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5. Characterising the pleiotropic activity and spatial dynamics of prostaglandin EP2 receptor signalling

Author

Walker, Abigail and Hanyaloglu, Aylin

Abstract

EP2 is a member of the G protein coupled receptor superfamily and is implicated in both physiological and pathophysiological signalling in reproductive tissues. Classically reported as Gαs-mediated in reproductive tissues EP2 can also signal via Gαq/11, although the mechanism underlying this promiscuity is unknown. Tight regulation of internalisation and trafficking to endosomal compartments such as the early, or very early endosomes, is fundamental to GPCR signalling capacity, thus discovery of ligands that take advantage of EP2 pleiotropy by preferentially activating specific EP2 pathways could be valuable therapeutically. Therefore, I first characterised EP2 trafficking and signalling using three highly specific ligands - butaprost, AH13205, and PGN9856i. In HEK 293 cells, EP2 undergoes dynamin-dependent constitutive, but limited ligand-directed, internalisation, which was required for full activation of Gαs-cAMP and Gαq/11-Ca2+ pathways. In pregnant myometrium, EP2 signals via Gαs/Gαq/11, activating contrasting pro- and anti- labour pathways until labour, when EP2 Gαs signalling is downregulated. Prostaglandin signalling is a key part of physiological labour, thus understanding the mechanics of EP2 signalling during labour could lead to novel therapeutics to combat preterm birth, which represents a major challenge to public health. I found that EP2 signalling is altered with the onset of labour, favouring pro-inflammatory pathways in early and late labour. OTR activation 'switched' EP2 signalling pathways to Gαi/o when activated with butaprost, enhancing pro-labour pathways and dampening Gαs-cAMP, which may be mediated by formation and rearrangement of EP2-OTR heteromers. Whilst AH13205 exhibited an extreme inflammatory profile in both HEK 293 and myometrial cells, and engaged EP2 in crosstalk with OTR, enhancing pro-labour pathways, PGN9856i did not activate Gαq/11-mediated pro-labour/inflammatory pathways in HEK cells or primary myometrial cells, and may actively antagonise OT-mediated pathways. Together, these findings uncover novel aspects of EP2 pleiotropy and suggest that biased EP2 ligands may be valuable tools for targeting reproductive tissues.

Published
2021
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6. Nature into landscape : pictorial and poetic landscape representation in Ovid's 'Metamorphoses' and Campanian wall-painting

Author

Walker, Abigail, Squire, Michael James, and Fitzgerald, William Claiborne

Abstract

This thesis argues that landscape was thought about in terms of its representation in an ancient Roman context. Starting with a twentieth-century Surrealist reflection on landscape painting, this thesis proceeds to locate a history for similar meta-landscape awareness that extends back at least to the first century BCE/CE. I have chosen pictorial and poetic corpora - Ovid's Metamorphoses and Campanian wall-paintings - which were both produced throughout the course of the late first century BCE and the first century CE and in which landscapes play a significant role. My suggestion here is not that these corpora alone exemplify the point, but rather that they serve as a subsection of a rich topic that has thus far been underappreciated. Whilst the subject of landscape has seen comprehensive scholarly analysis since the nineteenth century, far less has been done to press the question of its cross-medial representation more persistently. This thesis asks what it means to represent the landscape and what is at stake in doing so. The striking presence of landscape paintings in the Romano-Campanian corpus has encouraged a long history of scholarship. Whilst it seems unlikely that we can speak of an 'invention' of landscape painting in the first century BCE, the pervasiveness of natural imagery in various painted forms does at least suggest a taste for landscape representation at this time. Indeed, an array of texts have also been employed throughout scholarship to give us insight into first-century BCE/CE attitudes towards landscape; authors such as Pliny the Younger and Elder, Vitruvius, Varro, Cicero and Virgil show an impulse for thinking about and using the landscape in textual composition and imagery that runs parallel to the pictorial corpus. This thesis reconsiders these paintings alongside a text which has not yet been sufficiently recognised as a compelling literary landscape resource: Ovid's Metamorphoses. My Introduction starts by defining the terms of the thesis - 'landscape' and 'representation' - and analysing their place in an ancient Roman context. It then turns to the Methodology for the chapters that follow, outlining each of my four structuring themes, the scholarship that stands behind each one and the insight into landscape representation we can glean therefrom. Each theme explores an element of landscape representation and each is articulated through a myth that is found in Ovid's Metamorphoses and Campanian wall-painting. Chapter 1 discusses Polyphemus as a mediator of pictorial/poetic relations in the landscape. Chapter 2 investigates the potential that the myth of Narcissus offered in thinking about ars and natura, as they collide in 'naturalistic' representation, as well as in the representation of nature. Chapter 3 turns to the figure of Orpheus, who proves to be the ultimate creator of landscape as an artificial construction. Following this, Chapter 4 then identifies a self-consciousness in the myth of Actaeon surrounding the framing of space and the production of defined, landscape images. The thesis ends where it began, with Magritte's Surrealist painting and a comparison with a landscape painting from first-century Campania. We will see that the modernist narrative of a post-Renaissance 'landscape invention' ultimately fails to do justice to the equally rich discourse on meta-landscape representation mediated through first-century paintings and poetry.

