24 results on '"L. Hone"'
Search Results
2. Basal Cell Carcinoma on the Sole: An Easily Missed Cancer
- Author
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Natalie L. Hone, Radhika Grandhi, and Adam A. Ingraffea
- Subjects
Cancer screening ,Basal cell carcinoma ,Skin cancer ,Dermatology ,RL1-803 - Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, and solar ultraviolet ray exposure is the most significant risk factor for its development. The plantar foot is infrequently exposed to the sun, thus the presence of BCC on the sole is rare. We report a case of BCC on the sole of the foot and its treatment in the hope to facilitate its detection.
- Published
- 2016
- Full Text
- View/download PDF
3. 110 A Single Centre Study on the Thirty-Day Hospital Reattendance and Readmission of Older Patients During the SARS-CoV-2 Pandemic
- Author
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D. L. Fink, J. Cai, C. J. Mooney, M. Majid, L. Hone, and L. Mieiro
- Subjects
Aging ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Posters Clinical Quality: Clinical Effectiveness ,Retrospective cohort study ,General Medicine ,Emergency department ,Abstracts ,AcademicSubjects/MED00280 ,Older patients ,THIRTY-DAY ,Clinical diagnosis ,Pandemic ,Emergency medicine ,Medicine ,Geriatrics and Gerontology ,business - Abstract
Introduction Hospital and social care suffered major alterations during the SARS-CoV-2 pandemic in the UK. Older adults were disproportionally affected by routine care disruption. To our knowledge, no data has been published so far on the impact of service disruption on 30-day readmission. Methods We performed a retrospective observational study of all patients admitted to a single east London hospital with laboratory-confirmed or clinical diagnosis of COVID-19 between 16th March and 6th April 2020. Older patients were defined as aged 80 years and over. Readmission was captured within 30 days of discharge. Comparator defined as the same period in 2019. Descriptive statistics were used. Results Three hundred and ninety-three patients were included. The majority survived to discharge (69.7%). Positive laboratory testing was similar between older and younger patients (85.7% vs 84.7%, p = NS). Mortality was significantly higher for older patients on index presentation (60.2% vs 20.3%, p Conclusions Our data shows that readmission rates in the older population of East London during the SARS-CoV-2 pandemic were largely similar to non-pandemic periods. During this period, readmission rates appear to have been driven by clinical rather than social imperatives. This suggests that adapted social care services performed well and should be reinforced for future surges.
- Published
- 2021
4. Development and internal validation of a diagnostic prediction model for COVID-19 at time of admission to hospital
- Author
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Michael Marks, S Thomas, K H El-Shakankery, C. J. Mooney, N Goldman, L Hone, P Y Khan, D L Fink, Whitford, G Sismey, and J. Cai
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,MEDLINE ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,COVID-19 Testing ,medicine ,Infection control ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Framingham Risk Score ,business.industry ,SARS-CoV-2 ,Multivariable calculus ,COVID-19 ,Retrospective cohort study ,General Medicine ,Confidence interval ,Checklist ,Hospitals ,Emergency medicine ,Original Article ,business ,AcademicSubjects/MED00010 - Abstract
Summary Background Early coronavirus disease 2019 (COVID-19) diagnosis prior to laboratory testing results is crucial for infection control in hospitals. Models exist predicting COVID-19 diagnosis, but significant concerns exist regarding methodology and generalizability. Aim To generate the first COVID-19 diagnosis risk score for use at the time of hospital admission using the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) checklist. Design A multivariable diagnostic prediction model for COVID-19 using the TRIPOD checklist applied to a large single-centre retrospective observational study of patients with suspected COVID-19. Methods 581 individuals were admitted with suspected COVID-19; the majority had laboratory-confirmed COVID-19 (420/581, 72.2%). Retrospective collection was performed of electronic clinical records and pathology data. Results The final multivariable model demonstrated AUC 0.8535 (95% confidence interval 0.8121–0.8950). The final model used six clinical variables that are routinely available in most low and high-resource settings. Using a cut-off of 2, the derived risk score has a sensitivity of 78.1% and specificity of 86.8%. At COVID-19 prevalence of 10% the model has a negative predictive value (NPV) of 96.5%. Conclusions Our risk score is intended for diagnosis of COVID-19 in individuals admitted to hospital with suspected COVID-19. The score is the first developed for COVID-19 diagnosis using the TRIPOD checklist. It may be effective as a tool to rule out COVID-19 and function at different pandemic phases of variable COVID-19 prevalence. The simple score could be used by any healthcare worker to support hospital infection control prior to laboratory testing results.
