114 results on '"A. J. Stockdale"'
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2. Longer than 2 hours to antibiotics is associated with doubling of mortality in a multinational community-acquired bacterial meningitis cohort
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Damon P. Eisen, Elizabeth Hamilton, Jacob Bodilsen, Rasmus Køster-Rasmussen, Alexander J. Stockdale, James Miner, Henrik Nielsen, Olga Dzupova, Varun Sethi, Rachel K. Copson, Miriam Harings, and Oyelola A. Adegboye
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Medicine ,Science - Abstract
Abstract To optimally define the association between time to effective antibiotic therapy and clinical outcomes in adult community-acquired bacterial meningitis. A systematic review of the literature describing the association between time to antibiotics and death or neurological impairment due to adult community-acquired bacterial meningitis was performed. A retrospective cohort, multivariable and propensity-score based analyses were performed using individual patient clinical data from Australian, Danish and United Kingdom studies. Heterogeneity of published observational study designs precluded meta-analysis of aggregate data (I2 = 90.1%, 95% CI 71.9–98.3%). Individual patient data on 659 subjects were made available for analysis. Multivariable analysis was performed on 180–362 propensity-score matched data. The risk of death (adjusted odds ratio, aOR) associated with treatment after two hours was 2.29 (95% CI 1.28–4.09) and increased substantially thereafter. Similarly, time to antibiotics of greater than three hours was associated with an increase in the occurrence of neurological impairment (aOR 1.79, 95% CI 1.03–3.14). Among patients with community-acquired bacterial meningitis, odds of mortality increase markedly when antibiotics are given later than two hours after presentation to the hospital.
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- 2022
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3. Diagnostic performance evaluation of hepatitis B e antigen rapid diagnostic tests in Malawi
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Alexander J. Stockdale, Niza M. Silungwe, Isaac Thom Shawa, Benno Kreuels, Melita A. Gordon, and Anna Maria Geretti
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Hepatitis B ,Hepatitis B e antigens ,Reagent kits, diagnostic ,Sensitivity and specificity ,Malawi ,Africa south of the Sahara ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The World Health Organization (WHO) has targeted a reduction in viral hepatitis-related mortality by 65% and incidence by 90% by 2030, necessitating enhanced hepatitis B treatment and prevention programmes in low- and middle-income countries. Hepatitis B e antigen (HBeAg) status is used in the assessment of eligibility for antiviral treatment and for prevention of mother-to-child transmission (PMTCT). Accordingly, the WHO has classified HBeAg rapid diagnostic tests (RDTs) as essential medical devices. Methods We assessed the performance characteristics of three commercially available HBeAg RDTs (SD Bioline, Alere, South Africa; Creative Diagnostics, USA; and Biopanda Reagents, UK) in two hepatitis B surface antigen-positive cohorts in Blantyre, Malawi: participants of a community study (n = 100) and hospitalised patients with cirrhosis or hepatocellular carcinoma (n = 94). Two investigators, blinded to the reference test result, independently assessed each assay. We used an enzyme-linked immunoassay (Monolisa HBeAg, Bio-Rad, France) as a reference test and quantified HBeAg concentration using dilutions of the WHO HBeAg standard. We related the findings to HBV DNA levels, and evaluated treatment eligibility using the TREAT-B score. Results Among 194 HBsAg positive patients, median age was 37 years, 42% were femaleand 26% were HIV co-infected. HBeAg prevalence was 47/194 (24%). The three RDTs showed diagnostic sensitivity of 28% (95% CI 16–43), 53% (38–68) and 72% (57–84) and specificity of 96–100% for detection of HBeAg. Overall inter-rater agreement κ statistic was high at 0.9–1.0. Sensitivity for identifying patients at the threshold where antiviral treatment is recommended for PMTCT, with HBV DNA > 200,000 IU/ml (39/194; 20%), was 22, 49 and 54% respectively. Using the RDTs in place of the reference HBeAg assay resulted in 3/43 (9%), 5/43 (12%) and 8/43 (19%) of patients meeting the TREAT-B treatment criteria being misclassified as ineligible for treatment. A relationship between HBeAg concentration and HBeAg detection by RDT was observed. A minimum HBeAg concentration of 2.2–3.1 log10IU/ml was required to yield a reactive RDT. Conclusions Commercially available HBeAg RDTs lack sufficient sensitivity to accurately classify hepatitis B patients in Malawi. This has implications for hepatitis B public health programs in sub-Saharan Africa. Alternative diagnostic assays are recommended.
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- 2021
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4. Epidemiology of hepatitis B, C and D in Malawi: systematic review
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Alexander J Stockdale, Collins Mitambo, Dean Everett, Anna Maria Geretti, and Melita A Gordon
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Epidemiology ,Viral hepatitis ,Hepatitis B ,Hepatitis C ,Hepatitis D ,Malawi ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Viral hepatitis is an important public health issue in sub-Saharan Africa. Due to rising mortality from cirrhosis and hepatocellular carcinoma and limited implementation of screening and treatment programmes, it has been characterised as a neglected tropical disease. Synthesis of the existing evidence on the epidemiology of viral hepatitis B, C and D in Malawi is required to inform policy and identify research gaps. Methods We searched Pubmed, EMBASE and Scopus for studies reporting the epidemiology of viral hepatitis B, C and D in Malawi from 1990 to 2018. Articles reporting prevalence estimates were included provided they described details of participant selection, inclusion criteria and laboratory methods (detection of HBsAg, anti-HCV or anti-HDV antibody, HCV antigen or HCV RNA or HDV RNA). We assessed study quality using a prevalence assessment tool. Where appropriate, a pooled prevalence was calculated using a DerSimonian Laird random effects model. Results Searches identified 199 studies, 95 full text articles were reviewed and 19 articles were included. Hepatitis B surface antigen (HBsAg) seroprevalence was assessed in 14 general population cohorts. The pooled prevalence among adults was 8.1% (95% CI 6.1, 10.3). In 3 studies where HBsAg was stratified by HIV status, no effect of HIV on HBsAg prevalence was observed (OR 1.2 (95% CI: 0.8, 1.6, p = 0.80)). In a single study of HIV/HBV infected individuals, anti-hepatitis D antibody (anti-HDV) prevalence was low (1.5%). HCV antibody prevalence (anti-HCV) ranged from 0.7 to 18.0% among 12 cohorts in general populations. Among three studies which used PCR to confirm current infection, the pooled rate of HCV RNA confirmation among anti-HCV positive individuals was only 7.3% (95% CI: 0.0, 24.3). Conclusions Hepatitis B is highly prevalent in Malawi. There is a paucity of epidemiological data from rural areas where 85% of the population reside, and the Northern region. Priority research needs include large-scale representative community studies of HBV, HDV and HCV seroprevalence, assessment of children following introduction of the HBV vaccine in 2002, prevalence estimates of viral hepatitis among individuals with cirrhosis and HCC and data on HCV prevalence using PCR confirmation, to support a viral hepatitis strategy for Malawi.
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- 2018
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5. The ‘Outcome Reporting in Brief Intervention Trials: Alcohol’ (ORBITAL) framework: protocol to determine a core outcome set for efficacy and effectiveness trials of alcohol screening and brief intervention
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G. W. Shorter, N. Heather, Jeremy W. Bray, E. L. Giles, A. Holloway, C. Barbosa, A. H. Berman, A. J. O’Donnell, M. Clarke, K. J. Stockdale, and D. Newbury-Birch
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Consensus methods ,Core outcome set ,Delphi technique ,Screening ,Brief intervention ,Alcohol ,Medicine (General) ,R5-920 - Abstract
Abstract Background The evidence base to assess the efficacy and effectiveness of alcohol brief interventions (ABI) is weakened by variation in the outcomes measured and by inconsistent reporting. The ‘Outcome Reporting in Brief Intervention Trials: Alcohol’ (ORBITAL) project aims to develop a core outcome set (COS) and reporting guidance for its use in future trials of ABI in a range of settings. Methods/design An international Special Interest Group was convened through INEBRIA (International Network on Brief Interventions for Alcohol and Other Drugs) to inform the development of a COS for trials of ABI. ORBITAL will incorporate a systematic review to map outcomes used in efficacy and effectiveness trials of ABI and their measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. This will support a multi-round Delphi study to prioritise outcomes. Delphi panellists will be drawn from a range of settings and stakeholder groups, and the Delphi study will also be used to determine if a single COS is relevant for all settings. A consensus meeting with key stakeholder representation will determine the final COS and associated guidance for its use in trials of ABI. Discussion ORBITAL will develop a COS for alcohol screening and brief intervention trials, with outcomes stratified into domains and guidance on outcome measurement instruments. The standardisation of ABI outcomes and their measurement will support the ongoing development of ABI studies and a systematic synthesis of emerging research findings. We will track the extent to which the COS delivers on this promise through an exploration of the use of the guidance in the decade following COS publication.
