample size.
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http://dx.doi.org/10.3390/cancers12092653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564332PMC
September 2020

Culturally adapted family intervention for schizophrenia in Pakistan: a feasibility study.

Int J Psychiatry Clin Pract 2020 Sep 15:1-10. Epub 2020 Sep 15.

School of Health Sciences, University of Manchester, Manchester, UK.

Objectives: To establish feasibility and acceptability of a Culturally adapted Family Intervention (CulFI) that was developed using an empirically derived conceptual framework in Pakistan.

Methods: A rater-blind, randomised trial to evaluate the feasibility and acceptability of delivering CulFI compared to treatment as usual in Karachi, Pakistan. Indicators of feasibility included evaluation of recruitment rates, retention and randomisation. We also evaluated the acceptability of the intervention and trial procedures.

Results: Excellent recruitment and retention rates informed the feasibility of the intervention. CulFI had more than a 90% participant attendance of 8-10 sessions and retained more than 90% who commenced in the intervention. Eighty percent of those who initially provided consent were willing to be randomised and the quality of CulFI was rated as good to excellent by 85.7% of participants.

Conclusions: Importantly, this study determines that pathways into a psychosocial intervention can be established in Pakistan. A combination of factors contribute to low levels of access to psychiatric care including different explanatory models of illness, small numbers of trained staff, limited resources and reliance on traditional healers. These results support the feasibility, acceptability and merit of conducting a full-scale trial of CulFI in comparison with standard care. NCT02167347KEY POINTSThe significant treatment gap in LMICs leaves families providing much of the care for people with schizophrenia.There is limited evidence from LMICs supporting the effectiveness and feasibility of psychosocial interventions more broadly, and family interventions specifically.This study adds to the scarce literature and demonstrates that pathways into delivering psychosocial interventions can be established in Pakistan.The results of this trial support the feasibility and acceptability of a Culturally adapted Family Intervention (CulFI) for schizophrenia patients and their families in PakistanA full-scale trial of CulFI in comparison with standard care is warranted to determine clinical and cost-effectiveness.
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http://dx.doi.org/10.1080/13651501.2020.1819332DOI Listing
September 2020

Physical activity participation among adolescents with autism spectrum disorder.

Autism 2021 Apr 14;25(3):613-626. Epub 2020 Sep 14.

Rehabilitation Sciences Institute, University of Toronto, Canada.

Lay Abstract: Adolescents with autism spectrum disorder are less likely to be physically active compared to their age-related peers. Despite the lower levels of physical activity observed among adolescents with autism spectrum disorder, it is unknown why they are predominantly inactive. Much of the research so far has focused on understanding how biological aspects influence physical activity participation. But there is little research that has examined how social and cultural components influence their physical activity participation. There is also little research that has sought the perspectives and experiences of adolescents with autism spectrum disorder. In this study, 10 adolescent boys with autism spectrum disorder created a digital story, and also participated in two face-to-face interviews. The purpose of the study was to examine how individual, social, and cultural forces influenced physical activity participation. Analysis of the data highlight that bullying, challenges in community programs, and the prioritization of therapeutic interventions limited participation. On the contrary, participants were more likely to be active when physical activity generated meaning, purpose, a sense of identity, and affective pleasures. The findings add new knowledge suggesting that adolescents with autism spectrum disorder are not simply unmotivated. Rather, physical activity participation was shaped by wider social experiences, norms, values, and practices in which they were immersed. The findings suggest a need for directed efforts to create policies and practices which are individualized and reflective of the needs and abilities of adolescents with autism spectrum disorder to promote physical activity participation and potentially enhance physical health and wellbeing.
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http://dx.doi.org/10.1177/1362361320949344DOI Listing
April 2021

Psychosocial family interventions for relatives of people living with psychotic disorders in the Arab world: systematic review.

BMC Psychiatry 2020 08 20;20(1):413. Epub 2020 Aug 20.

Division of Psychology & Mental Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.