Published
2021

7. Effects of seasonal, geographical and demographic factors on otitis externa microbiota in Queensland, Australia.

Author

Wijesekera, Akila, Xu Wen, Amanda Chiam, Walker, Abigail, and Anders, Cervin

Subjects
EXTERNAL ear, PSEUDOMONAS aeruginosa, MYCOSES, SEASONS, STAPHYLOCOCCUS aureus, OTITIS externa, SEASONAL variations of diseases
Abstract

Background and objective Otitis externa (OE) is a very common disease in Australia. It is associated with swimming and exposure to water. Typically, treatment consists of aural toileting and the use of topical antimicrobial drops. Antimicrobial treatment is empiric, and most Australian guidelines advise the use of dexamethasone/framycetin/gramicidin as first-line therapy. This study aimed to identify the most prevalent pathogens implicated in OE in Queensland, Australia, and determine if there was any variability with the season, proximity to a coastline, age, gender and First Nations status. Methods The primary pathogen cultured, the specimen type, the date of collection and the patient demographics were retrieved from microbiology swabs sent from hospitals to Pathology Queensland. Multivariate analysis was performed on the swabs. Results Pseudomonas aeruginosa was the most prevalent pathogen cultured in the external ear in Queensland, at 37.9%. In inland regions, Staphylococcus aureus was the most prevalent organism. Children were three-fold less likely to have OE resulting from a fungal pathogen. Discussion The use of targeted antimicrobials against Pseudomonas aeruginosa in coastal regions during summer is sensible. Due to the low burden of fungal disease in children, there should be a high threshold for the commencement of antifungal ear drops. [ABSTRACT FROM AUTHOR]

Published
2024

8. Experiences of Animal Loss and Grief among Zoo Professionals and Volunteers: A Qualitative Study.

Author

Currin-McCulloch, Jennifer, Nageotte, Nichole Louise, Walker, Abigail, McDonald, Shelby, and Kogan, Lori

Subjects
ZOO animals, COMPLICATED grief, PSYCHOLOGICAL factors, PSYCHOLOGICAL literature, ANIMAL mortality
Abstract

Simple Summary: Zoo professionals and volunteers care for numerous animals, creating the potential for exposure to multiple deaths and transfer-related losses. Despite this, there is limited research exploring how zoo professionals and volunteers experience and adapt to zoo animal loss. This qualitative study was designed to explore the personal experiences of zoo animal loss among zoo professionals and volunteers, including their emotional challenges, coping mechanisms, and support-related needs. We found participants' responses highlighted two main themes: the lasting toll of animal-related loss and their interpersonal experience of loss. Within these themes, zoo professionals and volunteers' responses provided insights into experiences related to deaths (both expected and unexpected), transfer losses, experiences of complicated grief, and interpersonal factors that interfered with their ability to process their loss. Participants' suggestions for support when faced with these experiences included enhanced communication before pending losses and following deaths and transfers, environments conducive for memorializing rituals, and increased access to grief support resources. Zoo professionals and volunteers play essential roles in the wellbeing and conservation of a diverse array of animal species. Despite the growing body of literature revealing the psychological impacts of pet loss, there remains a dearth of information describing the experience of animal loss among those who work in zoo settings. This qualitative study explored the personal experiences of zoo animal loss among volunteers (n = 12), animal care and health professionals (ACHPs) (n = 135), and other zoo staff (n = 35) who participated in a larger mixed-method study. Participants responded to five open-ended questions exploring their most significant zoo animal death loss, where or from whom they found the most support, how the zoo community could better support them, advice for zoo leaders, and other thoughts about their grief and animal-related loss experiences. Using thematic analysis, two key themes were identified: the lasting toll of zoo animal loss and zoo professionals' and volunteers' interpersonal experiences. Participants described their experiences with animal transfers and both expected and unexpected deaths. Requests for support focused on better communication, grief resources, and opportunities to recognize and mourn animal losses. These findings suggest that zoo animal loss can negatively impact zoo professionals' and volunteers' psychological health. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Effect of early versus late time-restricted eating on glycaemic control, measured by continuous glucose monitoring, in adults at risk for type 2 diabetes

