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Article ; Online: Antenatal care and perinatal outcomes of asylum seeking women and their infants.

Sturrock, Sarah / Williams, Emma / Dassios, Theodore / Greenough, Anne

2021 Volume 49, Issue 5, Page(s) 619–623

Abstract: Objectives: Asylum seekers have been highlighted as a particularly vulnerable group of expectant mothers due to complex medical and psychosocial needs, as well as the difficulties they may face in accessing care. Our aim was to examine if there were ... ...

Abstract	Objectives: Asylum seekers have been highlighted as a particularly vulnerable group of expectant mothers due to complex medical and psychosocial needs, as well as the difficulties they may face in accessing care. Our aim was to examine if there were differences in the antenatal care and perinatal outcomes for asylum seeking women when compared to age- and ethnicity-matched controls delivering at the same hospital. Methods: Two age- and ethnicity-matched non-asylum seeking controls were identified for each asylum-seeking woman. Electronic patient records were analysed to determine the amount of antenatal care received and neonatal outcomes. Results: Thirty-four asylum-seeking women were identified who had term born infants. The median number of antenatal care episodes at the delivering hospital was significantly fewer amongst asylum-seeking women compared to controls (three vs. nine, p<0.0001). The median number of antenatal ultrasound examinations at the delivering hospital amongst asylum-seeking women was one (IQR 1-2), compared to three (IQR 3-4) in the controls (p<0.0001). The postnatal length of stay was significantly longer for infants of asylum-seeking women (median three vs. two days, p=0.002). Thirty-seven percent of asylum seeking women but none of the controls required assistance from social services. There was a significant correlation between antenatal and postnatal costs for asylum seeking women (r=0.373, p=0.042), but not for controls (r=0.171, p=0.181). Conclusions: The increased postnatal length of stay in the infants of asylum seeking mothers may reflect their mother's reduced antenatal care and hence insufficient discharge planning for mothers and infants with increased social needs.
MeSH term(s)	Adult ; Female ; Health Services Accessibility/standards ; Health Services Accessibility/statistics & numerical data ; Health Services Needs and Demand ; Humans ; Infant, Newborn ; Patient Discharge ; Perinatal Care/methods ; Perinatal Care/standards ; Pregnancy ; Pregnancy Outcome/epidemiology ; Pregnant Women/ethnology ; Pregnant Women/psychology ; Prenatal Care/methods ; Prenatal Care/psychology ; Prenatal Care/standards ; Refugees/psychology ; Refugees/statistics & numerical data ; United Kingdom/epidemiology ; Vulnerable Populations/ethnology
Language	English
Publishing date	2021-02-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123512-6
ISSN	1619-3997 ; 0300-5577 ; 0936-174X
ISSN (online)	1619-3997
ISSN	0300-5577 ; 0936-174X
DOI	10.1515/jpm-2020-0572
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Article ; Online: Antenatal and perinatal outcomes of refugees in high income countries.

Sturrock, Sarah / Williams, Emma / Greenough, Anne

Journal of perinatal medicine

2020 Volume 49, Issue 1, Page(s) 80–93

Abstract: Objectives: The World Health Organisation (WHO) has highlighted a marked trend for worse pregnancy-related indicators in migrants, such as maternal and neonatal morbidity and mortality, poor mental health and suboptimal care. The aim of this study was ... ...