Background: Family interventions in schizophrenia are evidence based and have been adapted to different cultural settings to improve their effectiveness and acceptability. The Arab world has a unique set of socio-cultural norms and values that cannot be ignored when developing or implementing such interventions. There is a lack of research on the feasibility of delivering family interventions for schizophrenia in the Arab region. The aim of this review is to synthesise the available evidence about culturally-adapted psychosocial family interventions in the Arab world. The review identifies the content and characteristics of these interventions, determines the strategies used to adapt them to Arab culture successfully, assesses the feasibility and acceptability of the interventions, and evaluates the effectiveness of these interventions for service users and their families.

Method: Five electronic databases were searched including MEDLINE, CINAHL, Cochrane Library, PsycINFO and EMBASE for articles written in Arabic and English from inception to August 2019. Data were extracted and synthesised narratively.

Results: Six studies were retrieved from the search: three randomised control studies, two non-randomised studies and one qualitative study. There is limited evidence about culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. The methodological quality of the included studies was generally poor, so there is a risk of underestimating the effect size of the interventions due to lack of rigour and the presence of bias.

Conclusion: The present review provides the foundation for future work regarding family interventions in the Arab world, and confirms the feasibility of implementing such interventions with some modifications. Furthermore, the data suggests that any family-oriented intervention for schizophrenia is likely to be better than standard care in improving the outcome for patients and their families.
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http://dx.doi.org/10.1186/s12888-020-02816-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441715PMC
August 2020

1D H NMR as a Tool for Fecal Metabolomics.

Curr Protoc Chem Biol 2020 09;12(3):e83

Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada.

Metabolomic studies allow a deeper understanding of the processes of a given ecological community than nucleic acid-based surveys alone. In the case of the gut microbiota, a metabolic profile of, for example, a fecal sample provides details about the function and interactions within the distal region of the gastrointestinal tract, and such a profile can be generated in a number of different ways. This unit elaborates on the use of 1D H NMR spectroscopy as a commonly used method to characterize small-molecule metabolites of the fecal metabonome (meta-metabolome). We describe a set of protocols for the preparation of fecal water extraction, storage, scanning, measurement of pH, and spectral processing and analysis. We also compare the effects of various sample storage conditions for processed and unprocessed samples to provide a framework for comprehensive analysis of small molecules from stool-derived samples. © 2020 Wiley Periodicals LLC Basic Protocol 1: Extracting fecal water from crude fecal samples Alternate Protocol 1: Extracting fecal water from small crude fecal samples Basic Protocol 2: Acquiring NMR spectra of metabolite samples Alternate Protocol 2: Acquiring NMR spectra of metabolite samples using Bruker spectrometer running TopSpin 3.x Alternate Protocol 3: Acquiring NMR spectra of metabolite samples by semiautomated process Basic Protocol 3: Measuring sample pH Support Protocol 1: Cleaning NMR tubes Basic Protocol 4: Processing raw spectra data Basic Protocol 5: Profiling spectra Support Protocol 2: Spectral profiling of sugars and other complex metabolites.
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http://dx.doi.org/10.1002/cpch.83DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968567PMC
September 2020

Development of the Wound Resource Education Nurse (WREN) programme.

Authors:
Caroline Renwick

Br J Nurs 2020 Aug;29(15):S18-S23

Tissue Viability Specialist Nurse, County Durham and Darlington NHS Foundation Trust, County Durham.

Aim: Managing wounds costs an estimated £5.3 billion a year in the UK. Poor wound care knowledge and a lack of access to specialist practitioners contribute to this expense. A project-the Wound Resource Education Nurse (WREN) programme-was developed to support patient-centred care, effective nursing outcomes and staff satisfaction in relation to wound care.

Method: The competency-based WREN programme is open to health professionals, healthcare assistants and tissue viability link nurses who are enthusiastic and willing to develop their tissue viability knowledge and skills. Sessions are delivered on a monthly basis and comprise a mix of didactic teaching, practical sessions and case-based scenarios. Learning is assessed through quizzes and practical assessments at the end of each session and at course completion.