Author

Walker, Abigail and Walker, Abigail

Abstract

Aim: To investigate via the use of continuous glucose monitors (CGM) the acute effect of time-restricted eating (TRE) in early (eTRE; 8:00-16:00 hrs) versus late (lTRE; 12:00-20:00 hrs) conditions on inter-day glycaemic variability (GV) in adults at risk for type 2 diabetes (T2D). Methods: Eight sedentary individuals (five female/ three male; 51±6 years; body mass index (BMI) 28.0±2.9 kg/m2; Glycated haemoglobin (HbA1c) 37.9±3.3 mmol/mol) with a habitual food intake distribution >14 hrs/day, participated in a randomised-crossover control TRE study. Protocol compared eTRE to lTRE as well as non-TRE to TRE periods, with each phase lasting 3-days. TRE conditions utilised were isocaloric and eucaloric, and energy intake was calculated via Mifflin-St Jeor equation. Meals provided within the TRE condition consisted of 60% CHO, 25% protein, and 16% fat. CGM was used to assess markers of GV, including but not exclusive to mean absolute glucose (MAG), coefficient of variation (CV), and mean amplitude of glycaemic excursions (MAGE). A 2 factor repeated measures analysis of variance was used (2 conditions [eTRE vs lTRE] x 2 time-points [baseline vs TRE]) for statistical testing. Results: Following TRE, a significant reduction, was observed within MAG by 0.4 mmol/l (95% CI 0.1 to 0.8; 0.041), MAGE by 0.4 mmol/l (95% CI 0.1 to 0.8; P= 0.024) and CV by 2.5 mmol/l (0.6, 4.4) p values 0.041, 0.024, 0.016 respectively (i.e., baseline to TRE). There were no significant changes in physical activity (PA) or diet (total caloric intake, CHO and fat), however protein did significantly differ from baseline to TRE, 21.8g (baseline before eTRE; beTRE) and 23.2g (baseline before lTRE; blTRE) less in comparison to TRE (150g). Conclusion: In the absence of calorie restriction, TRE improved some markers of inter-day GV. This data indicates a possible therapeutic role of TRE in adults at risk for T2D. Further direction: This small study of short-term TRE provided an understanding for possible eff

Published
2024

20. Navigating the postoperative nose as a primary care physician.

Author

Zhen Yu Liu, Wong, Michael, Brahmabhatt, Pranter, Walker, Abigail, Earnshaw, James, and Cervin, Anders

Subjects
PRIMARY care, PHYSICIANS, NOSE, SURGICAL complications, OTOLARYNGOLOGY, FIRST aid in illness & injury
Abstract

Background Rhinology procedures represent a wide and diverse category of procedures, which, on the surface, can appear very similar. Thus, it is difficult to navigate postoperative presentations in the general practice setting. Objective This article provides a comprehensive guide to managing acute presentations that might arise in primary care settings following common rhinology surgeries. It outlines common complications, their potential aetiology and first-aid measures that might be employed to temporise patients prior to escalation. It also provides a guide as to potential red flag symptomatology, and when and how to escalate specific presentations. Discussion Most acute postoperative complications can be effectively managed, or at the very least temporised, in the community setting. When in doubt, discuss with your local otolaryngologist or nearest centre with otolaryngology cover. [ABSTRACT FROM AUTHOR]

Published
2023
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22. HMRC v Quentin Skinner 2005 Settlement: An Update

Author

Walker, Abigail

Subjects
United Kingdom. His Majesty's Revenue and Customs -- Cases, Capital gains tax -- Laws, regulations and rules, Tax credits -- Laws, regulations and rules, Tax appeals -- Cases, Trusts and trustees -- Cases, Company legal issue, Government regulation, Business, international
Abstract

We give an update following the recent decision regarding the availability of Entrepreneurs' Relief for trusts. The Court of Appeal has overturned the previous decision of the Upper Tribunal ('UT') [...]