Abstract	Objectives: The World Health Organisation (WHO) has highlighted a marked trend for worse pregnancy-related indicators in migrants, such as maternal and neonatal morbidity and mortality, poor mental health and suboptimal care. The aim of this study was to determine whether such adverse outcomes occurred in refugees who moved to high income countries by comparing their antenatal and perinatal outcomes to those of non-immigrant women. Methods: A literature search was undertaken. Embase and Medline databases were searched using Ovid. Search terms included "refugee", "pregnan" or "neonat", and "outcome". Results: The search yielded 194 papers, 23 were included in the final analysis. All the papers included were either retrospective cohort or cross-sectional studies. The refugees studied originated from a wide variety of source countries, including Eritrea, Somalia, Afghanistan, Iraq, and Syria. Refugee women were more likely to be socially disadvantaged, but less likely to smoke or take illegal drugs during pregnancy. Refugee women were more likely to have poor, late, or no attendance at antenatal care. Miscarriages and stillbirth were more common amongst refugee women than non-refugees. Perinatal mortality was higher among refugees. Conclusions: Despite better health care services in high income countries, refugee mothers still had worse outcomes. This may be explained by their late or lack of attendance to antenatal care.
MeSH term(s)	Delivery, Obstetric ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Patient Acceptance of Health Care ; Perinatal Mortality ; Pregnancy ; Pregnancy Outcome ; Prenatal Care ; Refugees
Language	English
Publishing date	2020-09-01
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	123512-6
ISSN	1619-3997 ; 0300-5577 ; 0936-174X
ISSN (online)	1619-3997
ISSN	0300-5577 ; 0936-174X
DOI	10.1515/jpm-2020-0389
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Article ; Online: Closed loop automated oxygen control in neonates-A review.

Sturrock, Sarah / Williams, Emma / Dassios, Theodore / Greenough, Anne

Acta paediatrica (Oslo, Norway : 1992)

2019 Volume 109, Issue 5, Page(s) 914–922

Abstract: Aim: Neonates frequently require supplementary oxygen but may develop complications if the oxygen saturation is outside the target range. This review aimed to determine whether the algorithms used in closed loop automated oxygen control systems ... ...

Abstract	Aim: Neonates frequently require supplementary oxygen but may develop complications if the oxygen saturation is outside the target range. This review aimed to determine whether the algorithms used in closed loop automated oxygen control systems influenced their efficacy and whether use of the systems reduced relevant, long-term neonatal complications. Methods: A literature search was conducted using PubMed and Google Scholar. The search terms were 'closed loop' or 'automat', 'oxygen' and 'neonat'. Results: Eighteen studies were identified: sixteen comparison clinical studies, an observational study and an animal study. Overall, closed loop automated oxygen control was associated with an increased percentage of time spent within the target oxygen saturation range and there were fewer manual adjustments to the inspired oxygen concentration when compared with manual oxygen control. The systems were effective in infants on non-invasive respiratory support or mechanically ventilated, but no study included term-born infants. No long-term data were available to determine if complications of oxygen toxicity were reduced. Conclusion: Closed loop automated oxygen control has been shown in short term trials including preterm and low birth weight infants to improve target saturation achievement. Whether long-term outcomes will be improved with their use requires investigation.
MeSH term(s)	Humans ; Hyperoxia ; Infant ; Infant, Newborn ; Infant, Premature ; Observational Studies as Topic ; Oxygen ; Oxygen Inhalation Therapy
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2019-11-27
Publishing country	Norway
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.15089
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Article ; Online: Maternal smoking and cannabis use during pregnancy and infant outcomes.

Sturrock, Sarah / Williams, Emma / Ambulkar, Hemant / Dassios, Theodore / Greenough, Anne

Journal of perinatal medicine

2020 Volume 48, Issue 2, Page(s) 168–172

Abstract: Background Our aim was to determine the prevalence of tobacco smoking and e-cigarettes and cannabis use during pregnancy, whether these were influenced by ethnicity, and their relationship to perinatal outcomes. Methods A study was carried out in 4465 ... ...