- Published
- 2020
5. Diabetic wound healing in a MMP9-/- mouse model
- Author
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Timothy M. Crombleholme, Abdul Q. Sheikh, Swathi Balaji, Hongkwan Cho, Daria A. Narmoneva, Natalie L. Hone, Chad M. Moles, and Sundeep G. Keswani
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Inflammation ,Stem cell factor ,Dermatology ,030204 cardiovascular system & hematology ,MMP9 ,Neovascularization ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Progenitor cell ,business.industry ,Granulation tissue ,body regions ,030104 developmental biology ,medicine.anatomical_structure ,Endocrinology ,embryonic structures ,cardiovascular system ,Surgery ,Bone marrow ,medicine.symptom ,Wound healing ,business ,circulatory and respiratory physiology - Abstract
Reduced mobilization of endothelial progenitor cells (EPCs) from the bone marrow (BM) and impaired EPC recruitment into the wound represent a fundamental deficiency in the chronic ulcers. However, mechanistic understanding of the role of BM-derived EPCs in cutaneous wound neovascularization and healing remains incomplete, which impedes development of EPC-based wound healing therapies. The objective of this study was to determine the role of EPCs in wound neovascularization and healing both under normal conditions and using single deficiency (EPC) or double-deficiency (EPC + diabetes) models of wound healing. MMP9 knockout (MMP9 KO) mouse model was utilized, where impaired EPC mobilization can be rescued by stem cell factor (SCF). The hypotheses were: (1) MMP9 KO mice exhibit impaired wound neovascularization and healing, which are further exacerbated with diabetes; (2) these impairments can be rescued by SCF administration. Full-thickness excisional wounds with silicone splints to minimize contraction were created on MMP9 KO mice with/without streptozotocin-induced diabetes in the presence or absence of tail-vein injected SCF. Wound morphology, vascularization, inflammation, and EPC mobilization and recruitment were quantified at day 7 postwounding. Results demonstrate no difference in wound closure and granulation tissue area between any groups. MMP9 deficiency significantly impairs wound neovascularization, increases inflammation, decreases collagen deposition, and decreases peripheral blood EPC (pb-EPC) counts when compared with wild-type (WT). Diabetes further increases inflammation, but does not cause further impairment in vascularization, as compared with MMP9 KO group. SCF improves neovascularization and increases EPCs to WT levels (both nondiabetic and diabetic MMP9 KO groups), while exacerbating inflammation in all groups. SCF rescues EPC-deficiency and impaired wound neovascularization in both diabetic and nondiabetic MMP9 KO mice. Overall, the results demonstrate that BM-derived EPCs play a significant role during wound neovascularization and that the SCF-based therapy with controlled inflammation could be a viable approach to enhance healing in chronic diabetic wounds.
- Published
- 2016
6. Flourishing in New Zealand Workers
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L. Hone, Grant Schofield, Scott Duncan, and Aaron Jarden
- Subjects
Adult ,Employment ,Male ,medicine.medical_specialty ,Health Status ,Health Behavior ,education ,Personal Satisfaction ,Work related ,Surveys and Questionnaires ,Environmental health ,Epidemiology ,medicine ,Humans ,Life Style ,Flourishing ,Public Health, Environmental and Occupational Health ,Physical health ,Middle Aged ,Large sample ,Well-being ,Female ,Job satisfaction ,Psychology ,Psychosocial ,New Zealand - Abstract
To investigate the prevalence and associations of flourishing among a large sample of New Zealand workers.A categorical diagnosis of flourishing was applied to data from the Sovereign Wellbeing Index, a nationally representative sample of adults in paid employment (n = 5549) containing various lifestyle, physical, psychosocial, and work-related indicators.One in four New Zealand workers were categorized as flourishing. Being older and married, reporting greater income, financial security, physical health, autonomy, strengths awareness and use, work-life balance, job satisfaction, participation in the Five Ways to Well-being, volunteering, and feeling appreciated by others were all positively associated with worker flourishing independent of sociodemographics.Flourishing is a useful additional indicator for evaluating the prevalence, and identifying the drivers, of employee well-being. Employers may benefit from promoting these indicators among staff.