Published
2023

25. Functional rewiring of G protein-coupled receptor signaling in human labor

Author

Walker, Abigail R., primary, Larsen, Camilla B., additional, Kundu, Samit, additional, Stavrinidis, Christina, additional, Kim, Sung Hye, additional, Inoue, Asuka, additional, Woodward, David F., additional, Lee, Yun S., additional, Migale, Roberta, additional, MacIntyre, David A., additional, Terzidou, Vasso, additional, Fanelli, Francesca, additional, Khanjani, Shirin, additional, Bennett, Phillip R., additional, and Hanyaloglu, Aylin C., additional

Published
2022
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29. Admission avoidance in acute epistaxis: A prospective national audit during the initial peak of the COVID‐19 pandemic

Author

Smith, Matthew E., Swords, Chloe, Rocke, John P. J., Walker, Abigail, Bryan, James E., Milinis, Kristijonas, Mathew, Rajeev G., Jones, Gareth H., McLaren, Oliver, Hutson, Kristian, Slovick, Anna, Hopkins, Claire, Harries, Philip G., Heward, Elliot, Shakeel, Muhammad, Gomati, Anas, Bance, Manohar, Lancaster, Jeffrey, Gaskell, Peter, Smyth, Catherine, Dorris, Colm, Kelly, Andrew, McCrory, David, Bhatt, Yogesh M., Jama, Guled M., Morgan, Montio, Perkins, Victoria, Spraggs, Paul, Khosla, Shivun, Takwoingi, Yohanna, Gopala‐Krishnan, Srinish, Strachan, David, Omakobia, Eugene, Puvanendran, Mark, Myuran, Tharsika, Rennie, Catherine, Devabalan, Yadsan, Cardozo, Arun, Tse, Antonia, McRae, Duncan, Burgan, Omar T., Reddy, Ekambar, Wright, Brendan, Kara, Naveed, Ivy, Ashleigh, Williams, Richard, Walkden, Alex, Quraishi, Muhammad, Stobbs, Nicola, Chatzimichalis, Michail, Elston, Emily, Khemani, Sameer, Liu, Alison, Kirkland, Paul, Vasanthan, Rishi, Miah, Mohammed, Lee, Kristina, Mclarnon, Claire, Williams, Mark R, Okonkwo, Okechukwu, Mughal, Zahir, Karagama, Yakubu, Xie, Carol, De, Mriganka, Amlani, Aakash, Jassar, Patrick, Cao, Han, Patil, Sachin, Philpott, Carl, Meghji, Sheneen, Das, Sudip, Cole, Simon, Vijendren, Ananth, Ally, Munira, Kothari, Prasad, Schechter, Eyal, Ranganathan, Baskaran, Advani, Rajeev, Toma, Shamim, Haymes, Adam, Shakir, Adam, Yap, Darren, Costello, Rhodri, Evans, Louise, Chisholm, Edward, Ojha, Shilpa, Spielmann, Patrick, Steven, Richard, Supriya, Mrinal, Mathew, Elizabeth, Masood, Ajmal, Dewhurst, Samuel, Ward, Victoria, Haigh, Thomas, Patiar, Shalini, Nemeth, Zsofia, Terry, Roland, Vithlani, Rohan, Bowyer, Duncan, Yang, Ding, Monksfield, Peter, Muzaffar, Jameel, Siddiq, Azher, Whittaker, Joshua D, Ramakrishnan, Yujay, Vakharia, Nilesh, Cain, Angus, Cooper, Fergus, Izzat, Steve, Nair, Dilip, Tan, Shawn, Daudia, Anu, Gilchrist, Jennifer, Tan, Neil, Kim, Min, Singh, Vijay, Hallett, Emma, Ray, Jaydip, Yu, Beverley, DeCarpentier, John, Chandrasekar, Bhargavi, Bhimrao, Sanjiv, Eastwood, Michael, Sunkaraneni, Vishnu S., Patel, Jamie, Moore, Andrew, Shetty, Prajwal, Mawby, Thomas, Shelton, Fenella, Jindal, Mudit, Yao, Alexander, Geyer, Marcel, Lowe, Emily, Jones, Huw, Ghasemi, Aria Amir, Trinidade, Aaron, Hardy, Alistair, Little, Sarah, Munroe‐Gray, Tiffany, Bennett, Alex, Li, Lucy, Khalid‐Raja, Mamoona, McNally, George, Thomas, George, Elmorsy, Mohamed, Williams, Clare, Zammit, Matthew, Seymour, Kay, Warner, Elinor, Potter, Chris, Easto, Rachel, Shaida, Azhar, Forde, Cillian T., Karamchandani, Dheeraj, Gill, Charn, Syed, Irfan, Walker, David, Stewart, Kirsten, Simmons, Mark, Abou‐Foul, Ahmad K, Bathala, Srinivasalu, Emerson, Hannah, Almeyda, John, Leadon, Madeline, Fahmy, Fahmy, Kaleva, Anna I., Moorthy, Ram, Bates, James, Wasson, Joseph, Selwyn, Anya, Daultrey, Charles, Patel, Sanjay, Siau, Derrick, Sawant, Rupali, Moore, Phillip, and Ali, Faiza