Abstract	Background Our aim was to determine the prevalence of tobacco smoking and e-cigarettes and cannabis use during pregnancy, whether these were influenced by ethnicity, and their relationship to perinatal outcomes. Methods A study was carried out in 4465 infants whose mothers delivered during 2017 and 2018. Self-reported maternal smoking, e-cigarette and cannabis use at booking were recorded. Outcome measures were birthweight and head circumference z-scores and admission to the neonatal intensive care unit (NICU). Results Two hundred and five women reported smoking cigarettes (4.7%), five were using e-cigarettes (0.11%) and 106 were using cannabis (2.43%). Women were most likely to smoke if young (15-19 years old) or from a mixed-race or White background. Cigarette smoking was associated with a lower mean z-score for birthweight (-0.587 vs. -0.064) and head circumference (-0.782 vs. -0.157) (both outcomes P < 0.0001). Young, mixed-race women were most likely to be both smoking and using cannabis during pregnancy and their infants had a lower birthweight mean z score (-0.989 vs. -0.587, P = 0.028) and head circumference z score (-1.33 vs. 0.782, P = 0.025) than cigarette use alone. Conclusion Young, mixed-race women were most likely to be both smoking and using cannabis during pregnancy and should be targeted for cessation programmes.
MeSH term(s)	Adolescent ; Adult ; Birth Weight ; Female ; Humans ; Infant, Newborn ; Intensive Care, Neonatal/statistics & numerical data ; Pregnancy ; Pregnancy Outcome/epidemiology ; Retrospective Studies ; Smoking/ethnology ; United Kingdom/epidemiology ; Young Adult
Language	English
Publishing date	2020-01-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123512-6
ISSN	1619-3997 ; 0300-5577 ; 0936-174X
ISSN (online)	1619-3997
ISSN	0300-5577 ; 0936-174X
DOI	10.1515/jpm-2019-0422
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Article ; Online: What is the role of near-peer mentoring in informing medical students about a career in general practice?

Gondhalekar, Anjali / Fitzgibbon-Cadiou, Anne / Gossain, Manisha / Sturrock, Alison

Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors

2020 Volume 32, Issue 2, Page(s) 123–126

Abstract: Near-peer learning at undergraduate level has the potential to introduce students to a career in general practice. The Wass Report suggested the need to provide enthusiastic role models within general practice, and this was the stimulus for the ... ...

Abstract	Near-peer learning at undergraduate level has the potential to introduce students to a career in general practice. The Wass Report suggested the need to provide enthusiastic role models within general practice, and this was the stimulus for the introduction of a near-peer general practitioner (GP) mentoring scheme at University College London (UCL) Medical School.The UCL Medical School GP mentoring scheme was introduced in the academic year of 2019 enlisting UCL GP training scheme doctors to pair up with UCL medical students to meet face-to-face and discuss a career in general practice. Following the end of the scheme, a mix of focus groups and semi-structured interviews were used to provide an insight into the students' experiences of the mentoring scheme.This evaluation focused on the perceptions, experiences and insights of the medical students who participated in the GP near-peer mentoring scheme and considered their views about a career within general practice. The evaluation considered the students' perceptions of their trainee as a role-model figure.
MeSH term(s)	General Practice/education ; Humans ; Mentoring ; Mentors ; Peer Group ; Students, Medical
Language	English
Publishing date	2020-12-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2074818-8
ISSN	1475-990X ; 1473-9879
ISSN (online)	1475-990X
ISSN	1473-9879
DOI	10.1080/14739879.2020.1846141
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Article ; Online: Hypoxia induces expression of angiotensin-converting enzyme II in alveolar epithelial cells: Implications for the pathogenesis of acute lung injury in COVID-19.

Sturrock, Anne / Zimmerman, Elizabeth / Helms, My / Liou, Theodore G / Paine, Robert

Physiological reports

2021 Volume 9, Issue 9, Page(s) e14854

Abstract: SARS-CoV-2 uptake by lung epithelial cells is a critical step in the pathogenesis of COVID-19. Viral entry is dependent on the binding of the viral spike protein to the angiotensin converting enzyme II protein (ACE2) on the host cell surface, followed by ...

