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1. Asthma innovations from the first International Collaborative Asthma Network forum

Author

Benjamin Gaston, Donna D. Gardner, Kenzie Mahan, Praveen Akuthota, Eneida A. Mendonca, Hannah Durrington, Nadzeya Marozkina, Rocio T. Martinez-Nunez, Dawn Newcomb, Benjamin Ainsworth, Arthur H. Owora, Kian Fan Chung, Samantha Walker, Stephen J. Fowler, Salman Siddiqui, Tonya Winders, Joe Zein, Nizar Jarjour, Yvonne J. Huang, Katherine N. Cahill, and Ratko Djukanovic

Subjects
Medicine
Abstract

Background Many patients have uncontrolled asthma despite available treatments. Most of the new asthma therapies have focused on type 2 (T2) inflammation, leaving an unmet need for innovative research into mechanisms of asthma beyond T2 and immunity. An international group of investigators developed the International Collaborative Asthma Network (ICAN) with the goal of sharing innovative research on disease mechanisms, developing new technologies and therapies, organising pilot studies and engaging early-stage career investigators from across the world. This report describes the purpose, development and outcomes of the first ICAN forum. Methods Abstracts were solicited from interdisciplinary early-stage career investigators with innovative ideas beyond T2 inflammation for asthma and were selected for presentation at the forum. Breakout sessions were conducted to discuss innovation, collaboration and research translation. Results The abstracts were categorised into: 1) general omics and big data analysis; 2) lung–brain axis and airway neurology; 3) sex differences; 4) paediatric asthma; 5) new therapeutic targets inspired by airway epithelial biology; 6) new therapeutics targeting airway and circulating immune mediators; and 7) lung anatomy, physiology and imaging. Discussions revealed that research groups are looking for opportunities to further their findings using larger scale collaboration and the ability to translate their in vitro findings into clinical treatment. Conclusions Through ICAN, teams that included interdisciplinary early-stage career investigators discussed innovation, collaboration and translation in asthma and severe asthma research. With a combination of fresh ideas and energetic, collaborative, global participation, ICAN has laid a firm foundation and model for future collaborative global asthma research.

Published
2023
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2. Characteristics and risk factors for post-COVID-19 breathlessness after hospitalisation for COVID-19

Author

Luke Daines, Bang Zheng, Omer Elneima, Ewen Harrison, Nazir I. Lone, John R. Hurst, Jeremy S. Brown, Elizabeth Sapey, James D. Chalmers, Jennifer K. Quint, Paul Pfeffer, Salman Siddiqui, Samantha Walker, Krisnah Poinasamy, Hamish McAuley, Marco Sereno, Aarti Shikotra, Amisha Singapuri, Annemarie B. Docherty, Michael Marks, Mark Toshner, Luke S. Howard, Alex Horsley, Gisli Jenkins, Joanna C. Porter, Ling-Pei Ho, Betty Raman, Louise V. Wain, Christopher E. Brightling, Rachael A. Evans, Liam G. Heaney, Anthony De Soyza, and Aziz Sheikh

Subjects
Medicine
Abstract

Background Persistence of respiratory symptoms, particularly breathlessness, after acute coronavirus disease 2019 (COVID-19) infection has emerged as a significant clinical problem. We aimed to characterise and identify risk factors for patients with persistent breathlessness following COVID-19 hospitalisation. Methods PHOSP-COVID is a multicentre prospective cohort study of UK adults hospitalised for COVID-19. Clinical data were collected during hospitalisation and at a follow-up visit. Breathlessness was measured by a numeric rating scale of 0–10. We defined post-COVID-19 breathlessness as an increase in score of ≥1 compared to the pre-COVID-19 level. Multivariable logistic regression was used to identify risk factors and to develop a prediction model for post-COVID-19 breathlessness. Results We included 1226 participants (37% female, median age 59 years, 22% mechanically ventilated). At a median 5 months after discharge, 50% reported post-COVID-19 breathlessness. Risk factors for post-COVID-19 breathlessness were socioeconomic deprivation (adjusted OR 1.67, 95% CI 1.14–2.44), pre-existing depression/anxiety (adjusted OR 1.58, 95% CI 1.06–2.35), female sex (adjusted OR 1.56, 95% CI 1.21–2.00) and admission duration (adjusted OR 1.01, 95% CI 1.00–1.02). Black ethnicity (adjusted OR 0.56, 95% CI 0.35–0.89) and older age groups (adjusted OR 0.31, 95% CI 0.14–0.66) were less likely to report post-COVID-19 breathlessness. Post-COVID-19 breathlessness was associated with worse performance on the shuttle walk test and forced vital capacity, but not with obstructive airflow limitation. The prediction model had fair discrimination (concordance statistic 0.66, 95% CI 0.63–0.69) and good calibration (calibration slope 1.00, 95% CI 0.80–1.21). Conclusions Post-COVID-19 breathlessness was commonly reported in this national cohort of patients hospitalised for COVID-19 and is likely to be a multifactorial problem with physical and emotional components.

Published
2023
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3. Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis

Author

Bang Zheng, Luke Daines, Qing Han, John R. Hurst, Paul Pfeffer, Manu Shankar-Hari, Omer Elneima, Samantha Walker, Jeremy S. Brown, Salman Siddiqui, Jennifer K. Quint, Christopher E. Brightling, Rachael A. Evans, Louise V. Wain, Liam G. Heaney, and Aziz Sheikh

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Persistent breathlessness >28 days after acute COVID-19 infection has been identified as a highly debilitating post-COVID symptom. However, the prevalence, risk factors, mechanisms and treatments for post-COVID breathlessness remain poorly understood. We systematically searched PubMed and Embase for relevant studies published from 1 January 2020 to 1 November 2021 (PROSPERO registration number: CRD42021285733) and included 119 eligible papers. Random-effects meta-analysis of 42 872 patients with COVID-19 reported in 102 papers found an overall prevalence of post-COVID breathlessness of 26% (95% CI 23–29) when measuring the presence/absence of the symptom, and 41% (95% CI 34–48) when using Medical Research Council (MRC)/modified MRC dyspnoea scale. The pooled prevalence decreased significantly from 1–6 months to 7–12 months post-infection. Post-COVID breathlessness was more common in those with severe/critical acute infection, those who were hospitalised and females, and was less likely to be reported by patients in Asia than those in Europe or North America. Multiple pathophysiological mechanisms have been proposed (including deconditioning, restrictive/obstructive airflow limitation, systemic inflammation, impaired mental health), but the body of evidence remains inconclusive. Seven cohort studies and one randomised controlled trial suggested rehabilitation exercises may reduce post-COVID breathlessness. There is an urgent need for mechanistic research and development of interventions for the prevention and treatment of post-COVID breathlessness.

Published
2022
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5. Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Author

J. Jean Bousquet, Holger J. Schünemann, Alkis Togias, Marina Erhola, Peter W. Hellings, Torsten Zuberbier, Ioana Agache, Ignacio J. Ansotegui, Josep M. Anto, Claus Bachert, Sven Becker, Martin Bedolla-Barajas, Michael Bewick, Sinthia Bosnic-Anticevich, Isabelle Bosse, Louis P. Boulet, Jean Marc Bourrez, Guy Brusselle, Niels Chavannes, Elisio Costa, Alvaro A. Cruz, Wienczyslawa Czarlewski, Wytske J. Fokkens, Joao A. Fonseca, Mina Gaga, Tari Haahtela, Maddalena Illario, Ludger Klimek, Piotr Kuna, Violeta Kvedariene, L. T. T. Le, Desiree Larenas-Linnemann, Daniel Laune, Olga M. Lourenço, Enrica Menditto, Joaquin Mullol, Yashitaka Okamoto, Nikos Papadopoulos, Nhân Pham-Thi, Robert Picard, Hilary Pinnock, Nicolas Roche, Regina E. Roller-Wirnsberger, Christine Rolland, Boleslaw Samolinski, Aziz Sheikh, Sanna Toppila-Salmi, Ioanna Tsiligianni, Arunas Valiulis, Erkka Valovirta, Tuula Vasankari, Maria-Teresa Ventura, Samantha Walker, Sian Williams, Cezmi A. Akdis, Isabella Annesi-Maesano, Sylvie Arnavielhe, Xavier Basagana, Eric Bateman, Anna Bedbrook, K. S. Bennoor, Samuel Benveniste, Karl C. Bergmann, Slawomir Bialek, Nils Billo, Carsten Bindslev-Jensen, Leif Bjermer, Hubert Blain, Mateo Bonini, Philippe Bonniaud, Jacques Bouchard, Vitalis Briedis, Christofer E. Brightling, Jan Brozek, Roland Buhl, Roland Buonaiuto, Giorgo W. Canonica, Victoria Cardona, Ana M. Carriazo, Warner Carr, Christine Cartier, Thomas Casale, Lorenzo Cecchi, Alfonso M. Cepeda Sarabia, Eka Chkhartishvili, Derek K. Chu, Cemal Cingi, Elaine Colgan, Jaime Correia de Sousa, Anne Lise Courbis, Adnan Custovic, Biljana Cvetkosvki, Gennaro D’Amato, Jane da Silva, Carina Dantas, Dejand Dokic, Yves Dauvilliers, Antoni Dedeu, Giulia De Feo, Philippe Devillier, Stefania Di Capua, Marc Dykewickz, Ruta Dubakiene, Motohiro Ebisawa, Yaya El-Gamal, Esben Eller, Regina Emuzyte, John Farrell, Antjie Fink-Wagner, Alessandro Fiocchi, Jean F. Fontaine, Bilun Gemicioğlu, Peter Schmid-Grendelmeir, Amiran Gamkrelidze, Judith Garcia-Aymerich, Maximiliano Gomez, Sandra González Diaz, Maia Gotua, Nick A. Guldemond, Maria-Antonieta Guzmán, Jawad Hajjam, John O’B Hourihane, Marc Humbert, Guido Iaccarino, Despo Ierodiakonou, Juan C. Ivancevich, Guy Joos, Ki-Suck Jung, Marek Jutel, Igor Kaidashev, Omer Kalayci, Przemyslaw Kardas, Thomas Keil, Mussa Khaitov, Nikolai Khaltaev, Jorg Kleine-Tebbe, Marek L. Kowalski, Vicky Kritikos, Inger Kull, Lisa Leonardini, Philip Lieberman, Brian Lipworth, Karin C. Lodrup Carlsen, Claudia C. Loureiro, Renaud Louis, Alpana Mair, Gert Marien, Bassam Mahboub, Joao Malva, Patrick Manning, Esteban De Manuel Keenoy, Gailen D. Marshall, Mohamed R. Masjedi, Jorge F. Maspero, Eve Mathieu-Dupas, Poalo M. Matricardi, Eric Melén, Elisabete Melo-Gomes, Eli O. Meltzer, Jacques Mercier, Neven Miculinic, Florin Mihaltan, Branislava Milenkovic, Giuliana Moda, Maria-Dolores Mogica-Martinez, Yousser Mohammad, Steve Montefort, Ricardo Monti, Mario Morais-Almeida, Ralf Mösges, Lars Münter, Antonella Muraro, Ruth Murray, Robert Naclerio, Luigi Napoli, Leila Namazova-Baranova, Hugo Neffen, Kristoff Nekam, Angelo Neou, Enrico Novellino, Dieudonné Nyembue, Robin O’Hehir, Ken Ohta, Kimi Okubo, Gabrielle Onorato, Solange Ouedraogo, Isabella Pali-Schöll, Susanna Palkonen, Peter Panzner, Hae-Sim Park, Jean-Louis Pépin, Ana-Maria Pereira, Oliver Pfaar, Ema Paulino, Jim Phillips, Davor Plavec, Ted A. Popov, Fabienne Portejoie, David Price, Emmanuel P. Prokopakis, Benoit Pugin, Filip Raciborski, Rojin Rajabian-Söderlund, Sietze Reitsma, Xavier Rodo, Antonino Romano, Nelson Rosario, Menahenm Rottem, Dermot Ryan, Johanna Salimäki, Mario M. Sanchez-Borges, Juan-Carlos Sisul, Dirceu Solé, David Somekh, Talant Sooronbaev, Milan Sova, Otto Spranger, Cristina Stellato, Rafael Stelmach, Charlotte Suppli Ulrik, Michel Thibaudon, Teresa To, Ana Todo-Bom, Peter V. Tomazic, Antonio A. Valero, Rudolph Valenta, Marylin Valentin-Rostan, Rianne van der Kleij, Olivier Vandenplas, Giorgio Vezzani, Frédéric Viart, Giovanni Viegi, Dana Wallace, Martin Wagenmann, De Y. Wang, Susan Waserman, Magnus Wickman, Dennis M. Williams, Gary Wong, Piotr Wroczynski, Panayiotis K. Yiallouros, Arzu Yorgancioglu, Osman M. Yusuf, Heahter J. Zar, Stéphane Zeng, Mario Zernotti, Luo Zhang, Nan S. Zhong, Mihaela Zidarn, the ARIA Study Group, and the MASK Study Group

Subjects
Health care transformation, Care pathways, Rhinitis, ARIA, MASK, POLLAR, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

Published
2019
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6. The Simons Observatory: Galactic Science Goals and Forecasts

Author

Brandon S. Hensley, Susan E. Clark, Valentina Fanfani, Nicoletta Krachmalnicoff, Giulio Fabbian, Davide Poletti, Giuseppe Puglisi, Gabriele Coppi, Jacob Nibauer, Roman Gerasimov, Nicholas Galitzki, Steve K. Choi, Peter C. Ashton, Carlo Baccigalupi, Eric Baxter, Blakesley Burkhart, Erminia Calabrese, Jens Chluba, Josquin Errard, Andrei V. Frolov, Carlos Hervías-Caimapo, Kevin M. Huffenberger, Bradley R. Johnson, Baptiste Jost, Brian Keating, Heather McCarrick, Federico Nati, Mayuri Sathyanarayana Rao, Alexander van Engelen, Samantha Walker, Kevin Wolz, Zhilei Xu, Ningfeng Zhu, and Andrea Zonca

Subjects
Interstellar medium, Interstellar magnetic fields, Interstellar molecules, Interstellar dust, Polarimetry, Interstellar synchrotron emission, Astrophysics, QB460-466
Abstract

Observing in six frequency bands from 27 to 280 GHz over a large sky area, the Simons Observatory (SO) is poised to address many questions in Galactic astrophysics in addition to its principal cosmological goals. In this work, we provide quantitative forecasts on astrophysical parameters of interest for a range of Galactic science cases. We find that SO can: constrain the frequency spectrum of polarized dust emission at a level of Δ β _d ≲ 0.01 and thus test models of dust composition that predict that β _d in polarization differs from that measured in total intensity; measure the correlation coefficient between polarized dust and synchrotron emission with a factor of two greater precision than current constraints; exclude the nonexistence of exo-Oort clouds at roughly 2.9 σ if the true fraction is similar to the detection rate of giant planets; map more than 850 molecular clouds with at least 50 independent polarization measurements at 1 pc resolution; detect or place upper limits on the polarization fractions of CO(2–1) emission and anomalous microwave emission at the 0.1% level in select regions; and measure the correlation coefficient between optical starlight polarization and microwave polarized dust emission in 1° patches for all lines of sight with N _H ≳ 2 × 10 ^20 cm ^−2 . The goals and forecasts outlined here provide a roadmap for other microwave polarization experiments to expand their scientific scope via Milky Way astrophysics. ^37

Published
2022
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7. Individual health trainers to support health and well-being for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT

Author

Lynne Callaghan, Tom P Thompson, Siobhan Creanor, Cath Quinn, Jane Senior, Colin Green, Annie Hawton, Richard Byng, Gary Wallace, Julia Sinclair, Amy Kane, Emma Hazeldine, Samantha Walker, Rebecca Crook, Verity Wainwright, Doyo Gragn Enki, Ben Jones, Elizabeth Goodwin, Lucy Cartwright, Jane Horrell, Jenny Shaw, Jill Annison, and Adrian H Taylor

Subjects
health trainers, criminal justice system, offender health, health behaviour change, well-being, Public aspects of medicine, RA1-1270
Abstract

Background: Little is known about the effectiveness or cost-effectiveness of interventions, such as health trainer support, to improve the health and well-being of people recently released from prison or serving a community sentence, because of the challenges in recruiting participants and following them up. Objectives: This pilot trial aimed to assess the acceptability and feasibility of the trial methods and intervention (and associated costs) for a randomised trial to assess the effectiveness and cost-effectiveness of health trainer support versus usual care. Design: This trial involved a pilot multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1 : 1 individual allocation to receive support from a health trainer and usual care or usual care alone, with a mixed-methods process evaluation, in 2017–18. Setting: Participants were identified, screened and recruited in Community Rehabilitation Companies in Plymouth and Manchester or the National Probation Service in Plymouth. The intervention was delivered in the community. Participants: Those who had been out of prison for at least 2 months (to allow community stabilisation), with at least 7 months of a community sentence remaining, were invited to participate; those who may have posed an unacceptable risk to the researchers and health trainers and those who were not interested in the trial or intervention support were excluded. Interventions: The intervention group received, in addition to usual care, our person-centred health trainer support in one-to-one sessions for up to 14 weeks, either in person or via telephone. Health trainers aimed to empower participants to make healthy lifestyle changes (particularly in alcohol use, smoking, diet and physical activity) and take on the Five Ways to Well-being [Foresight Projects. Mental Capital and Wellbeing: Final Project Report. 2008. URL: www.gov.uk/government/publications/mental-capital-and-wellbeing-making-the-most-of-ourselves-in-the-21st-century (accessed 24 January 2019).], and also signposted to other options for support. The control group received treatment as usual, defined by available community and public service options for improving health and well-being. Main outcome measures: The main outcomes included the Warwick–Edinburgh Mental Well-being Scale scores, alcohol use, smoking behaviour, dietary behaviour, physical activity, substance use, resource use, quality of life, intervention costs, intervention engagement and feasibility and acceptability of trial methods and the intervention. Results: A great deal about recruitment was learned and the target of 120 participants was achieved. The minimum trial retention target at 6 months (60%) was met. Among those offered health trainer support, 62% had at least two sessions. The mixed-methods process evaluation generally supported the trial methods and intervention acceptability and feasibility. The proposed primary outcome, the Warwick–Edinburgh Mental Well-being Scale scores, provided us with valuable data to estimate the sample size for a full trial in which to test the effectiveness and cost-effectiveness of the intervention. Conclusions: Based on the findings from this pilot trial, a full trial (with some modifications) seems justified, with a sample size of around 900 participants to detect between-group differences in the Warwick-Edinburgh Mental Well-being Scale scores at a 6-month follow-up. Future work: A number of recruitment, trial retention, intervention engagement and blinding issues were identified in this pilot and recommendations are made in preparation of and within a full trial. Trial registration: Current Controlled Trials ISRCTN80475744. Funding: This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 20. See the National Institute for Health Research Journals Library website for further project information.

