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3. Modelling microscopic clusters of sulphuric acid and water relevant to atmospheric nucleation

Author

Stinson, J.

Subjects
500
Abstract

Classical nucleation theory has been a useful tool for predicting the phenomena of nucleation for the past seventy years. However the model has several limitations, which in some examples give rise to predicted rates that are several orders of magnitude in error. One such example is that of sulphuric acid and water nucleation which has long been framed as an important source of cloud condensation nuclei and therefore has implications for the climate, both locally and globally. In addition stratospheric aerosol injection of molecules containing sulphur, including sulphuric acid, are of interest as a potential geoengineering technique. The focus for this study is to improve upon our understanding of water and sulphuric acid nucleation. The initial phase of the project concerned performing quantum chemistry calculations which go beyond the macroscopic description employed by classical nucleation theory. Kohn-Sham density functional theory has been successfully employed in the fields of condensed matter, material physics and chemistry. However one of the assumptions of the theory is the classical treatment of the nuclei. The path integral molecular dynamics technique is used here to test this assumption on small clusters of sulphuric acid and water. We find that the introduction of zero point motion has a small effect on the equilibrium properties of certain configurations in line with expected behaviour. An interesting structure is found which serves to emphasise the importance of liquid like behaviour in this cluster at room temperature. The first study demonstrated the computational expense of treating systems at the microscopic scale using quantum chemistry approaches. The second phase of the research focused upon finding a suitable classical potential to employ within a molecular dynamics scheme, which would drastically reduce the computational expensive of performing simulations. This potential would be required to retain the ability for protons to transfer between selected species. The empirical valence bond method was chosen for its straightforward implementation and its similarity to traditional classical schemes. However some modifications were required to implement the scheme. Two algorithms were designed to identify species within the system and treat them in a fashion suitable for use in the empirical valence bond method. In addition the empirical valence bond method also needed to be parametrised for the sulphuric acid and water system. This was achieved by using the particle swarm optimisation technique, which performed force matching parametrisation using the Kohn-Sham density functional theory work from the previous phase of the project. The model was fully programmed in FORTRAN 90/95 and was incorporated into DL-POLY version 4.03. It is tested against the density functional theory data to which it is parametrised to check that the main features of the quantum chemistry are retained within the empirical valence bond technique. A puzzling issue appeared in preliminary molecular dynamics simulations performed with DL-POLY 4.03. The issue arises from a constraint imposed to fix the centre of mass. The solution to the modified Langevin equation introduced by this constraint is derived. The results are then compared to the puzzling DL-POLY simulations and found to be consistent. The constraint is then removed for all further simulations. The developed empirical valence bond potential was used to perform simulations of small clusters of sulphuric acid and water. We test the level of hydration required to ionise the system and find it to be in line with literature values. A thermodynamic integration scheme that was suitable for this system was derived. Preliminary simulations were performed using the model to compute free energies for use with classical nucleation theory in order to calculate nucleation rates.

Published
2015

8. POS1401-HPR LIVED EDUCATIONAL EXPERIENCE OF YOUNG ADULTS WITH CHILDHOOD- AND ADULT-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-CENTER CANADIAN QUALITATIVE STUDY

Author

Golding, M., primary, Nishat, F., additional, Merrill, K., additional, Kaur, R., additional, Stinson, J., additional, Protudjer, J., additional, Woodgate, R., additional, Peschken, C., additional, Lacaille, D., additional, Oguzoglo, U., additional, Touma, Z., additional, and Lim, L., additional

Published
2023
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9. "It Felt Really Nice to Have Someone Who Understands": The Experiences of Adolescent Thoracic Transplant Patients Participating in the iPeer2Peer Online Mentorship Program

Author

Liang, M., primary, Lin, J., additional, Siqueira, I., additional, Kohut, S. Ahola, additional, Stinson, J., additional, Gold, A., additional, Urschel, S., additional, Soto, S., additional, Seifert-Hansen, M., additional, McCoy, M., additional, Boucher, S., additional, and Anthony, S.J., additional

Published
2023
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12. Parental risk factors for the development of pediatric acute and chronic postsurgical pain: a longitudinal study

