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201. Magnetic Resonance Imaging of Ventilation and Perfusion in the Lung

Author

Prisk, Gordon Kim, Hopkins, Susan Roberta, Buxton, Richard Bruce, Pereira De Sa, Rui Carlos, Theilmann, Rebecca Jean, and Cronin, Matthew Vincent

Subjects
Instrumentation And Photography
Abstract

Methods, devices, and systems are disclosed for implementing a fully quantitative non-injectable contrast proton MRI technique to measure spatial ventilation-perfusion (VA/Q) matching and spatial distribution of ventilation and perfusion. In one aspect, a method using MRI to characterize ventilation and perfusion in a lung includes acquiring an MR image of the lung having MR data in a voxel and obtaining a breathing frequency parameter, determining a water density value, a specific ventilation value, and a perfusion value in at least one voxel of the MR image based on the MR data and using the water density value to determine an air content value, and determining a ventilation-perfusion ratio value that is the product of the specific ventilation value, the air content value, the inverse of the perfusion value, and the breathing frequency.

Published
2017

202. Antibiotic Review Kit for Hospitals (ARK-Hospital): a stepped wedge cluster randomised controlled trial

Author

Llewelyn, Martin J, primary, Budgell, Eric P, additional, Laskawiec-Szkonter, Magda, additional, Cross, Elizabeth LA, additional, Alexander, Rebecca, additional, Bond, Stuart, additional, Coles, Phil, additional, Conlon-Bingham, Geraldine, additional, Dymond, Samantha, additional, Evans, Morgan, additional, Fok, Rosemary, additional, Frost, Kevin J, additional, Garcia-Arias, Veronica, additional, Glass, Stephen, additional, Gormley, Cairine, additional, Gray, Katherine, additional, Hamson, Clare, additional, Harvey, David, additional, Hills, Tim, additional, Iyer, Shabnam, additional, Johnson, Alison, additional, Jones, Nicola, additional, Kang, Parmjit, additional, Kiapi, Gloria, additional, Mack, Damien, additional, Makanga, Charlotte, additional, Mawer, Damian, additional, McCullagh, Bernie, additional, Mirfenderesky, Mariyam, additional, McEwen, Ruth, additional, Nag, Sath, additional, Nagar, Aaron, additional, Northfield, John, additional, O’Driscoll, Jean, additional, Pegden, Amanda, additional, Porter, Robert, additional, Powell, Neil, additional, Price, David, additional, Sheridan, Elizabeth, additional, Slatter, Mandy, additional, Stewart, Bruce, additional, Watson, Cassandra, additional, Weichert, Immo, additional, Sivyer, Katy, additional, Wordsworth, Sarah, additional, Quaddy, Jack, additional, Santillo, Marta, additional, Krusche, Adele, additional, Roope, Laurence SJ, additional, Mowbray, Fiona, additional, Hand, Kieran S, additional, Dobson, Melissa, additional, Crook, Derrick, additional, Vaughan, Louella, additional, Hopkins, Susan, additional, Yardley, Lucy, additional, Peto, Timothy EA, additional, and Walker, Ann Sarah, additional

Published
2022
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203. CO-CONNECT: A hybrid architecture to facilitate rapid discovery and access to UK wide data in the response to the COVID-19 pandemic (Preprint)

Author

Jefferson, Emily, primary, Cole, Christian, additional, Mumtaz, Shahzad, additional, Cox, Sam, additional, Giles, Tom, additional, Adejumo, Samuel, additional, Urwin, Esmond, additional, Lea, Daniel, additional, McDonald, Calum, additional, Best, Joseph, additional, Masood, Erum, additional, Milligan, Gordon, additional, Johnston, Jenny, additional, Horban, Scott, additional, Birced, Ipek, additional, Hall, Christopher, additional, Jackson, Aaron, additional, Collins, Clare, additional, Rising, Sam, additional, Dodsley, Charlotte, additional, Hampton, Jill, additional, Hadfield, Andrew, additional, Santos, Roberto, additional, Tarr, Simon, additional, Panagi, Vasiliki, additional, Lavagna, Joseph, additional, Jackson, Tracy, additional, Chuter, Antony, additional, Beggs, Jillian, additional, Martinez-Queipo, Magdalena, additional, Ward, Helen, additional, von Ziegenweidt, Julie, additional, Burns, Frances, additional, Martin, Jo, additional, Sebire, Neil, additional, Morris, Carole, additional, Bradley, Declan, additional, Baxter, Rob, additional, Ahonen-Bishop, Anni, additional, Shoemark, Amelia, additional, Valdes, Ana, additional, Ollivere, Benjamin J, additional, Manisty, Charlotte, additional, Eyre, David William, additional, Gallant, Stephanie, additional, Joy, George, additional, McAuley, Andrew, additional, Connell, David W, additional, Northstone, Kate, additional, Jeffery, Katie JM, additional, Di Angelantonio, Emanuele, additional, McMahon, Amy, additional, Walker, Matthew, additional, Semple, Malcolm Gracie, additional, Sims, Jessica Mai, additional, Lawrence, Emma, additional, Davies, Bethan, additional, Baillie, J Kenneth, additional, Tang, Ming, additional, Leeming, Gary, additional, Power, Linda, additional, Breeze, Thomas, additional, Gilson, Natalie, additional, Murray, Duncan J, additional, Orton, Chris, additional, Pierce, Iain, additional, Hall, Ian, additional, Ladhani, Shamez, additional, Whitaker, Matthew, additional, Shallcross, Laura, additional, Seymour, David, additional, Varma, Susheel, additional, Reilly, Gerry, additional, Morris, Andrew, additional, Hopkins, Susan, additional, Sheikh, Aziz, additional, and Quinlan, Philip, additional

Published
2022
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204. Evolution of long-term vaccine induced and hybrid immunity in healthcare workers after different COVID-19 vaccination regimens: a longitudinal observational cohort study

Author

Moore, Shona C., primary, Kronsteiner, Barbara, additional, Longet, Stephanie, additional, Adele, Sandra, additional, Deeks, Alexandra S., additional, Liu, Chang, additional, Dejnirattisai, Wanwisa, additional, Reyes, Laura Silva, additional, Meardon, Naomi, additional, Faustini, Sian, additional, Al-Taei, Saly, additional, Tipton, Tom, additional, Hering, Luisa M, additional, Angyal, Adrienn, additional, Brown, Rebecca, additional, Nicols, Alexander R, additional, Dobson, Susan L, additional, Supasa, Piyada, additional, Tuekprakhon, Aekkachai, additional, Cross, Andrew, additional, Tyerman, Jessica K, additional, Hornsby, Hailey, additional, Grouneva, Irina, additional, Plowright, Megan, additional, Zhang, Peijun, additional, Newman, Thomas A.H., additional, Nell, Jeremy M., additional, Abraham, Priyanka, additional, Ali, Mohammad, additional, Malone, Tom, additional, Neale, Isabel, additional, Phillips, Eloise, additional, Wilson, Joseph D., additional, Murray, Sam M., additional, Zewdie, Martha, additional, Shields, Adrian, additional, Horner, Emily C., additional, Booth, Lucy H., additional, Stafford, Lizzie, additional, Bibi, Sagida, additional, Wootton, Daniel G., additional, Mentzer, Alexander J., additional, Conlon, Christopher P., additional, Jeffery, Katie, additional, Matthews, Philippa C., additional, Pollard, Andrew J., additional, Brown, Anthony, additional, Rowland-Jones, Sarah L., additional, Mongkolsapaya, Juthathip, additional, Payne, Rebecca P., additional, Dold, Christina, additional, Lambe, Teresa, additional, Thaventhiran, James E.D., additional, Screaton, Gavin, additional, Barnes, Eleanor, additional, Hopkins, Susan, additional, Hall, Victoria, additional, Duncan, Christopher JA, additional, Richter, Alex, additional, Carroll, Miles, additional, de Silva, Thushan I., additional, Klenerman, Paul, additional, Dunachie, Susanna, additional, and Turtle, Lance, additional