Results: Two years after it started, 60 WRENs in an acute trust have completed the programme or are attending sessions. The programme has been rolled out to a mental health trust and district nursing services over 12-18 months, and has been attended by doctors, physiotherapists and other practitioners.

Conclusion: The WREN programme has largely been successful, with the mental health trust showing the greatest improvement in practice and care. In all organisations, staff have developed competence and confidence in wound management, facilitating timely, appropriate care and realising cost savings. Although the programme was initially aimed at staff in nursing roles, other professionals have embraced it, so the trusts have a variety of competent practitioners.
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http://dx.doi.org/10.12968/bjon.2020.29.15.S18DOI Listing
August 2020

Characterizing and classifying neuroendocrine neoplasms through microRNA sequencing and data mining.

NAR Cancer 2020 Sep 15;2(3):zcaa009. Epub 2020 Jul 15.

Laboratory of Translational RNA Biology, Department of Pathology and Molecular Medicine, Queen's University, 88 Stuart Street, Kingston, ON K7L 3N6, Canada.

Neuroendocrine neoplasms (NENs) are clinically diverse and incompletely characterized cancers that are challenging to classify. MicroRNAs (miRNAs) are small regulatory RNAs that can be used to classify cancers. Recently, a morphology-based classification framework for evaluating NENs from different anatomical sites was proposed by experts, with the requirement of improved molecular data integration. Here, we compiled 378 miRNA expression profiles to examine NEN classification through comprehensive miRNA profiling and data mining. Following data preprocessing, our final study cohort included 221 NEN and 114 non-NEN samples, representing 15 NEN pathological types and 5 site-matched non-NEN control groups. Unsupervised hierarchical clustering of miRNA expression profiles clearly separated NENs from non-NENs. Comparative analyses showed that miR-375 and miR-7 expression is substantially higher in NEN cases than non-NEN controls. Correlation analyses showed that NENs from diverse anatomical sites have convergent miRNA expression programs, likely reflecting morphological and functional similarities. Using machine learning approaches, we identified 17 miRNAs to discriminate 15 NEN pathological types and subsequently constructed a multilayer classifier, correctly identifying 217 (98%) of 221 samples and overturning one histological diagnosis. Through our research, we have identified common and type-specific miRNA tissue markers and constructed an accurate miRNA-based classifier, advancing our understanding of NEN diversity.
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http://dx.doi.org/10.1093/narcan/zcaa009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380486PMC
September 2020

Short communication: The relationship between farm debt and dairy productivity and profitability in New Zealand.

J Dairy Sci 2020 Sep 16;103(9):8251-8256. Epub 2020 Jul 16.

School of Economics and Management, Nanjing University of Science and Technology, Nanjing 210094, China.

For a variety of reasons, dairy sector indebtedness has increased in recent years. However, it is not clear whether increased debt boosts or damages the economic performance of dairy farms. This paper provides empirical evidence by exploring the effects of farm debt measured by debt-to-asset ratio on dairy productivity and profitability, using the New Zealand DairyBase data of 2,637 dairy farms for a 10-yr period 2005 to 2014. A fixed-effects panel data model is utilized for the empirical analysis. The findings show that farm debt is significantly and negatively associated with both dairy productivity and profitability. We find that dairy productivity is positively determined by production intensification, irrigation intensity, milking frequency, cattle breeds and stocking rate, whereas dairy profitability is positively affected by milk price, business type, milking frequency, and stocking rate. Further analyses reveal that the debt ratio significantly decreases both the technical efficiency of dairy farms and return on assets; a high debt ratio increased dairy productivity between 2005 and 2009, whereas it decreased dairy productivity between 2011 and 2014; the effects of the debt ratio on dairy profitability vary over time. The analysis for a 10-yr balanced panel data (250 farms) shows that debt ratio does not significantly affect both dairy productivity and profitability, which suggests that the presence of farm-specific attributes such as farm life cycle and managerial ability of dairy farmers may also affect the debt ratio and through this farm performance.
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http://dx.doi.org/10.3168/jds.2019-17506DOI Listing
September 2020

Exploring perspectives on chronic obstructive pulmonary disease in people who smoke heroin: a qualitative study.