Published
2019
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8. A randomised pragmatic trial of corticosteroid optimization in severe asthma using a composite biomarker algorithm to adjust corticosteroid dose versus standard care: study protocol for a randomised trial

Author

Catherine E. Hanratty, John G. Matthews, Joseph R. Arron, David F. Choy, Ian D. Pavord, P. Bradding, Christopher E. Brightling, Rekha Chaudhuri, Douglas C. Cowan, Ratko Djukanovic, Nicola Gallagher, Stephen J. Fowler, Tim C. Hardman, Tim Harrison, Cécile T. Holweg, Peter H. Howarth, James Lordan, Adel H. Mansur, Andrew Menzies-Gow, Sofia Mosesova, Robert M. Niven, Douglas S. Robinson, Dominick E. Shaw, Samantha Walker, Ashley Woodcock, Liam G. Heaney, and on behalf of the RASP-UK (Refractory Asthma Stratification Programme) Consortium

Subjects
Asthma, Biomarkers, Corticosteroids, Steroid titration, T2-low, Personalized medicine, Medicine (General), R5-920
Abstract

Abstract Background Patients with difficult-to-control asthma consume 50–60% of healthcare costs attributed to asthma and cost approximately five-times more than patients with mild stable disease. Recent evidence demonstrates that not all patients with asthma have a typical type 2 (T2)-driven eosinophilic inflammation. These asthmatics have been called ‘T2-low asthma’ and have a minimal response to corticosteroid therapy. Adjustment of corticosteroid treatment using sputum eosinophil counts from induced sputum has demonstrated reduced severe exacerbation rates and optimized corticosteroid dose. However, it has been challenging to move induced sputum into the clinical setting. There is therefore a need to examine novel algorithms to target appropriate levels of corticosteroid treatment in difficult asthma, particularly in T2-low asthmatics. This study examines whether a composite non-invasive biomarker algorithm predicts exacerbation risk in patients with asthma on high-dose inhaled corticosteroids (ICS) (± long-acting beta agonist) treatment, and evaluates the utility of this composite score to facilitate personalized biomarker-specific titration of corticosteroid therapy. Methods/design Patients recruited to this pragmatic, multi-centre, single-blinded randomised controlled trial are randomly allocated into either a biomarker controlled treatment advisory algorithm or usual care group in a ratio of 4:1. The primary outcome measure is the proportion of patients with any reduction in ICS or oral corticosteroid dose from baseline to week 48. Secondary outcomes include the rate of protocol-defined severe exacerbations per patient per year, time to first severe exacerbation from randomisation, dose of inhaled steroid at the end of the study, cumulative dose of inhaled corticosteroid during the study, proportion of patients on oral corticosteroids at the end of the study, proportion of patients who decline to progress to oral corticosteroids despite composite biomarker score of 2, frequency of hospital admission for asthma, change in the 7-item Asthma Control Questionnaire (ACQ-7), Asthma Quality of Life Questionnaire (AQLQ), forced expiratory volume in 1 s (FEV1), exhaled nitric oxide, blood eosinophil count, and periostin levels from baseline to week 48. Blood will also be taken for whole blood gene expression; serum, plasma, and urine will be stored for validation of additional biomarkers. Discussion Multi-centre trials present numerous logistical issues that have been addressed to ensure minimal bias and robustness of study conduct. Trial registration ClinicalTrials.gov, NCT02717689 . Registered on 16 March 2016.

Published
2018
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9. Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST

Author

Tricia McKeever, Kevin Mortimer, Lucy Bradshaw, Rebecca Haydock, Ian Pavord, Bernard Higgins, Samantha Walker, Andrew Wilson, David Price, Mike Thomas, Graham Devereux, Christopher Brightling, Charlotte Renwick, Steve Parrott, Eleanor Mitchell, Lelia Duley, and Tim Harrison

Subjects
asthma, exacerbation, self-management plan, inhaled corticosteroids, oral steroids, randomised controlled trial, four-fold, primary care, Medical technology, R855-855.5
Abstract

Background: Asthma exacerbations affect the quality of life of patients with asthma and have a major effect on the overall costs of asthma care. An asthma self-management plan that advises the temporary quadrupling of inhaled corticosteroid dose may prevent asthma exacerbations, but this needs to be confirmed before being adopted widely. Objectives: To compare the clinical effectiveness and cost-effectiveness of an asthma self-management plan that advises patients to temporarily quadruple the dose of inhaled corticosteroid when asthma control starts to deteriorate with a standard self-management plan. Design: A multicentre, parallel-group, pragmatic randomised trial, with follow-up for 12 months. Setting: Primary and secondary care across 207 sites in the UK. Participants: Asthma patients aged ≥ 16 years treated with an inhaled corticosteroid who had experienced at least one exacerbation in the previous 12 months. Interventions: Participants were randomised (1 : 1) to a usual-care self-management plan or to a modified self-management plan that advised a temporary quadrupling of the inhaled corticosteroid at the point of asthma deterioration, both of which were actively implemented and supported by local research staff. Primary outcome: The primary outcome of ‘time to first asthma exacerbation’ was defined as the need for systemic corticosteroids (for at least 3 consecutive days) and/or unscheduled health-care consultations for asthma (i.e. reaching zone 3 or 4 of the Asthma UK self-management plan). Results: A total of 1922 participants were randomised: the primary analysis included 938 participants (97%) in the usual-care group and 933 participants (97%) in the modified self-management group. The number of participants having at least one exacerbation of asthma in the year after randomisation was 484 (51.6%) in the usual-care group and 420 (45.0%) in the modified self-management group [adjusted hazard ratio 0.81, 95% confidence interval (CI) 0.71 to 0.92; p = 0.002]. There were fewer serious adverse events reported in the modified self-management group than in the usual-care group (11 vs. 32, respectively). Eight and six events of pneumonia, lower respiratory tract infections or influenza were reported in the usual-care group and the modified self-management group, respectively. Health-care-related costs were lower in the modified self-management group. The modified self-management group was £24 (bootstrapped 95% CI –£122 to £71) less costly than usual care, with a greater quality-adjusted life-year gain of 0.02 (bootstrapped 95% CI –0.005 to 0.04). Therefore, the modified self-management group was ‘dominant’, with a 94–95% probability of being cost-effective at the £20,000–30,000 threshold. Limitations: As the Fourfold Asthma STudy (FAST) was an open-label pragmatic trial, the possibility of treatment bias that may have affected the participants in the modified self-management group cannot be ruled out. Poorer than expected completion of participant diary cards, particularly within the usual-care self-management group, could have led to a null bias, underestimating the true effect of the intervention. Conclusions: An asthma self-management plan that advises patients to temporarily quadruple their dose of inhaled corticosteroid at the point of asthma symptoms worsening does reduce clinically important asthma exacerbations. In addition, the plan is cost-effective compared with the usual-care self-management plan. Future work: To effectively implement asthma self-management plans that advise a temporary quadrupling of inhaled steroid at asthma deterioration into routine practice. Trial registration: Current Controlled Trials ISRCTN15441965. Funding: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 70. See the NIHR Journals Library website for further project information.

Published
2018
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10. National and regional asthma programmes in Europe

Author

Olof Selroos, Maciej Kupczyk, Piotr Kuna, Piotr Łacwik, Jean Bousquet, David Brennan, Susanna Palkonen, Javier Contreras, Mark FitzGerald, Gunilla Hedlin, Sebastian L. Johnston, Renaud Louis, Leanne Metcalf, Samantha Walker, Antonio Moreno-Galdó, Nikolaos G. Papadopoulos, José Rosado-Pinto, Pippa Powell, and Tari Haahtela

Subjects
Diseases of the respiratory system, RC705-779
Abstract

This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.

Published
2015
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11. Multiplex Assay for Simultaneous Detection of Mycoplasma genitalium and Macrolide Resistance Using PlexZyme and PlexPrime Technology.

Author

Sepehr N Tabrizi, Lit Y Tan, Samantha Walker, Jimmy Twin, Marin Poljak, Catriona S Bradshaw, Christopher K Fairley, Melanie Bissessor, Elisa Mokany, Alison V Todd, and Suzanne M Garland

Subjects
Medicine, Science
Abstract

Mycoplasma genitalium is a cause of non-gonoccocal urethritis (NGU) in men and cervicitis and pelvic inflammatory disease in women. Recent international data also indicated that the first line treatment, 1 gram stat azithromycin therapy, for M. genitalium is becoming less effective, with the corresponding emergence of macrolide resistant strains. Increasing failure rates of azithromycin for M. genitalium has significant implications for the presumptive treatment of NGU and international clinical treatment guidelines. Assays able to predict macrolide resistance along with detection of M. genitalium will be useful to enable appropriate selection of antimicrobials to which the organism is susceptible and facilitate high levels of rapid cure. One such assay recently developed is the MG 23S assay, which employs novel PlexZyme™ and PlexPrime™ technology. It is a multiplex assay for detection of M. genitalium and 5 mutations associated with macrolide resistance. The assay was evaluated in 400 samples from 254 (186 males and 68 females) consecutively infected participants, undergoing tests of cure. Using the MG 23S assay, 83% (331/440) of samples were positive, with 56% of positives carrying a macrolide resistance mutation. Comparison of the MG 23S assay to a reference qPCR method for M. genitalium detection and high resolution melt analysis (HRMA) and sequencing for detection of macrolide resistance mutations, resulted in a sensitivity and specificity for M. genitalium detection and for macrolide resistance of 99.1/98.5% and 97.4/100%, respectively. The MG 23S assay provides a considerable advantage in clinical settings through combined diagnosis and detection of macrolide resistance.

Published
2016
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13. Residual Lung Abnormalities after COVID-19 Hospitalization: Interim Analysis of the UKILD Post–COVID-19 Study

Author

Iain Stewart, Joseph Jacob, Peter M. George, Philip L. Molyneaux, Joanna C. Porter, Richard J. Allen, Shahab Aslani, J. Kenneth Baillie, Shaney L. Barratt, Paul Beirne, Stephen M. Bianchi, John F. Blaikley, James D. Chalmers, Rachel C. Chambers, Nazia Chadhuri, Christopher Coleman, Guilhem Collier, Emma K. Denneny, Annemarie Docherty, Omer Elneima, Rachael A. Evans, Laura Fabbri, Michael A. Gibbons, Fergus V. Gleeson, Bibek Gooptu, Neil J. Greening, Beatriz Guillen Guio, Ian P. Hall, Neil A. Hanley, Victoria Harris, Ewen M. Harrison, Melissa Heightman, Toby E. Hillman, Alex Horsley, Linzy Houchen-Wolloff, Ian Jarrold, Simon R. Johnson, Mark G. Jones, Fasihul Khan, Rod Lawson, Olivia Leavy, Nazir Lone, Michael Marks, Hamish McAuley, Puja Mehta, Dhruv Parekh, Karen Piper Hanley, Manuela Platé, John Pearl, Krisnah Poinasamy, Jennifer K. Quint, Betty Raman, Matthew Richardson, Pilar Rivera-Ortega, Laura Saunders, Ruth Saunders, Malcolm G. Semple, Marco Sereno, Aarti Shikotra, A. John Simpson, Amisha Singapuri, David J. F. Smith, Mark Spears, Lisa G. Spencer, Stefan Stanel, David R. Thickett, A. A. Roger Thompson, Mathew Thorpe, Simon L. F. Walsh, Samantha Walker, Nicholas David Weatherley, Mark E. Weeks, Jim M. Wild, Dan G. Wootton, Chris E. Brightling, Ling-Pei Ho, Louise V. Wain, and Gisli R. Jenkins

Subjects
Pulmonary and Respiratory Medicine, Critical Care and Intensive Care Medicine
Published
2023

14. Exacerbation Profile and Risk Factors in a Type-2–Low Enriched Severe Asthma Cohort: A Clinical Trial to Assess Asthma Exacerbation Phenotypes

Author

P. Jane McDowell, John Busby, Catherine E. Hanratty, Ratko Djukanovic, Ashley Woodcock, Samantha Walker, Timothy Colin Hardman, Joseph R. Arron, David F. Choy, Peter Bradding, Chris E. Brightling, Rekha Chaudhuri, Douglas Cowan, Adel H. Mansur, Stephen J. Fowler, Sarah E. Diver, Peter Howarth, James Lordan, Andrew Menzies-Gow, Timothy Harrison, Douglas S. Robinson, Cecile T. J. Holweg, John G. Matthews, Ian D. Pavord, and Liam G. Heaney

Subjects
Male, Pulmonary and Respiratory Medicine, Phenotype, Adrenal Cortex Hormones, Risk Factors, Disease Progression, Humans, Female, Anti-Asthmatic Agents, Original Articles, Critical Care and Intensive Care Medicine, Biomarkers, Asthma
Abstract

Rationale: The past 25 years have seen huge progress in understanding of the pathobiology of type-2 (T2) asthma, identification of measurable biomarkers, and the emergence of novel monoclonal antibody treatments. Although present in a minority of patients with severe asthma, very little is known about the mechanisms underlying T2-low asthma, making it a significant unmet need in asthma research. Objectives: The objective of this study was to explore the differences between study exacerbators and nonexacerbators, to describe physiological changes at exacerbation in those who are T2 HIGH and T2 LOW at the time of exacerbation, and to evaluate the stability of inflammatory phenotypes when stable and at exacerbation. Methods: Exacerbation assessment was a prespecified secondary analysis of data from a 48-week, multicenter, randomized controlled clinical study comparing the use of biomarkers and symptoms to adjust steroid treatment in a T2-low severe asthma-enriched cohort. Participants were phenotyped as T2 LOW (fractional exhaled nitric oxide < 20 ppb and blood eosinophil count < 150 cells/ml) or T2 HIGH (fractional exhaled nitric oxide. 20 or blood eosinophil count. 150) at study enrollment and at each exacerbation. Here, we report the findings of the exacerbation analyses, including comparison of exacerbators and nonexacerbators, the physiological changes at exacerbation in those who had evidence of T2 biology at exacerbation versus those that did not, and the stability of inflammatory phenotypes when stable and at exacerbation.Measurements and Main Results: Of the 301 participants, 60.8% (183) had one or more self-reported exacerbations (total of 390). Exacerbators were more likely to be female, have a higher body mass index, and have more exacerbations requiring oral corticosteroid and unscheduled primary care attendances for exacerbations. At enrollment, 23.6% (71) were T2 LOW and 76.4% (230) T2 HIGH. The T2 LOW group had more asthma primary care attendances, were more likely to have a previous admission to HDU (high dependency unit)/ICU and to be receiving maintenance oral corticosteroids. At exacerbation, the T2 LOW events were indistinguishable from T2 HIGH exacerbations in terms of lung function (mean fall in T2 LOW FEV 1, 200 [400] ml vs. T2 HIGH 200 [300] ml; P = 0.93) and symptom increase (ACQ5: T2 LOW, 1.4 [0.8] vs. T2 HIGH, 1.3 [0.8]; P = 0.72), with no increase in T2 biomarkers from stable to exacerbation state in the T2 LOW exacerbations. The inflammatory phenotype within individual patients was dynamic; inflammatory phenotype at study entry did not have a significant association with exacerbation phenotype. Conclusions: Asthma exacerbations demonstrating a T2 LOW phenotype were physiologically and symptomatically similar to T2 HIGH exacerbations. T2 LOW asthma was an unstable phenotype, suggesting that exacerbation phenotyping should occur at the time of exacerbation. The clinically significant exacerbations in participants without evidence of T2 biology at the time of exacerbation highlight the unmet and pressing need to further understand the mechanisms at play in non-T2 asthma.

Published
2022

15. MiR-433-3p Inhibition Alleviates Increased Endothelial Cell Permeability in Diabetes

Author

Anita Kovacs-Kasa, Samantha Walker, Murat Koseoglu, and Annex Brian

Subjects
Physiology
Abstract

Hypothesis: miR-433-3p is a potential therapeutic target to reduce the excess endothelial permeability seen in peripheral skeletal muscle of diabetes. Background: Peripheral arterial disease (PAD) is a complication of systemic atherosclerosis that results from occlusions in the large arteries of the leg(s). Though best known as a large vessel disease, patients with PAD also have microvascular disease including excess vascular permeability. Patients with diabetes have an increased risk to develop PAD and more severe symptoms compared to nondiabetic patients with PAD patients. MicroRNAs (miRNAs) are a class of small, non-coding RNAs that modulate gene expression by targeting mRNA post-transcriptionally. Methods: Age-, sex-, and risk factor-controlled plasma samples were selected from a PAD biobank. Plasma samples from non-PAD controls, patients with intermittent claudication (IC), or with critical limb ischemia (CLI), with or without diabetes, were selected and miR-433-3p expression was assessed by RT-qPCR. MiR-433-3p expression was analyzed in human ECs after high glucose (HG) (25 mM) or osmolar control (25 mM Mannitol) treatment under normoxia or hypoxia-serum starvation. ECs were also treated with miR-433 inhibitor or negative control. Endothelial vascular permeability, angiogenesis, and cell viability/survival were tested. Vascular permeability by Evans Blue Dye (EBD) was measured in High Fat Diet (HFD) mice versus C57BL/6 mice treated with 100 μM hind-limb, intramuscular injections of miR-433-3p inhibitor, or scramble. Results: Plasma levels of miR-433-3p were elevated in CLI patients with diabetes. In human ECs, miR-433-3p expression was also elevated after high glucose treatment. Endothelial barrier function was impaired after HG, which was restored by miR-433 inhibition. Similarly, miR-433-3p inhibitor improved angiogenesis and cell survival after HG treatment in ECs. HFD mice demonstrated an increased vascular permeability compared to C57BL/6 mice which was attenuated by miR-433-3p inhibition. Conclusion: These data suggest miR-433-3p’s effect on vascular permeability which may contribute to the very poor clinical course seen in PAD and DM. Improved EC permeability with miR-433-3p inhibition may improve skeletal muscle perfusion and create a novel approach for patients with PAD, diabetes, or both. NIH 5R01HL150003-03 (BHA) and AHA CDA932159 (AK) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Published
2023

16. A randomized trial of a composite T2-biomarker strategy adjusting corticosteroid treatment in severe asthma: a post- hoc analysis by sex

Author

Matthew C. Eastwood, John Busby, David J. Jackson, Ian D. Pavord, Catherine E. Hanratty, Ratko Djukanovic, Ashley Woodcock, Samantha Walker, Timothy C. Hardman, Joseph R. Arron, David F. Choy, Peter Bradding, Chris E. Brightling, Rekha Chaudhuri, Douglas Cowan, Adel H. Mansur, Stephen J. Fowler, Peter Howarth, James Lordan, Andrew Menzies-Gow, Timothy Harrison, Douglas S. Robinson, Cecile T.J. Holweg, John G. Matthews, and Liam G. Heaney

Subjects
Manchester Cancer Research Centre, ResearchInstitutes_Networks_Beacons/mcrc, Immunology and Allergy
Abstract

BackgroundApproximately 5% to 10% of patients with asthma have severe disease, with a consistent preponderance in females. Current asthma guidelines recommend stepwise treatment to achieve symptom control with no differential treatment considerations for either sex.ObjectiveTo examine whether patient sex affects outcomes when using a composite T2-biomarker score to adjust corticosteroid (CS) treatment in patients with severe asthma compared with standard care.MethodsThis is a post hoc analysis, stratifying patient outcomes by sex, of a 48-week, multicenter, randomized controlled clinical trial comparing a biomarker-defined treatment algorithm with standard care. The primary outcome was the proportion of patients with a reduction in CS treatment (inhaled and oral corticosteroids). Secondary outcomes included exacerbation rates, hospital admissions, and lung function.ResultsOf the 301 patients randomized, 194 (64.5%) were females and 107 (35.5%) were males. The biomarker algorithm led to a greater proportion of females being on a lower CS dose versus standard care, which was not seen in males (effect estimate: females, 3.57; 95% CI, 1.14-11.18 vs males, 0.54; 95% CI, 0.16-1.80). In T2-biomarker–low females, reducing CS dose was not associated with increased exacerbations. Females scored higher in all domains of the 7-item Asthma Control Questionnaire, apart from FEV1, but with no difference when adjusted for body mass index/anxiety and/or depression. Dissociation between symptoms and T2 biomarkers were noted in both sexes, with a higher proportion of females being symptom high/T2-biomarker low (22.8% vs 15.6%; P = .0002), whereas males were symptom low/T2-biomarker high (22.3% vs 11.4%; P < .0001).ConclusionsThis exploratory post hoc analysis identified that females achieved a greater benefit from biomarker-directed CS optimization versus symptom-directed treatment.