Published
2022
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205. Impact of prior SARS-CoV-2 infection and COVID-19 vaccination on the subsequent incidence of COVID-19: a multicentre prospective cohort study among UK healthcare workers – the SIREN (Sarscov2 Immunity & REinfection EvaluatioN) study protocol

Author

Wallace, Sarah, primary, Hall, Victoria, additional, Charlett, Andre, additional, Kirwan, Peter D, additional, Cole, Michele, additional, Gillson, Natalie, additional, Atti, Ana, additional, Timeyin, Jean, additional, Foulkes, Sarah, additional, Taylor-Kerr, Andrew, additional, Andrews, Nick, additional, Shrotri, Madhumita, additional, Rokadiya, Sakib, additional, Oguti, Blanche, additional, Vusirikala, Amoolya, additional, Islam, Jasmin, additional, Zambon, Maria, additional, Brooks, Tim J G, additional, Ramsay, Mary, additional, Brown, Colin S, additional, Chand, Meera, additional, and Hopkins, Susan, additional

Published
2022
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207. Covid-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant

Author

Andrews, Nick, primary, Stowe, Julia, additional, Kirsebom, Freja, additional, Toffa, Samuel, additional, Rickeard, Tim, additional, Gallagher, Eileen, additional, Gower, Charlotte, additional, Kall, Meaghan, additional, Groves, Natalie, additional, O’Connell, Anne-Marie, additional, Simons, David, additional, Blomquist, Paula B., additional, Zaidi, Asad, additional, Nash, Sophie, additional, Iwani Binti Abdul Aziz, Nurin, additional, Thelwall, Simon, additional, Dabrera, Gavin, additional, Myers, Richard, additional, Amirthalingam, Gayatri, additional, Gharbia, Saheer, additional, Barrett, Jeffrey C., additional, Elson, Richard, additional, Ladhani, Shamez N., additional, Ferguson, Neil, additional, Zambon, Maria, additional, Campbell, Colin N.J., additional, Brown, Kevin, additional, Hopkins, Susan, additional, Chand, Meera, additional, Ramsay, Mary, additional, and Lopez Bernal, Jamie, additional

Published
2022
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208. The mobilome associated with Gram-negative bloodstream infections: A large-scale observational hybrid sequencing based study

Author

Lipworth, Samuel, primary, Matlock, Willam, additional, Shaw, Liam, additional, Vihta, Karina-Doris, additional, Rodger, Gillian, additional, Chau, Kevin, additional, Barker, Leanne, additional, George, Sophie, additional, Kavanagh, James, additional, Davies, Timothy, additional, Vaughan, Alison, additional, Andersson, Monique, additional, Jeffery, Katie, additional, Oakley, Sarah, additional, Morgan, Marcus, additional, Hopkins, Susan, additional, Peto, Timothy, additional, Crook, Derrick, additional, Walker, A. Sarah, additional, and Stoesser, Nicole, additional

Published
2022
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210. How did a Quality Premium financial incentive influence antibiotic prescribing in primary care? Views of Clinical Commissioning Group and general practice professionals

Author

Borek, Aleksandra J., Anthierens, Sibyl, Allison, Rosalie, McNulty, Cliodna A.M., Lecky, Donna M., Costelloe, Ceire, Holmes, Alison, Butler, Christopher C., Walker, A. Sarah, Tonkin-Crine, Sarah, Anyanwu, Philip E., Bright, Nicole, Buchanan, James, Campbell, Anne, Hayhoe, Benedict, Hopkins, Susan, Majeed, Azeem, Mcleod, Monsey, Moore, Michael, Morrell, Liz, Pouwels, Koen B., Robotham, Julie V., Roope, Laurence S.J., Walker, Ann Sarah, Wordsworth, Sarah, Yadav, Sara, Zalevski, Anna, and Team, STEP-UP Study

Subjects
0301 basic medicine, Microbiology (medical), Quality management, Project commissioning, media_common.quotation_subject, General Practice, 030106 microbiology, MEDLINE, Antibiotic prescribing, 03 medical and health sciences, 0302 clinical medicine, Nursing, Humans, Antimicrobial stewardship, Pharmacology (medical), Quality (business), 030212 general & internal medicine, Practice Patterns, Physicians', Biology, media_common, Pharmacology, Motivation, Primary Health Care, Pharmacology. Therapy, Anti-Bacterial Agents, Infectious Diseases, Incentive, England, General practice, Human medicine, Psychology
Abstract

BackgroundThe Quality Premium (QP) was introduced for Clinical Commissioning Groups (CCGs) in England to optimize antibiotic prescribing, but it remains unclear how it was implemented.ObjectivesTo understand responses to the QP and how it was perceived to influence antibiotic prescribing.MethodsSemi-structured telephone interviews were conducted with 22 CCG and 19 general practice professionals. Interviews were analysed thematically.ResultsThe findings were organized into four categories. (i) Communication: this was perceived as unstructured and infrequent, and CCG professionals were unsure whether they received QP funding. (ii) Implementation: this was influenced by available local resources and competing priorities, with multifaceted and tailored strategies seen as most helpful for engaging general practices. Many antimicrobial stewardship (AMS) strategies were implemented independently from the QP, motivated by quality improvement. (iii) Mechanisms: the QP raised the priority of AMS nationally and locally, and provided prescribing targets to aim for and benchmark against, but money was not seen as reinvested into AMS. (iv) Impact and sustainability: the QP was perceived as successful, but targets were considered challenging for a minority of CCGs and practices due to contextual factors (e.g. deprivation, understaffing). CCG professionals were concerned with potential discontinuation of the QP and prescribing rates levelling off.ConclusionsCCG and practice professionals expressed positive views of the QP and associated prescribing targets and feedback. The QP helped influence change mainly by raising the priority of AMS and defining change targets rather than providing additional funding. To maximize impact, behavioural mechanisms of financial incentives should be considered pre-implementation.