Author

Pagé MG, Campbell F, Isaac L, Stinson J, and Katz J

Subjects
Medicine (General), R5-920
Abstract

M Gabrielle Pagé,1 Fiona Campbell,2,3 Lisa Isaac,2,3 Jennifer Stinson,2,4 Joel Katz1,3,5 1Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada; 2Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada; 3Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 4Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada; 5Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada Background: The goal of this longitudinal study was to examine the associations among psychological factors and pain reports of children and their parents over the 12 month period after pediatric surgery. Materials and methods: Included in the study were 83 children aged 8–18 years undergoing major surgery. In each case, the child and one of their parents completed measures of pain intensity and unpleasantness, psychological function, and functional disability at 48–72 hours, 2 weeks (child only), 6 months, and 12 months after surgery. Results: The strength of the correlation coefficients between the psychological measures of the parent and their child increased significantly over time. There was a fair level of agreement between parent ratings of child acute and chronic pain (6 months after surgery) and the child's actual ratings. Parent and child pain anxiety scores 48–72 hours after surgery interacted significantly to predict pain intensity, pain unpleasantness, and functional disability levels 2 weeks after discharge from hospital. Parent pain catastrophizing scores 48–72 hours after surgery predicted child pain intensity reports 12 months later. Conclusion: These results raise the possibility that as time from surgery increases, parents exert greater and greater influence over the pain response of their children, so that by 12 months postsurgery mark, parent pain catastrophizing (measured in the days after surgery) is the main risk factor for the development of postsurgical pain chronicity. Keywords: pain anxiety, pain catastrophizing, children, parental risk factors, postsurgical pain

Published
2013

13. Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain

Author

Pagé MG, Stinson J, Campbell F, Isaac L, and Katz J

Subjects
Medicine (General), R5-920
Abstract

M Gabrielle Pagé,1 Jennifer Stinson,2,3 Fiona Campbell,2,4 Lisa Isaac,2,4 Joel Katz1,4,51Department of Psychology, York University, 2Department of Anesthesia and Pain Medicine, Hospital for Sick Children, 3Lawrence S Bloomberg Faculty of Nursing, 4Department of Anesthesia, University of Toronto, 5Department of Psychology, Hospital for Sick Children, Toronto, ON, CanadaBackground: The goals of this study were to examine the trajectory of pediatric chronic postsurgical pain (CPSP) over the first year after surgery and to identify acute postsurgical predictors of CPSP.Methods: Eighty-three children aged 8–18 years (mean 13.8, standard deviation 2.4) who underwent major orthopedic or general surgery completed pain and pain-related psychological measures at 48–72 hours, 2 weeks (pain anxiety and pain measures only), and 6 and 12 months after surgery.Results: Results showed that 1 year after surgery, 22% of children developed moderate to severe CPSP with minimal functional disability. Children who reported a Numeric Rating Scale pain-intensity score ≥ 3 out of 10 two weeks after discharge were more than three times as likely to develop moderate/severe CPSP at 6 months and more than twice as likely to develop moderate/severe CPSP at 12 months than those who reported a Numeric Rating Scale pain score < 3 (6-month relative risk 3.3, 95% confidence interval 1.2–9.0 and 12-month relative risk 2.5, 95% confidence interval 0.9–7.5). Pain unpleasantness predicted the transition from acute to moderate/severe CPSP, whereas anxiety sensitivity predicted the maintenance of moderate/severe CPSP from 6 to 12 months after surgery.Conclusions: This study highlights the prevalence of pediatric CPSP and the role played by psychological variables in its development/maintenance. Risk factors that are associated with the development of CPSP are different from those that maintain it.Keywords: chronic postsurgical pain, children, adolescents, anxiety sensitivity