Published
2023

18. The Simons Observatory: science goals andforecasts

Author

Peter Ade, James Aguirre, Zeeshan Ahmed, Simone Aiola, Aamir Ali, David Alonso, Marcelo A. Alvarez, Kam Arnold, Peter Ashton, Jason Austermann, Humna Awan, Carlo Baccigalupi, Taylor Baildon, Darcy Barron, Nick Battaglia, Richard Battye, Eric Baxter, Andrew Bazarko, James A. Beall, Rachel Bean, Dominic Beck, Shawn Beckman, Benjamin Beringue, Federico Bianchini, Steven Boada, David Boettger, J. Richard Bond, Julian Borrill, Michael L. Brown, Sarah Marie Bruno, Sean Bryan, Erminia Calabrese, Victoria Calafut, Paolo Calisse, Julien Carron, Anthony Challinor, Grace Chesmore, Yuji Chinone, Jens Chluba, Hsiao-Mei Sherry Cho, Steve Choi, Gabriele Coppi, Nicholas F. Cothard, Kevin Coughlin, Devin Crichton, Kevin D. Crowley, Kevin T. Crowley, Ari Cukierman, John M. D'Ewart, Rolando Dünner, Tijmen de Haan, Mark Devlin, Simon Dicker, Joy Didier, Matt Dobbs, Bradley Dober, Cody J. Duell, Shannon Duff, Adri Duivenvoorden, Jo Dunkley, John Dusatko, Josquin Errard, Giulio Fabbian, Stephen Feeney, Simone Ferraro, Pedro Fluxà, Katherine Freese, Josef C. Frisch, Andrei Frolov, George Fuller, Brittany Fuzia, Nicholas Galitzki, Patricio A. Gallardo, Jose Tomas Galvez Ghersi, Jiansong Gao, Eric Gawiser, Martina Gerbino, Vera Gluscevic, Neil Goeckner-Wald, Joseph Golec, Sam Gordon, Megan Gralla, Daniel Green, Arpi Grigorian, John Groh, Chris Groppi, Yilun Guan, Jon E. Gudmundsson, Dongwon Han, Peter Hargrave, Masaya Hasegawa, Matthew Hasselfield, Makoto Hattori, Victor Haynes, Masashi Hazumi, Yizhou He, Erin Healy, Shawn W. Henderson, Carlos Hervias-Caimapo, Charles A. Hill, J. Colin Hill, Gene Hilton, Matt Hilton, Adam D. Hincks, Gary Hinshaw, Renée Hložek, Shirley Ho, Shuay-Pwu Patty Ho, Logan Howe, Zhiqi Huang, Johannes Hubmayr, Kevin Huffenberger, John P. Hughes, Anna Ijjas, Margaret Ikape, Kent Irwin, Andrew H. Jaffe, Bhuvnesh Jain, Oliver Jeong, Daisuke Kaneko, Ethan D. Karpel, Nobuhiko Katayama, Brian Keating, Sarah S. Kernasovskiy, Reijo Keskitalo, Theodore Kisner, Kenji Kiuchi, Jeff Klein, Kenda Knowles, Brian Koopman, Arthur Kosowsky, Nicoletta Krachmalnicoff, Stephen E. Kuenstner, Chao-Lin Kuo, Akito Kusaka, Jacob Lashner, Adrian Lee, Eunseong Lee, David Leon, Jason S.-Y. Leung, Antony Lewis, Yaqiong Li, Zack Li, Michele Limon, Eric Linder, Carlos Lopez-Caraballo, Thibaut Louis, Lindsay Lowry, Marius Lungu, Mathew Madhavacheril, Daisy Mak, Felipe Maldonado, Hamdi Mani, Ben Mates, Frederick Matsuda, Loïc Maurin, Phil Mauskopf, Andrew May, Nialh McCallum, Chris McKenney, Jeff McMahon, P. Daniel Meerburg, Joel Meyers, Amber Miller, Mark Mirmelstein, Kavilan Moodley, Moritz Munchmeyer, Charles Munson, Sigurd Naess, Federico Nati, Martin Navaroli, Laura Newburgh, Ho Nam Nguyen, Michael Niemack, Haruki Nishino, John Orlowski-Scherer, Lyman Page, Bruce Partridge, Julien Peloton, Francesca Perrotta, Lucio Piccirillo, Giampaolo Pisano, Davide Poletti, Roberto Puddu, Giuseppe Puglisi, Chris Raum, Christian L. Reichardt, Mathieu Remazeilles, Yoel Rephaeli, Dominik Riechers, Felipe Rojas, Anirban Roy, Sharon Sadeh, Yuki Sakurai, Maria Salatino, Mayuri Sathyanarayana Rao, Emmanuel Schaan, Marcel Schmittfull, Neelima Sehgal, Joseph Seibert, Uros Seljak, Blake Sherwin, Meir Shimon, Carlos Sierra, Jonathan Sievers, Precious Sikhosana, Maximiliano Silva-Feaver, Sara M. Simon, Adrian Sinclair, Praween Siritanasak, Kendrick Smith, Stephen R. Smith, David Spergel, Suzanne T. Staggs, George Stein, Jason R. Stevens, Radek Stompor, Aritoki Suzuki, Osamu Tajima, Satoru Takakura, Grant Teply, Daniel B. Thomas, Ben Thorne, Robert Thornton, Hy Trac, Calvin Tsai, Carole Tucker, Joel Ullom, Sunny Vagnozzi, Alexander van Engelen, Jeff Van Lanen, Daniel D. Van Winkle, Eve M. Vavagiakis, Clara Vergès, Michael Vissers, Kasey Wagoner, Samantha Walker, Jon Ward, Ben Westbrook, Nathan Whitehorn, Jason Williams, Joel Williams, Edward J. Wollack, Zhilei Xu, Byeonghee Yu, Cyndia Yu, Fernando Zago, Hezi Zhang, and Ningfeng Zhu

Subjects
Astrophysics, Astronomy
Abstract

The Simons Observatory (SO) is a new cosmic microwave background experiment being built on Cerro Toco in Chile, due to begin observations in the early 2020s. We describe the scientific goals of the experiment, motivate the design, and forecast its performance. SO will measure the temperature and polarization anisotropy of the cosmic microwave background in six frequency bands centered at: 27, 39, 93, 145, 225 and 280 GHz. The initial configuration of SO will have three small-aperture 0.5-m telescopes and one large-aperture 6-m telescope, with a total of 60,000 cryogenic bolometers. Our key science goals are to characterize the primordial perturbations, measure the number of relativistic species and the mass of neutrinos, test for deviations from a cosmological constant, improve our understanding of galaxy evolution, and constrain the duration of reionization. The small aperture telescopes will target the largest angular scales observable from Chile, mapping ≈ 10% of the sky to a white noise level of 2 μK-arcmin in combined 93 and 145 GHz bands, to measure the primordial tensor-to-scalar ratio, r, at a target level of σ(r)=0.003. The large aperture telescope will map ≈ 40% of the sky at arcminute angular resolution to an expected white noise level of 6 μK-arcmin in combined 93 and 145 GHz bands, overlapping with the majority of the Large Synoptic Survey Telescope sky region and partially with the Dark Energy Spectroscopic Instrument. With up to an order of magnitude lower polarization noise than maps from the Planck satellite, the high-resolution sky maps will constrain cosmological parameters derived from the damping tail, gravitational lensing of the microwave background, the primordial bispectrum, and the thermal and kinematic Sunyaev-Zel'dovich effects, and will aid in delensing the large-angle polarization signal to measure the tensor-to-scalar ratio. The survey will also provide a legacy catalog of 16,000 galaxy clusters and more than 20,000 extragalactic sources.

Published
2019
Full Text
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19. Condemned to precarity? Criminalised youths, social enterprise and the sub-precariat

Author

Sarah Soppitt, Rebecca Oswald, and Samantha Walker

Subjects
Sociology and Political Science, L300, Economics, Econometrics and Finance (miscellaneous), Business, Management and Accounting (miscellaneous), Management, Monitoring, Policy and Law, Development
Abstract

Purpose The paper aims to consider whether social enterprise, who are growing in number and seemingly a politically popular alternative to mainstream employment are a potential conduit for social change. Discussions relating to the value of (stable) employment in reducing and preventing (re)offending are not new. For many ex-offenders, a multitude of barriers stand between them and access to the labour market. As a potential conduit for social change, social enterprises are a growing and seemingly politically popular alternative to mainstream employment. Design/methodology/approach Focusing on the qualitative lived experiences of young people (aged between 16 and 18) with criminal convictions enrolled in one such enterprise, this paper examines the extent to which work-integrated social enterprise can assist in overcoming existing barriers to the labour market. Findings The paper highlights the value of social enterprise(s) in addressing the complex needs and precarities of criminalised youths, promoting social inclusion and assisting with progression into future employment. The paper also discusses the limitations of social enterprise(s) in overcoming external structural barriers to meaningful employment for those with an offending history and the implications for young people who aspire to more than precariat work. Originality/value Justice-orientated social enterprises are allowing young people with criminal records the opportunity to build social capita and access precarious work, previously unattainable for many. By focusing on the concept of “precarity”, this paper builds upon existing research on the collateral consequences of criminal convictions offering insights into the various challenges facing criminalised youths attempting to build a positive pro-social work identity within contemporary labour markets

Published
2021

20. Residual Lung Abnormalities Following COVID-19 Hospitalization:Interim Analysis of the UKILD Post-COVID Study

Author

Iain, Stewart, Joseph, Jacob, Peter M, George, Philip L, Molyneaux, Joanna C, Porter, Richard J, Allen, Shahab, Aslani, J Kenneth, Baillie, Shaney L, Barratt, Paul, Beirne, Stephen M, Bianchi, John F, Blaikley, James D, Chalmers, Rachel C, Chambers, Nazia, Chaudhuri, Christopher, Coleman, Guilhem, Collier, Emma K, Denneny, Annemarie, Docherty, Omer, Elneima, Rachel A, Evans, Laura, Fabbri, Michael A, Gibbons, Fergus V, Gleeson, Bibek, Gooptu, Neil J, Greening, Beatriz, Guillen Guio, Ian P, Hall, Neil A, Hanley, Victoria, Harris, Ewen M, Harrison, Melissa, Heightman, Toby E, Hillman, Alex, Horsley, Linzy, Houchen-Wolloff, Ian, Jarrold, Simon R, Johnson, Mark G, Jones, Fasihul, Khan, Rod, Lawson, Olivia, Leavy, Nazir, Lone, Michael, Marks, Hamish, McAuley, Puja, Mehta, Dhruv, Parekh, Karen, Piper Hanley, Manuela, Platé, John, Pearl, Krisnah, Poinasamy, Jennifer K, Quint, Betty, Raman, Matthew, Richardson, Pilar, Rivera-Ortega, Laura, Saunders, Ruth, Saunders, Malcolm G, Semple, Marco, Sereno, Aarti, Shikotra, A John, Simpson, Amisha, Singapuri, David Jf, Smith, Mark, Spears, Lisa G, Spencer, Stefan, Stanel, David, Thickett, A A Roger, Thompson, Mathew, Thorpe, Simon Lf, Walsh, Samantha, Walker, Nicholas David, Weatherley, Mark, Weeks, Jim M, Wild, Dan G, Wootton, Chris E, Brightling, Ling-Pei, Ho, Louise V, Wain, and R Gisli, Jenkins

Abstract

RATIONALE: Shared symptoms and genetic architecture between COVID-19 and lung fibrosis suggests SARS-CoV-2 infection may lead to progressive lung damage.OBJECTIVES: The UKILD Post-COVID study interim analysis was planned to estimate the prevalence of residual lung abnormalities in people hospitalized with COVID-19 based on risk strata.METHODS: The Post-HOSPitalisation COVID Study (PHOSP-COVID) was used for capture of routine and research follow-up within 240 days from discharge. Thoracic CTs linked by PHOSP-COVID identifiers were scored for percentage of residual lung abnormalities (ground glass opacities and reticulations). Risk factors in linked CT were estimated with Bayesian binomial regression and risk strata were generated. Numbers within strata were used to estimate post-hospitalization prevalence using Bayesian binomial distributions. Sensitivity analysis was restricted to participants with protocol driven research follow-up.MEASUREMENTS AND MAIN RESULTS: The interim cohort comprised 3700 people. Of 209 subjects with linked CTs (median 119 days, interquartile range 83-155), 166 people (79.4%) had >10% involvement of residual lung abnormalities. Risk factors included abnormal chest X-ray (RR 1·21 95%CrI 1·05; 1·40), percent predicted DLcoCONCLUSIONS: Residual lung abnormalities were estimated in up to 11% of people discharged following COVID-19 related hospitalization. Health services should monitor at-risk individuals to elucidate long-term functional implications. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).

Published
2022

22. Current Status of the Ali CMB Polarization Telescope Focal Plane Camera

Author

Jordi A. Montana-Lopez, Yi-Han Wu, Xiran Bai, Maria Salatino, Adrian Sinclair, Hamdi Mani, Bradley Dober, X. Zhang, Ki Won Yoon, Jeremy Meinke, Shannon M. Duff, Ryan Stephenson, Joel N. Ullom, Jason E. Austermann, Jeff Van Lanen, John A. B. Mates, Johannes Hubmayr, Richard C. Givhan, Chao-Lin Kuo, Eric Weeks, Samantha Walker, Keith L. Thompson, Gene C. Hilton, Jake Connors, E. Karpel, Justin Mathewson, James A. Beall, and Philip Daniel Mauskopf

Subjects
Physics, Physics::Instrumentation and Detectors, business.industry, Bolometer, Cosmic microwave background, Astrophysics::Instrumentation and Methods for Astrophysics, Polarimeter, Optical polarization, Astrophysics::Cosmology and Extragalactic Astrophysics, Condensed Matter Physics, Dichroic glass, Electronic, Optical and Magnetic Materials, law.invention, Telescope, Cardinal point, Optics, law, Electrical and Electronic Engineering, Transition edge sensor, business
Abstract

Ali CMB Polarization Telescope (AliCPT) is the first Cosmic Microwave Background (CMB) polarimeter with a large focal plane camera to be deployed in the Northern Hemisphere, in the Tibetan Plateau. Here we present the design of a dichroic (90/150 GHz) focal plane camera capable of hosting up to 32,376 Transition-Edge Sensor (TES) bolometers operating from a base temperature of 280 mK. Detectors are fabricated as monolithic arrays of 1,704 feedhorn-coupled and polarization-sensitive TES bolometers that are packaged in independent modules and read out with a microwave multiplexing architecture. A custom RFSoC-based system manages the multiplexing readout. Prototype AliCPT pixels have been fabricated and characterized, demonstrating passband performance within 2.5% of design and cross-polarization systematic sensitivity $\leq$ 2%.

Published
2021

23. Simons Observatory Focal-Plane Module: Detector Re-biasing With Bias-step Measurements

Author

Yuhan Wang, Tanay Bhandarkar, Steve K. Choi, Kevin T. Crowley, Shannon M. Duff, Daniel Dutcher, John Groh, Kathleen Harrington, Erin Healy, Bradley Johnson, Jack Lashner, Yaqiong Li, Max Silva-Feaver, Rita Sonka, Suzanne T. Staggs, Samantha Walker, and Kaiwen Zheng

Subjects
FOS: Physical sciences, Astrophysics - Instrumentation and Methods for Astrophysics, Instrumentation and Methods for Astrophysics (astro-ph.IM)
Abstract

The Simons Observatory is a ground-based cosmic microwave background survey experiment that consists of three 0.5 m small-aperture telescopes and one 6 m large-aperture telescope, sited at an elevation of 5200 m in the Atacama Desert in Chile. SO will deploy 60,000 transition-edge sensor (TES) bolometers in 49 separate focal-plane modules across a suite of four telescopes covering 30/40 GHz low frequency (LF), 90/150 GHz mid frequency (MF), and 220/280 GHz ultra-high frequency (UHF). Each MF and UHF focal-plane module packages 1720 optical detectors spreading across 12 detector bias lines that provide voltage biasing to the detectors. During observation, detectors are subject to varying atmospheric emission and hence need to be re-biased accordingly. The re-biasing process includes measuring the detector properties such as the TES resistance and responsivity in a fast manner. Based on the result, detectors within one bias line then are biased with suitable voltage. Here we describe a technique for re-biasing detectors in the modules using the result from bias-step measurement.