Published
2020
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211. Protection against SARS-CoV-2 after Covid-19 Vaccination and Previous Infection

Author

Hall, Victoria, Foulkes, Sarah, Insalata, Ferdinando, Kirwan, Peter, Saei, Ayoub, Atti, Ana, Wellington, Edgar, Khawam, Jameel, Munro, Katie, Cole, Michelle, Tranquillini, Caio, Taylor-Kerr, Andrew, Hettiarachchi, Nipunadi, Calbraith, Davina, Sajedi, Noshin, Milligan, Iain, Themistocleous, Yrene, Corrigan, Diane, Cromey, Lisa, Price, Lesley, Stewart, Sally, De Lacy, Elen, Norman, Chris, Linley, Ezra, Otter, Ashley D, Semper, Amanda, Hewson, Jacqueline, D'Arcangelo, Silvia, Chand, Meera, Brown, Colin S, Brooks, Tim, Islam, Jasmin, Charlett, Andre, Hopkins, Susan, SIREN Study Group, Hall, Victoria [0000-0001-8744-4277], Kirwan, Peter [0000-0001-6904-0500], Atti, Ana [0000-0001-6768-6586], Tranquillini, Caio [0000-0001-9478-2557], Sajedi, Noshin [0000-0001-7550-894X], Brooks, Tim [0000-0002-3783-1284], Apollo - University of Cambridge Repository, University of St Andrews. School of Medicine, and University of St Andrews. Infection and Global Health Division

Subjects
COVID-19 Vaccines, COVID-19/diagnosis, COVID-19 nucleic acid testing, Health Personnel, Vaccine efficacy, Vaccine Efficacy, Adaptive Immunity, SDG 3 - Good Health and Well-being, BNT162 vaccine/therapeutic use, ChAdOx1 nCoV-19, Humans, Vaccination/methods, QR180 Immunology, Prospective Studies, BNT162 Vaccine, ChAdOx1 nCoV-19/therapeutic use, SARS-CoV-2, Vaccination, COVID-19, 3rd-DAS, General Medicine, Health personnel, Asymptomatic diseases, United Kingdom, COVID-19 vaccines/immunology, COVID-19 Nucleic Acid Testing, QR180, Asymptomatic Diseases, Adaptive immunity/immunology, Prospective studies
Abstract

Supported by the U.K. Health Security Agency, the U.K. Department of Health and Social Care (with contributions from the governments in Northern Ireland, Wales, and Scotland), the National Institute for Health Research, and grants from the Medical Research Council. Background: The duration and effectiveness of immunity from infection with and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are relevant to pandemic policy interventions, including the timing of vaccine boosters. Methods: We investigated the duration and effectiveness of immunity in a prospective cohort of asymptomatic health care workers in the United Kingdom who underwent routine polymerase-chain-reaction (PCR) testing. Vaccine effectiveness (≤10 months after the first dose of vaccine) and infection-acquired immunity were assessed by comparing the time to PCR-confirmed infection in vaccinated persons with that in unvaccinated persons, stratified according to previous infection status. We used a Cox regression model with adjustment for previous SARS-CoV-2 infection status, vaccine type and dosing interval, demographic characteristics, and workplace exposure to SARS-CoV-2. Results: Of 35,768 participants, 27% (9488) had a previous SARS-CoV-2 infection. Vaccine coverage was high: 95% of the participants had received two doses (78% had received BNT162b2 vaccine [Pfizer-BioNTech] with a long interval between doses, 9% BNT162b2 vaccine with a short interval between doses, and 8% ChAdOx1 nCoV-19 vaccine [AstraZeneca]). Between December 7, 2020, and September 21, 2021, a total of 2747 primary infections and 210 reinfections were observed. Among previously uninfected participants who received long-interval BNT162b2 vaccine, adjusted vaccine effectiveness decreased from 85% (95% confidence interval [CI], 72 to 92) 14 to 73 days after the second dose to 51% (95% CI, 22 to 69) at a median of 201 days (interquartile range, 197 to 205) after the second dose; this effectiveness did not differ significantly between the long-interval and short-interval BNT162b2 vaccine recipients. At 14 to 73 days after the second dose, adjusted vaccine effectiveness among ChAdOx1 nCoV-19 vaccine recipients was 58% (95% CI, 23 to 77) - considerably lower than that among BNT162b2 vaccine recipients. Infection-acquired immunity waned after 1 year in unvaccinated participants but remained consistently higher than 90% in those who were subsequently vaccinated, even in persons infected more than 18 months previously. Conclusions: Two doses of BNT162b2 vaccine were associated with high short-term protection against SARS-CoV-2 infection; this protection waned considerably after 6 months. Infection-acquired immunity boosted with vaccination remained high more than 1 year after infection. Publisher PDF

Published
2022

213. Antibody correlates of protection from SARS-CoV-2 reinfection prior to vaccination: a nested case-control within the SIREN study (accepted)

Author

Atti, Ana, Insalata, Ferdinando, Carr, Edward J, Otter, Ashley D, Castillo-Olivares, Javier, Wu, Mary, Harvey, Ruth, Howell, Michael, Chan, Andrew, Lyall, Jonathan, Temperton, Nigel J., Cantoni, Diego, da Costa, Kelly, Nadesalingam, Angalee, Taylor-Kerr, Andrew, Hettiarachchi, Nipunadi, Tranquillini, Caio, Hewson, Jacqueline, Cole, Michelle J, Foulkes, Sarah, Munro, Katie, Monk, Edward J M, Milligan, Iain D, Linley, Ezra, Chand, Meera A, Brown, Colin S, Islam, Jasmin, Semper, Amanda, Charlett, Andre, Heeney, Jonathan L, Beale, Rupert, Zambon, Maria, Hopkins, Susan, Brooks, Tim, and Hall, Victoria

Abstract

Objectives: To investigate serological differences between SARS-CoV-2 reinfection cases and contemporary controls, to identify antibody correlates of protection against reinfection. Methods: We performed a case-control study, comparing reinfection cases with singly infected individuals pre-vaccination, matched by gender, age, region and timing of first infection. Serum samples were tested for anti-SARS-CoV-2 spike (anti-S), anti-SARS-CoV-2 nucleocapsid (anti-N), live virus microneutralisation (LV-N) and pseudovirus microneutralisation (PV-N). Results were analysed using fixed effect linear regression and fitted into conditional logistic regression models. Results: We identified 23 cases and 92 controls. First infections occurred before November 2020; reinfections occurred before February 2021, pre-vaccination. Anti-S levels, LV-N and PV-N titres were significantly lower among cases; no difference was found for anti-N levels. Increasing anti-S levels were associated with reduced risk of reinfection (OR 0•63, CI 0•47-0•85), but no association for anti-N levels (OR 0•88, CI 0•73-1•05). Titres >40 were correlated with protection against reinfection for LV-N Wuhan (OR 0•02, CI 0•001-0•31) and LV-N Alpha (OR 0•07, CI 0•009-0•62). For PV-N, titres >100 were associated with protection against Wuhan (OR 0•14, CI 0•03-0•64) and Alpha (0•06, CI 0•008-0•40). Conclusions: Before vaccination, protection against SARS-CoV-2 reinfection was directly correlated with anti-S levels, PV-N and LV-N titres, but not with anti-N levels. Detectable LV-N titres were sufficient for protection, whilst PV-N titres >100 were required for a protective effect., Author's Accepted Manuscript

Published
2022
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214. Protection against SARS-CoV-2 after Covid-19 Vaccination and Previous Infection

Author

Hall, Victoria, primary, Foulkes, Sarah, additional, Insalata, Ferdinando, additional, Kirwan, Peter, additional, Saei, Ayoub, additional, Atti, Ana, additional, Wellington, Edgar, additional, Khawam, Jameel, additional, Munro, Katie, additional, Cole, Michelle, additional, Tranquillini, Caio, additional, Taylor-Kerr, Andrew, additional, Hettiarachchi, Nipunadi, additional, Calbraith, Davina, additional, Sajedi, Noshin, additional, Milligan, Iain, additional, Themistocleous, Yrene, additional, Corrigan, Diane, additional, Cromey, Lisa, additional, Price, Lesley, additional, Stewart, Sally, additional, de Lacy, Elen, additional, Norman, Chris, additional, Linley, Ezra, additional, Otter, Ashley D., additional, Semper, Amanda, additional, Hewson, Jacqueline, additional, D’Arcangelo, Silvia, additional, Chand, Meera, additional, Brown, Colin S., additional, Brooks, Tim, additional, Islam, Jasmin, additional, Charlett, Andre, additional, and Hopkins, Susan, additional