Published
2013

14. Pain-related psychological correlates of pediatric acute post-surgical pain

Author

Pagé MG, Stinson J, Campbell F, Isaac L, and Katz J

Subjects
Medicine (General), R5-920
Abstract

M Gabrielle Pagé,1 Jennifer Stinson,2,3 Fiona Campbell,2,4 Lisa Isaac,2,4 Joel Katz1,4,51Department of Psychology, Faculty of Health, York University, 2Department of Anesthesia and Pain Medicine, Hospital for Sick Children, 3Lawrence S Bloomberg Faculty of Nursing, University of Toronto, 4Department of Anesthesia, Faculty of Medicine, University of Toronto, 5Department of Psychology, Hospital for Sick Children, Toronto, ON, CanadaBackground: Post-surgical pain is prevalent in children, yet is significantly understudied. The goals of this study were to examine gender differences in pain outcomes and pain-related psychological constructs postoperatively and to identify pain-related psychological correlates of acute post-surgical pain (APSP) and predictors of functional disability 2 weeks after hospital discharge.Methods: Eighty-three children aged 8–18 (mean 13.8 ± 2.4) years who underwent major orthopedic or general surgery completed pain and pain-related psychological measures 48–72 hours and 2 weeks after surgery.Results: Girls reported higher levels of acute postoperative anxiety and pain unpleasantness compared with boys. In addition, pain anxiety was significantly associated with APSP intensity and functional disability 2 weeks after discharge, whereas pain catastrophizing was associated with APSP unpleasantness.Conclusion: These results highlight the important role played by pain-related psychological factors in the experience of pediatric APSP by children and adolescents.Keywords: acute post-surgical pain, children, adolescents, pain anxiety, pain catastrophizing

Published
2012

16. Participatory Research:A Priority Setting Partnership for Chronic Musculoskeletal Pain in Denmark

Author

Lyng, KD, Larsen, JB, Birnie, K, Stinson, J, Hoegh, M, Olesen, AE, Arendt-Nielsen, L, Ehlers, L, Fonager, K, Jensen, MB, Würtzen, H, Palsson, TS, Poulin, P, Handberg, G, Ziegler, C, Møller, LB, Olsen, J, Heise, L, and Rathleff, MS

Abstract

Background Patient and stakeholder engagements in research have increasingly gained attention in healthcare and healthcare-related research. A common and rigorous approach to establish research priorities based on input from people and stakeholders is the James Lind Alliance Priority Setting Partnership (JLA-PSP). The aim of this study was to establish research priorities for chronic musculoskeletal (MSK) pain by engaging with humans living with chronic MSK pain, relatives to humans living with chronic MSK pain, healthcare professionals (HCP), and researchers working with chronic MSK pain.Methods This JLA-PSP included a nation-wide survey in Denmark, an interim prioritisation, and an online consensus building workshop. The information gained from this was the basis for developing the final list of specific research priorities within chronic MSK pain.Results In the initial survey, 1010 respondents (91% people living with chronic MSK pain/relatives, 9% HCPs/researchers) submitted 3121 potential questions. These were summarised into 19 main themes and 36 sub-themes. In the interim prioritisation exercise, 51% people living with pain/relatives and 49% HCPs/researchers reduced the list to 33 research questions prior to the final priority setting workshop. 23 participants attended the online workshop (12 people/relatives, 10 HCPs, and 1 researcher) who reached consensus for the most important research priorities after two rounds of discussion of each question.Conclusion This study identified several specific research questions generated by people living with chronic MSK pain, relatives, HCPs, and researchers. The stakeholders proposed prioritization of the healthcare system’s ability to support patients, focus on developing coherent pathways between sectors and education for both patients and HCP. These research questions can form the basis for future studies, funders, and be used to align research with end-users’ priorities

Published
2021
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18. Pediatric Project ECHO® for Pain: implementation and mixed methods evaluation of a virtual medical education program to support interprofessional pain management in children and youth.

Author

Lalloo, C., Mohabir, V., Campbell, F., Sun, N., Klein, S., Tyrrell, J., Mesaroli, G., Ataollahi-Eshqoor, S., Osei-Twum, J., and Stinson, J.

Subjects
MEDICAL education, INTERPROFESSIONAL education, PAIN management, MEDICAL personnel, COVID-19 pandemic, SIMULATED patients, CASE-based reasoning
Abstract