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Referral, Secondary care, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Pandemic, medicine, Humans, Prospective Studies, 030223 otorhinolaryngology, National audit, Medical Audit, Adult patients, business.industry, COVID-19, Emergency department, United Kingdom, Hospitalization, Epistaxis, Otorhinolaryngology, 030220 oncology & carcinogenesis, Acute Disease, Emergency medicine, Ambulatory, Female, Emergency Service, Hospital, business
Abstract

OBJECTIVES: To report changes in practice brought about by COVID-19 and the implementation of new guidelines, and to explore factors relating to unscheduled re-presentations for patients discharged from the emergency department (ED). DESIGN: Prospective multicentre national audit over 12 weeks from 6th April 2020. SETTING: UK secondary care ENT departments. PARTICIPANTS: Adult patients with acute epistaxis. MAIN OUTCOME MEASURES: Re-presentation within 10 days for patients discharged from the ED. RESULTS: Eighty three centres from all four UK nations submitted 2631 valid cases. The majority of cases were ED referrals (89.7%, n = 2358/2631). 54.6% were discharged from the ED following ENT review (n = 1267/2322), of whom 19.5% re-presented within 10 days (n = 245/1259) and 6.8% were ultimately admitted (n = 86/1259). 46.7% of patients had a non-dissolvable pack inserted by ED prior to referral to ENT (n = 1099/2355). The discharge rates for ED patients and their subsequent re-presentation rates were as follows: non-dissolvable packs, 29.5% discharged (n = 332/1125), 18.2% re-presented (n = 60/330); dissolvable products, 71.1% discharged (n = 488/686), 21.8% re-presented (n = 106/486); cautery only, 89.2% discharged (n = 247/277), 20.0% re-presented (n = 49/245); and no intranasal intervention, 85.5% discharged (n = 200/234), 15.2% re-presented (n = 30/198). Univariable logistic regression showed that not being packed by ED, antiplatelet medications, failed cautery and recent epistaxis treatment were significant predictors of re-presentation within 10 days. CONCLUSIONS: Management of acute epistaxis was notably affected during the initial peak of the pandemic, with a shift towards reduced admissions. This national audit highlights that many patients who may previously have been admitted to hospital may be safely discharged from the ED following acute epistaxis.

Published
2021
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33. Proposed closure of Inverness disease surveillance centre

Author

Swanson, Graeme, MacGregor-Robertson, Hamish, Swaffield, Douglas, Johnston, Kenny, Farrell, Colm, Morera-Pallares, Francisco, Walker, Abigail, Rafferty, Andrew, Harley, Jane, Corr, Eilidh, Beresford, Gabrielle, Patience, Joanne, Fraser, Charlotte, Fraser, Jim, Bacon, Alice, Holden, Rebecca, Brunner, Sabrina, Morrison, Paul, Donald, John, and McLaren, Jamie

Published
2015
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34. Admission avoidance in tonsillitis and peritonsillar abscess: A prospective national audit during the initial peak of the COVID‐19 pandemic