Published
2022
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216. P14 Procalcitonin evaluation of antibiotic use in COVID-19 hospitalized patients during the first wave of COVID-19: the PEACH study

Author

Euden, Joanne, primary, Howard, Philip, additional, Powell, Neil, additional, Llewelyn, Martin J., additional, Szakmany, Tamas, additional, Albur, Mahableswhar, additional, Bond, Stuart E., additional, Brookes-Howell, Lucy, additional, Dark, Paul, additional, Hellyer, Thomas P., additional, Hopkins, Susan, additional, McCullagh, Iain J., additional, Ogden, Margaret, additional, Pallmann, Philip, additional, Parsons, Helena, additional, Partridge, David G., additional, Shaw, Dominick E., additional, Shinkins, Bethany, additional, Todd, Stacy, additional, Thomas-Jones, Emma, additional, West, Robert, additional, Carrol, Enitan D., additional, and Sandoe, Jonathan A. T., additional

Published
2022
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217. Duration of Protection against Mild and Severe Disease by Covid-19 Vaccines

Author

Andrews, Nick, primary, Tessier, Elise, additional, Stowe, Julia, additional, Gower, Charlotte, additional, Kirsebom, Freja, additional, Simmons, Ruth, additional, Gallagher, Eileen, additional, Thelwall, Simon, additional, Groves, Natalie, additional, Dabrera, Gavin, additional, Myers, Richard, additional, Campbell, Colin N.J., additional, Amirthalingam, Gayatri, additional, Edmunds, Matt, additional, Zambon, Maria, additional, Brown, Kevin, additional, Hopkins, Susan, additional, Chand, Meera, additional, Ladhani, Shamez N., additional, Ramsay, Mary, additional, and Lopez Bernal, Jamie, additional

Published
2022
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219. T-cell and antibody responses to first BNT162b2 vaccine dose in previously infected and SARS-CoV-2-naive UK health-care workers: a multicentre prospective cohort study

Author

Angyal, Adrienn, primary, Longet, Stephanie, additional, Moore, Shona C, additional, Payne, Rebecca P, additional, Harding, Adam, additional, Tipton, Tom, additional, Rongkard, Patpong, additional, Ali, Mohammad, additional, Hering, Luisa M, additional, Meardon, Naomi, additional, Austin, James, additional, Brown, Rebecca, additional, Skelly, Donal, additional, Gillson, Natalie, additional, Dobson, Sue L, additional, Cross, Andrew, additional, Sandhar, Gurjinder, additional, Kilby, Jonathan A, additional, Tyerman, Jessica K, additional, Nicols, Alexander R, additional, Spegarova, Jarmila S, additional, Mehta, Hema, additional, Hornsby, Hailey, additional, Whitham, Rachel, additional, Conlon, Christopher P, additional, Jeffery, Katie, additional, Goulder, Philip, additional, Frater, John, additional, Dold, Christina, additional, Pace, Matthew, additional, Ogbe, Ane, additional, Brown, Helen, additional, Ansari, M Azim, additional, Adland, Emily, additional, Brown, Anthony, additional, Chand, Meera, additional, Shields, Adrian, additional, Matthews, Philippa C, additional, Hopkins, Susan, additional, Hall, Victoria, additional, James, William, additional, Rowland-Jones, Sarah L, additional, Klenerman, Paul, additional, Dunachie, Susanna, additional, Richter, Alex, additional, Duncan, Christopher J A, additional, Barnes, Eleanor, additional, Carroll, Miles, additional, Turtle, Lance, additional, de Silva, Thushan I, additional, Watson, Adam, additional, Angyal, Adrienn, additional, Alhussni, Ahmed, additional, Nicols, Alexander, additional, Deeks, Alexandra, additional, Webb-Bridges, Alice, additional, Jämsén, Anni, additional, Chawla, Anu, additional, Duncan, Christopher, additional, Conlon, Christopher, additional, O'Donnell, Denise, additional, Weeks, Esme, additional, Abuelgasim, Hibatullah, additional, Xiao, Huiyuan, additional, Spegarova, Jarmila, additional, Holmes, Jennifer, additional, Haworth, Jenny, additional, Tyerman, Jessica, additional, Kilby, Jonathan, additional, Cutteridge, Joseph, additional, Lillie, Katy, additional, Romaniuk, Leigh, additional, Denly, Lucy, additional, Hering, Luisa, additional, Ansari, M. Azim, additional, Kasanyinga, Mwila, additional, Matthews, Philippa, additional, Payne, Rebecca, additional, Wilson, Robert, additional, Rowland-Jones, Sarah, additional, Thomas, Sarah, additional, Moore, Shona, additional, Gardiner, Siobhan, additional, Tucker, Stephanie, additional, Dobson, Sue, additional, Adlou, Syed, additional, de Silva, Thushan, additional, Lawrie, Allan, additional, Smith, Nikki, additional, Turton, Helena, additional, Zawia, Amira, additional, Bayley, Martin, additional, Fairman, Alex, additional, Harrington, Kate, additional, Kirk, Rosemary, additional, Marsh, Louise, additional, Watson, Lisa, additional, Wood, Steven, additional, Diffey, Benjamin, additional, Jones, Chris, additional, Lett, Lauren, additional, Platt, Gareth, additional, Subramaniam, Krishanthi, additional, Wootton, Daniel, additional, Payne, Brendan, additional, Hambleton, Sophie, additional, Kelly, Sinead, additional, Marston, Judith, additional, Poolan, Sonia, additional, Turner, Dianne, additional, Haniffa, Muzlifah, additional, Stephenson, Emily, additional, Adele, Sandra, additional, Akhter, Hossain Delowar, additional, Chinnakannan, Senthil, additional, de Lara, Catherine, additional, Donnison, Timothy, additional, Hackstein, Carl-Philipp, additional, Lee, Lian, additional, Lim, Nicholas, additional, Malone, Tom, additional, Phillips, Eloise, additional, Ramamurthy, Narayan, additional, Robinson, Nichola, additional, Sampson, Oliver, additional, Eyre, David, additional, Simmons, Beatrice, additional, Stafford, Lizzie, additional, Mentzer, Alexander, additional, Amini, Ali, additional, Arancibia-Cárcamo, Carolina, additional, Provine, Nicholas, additional, Travis, Simon, additional, Dimitriadis, Stavros, additional, Johnson, Sile, additional, Foulkes, Sarah, additional, Khawam, Jameel, additional, Wellington, Edgar, additional, Gilbert-Jaramillo, Javier, additional, Knight, Michael, additional, Dupont, Maeva, additional, Horner, Emily, additional, Thaventhiran, James, additional, and Chalk, Jeremy, additional

Published
2022
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221. Evolution of Long-Term Hybrid Immunity in Healthcare Workers after Different Covid-19 Vaccination Regimens: A Longitudinal Observational Cohort Study