Background: Pediatric pain is a complex health challenge requiring a multi-modal management approach. It is critical that healthcare providers (HCPs) have access to ongoing, flexible education and mentorship specific to pediatric pain. However, there are significant gaps in available pain education and a need for more opportunities to support interprofessional training. Project Extension for Community Healthcare Outcomes (Project ECHO®) is a model for delivering online HCP education and cultivating a virtual community of practice. Within the pediatric pain setting, ECHO® has potential to improve local access to specialized pain knowledge, particularly among the physicians, nurses, and allied health providers who primarily manage these cases in community and hospital settings across rural and urban environments. The purpose of this study was three-fold. First, to evaluate the feasibility (participation levels, acceptability) of implementing Project ECHO® in the context of pediatric pain. Second, to measure preliminary program impacts on HCP knowledge, self-efficacy, and clinical practice. Third, to characterize HCP program engagement levels before and after onset of the COVID-19 pandemic. Methods: A needs assessment was conducted to identify interprofessional education gaps and inform the program curriculum. The no-cost Pediatric ECHO® for Pain program offered TeleECHO sessions (didactic and case-based learning) as well as foundational education. Surveys were distributed at baseline and 6 months to assess outcomes using 7-point Likert scales. Participant engagement was assessed for periods prior to and during the COVID-19 pandemic. Descriptive and inferential statistical analyses were conducted. Results: Eighty-five TeleECHO sessions were hosted, with a mean attendance of 34.1 ± 23.4 HCPs. Acceptability scores at 6 months (n = 33) ranged from 5.0 ± 1.4 to 6.5 ± 0.5. Participants reported statistically significant (p < 0.05) improvements in knowledge (7 out of 7 topics) and self-efficacy (8 out of 9 skills). Most participants reported positive practice impacts, including improved satisfaction with managing children with pain. Exploratory analyses showed a trend of greater engagement from ECHO® learners after onset of the COVID-19 pandemic. Conclusions: Project ECHO® is a feasible and impactful model for virtual education of interprofessional HCPs in managing pediatric pain. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Participatory Research: A Priority Setting Partnership for Chronic Musculoskeletal Pain in Denmark

Author

Lyng, KD, primary, Larsen, JB, additional, Birnie, K, additional, Stinson, J, additional, Hoegh, M, additional, Olesen, AE, additional, Arendt-Nielsen, L, additional, Ehlers, L, additional, Fonager, K, additional, Jensen, MB, additional, Würtzen, H, additional, Palsson, TS, additional, Poulin, P, additional, Handberg, G, additional, Ziegler, C, additional, Møller, LB, additional, Olsen, J, additional, Heise, L, additional, and Rathleff, MS, additional

Published
2021
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31. Inaugural national scientific medical meeting

