ORCID Profile
0000-0002-6888-3298
Current Organisation
University of Nottingham
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Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.CCELL.2019.03.007
Abstract: Tumor cells may adapt to metabolic challenges by alternating between glycolysis and oxidative phosphorylation (OXPHOS). To target this metabolic plasticity, we combined intermittent fasting, a clinically feasible approach to reduce glucose availability, with the OXPHOS inhibitor metformin. In mice exposed to 24-h feeding/fasting cycles, metformin impaired tumor growth only when administered during fasting-induced hypoglycemia. Synergistic anti-neoplastic effects of the metformin/hypoglycemia combination were mediated by glycogen synthase kinase 3β (GSK3β) activation downstream of PP2A, leading to a decline in the pro-survival protein MCL-1, and cell death. Mechanistically, specific activation of the PP2A-GSK3β axis was the sum of metformin-induced inhibition of CIP2A, a PP2A suppressor, and of upregulation of the PP2A regulatory subunit B56δ by low glucose, leading to an active PP2A-B56δ complex with high affinity toward GSK3β.
Publisher: Informa UK Limited
Date: 27-07-2022
DOI: 10.1080/14670100.2021.1954748
Abstract: To characterise opinions about needing to undergo MRI within the population of current cochlear implant (CI) users. Magnetic resonance imaging (MRI) of CI users is often associated with severe discomfort and magnet displacement. A global online survey of 310 CI users was conducted between 22nd July and 13th September 2020. Only 55% of respondents had been told whether their model of CI could undergo MRI. 31% of respondents considered MRI when deciding whether to receive a CI, and 28% when deciding which CI model to have. 64% reported concerns related to their CI if needing MRI compared to 29% reporting concerns unrelated to their CI. Willingness to undergo MRI reduced when considering magnet removal, splinting, bandaging, local anaesthesia, lasting discomfort, an inability to use their CI, or a reduction in image quality because of their CI. The single most influential factor was the possibility of damaging their CI (63%). 59% of respondents would consider minor surgery to upgrade their retaining magnet to one of a rotating design. These findings highlight the heterogeneity of CI users' opinions about MRI. We suggest several opportunities for improving the dissemination of current and accurate MRI-related information for CI users.
Publisher: Elsevier BV
Date: 07-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-07-2021
DOI: 10.1097/MAO.0000000000003281
Abstract: Brain magnetic resonance imaging in patients with cochlear implants (CIs) is impacted by image artefacts. The optimal positioning of the CI to minimize artefacts is unknown. This study aimed to characterize the dependence of the extent and distribution of the artefact on CI positioning. Three normally hearing in iduals underwent magnetic resonance imaging using a standard T1-weighted 3D sequence. Scans were acquired with a non-functioning CI placed underneath a swimming cap at four plausible scalp positions on each side, and without the CI in situ. The artefact in each image was assessed quantitatively using voxel-based techniques. Two radiologists also independently rated the likely impact of the artefact on the detection of pathology for 20 neuroradiological locations. The procedure was well tolerated. The most postero-inferior CI positions resulted in the smallest apparent artefacts. Radiological evaluations suggested that artefacts would likely limit pathology detection in the ipsilateral temporal, parietal, and occipital lobes, regardless of CI location. Pathology detection in contralateral structures and anterior corpus callosum was rarely affected. Certain CI locations appeared to selectively spare ipsilateral structures, for ex le, postero-inferior CI locations selectively spared ipsilateral midbrain, deep grey matter, and frontal lobes. A CI placed under a swimming cap is a feasible tool for observing the effect of CI location on image usability within a single subject and potentially informing surgical planning. Regardless of CI placement, artefacts involving ipsilateral parietal, temporal, and occipital lobes severely limited diagnostic image utility. Between 35% and 70% of neuroradiological features were deemed unaffected by the implant.
Publisher: British Institute of Radiology
Date: 09-2022
DOI: 10.1259/BJR.20220213
Abstract: To capture practice and opinions around the current clinical use of MRI in patients with cochlear implants (CIs), and to characterise patient progression from referral to image reporting. An online survey recruited 237 healthcare professionals between 9 December 2019 and 9 September 2020. Descriptive statistics and informal thematic analyses were conducted. Respondents estimated that approximately 75% of CI users referred for an MRI proceeded to image acquisition, of which ~70% of cases comprised image acquisition on the head and the remaining cases on another area. They estimated that the proportion of these images that were usable was 93 and 99%, respectively. Confidence in most processes was high, with at least two-thirds of respondents reporting to be very or somewhat confident in obtaining consent and acquiring images. Conversely, fewer than half the respondents had the same confidence when splinting and bandaging the implant and troubleshooting any issues arising. Patient safety was rated of paramount importance, with patient comfort a clear second and image quality third. These findings highlight the need for consistent publication of clear, succinct, and standardised operating procedures for scanning patients with CIs and the requirement for regular training of radiographic and radiological healthcare professionals to address the heterogeneity of devices available. There is a need to improve the communication to radiography and radiology personnel regarding the nature of CIs, the heterogeneity of devices in existence, and the key differences between them. CI users risk being underserved by diagnostic medical imaging.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Rebecca Dewey.