Author

Moore, Shona, primary, Kronsteiner, Barbara, additional, Longet, Stephanie, additional, Adele, Sandra, additional, Deeks, Alexandra, additional, Liu, Chang, additional, Dejnirattisai, Wanwisa, additional, Silva Reyes, Laura, additional, Meardon, Naomi, additional, Faustini, Sian, additional, Al-Taei, Saly, additional, Tipton, Tom, additional, Hering, Luisa M., additional, Angyal, Adrienn, additional, Brown, Rebecca, additional, Nicols, Alexander R., additional, Dobson, Sue L., additional, Supasa, Piyada, additional, Tuekprakhon, Aekkachai, additional, Cross, Andrew, additional, Tyerman, Jessica K., additional, Hornsby, Hailey, additional, Grouneva, Irina, additional, Plowright, Megan, additional, Zhang, Peijun, additional, Newman, Thomas, additional, Nell, Jeremy M., additional, Abraham, Priyanka, additional, Ali, Mohammad, additional, Malone, Tom, additional, Neale, Isabel, additional, Phillips, Eloise, additional, Wilson, Joseph D., additional, Murray, Sam M., additional, Shields, Adrian, additional, Horner, Emily C., additional, Booth, Lucy H., additional, Stafford, Lizzie, additional, Bibi, Sagida, additional, Wootton, Dan G., additional, Mentzer, Alexander J., additional, Conlon, Christopher P., additional, Jeffery, Katie, additional, Matthews, Philippa C., additional, Pollard, Andrew J., additional, Brown, Anthony, additional, Rowland-Jones, Sarah L., additional, Mongkolspaya, Juthathip, additional, Payne, Rebecca P., additional, Dold, Christina, additional, Lambe, Teresa, additional, Thaventhiran, James, additional, Screaton, Gavin R., additional, Barnes, Eleanor, additional, Hopkins, Susan, additional, Hall, Victoria Jane, additional, Duncan, Christopher JA, additional, Richter, Alex G., additional, Carroll, Miles W., additional, de Silva, Thushan I., additional, Klenerman, Paul, additional, Dunachie, Susanna, additional, Turtle, Lance, additional, and Consortium, PITCH, additional

Published
2022
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222. Tracking the emergence of SARS-CoV-2 alpha variant in the United Kingdom

Author

Walker, A. Sarah, Vihta, Karina-Doris, Gethings, Owen, Pritchard, Emma, Jones, Joel, House, Thomas, Bell, Iain, Bell, John I., Newton, John N., Farrar, Jeremy, Diamond, Ian, Studley, Ruth, Rourke, Emma, Hay, Jodie, Hopkins, Susan, Crook, Derrick, Peto, Tim, Matthews, Philippa C., Eyre, David W., Stoesser, Nicole, Pouwels, Koen B., and Covid-19 Infection Survey Team

Subjects
0303 health sciences, SARS-CoV-2, COVID-19, General Medicine, Health Surveys, Polymerase Chain Reaction, United Kingdom, 03 medical and health sciences, 0302 clinical medicine, Population Surveillance, Correspondence, Humans, Longitudinal Studies, 030212 general & internal medicine, 030304 developmental biology
Abstract

No abstract available.

Published
2021

224. Implementation of antimicrobial stewardship interventions recommended by national toolkits in primary and secondary healthcare sectors in England: TARGET and Start Smart Then Focus

Author

Ashiru-Oredope, D., Budd, E. L., Bhattacharya, A., Din, N., McNulty, C. A. M., Micallef, C., Ladenheim, D., Beech, E., Murdan, S., Hopkins, S., Hopkins, Susan, Ashiru-Oredope, Diane, Brown, Nicholas, Brown, Brian, Budd, Emma, Carter, Sue, Chadborn, Tim, Charlett, Andre, Cichowska, Anna, Dobra, Stephen, Eckford, Susan, Faulding, Sue, Gallagher, Rose, Geoghegan, Lourda, Gurney, Lene, Heginbothom, Maggie, Ironmonger, Dean, Johnson, Alan, McNulty, Cliodna, Moore, Michael, Morrow, Kate, Patel, Bharat, Pinder, Richard, Puleston, Richard, Richman, Colin, Robotham, Julie, Seal, Richard, Sharland, Mike, Stephens, Pete, Stokle, Liz, Underhill, Jonathan, Warner, Bruce, Watson, John, West, Tony, Whitney, Laura, Wight, Ailsa, Wiuff, Camilla, Woodford, Neil, and Young, Tony

Published
2016
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226. Implementing antibiotic stewardship in high-prescribing English general practices: a mixed-methods study.

Author

Tonkin-Crine, Sarah, McLeod, Monsey, Borek, Aleksandra J, Campbell, Anne, Anyanwu, Philip, Costelloe, Céire, Moore, Michael, Hayhoe, Benedict, Pouwels, Koen B, Roope, Laurence SJ, Morrell, Liz, Hopkins, Susan, Butler, Christopher C, and Walker, Ann Sarah

Subjects
ANTIMICROBIAL stewardship, C-reactive protein, DRUG prescribing, COMMUNICATION strategies, MEDICAL personnel, INFORMATION needs, PRESCRIPTION writing
Abstract

Background: Trials have identified antimicrobial stewardship (AMS) strategies that effectively reduce antibiotic use in primary care. However, many are not commonly used in England. The authors co-developed an implementation intervention to improve use of three AMS strategies: enhanced communication strategies, delayed prescriptions, and point-of-care C-reactive protein tests (POC-CRPTs). Aim: To investigate the use of the intervention in high-prescribing practices and its effect on antibiotic prescribing. Design and setting: Nine high-prescribing practices had access to the intervention for 12 months from November 2019. This was primarily delivered remotely via a website with practices required to identify an 'antibiotic champion'. Method: Routinely collected prescribing data were compared between the intervention and the control practices. Intervention use was assessed through monitoring. Surveys and interviews were conducted with professionals to capture experiences of using the intervention. Results: There was no evidence that the intervention affected prescribing. Engagement with intervention materials differed substantially between practices and depended on individual champions' preconceptions of strategies and the opportunity to conduct implementation tasks. Champions in five practices initiated changes to encourage use of at least one AMS strategy, mostly POC-CRPTs; one practice chose all three. POC-CRPTs was used more when allocated to one person. Conclusion: Clinicians need detailed information on exactly how to adopt AMS strategies. Remote, one-sided provision of AMS strategies is unlikely to change prescribing; initial clinician engagement and understanding needs to be monitored to avoid misunderstanding and suboptimal use. [ABSTRACT FROM AUTHOR]

Published
2023
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227. Long-term oral antibiotic use in people with acne vulgaris in UK primary care: a drug utilization study.

Author

Bhate, Ketaki, Mansfield, Kathryn E, Sinnott, Sarah-Jo, Margolis, David J, Adesanya, Elizabeth, Francis, Nick, Leyrat, Clemence, Hopkins, Susan, Stabler, Richard, Shallcross, Laura, Langan, Sinéad M, and Mathur, Rohini

Subjects
DRUG utilization, ACNE, PRIMARY care, INAPPROPRIATE prescribing (Medicine), MEDICAL research
Abstract

Background The inappropriate use of antibiotics is understood to contribute to antimicrobial resistance. Oral antibiotics are regularly used to treat moderate-to-severe acne vulgaris. In practice, we do not know the typical length of oral antibiotic treatment courses for acne in routine primary care and what proportion of people receive more than one course of treatment following a new acne diagnosis. Objectives To describe how oral antibiotics are prescribed for acne over time in UK primary care. Methods We conducted a descriptive longitudinal drug utilization study using routinely collected primary care data from the Clinical Practice Research Datalink GOLD (2004–2019). We included individuals (8–50 years) with a new acne diagnosis recorded between 1 January 2004 and 31 July 2019. Results We identified 217 410 people with a new acne diagnosis. The median age was 17 years [interquartile range (IQR) 15–25] and median follow-up was 4.3 years (IQR 1.9–7.6). Among people with a new acne diagnosis, 96 703 (44.5%) received 248 560 prescriptions for long-term oral antibiotics during a median follow-up of 5.3 years (IQR 2.8–8.5). The median number of continuous courses of antibiotic therapy (≥ 28 days) per person was four (IQR 2–6). The majority (n = 59 010, 61.0%) of first oral antibiotic prescriptions in those with a recorded acne diagnosis were between the ages of 12 and 18. Most (n = 71 544, 74.0%) first courses for oral antibiotics were for between 28 and 90 days. The median duration of the first course of treatment was 56 days (IQR 50–93 days) and 18 127 (18.7%) of prescriptions of ≥ 28 days were for < 6 weeks. Among people who received a first course of oral antibiotic for ≥ 28 days, 56 261 (58.2%) received a second course after a treatment gap of ≥ 28 days. The median time between first and second courses was 135 days (IQR 67–302). The cumulative duration of exposure to oral antibiotics during follow-up was 255 days (8.5 months). Conclusions Further work is needed to understand the consequences of using antibiotics for shorter periods than recommended. Suboptimal treatment duration may result in reduced clinical effectiveness or repeated exposures, potentially contributing to antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Published
2023
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229. Effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529) variant of concern