Published
2022

24. Potassium Binding Interactions with Aliphatic Amino Acids: Thermodynamic and Entropic Effects Analyzed via a Guided Ion Beam and Computational Study

Author

Roland M. Jones, Taylor Nilsson, Samantha Walker, and P. B. Armentrout

Subjects
Structural Biology, Metals, Alkali, Cations, Entropy, Fatty Acids, Potassium, Thermodynamics, Amino Acids, Spectroscopy
Abstract

Noncovalent interactions between alkali metals and amino acids are critical for many biological processes, especially for proper function of protein ion channels; however, many precise binding affinities between alkali metals and amino acids still need to be measured. This study addresses this need by using threshold collision-induced dissociation with a guided ion beam tandem mass spectrometer to measure binding affinities between potassium cations and the aliphatic amino acids: Gly, Ala, hAla, Val, Leu, and Ile. These measurements are supplemented by theoretical calculations and include commentary on effects of enthalpy, entropy, and structural preference. Notably, all levels of theory indicate that the lowest-lying isomers at 298 K have K

Published
2022

25. Seasonal responses of macroinvertebrate assemblages to magnesium in a seasonally flowing stream

Author

Thomas J. Mooney, Andrew J. Harford, Julie Hanley, Samantha Walker, Mia Sandgren, Andrew Jansen, and Chris Humphrey

Subjects
Rivers, Health, Toxicology and Mutagenesis, Humans, Animals, Magnesium, General Medicine, Seasons, Toxicology, Pollution, Invertebrates, Ecosystem, Environmental Monitoring
Abstract

Macroinvertebrates can be highly sensitive to elevated salinity in freshwater environments, and are known to respond to saline discharges. Magnesium (Mg) is a mine-related contaminant and is a potential environmental risk to a seasonally-flowing, receiving water stream in Kakadu National Park, located in the wet-dry tropics of Australia. The macroinvertebrate assemblage in the stream in the was characterised at four hydrographic phases, from early wet season flow to early dry season pools at flow cessation. On each of the four occasions representing the respective phases, individuals from the most abundant macroinvertebrate species present were collected and acutely exposed to a range (up to 19) of Mg concentrations under laboratory conditions. Sensitivity of taxa to Mg ranged between 39 mg/L Mg (Caenidae: Tasmanocoenis spp.) and 4400 mg/L Mg (Dytiscidae: Clypeodytes feryi), based on the 50% Lethal Concentration (LC50). Characterisation of the macroinvertebrate assemblage at each hydrographic phase indicated the seasons when Mg-sensitive species were present. Whilst no statistical differences in measures of seasonal sensitivity were found, the macroinvertebrate assemblages present during the early flow period had higher Mg-sensitivity than the assemblages present during other hydrographic phases. This could be attributed to the greater relative proportions of Mg-sensitive taxa (e.g. Ephemeroptera) present at early flow compared to greater relative proportions of more Mg-tolerant taxa (C. feryi and Hydacarina spp.) present during later hydrograph phases, especially periods of lower, or no, flow.

Published
2022

26. Composite type-2 biomarker strategy versus a symptom–risk-based algorithm to adjust corticosteroid dose in patients with severe asthma: a multicentre, single-blind, parallel group, randomised controlled trial

Author

David C. Jackson, Catherine E. Hanratty, Kian Fan Chung, John G. Matthews, Ratko Djukanovic, Maria Nunez, Robert Niven, Douglas S. Robinson, Liam G Heaney, Michelle Bourne, Catherine Borg, Clare Connolly, Mary Bellamy, Val Hudson, Gareth M. Davies, Christopher E. Brightling, Beverley Hargadon, Traceyanne Grandison, Ian M. Adcock, Sebastian L. Johnston, Rekha Chaudhuri, Geraldine Jones, James Lordan, Andrew Menzies-Gow, Adnam Azim, Dominic E. Shaw, John Busby, Ashley Woodcock, Freda Yang, Peter Bradding, Christopher Corrigan, David F. Choy, Cecile T.J. Holweg, Douglas C. Cowan, Paula McCourt, Tim Harrison, Peter H. Howarth, AH Mansur, Joel Solis, Avril Horn, Joseph R. Arron, Gabrielle Gainsborough, Sarah E Davies, Stephen J. Fowler, Roisin Stone, Timothy C. Hardman, Ian D. Pavord, Samantha Walker, Richard W. Costello, and Katherine C. Smith

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.drug_class, Population, Nitric Oxide, Corrections, law.invention, 1117 Public Health and Health Services, 03 medical and health sciences, Leukocyte Count, 0302 clinical medicine, Randomized controlled trial, law, Adrenal Cortex Hormones, Risk Factors, medicine, Humans, Drug Dosage Calculations, Single-Blind Method, 030212 general & internal medicine, Anti-Asthmatic Agents, education, Asthma, education.field_of_study, investigators for the MRC Refractory Asthma Stratification Programme, business.industry, Cumulative dose, 1103 Clinical Sciences, Odds ratio, Articles, Middle Aged, medicine.disease, Eosinophils, 030228 respiratory system, Exhaled nitric oxide, Acute Disease, Corticosteroid, Biomarker (medicine), Female, business, Algorithm, Cell Adhesion Molecules, Algorithms, Biomarkers, 1199 Other Medical and Health Sciences
Abstract

Background: Asthma treatment guidelines recommend increasing corticosteroid dose to control symptoms and reduce exacerbations. This approach is potentially flawed because symptomatic asthma can occur without corticosteroid responsive type-2 (T2)-driven eosinophilic inflammation, and inappropriately high-dose corticosteroid treatment might have little therapeutic benefit with increased risk of side-effects. We compared a biomarker strategy to adjust corticosteroid dose using a composite score of T2 biomarkers (fractional exhaled nitric oxide [FENO], blood eosinophils, and serum periostin) with a standardised symptom–risk-based algorithm (control). Methods: We did a single-blind, parallel group, randomised controlled trial in adults (18–80 years of age) with severe asthma (at treatment steps 4 and 5 of the Global Initiative for Asthma) and FENO of less than 45 parts per billion at12 specialist severe asthma centres across England, Scotland, and Northern Ireland. Patients were randomly assigned (4:1) to either the biomarker strategy group or the control group by an online electronic case-report form, in blocks of ten, stratified by asthma control and use of rescue systemic steroids in the previous year. Patients were masked to study group allocation throughout the entirety of the study. Patients attended clinic every 8 weeks, with treatment adjustment following automated treatment-group-specific algorithms: those in the biomarker strategy group received a default advisory to maintain treatment and those in the control group had their treatment adjusted according to the steps indicated by the trial algorithm. The primary outcome was the proportion of patients with corticosteroid dose reduction at week 48, in the intention-to-treat (ITT) population. Secondary outcomes were inhaled corticosteroid (ICS) dose at the end of the study; cumulative dose of ICS during the study; proportion of patients on maintenance oral corticosteroids (OCS) at study end; rate of protocol-defined severe exacerbations per patient year; time to first severe exacerbation; number of hospital admissions for asthma; changes in lung function, Asthma Control Questionnaire-7 score, Asthma Quality of Life Questionnaire score, and T2 biomarkers from baseline to week 48; and whether patients declined to progress to OCS. A secondary aim of our study was to establish the proportion of patients with severe asthma in whom T2 biomarkers remained low when corticosteroid therapy was decreased to a minimum ICS dose. This study is registered with ClinicalTrials.gov, NCT02717689 and has been completed. Findings: Patients were recruited from Jan 8, 2016, to July 12, 2018. Of 549 patients assessed, 301 patients were included in the ITT population and were randomly assigned to the biomarker strategy group (n=240) or to the control group(n=61). 28·4% of patients in the biomarker strategy group were on a lower corticosteroid dose at week 48 compared with 18·5% of patients in the control group (adjusted odds ratio [aOR] 1·71 [95% CI 0·80–3·63]; p=0·17). In the per-protocol (PP) population (n=121), a significantly greater proportion of patients were on a lower corticosteroid dose at week 48 in the biomarker strategy group (30·7% of patients) compared with the control group (5·0% of patients; aOR 11·48 [95% CI 1·35–97·83]; p=0·026). Patient choice to not follow treatment advice was the principle reason for loss to PP analysis. There was no difference in secondary outcomes between study groups and no loss of asthma control among patients in the biomarker strategy group who reduced their corticosteroid dose. Interpretation: Biomarker-based corticosteroid adjustment did not result in a greater proportion of patients reducing corticosteroid dose versus control. Understanding the reasons for patients not following treatment advice in both treatment strategies is an important area for future research. The prevalence of T2 biomarker-low severe asthma was low.

Published
2021

27. Robotic vault: a cooperative robotic assembly method for brick vault construction

Author

Edvard P.G. Bruun, Alessandro Beghini, Stefana Parascho, Sigrid Adriaenssens, Isla Xi Han, and Samantha Walker

Subjects
Engineering drawing, Brick, Vault (architecture), Computer science, business.industry, Robot, General Medicine, Arch, Masonry, Engineering design process, business, Falsework, Interlocking
Abstract

Geometrically complex masonry structures built with traditional techniques typically require either temporary scaffolding or skilled masons. This paper presents a novel fabrication process for the assembly of full-scale masonry vaults without the use of falsework. The fabrication method is based on a cooperative assembly approach in which two robots alternate between placement and support to first build a stable central arch. Subsequently, the construction is continued individually by the robots - building out from the central arch based on an interlocking diagonal brick sequence. This proposed method is validated through its successful implementation in a full-scale vault structure consisting of 256 glass and concrete standardized bricks. The paper includes strategies for developing the design, sequencing, and robotic assembly methods used to build the vault.

Published
2020

28. The culturalisation of ‘honour’-based violence and its impact on service provision in rural communities

Author

Samantha Walker

Subjects
Intersectionality, Service provision, media_common.quotation_subject, education, 050901 criminology, 05 social sciences, Human factors and ergonomics, Poison control, Suicide prevention, humanities, Occupational safety and health, 0506 political science, Gender Studies, Honour, Nursing, Injury prevention, 050602 political science & public administration, Sociology, 0509 other social sciences, Law, media_common
Abstract

The ‘culturalisation of violence’ – a process through which culture is credited as being the sole or principal cause of violence – has resulted in ‘honour’-based violence/abuse being commonly (mis)understood and (mis)interpreted as being an imported cultural practice unique to particular black, Asian and minority ethnic communities living in the West. Addressing a vital gap in the literature, this article considers the conceptual shortcomings of these culturalised narratives on honour and ‘honour’-based violence/abuse, as well as the impact that they have upon service provision in rural areas of England and Wales – areas often conceptualised as ‘white spaces’ lacking in ethnic diversity. This article draws upon semi-structured interviews with both victims/survivors and rural front-line service providers. It is argued that under culturalised narratives, not only does ethnicity remain a key indicator for ‘honour’-based violence/abuse cases, but, as such, and given their perceived lack of ethnic diversity, rural regions are also increasingly identified as ‘safe spaces’ to relocate black, Asian and minority ethnic victims/survivors away from the reach of their ‘problematic’ culture. Ultimately, the core contention of this article is that by founding policy, legislative and support responses on culturalised understandings of violence, service providers are destined to fail to meet the intersectional needs of black, Asian and minority ethnic victims/survivors.

Published
2020

29. Development of Space-Optimized TES Bolometer Arrays for LiteBIRD

Author

Kam Arnold, J. Austermann, Michael J. Link, N. W. Halverson, Michael R. Vissers, Adrian T. Lee, G. Jaehnig, Shannon M. Duff, Gene C. Hilton, Masashi Hazumi, Samantha Walker, Benjamin Westbrook, A. Suzuki, Johannes Hubmayr, and Dan Becker

Subjects
Physics, business.industry, Cosmic microwave background, Detector, Bolometer, Astrophysics::Instrumentation and Methods for Astrophysics, Condensed Matter Physics, Polarization (waves), 01 natural sciences, Atomic and Molecular Physics, and Optics, Radio spectrum, 010305 fluids & plasmas, law.invention, Optics, Band-pass filter, law, 0103 physical sciences, General Materials Science, Transition edge sensor, 010306 general physics, business, Space environment
Abstract

LiteBIRD is a cosmic microwave background polarization experiment with the goal of measuring the tensor-to-scalar ratio with a total uncertainty of $$\delta r

Published
2020

32. Patient symptoms and experience following COVID-19: results from a UK-wide survey

Author

Andrea Fallas, Keir E J Philip, Brigitte West, Jennifer K Quint, Andrew Cumella, Michael I. Polkey, Cheryl Cheung, Sara Buttery, Samantha Walker, Parris J Williams, Nicholas S Hopkinson, Imperial College London, and Guys & St Thomas NHS Foundation Trust

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Mental ability, Respiratory System, Declaration, Ethnic group, Disease, Diseases of the respiratory system, Post-Acute COVID-19 Syndrome, Surveys and Questionnaires, Patient experience, Health care, medicine, Humans, Psychiatry, Depression (differential diagnoses), Science & Technology, RC705-779, business.industry, SARS-CoV-2, Muscle weakness, COVID-19, Middle Aged, United Kingdom, Scholarship, Mood, Respiratory Research, Family medicine, Physical therapy, Anxiety, Medicine, Female, medicine.symptom, business, Life Sciences & Biomedicine
Abstract

SummaryObjectivesTo investigate the experience of people who continue to be unwell after acute COVID-19, often referred to as ‘long COVID’, both in terms of their symptoms and their interactions with healthcare.DesignWe conducted a mixed-methods analysis (quantitative and qualitative) of responses to a survey accessed through a UK online post-COVID support and information hub between April 2020 and December 2020 about people’s experiences after having acute COVID-19.ParticipantsOf 3290 respondents, 78% were female, median age range 45-54 years, 92.1% reported white ethnicity; 12.7% had been hospitalised. 494 respondents (16.5%) completed the survey between 4 and 8 weeks of the onset of their symptoms, 641 (21.4%) between 8 and 12 weeks and 1865 (62.1%) more than 12 weeks after.ResultsThe ongoing symptoms most frequently reported were; breathing problems (92.1%), fatigue (83.3%), muscle weakness or joint stiffness (50.6%), sleep disturbances (46.2%), problems with mental abilities (45.9%) changes in mood, including anxiety and depression (43.1%) and cough (42.3%). Symptoms did not appear to be related to the severity of the acute illness or to the presence of pre-existing medical conditions. Analysis of free text responses revealed three main themes (1) Experience of living with COVID-19 – physical and psychological symptoms that fluctuate unpredictably; (2) Interactions with healthcare; (3) Implications for the future – their own condition, society and the healthcare system and the need for researchConclusionPeople living with persistent problems after the acute phase of COVID-19 report multiple and varying symptoms that are not necessarily associated with initial disease severity or the presence of pre-existing health conditions. Many have substantial unmet needs and experience barriers to accessing healthcare. Consideration of patient perspective and experiences will assist in the planning of services to address this.Ethical approvalEthical approval was granted by Imperial College Research and Integrity Team (IREC; 20IC6625).What we already know on this subjectMany people who develop COVID-19 will go on to endure persistent symptoms past the acute phase of the disease, commonly termed long-COVID.Knowledge gaps exist regarding the lived experience and symptom frequency, in people with long-COVID, particularly in those who were not admitted to hospital during the acute phase of their illness.What this study addsThe findings from this large population, many of whom were not hospitalised during the acute phase of their illness, demonstrate the varying patterns and persistence of symptoms of long-COVID, which do not appear to be associated with severity of the acute phase of the disease or pre-existing medical conditions.Qualitative findings revealing the patient experience of long-COVID symptoms, healthcare, and suggestions for future research and service adaptation.

Published
2021

33. Factors affecting adherence with treatment advice in a clinical trial of patients with severe asthma

Author

James Lordan, Catherine E. Hanratty, Stephen J. Fowler, Robert Niven, Peter H. Howarth, Ian D. Pavord, Ratko Djukanovic, Douglas C. Cowan, Timothy C. Hardman, Douglas S. Robinson, Rekha Chaudhuri, David F. Choy, Joseph R. Arron, John Busby, Peter Bradding, Cecile T.J. Holweg, Christopher E. Brightling, Liam G Heaney, Samantha Walker, Andrew Menzies-Gow, Tim Harrison, AH Mansur, John G. Matthews, and Ashley Woodcock

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Multivariate analysis, business.industry, Attendance, MEDLINE, Ethnic group, Asthma, Advice (programming), Clinical trial, Adrenal Cortex Hormones, Internal medicine, medicine, Ethnicity, Biomarker (medicine), Humans, Single-Blind Method, Disease management (health), business, Minority Groups
Abstract

Background: understanding why patients with severe asthma do not follow healthcare provider (HCP) advice to adjust treatment is critical to achieving personalised disease management.Methods: we reviewed patient choice to follow HCP advice to adjust asthma treatment in a randomised, controlled, single-blind (study participant), multi-centre, parallel group 48-week clinical study comparing biomarker directed treatment adjustment to standard care in severe asthma.Results: of 1572 treatment advisories (301 participants), instructions were followed in 1377 cases (87.6%). Patients were more likely to follow advice to remain on treatment (96.7%) than to either reduce (70.3%) or increase (67.1%) their treatment, with 64% of patients following all treatment advice. Multivariate analysis associated belonging to an ethnic minority group (OR: 3.10; 95% CI: 1.68, 5.73) and prior study medication changes (≥2 OR: 2.77, 95% CI: 1.51, 5.10) with failure to follow treatment advice. In contrast, emergency room attendance in the prior year (OR: 0.54, 95% CI: 0.32, 0.92) was associated with following treatment advice. The largest effect was seen with transition onto or off oral corticosteroids (OR: 29.28; 95% CI: 16.07, 53.36) when compared to those requested to maintain treatment. Centre was also an important determinant regarding the likelihood of patients to follow treatment advice.Conclusions: belonging to an ethnic minority group and multiple prior treatment adjustments were associated with not following HCP treatment advice. Patients also responded differently to HCP advice across UK specialist centres. These findings have implications for generalisability for models of care in severe asthma and require further focussed studies.