- Published
- 2015
7. Perioperative complications with new oral anticoagulants dabigatran, apixaban, and rivaroxaban in Mohs micrographic surgery: A retrospective study
- Author
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Natalie L. Hone, Hugh M. Gloster, and Camila Antia
- Subjects
Male ,medicine.medical_specialty ,Pyridones ,medicine.medical_treatment ,Administration, Oral ,Dermatology ,Micrographic surgery ,Dabigatran ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Rivaroxaban ,medicine ,Mohs surgery ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Anticoagulants ,Retrospective cohort study ,Perioperative ,Middle Aged ,Mohs Surgery ,Surgery ,030220 oncology & carcinogenesis ,Pyrazoles ,Apixaban ,Female ,business ,medicine.drug - Published
- 2017
8. True Point of Care vs Centralised Testing of Arterial Blood Gasses. Time for a Change?
- Author
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Weatherby, Tom, L Hone, SJ Woodmansey, and Weichert, Immo
- Published
- 2017
- Full Text
- View/download PDF
9. An evaluation of positive psychology intervention effectiveness trials using the re-aim framework: A practice-friendly review
- Author
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Grant Schofield, Aaron Jarden, and L. Hone
- Subjects
Meta-analysis ,Intervention (counseling) ,Psychological intervention ,Positive psychology ,Psychology ,General Psychology ,Anecdotal evidence ,Clinical psychology - Abstract
Meta-analyses indicate the efficacy of positive psychology interventions in promoting well-being. But, despite accumulating empirical and anecdotal evidence of these interventions’ implementation in real-world settings, no review of effectiveness research exists. Accordingly, we identified 40 positive psychology intervention effectiveness trials targeting adults, and scored their reporting using the practice-friendly RE-AIM tool which assesses five dimensions of intervention utility: Reach, Efficacy, Adoption, Implementation and Maintenance. Reporting levels varied substantially: reporting on Reach scored 64%; Efficacy scored 73%; Adoption scored 84%; Implementation scored 58%; and Maintenance scored 16%. Within these five dimensions, reporting on participation rates, methods to select delivery agents, differences between participants and non-participants, programme maintenance and costs, was particularly sparse. The studies involved 10,664 participants, approximately half required specialist delivery, an...
- Published
- 2014
10. Religion and wellbeing around the world: Social purpose, social time, or social insurance?
- Author
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Grant Schofield, L. Hone, Aaron Jarden, and Scott Duncan
- Subjects
Religiosity ,Social insurance ,Social Psychology ,Flourishing ,Economics, Econometrics and Finance (miscellaneous) ,Well-being ,Agency (sociology) ,Attendance ,Positive psychology ,Psychology ,Causality ,Social psychology ,Applied Psychology - Abstract
A number of studies find that religious people are happier than non-religious ones. Yet a number of fundamental questions about that relationship remain unanswered. A critical one is the direction of causality: does religion make people happier or are happier people more likely to have faith in something that is beyond their control? We posit that the relationship between religion and wellbeing is mediated by factors ranging from intrinsic purpose, to its social aspects, to its role as an insurance mechanism for people who face great adversity. We explore a number of related questions, using world-wide data from the Gallup World Poll. As these data are cross- section data, we cannot establish causality; we do, however, explore: how or if the relationship between religion and wellbeing varies across the two distinct wellbeing dimensions (hedonic and evaluative); how social externalities mediate the relationship; how the relationship changes as countries and people within them become more prosperous and acquire greater means and agency; and how the relationship between religion and wellbeing varies depending on where respondents are in the wellbeing distribution. We find that the positive relation between religion and evaluative wellbeing is more important for respondents with lower levels of agency, while the positive relation with hedonic wellbeing holds across the board. The social dimension of religion is most important for the least social respondents, while the religiosity component of religion is most important for the happiest respondents, regardless of religious affiliation or service attendance. As such, it seems that the happiest are most likely to seek social purpose in religion, the poorest are most likely to seek social insurance in religion, and the least social are the most likely to seek social time in religion.