Author

Andrews, Nick, primary, Stowe, Julia, additional, Kirsebom, Freja, additional, Toffa, Samuel, additional, Rickeard, Tim, additional, Gallagher, Eileen, additional, Gower, Charlotte, additional, Kall, Meaghan, additional, Groves, Natalie, additional, O’Connell, Anne-Marie, additional, Simons, David, additional, Blomquist, Paula B., additional, Zaidi, Asad, additional, Nash, Sophie, additional, Aziz, Nurin Iwani Binti Abdul, additional, Thelwall, Simon, additional, Dabrera, Gavin, additional, Myers, Richard, additional, Amirthalingam, Gayatri, additional, Gharbia, Saheer, additional, Barrett, Jeffrey C., additional, Elson, Richard, additional, Ladhani, Shamez N, additional, Ferguson, Neil, additional, Zambon, Maria, additional, Campbell, Colin NJ, additional, Brown, Kevin, additional, Hopkins, Susan, additional, Chand, Meera, additional, Ramsay, Mary, additional, and Bernal, Jamie Lopez, additional

Published
2021
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231. Discordance between different bioinformatic methods for identifying resistance genes from short-read genomic data, with a focus on Escherichia coli

Author

Davies, Timothy J, primary, Swan, Jeremy, additional, Sheppard, Anna E, additional, Pickford, Hayleah, additional, Lipworth, Samuel, additional, AbuOun, Manal, additional, Ellington, Matthew, additional, Fowler, Philip W, additional, Hopkins, Susan, additional, Hopkins, Katie L, additional, Crook, Derrick W, additional, Peto, Tim EA, additional, Anjum, Muna F, additional, Sarah Walker, A, additional, and Stoesser, Nicole, additional

Published
2021
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232. Immunogenicity of standard and extended dosing intervals of BNT162b2 mRNA vaccine

Author

Payne, Rebecca P., primary, Longet, Stephanie, additional, Austin, James A., additional, Skelly, Donal T., additional, Dejnirattisai, Wanwisa, additional, Adele, Sandra, additional, Meardon, Naomi, additional, Faustini, Sian, additional, Al-Taei, Saly, additional, Moore, Shona C., additional, Tipton, Tom, additional, Hering, Luisa M., additional, Angyal, Adrienn, additional, Brown, Rebecca, additional, Nicols, Alexander R., additional, Gillson, Natalie, additional, Dobson, Susan L., additional, Amini, Ali, additional, Supasa, Piyada, additional, Cross, Andrew, additional, Bridges-Webb, Alice, additional, Reyes, Laura Silva, additional, Linder, Aline, additional, Sandhar, Gurjinder, additional, Kilby, Jonathan A., additional, Tyerman, Jessica K., additional, Altmann, Thomas, additional, Hornsby, Hailey, additional, Whitham, Rachel, additional, Phillips, Eloise, additional, Malone, Tom, additional, Hargreaves, Alexander, additional, Shields, Adrian, additional, Saei, Ayoub, additional, Foulkes, Sarah, additional, Stafford, Lizzie, additional, Johnson, Sile, additional, Wootton, Daniel G., additional, Conlon, Christopher P., additional, Jeffery, Katie, additional, Matthews, Philippa C., additional, Frater, John, additional, Deeks, Alexandra S., additional, Pollard, Andrew J., additional, Brown, Anthony, additional, Rowland-Jones, Sarah L., additional, Mongkolsapaya, Juthathip, additional, Barnes, Eleanor, additional, Hopkins, Susan, additional, Hall, Victoria, additional, Dold, Christina, additional, Duncan, Christopher J.A., additional, Richter, Alex, additional, Carroll, Miles, additional, Screaton, Gavin, additional, de Silva, Thushan I., additional, Turtle, Lance, additional, Klenerman, Paul, additional, Dunachie, Susanna, additional, Abuelgasim, Hibatullah, additional, Adland, Emily, additional, Adlou, Syed, additional, Akther, Hossain Delowar, additional, Alhussni, Ahmed, additional, Ali, Mohammad, additional, Ansari, M. Azim, additional, Arancibia-Cárcamo, Carolina V., additional, Bayley, Martin, additional, Brown, Helen, additional, Chalk, Jeremy, additional, Chand, Meera, additional, Chawla, Anu, additional, Chinnakannan, Senthil, additional, Cutteridge, Joseph, additional, de Lara, Catherine, additional, Denly, Lucy, additional, Diffey, Ben, additional, Dimitriadis, Stavros, additional, Drake, Thomas M., additional, Donnison, Timothy, additional, Dupont, Maeva, additional, Eyre, David, additional, Fairman, Alex, additional, Gardiner, Siobhan, additional, Gilbert-Jarmillo, Javier, additional, Goulder, Philip, additional, Hackstein, Carl-Philipp, additional, Hambleton, Sophie, additional, Haniffa, Muzlifah, additional, Haworth, Jenny, additional, Holmes, Jennifer, additional, Horner, Emily, additional, Jämsén, Anni, additional, Jones, Chris, additional, Kasanyinga, Mwila, additional, Kelly, Sinead, additional, Kirk, Rosemary, additional, Knight, Michael L., additional, Lawrie, Allan, additional, Lee, Lian, additional, Lett, Lauren, additional, Lillie, Katy, additional, Lim, Nicholas, additional, Mehta, Hema, additional, Mentzer, Alexander J., additional, O’Donnell, Denise, additional, Ogbe, Ane, additional, Pace, Matthew, additional, Payne, Brendan A.I., additional, Platt, Gareth, additional, Poolan, Sonia, additional, Provine, Nicholas, additional, Ramamurthy, Narayan, additional, Robinson, Nichola, additional, Romaniuk, Leigh, additional, Rongkard, Patpong, additional, Sampson, Oliver L., additional, Simmons, Beatrice, additional, Spegarova, Jarmila S., additional, Stephenson, Emily, additional, Subramaniam, Kris, additional, Thaventhiran, James, additional, Thomas, Sarah, additional, Travis, Simon, additional, Tucker, Stephanie, additional, Turton, Helena, additional, Watson, Adam, additional, Watson, Lisa, additional, Weeks, Esme, additional, Wilson, Robert, additional, Wood, Steven, additional, Wright, Rachel, additional, Xiao, Huiyuan, additional, and Zawia, Amira A.T., additional

Published
2021
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237. Longitudinal trends and cross-sectional analysis of English national hospital antibacterial use over 5 years (2008–13): working towards hospital prescribing quality measures

Author

Cooke, Jonathan, Stephens, Peter, Ashiru-Oredope, Diane, Charani, Esmita, Dryden, Mathew, Fry, Carole, Hand, Kieran, Holmes, Alison, Howard, Philip, Johnson, Alan P., Livermore, David M., Mansell, Paula, McNulty, Cliodna A. M., Wellsteed, Sally, Hopkins, Susan, and Sharland, Mike

Published
2015
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238. Daily use of lateral flow devices by contacts of confirmed COVID-19 cases to enable exemption from isolation compared with standard self-isolation to reduce onward transmission of SARS-CoV-2 in England: a randomised, controlled, non-inferiority trial.