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- 2017
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6. Contributors
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Kosh Agarwal, Angelo Armandi, Genoveva Berná, George Boon-Bee Goh, Elisabetta Bugianesi, Esther W. Chan, Jacky C.H. Chan, Ka Wang Cheung, Won-Mook Choi, Jonggi Choi, Andrea Cornejo, Claire Crowley, Yock Young Dan, Delphine Degré, Pierre Deltenre, Oluwaseun Falade-Nwulia, Jian-Gao Fan, Yi Bin Feng, Peter Ferenci, Miguel Fernández Gómez, Malin Fromme, Lisbet Grønbæk, Henning Grønbæk, Mukesh Harisinghani, Giuseppe Indolfi, Takako Inoue, Jeong Won Jang, Guan Sen Kew, Kevin Kim-Jun Teh, Min Kim, Mikkel Breinholt Kjær, Linda Skibsted Kornerup, Carmen Lara Romero, Sung Won Lee, Soon Kyu Lee, Young-Suk Lim, Chieh Liu, Chun-Jen Liu, James Lok, Lucía López Bermudo, Lung-Yi Mak, Nahum Méndez-Sánchez, Christophe Moreno, Mark Muthiah, Heechul Nam, Yvonne A. Nartey, Pankaj Nepal, Mindie H. Nguyen, Emanuele Nicastro, Eiichi Ogawa, Jean-Michel Pawlotsky, Serena Pelusi, Jason Pik-Eu Chang, Mathias Plauth, Manuel Romero-Gómez, Luisa Ronzoni, Mimi Tin-Yan Seto, Yi-Wen Shi, Yi-Fen Shih, Siddharth Sridhar, Alexander J. Stockdale, Pavel Strnad, Yasuhito Tanaka, Rolf Teschke MD, Joseph D. Tucker, Luca Valenti, Maria Fernanda Guerra Veloz, Man-Fung Yuen, Cheng Zhang, Jiaxi Zhao, and Kali Zhou
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- 2023
7. Hepatitis D
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Alexander J. Stockdale
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- 2023
8. Epidemiological data for hepatitis D in Africa – Authors' reply
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Alexander J Stockdale, Apostolos Beloukas, and Anna Maria Gerretti
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Public aspects of medicine ,RA1-1270 - Published
- 2018
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9. Sensitivity of SARS-CoV-2 RNA polymerase chain reaction using a clinical and radiological reference standard
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Muhammad S Ahmed, Diana Penha, Sheetal Sharma, Cairine Probert, Michael Beadsworth, Catriona Farrell, Katharine E. Stott, Meng-San Wu, Elizabeth Joekes, Rory Hicks, David A Barr, Beth Hankinson, Stacy Todd, James Cruise, Kathryn Haigh, Tamsin Paterson, Fred Fyles, Vijay Chindambaram, Nuria Santamaria, Alice Maxwell, Michael Abouyannis, Alexander J. Stockdale, Nick Moody, Rashika Fernando, Joseph M. Lewis, Imogen Fordham, and Rebecca Wiles
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Diagnostic X-Ray ,030106 microbiology ,Diagnostic Testing ,Sensitivity and Specificity ,Polymerase Chain Reaction ,Asymptomatic ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,medicine ,Humans ,Infection control ,030212 general & internal medicine ,Medical diagnosis ,Diagnostic Tests, Routine ,SARS-CoV-2 ,business.industry ,COVID-19 ,Odds ratio ,Reference Standards ,Confidence interval ,Infectious Diseases ,Real-time polymerase chain reaction ,Radiological weapon ,RNA, Viral ,medicine.symptom ,Radiology ,business ,SARS-CoV-2, COVID-19, Real-Time Polymerase Chain Reaction - Abstract
Objectives Diagnostic tests for SARS-CoV-2 are important for epidemiology, clinical management, and infection control. Limitations of oro-nasopharyngeal real-time PCR sensitivity have been described based on comparisons of single tests with repeated sampling. We assessed SARS-CoV-2 PCR clinical sensitivity using a clinical and radiological reference standard. Methods Between March-May 2020, 2060 patients underwent thoracic imaging and SARS-CoV-2 PCR testing. Imaging was independently double- or triple-reported (if discordance) by blinded radiologists according to radiological criteria for COVID-19. We excluded asymptomatic patients and those with alternative diagnoses that could explain imaging findings. Associations with PCR-positivity were assessed with binomial logistic regression. Results 901 patients had possible/probable imaging features and clinical symptoms of COVID-19 and 429 patients met the clinical and radiological reference case definition. SARS-CoV-2 PCR sensitivity was 68% (95% confidence interval 64–73), was highest 7-8 days after symptom onset (78% (68–88)) and was lower among current smokers (adjusted odds ratio 0.23 (0.12–0.42) p Conclusions In patients with clinical and imaging features of COVID-19, PCR test sensitivity was 68%, and was lower among smokers; a finding that could explain observations of lower disease incidence and that warrants further validation. PCR tests should be interpreted considering imaging, symptom duration and smoking status.
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- 2021
10. Prevalence of hepatitis D virus infection in sub-Saharan Africa: a systematic review and meta-analysis
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Alexander J Stockdale, MRes, Mas Chaponda, PhD, Apostolos Beloukas, PhD, Richard Odame Phillips, PhD, Philippa C Matthews, PhD, Athanasios Papadimitropoulos, MSc, Simon King, PhD, Laura Bonnett, PhD, and Prof Anna Maria Geretti, PhD
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Public aspects of medicine ,RA1-1270 - Abstract
Background: Hepatitis D virus (also known as hepatitis delta virus) can establish a persistent infection in people with chronic hepatitis B, leading to accelerated progression of liver disease. In sub-Saharan Africa, where HBsAg prevalence is higher than 8%, hepatitis D virus might represent an important additive cause of chronic liver disease. We aimed to establish the prevalence of hepatitis D virus among HBsAg-positive populations in sub-Saharan Africa. Methods: We systematically reviewed studies of hepatitis D virus prevalence among HBsAg-positive populations in sub-Saharan Africa. We searched PubMed, Embase, and Scopus for papers published between Jan 1, 1995, and Aug 30, 2016, in which patient selection criteria and geographical setting were described. Search strings included sub-Saharan Africa, the countries therein, and permutations of hepatitis D virus. Cohort data were also added from HIV-positive populations in Malawi and Ghana. Populations undergoing assessment in liver disease clinics and those sampled from other populations (defined as general populations) were analysed. We did a meta-analysis with a DerSimonian-Laird random-effects model to calculate a pooled estimate of hepatitis D virus seroprevalence. Findings: Of 374 studies identified by our search, 30 were included in our study, only eight of which included detection of hepatitis D virus RNA among anti-hepatitis D virus seropositive participants. In west Africa, the pooled seroprevalence of hepatitis D virus was 7·33% (95% CI 3·55–12·20) in general populations and 9·57% (2·31–20·43) in liver-disease populations. In central Africa, seroprevalence was 25·64% (12·09–42·00) in general populations and 37·77% (12·13–67·54) in liver-disease populations. In east and southern Africa, seroprevalence was 0·05% (0·00–1·78) in general populations. The odds ratio for anti-hepatitis D virus detection among HBsAg-positive patients with liver fibrosis or hepatocellular carcinoma was 5·24 (95% CI 2·74–10·01; p
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- 2017
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11. Whose Voices are Prioritised in Criminology, and Why Does it Matter?
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Kelly J. Stockdale and Rowan Sweeney
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Sociology and Political Science ,L300 ,Anthropology ,M200 ,HV6001 ,Law - Abstract
This paper presents in-depth research into the reading lists used by a new criminology Bachelor of Arts degree programme at a post-92 English University. Previous research into structural inequalities in relation to race, ethnicity, and gender that exist within academia in relation to scholarly outlets, and that have focussed on scholarly influence, have charted the most cited or most significant texts in the field or explored gender and race discrepancies within elements of the publication process. In this paper we explore how scholarly work is included in our teaching practice and the impact reading lists have on the student experience of criminology. We highlight a distinct lack of representation and diversity within the authorship of texts in the context of both core and recommended reading for students. We found reading lists to be overwhelmingly white and male. Work by women and people of colour only tended to feature on distinct modules which focussed on gender or ethnicity, race, and crime. Voices from the global majority are excluded from fundamental concepts and criminological theory modules. This paper will discuss our research findings in depth, highlighting where Black and female voices are neglected, marginalised, and excluded in the criminology curriculum.
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- 2022
12. Investigating Alcohol Sweetspot Phenomena in Reduced Alcohol Red Wines
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Duc-Truc Pham, Vanessa J. Stockdale, David W. Jeffery, Jonathan Tuke, and Kerry L. Wilkinson
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alcohol adjustment ,evaporative perstraction ,one proportion test ,partial dealcoholization ,reverse osmosis ,sensory analysis ,Chemical technology ,TP1-1185 - Abstract
Warmer growing seasons, variations to grape ripening dynamics, and stylistic changes have contributed to increased wine alcohol levels, which can negatively impact sensory properties. As a consequence, winemakers have sought technological innovations to produce reduced alcohol wine (RAW). The sensory methodology used by industry to optimize the ethanol content of RAW is known as ‘alcohol sweetspotting’. However, to date, there is no scientific evidence to support the alcohol sweetspot phenomenon, and the sensory methodology used for alcohol sweetspotting has not been validated. In this study, different methods of presenting wine samples (i.e., ordered vs. randomized, and linear vs. circular) were employed to determine to what extent presentation order influences the outcome of alcohol sweetspotting trials. Two different approaches to statistical analysis of sensory data, i.e., chi-square goodness of fit vs. one proportion tests, were also evaluated. Statistical analyses confirmed alcohol sweetspots were apparent in some sweetspot determination trials, but outcomes were not reproducible in replicate determinations (either by panel or by individual panelists). Analysis of data using the one proportion test improved the likelihood of identifying statistically significant differences between RAWs, but variation in individuals’ sensitivity to differences in sensory properties following ethanol removal prevented validation of the alcohol sweetspot phenomenon based on the wines studied.
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- 2019
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13. Compositional Consequences of Partial Dealcoholization of Red Wine by Reverse Osmosis-Evaporative Perstraction
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Duc-Truc Pham, Vanessa J. Stockdale, David Wollan, David W. Jeffery, and Kerry L. Wilkinson
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alcohol ,evaporative perstraction ,dealcoholization ,reduced alcohol wine ,reverse osmosis ,Organic chemistry ,QD241-441 - Abstract
This study investigated compositional changes in red wines resulting from wine alcohol removal by reverse osmosis-vaporative perstraction (RO-EP) and provides insight into the physical and chemical changes in reduced alcohol wine (RAW). Trial 1 involved RO-EP treatment of three wines that were analyzed pre-treatment, post-treatment, and post-treatment with alcohol adjustment (i.e., addition of ethanol to achieve the original alcohol content). Trial 2 involved partial dealcoholization of two wines and analysis of samples collected during RO-EP treatment, i.e., wine in, wine out, retentate, permeate (pre- and post-EP treatment) and strip water. Wine color was analyzed by spectrophotometric methods, while other compositional changes were determined by WineScan, high performance liquid chromatography (HPLC) and gas chromatography–mass spectrometry (GC–MS) analyses. In general, RAWs were slightly more concentrated than pre-treatment wines, which resulted in greater color intensity and increased phenolics and organic acids. However, partial dealcoholization resulted in lower concentrations of some fermentation volatiles, particularly ethyl esters, which may reflect ester hydrolysis following ethanol removal.
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- 2019
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14. Diagnostic performance of non-invasive fibrosis markers for chronic hepatitis B in sub-Saharan Africa: a Bayesian individual patient data meta-analysis
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Asgeir Johannessen, Alexander J. Stockdale, Marc Y.R. Henrion, Edith Okeke, Moussa Seydi, Gilles Wandeler, Mark Sonderup, C. Wendy Spearman, Michael Vinikoor, Edford Sinkala, Hailemichael Desalegn, Fatou Fall, Nicholas Riches, Pantong Davwar, Mary Duguru, Tongai Maponga, Jantjie Taljaard, Philippa C. Matthews, Monique Andersson, Roger Sombie, Yusuke Shimakawa, and Maud Lemoine
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ObjectiveIn sub-Saharan Africa, hepatitis B is the principal cause of liver disease. Non-invasive biomarkers of liver fibrosis are needed to identify patients requiring antiviral treatment. We assessed aspartate aminotransferase-to-platelet ratio index (APRI), gamma-glutamyl transferase-to-platelet ratio (GPR) and FIB-4 to diagnose significant fibrosis and cirrhosis in an individual patient data (IPD) meta-analysis.DesignIn total, 3,549 patients from 12 cohorts of HBsAg positive individuals in 8 sub-Saharan African countries were included. Transient elastography was used as a reference test for cirrhosis (>12.2 kPa), excluding patients who were pregnant, had hepatitis C, D, or HIV co-infection, were on hepatitis B therapy, or had acute hepatitis. A bivariate Bayesian IPD model was fitted with patient-level covariates and study-level random effects.ResultsAPRI and GPR had the best discriminant performance (area under receiver operating curve 0.81 and 0.82) relative to FIB-4 (0.77) for cirrhosis. The World Health Organization (WHO) recommended APRI threshold of ≥2.0 was associated with a sensitivity and specificity (95% credible interval) of 16.5% (12.5-20.5) and 99.5% (99.2-99.7) for cirrhosis. For APRI, we identified an optimised rule-in threshold for cirrhosis (cut-off 0.65) with a sensitivity and specificity of 56.2% (50.5-62.2) and 90.0% (89.0-91.0), and an optimised rule-out threshold (cut-off 0.36) with a sensitivity and specificity of 80.6% (76.1-85.1) and 64.3% (62.8-65.8).ConclusionsThe WHO recommended APRI threshold of 2.0 is too high to diagnose cirrhosis in sub-Saharan Africa. We identified new and optimised rule-in and rule-out thresholds for cirrhosis, with direct consequences for treatment guidelines in this setting.