Author

Cooke, T. T., Sheahan, R., Foley, D., D’Arcy, G., Gibney, M., Jauch, W., Gearty, G., Crean, P., Walsh, M., Murchan, P. M., O’Donoghue, M. K., Marks, P., Leen, E. J., Shanik, G. D., Feely, T. M., O’Riordan, J., Kellett, J. G., Sheahan, N. F., MacMahon, M., Colgan, M., Walsh, J. B., .Shanik, G, Moore, R., Malone, J. F., Coakley, D., Subareddy, K., Hurley, J., McGovern, E., Sullivan, P. A., O’Mahony, S., Carroll, K., Chua, A., Keeling, R. W. N., O’Kane, A., Dinan, T., Collins, J. K., O’Sullivan, G., Hahnvajanawong, C., McCarthy, M., O’Brien, F., Collins, R. A., Beattie, S., Hamilton, H., O’Morain, C. A., Lynch, S., Murphy, A., Weir, D. G., Feighery, C., O’Farrelly, C., Kelleher, D., Murphy, D., O’Brien, M., Harte, P., Shahi, C. N., Fan, X. J., Huang, J., Smyth, C. J., McDevitt, J., Keeling, P. W. N., Cleary, M., Morrow, G., O’Loughlin, S., Murphy, G. M., Elder, G., Abouzakouk, M., Casey, E., Veale, D., Fitzgerald, O., Bradford, A., O’Regan, R. G., Nolan, P., McKeogh, D., Howell, F., O’Connor, C. M., Rook, G., FitzGerald, M. X., Power, C., Sreenan, S., Poulter, L. W., Burke, C. M., Shanahan, P., O’Donnell, N., Birthistle, K., O’Mahony, M., Shattock, A. G., Hillery, I. B., Bolger, C., Sheehan, N., Hutchinson, M., Phillips, J. P., Malone, J., Esmonde, T. F. G., Will, R. G., Faller, D., Ryan, M. P., Manning, B., Martin, F., McCormack, P. M. E., McGrath, A., Lawlor, R., Donegan, C., Boyce, C., O’Neill, D., Smith, S., Moloney, C., Feely, J., Stanton, A., Atkins, N., O’Brien, E., O’Malley, K., Gough, D. B., Jordan, A., Mannick, J. A., Rodrick, M. L., McCarthy, E., Cooney, C. M., Bourke, J., Phelan, D. M., Robertson, A. M., McShane, A. J., Buggy, D., Breathnach, A., Keogh, B., Coole†, T., Behan, P. O., Cavanagh, H. M. A., Gow, J. W., Simpson, K., Behan, W. M. H., Foley, M., Firth, R., Stronge, J., Bonnar, J., Sheppard, B. L., McClelland, R. J., Watson, D. R., Lawless, V., Houston, H. G., Adams, D., Fitzpatrick, C., Keary, K., Jennings, S., Matthews, T. G., Gormally, S., O’Regan, M., Ward, O. C., Kehoe, S., Luesley, D., Chan, K., Ward, K., Cox, M., Caird, J., Owens, D., Gilligan, S., McBrinn, S., Collins, P., Johnson, A., Tomkin, G., Fiad, T. M., Culliton, M., McKenna, T. J., Collins, P. B., Tomkin, G. H., Stinson, J. C., Clancy, L., Shannon, A., Lucey, M., Cooney, M., Stinson, J., Corcoran, P., Kelly, P., Hayes, C., Laffoy, M., McKnight, J. A., McCance, D. R., O’Hare, F., Wisdom, B., Hayes, J. R., Thornton, L., Fogarty, J., O’Flanagan, D., Corcoran, R., O’Mahony, D., Rowan, M., Clyne, M. G., Duffy, M. J., Davis, M., Kelly, D. G., Quinlan, D. M., Corbally, N., Keane, M. M., Grogan, L., Dervan, P. A., Carney, D. N., Duffy, K., Nugent, A., McDermott, E. W. M., O’Higgins, N. J., Fennelly, J. J., Atkinson, A. B., Ferrett, C. G., Leslie, H., Mcllrath, E. M., Ritchie, C. M., Russell, C. F. J., Sheridan, B., Bashyam, M., O’Sullivan, N., Baker, H., Duggan, P. F., Mitchell, T. H., Beatty, O., Browne, J., Clarke, K., Bell, P. M., Devlin, J. G., Laski, J., O’Neill, S., Redington, F., Dominique, A. V., Scanlan, P., Firth, R. G. R., Fiad, T., Freaney, R., Murray, B., McKenna, M. J., Murphy, J., Love, Wm. C., Cunningham, S. K., Crothers, J. G., McIlrath, E., Chiardha, F. Ni, Gebruers, E. M., Hall, W. J., Hegarty, D. A., O’Hare, J., Geoghegan, M., Abuaisha, F., Passmore, A. P., Whitehead, E. M., Crawford, V., Johnson, G. D., Gallagher, H. G., Stokes, M., Plank, L., Knight, G., Mitra, S., Hill, G., Buckley, P., O’Callaghan, E., Redmond, O., Stack, J. T., Ennis, J. T., Waddington, J. L., Larkin, C., Cannon, M., Byrne, M., Cotter, D., Sham, P., Colgan, K., Walsh, D., Gillian, A. M., Byrne, N., Breen, K. C., Lane, A., Mulvaney, F., Wadding-ton, J. L., Walsh, D., Lawlor, B. A., Colohan, H. A., Walshe, D., Gibson, T., Ronayne, E., Maguire, T. M., Staunton, H., Coughlin, A., Ming, P. Shu, Phillips, J., Youssef, H. A., Adebayo, G., Feely, G., Daly, S. A., Fennell, J. S., Coakley, F., Johnson, Z., Hall, M., McCormack, P. M., Martin, M., O’Connor, M., Curley, P., O’Connell, Y., Mulryan, G., Meenan, E., Kelly, J., Kilfeather, S., Cotter, T., McGlynn, H., Gharbháin, F. Ó, Chambers, P. L., Campbell, H., Stout, R. W., Hegarty, V., Scott, T., Keane, C. T., Healy, M., O’Moore, R. R., Coakley, D., Mulkerin, E., Brain, A., Hampton, D., Penney, M., Woodhouse, K., and Treacy, F.