- Published
- 2014
11. Psychometric Properties of the Flourishing Scale in a New Zealand Sample
- Author
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Aaron Jarden, L. Hone, and Grant Schofield
- Subjects
education.field_of_study ,Sociology and Political Science ,Flourishing ,Population ,General Social Sciences ,Confirmatory factor analysis ,Arts and Humanities (miscellaneous) ,Cronbach's alpha ,Scale (social sciences) ,Well-being ,Developmental and Educational Psychology ,Positive psychology ,Subjective well-being ,education ,Psychology ,Social psychology ,Clinical psychology - Abstract
The Flourishing Scale (FS; Diener et al. in Soc Indic Res 97(2):143–156, 2010) was developed to assess psychological flourishing, which can be conceived of as a social-psychological prosperity incorporating important aspects of human functioning. This study takes the FS, which has previously been validated on convenience samples of students, and analyses the underlying structure, psychometric properties, and demographic norms using nationally-representative data from New Zealand’s Sovereign Wellbeing Index (n = 10,009; Human Potential Centre in Sovereign Wellbeing Index: New Zealand’s first measure of wellbeing. Auckland University of Technology, Auckland, 2013). Evidence for the reliability and validity of the FS is presented (Cronbach alpha) and its performance compared to other related scales and behaviors. Exploratory and confirmatory factor analysis demonstrated the one factor structure of the 8-item FS. Contemporary population norms for the FS are reported, providing a much-needed benchmark for estimation of population health and permitting cross-study and international comparisons. The study provides further evidence that the FS is a valid and reliable brief summary measure of psychological functioning, suited for use with a wide range of age groups and applications.
- Published
- 2013
12. Macrophage Activation Syndrome in Scleroderma
- Author
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Natalie L. Hone, Rina Mina, John Brian Houk, and Catherine Donnelly
- Subjects
030203 arthritis & rheumatology ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Systemic blood ,business.industry ,Treatment outcome ,MEDLINE ,medicine.disease ,Scleroderma ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Rheumatology ,Macrophage activation syndrome ,Immunology ,medicine ,business - Published
- 2017
13. Diabetic wound healing in a MMP9-/- mouse model
- Author
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Hongkwan, Cho, Swathi, Balaji, Natalie L, Hone, Chad M, Moles, Abdul Q, Sheikh, Timothy M, Crombleholme, Sundeep G, Keswani, and Daria A, Narmoneva
- Abstract
Reduced mobilization of endothelial progenitor cells (EPCs) from the bone marrow (BM) and impaired EPC recruitment into the wound represent a fundamental deficiency in the chronic ulcers. However, mechanistic understanding of the role of BM-derived EPCs in cutaneous wound neovascularization and healing remains incomplete, which impedes development of EPC-based wound healing therapies. The objective of this study was to determine the role of EPCs in wound neovascularization and healing both under normal conditions and using single deficiency (EPC) or double-deficiency (EPC + diabetes) models of wound healing. MMP9 knockout (MMP9 KO) mouse model was utilized, where impaired EPC mobilization can be rescued by stem cell factor (SCF). The hypotheses were: (1) MMP9 KO mice exhibit impaired wound neovascularization and healing, which are further exacerbated with diabetes; (2) these impairments can be rescued by SCF administration. Full-thickness excisional wounds with silicone splints to minimize contraction were created on MMP9 KO mice with/without streptozotocin-induced diabetes in the presence or absence of tail-vein injected SCF. Wound morphology, vascularization, inflammation, and EPC mobilization and recruitment were quantified at day 7 postwounding. Results demonstrate no difference in wound closure and granulation tissue area between any groups. MMP9 deficiency significantly impairs wound neovascularization, increases inflammation, decreases collagen deposition, and decreases peripheral blood EPC (pb-EPC) counts when compared with wild-type (WT). Diabetes further increases inflammation, but does not cause further impairment in vascularization, as compared with MMP9 KO group. SCF improves neovascularization and increases EPCs to WT levels (both nondiabetic and diabetic MMP9 KO groups), while exacerbating inflammation in all groups. SCF rescues EPC-deficiency and impaired wound neovascularization in both diabetic and nondiabetic MMP9 KO mice. Overall, the results demonstrate that BM-derived EPCs play a significant role during wound neovascularization and that the SCF-based therapy with controlled inflammation could be a viable approach to enhance healing in chronic diabetic wounds.