Published
2021

35. Factors affecting patients’ decision to adjust treatment; secondary analysis of a randomised trial of treatment optimisation in patients with severe asthma

Author

Ashley Woodcock, Liam G Heaney, Samantha Walker, James Lordan, John Busby, Peter Bradding, Douglas N. Robinson, John Matthews, Robert Niven, Rekha Chaudhuri, Cecile T.J. Holweg, Timothy C. Hardman, Adel H. Mansur, Catherine E. Hanratty, Peter H. Howarth, David F. Choy, Christopher E. Brightling, Douglas C. Cowan, Stephen J. Fowler, Tim Harrison, Ratko Djukanovic, Joseph R. Arron, Andrew Menzies-Gow, and Ian D. Pavord

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Severe asthma, Secondary analysis, medicine, In patient, business
Published
2021

36. Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients

Author

Pam Young, David Price, Salman Siddiqui, Victoria Carter, Liam G Heaney, Kamlesh Khunti, Francis Appiagyei, Tony Megaw, Antony Hardjojo, David H M Jones, Jennifer K Quint, Marije A. van Melle, Hilary Pinnock, Ian D. Pavord, Andrew K. Davis, Rupert Jones, Michael E. Hyland, Steven A. Julious, Anu Kemppinen, Samantha Walker, Emma-Jane Roberts, Lewis D Ritchie, David A. Jackson, Brooklyn Stanley, Stephen T. Holgate, Phillip Oliver, Megan Preston, Dermot Ryan, Steve Davis, Sue Beecroft, Katherine Hickman, and David M.G. Halpin

Subjects
Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Population, Sars-cov-2, Observational Study, Primary care, frailty, chronic diseases, SDG 3 - Good Health and Well-being, Medicine, education, Pragmatic and Observational Research, Original Research, education.field_of_study, Frailty, Questionnaire, business.industry, SARS-CoV-2, questionnaire, Odds ratio, Questionnaire data, Patient population, Hospital admission, Observational study, observational study, business
Abstract

Rupert Jones,1– 3 Andrew Davis,1,2 Brooklyn Stanley,1,2 Steven Julious,4 Dermot Ryan,5 David J Jackson,6 David MG Halpin,7 Katherine Hickman,8 Hilary Pinnock,9 Jennifer K Quint,10 Kamlesh Khunti,11 Liam G Heaney,12 Phillip Oliver,4 Salman Siddiqui,13 Ian Pavord,14 David HM Jones,15 Michael Hyland,3,16 Lewis Ritchie,17 Pam Young,18 Tony Megaw,18 Steve Davis,19 Samantha Walker,20 Stephen Holgate,21 Sue Beecroft,22 Anu Kemppinen,1,2 Francis Appiagyei,1,2 Emma-Jane Roberts,1,2 Megan Preston,1,2 Antony Hardjojo,1,2 Victoria Carter,1,2 Marije van Melle,1,2 David Price1,2,17 1Optimum Patient Care, Cambridge, UK; 2Observational and Pragmatic Research Institute, Singapore, Singapore; 3Faculty of Health, University of Plymouth, Plymouth, UK; 4University of Sheffield, South Yorkshire, UK; 5Usher Institute, University of Edinburgh, Edinburgh, UK; 6Guy’s & St Thomas’ NHS Trust, School of Immunology & Microbial Sciences, King’s College London, London, UK; 7University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK; 8Bradford and Leeds Clinical Commissioning Group, Leeds, UK; 9Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, UK; 10National Heart & Lung Institute, Imperial College London, London, UK; 11Diabetes Research Centre, University of Leicester, Leicester, UK; 12Wellcome-Wolfson Centre for Experimental Medicine, Queen’s University Belfast, Belfast, Northern Ireland; 13Institute for Lung Health, Leicester National Institute for Health Research Biomedical Research Centre, University of Leicester, Leicester, UK; 14Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of Medicine, University of Oxford, Oxford, UK; 15Box Surgery, Wiltshire, UK; 16Plymouth Marjon University, Plymouth, UK; 17Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; 18Wellbeing Software, Mansfield, UK; 19Interface Clinical Services, Leeds, UK; 20Asthma UK & British Lung Foundation, London, UK; 21Clinical and Experimental Sciences, University of Southampton, Southampton, UK; 22OPEN Health, Buckinghamshire, UKCorrespondence: David PriceAcademic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UKTel +65 3105 1489Email dprice@opri.sgIntroduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and untested COVID-19 patients in primary care.Methods: This is an observational study using data from Platform C19, a quality improvement program-derived research database linking primary care electronic health record data (EHR) with patient-reported questionnaire information. Participating general practices invited consenting patients aged 18– 85 to complete an online questionnaire since 7th August 2020. COVID-19 self-diagnosis, clinician-diagnosis, testing, and the presence and duration of symptoms were assessed via the questionnaire. Patients were considered present with long COVID if they reported symptoms lasting ≥ 4 weeks. EHR and questionnaire data up till 22nd January 2021 were extracted for analysis. Multivariable regression analyses were conducted comparing demographics, clinical characteristics, and presence of symptoms between patients with long COVID and patients with shorter symptom duration.Results: Long COVID was present in 310/3151 (9.8%) patients with self-diagnosed, clinician-diagnosed, or test-confirmed COVID-19. Only 106/310 (34.2%) long COVID patients had test-confirmed COVID-19. Risk predictors of long COVID were age ≥ 40 years (adjusted Odds Ratio [AdjOR]=1.49 [1.05– 2.17]), female sex (adjOR=1.37 [1.02– 1.85]), frailty (adjOR=2.39 [1.29– 4.27]), visit to A&E (adjOR=4.28 [2.31– 7.78]), and hospital admission for COVID-19 symptoms (adjOR=3.22 [1.77– 5.79]). Aches and pain (adjOR=1.70 [1.21– 2.39]), appetite loss (adjOR=3.15 [1.78– 5.92]), confusion and disorientation (adjOR=2.17 [1.57– 2.99]), diarrhea (adjOR=1.4 [1.03– 1.89]), and persistent dry cough (adjOR=2.77 [1.94– 3.98]) were symptom features statistically more common in long COVID.Conclusion: This study reports the factors and symptom features predicting long COVID in a broad primary care population, including both test-confirmed and the previously missed group of COVID-19 patients.Keywords: SARS-CoV-2, questionnaire, observational study, frailty, chronic diseases

Published
2021

37. Size does matter: An exploration of the relationship between licensed venue capacity and on-premise assaults

Author

Samantha Walker, Melanie Millsteed, Kerri Coomber, Ashlee Curtis, Peter Miller, Smriti Nepal, Tanya Chikritzhs, and Travis Harries

Subjects
Population Density, Alcohol Drinking, Aggression, 030508 substance abuse, Medicine (miscellaneous), Violence, 16. Peace & justice, Toxicology, Crowding, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Geography, Increased risk, Private Facilities, medicine, Humans, medicine.symptom, 0305 other medical science, 030217 neurology & neurosurgery, Facilities and Services Utilization, Demography
Abstract

AIMS Venue capacity has been proposed as a factor associated with increased number of violent incidents on-premises, though no specific research has demonstrated this association, and instead has tended to focus on the relationship between crowding and aggression. The aim of current paper is to investigate the association between venue capacity and the number of violent incidents on-premises. METHODS Venue capacity data (the maximum capacity listed on the liquor license) were obtained for all venues in central Melbourne from 2010 until 2016. These data were then matched with police-recorded on-premises assaults that occurred within high-alcohol hours (Friday and Saturday 8 pm-6 am) inside the venue. RESULTS Analyses were conducted on 5729 venue-years (yearly assault counts per venue, per year) across central Melbourne. Compared with venues that have a maximum capacity of between 0 and 100 patrons, venues with higher capacities have increasingly more recorded assaults. Venues with maximum capacities between 501 and 1000 are 6.1 times more likely to have an assault recorded compared with venues with a maximum capacity between 0 and 100. Further, each additional high-alcohol hour that a venue can be open for is associated with a 72% increase in the number of recorded assaults. CONCLUSIONS Greater venue capacity was found to be strongly associated with an increased risk of violent incidents for any given venue. This was further exacerbated by late-night trading which substantially adds to the risk of assaults inside the venue.

Published
2021

38. The persistence of place: Hunter-gatherer mortuary practices and land-use in the Trent Valley, Ontario

Author

Samantha Walker

Subjects
Archeology, History, geography, Resource (biology), geography.geographical_feature_category, Floodplain, Land use, Human Factors and Ergonomics, Wetland, Woodland, Archaic period, Archaeology, Indigenous, Hunter-gatherer
Abstract

Hunter-gatherer mortuary practices identified in the Trent Valley region, ON are highly patterned for the Middle Woodland period (400 BCE-700 CE), but the importance of many of these mortuary sites can be recognized as far back as the Late Archaic period (2500–1000 BCE). A geospatial modelling approach is used to predict the distribution of mortuary sites based on ecological factors that may have influenced land use strategies. The assessment reveals that Late Archaic and Middle Woodland mortuary sites were primarily located near aerobic wetlands that were likely rich in emergent plant life. The predicted suitably of mineral soil horizons, when compared with Trent Valley floodplain behaviour, suggests that wild rice may have been a particularly abundant resource near mortuary sites. The position of wild rice in Anishinaabe traditional stories is discussed to contextualize its potential early food value to Indigenous occupants of the Trent Valley, prior to the resource’s documented historic importance. The highly selective positioning of mortuary sites and their continuity within the Trent Valley region shed light on how ancestral ties to key places were established and maintained in precolonial hunter-gatherer societies.

Published
2019

39. The Future of Asthma Care

Author

Brigitte West, Stephen T. Holgate, Samantha Walker, and Kay Boycott

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Disease entity, business.industry, Asthma treatment, Disease, medicine.disease, Asthma care, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Medicine, Eosinophilia, Sputum, 030212 general & internal medicine, medicine.symptom, business, Intensive care medicine, mHealth, Asthma
Abstract

Although once considered a single disease entity, asthma is now known to be a complex inflammatory disease engaging a range of causal pathways. The most frequent forms of asthma are identified by sputum/blood eosinophilia and activation of type 2 inflammatory pathways involving interleukins-3, -4, -5, and granulocyte-macrophage colony-stimulating factor. The use of diagnostics that identify T2 engagement linked to the selective use of highly targeted biologics has opened up a new way of managing severe disease. Novel technologies, such as wearables and intelligent inhalers, enable real-time remote monitoring of asthma, creating a unique opportunity for personalized health care.

Published
2019

40. Transforming Rehabilitation: The impact of austerity and privatisation on day-to-day cultures and working practices in ‘probation’

Author

Jill Annison, Samantha Walker, and Sharon Beckett

Subjects
Government, Rehabilitation, L400, L300, media_common.quotation_subject, Corporate governance, medicine.medical_treatment, 050901 criminology, 05 social sciences, L500, Neoliberalism, Public administration, 0506 political science, Culmination, Austerity, Political science, 050602 political science & public administration, medicine, 0509 other social sciences, Day to day, Law, media_common
Abstract

Viewed as a culmination of broader neoliberal governance within the UK, this paper examines the impact of the government’s Transforming Rehabilitation (TR) agenda on day-to-day working cultures at the frontline of probation work. TR has brought with it extensive structural and cultural changes to probation work in England and Wales. Once a single public-sector service with a social welfare ethos of ‘advise, assist and befriend’, probation has been dismantled, partially privatised and culturally transformed into a collection of fragmented, target-driven organisations, divided according to risk and with an official rhetoric emphasising public protection. The implications of TR are now starting to surface. While much of this attention has focused on the impact of TR on both the supervision of offenders and in terms of public protection, less research has been conducted on how these organisational changes have impacted upon staff. Drawing upon findings from qualitative research, this article suggests that deepening cuts, precarious working environments, and increasingly unmanageable caseloads inflict upon staff what we consider to be a pervasive form of systemic workplace harm, resulting in mental health issues, stress, and professional dissatisfaction.

Published
2019

41. Next-generation care pathways for allergic rhinitis and asthma multimorbidity: a model for multimorbid non-communicable diseases -Meeting Report (Part 1)

Author

Elaine Colgan, Mario Sánchez-Borges, Jim Phillips, Ignacio J. Ansotegui, Bolesław Samoliński, Olga Lourenço, Giorgio Walter Canonica, F. Portejoie, Isabella Annesi-Maesano, Gabrielle L. Onorato, Victoria Cardona, João O. Malva, Eugene Cash, Christine Rolland, Hilary Pinnock, Samantha Walker, Yoshitaka Okamoto, Ana Maria Carriazo, Lorenzo Cecchi, Nikos G. Papadopoulos, Jean Bousquet, L. T. T. Le, João Fonseca, Oliver Pfaar, Luis Caraballo, Elísio Costa, Maritta Perala, Pablo Quinones-Delgado, Torsten Zuberbier, Holger J. Schünemann, Tomohisa Iinuma, Enrica Menditto, Maddalena Illario, Nils E. Billo, Arunas Valiulis, Sinthia Bosnic-Anticevich, Josep M. Antó, Nick A. Guldemond, Maria Teresa Ventura, Claus Bachert, Wytske Fokkens, Lars Münter, Mohamed H. Shamji, Ioana Agache, Ulysse Rodts, Daniel Laune, Sanna Toppila-Salmi, Joaquim Mullol, Ioanna Tsiligianni, Motohiro Ebisawa, Isabelle Bosse, Samuel Benveniste, Arzu Yorgancioglu, Alkis Togias, M. Bewick, Nhân Pham-Thi, Stephen R. Durham, Moises A. Calderon, Marina Erhola, Violeta Kvedariene, Omar S. Usmani, Alvaro A. Cruz, Anna Bedbrook, Abigail Phillips, Desiree Larenas-Linneman, Guy Brusselle, Gert Marien, Dana Wallace, David Somekh, Sian Williams, Wienczyslawa Czarlewski, Ludger Klimek, Piotr Kuna, Jean-Luc Fauquert, Rianne van der Kleij, Derek K. Chu, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris], Transilvania University of Brasov, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital Quiròn Bizkaia Erandio, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Ghent University Hospital, Centre de Recherche en Informatique (CRI), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], iQ4U consultants Ltd, University of Joensuu, The University of Sydney, Imperial College London, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Institute for Immunological Research (University of Cartagena), Vall d'Hebron University Hospital [Barcelona], Servicio Andaluz de Salud, Nova Southeastern University (NSU), Azienda Sanitaria di Prato, McMaster University [Hamilton, Ontario], DEPARTMENT OF HEALTH ( Social Services and Public Safety), Universidade do Porto, Universidade Federal da Bahia (UFBA), UCB Pharma, Colombes, Sagamihara National Hospital, National Institute for Health and Welfare [Helsinki], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Faculdade de Medicina da Universidade do Porto (FMUP), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Chiba University Hospital, 'Federico II' University of Naples Medical School, Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], Medical University of Łódź (MUL), Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], KYomed INNOV, Ho Chi Minh City University of Technology (HCMUT), Faculty of Health Sciences and CICS-UB (Health Sciences Research Centre), University of Coimbra [Portugal] (UC), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University of Manchester [Manchester], University of Athens Medical School [Athens], University of Oulu, Philipps University of Marburg, Cardiff University, University of Edinburgh, Regional Government for Equality, Medical University of Warsaw - Poland, Centro Medico-Docente La Trinidad, Department of Clinical Epidemiology and Biostatistics and Medicine, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), University of Helsinki, University of Crete [Heraklion] (UOC), National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, King's College Hospital (KCH), Leiden University Medical Center (LUMC), University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Humboldt-Universität zu Berlin, Association Asthme et Allergie, Health Services Management & Organisation (HSMO), University Hospital Montpellier, Montpellier, France, MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France, INSERM U 1168, VIMA, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France, EUFOREA, Brussels, Belgium, Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany, Allergy Department, Pasteur Institute, Paris, France, Faculty of Medicine, Transylvania University, Brasov, Romania, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Universités, Medical School Saint Antoine, Paris, France, Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain, ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain, Universitat Pompeu Fabra (UPF), Barcelona, Spain, CIBER Epidemiolog a y Salud Pública (CIBERESP), Barcelona, Spain, Upper Airways Research Laboratory, ENT Dept., Ghent University Hospital, Ghent, Belgium, National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France, Mines ParisTech CRI - PSL Research University, Fontainebleau, France, iQ4U Consultants Ltd., London, United Kingdom, Joensuu, Finland, Woolcock Institute of Medical Research, University of Sydney, Woolcock Emphysema Centre, Sydney Local Health District, Glebe, NSW, Australia, La Rochelle, France, Dept. of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium, Imperial College London, National Heart and Lung Institute, London, United Kingdom, Personalized Medicine Clinic Asthma and Allergy, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy, Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer piso, Cartagena, Colombia, Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia, Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron and ARADyAL Research Network, Barcelona, Spain, Regional Ministry of Health of Andalusia, Seville, Spain, College of Psychology, Nova Southeastern University, School-related Psychological Assessments and Clinical Interventions Clinic, Ft Lauderdale, FL, United States, SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy, Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada, Department of Health, Social Services and Public Safety, Belfast, United Kingdom, UCIBIO, REQUIMTE, Faculty of Pharmacy, Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, Porto, Portugal, ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Executive Committee, Bahia, Brazil, Medical Consulting Czarlewski, Levallois, France, Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan, National Institute for Health and Welfare, Helsinki, Finland, CHU Clermont-Ferrand, Unité d’Allergologie de l’Enfant, Pôle Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France, Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, Netherlands, CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina, Universidade do Porto, Medida, Lda, Porto, Portugal, Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, Netherlands, Dept. of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan, Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R and D and DISMET), Naples, Italy, Center for Rhinology and Allergology, Wiesbaden, Germany, Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland, Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania, Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius, Lithuania, Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico, KYomed INNOV, Montpellier, France, University of Medicine and Pharmacy, Hochiminh City, Viet Nam, Faculty of Health Sciences, CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal, CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy, Rhinology Unit and Smell Clinic, ENT Department, Hospital Cl nic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain, Danish Committee for Health Education, Copenhagen East, Denmark, Division of Infection, Immunity and Respiratory Medicine, Royal Manchester Children’s Hospital, University of Manchester, Manchester, United Kingdom, Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital 'P and A Kyriakou', University of Athens, Athens, Greece, University of Oulu, Faculty of Medicine, Oulun Yliopisto, Finland, Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany, Department of Health and Social Services, Welsh Government, Cardiff, United Kingdom, Centre For Empowering Patients and Communities, Dublin, Ireland, Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom, Agency for Social Services and Dependency, Regional Government for Equality, Social Policies and Conciliation of Andalucia, Seville, Spain, Association Asthme et Allergie, Paris, France, KanopyMed, Paris, France, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland, Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela, Immunomodulation and Tolerance Group, Imperial College London, London, United Kingdom, Allergy and Clinical Immunology, Imperial College London, London, United Kingdom, European Health Futures Forum (EHFF), Dromahair, Ireland, Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States, Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland, Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece, International Primary Care Respiratory Group IPCRG, Aberdeen, United Kingdom, National Heart and Lung Institute (NHLI), Imperial College London, Royal Brompton Hospital, Airways Disease Section, London, United Kingdom, Asthma UK, London, United Kingdom, Nova Southeastern University, Fort Lauderdale, FL, United States, Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Institute of Health Sciences, Vilnius, Lithuania, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands, University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy, Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey, Universitätsmedizin Berlin, Humboldt-Uniersität zu Berlin, Berlin, Germany, Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Berlin, Germany, uBibliorum, Ear, Nose and Throat, AII - Inflammatory diseases, Institut Pasteur [Paris] (IP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hospital Quirónsalud Bizkaia [Bilbao], Mines Paris - PSL (École nationale supérieure des mines de Paris), Universidade do Porto = University of Porto, Sagamihara National Hospital [Kanagawa, Japan], University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Philipps Universität Marburg = Philipps University of Marburg, Centro Médico Docente La Trinidad, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Humboldt University Of Berlin, Salvy-Córdoba, Nathalie, Universiteit Leiden, Bousquet, J., Pham-Thi, N., Bedbrook, A., Agache, I., Annesi-Maesano, I., Ansotegui, I., Anto, J. M., Bachert, C., Benveniste, S., Bewick, M., Billo, N., Bosnic-Anticevich, S., Bosse, I., Brusselle, G., Calderon, M. A., Canonica, G. W., Caraballo, L., Cardona, V., Carriazo, A. M., Cash, E., Cecchi, L., Chu, D. K., Colgan, E., Costa, E., Cruz, A. A., Czarlewski, W., Durham, S., Ebisawa, M., Erhola, M., Fauquert, J. -L., Fokkens, W. J., Fonseca, J. A., Guldemond, N., Iinuma, T., Illario, M., Klimek, L., Kuna, P., Kvedariene, V., Larenas-Linneman, D., Laune, D., Le, L. T. T., Lourenco, O., Malva, J. O., Marien, G., Menditto, E., Mullol, J., Munter, L., Okamoto, Y., Onorato, G. L., Papadopoulos, N. G., Perala, M., Pfaar, O., Phillips, A., Phillips, J., Pinnock, H., Portejoie, F., Quinones-Delgado, P., Rolland, C., Rodts, U., Samolinski, B., Sanchez-Borges, M., Schunemann, H. J., Shamji, M., Somekh, D., Togias, A., Toppila-Salmi, S., Tsiligianni, I., Usmani, O., Walker, S., Wallace, D., Valiulis, A., Van Der Kleij, R., Ventura, M. T., Williams, S., Yorgancioglu, A., and Zuberbier, T.