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- 2022
15. Exploring the Criminology Curriculum—Reflections on Developing and Embedding Critical Information Literacy
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Kelly J. Stockdale, Rowan Sweeney, Clare McCluskey-Dean, Jodie Brown, and Ismail Azam
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- 2022
16. Navigating Custodial Environments: Novel Psychoactive Substance Users Experiences of Stigma
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Kelly J. Stockdale, Michelle Addison, and Georgia Ramm
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- 2022
17. Doravirine: its role in HIV treatment
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Alexander J. Stockdale and Saye Khoo
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Oncology ,medicine.medical_specialty ,Efavirenz ,Anti-HIV Agents ,Pyridones ,Immunology ,Integrase inhibitor ,HIV Infections ,Drug resistance ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Virology ,Doravirine ,Internal medicine ,medicine ,Humans ,Darunavir ,Reverse-transcriptase inhibitor ,Oncology (nursing) ,business.industry ,Hematology ,Triazoles ,Infectious Diseases ,chemistry ,Reverse Transcriptase Inhibitors ,Ritonavir ,business ,medicine.drug - Abstract
PURPOSE OF REVIEW We reviewed evidence concerning the novel nonnucleoside reverse transcriptase inhibitor doravirine, aiming to identify situations where it may be selected in preference to integrase inhibitors. RECENT FINDINGS Doravirine is licenced for the treatment of HIV-1 in North America and Europe. In two multicentre randomized controlled trials, noninferiority with comparator drugs efavirenz and darunavir/ritonavir was observed at 96 weeks. Doravirine is associated with a lower incidence of neuropsychiatric side effects relative to efavirenz, and favourable lipid changes relative to darunavir over 96 weeks. A lower incidence of weight gain, relative to indirect comparisons with integrase inhibitors, was observed. Doravirine has a high genetic barrier to resistance with retained activity in the presence of single NNRTI mutations K103N, Y181C and G190A. Primary drug resistance is infrequent and may be higher in South Africa relative to European populations. Doravirine may be used in renal or hepatic impairment and has a low potential for drug-drug interactions. SUMMARY Doravirine is a well tolerated and effective agent in ART-naive patients. Direct comparison with integrase inhibitors, and evidence on the outcomes of treatment with doravirine in the presence of prior NNRTI experience are required to better elucidate which patients will benefit most from doravirine therapy.
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- 2022
18. Exploring the Criminology Curriculum – Using the Intersectionality Matrix as a Pedagogical Tool to Develop Students’ Critical Information Literacy Skills
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Kelly J. Stockdale, Rowan Sweeney, and Clare McCluskey Dean
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LB2300 ,ZA ,ComputingMilieux_COMPUTERSANDEDUCATION ,X200 ,HV6001 ,Law ,Education - Abstract
Traditional literacy skills often neglect to develop students’ critical understanding of how information and knowledge are formed, and the unequal power relations at the heart of this process (Beilin, 2005). There are deep, entrenched biases within criminology curriculum content, and empowering students to use critical information literacy skills is an important part of recognising and disrupting knowledge hierarchies in relation to race, class, and gender. This paper builds on research exploring the content of student reading lists from the curriculum of a new criminology degree programme at an English university. Focus groups and one-to-one interviews were held with 20 undergraduate criminology students to explore how students interact with the course reading lists and how they consider and engage with the sources they use. We argue for critical information literacy to be embedded within our teaching of criminology, and for lecturers and students to more pro-actively consider the sources they use.
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- 2021
19. A clinical and molecular epidemiological survey of hepatitis C in Blantyre, Malawi, suggests a historic mechanism of transmission
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Alexander J. Stockdale, Benno Kreuels, Isaac T. Shawa, James E. Meiring, Deus Thindwa, Niza M. Silungwe, Karen Chetcuti, Elizabeth Joekes, Maurice Mbewe, Blessings Mbale, Pratiksha Patel, Rabson Kachala, Priyanka D. Patel, Jane Malewa, Peter Finch, Chris Davis, Rajiv Shah, Lily Tong, Ana Silva Filipe, Emma C. Thomson, Anna Maria Geretti, and Melita A. Gordon
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Adult ,Liver Cirrhosis ,Malawi ,Carcinoma, Hepatocellular ,Hepatology ,Adolescent ,Liver Neoplasms ,Hepacivirus ,Hepatitis C Antibodies ,Middle Aged ,Hepatitis C ,Infectious Diseases ,Virology ,Prevalence ,Humans ,RNA ,Prospective Studies ,Aged - Abstract
Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. There are no previous representative community HCV prevalence studies from Southern Africa, and limited genotypic data. Epidemiological data are required to inform an effective public health response. We conducted a household census-based random sampling serological survey, and a prospective hospital-based study of patients with cirrhosis and hepatocellular carcinoma (HCC) in Blantyre, Malawi. We tested participants with an HCV antigen/antibody ELISA (Monolisa, Bio-Rad), confirmed with PCR (GeneXpert, Cepheid) and used line immunoassay (Inno-LIA, Fujiribio) for RNA-negative participants. We did target-enrichment whole-genome HCV sequencing (NextSeq, Illumina). Among 96,386 censused individuals, we randomly selected 1661 people aged ≥16 years. Population-standardized HCV RNA prevalence was 0.2% (95% CI 0.1-0.5). Among 236 patients with cirrhosis and HCC, HCV RNA prevalence was 1.9% and 5.0%, respectively. Mapping showed that HCV RNA+ patients were from peri-urban areas surrounding Blantyre. Community and hospital HCV RNA+ participants were older than comparator HCV RNA-negative populations (median 53 vs 30 years for community, p = 0.01 and 68 vs 40 years for cirrhosis/HCC, p 0.001). Endemic HCV genotypes (n = 10) were 4v (50%), 4r (30%) and 4w (10%). In this first census-based community serological study in Southern Africa, HCV was uncommon in the general population, was centred on peri-urban regions and was attributable for5% of liver disease. HCV infection was observed only among older people, suggesting a historic mechanism of transmission. Genotype 4r, which has been associated with treatment failure with ledipasvir and daclatasvir, is endemic.
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- 2021
20. Hepatitis B Vaccination Impact and the Unmet Need for Antiviral Treatment in Blantyre, Malawi
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Deus Thindwa, Alexander J. Stockdale, Maurice Mbewe, Naor Bar-Zeev, Niza M Silungwe, Benno Kreuels, Anna Maria Geretti, Isaac Thom Shawa, James E Meiring, Priyanka Patel, Melita A. Gordon, Pratiksha Patel, Stephen B. Gordon, Marc Y R Henrion, Robert S. Heyderman, Todd D. Swarthout, and Rabson Kachala
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Adult ,Male ,HBsAg ,medicine.medical_specialty ,qv_268.5 ,Hepatitis B virus ,Malawi ,Adolescent ,wa_395 ,HIV Infections ,Antiviral Agents ,Seroepidemiologic Studies ,Internal medicine ,Epidemiology ,medicine ,Immunology and Allergy ,Seroprevalence ,Humans ,Hepatitis B Vaccines ,Child ,Hepatitis B Surface Antigens ,business.industry ,Public health ,Vaccination ,Infant ,wc_536 ,Hepatitis B ,Hepatology ,medicine.disease ,Infectious Diseases ,Female ,Liver cancer ,business ,Demography - Abstract
Background Hepatitis B is the leading cause of cirrhosis and liver cancer in sub-Saharan Africa. To reduce mortality, antiviral treatment programs are needed. We estimated prevalence, vaccine impact, and need for antiviral treatment in Blantyre, Malawi. Methods We conducted a household study in 2016–2018. We selected individuals from a census using random sampling and estimated age-sex-standardized hepatitis B surface antigen (HBsAg) seroprevalence. Impact of infant hepatitis B vaccination was estimated by binomial log-linear regression comparing individuals born before and after vaccine implementation. In HBsAg-positive adults, eligibility for antiviral therapy was assessed. Results Of 97386 censused individuals, 6073 (median age 18 years; 56.7% female) were sampled. HBsAg seroprevalence was 5.1% (95% confidence interval [CI], 4.3%–6.1%) among adults and 0.3% (95% CI, .1%–.6%) among children born after vaccine introduction. Estimated vaccine impact was 95.8% (95% CI, 70.3%–99.4%). Of HBsAg-positive adults, 26% were HIV-positive. Among HIV-negative individuals, 3%, 6%, and 9% were eligible for hepatitis B treatment by WHO, European, and American hepatology association criteria, respectively. Conclusions Infant HBV vaccination has been highly effective in reducing HBsAg prevalence in urban Malawi. Up to 9% of HBsAg-positive HIV-negative adults are eligible, but have an unmet need, for antiviral therapy.