BJGP Open 2020 Aug 25;4(3). Epub 2020 Aug 25.

Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK.

Background: Smoking rather than injecting heroin has become more common over the last 20 years. Although there is an increasing body of evidence describing high levels of chronic obstructive pulmonary disease (COPD) in people who smoke heroin, there is limited evidence documenting the impact of the long-term condition on this population group.

Aim: This study aimed to describe the experiences of people who smoke heroin with COPD in Liverpool, UK.

Design & Setting: Participants were purposefully sampled for this qualitative study. They included adults enrolled in an opioid replacement clinic run by Addaction in Liverpool, who had already engaged with spirometry testing for COPD as part of a previous study.

Method: Semi-structured interviews were performed with participants with spirometrically confirmed COPD in opioid replacement clinics. Data were analysed using a framework analysis approach.

Results: Sixteen potential participants were invited to take part in the study, of which 10 agreed and were interviewed. Three themes common to all interviews were identified: functional measures of lung health that impacted on their activities of daily living; inhaler and medication perceptions with erratic use that was not concordant with their prescription; and the impact of difficulties accessing care.

Conclusion: These findings, along with previous studies highlighting the prevalence of COPD in this population, warrant efforts to integrate community COPD and opioid replacement services to improve outcomes for this vulnerable population.
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http://dx.doi.org/10.3399/bjgpopen20X101055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465580PMC
August 2020

Patients' perspectives on shared decision making in secondary mental healthcare in Taiwan: A qualitative study.

Patient Educ Couns 2020 May 26. Epub 2020 May 26.

Division of Nursing, Midwifery & Social Work, School of Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester M25 3BL, United Kingdom.

Objective: The aim of this study is to explore patient perspectives on shared decision making in secondary mental healthcare in Taiwan.

Methods: Qualitative semi-structured interviews were used to explore patient perspectives on shared decision making in secondary mental healthcare in Taiwan. Individual semi-structured interviews were conducted from July to August 2017 with a purposive sample of twenty patients using halfway houses. Data were analysed using thematic analysis.

Results: Analysis of the interviews identified two themes: barriers to shared decision making; facilitators of shared decision making. Patients perceived that they were not involved in decision making due to: the professional status of health professionals; negative perception of making decisions; and limited time resources. However, patients reported a desire to be involved and felt sufficient information exchange would be a necessary step towards collaboration/sharing decisions about treatment with clinicians.

Conclusion: The findings provided an understanding of significant barriers to and facilitators of implementing shared decision making to aid further professional training and the development of national policies.

Practice Implications: The findings could be the basis for developing effective strategies to overcome barriers to shared decision making and improve the process quality of delivering shared decision making.
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http://dx.doi.org/10.1016/j.pec.2020.05.030DOI Listing
May 2020

Distinguishing Tumor and Stromal Sources of MicroRNAs Linked to Metastasis in Cutaneous Melanoma.

Transl Oncol 2020 Sep 28;13(9):100802. Epub 2020 May 28.

Cancer Biology and Genetics Division, Queen's Cancer Research Institute, Kingston, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada. Electronic address:

MicroRNA (miRNA) dysregulation in cancer causes changes in gene expression programs regulating tumor progression and metastasis. Candidate metastasis suppressor miRNA are often identified by differential expression in primary tumors compared to metastases. Here, we performed comprehensive analysis of miRNA expression in The Cancer Genome Atlas (TCGA) skin cutaneous melanoma (SKCM) tumors (97 primary, 350 metastatic), and identified candidate metastasis-suppressor miRNAs. Differential expression analysis revealed miRNA significantly downregulated in metastatic tumors, including miR-205, miR-203, miR-200a-c, and miR-141. Furthermore, sequential feature selection and classification analysis identified miR-205 and miR-203 as the miRNA best able to discriminate between primary and metastatic tumors. However, cell-type enrichment analysis revealed that gene expression signatures for epithelial cells, including keratinocytes and sebocytes, were present in primary tumors and significantly correlated with expression of the candidate metastasis-suppressor miRNA. Examination of miRNA expression in cell lines revealed that candidate metastasis-suppressor miRNA identified in the SKCM tumors, were largely absent in melanoma cells or melanocytes, and highly restricted to keratinocytes and other epithelial cell types. Indeed, the differences in stromal cell composition between primary and metastatic tumor tissues is the main basis for identification of differential miRNA that were previously classified as metastasis-suppressor miRNAs. We conclude that future studies must consider tumor-intrinsic and stromal sources of miRNA in their workflow to identify bone fide metastasis-suppressor miRNA in cutaneous melanoma and other cancers.
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http://dx.doi.org/10.1016/j.tranon.2020.100802DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260684PMC
September 2020