- Published
- 2015
14. Alluvial record of an early Eocene hyperthermal within the Castissent Formation, the Pyrenees, Spain
- Author
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L. Honegger, T. Adatte, J. E. Spangenberg, J. K. C. Rugenstein, M. Poyatos-Moré, C. Puigdefàbregas, E. Chanvry, J. Clark, A. Fildani, E. Verrechia, K. Kouzmanov, M. Harlaux, and S. Castelltort
- Subjects
Environmental pollution ,TD172-193.5 ,Environmental protection ,TD169-171.8 ,Environmental sciences ,GE1-350 - Abstract
The late Palaeocene to the middle Eocene (57.5 to 46.5 Ma) recorded a total of 39 hyperthermals – periods of rapid global warming documented by prominent negative carbon isotope excursions (CIEs) as well as peaks in iron content – have been recognized in marine cores. Documenting how the Earth system responded to rapid climatic shifts during hyperthermals provides fundamental information to constrain climatic models. However, while hyperthermals have been well documented in the marine sedimentary record, only a few have been recognized and described in continental deposits, thereby limiting our ability to understand the effect and record of global warming on terrestrial systems. Hyperthermals in the continental record could be a powerful correlation tool to help connect marine and continental deposits, addressing issues of environmental signal propagation from land to sea. In this study, we generate new stable carbon isotope data (δ13C values) across the well-exposed and time-constrained fluvial sedimentary succession of the early Eocene Castissent Formation in the south central Pyrenees (Spain). The δ13C values of pedogenic carbonate reveal – similarly to the global records – stepped CIEs, culminating in a minimum δ13C value that we correlate with the hyperthermal event “U” at ca. 50 Ma. This general trend towards more negative values is most probably linked to higher primary productivity leading to an overall higher respiration of soil organic matter during these climatic events. The relative enrichment in immobile elements (Zr, Ti, Al) and higher estimates of mean annual precipitation together with the occurrence of small iron oxide and iron hydroxide nodules during the CIEs suggest intensification of chemical weathering and/or longer exposure of soils in a highly seasonal climate. The results show that even relatively small-scale hyperthermals compared with their prominent counterparts, such as PETM, ETM2, and ETM3, can leave a recognizable signature in the terrestrial stratigraphic record, providing insights into the dynamics of the carbon cycle in continental environments during these events.
- Published
- 2020
- Full Text
- View/download PDF
15. OSTEOPOROSIS AND TREADMILL PERFORMANCE
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P. C. Birge, L. Hone, and J. R. Shepherd
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medicine.medical_specialty ,business.industry ,Osteoporosis ,Physical therapy ,medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,Treadmill ,medicine.disease ,business - Published
- 1999
16. 202 DOES DELAYED MUSCLE SORENESS AFFECT OXYGEN CONSUMPTION AND SELECTED GAIT PARAMETERS DURING RUNNING?