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- 2021
21. Cohort Profile: The National Institute for Health Research Health Informatics Collaborative: Hepatitis B Virus (NIHR HIC HBV) research dataset
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Tingyan Wang, David A Smith, Cori Campbell, Oliver Freeman, Zuzana Moysova, Theresa Noble, Kinga A Várnai, Steve Harris, Hizni Salih, Gail Roadknight, Stephanie Little, Ben Glampson, Luca Mercuri, Dimitri Papadimitriou, Christopher R Jones, Vince Taylor, Afzal Chaudhry, Hang Phan, Florina Borca, Josune Olza, Frazer Warricker, Luis Romão, David Ramlakhan, Louise English, Paul Klenerman, Monique Andersson, Jane Collier, Alexander J Stockdale, Stacy Todd, Karl McIntyre, Andrew Frankland, Eleni Nastouli, Salim I Khakoo, William Gelson, Graham S Cooke, Kerrie Woods, Jim Davies, Eleanor Barnes, and Philippa C Matthews
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Epidemiology ,FOS: Clinical medicine ,Immunology ,Infectious Disease ,General Medicine ,Genetics & Genomics - Abstract
No description supplied
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- 2021
22. Diagnostic performance evaluation of hepatitis B e antigen rapid diagnostic tests in Malawi
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Niza M Silungwe, Alexander J. Stockdale, Isaac Thom Shawa, Benno Kreuels, Anna Maria Geretti, and Melita A. Gordon
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Adult ,Male ,HBsAg ,medicine.medical_specialty ,Malawi ,Hepatitis B virus ,Cirrhosis ,Enzyme-Linked Immunosorbent Assay ,HIV Infections ,Infectious and parasitic diseases ,RC109-216 ,Antiviral Agents ,Sensitivity and Specificity ,Hepatitis B e antigens ,03 medical and health sciences ,Reagent kits, diagnostic ,0302 clinical medicine ,Medical microbiology ,Internal medicine ,medicine ,Humans ,Serologic Tests ,030212 general & internal medicine ,Hepatitis B Surface Antigens ,medicine.diagnostic_test ,business.industry ,Coinfection ,Diagnostic Tests, Routine ,Incidence (epidemiology) ,Research ,virus diseases ,Hepatitis B ,Middle Aged ,medicine.disease ,digestive system diseases ,Infectious Disease Transmission, Vertical ,Infectious Diseases ,HBeAg ,Africa south of the Sahara ,Immunoassay ,Hepatocellular carcinoma ,DNA, Viral ,030211 gastroenterology & hepatology ,business - Abstract
Background The World Health Organization (WHO) has targeted a reduction in viral hepatitis-related mortality by 65% and incidence by 90% by 2030, necessitating enhanced hepatitis B treatment and prevention programmes in low- and middle-income countries. Hepatitis B e antigen (HBeAg) status is used in the assessment of eligibility for antiviral treatment and for prevention of mother-to-child transmission (PMTCT). Accordingly, the WHO has classified HBeAg rapid diagnostic tests (RDTs) as essential medical devices. Methods We assessed the performance characteristics of three commercially available HBeAg RDTs (SD Bioline, Alere, South Africa; Creative Diagnostics, USA; and Biopanda Reagents, UK) in two hepatitis B surface antigen-positive cohorts in Blantyre, Malawi: participants of a community study (n = 100) and hospitalised patients with cirrhosis or hepatocellular carcinoma (n = 94). Two investigators, blinded to the reference test result, independently assessed each assay. We used an enzyme-linked immunoassay (Monolisa HBeAg, Bio-Rad, France) as a reference test and quantified HBeAg concentration using dilutions of the WHO HBeAg standard. We related the findings to HBV DNA levels, and evaluated treatment eligibility using the TREAT-B score. Results Among 194 HBsAg positive patients, median age was 37 years, 42% were femaleand 26% were HIV co-infected. HBeAg prevalence was 47/194 (24%). The three RDTs showed diagnostic sensitivity of 28% (95% CI 16–43), 53% (38–68) and 72% (57–84) and specificity of 96–100% for detection of HBeAg. Overall inter-rater agreement κ statistic was high at 0.9–1.0. Sensitivity for identifying patients at the threshold where antiviral treatment is recommended for PMTCT, with HBV DNA > 200,000 IU/ml (39/194; 20%), was 22, 49 and 54% respectively. Using the RDTs in place of the reference HBeAg assay resulted in 3/43 (9%), 5/43 (12%) and 8/43 (19%) of patients meeting the TREAT-B treatment criteria being misclassified as ineligible for treatment. A relationship between HBeAg concentration and HBeAg detection by RDT was observed. A minimum HBeAg concentration of 2.2–3.1 log10IU/ml was required to yield a reactive RDT. Conclusions Commercially available HBeAg RDTs lack sufficient sensitivity to accurately classify hepatitis B patients in Malawi. This has implications for hepatitis B public health programs in sub-Saharan Africa. Alternative diagnostic assays are recommended.
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- 2021
23. New World, New Church: the theology of the emerging church movement
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Todd J. Stockdale
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Philosophy ,Movement (music) ,media_common.quotation_subject ,Criticism ,Art ,Theology ,media_common - Abstract
When interest in ‘emerging’ forms of church exploded during the first decade of this century, apologists and detractors in the evangelical sphere moved quickly to opposing corners. Sharp criticism ...
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- 2020
24. New Wineskins for Global Mission: A Compendium of the New Wineskins for Global Mission Conference, Ridgecrest, North Carolina, April 1994
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Sharon J. Stockdale, Helen Camlin, Sharon J. Stockdale, Helen Camlin and Sharon J. Stockdale, Helen Camlin, Sharon J. Stockdale, Helen Camlin
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- 1996
25. Loring Paul Jones: Life After Foster Care: Improving Outcomes for Former Foster Youth
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William J. Stockdale
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Health psychology ,Psychoanalysis ,Foster care ,Social Psychology ,History of psychology ,Developmental and Educational Psychology ,Psychology ,Social Sciences (miscellaneous) ,Education ,Legal psychology - Published
- 2019
26. Carrageenans as heat stabilisers of white wine
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Antony Bacic, Jacqui M. McRae, Vanessa J. Stockdale, Wes Pearson, P. Munro, S. Grafton, Sunil Ratnayake, and Anthony L. Robinson
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0106 biological sciences ,Wine ,Sodium ,digestive, oral, and skin physiology ,food and beverages ,chemistry.chemical_element ,04 agricultural and veterinary sciences ,Horticulture ,01 natural sciences ,Lees ,Carrageenan ,carbohydrates (lipids) ,chemistry.chemical_compound ,chemistry ,White Wine ,Bentonite ,Fermentation ,Food science ,0405 other agricultural sciences ,010606 plant biology & botany ,040502 food science ,Winemaking - Abstract
Background and Aims Carrageenan addition has been previously shown to remove proteins from wine and to heat stabilise wines, however, many types of carrageenans are now available with potentially different protein‐adsorbing properties. This study investigated a range of commercially available carrageenans added at several stages of winemaking for efficacy of protein removal, heat stability and impact on wine sensory properties. Methods and Results In preliminary screening trials, 11 types of carrageenan were added to a Chardonnay wine and the heat stability of the wine measured with a heat test. Three of the carrageenans successfully heat‐stabilised the wine and were included in large‐scale winemaking trials: sodium‐rich kappa (kN), potassium‐rich kappa (kK) and kappa/iota (90:10, ki) carrageenan. Each carrageenan was added at three stages of winemaking, to juice, during fermentation and to wine. All carrageenans produced heat‐stable wine regardless of time of addition. Addition of kN during fermentation also improved wine recovery compared to bentonite addition, the positive Control, although sodium concentration also significantly increased in the wine. Addition of kK‐carrageenan to either wine or clarified juice was the most effective treatment for producing heat‐stable wine with minimal impact on the sensory profile, wine lees, turbidity and concentration of metal ions compared to that of untreated Control wines. Conclusions Kappa‐ and kappa‐/iota‐carrageenans can be effective at heat stabilising white wines without negative impact on sensory properties, although the filterability and concentration of metal ions of the wines can vary with carrageenan structure and time of addition. Significance of the Study Kappa‐carrageenan, a renewable fining agent, is effective in heat stabilising wines and maybe become a useful alternative to bentonite.
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- 2019
27. The Variability of Outcomes Used in Efficacy and Effectiveness Trials of Alcohol Brief Interventions: A Systematic Review
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Emma L. Giles, Mike Clarke, Dorothy Newbury-Birch, Anne H. Berman, Kelly J. Stockdale, Nick Heather, Jeremy W. Bray, Carolina Barbosa, Amy O’Donnell, Aisha Holloway, Stephanie Scott, and Gillian W Shorter
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medicine.medical_specialty ,Health (social science) ,alcohol brief intervention ,Psychological intervention ,MEDLINE ,Alcoholism therapy ,Alcohol ,Outcome assessment ,core outcome set ,outcomes ,Toxicology ,brief intervention ,law.invention ,chemistry.chemical_compound ,systematic review ,SDG 3 - Good Health and Well-being ,Randomized controlled trial ,law ,medicine ,outcome assessment ,COMET Initiative ,Alcohol brief intervention ,business.industry ,core outcome sets ,alcohol drinking ,body regions ,Psychiatry and Mental health ,chemistry ,randomized controlled trials ,Physical therapy ,measurement ,Brief intervention ,business - Abstract
OBJECTIVE: The purpose of this study was to characterize recent alcohol brief intervention (ABI) efficacy and effectiveness trials, summarize outcomes, and show how variability in outcomes and reporting compromises the evidence base.METHOD: A systematic review and narrative synthesis of articles from 10 databases were undertaken (January 2000-November 2017); study selection represented recent, readily available publications. The National Institute of Care Excellence (NICE) Public Health Guideline 24 (Alcohol use disorders: prevention) informed ABI definitions. The review was conducted using Centre for Reviews and Dissemination (CRD) guidance and pre-registered on PROSPERO (CRD42016047185). Seven a priori specified domains were used to classify outcomes: biomarkers, alcohol-related outcomes, economic factors/resource use, health measures, life impact, intervention factors, and psychological/behavioral factors.RESULTS: The search identified 405 trials from 401 eligible papers. In 405 trials, 2,641 separate outcomes were measured in approximately 1,560 different ways. The most common outcomes used were the number of drinks consumed in a week and frequency of heavy episodic drinking. Biomarkers were least frequently used. The most common primary outcome was weekly drinks. By trial type, the most frequent outcome in efficacy and effectiveness trials was frequency of heavy drinking.CONCLUSIONS: Consumption outcomes predominated; however, no single outcome was found in all trials. This comprehensive outcome map and methodological detail on ABI effectiveness and efficacy trials can aid decision making in future trials. There was a diversity of instruments, time points, and outcome descriptions in methods and results sections. Compliance with reporting guidance would support data synthesis and improve trial quality. This review establishes the need for a core outcome set (COS)/minimum data standard and supports the Outcome Reporting in Brief Interventions: Alcohol initiative (ORBITAL) to improve standards in the ABI field through a COS for effectiveness and efficacy randomized trials.
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- 2019
28. Enter the Dragon: The Dynamic and Multifunctional Evolution of Anguimorpha Lizard Venoms
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Ivan Koludarov, Timothy NW Jackson, Bianca op den Brouw, James Dobson, Daniel Dashevsky, Kevin Arbuckle, Christofer J. Clemente, Edward J. Stockdale, Chip Cochran, Jordan Debono, Carson Stephens, Nadya Panagides, Bin Li, Mary-Louise Roy Manchadi, Aude Violette, Rudy Fourmy, Iwan Hendrikx, Amanda Nouwens, Judith Clements, Paolo Martelli, Hang Fai Kwok, and Bryan G. Fry
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venom ,lizard ,evolution ,Toxicofera ,coagulation ,fibrinogen ,proteomics ,Medicine - Abstract
While snake venoms have been the subject of intense study, comparatively little work has been done on lizard venoms. In this study, we have examined the structural and functional diversification of anguimorph lizard venoms and associated toxins, and related these results to dentition and predatory ecology. Venom composition was shown to be highly variable across the 20 species of Heloderma, Lanthanotus, and Varanus included in our study. While kallikrein enzymes were ubiquitous, they were also a particularly multifunctional toxin type, with differential activities on enzyme substrates and also ability to degrade alpha or beta chains of fibrinogen that reflects structural variability. Examination of other toxin types also revealed similar variability in their presence and activity levels. The high level of venom chemistry variation in varanid lizards compared to that of helodermatid lizards suggests that venom may be subject to different selection pressures in these two families. These results not only contribute to our understanding of venom evolution but also reveal anguimorph lizard venoms to be rich sources of novel bioactive molecules with potential as drug design and development lead compounds.