Author

Love, Nicola K, Ready, Derren R, Turner, Charlie, Verlander, Neville Q, French, Clare E, Martin, Alex F, Sorensen, Tina B, Metelmann, Soeren, Denford, Sarah, Rubin, G James, Yardley, Lucy, Amlôt, Richard, Hopkins, Susan, and Oliver, Isabel

Subjects
COVID-19 pandemic, QUARANTINE, TELECOMMUTING, DIAGNOSTIC use of polymerase chain reaction, SARS-CoV-2
Abstract

In the UK, during the study period (April to July, 2021), all contacts of people with COVID-19 were required to self-isolate for 10 days, which had adverse impacts on individuals and society. Avoiding the need to self-isolate for those who remain uninfected would be beneficial. We investigated whether daily use of lateral flow devices (LFDs) to test for SARS-CoV-2, with removal of self-isolation for 24 h if negative, could be a safe alternative to self-isolation as a means to minimise onward transmission of the virus. We conducted a randomised, controlled, non-inferiority trial in adult contacts identified by COVID-19 contact tracing in England. Consenting participants were randomly assigned to self-isolation (single PCR test, 10-day isolation) or daily contact testing (DCT; seven LFD tests, two PCR tests, no isolation if negative on LFD); participants from a single household were assigned to the same group. Participants were prospectively followed up, with the effect of each intervention on onward transmission established from routinely collected NHS Test and Trace contact tracing data for participants who tested PCR-positive for SARS-CoV-2 during the study period and tertiary cases arising from their contacts (ie, secondary contacts). The primary outcome of the study was the attack rate, the percentage of secondary contacts (close contacts of SARS-CoV-2-positive study participants) who became COVID-19 cases (tertiary cases) in each group. Attack rates were derived from Bernoulli regression models using Huber-White (robust) sandwich estimator clustered standard errors. Attack rates were adjusted for household exposure, vaccination status, and ability to work from home. The non-inferiority margin was 1·9%. The primary analysis was a modified intention-to-treat analysis excluding those who actively withdrew from the study as data from these participants were no longer held. This study is registered with the Research Registry (number 6809). Data collection is complete; analysis is ongoing. Between April 29 and July 28, 2021, 54 923 eligible individuals were enrolled in the study, with final group allocations (following withdrawals) of 26 123 (52·6%) participants in the DCT group and 23 500 (47·4%) in the self-isolation group. Overall, 4694 participants tested positive for SARS-CoV-2 by PCR (secondary cases), 2364 (10·1%) in the self-isolation group and 2330 (8·9%) in the DCT group. Adjusted attack rates (among secondary contacts) were 7·5% in the self-isolation group and 6·3% in the DCT group (difference of –1·2% [95% CI –2·3 to –0·2]; significantly lower than the non-inferiority margin of 1·9%). DCT with 24 h exemption from self-isolation for essential activities appears to be non-inferior to self-isolation. This study, which provided evidence for the UK Government's daily lateral flow testing policy for vaccinated contacts of COVID-19 cases, indicated that daily testing with LFDs could allow individuals to reduce the risk of onward transmission while minimising the adverse effects of self-isolation. Although contacts in England are no longer required to isolate, the findings will be relevant for future policy decisions around COVID-19 or other communicable infections. UK Government Department of Health and Social Care. [ABSTRACT FROM AUTHOR]

Published
2022
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242. Ten-year longitudinal molecular epidemiology study of Escherichia coli and Klebsiella species bloodstream infections in Oxfordshire, UK

Author

Lipworth, Samuel, primary, Vihta, Karina-Doris, additional, Chau, Kevin, additional, Barker, Leanne, additional, George, Sophie, additional, Kavanagh, James, additional, Davies, Timothy, additional, Vaughan, Alison, additional, Andersson, Monique, additional, Jeffery, Katie, additional, Oakley, Sarah, additional, Morgan, Marcus, additional, Hopkins, Susan, additional, Peto, Timothy E. A., additional, Crook, Derrick W., additional, Walker, Ann Sarah, additional, and Stoesser, Nicole, additional

Published
2021
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243. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant

Author

Lopez Bernal, Jamie, primary, Andrews, Nick, additional, Gower, Charlotte, additional, Gallagher, Eileen, additional, Simmons, Ruth, additional, Thelwall, Simon, additional, Stowe, Julia, additional, Tessier, Elise, additional, Groves, Natalie, additional, Dabrera, Gavin, additional, Myers, Richard, additional, Campbell, Colin N.J., additional, Amirthalingam, Gayatri, additional, Edmunds, Matt, additional, Zambon, Maria, additional, Brown, Kevin E., additional, Hopkins, Susan, additional, Chand, Meera, additional, and Ramsay, Mary, additional

Published
2021
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244. Modelling the effectiveness and social costs of daily lateral flow antigen tests versus quarantine in preventing onward transmission of COVID-19 from traced contacts

Author

Ferretti, Luca, primary, Wymant, Chris, additional, Nurtay, Anel, additional, Zhao, Lele, additional, Hinch, Robert, additional, Bonsall, David, additional, Kendall, Michelle, additional, Masel, Joanna, additional, Bell, John, additional, Hopkins, Susan, additional, Kilpatrick, A. Marm, additional, Peto, Tim, additional, Abeler-Dörner, Lucie, additional, and Fraser, Christophe, additional

Published
2021
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245. A cluster randomised trial of the impact of a policy of daily testing for contacts of COVID-19 cases on attendance and COVID-19 transmission in English secondary schools and colleges

Author

Young, Bernadette C, primary, Eyre, David W, additional, Kendrick, Saroj, additional, White, Chris, additional, Smith, Sylvester, additional, Beveridge, George, additional, Nonnemacher, Toby, additional, Ichofu, Fegor, additional, Hillier, Joseph, additional, Diamond, Ian, additional, Rourke, Emma, additional, Dawe, Fiona, additional, Day, Ieuan, additional, Davies, Lisa, additional, Staite, Paul, additional, Lacey, Andrea, additional, McCrae, James, additional, Jones, Ffion, additional, Kelly, Joseph, additional, Bankiewicz, Urszula, additional, Tunkel, Sarah, additional, Ovens, Richard, additional, Chapman, David, additional, Marks, Peter, additional, Hicks, Nick, additional, Fowler, Tom, additional, Hopkins, Susan, additional, Yardley, Lucy, additional, and Peto, Tim EA, additional

Published
2021
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247. Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease

Author

Hopkins, Susan R, Dominelli, Paolo B, Davis, Christopher K, Guenette, Jordan A, Luks, Andrew M, Molgat-Seon, Yannick, Sá, Rui Carlos, Sheel, A William, Swenson, Erik R, and Stickland, Michael K

Subjects
SARS-CoV-2, face mask, pulmonary limitations to exercise, Clinical Sciences, Respiratory System, Masks, Infectious, COVID-19, United States, Disease Transmission, Humans, Exercise, Pandemics, Personal Protective Equipment
Abstract