Author

Hardman, John C, Swords, Chloe, Rocke, John P J, Walker, Abigail, Bryan, James E, Milinis, Kristijonas, Mathew, Rajeev G, Jones, Gareth H, McLaren, Oliver, Smith, Matthew E, Hutson, Kristian, Slovick, Anna, McNally, George, Burgess, Andrea, Shakeel, Muhammad, Gomati, Anas, Bance, Manohar, Lancaster, Jeffrey, Maple, Natalie, Smyth, Catherine, Dorris, Colm, Kelly, Andrew, McCrory, David, MBhatt, Yogesh, Jama, Guled M, Morgan, Montio, Perkins, Victoria, Spraggs, Paul, Geyton, Thomas, Takwoingi, Yohanna, Gopala‐Krishnan, Srinish, Strachan, David, Taylor, Robert, Puvanendran, Mark, Egan, Matthew, Rennie, Catherine, Cereceda‐Monteoliva, Nicholas, Cardozo, Arun, Tse, Antonia, McRae, Duncan, Burgan, Omar T, Reddy, Ekambar, Wright, Brendan, Kara, Naveed, Walters, Holt, Williams, Richard, Walkden, Alex, Quraishi, Muhammad, Stobbs, Nicola, Chatzimichalis, Michail, Elston, Emily, Khemani, Sameer, Fang, Sean, Kirkland, Paul, Vasanthan, Rishi, Miah, Mohammed, Lee, Kristina, Mclarnon, Claire, Williams, Mark R, Okonkwo, Okechukwu, Mughal, Zahir, Karagama, Yakubu, Xie, Carol, De, Mriganka, Amlani, Aakash, Jassar, Patrick, Cao, Han, Patil, Sachin, Wong, Billy, Philpott, Carl, Meghji, Sheneen, Das, Sudip, Cole, Simon, Vijendren, Ananth, Ally, Munira, Kothari, Prasad, Schechter, Eyal, Ranganathan, Baskaran, Advani, Rajeev, Toma, Shamim, Haymes, Adam, Shakir, Adam, Yap, Darren, Costello, Rhodri, Wallace, Jennifer, Chisholm, Edward, Ojha, Shilpa, Spielmann, Patrick, Steven, Richard, Supriya, Mrinal, Mathew, Elizabeth, Masood, Ajmal, Dewhurst, Samuel, Ward, Victoria, Darwich, Ayman, Patiar, Shalini, Nemeth, Zsofia, Terry, Roland, Vithlani, Rohan, Bowyer, Duncan, Yang, Ding, Monksfield, Peter, Corbett, Peter, Siddiq, Azher, Whittaker, Joshua D, Ramakrishnan, Yujay, Cho, Wai Sum, Cain, Angus, Mondal, Bobby, Izzat, Steve, Ainine, Amru, Nair, Dilip, Tan, Shawn, Daudia, Anu, Gilchrist, Jennifer, Tan, Neil, Kim, Min, Truro, Singh, Vijay, Hallett, Emma, Ray, Jaydip, Yu, Beverley, DeCarpentier, John, Chandrasekar, Bhargavi, Bhimrao, Sanjiv, Eastwood, Michael, Sunkaraneni, Vishnu S, Lee, Chang Woo, Moore, Andrew, Shetty, Prajwal, Mawby, Thomas, Bisson, Elspeth, Jindal, Mudit, Yao, Alexander, Geyer, Marcel, Mohammed, Omnya, Jones, Huw, Ghasemi, Aria Amir, Trinidade, Aaron, Hardy, Alistair, Little, Sarah, Munroe‐Gray, Tiffany, Bennett, Alex, Li, Lucy, Khalid‐Raja, Mamoona, Thomas, George, Elmorsy, Mohamed, Williams, Clare, Zammit, Matthew, Seymour, Kay, Warner, Elinor, Potter, Chris, Easto, Rachel, Shaida, Azhar, Elshahhat, Mohamed, Karamchandani, Dheeraj, Gill, Charn, Syed, Irfan, Walker, David, Stewart, Kirsten, Simmons, Mark, Abou‐Foul, Ahmad K, Bathala, Srinivasalu, Emerson, Hannah, Almeyda, John, Pericleous, Agamemnon, Fahmy, Fahmy, Kaleva, AnnaI, Moorthy, Ram, Bates, James, Wasson, Joseph, Selwyn, Anya, Daultrey, Charles, Patel, Sanjay, Siau, Derrick, Sawant, Rupali, Moore, Phillip, and Rajamanickan, Senthil Kumar

Subjects
Male, Time Factors, multicentre, Tonsillitis, ambulatory, Comorbidity, Patient Admission, 0302 clinical medicine, Pandemic, Ambulatory Care, Medicine, Prospective Studies, Practice Patterns, Physicians', 030223 otorhinolaryngology, Aged, 80 and over, Acute Tonsillitis, Disease Management, Outpatient, Middle Aged, 030220 oncology & carcinogenesis, Ambulatory, Female, Original Article, Adult, medicine.medical_specialty, Adolescent, Coronavirus disease 2019 (COVID-19), Young Adult, 03 medical and health sciences, Ambulatory care, stomatognathic system, discharge, Internal medicine, otorhinolaryngologic diseases, Humans, observational, Peritonsillar Abscess, Pandemics, Aged, Retrospective Studies, Clinical Audit, SARS-CoV-2, business.industry, COVID-19, Original Articles, Emergency department, medicine.disease, United Kingdom, Otorhinolaryngology, business, Follow-Up Studies
Abstract