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- 2017
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29. Restorative policing: concepts, theory and practice
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Kelly J. Stockdale
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- 2018
30. Longitudinal characterisation of haematological and biochemical parameters in cancer patients prior to and during COVID-19 reveals features associated with outcome
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P. Huddar, A. Angelakas, Michelle Harrison, G. Brearton, Umair T Khan, S. Khan, T. Robinson, C. Wilson, Oskar Wysocki, K. Banfill, Alec Maynard, C. Hague, Daniel H. Palmer, Mark Baxter, Tim Cooksley, Anne Thomas, J. Tweedy, Carlo Palmieri, André Freitas, C. Dive, H. Boyce, Simon G. Williams, C. Zhou, Anne C Armstrong, Alexander J. Stockdale, T. Aung, Z. Hudson, Ellen Copson, L. Eastlake, M. Rowe, E. Dickens, F. Gomes, T. Bhogal, Jamie M Weaver, L. Horsley, A. Tivey, Rebecca Lee, Rohan Shotton, H. McKenzie, and R. Sheehan
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Cancer Research ,medicine.medical_specialty ,neutrophils/metabolism ,Lymphocyte ,COVID-19/prevention & control ,neoplasms/blood ,Logistic regression ,chemistry.chemical_compound ,C-Reactive Protein/analysis ,male ,Internal medicine ,Lactate dehydrogenase ,L-Lactate Dehydrogenase/metabolism ,middle aged ,medicine ,cancer ,longitudinal studies ,humans ,lymphocyte count ,Original Research ,Aged, 80 and over ,Manchester Cancer Research Centre ,business.industry ,SARS-CoV-2 ,SARS-CoV-2/isolation & purification ,adult ,ResearchInstitutes_Networks_Beacons/mcrc ,Albumin ,Cancer ,COVID-19 ,Outcome Assessment, Health Care/methods ,platelet count ,medicine.disease ,United Kingdom ,Exact test ,aged ,medicine.anatomical_structure ,female ,Oncology ,chemistry ,Cohort ,Mann–Whitney U test ,young adult ,lymphocytes/metabolism ,business ,logistic models - Abstract
Background Cancer patients are at increased risk of death from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cancer and its treatment affect many haematological and biochemical parameters, therefore we analysed these prior to and during coronavirus disease 2019 (COVID-19) and correlated them with outcome. Patients and methods Consecutive patients with cancer testing positive for SARS-CoV-2 in centres throughout the United Kingdom were identified and entered into a database following local governance approval. Clinical and longitudinal laboratory data were extracted from patient records. Data were analysed using Mann–Whitney U test, Fisher's exact test, Wilcoxon signed rank test, logistic regression, or linear regression for outcomes. Hierarchical clustering of heatmaps was performed using Ward's method. Results In total, 302 patients were included in three cohorts: Manchester (n = 67), Liverpool (n = 62), and UK (n = 173). In the entire cohort (N = 302), median age was 69 (range 19-93 years), including 163 males and 139 females; of these, 216 were diagnosed with a solid tumour and 86 with a haematological cancer. Preinfection lymphopaenia, neutropaenia and lactate dehydrogenase (LDH) were not associated with oxygen requirement (O2) or death. Lymphocyte count (P < 0.001), platelet count (P = 0.03), LDH (P < 0.0001) and albumin (P < 0.0001) significantly changed from preinfection to during infection. High rather than low neutrophils at day 0 (P = 0.007), higher maximal neutrophils during COVID-19 (P = 0.026) and higher neutrophil-to-lymphocyte ratio (NLR; P = 0.01) were associated with death. In multivariable analysis, age (P = 0.002), haematological cancer (P = 0.034), C-reactive protein (P = 0.004), NLR (P = 0.036) and albumin (P = 0.02) at day 0 were significant predictors of death. In the Manchester/Liverpool cohort 30 patients have restarted therapy following COVID-19, with no additional complications requiring readmission. Conclusion Preinfection biochemical/haematological parameters were not associated with worse outcome in cancer patients. Restarting treatment following COVID-19 was not associated with additional complications. Neutropaenia due to cancer/treatment is not associated with COVID-19 mortality. Cancer therapy, particularly in patients with solid tumours, need not be delayed or omitted due to concerns that treatment itself increases COVID-19 severity., Highlights • Pre-infection haematological/biochemical characteristics are not associated with COVID-19 severity. • Significant haematological/biochemical changes occur upon infection with heterogeneity in response observed. • High not low neutrophils were associated with oxygen requirement and COVID-19 mortality – GCSF should be used with caution. Age, haematological cancer, high neutrophil:lymphocyte ratio, CRP and low albumin were significant predictors of death in multivariable analysis. No significant complications requiring readmission were seen upon restart of cancer therapy following diagnosis of COVID-19.
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- 2021
31. Views of Our Readers
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Hopkins, Evelyn Harvey, Vogl, Albert L., Kobb, J. Stockdale, Gibson, Gordon, Weinberg, Max L., Beard, William M., and Walsh, William F.
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- 1957
32. Haematological malignancy and nosocomial transmission are associated with an increased risk of death from COVID-19: results of a multi-center UK cohort
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Ruth Suckling, Avith Jathanna, Christian Hesford, Rohan Shotton, Nagesh Kalakonda, Umair T Khan, Alexander J. Stockdale, Ann Tivey, Lance Turtle, Amir Norouzi, Daniel H. Palmer, Ram Sundar, Talvinder Bhogal, Carlo Palmieri, Gillian Brearton, Richard J. Jackson, Rebecca Lee, Anne C Armstrong, Andrew R. Pettitt, Christopher Valerio, Shaun Rahman, Philip Walker, and Vaishnav Potti-Dhananjaya
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Cross Infection/epidemiology ,medicine.medical_specialty ,Cancer Research ,medicine.medical_treatment ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,COVID-19 Testing ,Risk Factors ,Internal medicine ,Pandemic ,medicine ,Infection control ,Humans ,Pandemics ,Retrospective Studies ,Cross Infection ,Chemotherapy ,Manchester Cancer Research Centre ,business.industry ,Transmission (medicine) ,SARS-CoV-2 ,United Kingdom/epidemiology ,ResearchInstitutes_Networks_Beacons/mcrc ,Cancer ,COVID-19 ,Retrospective cohort study ,Hematology ,medicine.disease ,United Kingdom ,3. Good health ,Oncology ,Hematologic Neoplasms/epidemiology ,Hematologic Neoplasms ,030220 oncology & carcinogenesis ,Cohort ,Female ,business ,030215 immunology - Abstract
The COVID-19 pandemic has been a disruptive event for cancer patients, especially those with haematological malignancies (HM). They may experience a more severe clinical course due to impaired immune responses. This multi-center retrospective UK audit identified cancer patients who had SARS-CoV-2 infection between 1 March and 10 June 2020 and collected data pertaining to cancer history, COVID-19 presentation and outcomes. In total, 179 patients were identified with a median age of 72 (IQR 61, 81) and follow-up of 44 days (IQR 42, 45). Forty-one percent were female and the overall mortality was 37%. Twenty-nine percent had HM and of these, those treated with chemotherapy in the preceding 28 days to COVID-19 diagnosis had worse outcome compared with solid malignancy (SM): 62% versus 19% died [HR 8.33 (95% CI, 2.56-25), p p = 0.001). Patients with haematological malignancies and those who acquire nosocomial transmission are at increased risk of death. Therefore, there is an urgent need to reassess shielding advice, reinforce stringent infection control, and ensure regular patient and staff testing to prevent nosocomial transmission.
