Matthew Richardson

NIHR Leicester Biomedical Research Centre

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Alain Vignal

Génétique Physiologie et Systèmes d'Elevage

Melanie Parejo

University of the Basque Country

Mark Barnett

Scottish National Blood Transfusion Service

Andrea Talenti

Roslin Institute

David Wragg

Roslin Institute

Neil Greening

Glenfield Hospital

Sally Singh

Glenfield Hospital

Rachael A. Evans

University Hospitals of Leicester NHS Trust

Christopher E. Brightling

NIHR Leicester Biomedical Research Centre

Jennifer K Quint

Imperial College London

Cooperative Institutions

University of Oxford

551

Imperial College London

487

University of Leicester

470

NIHR Leicester Biomedical Research Centre

411

National Institute for Health Research

391

University Hospitals of Leicester NHS Trust

294

Newcastle upon Tyne Hospitals NHS Foundation Trust

290

Newcastle University

288

Oxford Health NHS Foundation Trust

256

Glenfield Hospital

205

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Predicting an AECOPD from vital signs during daily life: insights from novel technology

05.02 - Monitoring airway disease (2021)

G France Matthew Richardson Neil Greening Dale Esliger Samuel Briggs‐Price

Many studies have suggested the use of telemonitoring in the management of COPD, but the use of telemonitoring to predict the onset of an AECOPD is still unclear. We aimed to determine whether respiratory rate (RR), heart rate (HR), skin temperature (ST) and physical activity (PA), measured continuously using novel wearable technology can predict the onset of an exacerbation post-AECOPD. Following hospitalisation for an AECOPD, participants were asked to wear an Equivital vest during waking hours for 42 days to measure RR, HR, ST and PA. An AECOPD was classified as either mild (worsening of symptoms via the EXACT-Pro), moderate (change in medication), or severe (hospitalisation). Three time points within the 42 days were compared; i) three days during stable symptoms; ii) three days prior to the exacerbation; iii) the day of exacerbation. 31 participants provided sufficient vital signs and symptom data, with 14 participants (45%) exacerbating during the 6 weeks post-discharge (7 mild, 2 moderate, 5 severe). Little change was seen for HR, ST and PA between time points (Fig 1). RR increased across time points (median[IQR], 19.6[5.7]; 21.5[7.1]; 22.9[7.3]; Fig 1), but there was notable variation for all measures across all time points. We were unable to predict an exacerbation using these data. RR was the most promising vital sign; however, the wide variation for all vital signs limits their predictive capabilities.

Vital signs

Respiratory Rate

Copd exacerbation

10.1183/13993003.congress-2021.pa3833

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PRJNA311274 raw variants

Zenodo (CERN European Organization for Nuclear Research) (2022)

Melanie Parejo Andrea Talenti Matthew Richardson Alain Vignal Mark Barnett

Sequencing reads were aligned to the Amel_HAv3.1 reference genome using BWA-MEM v0.7.17. Reads were sorted with SAMtools v1.9 and duplicates marked (MarkDuplicates) with GATK v4.0.11.0. Variants for each sample were called using GATK’s HaplotypeCaller with the following non-default parameters --ERC GVCF, --sample-ploidy 1 and -A AlleleFraction. Joint variant calling was performed across all samples collated for AmelHap using GATK’s GenomicDBImport and GenotypeGVCFs with --sample-ploidy 1 and a window size of 10 Mb. This dataset comprises the raw variant calls only for samples belonging to project accession: PRJNA311274.

10.5281/zenodo.6669899

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Erythropoietin production as a result of repeated apneas