Abstract	SARS-CoV-2 uptake by lung epithelial cells is a critical step in the pathogenesis of COVID-19. Viral entry is dependent on the binding of the viral spike protein to the angiotensin converting enzyme II protein (ACE2) on the host cell surface, followed by proteolytic cleavage by a host serine protease such as TMPRSS2. Infection of alveolar epithelial cells (AEC) in the distal lung is a key feature in progression to the acute respiratory distress syndrome (ARDS). We hypothesized that AEC expression of ACE2 is induced by hypoxia. In a murine model of hypoxic stress (12% FiO2), the total lung Ace2 mRNA and protein expression was significantly increased after 24 hours in hypoxia compared to normoxia (21% FiO2). In experiments with primary murine type II AEC, we found that exposure to hypoxia either in vivo (prior to isolation) or in vitro resulted in greatly increased AEC expression of both Ace2 (mRNA and protein) and of Tmprss2. However, when isolated type II AEC were maintained in culture over 5 days, with loss of type II cell characteristics and induction of type I cell features, Ace2 expression was greatly reduced, suggesting that this expression was a feature of only this subset of AEC. Finally, in primary human small airway epithelial cells (SAEC), ACE2 mRNA and protein expression were also induced by hypoxia, as was binding to purified spike protein. Hypoxia-induced increase in ACE2 expression in type II AEC may provide an explanation of the extended temporal course of human patients who develop ARDS in COVID-19.
MeSH term(s)	Acute Lung Injury/enzymology ; Acute Lung Injury/genetics ; Alveolar Epithelial Cells/enzymology ; Angiotensin-Converting Enzyme 2/biosynthesis ; Angiotensin-Converting Enzyme 2/genetics ; Animals ; COVID-19/enzymology ; COVID-19/genetics ; Cells, Cultured ; Female ; Gene Expression Regulation, Enzymologic ; Humans ; Hypoxia/enzymology ; Hypoxia/genetics ; Male ; Mice ; Mice, Inbred C57BL
Chemical Substances	Ace2 protein, mouse (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
Language	English
Publishing date	2021-04-27
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2724325-4
ISSN	2051-817X ; 2051-817X
ISSN (online)	2051-817X
ISSN	2051-817X
DOI	10.14814/phy2.14854
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Article ; Online: Comparison of biological responses between submerged, pseudo-air-liquid interface, and air-liquid interface exposure of A549 and differentiated THP-1 co-cultures to combustion-derived particles.

Kaur, Kamaljeet / Mohammadpour, Raziye / Sturrock, Anne / Ghandehari, Hamidreza / Reilly, Christopher / Paine, Robert / Kelly, Kerry E

Journal of environmental science and health. Part A, Toxic/hazardous substances & environmental engineering

2022 Volume 57, Issue 7, Page(s) 540–551

Abstract: Air liquid interface (ALI) exposure systems are gaining interest, and studies suggest enhanced response of lung cells exposed to particles at ALI as compared to submerged exposure, although the results have been somewhat inconsistent. Previous studies ... ...

Abstract	Air liquid interface (ALI) exposure systems are gaining interest, and studies suggest enhanced response of lung cells exposed to particles at ALI as compared to submerged exposure, although the results have been somewhat inconsistent. Previous studies have used monocultures and measured particle deposition using assumptions including consistent particle deposition, particle density, and shape. This study exposed co-cultures of A549 and differentiated THP-1 cells to flame-generated particles using three exposure methods: ALI, pseudo-ALI, and submerged. The dose at ALI was measured directly, reducing the need for assumptions about particle properties and deposition. For all exposure methods an enhanced pro-inflammatory response (TNFα) and Cytochrome P450 (CYP1A1) gene expression, compared to their corresponding negative controls, was observed. ALI exposure induced a significantly greater TNFα response compared to submerged exposure. The submerged exposures exhibited greater induction of CYP1A1 than other exposure methods, although not statistically significant. Some of the factors behind the observed difference in responses for the three exposure methods include differences in physicochemical properties of particles in suspending media, delivered dose, and potential contribution of gas-phase species to cellular response in ALI exposure. However, given the difficulty and expense of ALI exposures, submerged exposure may still provide relevant information for particulate exposures.
MeSH term(s)	Aerosols/chemistry ; Coculture Techniques ; Cytochrome P-450 CYP1A1/metabolism ; Epithelial Cells ; Lung ; Tumor Necrosis Factor-alpha/metabolism
Chemical Substances	Aerosols ; Tumor Necrosis Factor-alpha ; Cytochrome P-450 CYP1A1 (EC 1.14.14.1)
Language	English
Publishing date	2022-06-20
Publishing country	England
Document type	Journal Article
ZDB-ID	196584-0
ISSN	1532-4117 ; 0360-1226 ; 1077-1204 ; 1093-4529
ISSN (online)	1532-4117
ISSN	0360-1226 ; 1077-1204 ; 1093-4529
DOI	10.1080/10934529.2022.2083429
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Article ; Online: Using μX-Ray CT to observe postmortem diffusion from the stomach in a rat model.