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- 2021
33. Establishment of CORONET: COVID-19 Risk in Oncology Evaluation Tool to Identify Cancer Patients at Low Versus High Risk of Severe Complications of COVID-19 Infection Upon Presentation to Hospital
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Rebecca Lee, Oskar Wysocki, C. Zhou, Rohan Shotton, Ann Tivey, Louise Lever, Joshua Woodcock, Angelos Angelakas, D. Arnold, Theingi Aung, Kathryn Banfill, Mark Baxter, Talvinder Bhogal, Hayley Boyce, Fiona Britton, Antonio Calles, Louis Castelo-Branco, Ellen Copson, Adina Croitoru, Sourbha Dani, Elena Dickens, Leonie Eastlake, P. Fitzpatrick, H. Frost, Sarju Ganatra, Spyridon Gennatas, F. Gomes, Donna Graham, Christina Hague, Kevin Harrington, Michelle Harrison, Laura Horsley, R. Hoskins, Prerana Huddar, Zoe Hudson, Nalinie Joharatnam-Hogan, S. Khan, U.T. Khan, Khurum Khan, Alec Maynard, H. McKenzie, Olivier Michielin, Anne Mosenthal, Berta Obispo, Rushin Patel, George pentheroudakis, solange peters, Kimberly Rieger-Christ, T. Robinson, Jacobo Rogado, Emanuela Romano, M. Rowe, Marina Sekacheva, Roseleen Sheehan, Julie Stevenson, Alexander J. Stockdale, A. Thomas, Lance Turtle, D. Viñal, J. Weaver, S. Williams, C. Wilson, Carlo Palmieri, Donal Landers, Tim Cooksley, ESMO Co-Care Group, Caroline Dive, Andre Freitas, and A. C. Armstrong
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Clinical trial ,Oncology ,medicine.medical_specialty ,Research ethics ,Institutional research ,Coronavirus disease 2019 (COVID-19) ,Lasso regression ,North west ,Internal medicine ,Public health ,medicine ,In patient - Abstract
Background: Patients with cancer are at increased risk of severe COVID-19, but have heterogeneous presentations and outcomes. Decision-making tools for hospital admission, severity prediction and increased monitoring for early intervention are critical. We sought to identify features of COVID-19 in cancer patients predicting severe disease and build a decision-support online tool; COVID-19 Risk in Oncology Evaluation Tool (CORONET). Methods: Patients with active cancer (stage I-IV) and laboratory confirmed COVID-19 presenting to hospitals worldwide were included. Discharge (within 24hrs), admission (≥24hrs inpatient), oxygen requirement (O2) and death were combined in a 0-3 point severity scale. Association of features with outcome were investigated using Lasso regression and Random Forest (RF) combined with SHapley Additive exPlanations (SHAP). RF was further validated in 4 cohorts, split by geography. The CORONET model was then examined in the entire cohort to build an online CORONET decision-support tool. Admission and severe disease thresholds were established through pragmatically defined cost functions. Findings: The dataset comprised 920 patients; median age 70 (range 5-99), 56% males, 44% females, 81% solid vs. 19% haematological cancers. In derivation, RF demonstrated superior performance over Lasso with lower mean squared error (0.801 vs. 0.807) and was selected for development. During validation, RF achieved mean AUROC 0.77, 0.80 and 0.75 for prediction of admission, O 2 and death, respectively. Using the entire cohort, CORONET cut-offs for admission and mortality of 1.0 and 2.3 were established. The CORONET decision support tool recommended admission for 95% of patients eventually requiring oxygen and 97% of those who died. SHAP explanations revealed National-Early-Warning-Score-2, C-reactive protein and albumin were the most important features contributing to COVID-19 severity prediction in patients with cancer at time of hospital presentation. Interpretation: CORONET, a decision-support tool validated in healthcare systems worldwide can aid admission decisions and predict COVID-19 severity in patients with cancer. Funding Information: R. Lee and T. Robinson and J. Weaver are supported by the National Institute for Health Research as Clinical Lecturers. T. Bhogal is supported by the National Institute for Health Research as an academic clinical fellow. U. Khan is an MRC Clinical Training Fellow based at the University of Liverpool supported by the North West England Medical Research Council Fellowship Scheme in Clinical Pharmacology and Therapeutics, which is funded by the Medical Research Council (Award Ref. MR/N025989/1). The Liverpool Experimental Cancer Medicine Centre for providing infrastructure support (Grant Reference: C18616/A25153) and The Clatterbridge Cancer charity (North West Cancer Research). C. Dive is funded by CRUK Core funding to Manchester Institute (C5757/A27412) and is supported by the CRUK Manchester Centre Award (C5759/A25254), and by the NIHR Manchester Biomedical Research Centre. C. Zhou is funded by the CRUK Manchester Centre Award (C5759/A25254), J. Stevenson and P. Fitzpatrick are funded by the CRUK Accelerator Award (29374). This research was funded in part, by the Wellcome Trust [205228/Z/16/Z]. LT is also supported by the National Institute for Health Research Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections (NIHR200907) at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford. LT is based at University of Liverpool. MS is supported by a grant from the Ministry of Science and Higher Education of the Russian Federation for the state support for the creation and development of World Class Research Centers "Digital biodesign and personalized healthcare” N.075-15-2020-926. Declaration of Interests: R Lee research funding (institution) BMS and speaker fees Astrazeneca. A. Croitoru Consulting or Advisory Role: Lilly, Merck, Roche, Bayer, Novartis, Ipsen, Research Funding me and my hospital: Gilead Sciences, Pfizer, Canfite, NanoCarrier, Bristol-Myers Squibb, Merck, Amgen, Servier, Five Prime Therapeutics, Travel Accommodations: Pfizer, Genekor, and oz, Merck, Pfizer, Servier, Roche. O. Michielin reports personal fees from Bristol-Myers Squibb, personal fees from MSD, personal fees from Novartis, personal fees from Roche, personal fees from Amgen, personal fees from NeraCare GmbH, outside the submitted work. E. Romano institutional research grants from Amgen, Astra Zeneca, Bristol-Myers Squibb. G. Pentheroudakis advisory board for Amgen, Astra Zeneca, Bristol-Myers Squibb, Lilly, Merck, MSD, Roche, Abbvie, institutional research grants from Amgen, Astra Zeneca, Boehringer Ingelheim, Bristol Myers Squibb, Debbio, Enorasis, Genekor, Ipsen, Janssen, Lilly, Merck, MSD, Pfizer, Roche, Sanofi, Servier. Solange Peters reports consultation/advisory role: AbbVie, Amgen, AstraZeneca, Bayer, Beigene, Biocartis, Bio Invent, Blueprint Medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, Elsevier, F. Hoffmann-La Roche/Genentech, Foundation Medicine, Illumina, Incyte, IQVIA, Janssen, Medscape, Merck Sharp and Dohme, Merck Serono, Merrimack, Mirati, Novartis, Pharma Mar, Phosplatin Therapeutics, Pfizer, Regeneron, Sanofi, Seattle Genetics, Takeda, Vaccibody, talk in a company’s organized public event: AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, e-cancer, Eli Lilly, F. Hoffmann-La Roche/Genentech, Illumina, Medscape, Merck Sharp and Dohme, Novartis, PER, Pfizer, Prime, RTP, Sanofi, Takeda, receipt of grants/research supports: (Sub)investigator in trials (institutional financial support for clinical trials) sponsored by Amgen, AstraZeneca, Biodesix, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, F. Hoffmann-La Roche/Genentech, GSK, Illumina, Lilly, Merck Sharp and Dohme, Merck Serono, Mirati, Novartis, and Pfizer, Phosplatin Therapeutics. M Rowe honoraria from Astellas Pharma, speaker fees MSD and Servier. C. Wilson consultancy and speaker fees Pfizer, Amgen, Novartis, A Armstrong conference fee Merck, spouse shares in Astrazeneca. T Robinson financial support to attend educational workshops from Amgen and Daiichi-Sankyo. C Dive, outside of this scope of work, has received research funding from AstraZeneca, Astex Pharmaceuticals, Bioven, Amgen, Carrick Therapeutics, Merck AG, Taiho Oncology, Clearbridge Biomedics, Angle PLC, Menarini Diagnostics, GSK, Bayer, Boehringer Ingelheim, Roche, BMS, Novartis, Celgene, Thermofisher. C Dive is on advisory boards for, and has received consultancy fees/honoraria from, AstraZeneca, Biocartis and Merck KGaA. No other authors have nothing to declare. Ethics Approval Statement: Approval (reference 20/WA/0269) was granted from the UK Research Ethics Committee for the study. Information regarding governance/regulatory approvals for each international cohort are available in the Supp. Methods.
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- 2021
34. Outcomes of coronavirus disease 2019 (COVID-19) related hospitalization among people with human immunodeficiency virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): a prospective observational study
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Malcolm G Semple, Alexander J. Stockdale, Ewen M Harrison, Lance Turtle, Giovanni Villa, Annemarie B Docherty, Simon Collins, J Kenneth Baillie, Peter J. M. Openshaw, Caroline A. Sabin, Anna Maria Geretti, Muge Cevik, Sophie H. Kelly, Laura Waters, and Sigfrid, L
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Human immunodeficiency virus (HIV) ,Ethnic group ,medicine.disease ,medicine.disease_cause ,Comorbidity ,Confidence interval ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Infectious Diseases ,Oxygen therapy ,Internal medicine ,medicine ,Observational study ,030212 general & internal medicine ,business - Abstract
Background Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.
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- 2020
35. Establishment of CORONET; COVID-19 Risk in Oncology Evaluation Tool to identify cancer patients at low versus high risk of severe complications of COVID-19 infection upon presentation to hospital
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Donal Landers Dr, Prerana Huddar Dr, Tim Cooksley Dr, Hayley Boyce Dr, Cong Zhou Dr, Hayley McKenzie Dr, Caroline Wilson Dr, Umair T Khan Dr, Jamie Weaver Dr, Anne C Armstrong Dr, Michael Rowe Dr, Kathryn Banfill Dr, Angelos Angelakas Dr, Alec Maynard Dr, Paul Fitzpartick Dr, Joshua Woodcock Dr, Theingi Aung Dr, Anne Thomas Prof, Christina Hague Dr, Rohan Shotton Dr, Donna Graham Dr, Sophie Williams Dr, Sam Khan Dr, Rebecca J Lee Dr, Louise Lever Dr, Roseleen Sheehan Dr, Talvinder Bhogal Dr, Lance Turtle, Caroline Dive Prof, Tim Robinson Dr, Ellen Copson Dr, Richard Hoskins Dr, Hannah Frost Ms, Julie Stevenson Dr, Andre Freitas Dr, Elena Dickens Dr, Leonie Eastlake Dr, Mark Baxter Dr, Laura Horsley Dr, Oskar Wysocki Dr, Fabio Gomes Dr, Michelle Harrison Dr, Zoe Hudson Dr, Alexander J. Stockdale, Ann Tivey Dr, and Carlo Palmieri Prof
- Subjects
Oncology ,medicine.medical_specialty ,Training set ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Cancer ,medicine.disease ,Logistic regression ,Internal medicine ,Cohort ,Hospital admission ,medicine ,In patient ,Presentation (obstetrics) ,business - Abstract
BackgroundCancer patients are at increased risk of severe COVID-19. As COVID-19 presentation and outcomes are heterogeneous in cancer patients, decision-making tools for hospital admission, severity prediction and increased monitoring for early intervention are critical.ObjectiveTo identify features of COVID-19 in cancer patients predicting severe disease and build a decision-support online tool; COVID-19 Risk in Oncology Evaluation Tool (CORONET)MethodData was obtained for consecutive patients with active cancer with laboratory confirmed COVID-19 presenting in 12 hospitals throughout the United Kingdom (UK). Univariable logistic regression was performed on pre-specified features to assess their association with admission (≥24 hours inpatient), oxygen requirement and death. Multivariable logistic regression and random forest models (RFM) were compared with patients randomly split into training and validation sets. Cost function determined cut-offs were defined for admission/death using RFM. Performance was assessed by sensitivity, specificity and Brier scores (BS). The CORONET model was then assessed in the entire cohort to build the online CORONET tool.ResultsTraining and validation sets comprised 234 and 66 patients respectively with median age 69 (range 19-93), 54% males, 46% females, 71% vs 29% had solid and haematological cancers. The RFM, selected for further development, demonstrated superior performance over logistic regression with AUROC predicting admission (0.85 vs. 0.78) and death (0.76 vs. 0.72). C-reactive protein was the most important feature predicting COVID-19 severity. CORONET cut-offs for admission and mortality of 1.05 and 1.8 were established. In the training set, admission prediction sensitivity and specificity were 94.5% and 44.3% with BS 0.118; mortality sensitivity and specificity were 78.5% and 57.2% with BS 0.364. In the validation set, admission sensitivity and specificity were 90.7% and 42.9% with BS 0.148; mortality sensitivity and specificity were 92.3% and 45.8% with BS 0.442. In the entire cohort, the CORONET decision support tool recommended admission of 99% of patients requiring oxygen and of 99% of patients who died.Conclusions and RelevanceCORONET, a decision support tool validated in hospitals throughout the UK showed promise in aiding decisions regarding admission and predicting COVID-19 severity in patients with cancer presenting to hospital. Future work will validate and refine the tool in further datasets.