Objectives To report changes in practice brought about by COVID‐19 and the implementation of new guidelines for the management of tonsillitis and peritonsillar abscess (PTA), and to explore factors relating to unscheduled re‐presentations for patients discharged from the emergency department (ED). Design Prospective multicentre national audit over 12 weeks from 6 April 2020. Setting UK secondary care ENT departments. Participants Adult patients with acute tonsillitis or PTA. Main outcome measures Re‐presentation within 10 days for patients discharged from the ED. Results 83 centres submitted 765 tonsillitis and 416 PTA cases. 54.4% (n = 410) of tonsillitis and 45.3% (187/413) of PTAs were discharged from ED. 9.6% (39/408) of tonsillitis and 10.3% (19/184) of PTA discharges re‐presented within 10 days, compared to 9.7% (33/341) and 10.6% (24/224) for those admitted from ED. The subsequent admission rate of those initially discharged from ED was 4.7% for tonsillitis and 3.3% for PTAs. IV steroids and antibiotics increased the percentage of patients able to swallow from 35.8% to 72.5% for tonsillitis (n = 270/754 and 441/608) and from 22.3% to 71.0% for PTA (n = 92/413 and 265/373). 77.2% of PTAs underwent drainage (n = 319/413), with no significant difference in re‐presentations in those drained vs not‐drained (10.6% vs 9.5%, n = 15/142 vs 4/42, P = .846). Univariable logistic regression showed no significant predictors of re‐presentation within 10 days. Conclusions Management of tonsillitis and PTA changed during the initial peak of the pandemic, shifting towards outpatient care. Some patients who may previously have been admitted to hospital may be safely discharged from the ED.

Published
2021

36. The Native Graphic Design Project

Author

Walker, Abigail

Subjects
Library science, Art
Abstract

Review of The Native Graphic Design Project, Reviewed June 2021 by Abigail Walker, Library Assistant Institute of Fine Arts Library, New York University abigail.walker@nyu.edu.

Published
2021
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38. Tackling nasal symptoms in athletes: Moving towards personalized medicine.

Author

UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'oto-rhino-laryngologie, Hox, Valérie, Beyaert, Simon, Bullens, Dominique, Couto, Mariana, Langer, Daniel, Hellings, Peter-Willem, Huart, Caroline, Rombaux, Philippe, Seys, Sven F, Surda, Pavol, Walker, Abigail, Steelant, Brecht, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'oto-rhino-laryngologie, Hox, Valérie, Beyaert, Simon, Bullens, Dominique, Couto, Mariana, Langer, Daniel, Hellings, Peter-Willem, Huart, Caroline, Rombaux, Philippe, Seys, Sven F, Surda, Pavol, Walker, Abigail, and Steelant, Brecht

Abstract

Adequate nasal breathing is indispensable for athletes, and nasal symptoms have been shown to interfere with their subjective feeling of comfortable breathing and quality of life. Nasal symptoms are caused by either structural abnormalities or mucosal pathology. Structural pathologies are managed differently from mucosal disease, and therefore, adequate diagnosis is of utmost importance in athletes in order to choose the correct treatment option for the individual. Literature suggests that nasal symptoms are more prevalent in athletes compared to the general population and certain sports environments might even trigger the development of symptoms. Given the high demands of respiratory function in athletes, insight into triggering factors is of high importance for disease prevention. Also, it has been suggested that athletes are more neglectful to their symptoms and hence remain undertreated, meaning that special attention should be paid to education of athletes and their caregivers. This review aims at giving an overview of nasal physiology in exercise as well as the possible types of nasal pathology. Additionally, diagnostic and treatment options are discussed and we focus on unmet needs for the management and prevention of these symptoms in athletes within the concept of precision medicine.

Published
2021

39. British Rhinological Society Consensus Guidance on the use of biological therapies for chronic rhinosinusitis with nasal polyps

Author

Hopkins, Claire, primary, McKenzie, Jo‐Lyn, additional, Anari, Shahram, additional, Carrie, Sean, additional, Ramakrishnan, Yujay, additional, Kara, Naveed, additional, Philpott, Carl, additional, Hobson, Jonathan, additional, Qureishi, Ali, additional, Stew, Ben, additional, Bhalla, Raj, additional, Gane, Simon, additional, Walker, Abigail, additional, Harries, Phil, additional, Hathorn, Iain, additional, and Lund, Valerie, additional

Published
2021
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40. Robust and Comprehensive Targeted Metabolomics Method for Quantification of 50 Different Primary, Secondary, and Sulfated Bile Acids in Multiple Biological Species (Human, Monkey, Rabbit, Dog, and Rat) and Matrices (Plasma and Urine) Using Liquid Chromatography High Resolution Mass Spectrometry (LC-HRMS) Analysis

Author

Sangaraju, Dewakar, primary, Shi, Yao, additional, Van Parys, Michael, additional, Ray, Adam, additional, Walker, Abigail, additional, Caminiti, Rachel, additional, Milanowski, Dennis, additional, Jaochico, Allan, additional, Dean, Brian, additional, and Liang, Xiaorong, additional

Published
2021
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41. Tackling nasal symptoms in athletes: Moving towards personalized medicine