To minimize transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus responsible for coronavirus disease (COVID-19), the U.S. Centers for Disease Control and Prevention and the World Health Organization recommend wearing face masks in public. Some have expressed concern that these may affect the cardiopulmonary system by increasing the work of breathing, altering pulmonary gas exchange and increasing dyspnea, especially during physical activity. These concerns have been derived largely from studies evaluating devices intentionally designed to severely affect respiratory mechanics and gas exchange. We review the literature on the effects of various face masks and respirators on the respiratory system during physical activity using data from several models: cloth face coverings and surgical masks, N95 respirators, industrial respirators, and applied highly resistive or high-dead space respiratory loads. Overall, the available data suggest that although dyspnea may be increased and alter perceived effort with activity, the effects on work of breathing, blood gases, and other physiological parameters imposed by face masks during physical activity are small, often too small to be detected, even during very heavy exercise. There is no current evidence to support sex-based or age-based differences in the physiological responses to exercise while wearing a face mask. Although the available data suggest that negative effects of using cloth or surgical face masks during physical activity in healthy individuals are negligible and unlikely to impact exercise tolerance significantly, for some individuals with severe cardiopulmonary disease, any added resistance and/or minor changes in blood gases may evoke considerably more dyspnea and, thus, affect exercise capacity.

Published
2021

248. Impact of obstructive sleep apnea on cardiopulmonary performance, endothelial dysfunction, and pulmonary hypertension during exercise

Author

Jen, Rachel, Orr, Jeremy E, Gilbertson, Dillon, Fine, Janelle, Li, Yanru, Wong, Darrin, Bosompra, Naa-Oye, Hopkins, Susan R, Raisinghani, Ajit, and Malhotra, Atul

Subjects
Adult, Male, Sleep Apnea, Physiology, Medical Physiology, Cardiorespiratory Medicine and Haematology, Cardiovascular, Severity of Illness Index, Pulmonary hypertension, Clinical Research, Vascular, Humans, 2.1 Biological and endogenous factors, Endothelium, Obesity, Aetiology, Pulse, Exercise, Cardiopulmonary exercise test, Lung, Aged, Obstructive, Prevention, Neurosciences, Endothelial function, Pulmonary, Middle Aged, Obstructive sleep apnea, Echocardiography, Hypertension, Exercise Test, Female, Sleep Research
Abstract

RationaleOSA has been associated with reduced exercise capacity. Endothelial dysfunction and exercise-induced pulmonary hypertension (ePH) may be mediators of this impairment. We hypothesized that OSA severity would be associated with impaired exercise performance, endothelial dysfunction, and ePH.MethodsSubjects with untreated OSA were recruited. Subjects underwent endothelial function, and cardiopulmonary exercise testing with an echocardiogram immediately before and following exercise.Results22 subjects were recruited with mean age 56 ± 8 years, 74 % male, BMI 29 ± 3 kg/m2, and AHI 22 ± 12 events/hr. Peak V˙O2 did not differ from normal (99.7 ± 17.3 % predicted; p = 0.93). There was no significant association between OSA severity (as AHI, ODI) and exercise capacity, endothelial function, or pulmonary artery pressure. However, ODI, marker of RV diastolic dysfunction, and BMI together explained 59.3 % of the variability of exercise performance (p < 0.001) via our exploratory analyses.ConclusionsExercise capacity was not impaired in this OSA cohort. Further work is needed to elucidate mechanisms linking sleep apnea, obesity, endothelial dysfunction and exercise impairment.

Published
2021

249. Consumption of antibiotics in the community, European Union/European Economic Area, 1997-2017

Author

Bruyndonckx, Robin, Adriaenssens, Niels, Versporten, Ann, Hens, Niel, Monnet, Dominique L., Molenberghs, Geert, Goossens, Herman, Weist, Klaus, Coenen, Samuel, Strauss, Reinhild, Vandael, Eline, Sabtcheva, Stefana, Andrašević, Arjana Tambić, Kyriakidou, Isavella, Vlček, Jiří, Sönksen, Ute Wolff, Linask, Elviira, Sarvikivi, Emmi, Hider-Mlynarz, Karima, Richter, Doreen, Kontopidou, Flora, Matuz, Mária, Aspelund, Gudrun, Burns, Karen, Fortinguerra, Filomena, Dimina, Elīna, Kuklytė, Jolanta, Bruch, Marcel, Zarb, Peter, Natsch, Stephanie, Blix, Hege Salvesen, Olczak-Pieńkowska, Anna, Silva, Ana, Popescu, Gabriel Adrian, Tesař, Tomáš, Čižman, Milan, Navas, Antonio López, Bergfeldt, Vendela, Hopkins, Susan, Adriaenssens, Niels/0000-0002-7957-1177, Bruyndonckx, Robin/0000-0002-4217-2869, Coenen, Samuel/0000-0002-1238-8052, and ESAC-Net Study Group

Subjects
0301 basic medicine, Pharmacology, Microbiology (medical), Pharmacology. Therapy, 030106 microbiology, Bacterial Infections, Drug Utilization, Trimethoprim, Anti-Bacterial Agents, 03 medical and health sciences, AcademicSubjects/MED00290, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], 0302 clinical medicine, Infectious Diseases, Supplement Papers, AcademicSubjects/MED00740, Humans, Pharmacology (medical), Human medicine, 030212 general & internal medicine, European Union, AcademicSubjects/MED00230, Biology
Abstract

Objectives Data on antibiotic consumption in the community were collected from 30 EU/EEA countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of the main antibiotic groups. Methods For the period 1997–2017, data on consumption of antibiotics, i.e. antibacterials for systemic use (ATC group J01), in the community, aggregated at the level of the active substance, were collected using the WHO ATC/DDD methodology (ATC/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Antibiotic consumption was analysed based on ATC-3 groups, and presented as trends, seasonal variation, presence of change-points and compositional changes. Results In 2017, antibiotic consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor 3.6 between countries with the highest (Greece) and the lowest (the Netherlands) consumption. Antibiotic consumption in the EU/EEA did not change significantly over time. Antibiotic consumption showed a significant seasonal variation, which decreased over time. The number of DDD per package significantly increased over time. The proportional consumption of sulphonamides and trimethoprim (J01E) relative to other groups significantly decreased over time, while the proportional consumption of other antibacterials (J01X) relative to other groups significantly increased over time. Conclusions Overall, antibiotic consumption in the community in the EU/EEA did not change during 1997–2017, while seasonal variation consistently decreased over time. The number of DDD per package increased during 1997–2017.

Published
2021

250. Computer says no? Limitations of tech-focused transitions to higher education for Australian LSES students

Author

Hopkins, Susan and Hopkins, Susan

Abstract

This article explores the limitations of technology-focused teaching and online learning in ‘widening participation’ tertiary preparation programs, from the perspective of non-traditional university students, and in their own words. Specifically, the article draws on data derived from the Life Literacies academic preparation and action research project which was designed to enhance the capacity of students from low socioeconomic (LSES) backgrounds to successfully undertake undergraduate study at a regional Australian university. Reflecting on this data, as an action researcher and critically reflective practitioner, I argue for a more human-centred and holistic approach to teaching LSES students in widening participation programs. This approach does not overestimate the potential of computer-mediated learning, but provides embedded digital literacy support through positive, supportive social relationships. What enabling educators need, is not ever more complex communications technologies, but the time, through-care and people skills to be authentically and consistently available and present for their non-traditional students.

Published
2021

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