- Published
- 2020
36. Reply to: 'Revisiting the estimation of hepatitis D global prevalence'
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Anna Maria Geretti, Yvan Hutin, and Alexander J. Stockdale
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Estimation ,Hepatology ,business.industry ,Statistics ,Prevalence ,Humans ,Medicine ,Hepatitis Delta Virus ,Global Health ,business ,medicine.disease ,Hepatitis D - Published
- 2020
37. Late presentation of hepatocellular carcinoma highlights the need for a public health programme to eliminate hepatitis B
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Richard Nhlane, Benno Kreuels, Jane Mallewa, Karen Chetcuti, Melita A Gordon, and Alexander J Stockdale
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Adult ,Diagnosis, Differential ,Male ,Carcinoma, Hepatocellular ,Fatal Outcome ,Liver Neoplasms ,Humans ,General Medicine ,Public Health ,Hepatitis B ,World Health Organization ,Africa South of the Sahara ,Ultrasonography - Published
- 2020
38. The global prevalence of hepatitis D virus infection:systematic review and metaanalysis
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Marc Henrion, Emanuele Giorgi, Alexander J. Stockdale, Catherine de Martel, Yvan Hutin, Benno Kreuels, Irene Kyomuhangi, and Anna Maria Geretti
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0301 basic medicine ,medicine.medical_specialty ,HBsAg ,viruses ,Population ,wi_700 ,Men who have sex with men ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,medicine ,education ,education.field_of_study ,Hepatology ,business.industry ,wa_900 ,virus diseases ,wc_536 ,Hepatitis B ,medicine.disease ,Hepatitis D ,030104 developmental biology ,Attributable risk ,030211 gastroenterology & hepatology ,business ,Demography - Abstract
BACKGROUND AND AIMS\ud There are uncertainties about the epidemic patterns of hepatitis delta virus (HDV) infection and its contribution to the burden of liver disease. We estimated the global prevalence of HDV infection and explored its contribution to the development of cirrhosis and hepatocellular carcinoma (HCC) among hepatitis B surface antigen (HBsAg)-positive people.\ud METHODS\ud We searched Pubmed, EMBASE and Scopus for studies reporting on total or IgG anti-HDV among HBsAg-positive people. Anti-HDV prevalence was estimated using a binomial mixed model, weighting for study quality and population size. The population attributable fraction (PAF) of HDV to cirrhosis and HCC among HBsAg-positive people was estimated using random-effects models.\ud RESULTS\ud We included 282 studies, comprising 376 population samples from 95 countries, which together tested 120,293 HBsAg-positive people for anti-HDV. The estimated anti-HDV prevalence was 4.5% (95% CI 3.6, 5.7) among all HBsAg-positive people and 16.4% (14.6, 18.6) among those attending hepatology clinics. Worldwide, 0.16% (0.11, 0.25) of the general population, totalling 12.0 (8.7, 18.7) million people, were estimated to be anti-HDV positive. Prevalence among HBsAg-positive people was highest in Mongolia, the Republic of Moldova and countries in Western and Middle Africa, and was higher in injecting drug users, haemodialysis recipients, men who have sex with men, commercial sex workers, and those with hepatitis C virus or HIV. Among HBsAg-positive people, preliminary PAF estimates of HDV were 18% (10, 26) for cirrhosis and 20% (8, 33) for HCC.\ud \ud CONCLUSIONS\ud \ud An estimated 12 million people worldwide have experienced HDV infection, with higher prevalence in certain geographic areas and populations. HDV is a significant contributor to HBV-associated liver disease. More quality data are needed to improve the precisions of burden estimates.
- Published
- 2020
39. Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study
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Ann Sullivan, Ewen M Harrison, Giovanni Villa, Annemarie B Docherty, Simon Collins, J Kenneth Baillie, Caroline A. Sabin, Peter J. M. Openshaw, N. Connor, Saye Khoo, Chloe Orkin, Daniel Bradshaw, Anna Maria Geretti, Valerie Delpech, Sophie H. Kelly, Alison E Brown, Alexander J. Stockdale, Laura Waters, Malcolm G Semple, Isaric C Investigators, Tamyo Mbisa, Lance Turtle, Muge Cevik, and Sigfrid, L
- Subjects
Research ethics ,Pediatrics ,medicine.medical_specialty ,education.field_of_study ,Proportional hazards model ,business.industry ,Hazard ratio ,Population ,Ethnic group ,Context (language use) ,Disease ,Family medicine ,Health care ,medicine ,Risk of mortality ,Clinical endpoint ,Cumulative incidence ,Observational study ,business ,education ,Prospective cohort study ,Cohort study - Abstract
Background.There is conflicting evidence about how HIV infection influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom.Methods.We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease severity at presentation as defined by hypoxia/oxygen therapy.Findings.Among 47,539 patients, 115 (0·24%) had confirmed HIV-positive status and 103/115 (89·6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; pInterpretation.HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.Funding.NIHR, MRC, Wellcome Trust, Department for International Development, Bill and Melinda Gates Foundation.Study registrationISRCTN66726260RESEARCH IN CONTEXTEvidence before this studyWe searched PubMed for articles in all languages containing the words “COVID*”, “coronavirus”, “SARS CoV-2” AND “HIV”. After screening on 23rd July 2020, we found 51 articles reporting outcomes of COVID-19 in HIV-positive people. Of these, 2 were systematic reviews, 24 were single case reports or case series of under 10 participants, and 12 were larger case series or retrospective cohorts without matched controls. There were two cohort studies that matched HIV-positive people diagnosed with COVID-19 to the general population attending for HIV care in the same area, and three studies that matched HIV-positive people diagnosed with COVID-19 to HIV-negative controls. Some of the evidence from the United States and Europe to date suggests that people with HIV experience a similar disease course and outcomes of COVID-19 compared to the general population. However, many of the studies are limited by small sample size, lack of comparator group and lack of adjustment for potential confounding. In contrast, preliminary results from a cohort study of over 20,000 participants in South Africa indicate that HIV-positive status more than doubles the risk of COVID-19 related mortality. Currently, the evidence from the United Kingdom is limited to two case series comprising a total of 21 patients.Added value of this studyThis study analysed data collected from 207 sites across the United Kingdom as part of ISARIC CCP, the largest prospective cohort of patients hospitalised with COVID-19, to evaluate the association between HIV-positive status and day-28 mortality. The study has the benefit of a relatively large number of participants with HIV (n=115, almost all receiving antiretroviral therapy) and importantly, the ability to direct compare their presenting characteristics and outcomes to those of 47,424 HIV-negative controls within the same dataset. This includes the ability to assess the influence of gender, ethnicity and age, as well as the effect of key comorbidities including chronic cardiac, pulmonary, renal and haematological disease, diabetes, obesity, chronic neurological disorder, dementia, liver disease, and malignancy. Unlike some of the other evidence to date, but in line with the data from South Africa, this study indicates that HIV-positive status may increase the risk of mortality with COVID-19 compared to the general population, with an effect that was especially evident among people with HIV aged below 60 years and was independent of gender or ethnicity. Although we detected an association between mortality among people with HIV and occurrence of obesity and diabetes with complication, the effect of HIV-positive status persisted after adjusting for comorbidities.Implications of all the available evidencePeople with HIV may be at increased risk of severe outcomes from COVID-19 compared to the general population. Ongoing data collection is needed to confirm this association. Linkage of hospital outcome data to the HIV history will be paramount to establishing the determinants of the increased risk. COVID-19 related hospitalisation should pursue systematic recording of HIV status to ensure optimal management and gathering of evidence.
- Published
- 2020
40. Renal health after long-term exposure to tenofovir disoproxil fumarate (TDF) in HIV/HBV positive adults in Ghana
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Alessandra Ruggiero, CJ Smith, Anna Maria Geretti, Richard Phillips, Giovanni Villa, Frank A. Post, David Chadwick, Alexander J. Stockdale, Fred Stephen Sarfo, Apostolos Beloukas, and Lambert Appiah
- Subjects
Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,Hepatitis B virus ,medicine.medical_specialty ,Time Factors ,Efavirenz ,Cirrhosis ,Anti-HIV Agents ,Urinary system ,030106 microbiology ,Renal function ,HIV Infections ,Kidney ,Ghana ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,HBV ,Humans ,Medicine ,030212 general & internal medicine ,Tenofovir ,Coinfection ,business.industry ,HIV ,Lopinavir ,Middle Aged ,Hepatitis B ,medicine.disease ,R1 ,Booster ,CD4 Lymphocyte Count ,Proteinuria ,Infectious Diseases ,Blood pressure ,chemistry ,HBeAg ,Tubular proteinuria ,Hypertension ,Female ,Kidney Diseases ,business ,Glomerular Filtration Rate ,medicine.drug - Abstract
Objectives The study assessed markers of renal health in HIV/HBV co-infected patients receiving TDF-containing antiretroviral therapy in Ghana. Methods Urinary protein-to-creatinine ratio (uPCR) and albumin-to-protein ratio (uAPR) were measured cross-sectionally after a median of four years of TDF. At this time, alongside extensive laboratory testing, patients underwent evaluation of liver stiffness and blood pressure. The estimated glomerular filtration rate (eGFR) was measured longitudinally before and during TDF therapy. Results Among 101 participants (66% women, median age 44 years, median CD4 count 572 cells/mm3) 21% and 17% had detectable HIV-1 RNA and HBV DNA, respectively. Overall 35% showed hypertension, 6% diabetes, 7% liver stiffness indicative of cirrhosis, and 18% urinary excretion of Schistosoma antigen. Tubular proteinuria occurred in 16% of patients and was independently predicted by female gender and hypertension. The eGFR declined by median 1.8 ml/min/year during TDF exposure (IQR -4.4, -0.0); more pronounced declines (≥5ml/min/year) occurred in 22% of patients and were associated with receiving ritonavir-boosted lopinavir rather than efavirenz. HBV DNA, HBeAg, transaminases, and liver stiffness were not predictive of renal function abnormalities. Conclusions The findings mandate improved diagnosis and management of hypertension and suggest targeted laboratory monitoring of patients receiving TDF alongside a booster in sub-Saharan Africa.
- Published
- 2018
41. A sociology of mystic practices: use and adaptation in the emergent church
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Todd J. Stockdale
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Philosophy ,Environmental ethics ,Sociology ,Adaptation (computer science) ,Mysticism - Published
- 2019
42. The Variability of Outcomes Used in Efficacy and Effectiveness Trials of Alcohol Brief Interventions: A Systematic Review
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Gillian W, Shorter, Jeremy W, Bray, Emma L, Giles, Amy J, O'Donnell, Anne H, Berman, Aisha, Holloway, Nick, Heather, Carolina, Barbosa, Kelly J, Stockdale, Stephanie J, Scott, Mike, Clarke, and Dorothy, Newbury-Birch
- Subjects
Alcoholism ,Clinical Trials as Topic ,Time Factors ,Outcome Assessment, Health Care ,Humans - Abstract
The purpose of this study was to characterize recent alcohol brief intervention (ABI) efficacy and effectiveness trials, summarize outcomes, and show how variability in outcomes and reporting compromises the evidence base.A systematic review and narrative synthesis of articles from 10 databases were undertaken (January 2000-November 2017); study selection represented recent, readily available publications. The National Institute of Care Excellence (NICE) Public Health Guideline 24 (Alcohol use disorders: prevention) informed ABI definitions. The review was conducted using Centre for Reviews and Dissemination (CRD) guidance and pre-registered on PROSPERO (CRD42016047185). Seven a priori specified domains were used to classify outcomes: biomarkers, alcohol-related outcomes, economic factors/resource use, health measures, life impact, intervention factors, and psychological/behavioral factors.The search identified 405 trials from 401 eligible papers. In 405 trials, 2,641 separate outcomes were measured in approximately 1,560 different ways. The most common outcomes used were the number of drinks consumed in a week and frequency of heavy episodic drinking. Biomarkers were least frequently used. The most common primary outcome was weekly drinks. By trial type, the most frequent outcome in efficacy and effectiveness trials was frequency of heavy drinking.Consumption outcomes predominated; however, no single outcome was found in all trials. This comprehensive outcome map and methodological detail on ABI effectiveness and efficacy trials can aid decision making in future trials. There was a diversity of instruments, time points, and outcome descriptions in methods and results sections. Compliance with reporting guidance would support data synthesis and improve trial quality. This review establishes the need for a core outcome set (COS)/minimum data standard and supports the Outcome Reporting in Brief Interventions: Alcohol initiative (ORBITAL) to improve standards in the ABI field through a COS for effectiveness and efficacy randomized trials.