Re-assessing ICR GAC Treatment Study Database: Effect of Bromide on DBP Formation.

AWWA Water Sci 2019 Jul;1(4)

Office of Ground Water and Drinking Water, U.S. Environmental Protection Agency, Washington, DC 20460, United States.

While granular active carbon (GAC) can effectively remove disinfection byproduct (DBP) precursors, its use has raised concerns over increased formation of some brominated DBP species in treated water following postchlorination, especially for waters with high bromide concentrations. The Information Collection Rule Treatment Study Database contains results of the most extensive GAC studies ever conducted nationwide. Data were analyzed to assess the extent of DBP speciation changes and overall reduction of brominated DBPs by GAC to gain new insights of the bromide effect. Results showed that formation of three brominated trihalomethanes (collectively, Br-THM3) varied greatly depending on TOC removal and bromide concentrations. Low TOC concentrations in GAC effluents resulted in greatly reduced Br-THM3 formation, except for a few cases where Br-THM3 formation increased. GAC followed by chloramination were likely to better control Br-THM3 formation for waters with high TOC and high bromide. Lastly, the chlorine demand reduction by GAC was quantified.
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http://dx.doi.org/10.1002/aws2.1147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252525PMC
July 2019

A case-control study to identify risk factors for adult-onset idiopathic megaoesophagus in Australian dogs, 2017-2018.

BMC Vet Res 2020 May 24;16(1):157. Epub 2020 May 24.

Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.

Background: Epidemiological investigations were carried out following detection of an outbreak of megaoesophagus in Victorian Police working dogs in early 2018 and an increase in the number of canine megaoesophagus cases reported by companion animal veterinarians in Eastern Australia starting in late 2017. VetCompass Australia data were used to quantify the incidence of canine megaoesophagus for the period January 2012 to February 2018 and a matched case-control study carried out to identify individual animal risk factors for canine megaoesophagus in 2017-2018.

Results: There was a 7-fold increase in the incidence rate of canine megaoesophagus from 2014 (0.11 [95% CI 0.02 to 0.58] cases per 100,000 dogs per day) to 2018 (0.82 [95% CI 0.19 to 4.2] cases per 100,000 dogs per day). Since 2013, the incidence of megaoesophagus in Australia has shown a seasonal pattern, with greater numbers of cases diagnosed during the warmer months of the year. In the case-control study, use of Mars Petcare Advance Dermocare as a source of food was 325 (95% CI 64 to 1644) times greater for cases, compared with controls.

Conclusions: Our analyses provide evidence that the feeding of Advance Dermocare was responsible for the majority of cases in the outbreak of megaoesophagus in Eastern Australia in 2017-2018. The increase in the incidence rate of megaoesophagus in Australia since 2014-2015 warrants further investigation.
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http://dx.doi.org/10.1186/s12917-020-02376-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247263PMC
May 2020

Deteriorating Water Distribution Systems Can Impact Public Health.

Opflow 2019 Sep;45(9):12-15

Office of Ground Water and Drinking Water's Standards and Risk Management Division, US Environmental Protection Agency (www.epa.gov), Washington, D.C.

Distribution system infrastructure issues can affect water reliability and quality and could contribute to waterborne disease outbreaks. It's important to know potential contamination mechanisms and consider rehab and replacement options.
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http://dx.doi.org/10.1002/opfl.1246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147722PMC
September 2019