Publications by authors named "R. Deane"

Objective: To assess the responsiveness of a hand-held dynamometer (HHD) in evaluating changes in trunk isometric strength in people with chronic low back pain (LBP).

Background: Reduced trunk muscle strength has been associated with pain incidence and severity in people with chronic LBP. Trunk muscle strength is an important functional outcome that is measured in clinical practice and research.

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Key functions of antibodies, such as viral neutralisation, depend on high-affinity binding. However, viral neutralisation poorly correlates with antigen affinity for reasons that have been unclear. Here, we use a new mechanistic model of bivalent binding to study  >45 patient-isolated IgG1 antibodies interacting with SARS-CoV-2 RBD surfaces.

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Antibodies are a popular and powerful class of therapeutic due to their ability to exhibit high affinity and specificity to target proteins. However, the majority of antibody therapeutics are not genetically human, with initial therapeutic designs typically obtained from animal models. Humanization of these precursors is essential to reduce immunogenic risks when administered to humans.

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  • Micronutrient (MN) alterations in critically ill patients can lead to complications, but improving MN status may help as a supportive therapy.
  • This review, done by a specialized group, focuses on individual important MNs, such as vitamins A, B, C, D, E, as well as minerals like iron and zinc, to guide future research.
  • It emphasizes that high-dose single MN treatments are not advised; instead, patients should receive daily basal needs, with adjustments for higher requirements and treatment for deficiencies, and lists ongoing trials and future research priorities.
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Summary: A key challenge in antibody drug discovery is designing novel sequences that are free from developability issues-such as aggregation, polyspecificity, poor expression, or low solubility. Here, we present p-IgGen, a protein language model for paired heavy-light chain antibody generation. The model generates diverse, antibody-like sequences with pairing properties found in natural antibodies.

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Engineered antibody formats, such as antibody fragments and bispecifics, have the potential to offer improved therapeutic efficacy compared to traditional full-length monoclonal antibodies (mAbs). However, the translation of these non-natural molecules into successful therapeutics can be hampered by developability challenges. Here, we systematically analyzed 64 different antibody constructs targeting Tumor Necrosis Factor (TNF) which cover 8 distinct molecular format families, encompassing full-length antibodies, various types of single chain variable fragments, and bispecifics.

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Objective: Critically ill patients suffer disrupted sleep. Hypnotic medications may improve sleep; however, local epidemiological data regarding the amount of nocturnal time awake and the use of such medications is needed.

Design: Point prevalence study.

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Background: Rheumatoid arthritis (RA) affects roughly 1% of the population and commonly involves the lungs. Of lung involvement in RA, interstitial lung disease (ILD) is well known; however, airways disease in RA is relatively understudied.

Research Question: What are the baseline airways abnormalities in a prospective cohort of patients with RA based on pulmonary function testing (PFT) results, high-resolution CT (HRCT) scans, and computational imaging analysis and are there associations between these abnormalities and respiratory symptoms?

Study Design And Methods: In this single-center study, 188 patients with RA without a clinical diagnosis of ILD underwent HRCT imaging and PFT.

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  • A study was conducted to evaluate the effects of the proton-pump inhibitor pantoprazole on critically ill patients undergoing invasive ventilation, comparing it to a placebo.
  • The trial included 4,821 patients and found that pantoprazole significantly reduced the incidence of clinically important upper gastrointestinal bleeding compared to placebo (1.0% vs. 3.5%).
  • However, there was no significant difference in overall mortality rates at 90 days between the pantoprazole group (29.1%) and the placebo group (30.9%).
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Introduction: People with chronic neck pain (CNP) commonly exhibit a range of physical impairments including cervical proprioceptive deficits. Assessing proprioception using a head mounted laser to assess joint position error (JPE) is a reliable and valid measure. However, the responsiveness of this measure has not been assessed.

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Background: Peer support is a promising intervention to mitigate post-ICU disability, however there is a paucity of rigorously designed studies.

Objectives: The objective of this study was to establish feasibility of an in-person, co-designed, peer-support model.

Methods: Prospective, randomised, adaptive, single-centre pilot trial with blinded outcome assessment, conducted at a university-affiliated hospital in Melbourne, Australia.

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Intrathecal synthesis of central nervous system (CNS)-reactive autoantibodies is observed across patients with autoimmune encephalitis (AE), who show multiple residual neurobehavioral deficits and relapses despite immunotherapies. We leveraged two common forms of AE, mediated by leucine-rich glioma inactivated-1 (LGI1) and contactin-associated protein-like 2 (CASPR2) antibodies, as human models to comprehensively reconstruct and profile cerebrospinal fluid (CSF) B cell receptor (BCR) characteristics. We hypothesized that the resultant observations would both inform the observed therapeutic gap and determine the contribution of intrathecal maturation to pathogenic B cell lineages.