- Published
- 2019
43. Police officers comprise only 60% of the police workforce in England and Wales
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Kelly J. Stockdale
- Subjects
Political science ,Workforce ,Criminology - Published
- 2019
44. Hepatitis D prevalence:problems with extrapolation to global population estimates
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Anna Maria Geretti, Marc Yr Henrion, Emanuele Giorgi, Irene Kyomuhangi, Benno Kreuels, and Alexander J. Stockdale
- Subjects
0301 basic medicine ,medicine.medical_specialty ,endocrine system ,wc_20 ,Cirrhosis ,wa_950 ,viruses ,Population ,Virus ,03 medical and health sciences ,0302 clinical medicine ,Hepatitis B, Chronic ,Epidemiology ,medicine ,Prevalence ,Seroprevalence ,Humans ,education ,education.field_of_study ,business.industry ,Gastroenterology ,virus diseases ,wc_536 ,biochemical phenomena, metabolism, and nutrition ,Hepatitis B ,medicine.disease ,Virology ,Hepatitis D ,3. Good health ,Chronic infection ,030104 developmental biology ,030211 gastroenterology & hepatology ,Hepatitis Delta Virus ,business - Abstract
We read the meta-analysis of global hepatitis D prevalence by Chen et al and have some serious concerns relating to the proposed epidemiological estimates.1 Seroprevalence of hepatitis delta virus (HDV) was not adequately defined. In the methods, hepatitis delta antibody (anti-HDV), HDV RNA and HDV antigen (HDAg) were described as markers of HDV infection. In Supplementary Table S8, it is evident that total, IgG and IgM anti-HDV and HDAg were variably used to define HDV infection. HDAg is a transient marker of HDV infection, whereas IgM expression is inconsistently associated with both acute and chronic infection; neither are suitable epidemiological markers of chronic HDV infection.2 A total of 50 cohorts were used to inform the primary outcome, global HDV seroprevalence in the general population; of these, 30 were conducted in the last 20 years. The authors estimated …
- Published
- 2018
45. Proper Ferroelectricity in the Dion–Jacobson Material CsBi2Ti2NbO10: Experiment and Theory
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Charles A. Deacon, T. Thao Tran, Neil C. Hyatt, Eric Bousquet, Emma E. McCabe, Martin C. Stennett, Christopher P. J. Stockdale, and P. Shiv Halasyamani
- Subjects
Neutron powder diffraction ,Materials science ,Condensed matter physics ,biology ,General Chemical Engineering ,General Chemistry ,biology.organism_classification ,Ferroelectricity ,Characterization (materials science) ,Aurivillius ,Octahedron ,11000/13 ,QD156 ,11000/12 ,11000/11 ,QD473 ,Materials Chemistry ,Polar ,Density functional theory ,Perovskite (structure) - Abstract
A diverse range of materials and properties are exhibited by layered perovskites. We report on the synthesis, characterization, and computational investigation of a new ferroelectric?CsBi2Ti2NbO10, an n = 3 member of the Dion?Jacobson (DJ) family. Structural studies using variable temperature neutron powder diffraction indicate that a combination of octahedral rotations and polar displacements result in the polar structure. Density functional theory calculations reveal that the wider perovskite blocks in CsBi2Ti2NbO0 stabilize proper ferroelectricity, in contrast to the hybrid-improper ferroelectricity reported for all other DJ phases. Our results raise the possibility of a new class of proper ferroelectric materials analogous to the well-known Aurivillius phases.
- Published
- 2015
46. Left ventricular thrombus on point-of-care ultrasound
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Caleb P. Canders, Cameron W. Harrison, and Garrett J. Stockdale
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Point of care ultrasound ,Emergency Medicine ,medicine ,Cardiology ,Left ventricular thrombus ,business - Published
- 2020
47. Influence of partial dealcoholization on the composition and sensory properties of Cabernet Sauvignon wines
- Author
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David W. Jeffery, Kerry L. Wilkinson, Vanessa J. Stockdale, Jonathan Tuke, Renata Ristic, and Duc-Truc Pham
- Subjects
Wine ,Chemistry ,digestive, oral, and skin physiology ,010401 analytical chemistry ,Aroma of wine ,food and beverages ,Sensory system ,Alcohol ,04 agricultural and veterinary sciences ,General Medicine ,Sweetness ,040401 food science ,01 natural sciences ,0104 chemical sciences ,Analytical Chemistry ,chemistry.chemical_compound ,0404 agricultural biotechnology ,Statistical analysis ,Composition (visual arts) ,Food science ,Flavor ,Food Science - Abstract
Worldwide, winemakers are increasingly adopting alcohol management strategies to counter the higher wine ethanol concentrations observed over the past ~30 years. Wines with high ethanol levels exhibit increased ‘hotness’ on the palate, which is generally considered to negatively impact wine quality. This study investigated changes in the chemical and sensory profiles of five Cabernet Sauvignon wines following their partial dealcoholization by reverse osmosis-evaporative perstraction (RO-EP). Descriptive analysis (DA) of wine before and after RO-EP treatment indicated dealcoholization did not strongly affect wine aroma and flavor, consistent with the small changes observed in wine chemical composition. However, significant differences in the perception of wine palate attributes were observed, with dealcoholized wines found to exhibit lower acidity, sweetness, bitterness, saltiness and/or body. Astringency was enhanced following partial dealcoholization of one wine, but diminished in another. Sensory trials were also undertaken to determine the optimal ethanol concentration of wines, or the ‘alcohol sweetspot’. Two approaches to alcohol sweetspotting of dealcoholized wines were evaluated, together with two methods of statistical analysis, chi-squared goodness of fit and one proportion tests.
- Published
- 2020
48. A systematic review of the efficacy of alcohol interventions for incarcerated people
- Author
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Charlotte Gill, Emma L. Giles, Kelly J. Stockdale, Sarah Landale, Grant McGeechan, Dorothy Newbury-Birch, Jennifer Ferguson, and Aisha Holloway
- Subjects
Alcohol Drinking ,L400 ,Population ,efficacy ,MEDLINE ,Psychological intervention ,BF ,030508 substance abuse ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Humans ,Medicine ,HV6001-7220.5 ,030212 general & internal medicine ,education ,criminal justice ,interventions ,education.field_of_study ,business.industry ,alcohol ,Prisoners ,General Medicine ,Checklist ,B900 ,Psychotherapy ,Critical appraisal ,Brief intervention ,0305 other medical science ,business ,Psychosocial ,Clinical psychology - Abstract
Aim: The aim of this current study was to systematically review the literature on brief alcohol interventions for incarcerated individuals to ascertain the efficacy or effectiveness in making changes to either consumption of alcohol or other social outcomes.Short summary Levels of risky drinking and dependency are high amongst incarcerated individuals. Eleven studies from nine articles were included in the systematic review. Six of the studies included brief intervention and three extended interventions. Interventions have the potential to positively impact on risky drinking. More studies are needed in this setting. Introduction: It has been shown that around three times as many incarcerated individuals are risky drinkers and alcohol dependency is ten times higher than in the general population. Methods: Systematic review of randomised controlled trials or matched group trials of the efficacy of psychosocial alcohol interventions for incarcerated individuals: we searched seven databases, with no restrictions on language, year or location from inception through to August 2017. The Critical Appraisal Skills Programme tool was used to assess the quality of included studies. The Template for Intervention Description and Replication checklist was used to ascertain intervention descriptions. Results: Nine studies from 11 papers were included in the analysis. Six of the studies included brief interventions and three extended interventions. Every study used a different measure of alcohol consumption. Three of the studies that looked at brief interventions and all of the three extended intervention studies found significant reductions in relation to alcohol outcomes. Conclusions: Results show that interventions in the prison setting have the potential to positively impact on alcohol use; however, because of small numbers and the use of different outcome measures we could not conduct a meta-analysis or generalise findings. Future studies are needed to standardise approaches to ensure greater rigour and efficacy.
- Published
- 2018
49. Exploring the intersections between novel psychoactive substances (NPS) and other substance use in a police custody suite setting in the north east of England
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Lisa Crowe, William McGovern, I McKinnon, Eileen Kaner, Michelle Addison, Lisa Hogan, Ruth McGovern, and Kelly J. Stockdale
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Health (social science) ,Police custody ,media_common.quotation_subject ,L300 ,030508 substance abuse ,Medicine (miscellaneous) ,North east ,Criminology ,HM ,Heroin ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,medicine ,030212 general & internal medicine ,media_common ,biology ,biology.organism_classification ,Feeling ,Cannabis ,Substance use ,Thematic analysis ,0305 other medical science ,Psychology ,Qualitative research ,medicine.drug - Abstract
Aims: Novel psychoactive substances (NPS), a range of plant-based/synthetic substances that mimic effects of other illicit substances (e.g. cannabis), are now illegal in the United Kingdom (May 2016) to produce/supply. Negative behavioural consequences of NPS use mean that users frequently transgress the law are arrested and detained in police custody suites. Evidence shows a link between traditional substance use and offending behaviour, with significant police time spent on alcohol-related incidents. We explore the intersections between NPS and other substances with police staff and users in custody; specifically the similarities and differences in treatment, management and policing of these substances.\ud \ud Methods: A qualitative study using semistructured interviews and thematic analysis. We recruited 15 police staff (4 women/11 men) and 25 NPS users (9 women/16 men).\ud \ud Results: Police staff perceived NPS users to be extremely volatile in custody and reported feeling less knowledgeable about how to manage and respond to their needs compared to other substance users (e.g. alcohol, heroin). Users rarely took NPS in isolation and often compared them to other illicit substances, balancing effects versus costs.\ud \ud Conclusion: NPS use has a striking effect on custody work, primarily because of unpredictable user behaviour, adding further pressure to already overstretched police staff.
- Published
- 2018
50. Depth dependant element analysis of PbMg
- Author
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K L, Brown, C P J, Stockdale, H, Luo, X, Zhao, J-F, Li, D, Viehland, G, Xu, P M, Gehring, K, Ishida, A D, Hillier, and C, Stock
- Abstract
The relaxor PbMg
- Published
- 2018
Catalog
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