Dryburgh, Eve / Honeybun, Llinos / Sturrock, Keith / Savage, Anne / Maskell, Peter D

Forensic science international

2020 Volume 312, Page(s) 110310

Abstract: The stomach has long been recognised as a depot for postmortem diffusion. A better understanding of the phenomena of postmortem diffusion would aid forensic practitioners in their interpretation of toxicological results. A limitation of previous stomach ... ...

Abstract	The stomach has long been recognised as a depot for postmortem diffusion. A better understanding of the phenomena of postmortem diffusion would aid forensic practitioners in their interpretation of toxicological results. A limitation of previous stomach diffusion studies was the lack of ability to visualise postmortem diffusion in real time, the use of μX-ray Computed Tomography (CT) could overcome this problem. We utilised CT to track the diffusion of the contrast medium caesium ions (Cs
MeSH term(s)	Animals ; Cesium/chemistry ; Chlorides/chemistry ; Contrast Media/chemistry ; Diffusion ; Forensic Toxicology/methods ; Gastrointestinal Contents/diagnostic imaging ; Models, Animal ; Postmortem Changes ; Posture ; Rats, Wistar ; Stomach/diagnostic imaging ; Temperature ; Tomography, X-Ray Computed
Chemical Substances	Chlorides ; Contrast Media ; Cesium (1KSV9V4Y4I) ; cesium chloride (GNR9HML8BA)
Language	English
Publishing date	2020-05-05
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	424042-x
ISSN	1872-6283 ; 0379-0738
ISSN (online)	1872-6283
ISSN	0379-0738
DOI	10.1016/j.forsciint.2020.110310
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Article: Comparison of biological responses between submerged, pseudo-air-liquid interface, and air-liquid interface exposure of A549 and differentiated THP-1 co-cultures to combustion-derived particles

Kaur, Kamaljeet / Mohammadpour, Raziye / Sturrock, Anne / Ghandehari, Hamidreza / Reilly, Christopher / Paine, Robert / Kelly, Kerry E.