- Author
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L. Hone, W. Siler, and J. Schwane
- Subjects
Consumption (economics) ,medicine.medical_specialty ,Gait (human) ,chemistry ,business.industry ,Physical therapy ,Medicine ,chemistry.chemical_element ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,business ,Affect (psychology) ,Oxygen - Published
- 1990
17. Age independently affects myelin integrity as detected by magnetization transfer magnetic resonance imaging in multiple sclerosis
- Author
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R.D. Newbould, R. Nicholas, C.L. Thomas, R. Quest, J.S.Z. Lee, L. Honeyfield, A. Colasanti, O. Malik, M. Mattoscio, P.M. Matthews, M.P. Sormani, A.D. Waldman, and P.A. Muraro
- Subjects
Magnetization transfer ,MRI ,Multiple sclerosis ,Aging ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: Multiple sclerosis (MS) is a heterogeneous disorder with a progressive course that is difficult to predict on a case-by-case basis. Natural history studies of MS have demonstrated that age influences clinical progression independent of disease duration. Objective: To determine whether age would be associated with greater CNS injury as detected by magnetization transfer MRI. Materials and methods: Forty MS patients were recruited from out-patient clinics into two groups stratified by age but with similar clinical disease duration as well as thirteen controls age-matched to the older MS group. Images were segmented by automated programs and blinded readers into normal appearing white matter (NAWM), normal appearing gray matter (NAGM), and white matter lesions (WMLs) and gray matter lesions (GMLs) in the MS groups. WML and GML were delineated on T2-weighted 3D fluid-attenuated inversion recovery (FLAIR) and T1 weighted MRI volumes. Mean magnetization transfer ratio (MTR), region volume, as well as MTR histogram skew and kurtosis were calculated for each region. Results: All MTR measures in NAGM and MTR histogram metrics in NAWM differed between MS subjects and controls, as expected and previously reported by several studies, but not between MS groups. However, MTR measures in the WML did significantly differ between the MS groups, in spite of no significant differences in lesion counts and volumes. Conclusions: Despite matching for clinical disease duration and recording no significant WML volume difference, we demonstrated strong MTR differences in WMLs between younger and older MS patients. These data suggest that aging-related processes modify the tissue response to inflammatory injury and its clinical outcome correlates in MS.
- Published
- 2014
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18. Impact of rituximab treatment regime on time to relapse in aquaporin-4 antibody positive neuromyelitis optica spectrum disorder.
- Author
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Nasir M, Hone L, Tallantyre E, Kelly P, Leite MI, Robertson N, Bestwick J, Huda S, Palace J, and Dobson R
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- Humans, Female, Adult, Male, Retrospective Studies, Middle Aged, Autoantibodies blood, Young Adult, Neuromyelitis Optica drug therapy, Rituximab administration & dosage, Rituximab pharmacology, Rituximab adverse effects, Aquaporin 4 immunology, Recurrence, Immunologic Factors administration & dosage, Immunologic Factors pharmacology
- Abstract
Background: Aquaporin-4 (AQP4) antibody associated neuromyelitis optica (NMOSD) requires long-term immunosuppression. Rituximab is increasingly used worldwide, however the optimal regime is not established., Methods: We retrospectively examined different rituximab regimens in AQP4-NMOSD. Standard monotherapy (SM; 6 monthly infusions), SM plus oral steroids (SM+S), extended interval dosing (EID; guided by CD19 repopulation) and EID with oral steroids (EID+S) were compared. The primary outcome was time to first clinical relapse. Potential confounders including age, gender, number of previous relapses, and onset phenotype were included., Results: 77 patients were included: 67 females, median onset age 35.6, median DSS at rituximab initiation 5.0. 39 were on SM+S, 20 SM, 6 EID, and 12 EID+S. 25/77 patients relapsed during a median follow-up of 44.0 months. No significant difference in time to first relapse was observed between any rituximab regimen. Pooled analyses to compare regimens that use standard monotherapy (SM and SM+S) against those that use extended interval dosing (EID and EID+S) showed no significant difference. Pooled analysis of regimens using steroids with those not using steroids also showed no significant difference. Adjusted Cox proportional hazard model revealed no significant difference between rituximab regimens or influence of demographic factors. 9 significant adverse events were recorded, 5 in the SM group and 4 in SM+S., Conclusions: This study provides some basis for further exploring EID as a viable option for long term treatment of AQP4-NMOSD. This may improve patient experience and consolidate use of hospital resources., Competing Interests: Declaration of competing interest N/A., (Copyright © 2024. Published by Elsevier B.V.)
- Published
- 2024
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19. Age-specific effects of childhood body mass index on multiple sclerosis risk.