Subjects
Pulmonary and Respiratory Medicine, Allergy, medicine.medical_specialty, Allergic and chronic respiratory diseases, [SDV.IMM] Life Sciences [q-bio]/Immunology, Allergic rhinitis - Asthma - Multimorbidity, Health care system, Health literacy, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Health care, medicine, Patient participation, mHealth, Asthma, Rhinitis, [SDV.EE]Life Sciences [q-bio]/Ecology, environment, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Newsletter of GARD Section, business.industry, Environmental exposure, medicine.disease, 3. Good health, Integrated care, [SDV.EE] Life Sciences [q-bio]/Ecology, environment, 030228 respiratory system, 13. Climate action, Family medicine, [SDV.IMM]Life Sciences [q-bio]/Immunology, 030211 gastroenterology & hepatology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system for integrated care with organizational health literacy. MASK (Mobile Airways Sentinel NetworK) (1), a new development of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health) (2), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life integrated care pathways (ICPs) (3)-centred around the patient with rhinitis and using mHealth monitoring of environmental exposure (4).An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018. The aim was to discuss next-generation care pathways: (I) Patient participation, health literacy and self-care through technology-assisted “patient activation”; (II) Implementation of care pathways by pharmacists and (III) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) assessed by mobile technology.The EU (5) and global political agendas are of great importance in supporting health care transformation. MASK has been recognized by DG Santé as a Good Practice (6) in the field of digitally-enabled, integrated, person-centred care.The one-day meeting objectives were clear (Figure 1). The meeting was followed by a workshop. The present paper reports the background of the two-day meeting.

Published
2019

42. Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST

Author

Bernard Higgins, Andrew Wilson, Rebecca Haydock, Mike Thomas, Charlotte Renwick, Graham Devereux, Lucy Bradshaw, David Price, Christopher E. Brightling, Samantha Walker, Kevin Mortimer, Lelia Duley, Tricia M. McKeever, Ian D. Pavord, Steve Parrott, Tim Harrison, and Eleanor J Mitchell

Subjects
Male, medicine.medical_specialty, lcsh:Medical technology, Technology Assessment, Biomedical, Exacerbation, Cost-Benefit Analysis, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Quality of life, Adrenal Cortex Hormones, law, medicine, Humans, Anti-Asthmatic Agents, 030212 general & internal medicine, Adverse effect, Asthma, Dose-Response Relationship, Drug, business.industry, Self-Management, Health Policy, Hazard ratio, Middle Aged, medicine.disease, United Kingdom, Confidence interval, Clinical trial, lcsh:R855-855.5, 030228 respiratory system, Emergency medicine, Quality of Life, Female, business, Research Article
Abstract

BackgroundAsthma exacerbations affect the quality of life of patients with asthma and have a major effect on the overall costs of asthma care. An asthma self-management plan that advises the temporary quadrupling of inhaled corticosteroid dose may prevent asthma exacerbations, but this needs to be confirmed before being adopted widely.ObjectivesTo compare the clinical effectiveness and cost-effectiveness of an asthma self-management plan that advises patients to temporarily quadruple the dose of inhaled corticosteroid when asthma control starts to deteriorate with a standard self-management plan.DesignA multicentre, parallel-group, pragmatic randomised trial, with follow-up for 12 months.SettingPrimary and secondary care across 207 sites in the UK.ParticipantsAsthma patients aged ≥ 16 years treated with an inhaled corticosteroid who had experienced at least one exacerbation in the previous 12 months.InterventionsParticipants were randomised (1 : 1) to a usual-care self-management plan or to a modified self-management plan that advised a temporary quadrupling of the inhaled corticosteroid at the point of asthma deterioration, both of which were actively implemented and supported by local research staff.Primary outcomeThe primary outcome of ‘time to first asthma exacerbation’ was defined as the need for systemic corticosteroids (for at least 3 consecutive days) and/or unscheduled health-care consultations for asthma (i.e. reaching zone 3 or 4 of the Asthma UK self-management plan).ResultsA total of 1922 participants were randomised: the primary analysis included 938 participants (97%) in the usual-care group and 933 participants (97%) in the modified self-management group. The number of participants having at least one exacerbation of asthma in the year after randomisation was 484 (51.6%) in the usual-care group and 420 (45.0%) in the modified self-management group [adjusted hazard ratio 0.81, 95% confidence interval (CI) 0.71 to 0.92;p = 0.002]. There were fewer serious adverse events reported in the modified self-management group than in the usual-care group (11 vs. 32, respectively). Eight and six events of pneumonia, lower respiratory tract infections or influenza were reported in the usual-care group and the modified self-management group, respectively. Health-care-related costs were lower in the modified self-management group. The modified self-management group was £24 (bootstrapped 95% CI –£122 to £71) less costly than usual care, with a greater quality-adjusted life-year gain of 0.02 (bootstrapped 95% CI –0.005 to 0.04). Therefore, the modified self-management group was ‘dominant’, with a 94–95% probability of being cost-effective at the £20,000–30,000 threshold.LimitationsAs the Fourfold Asthma STudy (FAST) was an open-label pragmatic trial, the possibility of treatment bias that may have affected the participants in the modified self-management group cannot be ruled out. Poorer than expected completion of participant diary cards, particularly within the usual-care self-management group, could have led to a null bias, underestimating the true effect of the intervention.ConclusionsAn asthma self-management plan that advises patients to temporarily quadruple their dose of inhaled corticosteroid at the point of asthma symptoms worsening does reduce clinically important asthma exacerbations. In addition, the plan is cost-effective compared with the usual-care self-management plan.Future workTo effectively implement asthma self-management plans that advise a temporary quadrupling of inhaled steroid at asthma deterioration into routine practice.Trial registrationCurrent Controlled Trials ISRCTN15441965.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 70. See the NIHR Journals Library website for further project information.

Published
2018

43. Monterey Revival

Author

Mark Sarkisian, Neville Mathias, Joanna Zhang, and Samantha Walker

Subjects
General Medicine
Published
2018

44. Demonstration of 220/280 GHz Multichroic Feedhorn-Coupled TES Polarimeter

Author

Shannon M. Duff, Jason E. Austermann, Dan Becker, Johannes Hubmayr, B. Dober, Samantha Walker, Jeff McMahon, Sara M. Simon, Michael R. Vissers, Gene C. Hilton, J. A. Beall, Carlos Sierra, J. Van Lanen, and Joel N. Ullom

Subjects
Physics::Instrumentation and Detectors, FOS: Physical sciences, Astrophysics::Cosmology and Extragalactic Astrophysics, 01 natural sciences, Article, 010305 fluids & plasmas, law.invention, Optics, law, 0103 physical sciences, General Materials Science, 010306 general physics, Diplexer, Passband, Instrumentation and Methods for Astrophysics (astro-ph.IM), Astrophysics::Galaxy Astrophysics, Physics, business.industry, Linear polarization, Bolometer, Astrophysics::Instrumentation and Methods for Astrophysics, Polarimeter, Condensed Matter Physics, Atomic and Molecular Physics, and Optics, Orthomode transducer, 13. Climate action, Extremely high frequency, Transition edge sensor, Astrophysics - Instrumentation and Methods for Astrophysics, business
Abstract

We describe the design and measurement of feedhorn-coupled, transition-edge sensor (TES) polarimeters with two passbands centered at 220 GHz and 280 GHz, intended for observations of the cosmic microwave background. Each pixel couples polarized light in two linear polarizations by use of a planar orthomode transducer and senses power via four TES bolometers, one for each band in each linear polarization. Previous designs of this detector architecture incorporated passbands from 27 GHz to 220 GHz; we now demonstrate this technology at frequencies up to 315 GHz. Observational passbands are defined with an on-chip diplexer, and Fourier-transform-spectrometer measurements are in excellent agreement with simulations. We find coupling from feedhorn to TES bolometer using a cryogenic, temperature-controlled thermal source. We determine the optical efficiency of our device is $\eta$ = 77%$\pm$6% (75%$\pm$5%) for 220 (280) GHz, relative to the designed passband shapes. Lastly, we compare two power-termination schemes commonly used in wide-bandwidth millimeter-wave polarimeters and find equal performance in terms of optical efficiency and passband shape., Comment: Proceedings for the 18th International Workshop on Low Temperature Detectors (LTD18), submitted to the Journal of Low Temperature Physics

Published
2021

45. Measurements of AlMn TES bolometers well described by simple electrothermal model

Author

Michael R. Vissers, Shannon M. Duff, Samantha Walker, James A. Beall, Gene C. Hilton, Bradley Dober, Jason E. Austermann, Johannes Hubmayr, Jeffrey L. Van Lanen, and Joel N. Ullom

Subjects
Superconductivity, Materials science, business.industry, Bolometer, Detector, Astrophysics::Instrumentation and Methods for Astrophysics, Time constant, Astrophysics::Cosmology and Extragalactic Astrophysics, law.invention, law, Volumetric heat capacity, Optoelectronics, Transition edge sensor, business, Electrical impedance, Microwave
Abstract

Cosmic microwave background (CMB) polarization experiments utilize arrays of low temperature detectors, such as superconducting transition-edge sensor (TES) bolometers. Voltage-biased TES bolometers must be embedded in a readout circuit that allows for stable operation. To ensure stability and to test our physical and electrothermal model of these devices, measurements aimed at characterizing the dynamics of the sensor over the range of detector bias and loading conditions relevant to our application are carried out for multiple bolometer designs. In this work, we present bolometer electrothermal properties derived from current-voltage curves, effective electrothermal time constant measurements, and complex impedance measurements of AlMn TES bolometers intended for the Ali CMB Polarization Telescope (AliCPT). All bolometers consist of 385nm thick 1400 ppma AlMn film with measured superconducting critical temperature Tc = 480 mK. The bolometers are well-described by a simple, one-pole electrothermal model with a natural time constant τ0 that we adjust by varying the leg geometry and the amount of PdAu thermal ballast on the bolometer island. From these measurements, we determine that the volumetric heat capacity of sputtered PdAu (atomic percentages 67.6%/32.4%) at 480mK is 0.22 fJ/(K·μm3). Finally, we present the TES parameters as a function of operational resistance and over a range of loading conditions.

Published
2021

46. Moving towards a Treatable Traits model of care for the management of obstructive airways diseases

Author

Alvar Agusti, John Oppenheimer, Louisa Yates, Vanessa M. McDonald, Mike Thomas, Liam G Heaney, Ian D. Pavord, Fernando J. Martinez, Samantha Walker, Neil Barnes, David Leather, Alberto Papi, Alvaro A. Cruz, Hiromasa Inoue, and Peter G. Gibson

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pulmonary disease, NO, Pulmonary Disease, Chronic Obstructive, Pharmacotherapy, Asthma, biomarkers,COPD, targeted therapy, Humans, Medicine, COPD, In patient, Precision Medicine, Intensive care medicine, Asthma, Evidence-Based Medicine, business.industry, biomarkers, medicine.disease, targeted therapy, respiratory tract diseases, Management strategy, Practice Guidelines as Topic, Female, business, Airway, Stepwise approach
Abstract

Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airways diseases. Both are complex and heterogeneous. Traditionally, clinical guidelines have advocated a stepwise approach to pharmacotherapy of asthma and COPD, but there is increasing realization that both require a more personalized and precise management approach. To this end, a management strategy based on the so-called Treatable Traits has been proposed. Emerging evidence suggests that this model improves relevant outcomes in patients with chronic airway diseases but further research is needed to guide implementation. This review discusses the challenges, opportunities, and hurdles that its implementation will have to face.

Published
2021

47. Simons Observatory Small Aperture Telescope overview

Author

Heather McCarrick, Osamu Tajima, Yuji Chinone, Jon E. Gudmundsson, Nicholas Galitzki, Federico Nati, Gabriele Coppi, Andrew Bazako, Joseph Seibert, Kevin D. Crowley, Jason E. Austermann, Masaya Hasegawa, Grant Teply, Jacob Spisak, Tran Tsan, Bradley R. Johnson, Edward J. Wollack, Giulio Fabbian, Brian Keating, Simon Dicker, Mario Zannoni, Mayuri Sathyanarayana Rao, Yume Nishinomiya, Frederick Matsuda, Kam Arnold, Shunsuke Adachi, Ningfeng Zhu, Charles A. Hill, James A. Beall, Tomoki Terasaki, D. Kaneko, Akito Kusaka, Kevin T. Crowley, Bradley Dober, Samantha Walker, Lyman A. Page, Adrian T. Lee, Kenji Kiuchi, Kathleen Harrington, Shuay-Pwu Patty Ho, Nobuhiko Katayama, Makoto Hattori, Peter Ashton, Johannes Hubmayr, Joseph E. Golec, Kana Sakaguri, Masaaki Murata, Shannon M. Duff, Kyohei Yamada, Zhilei Xu, Yuki Sakurai, Jack Lashner, Christian L. Reichardt, Aamir Ali, Marshall, HK, Spyromilio, J, Usuda, T, Kiuchi, K, Adachi, S, Ali, A, Arnold, K, Ashton, P, Austermann, J, Bazako, A, Beall, J, Chinone, Y, Coppi, G, Crowley, K, Dicker, S, Dober, B, Duff, S, Fabbian, G, Galitzki, N, Golec, J, Gudmundsson, J, Harrington, K, Hasegawa, M, Hattori, M, Hill, C, Ho, S, Hubmayr, J, Johnson, B, Kaneko, D, Katayama, N, Keating, B, Kusaka, A, Lashner, J, Lee, A, Matsuda, F, Mccarrick, H, Murata, M, Nati, F, Nishinomiya, Y, Page, L, Rao, M, Reichardt, C, Sakaguri, K, Sakurai, Y, Sibert, J, Spisak, J, Tajima, O, Teply, G, Terasaki, T, Tsan, T, Walker, S, Wollack, E, Xu, Z, Yamada, K, Zannoni, M, and Zhu, N

Subjects
Aperture, Cosmic microwave background, FOS: Physical sciences, Field of view, Astrophysics::Cosmology and Extragalactic Astrophysics, CMB, law.invention, Telescope, FIS/05 - ASTRONOMIA E ASTROFISICA, Optics, law, Observatory, Cosmic Microwave Background, Instrumentation and Methods for Astrophysics (astro-ph.IM), Physics, business.industry, Gravitational wave, Stray light, Bolometer, Astrophysics::Instrumentation and Methods for Astrophysics, Radio, Primordial gravitational wave, B-mode, Ground-Based Telescope, business, Astrophysics - Instrumentation and Methods for Astrophysics
Abstract

The Simons Observatory (SO) is a cosmic microwave background (CMB) experiment from the Atacama Desert in Chile comprising three small-aperture telescopes (SATs) and one large-aperture telescope (LAT). In total, SO will field over 60,000 transition-edge sensor (TES) bolometers in six spectral bands centered between 27 and 280 GHz in order to achieve the sensitivity necessary to measure or constrain numerous cosmological quantities. In this work, we focus on the SATs which are optimized to search for primordial gravitational waves that are detected as parity-odd polarization patterns called a B-modes on degree scales in the CMB. Each SAT employs a single optics tube with TES arrays operating at 100 mK. The high throughput optics system has a 42 cm aperture and a 35-degree field of view coupled to a 36 cm diameter focal plane. The optics consist of three metamaterial anti-re ection coated silicon lenses. Cryogenic ring baffles with engineered blackbody absorbers are installed in the optics tube to minimize the stray light. The entire optics tube is cooled to 1 K. A cryogenic continuously rotating half-wave plate near the sky side of the aperture stop helps to minimize the effect of atmospheric uctuations. The telescope warm baffling consists of a forebaffle, an elevation stage mounted co-moving shield, and a fixed ground shield that together control the far side-lobes and mitigates ground-synchronous systematics. We present the status of the SAT development., Comment: 8 pages, 6 figures

Published
2021
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48. The long-term sequelae of COVID-19: an international consensus on research priorities for patients with pre-existing and new-onset airways disease

Author

Davies Adeloye, Omer Elneima, Luke Daines, Krisnah Poinasamy, Jennifer K Quint, Samantha Walker, Chris E Brightling, Salman Siddiqui, John R Hurst, James D Chalmers, Paul E Pfeffer, Petr Novotny, Thomas M Drake, Liam G Heaney, Igor Rudan, Aziz Sheikh, Anthony De Soyza, Mohammad Abdollahi, Dhiraj Agarwal, Riyad Al-Lehebi, Peter J Barnes, Jagadeesh Bayry, Marcel Bonay, Louis J Bont, Arnaud Bourdin, Thomas Brown, Gaetano Caramori, Amy Hai Yan Chan, David H Dockrell, Simon Doe, Jamie Duckers, Anthony D'Urzo, Magnus Ekström, Cristóbal Esteban, Catherine M Greene, Atul Gupta, Jennifer L Ingram, Ee Ming Khoo, Fanny Wai San Ko, Gerard H Koppelman, Brian J Lipworth, Karin Lisspers, Michael Loebinger, Jose Luis Lopez-Campos, Matthew Maddocks, David Mannino, Miguel A Martinez-Garcia, Renae Mcnamara, Marc Miravitlles, Pisirai Ndarukwa, Alison Pooler, Chin Kook Rhee, Peter Schwarz, Dominick Shaw, Michael Steiner, Andrew Tai, Charlotte Suppli Ulrik, Paul Walker, and Michelle C Williams

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Consensus, Coronavirus disease 2019 (COVID-19), MEDLINE, New onset, long COVID, COPD, airway disease, asthma, Post-Acute COVID-19 Syndrome, medicine, Humans, Intensive care medicine, Depression (differential diagnoses), business.industry, SARS-CoV-2, Airways disease, Research, Comment, COVID-19, medicine.disease, Respiration Disorders, Sarcopenia, Anxiety, Ill health, Position Paper, medicine.symptom, business
Abstract

Persistent ill health after acute COVID-19-referred to as long COVID, the post-acute COVID-19 syndrome, or the post-COVID-19 condition-has emerged as a major concern. We undertook an international consensus exercise to identify research priorities with the aim of understanding the long-term effects of acute COVID-19, with a focus on people with pre-existing airways disease and the occurrence of new-onset airways disease and associated symptoms. 202 international experts were invited to submit a minimum of three research ideas. After a two-phase internal review process, a final list of 98 research topics was scored by 48 experts. Patients with pre-existing or post-COVID-19 airways disease contributed to the exercise by weighting selected criteria. The highest-ranked research idea focused on investigation of the relationship between prognostic scores at hospital admission and morbidity at 3 months and 12 months after hospital discharge in patients with and without pre-existing airways disease. High priority was also assigned to comparisons of the prevalence and severity of post-COVID-19 fatigue, sarcopenia, anxiety, depression, and risk of future cardiovascular complications in patients with and without pre-existing airways disease. Our approach has enabled development of a set of priorities that could inform future research studies and funding decisions. This prioritisation process could also be adapted to other, non-respiratory aspects of long COVID.