Published
1993
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34. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Author

Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Novo S, Krum H, Varigos J, Siostrzonek P, Sinnaeve P, Gotcheva N, Yong H, Urina-Triana M, Milicic D, Vettus R, Manolis AJ, Wyss F, Sigurdsson A, Fucili A, Veze I, Petrauskiene B, Salvador L, Klemsdal TO, Medina F, Budaj A, Otasevic P, Lainscak M, Seung KB, Commerford P, Donath M, Hwang JJ, Kultursay H, Bilazarian S, East C, Forgosh L, Harris B, Ligueros M, Bohula E, Charmarthi B, Cheng S, Chou S, Danik J, McMahon G, Maron B, Ning M, Olenchock B, Pande R, Perlstein T, Pradhan A, Rost N, Singhal A, Taqueti V, Wei N, Burris H, Cioffi A, Dalseg AM, Ghosh N, Gralow J, Mayer T, Rugo H, Fowler V, Limaye AP, Cosgrove S, Levine D, Lopes R, Scott J, Hilkert R, Tamesby G, Mickel C, Manning B, Woelcke J, Tan M, Manfreda S, Ponce T, Kam J, Saini R, Banker K, Salko T, Nandy P, Tawfik R, O’Neil G, Manne S, Jirvankar P, Lal S, Nema D, Jose J, Collins R, Bailey K, Blumenthal R, Colhoun H, Gersh B, Abreu M, Actis MV, Aiub J, Aiub F, Albisu J, Alvarisqueta A, Avalos V, Barreto M, Berli MA, Blumberg C, Bocanera M, Botta C, Bowen L, Budassi N, Buhlman S, Westberg JC, Carabajal T, Caruso G, Casala J, Cendali G, Coloma G, Berra FC, Cuneo C, Degennaro N, Dellasa M, Diaz M, Dos Santos P, Espinosa V, Facello A, Facello M, Farias E, Fernandez AA, Ferrari V, Pacora FF, Flores GS, Franco M, Gabito A, Viola HG, Garcia F, Garcia Duran R, Garcia Pinna J, Glenny J, Godoy Sanchez M, Grosse A, Guzman P, Hasbani E, Hominal M, Ibañez J, Jure H, Jure D, Vico ML, Liniado G, Luciardi H, Luquez H, Maehara G, Maffei L, Majul C, Mallagray M, Marinaro S, Martinez J, Massaccesi R, De Los Milagros Had M, Azize GM, Montana O, Montenegro E, Morell Y, Muntaner J, Navarrete S, Olmedo M, Paganini M, Paz S, Perez Manghi F, Piskorz D, Polato C, Recoaro R, Romano A, Salinger M, Sanchez A, Saravia MA, Sarjanovich R, Scaro G, Schiavi LB, Soler J, Tinnirello V, Tomassi A, Valle M, Vallejo MA, Venturini C, Marcela Wenetz LM, Yossen M, Zaidman C, Zalazar L, Zangroniz P, Amerena J, Brady L, Colquhoun D, Eccleston D, Ferreira-Jardim A, French J, Jayasinghe R, Mcintosh C, Ord M, Plotz M, Purnell P, Roberts-Thomson P, Schultz C, Shanahan T, Tan R, Taverner P, Turner F, Vibert J, Vorster M, William M, Youssef G, Bergler-Klein J, Brath H, Brodmann M, Fliesser-Goerzer E, Haider K, Heeren G, Hiden C, Mandic L, Paulweber B, Ploechl A, Prenner A, Steringer-Mascherbauer R, Strohner-Kaestenbauer H, Barbato E, Bouvy C, Briké C, Charlier F, Cools F, De Knijf K, De Wolf L, Delforge M, Deweerdt N, Gits F, Goffinet C, Hermans K, Hollanders G, Mestdagh I, Pirenne B, Servaes V, Simons N, Tahon S, Theunissen E, Van Genechten G, Vervoort G, Vissers C, Vranckx P, Vrolix M, Abib E Jr, Abrantes J, Araujo Fonseca M, Barbosa E, Barroso W, Barroso A, Bodanese L, Botelho R, Costa Amorim R, Da Costa F, Da Silva A, Da Silva O Jr, Da Silva D Jr, Ferreira Dos Santos T, Dos Santos F, Dos Santos A, Duda N, Feitosa G, Felario Junior GA, Ferraz R, Filho P, Fonseca A, Wanderley FF, Freitas E, Fucci F, Marengo Garcia De Carvalho L, Hernandez M, Hettwer Magedanz E, Julião K, Kormann A, Lameira A, Lima F, Lino E, Maia L, Manenti E, Marchi AL, Fischer SM, Michalaros Y, Moraes J Jr, Moreira L, Pagnan M, Pesce F, Pinheiro L, Rassi S, Reis G, Reis H, Resende I, Roel A, Ruschel K, Saporito W, Saraiva JF, Seroqui M, Silva R, Unterkircher B, Vicente C, Vieira N, Xavier JP, Zucchetti C, Angelova I, Dimitrov G, Genova D, Gospodinov K, Goudev A, Grigorova V, Hristova K, Makedonska JJ, Katova T, Kostov K, Lazov P, Manov E, Manukov I, Manukov D, Milanova M, Kabakchieva VM, Petrov D, Petrusheva T, Pramatarova I, Raev D, Runev N, Sirakova-Taseva A, Tisheva-Gospodinova S, Todorova A, Tzekova M, Yakovova S, Yanev T, 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Subjects
0301 basic medicine, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, c-reactive protein, Randomized controlled trial, law, Cardiovascular Disease, middle aged, double-blind method, antibodies, Myocardial infarction, humans, Stroke, interleukin-1beta, biology, Antibodies, Monoclonal, drug, General Medicine, Lipid, Aged, anti-inflammatory agents, monoclonal, humanized, atherosclerosis, cardiovascular diseases, dose-response relationship, female, incidence, infections, lipids, male, myocardial infarction, neutropenia, secondary prevention, stroke, Anti-Inflammatory Agent, aged, Editorial, Atherosclerosi, Monoclonal, Human, medicine.drug, medicine.medical_specialty, Neutropenia, Antibodies, Monoclonal, Humanized, Infections, Placebo, antibodies, monoclonal, dose-response relationship, drug, infection, medicine (all), 03 medical and health sciences, Internal medicine, medicine, Dose-Response Relationship, Drug, business.industry, Antiinflammatory Therapy, Canakinumab, for Atherosclerotic Disease, C-reactive protein, medicine.disease, Surgery, Canakinumab, 030104 developmental biology, biology.protein, business
Abstract