Robert de Bruijn Matthew Richardson U Milling Henry M. Lemon Erika Schagatay

Background: It has been known for decades that high altitude hypoxia will lead to increased erythropoiesis. Hypoxia in mainly the kidney results in an increased production of erythropoietin (EPO) stimulating erythropoiesis. High altitude natives display a higher haemoglobin concentration than sea level residents, which in turn increase their haemoglobin concentration as part of the adaptation to altitude. Another group of humans exposed to hypoxia is apneic divers, which may endure transient acute hypoxia, spaced by periods of normal breathing. We recently found higher haemoglobin levels in elite apneic divers, compared to groups of elite skiers and untrained subjects, suggesting that apnea training may induce erythropoiesis in humans. It is well known that diving mammals display high haemoglobin concentrations, and the beneficial effects are obvious: A larger oxygen store before diving prolongs the aerobic dive limit, and a higher haemoglobin concentration may speed up recovery after apneas and act as a buffer against acidosis during the dive. Although our group comparisons reveal a higher haemoglobin concentration in divers, it cannot be determined whether this is a training effect or genetically determined i.e. if individuals with higher concentrations of haemoglobin are more prone to take up apneic diving. Methods: To investigate if apnea training can induce EPO production, 5 previously untrained volunteers (3 men and 2 women, mean ageSD 28 5.5 years) performed 15 maximal apneas in a horizontal position in air. The apneas were grouped in 3 series of 5 apneas and spaced by 2 minutes of which 1 minute was spent slightly hyperventilating, to produce apneas sufficiently long to induce hypoxia. Series were spaced by 10 minutes resting periods. To determine EPO levels, venous blood samples were taken before apneas and directly after the last apnea series, followed by samples 1, 2, 3 and 5 hours after the apneas. Results: Mean baseline EPO before the apneas was 10.2 U/L. In all subjects EPO levels increased during the 5 hours period after the apneas. The time for EPO-peak values were different among individuals. The mean peak value occurred after 3 h, where the mean increase was 12 % of the pre apnea reference value. Conclusion: The results suggest that apnea induced intermittent hypoxia could lead to increased erythropoiesis. The evaluation of these findings in a larger group of subjects, including measurements of the individual circadian variations in EPO production, is in progress.

Hypoxia

Hypoxic ventilatory response

Altitude training

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PRJNA578233 raw variants

Zenodo (CERN European Organization for Nuclear Research) (2022)

Melanie Parejo Andrea Talenti Matthew Richardson Alain Vignal Mark Barnett

10.5281/zenodo.6669928

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Conservative management of a suspected triangular fibrocartilage complex injury utilizing strength training exercises: A case report

Journal of Bodywork and Movement Therapies (2023)

Adam Sergent Trevor Shaw Matthew Richardson

Conservative Management

Fibrocartilage

Strength Training

10.1016/j.jbmt.2023.07.001

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Prediction of in-hospital death following aortic valve replacement: a new accurate model

European Journal of Cardio-Thoracic Surgery (2012)

Matthew Richardson Neil Howell Nick Freemantle Ben Bridgewater Duilio Pagano

Aortic valve replacement (AVR) is accepted as the standard treatment for severe symptomatic aortic valve stenosis and regurgitation. As novel treatments are introduced for patients at high risk for conventional surgery, it is important to have models that accurately predict procedural risk. The aim of this study was to develop and validate a risk-stratification model to predict in-hospital risk of death for patients undergoing AVR and to compare the model with existing algorithms. We reviewed data from the Central Cardiac Adult Database, which holds prospectively collected clinical information on all adult patients undergoing cardiac surgery in National Health Service (NHS) hospitals and some private providers in the UK and Ireland. We included all the patients undergoing AVR with or without coronary artery bypass grafting. The study population consists of 55 157 patients undergoing surgery between 1 April 2001 and 31 March 2009. The model was built using data from April 2001 to March 2008 and validated using data from patients undergoing surgery from April 2008 to March 2009. The model was compared against the additive and logistic EuroSCORE models and a valve-specific risk-prediction model. The final multivariable model includes items describing cardiovascular risk status and procedural factors. Applying the model to the independent validation dataset provided a c-statistic (index of rank correlation) of 0.791, which was substantially better than that achieved by previously developed risk models in Europe, and significantly improved risk prediction in higher-risk patients. We have produced an accurate risk model to predict outcome following AVR surgery. It will be of use for patient selection and informed consent, and of particular interest in defining those patients at high risk who may benefit from novel approaches to AVR.

EuroSCORE

10.1093/ejcts/ezs457

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Hypoxia - A trigger for spleen contraction?

Matthew Richardson Robert de Bruijn Erika Schagatay

Several mechanisms involving oxygen conservation or increased blood gas storage capacity serve to facilitate prolonged diving in mammals. Two such mechanisms present in humans are the cardiovascula ...