Journal of environmental science and health. 2022 July 22, v. 57, no. 7

2022

Abstract	Air liquid interface (ALI) exposure systems are gaining interest, and studies suggest enhanced response of lung cells exposed to particles at ALI as compared to submerged exposure, although the results have been somewhat inconsistent. Previous studies have used monocultures and measured particle deposition using assumptions including consistent particle deposition, particle density, and shape. This study exposed co-cultures of A549 and differentiated THP-1 cells to flame-generated particles using three exposure methods: ALI, pseudo-ALI, and submerged. The dose at ALI was measured directly, reducing the need for assumptions about particle properties and deposition. For all exposure methods an enhanced pro-inflammatory response (TNFα) and Cytochrome P450 (CYP1A1) gene expression, compared to their corresponding negative controls, was observed. ALI exposure induced a significantly greater TNFα response compared to submerged exposure. The submerged exposures exhibited greater induction of CYP1A1 than other exposure methods, although not statistically significant. Some of the factors behind the observed difference in responses for the three exposure methods include differences in physicochemical properties of particles in suspending media, delivered dose, and potential contribution of gas-phase species to cellular response in ALI exposure. However, given the difficulty and expense of ALI exposures, submerged exposure may still provide relevant information for particulate exposures.
Keywords	coculture ; cytochrome P-450 ; environmental science ; gene expression ; inflammation ; liquid-air interface ; lungs
Language	English
Dates of publication	2022-0722
Size	p. 540-551.
Publishing place	Taylor & Francis
Document type	Article
ZDB-ID	196584-0
ISSN	1532-4117 ; 0360-1226 ; 1077-1204 ; 1093-4529
ISSN (online)	1532-4117
ISSN	0360-1226 ; 1077-1204 ; 1093-4529
DOI	10.1080/10934529.2022.2083429
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Consequences of Hypoxia for the Pulmonary Alveolar Epithelial Cell Innate Immune Response.

Sturrock, Anne / Woller, Diana / Freeman, Andrew / Sanders, Karl / Paine, Robert

Journal of immunology (Baltimore, Md. : 1950)

2018 Volume 201, Issue 11, Page(s) 3411–3420

Abstract: Pulmonary innate immune responses involve a highly regulated multicellular network to defend the enormous surface area of the lung. Disruption of these responses renders the host susceptible to pneumonia. Alveolar epithelial cells (AEC) are a critical ... ...

Abstract	Pulmonary innate immune responses involve a highly regulated multicellular network to defend the enormous surface area of the lung. Disruption of these responses renders the host susceptible to pneumonia. Alveolar epithelial cells (AEC) are a critical source of innate immune molecules such as GM-CSF, which determine the functional maturation of alveolar macrophages. In many pulmonary diseases, heterogeneous ventilation leads to regional hypoxia in the lung. The effect of hypoxia on AEC innate immune function is unknown. We now report that exposure of primary murine AEC to hypoxia (1% oxygen) for 24 h results in significant suppression of key innate immune molecules, including GM-CSF, CCL2, and IL-6. This exposure did not cause toxicity but did induce stabilization of hypoxia-inducible factor 1α protein (HIF-1α) and shift to glycolytic metabolism. Focusing on GM-CSF, we found that hypoxia greatly decreased the rate of GM-CSF transcription. Hypoxia both decreased NF-κB signaling in AEC and induced chromosomal changes, resulting in decreased accessibility in the GM-CSF proximal promoter of target sequences for NF-κB binding. In mice exposed to hypoxia in vivo (12% oxygen for 2 d), lung GM-CSF protein expression was reduced. In vivo phagocytosis of fluorescent beads by alveolar macrophages was also suppressed, but this effect was reversed by treatment with GM-CSF. These studies suggest that in critically ill patients, local hypoxia may contribute to the susceptibility of poorly ventilated lung units to infection through complementary effects on several pathways, reducing AEC expression of GM-CSF and other key innate immune molecules.
MeSH term(s)	Alveolar Epithelial Cells/immunology ; Animals ; Cells, Cultured ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor/genetics ; Granulocyte-Macrophage Colony-Stimulating Factor/metabolism ; Hypoxia/immunology ; Immunity, Innate ; Lung/pathology ; Macrophages, Alveolar/immunology ; Male ; Mice ; Mice, Inbred C57BL ; NF-kappa B/genetics ; NF-kappa B/metabolism ; Phagocytosis ; Promoter Regions, Genetic/genetics ; Signal Transduction
Chemical Substances	NF-kappa B ; Granulocyte-Macrophage Colony-Stimulating Factor (83869-56-1)
Language	English
Publishing date	2018-10-31
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	3056-9
ISSN	1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
ISSN (online)	1550-6606
ISSN	0022-1767 ; 1048-3233 ; 1047-7381
DOI	10.4049/jimmunol.1701387
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