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  • The study investigates ascorbate (vitamin C) levels in plasma and cerebrospinal fluid (CSF) following aneurysmal subarachnoid hemorrhage (aSAH) in patients, comparing them to levels in pregnant women.
  • Results show that ascorbate levels in both plasma and CSF are significantly lower in aSAH patients than in controls, indicating a potential deficiency.
  • Additionally, patients who developed vasospasm had notably lower CSF ascorbate levels, suggesting a link between ascorbate concentration and the severity of post-aSAH complications.
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  • Surgery for urological cancers can lead to complications and a decline in fitness and quality of life, prompting the use of high-intensity interval training (HIIT) as a prehabilitation method to improve health outcomes before surgery.
  • A study involving 19 male patients showed that those who underwent 4 weeks of HIIT experienced an increase in mitochondrial oxidative phosphorylation (OXPHOS) capacity, which is linked to improved cardiorespiratory fitness, while muscle protein synthesis did not significantly change.
  • The findings suggest that HIIT offers a mechanistic basis for enhancing muscle energy capacity before surgery in urological cancer patients, which may help support recovery and overall physical condition.
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  • A study evaluated plasma glucose levels in survivors of critical illness with stress hyperglycaemia, specifically measuring 1-hour glucose levels after a 75 g oral glucose tolerance test 3 months post-ICU discharge.
  • Out of 35 participants, 91% had a 1-hour glucose level of ≥ 8.6 mmol/L, indicating continued glucose intolerance linked to the stress hyperglycaemia experienced in critical care.
  • The research suggests a need for further studies to explore how dysglycaemia progresses to diabetes in patients who experienced stress hyperglycaemia during their ICU stay.
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Molecular markers of autoimmunity, such as antibodies to citrullinated protein antigens (ACPA), are detectable prior to inflammatory arthritis (IA) in rheumatoid arthritis (RA) and may define a state that is 'at-risk' for future RA. Here we present a cross-sectional comparative analysis among three groups that include ACPA positive individuals without IA (At-Risk), ACPA negative individuals and individuals with early, ACPA positive clinical RA (Early RA). Differential methylation analysis among the groups identifies non-specific dysregulation in peripheral B, memory and naïve T cells in At-Risk participants, with more specific immunological pathway abnormalities in Early RA.

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Rheumatoid arthritis is a prototypical autoimmune disease that causes joint inflammation and destruction. There is currently no cure for rheumatoid arthritis, and the effectiveness of treatments varies across patients, suggesting an undefined pathogenic diversity. Here, to deconstruct the cell states and pathways that characterize this pathogenic heterogeneity, we profiled the full spectrum of cells in inflamed synovium from patients with rheumatoid arthritis.

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Background: People with chronic neck pain (CNP) often present with impaired neck proprioception. The most widely used clinical test for assessing neck proprioception is cervical joint position sense which measures joint position error (JPE). This clinical test is typically performed using a laser pointer to examine the accuracy of returning to a neutral head position (NHP) or target head position (THP) following active neck movements.

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  • - Following the NASA twins' study, there's growing interest in using omics techniques in spaceflight, leading various space agencies to set up initiatives like NASA's GeneLab and JAXA's ibSLS.
  • - The Space Omics Topical Team has made recommendations to standardize space omics practices in Europe, emphasizing collaboration with international efforts and improving local infrastructure.
  • - Key recommendations include enhancing workforce and facility capabilities, tapping into opportunities in the commercial space sector, and expanding research involving human subjects.
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  • Proteins can change structure when binding to other molecules or in response to environmental factors, and HDX-MS (hydrogen-deuterium exchange mass spectrometry) is a method used to study these conformational changes.
  • Recent innovations in statistical analysis for HDX-MS leverage time-based data to better understand deuterium incorporation, but existing methods have limitations in flexibility.
  • The proposed Bayesian framework enhances stability, quantifies uncertainty, and allows for improved model selection and interpretation in protein interactions, demonstrated through various experiments including those involving antibody-dimer interactions and small molecules.
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  • Guidelines suggest maintaining normal carbon dioxide levels for adults in a coma resuscitated from cardiac arrest, but mild higher levels may help increase brain blood flow and improve outcomes.
  • In a study involving 1,700 patients, participants were randomly assigned to either mild hypercapnia or normocapnia for 24 hours and were assessed 6 months later for neurologic recovery.
  • Results showed no significant difference in favorable neurological outcomes or mortality between the two groups, indicating that mild hypercapnia did not improve recovery compared to normal levels.
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Fragment merging is a promising approach to progressing fragments directly to on-scale potency: each designed compound incorporates the structural motifs of overlapping fragments in a way that ensures compounds recapitulate multiple high-quality interactions. Searching commercial catalogues provides one useful way to quickly and cheaply identify such merges and circumvents the challenge of synthetic accessibility, provided they can be readily identified. Here, we demonstrate that the Fragment Network, a graph database that provides a novel way to explore the chemical space surrounding fragment hits, is well-suited to this challenge.

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Genetic and in vivo evidence suggests that aberrant recognition of RNA-containing autoantigens by Toll-like receptors (TLRs) 7 and 8 drives autoimmune diseases. Here we report on the preclinical characterization of MHV370, a selective oral TLR7/8 inhibitor. In vitro, MHV370 inhibits TLR7/8-dependent production of cytokines in human and mouse cells, notably interferon-α, a clinically validated driver of autoimmune diseases.

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