Published
2021

49. The Simons Observatory: the Large Aperture Telescope Receiver (LATR) Integration and Validation Results

Author

Suzanne T. Staggs, Jenna Moore, Jake Connors, John Orlowski-Scherer, Steve K. Choi, Federico Nati, Michael D. Niemack, Erin Healy, Ningfeng Zhu, Joseph Seibert, Bradley Dober, Robert Thornton, Brian J. Koopman, Zhilei Xu, Johannes Hubmayr, Jack Lashner, Tanay Bhandarkar, Christian L. Reichardt, Nicholas F. Cothard, Jason E. Austermann, Giulio Fabbian, Shuay-Pwu Patty Ho, Edward J. Wollack, Gabriele Coppi, Yuhan Wang, Michele Limon, Jeffrey Iuliano, Mark J. Devlin, Kathleen Harrington, Kaiwen Zheng, Shannon M. Duff, Kam Arnold, Heather McCarrick, Samantha Walker, Simon Dicker, Eve M. Vavagiakis, Maximiliano Silva-Feaver, Nicholas Galitzki, A. M. Kofman, Rita Sonka, Michael R. Vissers, Karen Perez Sarmiento, Yaqiong Li, Aamir Ali, Saianeesh K. Haridas, Zmuidzinas J.,Gao J.-R., Xu, Z, Bhandarkar, T, Coppi, G, Kofman, A, Orlowski-Scherer, J, Zhu, N, Ali, A, Arnold, K, Austermann, J, Choi, S, Connors, J, Cothard, N, Devlin, M, Dicker, S, Dober, B, Duff, S, Fabbian, G, Galitzki, N, Haridas, S, Harrington, K, Healy, E, Ho, S, Hubmayr, J, Iuliano, J, Lashner, J, Li, Y, Limon, M, Koopman, B, Mccarrick, H, Moore, J, Nati, F, Niemack, M, Reichardt, C, Sarmiento, K, Seibert, J, Silva-Feaver, M, Sonka, R, Staggs, S, Thornton, R, Vavagiakis, E, Vissers, M, Walker, S, Wang, Y, Wollack, E, and Zheng, K

Subjects
Physics, COSMIC cancer database, Astrophysics::High Energy Astrophysical Phenomena, Cosmic microwave background, Bolometer, Astrophysics::Instrumentation and Methods for Astrophysics, Observa-tional Cosmology, Astronomy, FOS: Physical sciences, Astrophysics::Cosmology and Extragalactic Astrophysics, Radio spectrum, Cryogenic Technology, law.invention, Astronomical Instrumentation, Telescope, law, Observatory, Observational cosmology, Cosmic Microwave Background, Astrophysics::Earth and Planetary Astrophysics, Neutrino, Astrophysics - Instrumentation and Methods for Astrophysics, Instrumentation and Methods for Astrophysics (astro-ph.IM)
Abstract

The Simons Observatory (SO) will observe the cosmic microwave background (CMB) from Cerro Toco in the Atacama Desert of Chile. The observatory consists of three 0.5 m Small Aperture Telescopes (SATs) and one 6 m Large Aperture Telescope (LAT), covering six frequency bands centering around 30, 40, 90, 150, 230, and 280 GHz. The SO observations will transform the understanding of our universe by characterizing the properties of the early universe, measuring the number of relativistic species and the mass of neutrinos, improving our understanding of galaxy evolution, and constraining the properties of cosmic reionization. As a critical instrument, the Large Aperture Telescope Receiver (LATR) is designed to cool $\sim$ 60,000 transition-edge sensors (TES) to $, Comment: 20 pages, 12 figures, submitted to the 2020 SPIE Astronomical Telescopes + Instrumentation