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.)

Published
2017
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40. The development and evaluation of a self-management web app for women with cardiac pain

Author

Parry, M., primary, Bjørnnes, A.K., additional, Clarke, H., additional, Cafazzo, J., additional, Cooper, L., additional, Dhukai, A., additional, Harvey, P., additional, Katz, J., additional, Lalloo, C., additional, Leegaard, M., additional, Légaré, F., additional, McFetridge-Durdle, J., additional, McGillion, M., additional, Norris, C., additional, Patterson, R., additional, Pilote, L., additional, Pink, L., additional, Price, J., additional, Stinson, J., additional, Victor, J.C., additional, Watt-Watson, J., additional, Auld, C., additional, Faubert, C., additional, Park, D., additional, Park, M., additional, and DeBonis, V Spiteri, additional

Published
2021
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41. An integrated mixed methods systematic review to summarize research evidence related to self-management programs for women with cardiac pain

Author

Parry, M., primary, Bjørnnes, A.K., additional, Clarke, H., additional, Cooper, L., additional, Gordon, A., additional, Harvey, P., additional, Lalloo, C., additional, Leegaard, M., additional, LeFort, S., additional, McFetridge-Durdle, J., additional, McGillion, M., additional, O`Keffe-McCarthy, S., additional, Price, J., additional, Stinson, J., additional, Victor, J.C., additional, and Watt-Watson, J., additional

Published
2021
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47. A MIXED METHODS APPROACH TO DEVELOP AND TEST A WEBAPP FOR WOMEN WITH HEART DISEASE

Author

Parry, M., primary, Bjørnnes, A., additional, Clarke, H., additional, Dhukai, A., additional, Harvey, P., additional, Lalloo, C., additional, Leegaard, M., additional, McFetridge-Durdle, J., additional, Norris, C., additional, Pilote, L., additional, Price, J., additional, Stinson, J., additional, Watt-Watson, J., additional, Parente, L., additional, and Nyakairu, P., additional

Published
2020
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