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Hone L, Jacobs BM, Marshall C, Giovannoni G, Noyce A, and Dobson R
- Subjects
- Age Factors, Body Mass Index, Child, Child, Preschool, Genome-Wide Association Study, Humans, Infant, Polymorphism, Single Nucleotide, Mendelian Randomization Analysis, Multiple Sclerosis epidemiology, Multiple Sclerosis genetics
- Abstract
Objective: Higher body mass index (BMI) during early life is thought to be a causal risk factor for multiple sclerosis (MS). We used longitudinal Mendelian randomisation (MR) to determine whether there is a critical window during which BMI influences MS risk., Methods: Summary statistics for childhood BMI (n ~ 28,000 children) and for MS susceptibility were obtained from recent large genome-wide association studies (GWAS) (n = 14,802 MS, 26,703 controls). We generated exposure instruments for BMI during four non-overlapping age epochs (< 3 months, 3 months-1.5 years, 2-5 years, and 7-8 years) and performed MR using the inverse variance weighted method with standard sensitivity analyses. Multivariable MR was used to account for effects mediated via later-life BMI., Results: For all age epochs other than birth, genetically determined higher BMI was associated with an increased liability to MS: Birth [Odds Ratio (OR) 0.81, 95% Confidence Interval (CI) 0.50-1.31, Number of Single-Nucleotide Polymorphisms (N
SNPs ) = 7, p = 0.39], Infancy (OR 1.18, 95% CI 1.04-1.33, NSNPs = 18, p = 0.01), Early childhood (OR 1.31, 95% CI 1.03-1.66, NSNPs = 4, p = 0.03), Later childhood (OR 1.34, 95% CI 1.08-1.66, NSNPs = 4, p = 0.01). Multivariable MR suggested that these effects may be mediated by effects on adult BMI., Conclusion: We provide evidence using MR that genetically determined higher BMI during early life is associated with increased MS risk. This effect may be driven by shared genetic architecture with later-life BMI., (© 2022. The Author(s).)- Published
- 2022
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20. 2022 update on the clinical outcome of coronavirus disease 2019 in haemato-oncology patients.
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Bradwell S, Hone L, Thorneycroft K, Lambourne J, Aries JA, Davies JK, Cutino-Moguel T, and Riches JC
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- Humans, COVID-19, Hematologic Neoplasms complications, Hematologic Neoplasms therapy, Neoplasms complications, Neoplasms therapy
- Published
- 2022
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21. Predicting Multiple Sclerosis: Challenges and Opportunities.
- Author
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Hone L, Giovannoni G, Dobson R, and Jacobs BM
- Abstract
Determining effective means of preventing Multiple Sclerosis (MS) relies on testing preventive strategies in trial populations. However, because of the low incidence of MS, demonstrating that a preventive measure has benefit requires either very large trial populations or an enriched population with a higher disease incidence. Risk scores which incorporate genetic and environmental data could be used, in principle, to identify high-risk individuals for enrolment in preventive trials. Here we discuss the concepts of developing predictive scores for identifying individuals at high risk of MS. We discuss the empirical efforts to do so using real cohorts, and some of the challenges-both theoretical and practical-limiting this work. We argue that such scores could offer a means of risk stratification for preventive trial design, but are unlikely to ever constitute a clinically-helpful approach to predicting MS for an individual., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hone, Giovannoni, Dobson and Jacobs.)
- Published
- 2022
- Full Text
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22. Development and internal validation of a diagnostic prediction model for COVID-19 at time of admission to hospital.