Published
2020

50. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies

Author

Bousquet, Jean, Cristol, Jean-Paul, Czarlewski, Wienczyslawa, Anto, Josep M, Martineau, Adrian, Haahtela, Tari, Fonseca, Susana C, Iaccarino, Guido, Blain, Hubert, Fiocchi, Alessandro, Canonica, G Walter, Fonseca, Joao A, Vidal, Alain, Choi, Hak-Jong, Kim, Hyun Ju, Le Moing, Vincent, Reynes, Jacques, Sheikh, Aziz, Akdis, Cezmi A, Zuberbier, Torsten, Amir Hamzah Abdul Latiff, Baharudin, Abdullah, Werner, Aberer, Nancy, Abusada, Ian, Adcock, Alejandro, Afani, Ioana, Agache, Xenofon, Aggelidis, Jenifer, Agustin, Cezmi, A Akdis, Mübeccel, Akdis, Mona, Al-Ahmad, Abou Al-Zahab Bassam, Hussam, Alburdan, Oscar, Aldrey-Palacios, Emilio Alvarez Cuesta, Hiba Alwan Salman, Ashraf, Alzaabi, Salma, Amade, Gene, Ambrocio, Rosana, Angles, Isabella, Annesi-Maesano, Ignacio, J Ansotegui, Josep, M Anto, Paula Ara Bardajo, Stefania, Arasi, Margarete, Arrais, Hasan, Arshad, Maria-Cristina, Artesani, Estrella, Asayag, Francesca, Avolio, Khuzama, Azhari, Claus, Bachert, Diego, Bagnasco, Ilaria, Baiardini, Nissera, Bajrović, Petros, Bakakos, Sergio Bakeyala Mongono, Christine, Balotro-Torres, Sergio, Barba, Cristina, Barbara, Elsa, Barbosa, Bruno, Barreto, Joan, Bartra, Xavier, Basagana, Eric, D Bateman, Lkhagvaa, Battur, Anna, Bedbrook, Martín Bedolla Barajas, Bianca, Beghé, Antra, Bekere, Elizabeth, Bel, Ali Ben Kheder, Mikael, Benson, Elena-Camelia, Berghea, Karl-Christian, Bergmann, Roberto, Bernardini, David, Bernstein, Mike, Bewick, Slawomir, Bialek, Artur, Białoszewski, Thomas, Bieber, Nils, E Billo, Maria-Beatrice, Bilo, Carsten, Bindslev-Jensen, Leif, Bjermer, Hubert, Blain, Irina, Bobolea, Malgorzata Bochenska Marciniak, Christine, Bond, Attilio, Boner, Matteo, Bonini, Sergio, Bonini, Sinthia, Bosnic-Anticevich, Isabelle, Bosse, Sofia, Botskariova, Jacques, Bouchard, Louis-Philippe, Boulet, Rodolphe, Bourret, Philippe, Bousquet, Fulvio, Braido, Andrew, Briggs, Christopher, E Brightling, Jan, Brozek, Luisa, Brussino, Roland, Buhl, Roxana, Bumbacea, Rosalva, Buquicchio, María-Teresa Burguete Cabañas, Andrew, Bush, William, W Busse, Jeroen, Buters, Fernan, Caballero-Fonseca, Moïses, A Calderon, Mario, Calvo, Paulo, Camargos, Thierry, Camuzat, R Canevari, F, Antonio, Cano, G Walter Canonica, Arnaldo, Capriles-Hulett, Luis, Caraballo, Vicky, Cardona, Kai-Hakon, Carlsen, Jonas Carmona Pirez, Jorge, Caro, Warner, Carr, Pedro, Carreiro-Martins, Fredelita, Carreon-Asuncion, Ana-Maria, Carriazo, Carme Carrion, Y Ribas, Thomas, Casale, Mary-Ann, Castor, Elizabeth, Castro, G Caviglia, A, Lorenzo, Cecchi, Alfonso Cepeda Sarabia, Maciej, Chalubinski, Ramanathan, Chandrasekharan, Yoon-Seok, Chang, Victoria, Chato-Andeza, Lida, Chatzi, Christina, Chatzidaki, Niels, H Chavannes, Claudia Chaves Loureiro, Aurora-Alejandra Chavez Garcia, Marta, Chelninska, Yuzhi, Chen, Lei, Cheng, Sharon, Chinthrajah, Tomas, Chivato, Ekaterine, Chkhartishvili, George, Christoff, Henry, Chrystyn, Derek, K Chu, Antonio, Chua, Alexander, Chuchalin, Kian Fan Chung, Alberto, Cicerán, Cemal, Cingi, Giorgio, Ciprandi, Ieva, Cirule, Ana-Carla, Coelho, Enrico, Compalati, Jannis, Constantinidis, Jaime Correia de Sousa, Elisio Manuel Costa, David, Costa, María Del Carmen Costa Domínguez, André, Coste, Cottini, M, Linda, Cox, Carlos, Crisci, Maria Angiola Crivellaro, Alvaro, A Cruz, John, Cullen, Adnan, Custovic, Biljana, Cvetkovski, Wienczyslawa, Czarlewski, Gennaro, D'Amato, Jane da Silva, Ronald, Dahl, Sven-Erik, Dahlen, Vasilis, Daniilidis, Louei Darjazini Nahhas, Ulf, Darsow, Janet, Davies, Frédéric de Blay, Giulia De Feo, Eloisa De Guia, José-Ricardo De la Torre Navarrete, Chato De Los Santos, Esteban De Manuel Keenoy, Govert De Vries, Diana, Deleanu, Pascal, Demoly, Judah, Denburg, Philippe, Devillier, Alain, Didier, Sanja Dimic Janjic, Maria, Dimou, Anh Tuan Dinh-Xuan, Ratko, Djukanovic, Maria Do Ceu Texeira, Dejan, Dokic, Margarita Gabriela Domínguez Silva, Habib, Douagui, Nikolaos, Douladiris, Maria, Doulaptsi, Gérard, Dray, Ruta, Dubakiene, Eve, Dupas, Stephen, Durham, Marzia, Duse, Mark, Dykewicz, Didier, Ebo, Natalija, Edelbaher, Thomas, Eiwegger, Patrik, Eklund, Yehia, El-Gamal, Zeinab, A El-Sayed, Shereen, S El-Sayed, Magda, El-Seify, Regina, Emuzyte, Lourdes, Enecilla, Marina, Erhola, Heidilita, Espinoza, Jesús Guillermo Espinoza Contreras, John, Farrell, Lenora, Fernandez, Paola Fimbres Jimenez, Antje Fink Wagner, Alessandro, Fiocchi, Wytske, J Fokkens, Lenia, Folletti, Joao, A Fonseca, Jean-François, Fontaine, Francesco, Forastiere, Jose Miguel Fuentes Pèrez, Emily, Gaerlan-Resureccion, Mina, Gaga, José Luis Gálvez Romero, Amiran, Gamkrelidze, Alexis, Garcia, Cecilia Yvonne García Cobas, María de la Luz Hortensia García Cruz, Valeria Garcia Ortiz, Jacques, Gayraud, Matteo, Gelardi, Bilun, Gemicioglu, Dimitra, Gennimata, Sonya, Genova, José, Gereda, Roy Gerth van Wijk, Antonio, Giuliano, René-Maximiliano, Gomez, Miguel-Ange Gonzalez Ballester, Sandra González Diaz, Maia, Gotua, Christos, Grigoreas, Ineta, Grisle, Marta, Guidacci, Nick, Guldemond, Zdenek, Gutter, Antonieta, Guzmán, Tari, Haahtela, Ramsa, Halloum, David, Halpin, Eckard, Hamelmann, Suleiman, Hammadi, Richard, Harvey, Enrico, Heffler, Joachim, Heinrich, Adnan, Hejjaoui, Birthe, Hellquist-Dahl, Luiana Hernández Velázquez, Mark, Hew, Elham, Hossny, Peter, Howarth, Martin, Hrubiško, Yunuen Rocío Huerta Villalobos, Marc, Humbert, Salina, Husain, Michael, Hyland, Guido, Iaccarino, Moustafa, Ibrahim, Nataliya, Ilina, Maddalena, Illario, Cristoforo, Incorvaia, Antonio, Infantino, Carla, Irani, Zhanat, Ispayeva, Juan Carlos Ivancevich, Edgardo Ej Jares, Deborah, Jarvis, Ewa, Jassem, Klemen, Jenko, Rubén Darío Jiméneracruz Uscanga, Sebastian, L Johnston, Guy, Joos, Maja, Jošt, Kaja, Julge, Ki-Suck, Jung, Jocelyne, Just, Marek, Jutel, Igor, Kaidashev, Omer, Kalayci, Fuat, Kalyoncu, Jeni, Kapsali, Przemyslaw, Kardas, Jussi, Karjalainen, Carmela, A Kasala, Michael, Katotomichelakis, Loreta, Kavaliukaite, Kazi, S Bennoor, Thomas, Keil, Paul, Keith, Musa, Khaitov, Nikolai, Khaltaev, You-Young, Kim, Bruce, Kirenga, Jorg, Kleine-Tebbe, Ludger, Klimek, Fanny, W Ko, Bernard Koffi N'Goran, Evangelia, Kompoti, Peter, Kopač, Gerard, Koppelman, Anja Koren Jeverica, Seppo, Koskinen, Mitja, Košnik, Tomasz, Kostka, Kosta, V Kostov, Marek, L Kowalski, Tanya, Kralimarkova, Karmen Kramer Vrščaj, Helga, Kraxner, Samo, Kreft, Vicky, Kritikos, Dmitry, Kudlay, Mikael, Kuitunen, Inger, Kull, Piotr, Kuna, Maciej, Kupczyk, Violeta, Kvedariene, Marialena, Kyriakakou, Nika, Lalek, Massimo, Landi, Stephen, Lane, Désiree, E Larenas-Linnemann, Susanne, Lau, Daniel, Laune, Jorge, Lavrut, Lan, Le, Martina, Lenzenhuber, Gualtiero, Leo, Marcus, Lessa, Michael, Levin, Jing, Li, Philip, Lieberman, Giuseppe, Liotta, Brian, Lipworth, Xuandao, Liu, Rommel, Lobo, Karin, C Lodrup Carlsen, Carlo, Lombardi, Renaud, Louis, Stelios, Loukidis, Olga, Lourenço, Jorge, A Luna Pech, Bojan, Madjar, Enrico, Maggi, Antoine, Magnan, Bassam, Mahboub, Alpana, Mair, Anke-Hilse Maitland van der Zee, Mika, Makela, Michael, Makris, Hans-Jorgen, Malling, Mariana, Mandajieva, Patrick, Manning, Manolis, Manousakis, Pavlos, Maragoudakis, Gianluigi, Marseglia, Gailen, Marshall, Mohammad Reza Masjedi, Jorge, F Máspero, Juan José Matta Campos, Marcus, Maurer, Sandra, Mavale-Manuel, Cem, Meço, Erik, Melén, Giovanni, Melioli, Elisabete, Melo-Gomes, Eli, O Meltzer, Enrica, Menditto, Andrew, Menzies-Gow, Hans, Merk, Jean-Pierre, Michel, Yann, Micheli, Neven, Miculinic, Luís, Midão, Florin, Mihaltan, Nikolaos, Mikos, Manlio, Milanese, Branislava, Milenkovic, Dimitrios, Mitsias, Bassem, Moalla, Giuliana, Moda, María Dolores Mogica Martínez, Yousser, Mohammad, Frances-Montserrat, Moharra, Mostafa, Moin, Mathieu, Molimard, Isabelle, Momas, Monique, Mommers, Alessandro, Monaco, Stephen, Montefort, Lucia-Elvira, Montenegro, Riccardo, Monti, Dory, Mora, Mario, Morais-Almeida, Ralph, Mösges, Badr Eldin Mostafa, Joaquim, Mullol, Lars, Münter, Antonella, Muraro, Ruth, Murray, Antonio, Musarra, Tihomir, Mustakov, Robert, Naclerio, Kari, C Nadeau, Rachel, Nadif, Alla, Nakonechna, Leyla, Namazova-Baranova, Gretchen, Navarro-Locsin, Hugo, Neffen, Kristof, Nekam, Angelos, Neou, Eustachio, Nettis, Daniel, Neuberger, Laurent, Nicod, Stefania, Nicola, Verena, Niederberger-Leppin, Marek, Niedoszytko, Antonio, Nieto, Ettore, Novellino, Elizabete, Nunes, Dieudonné, Nyembue, Robyn, E O'Hehir, Cvetanka, Odjakova, Ken, Ohta, Yoshitaka, Okamoto, Kimi, Okubo, Brian, Oliver, Gabrielle, L Onorato, Maria Pia Orru, Solange, Ouédraogo, Kampadilemba, Ouoba, Francisco-Javier, Padilla, Pier Luigi Paggiaro, Aris, Pagkalos, Pajno, Giovanni Battista, Gianni, Pala, P Palaniappan, S, Isabella, Pali-Schöll, Susanna, Palkonen, Stephen, Palmer, Carmen Panaitescu Bunu, Petr, Panzner, Nikos, G Papadopoulos, Vasilis, Papanikolaou, Alberto, Papi, Bojidar, Paralchev, Giannis, Paraskevopoulos, Hae-Sim, Park, Giovanni, Passalacqua, Vincenzo, Patella, Ian, Pavord, Ruby, Pawankar, Soren, Pedersen, Susete, Peleve, Simona, Pellegino, Ana, Pereira, Mariana, Pereira, Tamara, Pérez, Andrea, Perna, Diego, Peroni, Oliver, Pfaar, Nhân, Pham-Thi, Bernard, Pigearias, Isabelle, Pin, Konstantina, Piskou, Constantinos, Pitsios, Davor, Plavec, Dagmar, Poethig, Wolfgang, Pohl, Antonija Poplas Susic, Todor, A Popov, Fabienne, Portejoie, Paul, Potter, Lars, Poulsen, Alexandra, Prados-Torres, Fotis, Prarros, David, Price, Emmanuel, Prokopakis, Francesca, Puggioni, Elisa, Puig-Domenech, Robert, Puy, Klaus, Rabe, Silvia, Rabotti, Filip, Raciborski, Josephine, Ramos, Cristina, Recalcati, Marysia, T Recto, Shereen, M Reda, Frederico, S Regateiro, Norbert, Reider, Sietze, Reitsma, Susana, Repka-Ramirez, Erminia, Ridolo, Janet, Rimmer, Daniela Rivero Yeverino, José Angelo Rizzo, Carlos, Robalo-Cordeiro, Graham, Roberts, Karen, Robles, Nicolas, Roche, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Giovanni, Rolla, Christine, Rolland, Regina, Roller-Wirnsberger, Miguel Roman Rodriguez, Antonino, Romano, Jan, Romantowski, Philippe, Rombaux, Joel, Romualdez, Jose, Rosado-Pinto, Nelson, Rosario, Lanny, Rosenwasser, Oliviero, Rossi, Menachem, Rottem, Philip, W Rouadi, Nikoleta, Rovina, Irma Rozman Sinur, Mauricio, Ruiz, Lucy Tania Ruiz Segura, Dermot, Ryan, Hironori, Sagara, Daiki, Sakai, Daiju, Sakurai, Wafaa, Saleh, Johanna, Salimaki, Konstantinos, Samitas, Boleslaw, Samolinski, María Guadalupe Sánchez Coronel, Mario, Sanchez-Borges, Jaime, Sanchez-Lopez, Melissa, Sansonna, Codrut, Sarafoleanu, Faradiba Sarquis Serpa, Joaquin, Sastre, Eleonora, Savi, Agne, Savonyte, Bisher, Sawaf, Glenis, K Scadding, Sophie, Scheire, Peter, Schmid-Grendelmeier, Juan Francisco Schuhl, Holger, Schunemann, Maria, Schvalbová, Jorgen, Schwarze, Nicola, Scichilone, Gianenrico, Senna, Cecilia, Sepúlveda, Elie, Serrano, Sara, Shamai, Aziz, Sheikh, Mike, Shields, Vasil, Shishkov, Nikos, Siafakas, Alexander, Simeonov, Estelle Fer Simons, Juan Carlos Sisul, Brigita, Sitkauskiene, Ingelbjorg, Skrindo, Tanja Soklič Košak, Dirceu, Solé, Martin, Sondermann, Talant, Sooronbaev, Manuel, Soto-Martinez, Manuel, Soto-Quiros, Barnaro Sousa Pinto, Milan, Sova, Michael, Soyka, Krzysztof, Specjalski, Annette, Sperl, Otto, Spranger, Sofia, Stamataki, Lina, Stefanaki, Cristiana, Stellato, Rafael, Stelmach, Timo, Strandberg, Petra, Stute, Abirami, Subramaniam, Charlotte Suppli Ulrik, Michael, Sutherland, Silvia, Sylvestre, Aikaterini, Syrigou, Luis Taborda Barata, Nadejda, Takovska, Rachel, Tan, Frances, Tan, Vincent, Tan, Ing Ping Tang, Masami, Taniguchi, Line, Tannert, Pongsakorn, Tantilipikorn, Jessica, Tattersall, Filippo, Tesi, Uta, Thieme, Carel, Thijs, Mike, Thomas, Teresa, To, Ana Maria Todo-Bom, Alkis, Togias, Peter-Valentin, Tomazic, Vesna, Tomic-Spiric, Sanna, Toppila-Salmi, Maria-José Torres Jaen, Elina, Toskala, Massimo, Triggiani, Nadja, Triller, Katja, Triller, Ioanna, Tsiligianni, Uberti, M, Ruxandra, Ulmeanu, Jure, Urbancic, Marilyn Urrutia Pereira, Martina, Vachova, Felipe, Valdés, Rudolf, Valenta, Marylin Valentin Rostan, Antonio, Valero, Arunas, Valiulis, Mina, Vallianatou, Erkka, Valovirta, Michiel Van Eerd, Eric Van Ganse, Marianne van Hage, Olivier, Vandenplas, Tuula, Vasankari, Dafina, Vassileva, Cesar Velasco Munoz, Maria Teresa Ventura, Cécilia, Vera-Munoz, Frédéric, Viart, Dilyana, Vicheva, Pakit, Vichyanond, Petra, Vidgren, Giovanni, Viegi, Claus, Vogelmeier, Leena Von Hertzen, Theodoros, Vontetsianos, Dimitris, Vourdas, Vu Tran Thien Quan, Martin, Wagenmann, Samantha, Walker, Dana, Wallace, Yun De Wang, Susan, Waserman, Katrin, Wehner, Magnus, Wickman, Sian, Williams, Dennis, Williams, Nicola, Wilson, Gary, Wong, Kent, Woo, Lucyna, Wozniak, John, Wright, Piotr, Wroczynski, Paraskevi, Xepapadaki, Plamen, Yakovliev, Masao, Yamaguchi, Kwok, Yan, Yoke Yeow Yap, Mais, Yassin, Barbara, Yawn, Panayiotis, Yiallouros, Arzu, Yorgancioglu, Shigemi, Yoshihara, Ian, Young, Osman, B Yusuf, Asghar, Zaidi, Fares, Zaitoun, Petra, Zalud, Heather, Zar, T Zedda, M, Mario, E Zernotti, Luo, Zhang, Nanshan, Zhong, Mihaela, Zidarn, Torsten, Zuberbier, Celia, Zubrinich, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Humboldt University Of Berlin, Berlin Institute of Health (BIH), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Central Hospital [Finland] (HUCH), Departamento de Geociencias, Ambiente e Ordenamento do Territorio (DGAOT), Universidade do Porto = University of Porto, University of Naples Federico II = Università degli studi di Napoli Federico II, Euromov (EuroMov), Université de Montpellier (UM), IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), Center of Research in Health Technologies and Information Systems (CINTESIS), AgroParisTech, World Institute of Kimchi [Gwangju], Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Edinburgh, Universität Zürich [Zürich] = University of Zurich (UZH), Humboldt-Universität zu Berlin, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), University of Helsinki, Universidade do Porto, University of Naples Federico II, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), MORNET, Dominique, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Bousquet J., Cristol J.-P., Czarlewski W., Anto J.M., Martineau A., Haahtela T., Fonseca S.C., Iaccarino G., Blain H., Fiocchi A., Canonica G.W., Fonseca J.A., Vidal A., Choi H.-J., Kim H.J., Le Moing V., Reynes J., Sheikh A., Akdis C.A., Zuberbier T., Abdul Latiff A.H., Abdullah B., Aberer W., Abusada N., Adcock I., Afani A., Agache I., Aggelidis X., Agustin J., Akdis M., Al-Ahmad M., Al-Zahab Bassam A., Alburdan H., Aldrey-Palacios O., Alvarez Cuesta E., Alwan Salman H., Alzaabi A., Amade S., Ambrocio G., Angles R., Annesi-Maesano I., Ansotegui I.J., Ara Bardajo P., Arasi S., Arrais M., Arshad H., Artesani M.-C., Asayag E., Avolio F., Azhari K., Bachert C., Bagnasco D., Baiardini I., Bajrovic N., Bakakos P., Bakeyala Mongono S., Balotro-Torres C., Barba S., Barbara C., Barbosa E., Barreto B., Bartra J., Basagana X., Bateman E.D., Battur L., Bedbrook A., Bedolla Barajas M., Beghe B., Bekere A., Bel E., Ben Kheder A., Benson M., Berghea E.-C., Bergmann K.-C., Bernardini R., Bernstein D., Bewick M., Bialek S., Bialoszewski A., Bieber T., Billo N.E., Bilo M.-B., Bindslev-Jensen C., Bjermer L., Bobolea I., Bochenska Marciniak M., Bond C., Boner A., Bonini M., Bonini S., Bosnic-Anticevich S., Bosse I., Botskariova S., Bouchard J., Boulet L.-P., Bourret R., Bousquet P., Braido F., Briggs A., Brightling C.E., Brozek J., Brussino L., Buhl R., Bumbacea R., Buquicchio R., Burguete Cabanas M.-T., Bush A., Busse W.W., Buters J., Caballero-Fonseca F., Calderon M.A., Calvo M., Camargos P., Camuzat T., Canevari F., Cano A., Canonican G.W., Capriles-Hulett A., Caraballo L., Cardona V., Carlsen K.-H., Carmona Pirez J., Caro J., Carr W., Carreiro-Martins P., Carreon-Asuncion F., Carriazo A.-M., CarrionyRibas C., Casale T., Castor M.-A., Castro E., Caviglia A.G., Cecchi L., Cepeda Sarabia A., Chalubinski M., Chandrasekharan R., Chang Y.-S., Chato-Andeza V., Chatzi L., Chatzidaki C., Chavannes N.H., Chaves Loureiro C., Chavez Garcia A.-A., Chelninska M., Chen Y., Cheng L., Chinthrajah S., Chivato T., Chkhartishvili E., Christoff G., Chrystyn H., Chu D.K., Chua A., Chuchalin A., Chung K.F., Ciceran A., Cingi C., Ciprandi G., Cirule I., Coelho A.-C., Compalati E., Constantinidis J., Correia de Sousa J., Costa E.M., Costa D., del Carmen Costa Dominguez M., Coste A., Cottini M., Cox L., Crisci C., Crivellaro M.A., Cruz A.A., Cullen J., Custovic A., Cvetkovski B., D'Amato G., da Silva J., Dahl R., Dahlen S.-E., Daniilidis V., Darjazini Nahhas L., Darsow U., Davies J., de Blay F., De Feo G., De Guia E., De la Torre Navarrete J.-R., De los Santos C., De Manuel Keenoy E., De Vries G., Deleanu D., Demoly P., Denburg J., Devillier P., Didier A., Dimic Janjic S., Dimou M., Dinh-Xuan A.T., Djukanovic R., Do Ceu Texeira M., Dokic D., Dominguez Silva M.G., Douagui H., Douladiris N., Doulaptsi M., Dray G., Dubakiene R., Dupas E., Durham S., Duse M., Dykewicz M., Ebo D., Edelbaher N., Eiwegger T., Eklund P., El-Gamal Y., El-Sayed Z.A., El-Sayed S.S., El-Seify M., Emuzyte R., Enecilla L., Erhola M., Espinoza H., Espinoza Contreras J.G., Farrell J., Fernandez L., Fimbres Jimenez P., Fink Wagner A., Fokkens W.J., Folletti L., Fontaine J.-F., Forastiere F., Fuentes Perez J.M., Gaerlan-Resureccion E., Gaga M., Galvez Romero J.L., Gamkrelidze A., Garcia A., Garcia Cobas C.Y., de la Luz Hortensia Garcia Cruz M., Ortiz V.G., Gayraud J., Gelardi M., Gemicioglu B., Gennimata D., Genova S., Gereda J., Gerth van Wijk R., Giuliano A., Gomez R.-M., Gonzalez Ballester M.-A., Gonzalez Diaz S., Gotua M., Grigoreas C., Grisle I., Guidacci M., Guldemond N., Gutter Z., Guzman A., Halloum R., Halpin D., Hamelmann E., Hammadi S., Harvey R., Heffler E., Heinrich J., Hejjaoui A., Hellquist-Dahl B., Hernandez Velazquez L., Hew M., Hossny E., Howarth P., Hrubisko M., Huerta Villalobos Y.R., Humbert M., Husain S., Hyland M., Ibrahim M., Ilina N., Illario M., Incorvaia C., Infantino A., Irani C., Ispayeva Z., Ivancevich J.C., Jares E.E., Jarvis D., Jassem E., Jenko K., Jimeneracruz Uscanga R.D., Johnston S.L., Joos G., Jost M., Julge K., Jung K.-S., Just J., Jutel M., Kaidashev I., Kalayci O., Kalyoncu F., Kapsali J., Kardas P., Karjalainen J., Kasala C.A., Katotomichelakis M., Kavaliukaite L., Bennoor K.S., Keil T., Keith P., Khaitov M., Khaltaev N., Kim Y.-Y., Kirenga B., Kleine-Tebbe J., Klimek L., Ko F.W., Koffi N'Goran B., Kompoti E., Kopac P., Koppelman G., Koren Jeverica A., Koskinen S., Kosnik M., Kostka T., Kostov K.V., Kowalski M.L., Kralimarkova T., Kramer Vrscaj K., Kraxner H., Kreft S., Kritikos V., Kudlay D., Kuitunen M., Kull I., Kuna P., Kupczyk M., Kvedariene V., Kyriakakou M., Lalek N., Landi M., Lane S., Larenas-Linnemann D.E., Lau S., Laune D., Lavrut J., Le L., Lenzenhuber M., Leo G., Lessa M., Levin M., Li J., Lieberman P., Liotta G., Lipworth B., Liu X., Lobo R., Lodrup Carlsen K.C., Lombardi C., Louis R., Loukidis S., Lourenco O., Luna Pech J.A., Madjar B., Maggi E., Magnan A., Mahboub B., Mair A., Maitland van der Zee A.-H., Makela M., Makris M., Malling H.-J., Mandajieva M., Manning P., Manousakis M., Maragoudakis P., Marseglia G., Marshall G., Masjedi M.R., Maspero J.F., Matta Campos J.J., Maurer M., Mavale-Manuel S., Meco C., Melen E., Melioli G., Melo-Gomes E., Meltzer E.O., Menditto E., Menzies-Gow A., Merk H., Michel J.-P., Micheli Y., Miculinic N., Midao L., Mihaltan F., Mikos N., Milanese M., Milenkovic B., Mitsias D., Moalla B., Moda G., Mogica Martinez M.D., Mohammad Y., Moharra F.-M., Moin M., Molimard M., Momas I., Mommers M., Monaco A., Montefort S., Montenegro L.-E., Monti R., Mora D., Morais-Almeida M., Mosges R., Mostafa B.E., Mullol J., Munter L., Muraro A., Murray R., Musarra A., Mustakov T., Naclerio R., Nadeau K.C., Nadif R., Nakonechna A., Namazova-Baranova L., Navarro-Locsin G., Neffen H., Nekam K., Neou A., Nettis E., Neuberger D., Nicod L., Nicola S., Niederberger-Leppin V., Niedoszytko M., Nieto A., Novellino E., Nunes E., Nyembue D., O'Hehir R.E., Odjakova C., Ohta K., Okamoto Y., Okubo K., Oliver B., Onorato G.L., Orru M.P., Ouedraogo S., Ouoba K., Padilla F.-J., Paggiaro P.L., Pagkalos A., Pajno G., Pala G., Palaniappan S., Pali-Scholl I., Palkonen S., Palmer S., Panaitescu Bunu C., Panzner P., Papadopoulos N.G., Papanikolaou V., Papi A., Paralchev B., Paraskevopoulos G., Park H.-S., Passalacqua G., Patella V., Pavord I., Pawankar R., Pedersen S., Peleve S., Pellegino S., Pereira A., Pereira M., Perez T., Perna A., Peroni D., Pfaar O., Pham-Thi N., Pigearias B., Pin I., Piskou K., Pitsios C., Plavec D., Poethig D., Pohl W., Poplas Susic A., Popov T.A., Portejoie F., Potter P., Poulsen L., Prados-Torres A., Prarros F., Price D., Prokopakis E., Puggioni F., Puig-Domenech E., Puy R., Rabe K., Rabotti S., Raciborski F., Ramos J., Recalcati C., Recto M.T., Reda S.M., Regateiro F.S., Reider N., Reitsma S., Repka-Ramirez S., Ridolo E., Rimmer J., Rivero Yeverino D., Rizzo J.A., Robalo-Cordeiro C., Roberts G., Robles K., Roche N., Rodriguez Gonzalez M., Rodriguez Zagal E., Rolla G., Rolland C., Roller-Wirnsberger R., Roman Rodriguez M., Romano A., Romantowski J., Rombaux P., Romualdez J., Rosado-Pinto J., Rosario N., Rosenwasser L., Rossi O., Rottem M., Rouadi P.W., Rovina N., Rozman Sinur I., Ruiz M., Ruiz Segura L.T., Ryan D., Sagara H., Sakai D., Sakurai D., Saleh W., Salimaki J., Samitas K., Samolinski B., Sanchez Coronel M.G., Sanchez-Borges M., Sanchez-Lopez J., Sansonna M., Sarafoleanu C., Sarquis Serpa F., Sastre J., Savi E., Savonyte A., Sawaf B., Scadding G.K., Scheire S., Schmid-Grendelmeier P., Schuhl J.F., Schunemann H., Schvalbova M., Schwarze J., Scichilone N., Senna G., Sepulveda C., Serrano E., Shamai S., Shields M., Shishkov V., Siafakas N., Simeonov A., Simons E.F., Sisul J.C., Sitkauskiene B., Skrindo I., Soklic Kosak T., Sole D., Sondermann M., Sooronbaev T., Soto-Martinez M., Soto-Quiros M., Pinto B.S., Sova M., Soyka M., Specjalski K., Sperl A., Spranger O., Stamataki S., Stefanaki L., Stellato C., Stelmach R., Strandberg T., Stute P., Subramaniam A., Suppli Ulrik C., Sutherland M., Sylvestre S., Syrigou A., Taborda Barata L., Takovska N., Tan R., Tan F., Tan V., Tang I.P., Taniguchi M., Tannert L., Tantilipikorn P., Tattersall J., Tesi F., Thieme U., Thijs C., Thomas M., To T., Todo-Bom A.M., Togias A., Tomazic P.-V., Tomic-Spiric V., Toppila-Salmi S., Torres Jaen M.-J., Toskala E., Triggiani M., Triller N., Triller K., Tsiligianni I., Uberti M., Ulmeanu R., Urbancic J., Urrutia Pereira M., Vachova M., Valdes F., Valenta R., Valentin Rostan M., Valero A., Valiulis A., Vallianatou M., Valovirta E., Van Eerd M., Van Ganse E., van Hage M., Vandenplas O., Vasankari T., Vassileva D., Velasco Munoz C., Ventura M.T., Vera-Munoz C., Viart F., Vicheva D., Vichyanond P., Vidgren P., Viegi G., Vogelmeier C., Von Hertzen L., Vontetsianos T., Vourdas D., Tran Thien Quan V., Wagenmann M., Walker S., Wallace D., De Wang Y., Waserman S., Wehner K., Wickman M., Williams S., Williams D., Wilson N., Wong G., Woo K., Wozniak L., Wright J., Wroczynski P., Xepapadaki P., Yakovliev P., Yamaguchi M., Yan K., Yap Y.Y., Yassin M., Yawn B., Yiallouros P., Yorgancioglu A., Yoshihara S., Young I., Yusuf O.B., Zaidi A., Zaitoun F., Zalud P., Zar H., Zedda M.T., Zernotti M.E., Zhang L., Zhong N., and Zidarn M.

Subjects
MAPK/ERK pathway, ARIA group, Allergy, [SDV]Life Sciences [q-bio], NF-KAPPA-B, debelost, Review, Pharmacology, Resveratrol, PROTECTS, chemistry.chemical_compound, 0302 clinical medicine, RESPIRATORY SYNDROME CORONAVIRUS, ENDOPLASMIC-RETICULUM STRESS, Medicine and Health Sciences, Immunology and Allergy, Medicine, OXIDATIVE STRESS, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, 2. Zero hunger, 0303 health sciences, RESPIRATORY, INSULIN-RESISTANCE, Muscle cell proliferation, SULFORAPHANE, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, SIGNALING PATHWAY, Signal transduction, Life Sciences & Biomedicine, Pulmonary and Respiratory Medicine, NRF2 ACTIVATORS, MUSCLE-CELL PROLIFERATION, Immunology, 610 Medicine & health, Lung injury, Settore MED/10 - Malattie Dell'Apparato Respiratorio, ACUTE LUNG INJURY, 03 medical and health sciences, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, udc:616.9, odpornost proti inzulinu, SULFORAPHANE PROTECTS, Transcription factor, PI3K/AKT/mTOR pathway, 030304 developmental biology, Science & Technology, business.industry, SARS-CoV-2, food, medicine.disease, chemistry, hranila, SYNDROME CORONAVIRUS, business, hrana, GREEN TEA
Abstract

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.

Published
2020

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