Author

Hox, Valerie, primary, Beyaert, Simon, additional, Bullens, Dominique, additional, Couto, Mariana, additional, Langer, Daniel, additional, Hellings, Peter‐Willem, additional, Huart, Caroline, additional, Rombaux, Philippe, additional, Seys, Sven F., additional, Surda, Pavol, additional, Walker, Abigail, additional, and Steelant, Brecht, additional

Published
2021
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42. Characterising the pleiotropic activity and spatial dynamics of Prostaglandin EP2 receptor signalling

Author

Walker, Abigail, Hanyaloglu, Aylin, Genesis Research Trust, and Society for Endocrinology

Subjects
endocrine system, urogenital system, lipids (amino acids, peptides, and proteins), musculoskeletal system, female genital diseases and pregnancy complications
Abstract

EP2 is a member of the G protein coupled receptor superfamily and is implicated in both physiological and pathophysiological signalling in reproductive tissues. Classically reported as Gαs-mediated in reproductive tissues EP2 can also signal via Gαq/11, although the mechanism underlying this promiscuity is unknown. Tight regulation of internalisation and trafficking to endosomal compartments such as the early, or very early endosomes, is fundamental to GPCR signalling capacity, thus discovery of ligands that take advantage of EP2 pleiotropy by preferentially activating specific EP2 pathways could be valuable therapeutically. Therefore, I first characterised EP2 trafficking and signalling using three highly specific ligands – butaprost, AH13205, and PGN9856i. In HEK 293 cells, EP2 undergoes dynamin-dependent constitutive, but limited ligand-directed, internalisation, which was required for full activation of Gαs-cAMP and Gαq/11-Ca2+ pathways. In pregnant myometrium, EP2 signals via Gαs/Gαq/11, activating contrasting pro- and anti- labour pathways until labour, when EP2 Gαs signalling is downregulated. Prostaglandin signalling is a key part of physiological labour, thus understanding the mechanics of EP2 signalling during labour could lead to novel therapeutics to combat preterm birth, which represents a major challenge to public health. I found that EP2 signalling is altered with the onset of labour, favouring pro-inflammatory pathways in early and late labour. OTR activation ‘switched’ EP2 signalling pathways to Gαi/o when activated with butaprost, enhancing pro-labour pathways and dampening Gαs-cAMP, which may be mediated by formation and rearrangement of EP2-OTR heteromers. Whilst AH13205 exhibited an extreme inflammatory profile in both HEK 293 and myometrial cells, and engaged EP2 in crosstalk with OTR, enhancing pro-labour pathways, PGN9856i did not activate Gαq/11-mediated pro-labour/inflammatory pathways in HEK cells or primary myometrial cells, and may actively antagonise OT-mediated pathways. Together, these findings uncover novel aspects of EP2 pleiotropy and suggest that biased EP2 ligands may be valuable tools for targeting reproductive tissues. Open Access

Published
2020
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45. Tackling nasal symptoms in athletes: moving towards personalized medicine

Author

Hox, Valerie, primary, Beyaert, Simon, additional, Bullens, Dominique, additional, Couto, Mariana, additional, Langer, Daniel, additional, Helllings, Peter, additional, Huart, Caroline, additional, Rombaux, Philippe, additional, Seys, Sven, additional, Surda, Pavol, additional, Walker, Abigail, additional, and Steelant, Brecht, additional

Published
2020
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46. Defining appropriateness criteria for endoscopic sinus surgery in the management of adult dental implant patients with incidental maxillary sinus findings on conebeam computed tomography

Author

Amin, Nikul, primary, Walker, Abigail, additional, Alobid, Isam, additional, Anari, Shahram, additional, Bast, Florian, additional, Bhalla, Rajiv K., additional, Cathcart, Russell, additional, Harries, Philip G., additional, Hathorn, Iain, additional, Philpott, Carl M., additional, Ramakrishnan, Yujay, additional, Stew, Benjamin, additional, Surda, Pavol, additional, Ting, Fiona, additional, and Hopkins, Claire, additional

Published
2020
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48. Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline

Author

Rovira, Aleix, primary, Dawson, Deborah, additional, Walker, Abigail, additional, Tornari, Chrysostomos, additional, Dinham, Alison, additional, Foden, Neil, additional, Surda, Pavol, additional, Archer, Sally, additional, Lonsdale, Dagan, additional, Ball, Jonathan, additional, Ofo, Enyi, additional, Karagama, Yakubu, additional, Odutoye, Tunde, additional, Little, Sarah, additional, Simo, Ricard, additional, and Arora, Asit, additional

Published
2020
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