- Author
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Fink DL, Khan PY, Goldman N, Cai J, Hone L, Mooney C, El-Shakankery KH, Sismey G, Whitford V, Marks M, and Thomas S
- Subjects
- COVID-19 Testing, Hospitals, Humans, Retrospective Studies, SARS-CoV-2, COVID-19
- Abstract
Background: Early coronavirus disease 2019 (COVID-19) diagnosis prior to laboratory testing results is crucial for infection control in hospitals. Models exist predicting COVID-19 diagnosis, but significant concerns exist regarding methodology and generalizability., Aim: To generate the first COVID-19 diagnosis risk score for use at the time of hospital admission using the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) checklist., Design: A multivariable diagnostic prediction model for COVID-19 using the TRIPOD checklist applied to a large single-centre retrospective observational study of patients with suspected COVID-19., Methods: 581 individuals were admitted with suspected COVID-19; the majority had laboratory-confirmed COVID-19 (420/581, 72.2%). Retrospective collection was performed of electronic clinical records and pathology data., Results: The final multivariable model demonstrated AUC 0.8535 (95% confidence interval 0.8121-0.8950). The final model used six clinical variables that are routinely available in most low and high-resource settings. Using a cut-off of 2, the derived risk score has a sensitivity of 78.1% and specificity of 86.8%. At COVID-19 prevalence of 10% the model has a negative predictive value (NPV) of 96.5%., Conclusions: Our risk score is intended for diagnosis of COVID-19 in individuals admitted to hospital with suspected COVID-19. The score is the first developed for COVID-19 diagnosis using the TRIPOD checklist. It may be effective as a tool to rule out COVID-19 and function at different pandemic phases of variable COVID-19 prevalence. The simple score could be used by any healthcare worker to support hospital infection control prior to laboratory testing results., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
23. Improving outcomes in gestational diabetes: does gestational weight gain matter?
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Aiken CEM, Hone L, Murphy HR, and Meek CL
- Subjects
- Adult, Body Mass Index, Delivery, Obstetric statistics & numerical data, Diabetes, Gestational drug therapy, Female, Fetal Macrosomia etiology, Humans, Hypoglycemic Agents therapeutic use, Infant, Newborn, Infant, Small for Gestational Age, Insulin therapeutic use, Male, Maternal Age, Metformin therapeutic use, Pregnancy, Pregnancy Outcome, Pregnancy Trimesters, Prenatal Care methods, Retrospective Studies, Diabetes, Gestational physiopathology, Gestational Weight Gain physiology
- Abstract
Aim: Excessive gestational weight gain increases risk of gestational diabetes mellitus (GDM) but it remains unclear whether weight control after GDM diagnosis improves outcomes. We assessed whether: (1) total gestational weight gain during pregnancy (0-36 weeks); (2) early gestational weight gain (0-28 weeks, before GDM diagnosis); or (3) late gestational weight gain (28-36 weeks, after diagnosis) are associated with maternal-fetal outcomes., Methods: Some 546 women with GDM who delivered viable singleton infants at a single UK obstetric centre (October 2014 to March 2017) were included in this retrospective observational study., Results: Higher total gestational weight gain was associated with Caesarean section [n = 376; odds ratio (OR) 1.05; confidence intervals (CI) 1.02-1.08, P < 0.001] and large for gestational age (OR 1.08; CI 1.03-1.12, P < 0.001). Higher late gestational weight gain (28-36 weeks; n = 144) was associated with large for gestational age (OR 1.17; CI 1.01-1.37, P < 0.05), instrumental deliveries (OR 1.26; CI 1.03-1.55, P < 0.01), higher total daily insulin doses (36 weeks; beta coefficient 4.37; CI 1.92-6.82, P < 0.001), and higher post-partum 2-h oral glucose tolerance test concentrations (beta coefficient 0.12; CI 0.01-0.22, P < 0.05). Women who avoided substantial weight gain after GDM diagnosis had 0.7 mmol/l lower postnatal 2-h glucose and needed half the amount of insulin/day at 36 weeks compared with women with substantial weight gain after diagnosis. There were no significant associations between early gestational weight gain (0-28 weeks) and pregnancy outcomes., Conclusions: These findings suggest that controlling gestational weight gain should be a priority following GDM diagnosis to optimize pregnancy outcomes and improve maternal postnatal glucose homeostasis. The period after diagnosis of GDM (often 28 weeks gestation) is not too late to offer lifestyle advice or intervention to improve weight management and pregnancy outcomes., (© 2018 Diabetes UK.)
- Published
- 2019
- Full Text
- View/download PDF
24. Teaching of gynecological examinations: Medical student perspective.
- Author
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Carr O, Hone L, and McKane T
- Subjects
- Female, Humans, Informed Consent, Interpersonal Relations, Education, Medical, Undergraduate, Gynecology education, Students, Medical
- Published
- 2018
- Full Text
- View/download PDF
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