Hypoxia

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Influence of ground cover and tunnels on production of Red Russian kale in urban gardes

Advances in Horticultural Science (2024)

Matthew Richardson Caitlin G. Arlotta Lillie Monroe-Lord

Kale, Brassica oleracea L. var. acephala, is an important urban crop for human health and may potentially be grown year-round even in a temperate climate. We investigated black plastic and straw mulch compared to bare soil cover in low tunnels at 10 urban garden sites and in low tunnels within a high tunnel in the USA to ascertain the influence on yield and nutrients of Red Russian kale, soil temperature, air temperature, weed pressure, and aphid abundance. Kale had low yield in garden sites, likely because the outside environment was too cold for low tunnels to gain and retain heat. Cultivating kale in a high tunnel resulted in good yields, especially when paired with a low tunnel and plastic or straw mulch, which resulted in the highest air and soil temperatures. The amount of minerals in plants within the high tunnel largely did not vary across combinations of low tunnels and ground covers, except for copper and sulfur, which were lowest in plots with no low tunnel or ground cover. Also, dietary fiber was higher when no low tunnel or ground cover was used compared to plots with a low tunnel and no ground cover. Weeds were suppressed by straw and black plastic mulch, but none of the ground covers influenced aphid abundance. Overall, our work demonstrates that Red Russian kale can be grown in a temperate climate during winter with some combinations of tunnels and ground covers.

10.36253/ahsc-14997

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PRJNA596071 gVCFs

Zenodo (CERN European Organization for Nuclear Research) (2022)

Melanie Parejo Andrea Talenti Matthew Richardson Alain Vignal Mark Barnett

Sequencing reads were aligned to the Amel_HAv3.1 reference genome using BWA-MEM v0.7.17. Reads were sorted with SAMtools v1.9 and duplicates marked (MarkDuplicates) with GATK v4.0.11.0. Variants for each sample were called using GATK’s HaplotypeCaller with the following non-default parameters --ERC GVCF, --sample-ploidy 1 and -A AlleleFraction. This dataset comprises the gVCF files for samples belonging to project accession: PRJNA596071.

10.5281/zenodo.6678234

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Missing a signal in exercise outcomes–is ventilatory limitation a factor in COPD?

01.02 - Rehabilitation and chronic care (2019)

Theresa Harvey‐Dunstan Ruth Tal‐Singer Matthew Allinder Michael I. Polkey Matthew Richardson

Introduction: Exercise limitation is a significant but modifiable symptom for patients with COPD. Response of exercise outcomes may vary with ventilatory limitation (VL, defined as VE/MVV>0.8 [MVV=FEV₁*37.5]). We aimed to compare the response of exercise outcomes in subjects with or without VL and following either bronchodilation or pulmonary rehabilitation (PR). Methods: Subjects with symptomatic COPD (MRC>2, FEV₁<80%predicted) were randomised to six weeks long acting muscarinic antagonist (LAMA) or PR. Incremental/constant work rate cardiopulmonary cycle (ICE & CWRCT), incremental/endurance shuttle walk (ISWT and ESWT) and six-minute walk (6MWT) were completed at baseline and post-intervention, to recommended standards^1,2. Analysed with paired/independent t-test (p<0.05). Results: 76 subjects were included: (mean±SD) age 66±9 (yrs), FEV₁ 48.75±17.80 (%pred), Male 72%, VE/MVV 0.96±0.36. Subjects with VL elicited significant within group changes in ISWT, CWRCT, ESWT and 6MWT (36± 64m, p=0.03; 149±261sec, p=0.03; 168±263sec, p=0.02; 38±67m, p=0.03, respectively) following PR, while those without VL provoked changes in 6MWT and ICE (49±40m, p=0.02, 18±14w, p=0.01). LAMA did not significantly change any outcome. There were no between group differences. See Table 1. Conclusions: The presence of a ventilatory limit may influence the pattern of change in exercise outcomes following pulmonary rehabilitation. References: ¹ATS/ACCP. AJRCCM.2003 ²Holland. ERJ.2014

Lama

Group B

10.1183/13993003.congress-2019.pa684

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