1
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Emiru T, Getachew D, Murphy M, Sedda L, Ejigu LA, Bulto MG, Byrne I, Demisse M, Abdo M, Chali W, Elliott A, Vickers EN, Aranda-Díaz A, Alemayehu L, Behaksera SW, Jebessa G, Dinka H, Tsegaye T, Teka H, Chibsa S, Mumba P, Girma S, Hwang J, Yoshimizu M, Sutcliffe A, Taffese HS, Bayissa GA, Zohdy S, Tongren JE, Drakeley C, Greenhouse B, Bousema T, Tadesse FG. Evidence for a role of Anopheles stephensi in the spread of drug- and diagnosis-resistant malaria in Africa. Nat Med 2023; 29:3203-3211. [PMID: 37884028 PMCID: PMC10719088 DOI: 10.1038/s41591-023-02641-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Anopheles stephensi, an Asian malaria vector, continues to expand across Africa. The vector is now firmly established in urban settings in the Horn of Africa. Its presence in areas where malaria resurged suggested a possible role in causing malaria outbreaks. Here, using a prospective case-control design, we investigated the role of An. stephensi in transmission following a malaria outbreak in Dire Dawa, Ethiopia in April-July 2022. Screening contacts of patients with malaria and febrile controls revealed spatial clustering of Plasmodium falciparum infections around patients with malaria in strong association with the presence of An. stephensi in the household vicinity. Plasmodium sporozoites were detected in these mosquitoes. This outbreak involved clonal propagation of parasites with molecular signatures of artemisinin and diagnostic resistance. To our knowledge, this study provides the strongest evidence so far for a role of An. stephensi in driving an urban malaria outbreak in Africa, highlighting the major public health threat posed by this fast-spreading mosquito.
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Affiliation(s)
- Tadele Emiru
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Maxwell Murphy
- EPPIcenter program, Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Luigi Sedda
- Lancaster Ecology and Epidemiology Group, Lancaster Medical School, Lancaster University, Lancaster, UK
| | | | | | - Isabel Byrne
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Melat Abdo
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Wakweya Chali
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
- Radboudumc, Nijmegen, the Netherlands
| | - Aaron Elliott
- EPPIcenter program, Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Eric Neubauer Vickers
- EPPIcenter program, Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Andrés Aranda-Díaz
- EPPIcenter program, Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lina Alemayehu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Gutema Jebessa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Hunduma Dinka
- Adama Science and Technology University, Adama, Ethiopia
| | - Tizita Tsegaye
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Hiwot Teka
- U.S. President's Malaria Initiative, USAID, Addis Ababa, Ethiopia
| | - Sheleme Chibsa
- U.S. President's Malaria Initiative, USAID, Addis Ababa, Ethiopia
| | - Peter Mumba
- U.S. President's Malaria Initiative, USAID, Addis Ababa, Ethiopia
| | - Samuel Girma
- U.S. President's Malaria Initiative, USAID, Addis Ababa, Ethiopia
| | - Jimee Hwang
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Alice Sutcliffe
- U.S. President's Malaria Initiative, Entomology Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Sarah Zohdy
- U.S. President's Malaria Initiative, Entomology Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jon Eric Tongren
- U.S. President's Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | - Bryan Greenhouse
- EPPIcenter program, Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Fitsum G Tadesse
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
- London School of Hygiene and Tropical Medicine, London, UK.
- Radboudumc, Nijmegen, the Netherlands.
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2
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Potts C, Bond RR, Jordan JA, Mulvenna MD, Dyer K, Moorhead A, Elliott A. Process mining to discover patterns in patient outcomes in a Psychological Therapies Service. Health Care Manag Sci 2023; 26:461-476. [PMID: 37191758 PMCID: PMC10186289 DOI: 10.1007/s10729-023-09641-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/21/2023] [Indexed: 05/17/2023]
Abstract
In the mental health sector, Psychological Therapies face numerous challenges including ambiguities over the client and service factors that are linked to unfavourable outcomes. Better understanding of these factors can contribute to effective and efficient use of resources within the Service. In this study, process mining was applied to data from the Northern Health and Social Care Trust Psychological Therapies Service (NHSCT PTS). The aim was to explore how psychological distress severity pre-therapy and attendance factors relate to outcomes and how clinicians can use that information to improve the service. Data included therapy episodes (N = 2,933) from the NHSCT PTS for adults with a range of mental health difficulties. Data were analysed using Define-Measure-Analyse model with process mining. Results found that around 11% of clients had pre-therapy psychological distress scores below the clinical cut-off and thus these individuals were unlikely to significantly improve. Clients with fewer cancelled or missed appointments were more likely to significantly improve post-therapy. Pre-therapy psychological distress scores could be a useful factor to consider at assessment for estimating therapy duration, as those with higher scores typically require more sessions. This study concludes that process mining is useful in health services such as NHSCT PTS to provide information to inform caseload planning, service management and resource allocation, with the potential to improve client's health outcomes.
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Affiliation(s)
- C Potts
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Coleraine, Northern Ireland.
| | - R R Bond
- School of Computing, Faculty of Computing Engineering & the Built Environment, Ulster University, Belfast, Northern Ireland
| | - J-A Jordan
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - M D Mulvenna
- School of Computing, Faculty of Computing Engineering & the Built Environment, Ulster University, Belfast, Northern Ireland
| | - K Dyer
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland
- Psychological Therapies Service, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - A Moorhead
- School of Communication and Media, Institute of Nursing and Health Research, Ulster University, Belfast, Northern Ireland
| | - A Elliott
- IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland
- Psychological Therapies Service, Northern Health and Social Care Trust, Antrim, Northern Ireland
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3
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Elliott A, Walters RK, Pirinen M, Kurki M, Junna N, Goldstein J, Reeve M, Siirtola H, Lemmelä S, Turley P, Palotie A, Daly M, Widén E. Distinct and shared genetic architectures of Gestational diabetes mellitus and Type 2 Diabetes Mellitus. medRxiv 2023:2023.02.16.23286014. [PMID: 36865330 PMCID: PMC9980250 DOI: 10.1101/2023.02.16.23286014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Gestational diabetes mellitus (GDM) affects more than 16 million pregnancies annually worldwide and is related to an increased lifetime risk of Type 2 diabetes (T2D). The diseases are hypothesized to share a genetic predisposition, but there are few GWAS studies of GDM and none of them is sufficiently powered to assess whether any variants or biological pathways are specific to GDM. We conducted the largest genome-wide association study of GDM to date in 12,332 cases and 131,109 parous female controls in the FinnGen Study and identified 13 GDM-associated loci including 8 novel loci. Genetic features distinct from T2D were identified both at the locus and genomic scale. Our results suggest that the genetics of GDM risk falls into two distinct categories - one part conventional T2D polygenic risk and one part predominantly influencing mechanisms disrupted in pregnancy. Loci with GDM-predominant effects map to genes related to islet cells, central glucose homeostasis, steroidogenesis, and placental expression. These results pave the way for an improved biological understanding of GDM pathophysiology and its role in the development and course of T2D.
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Affiliation(s)
- A. Elliott
- Analytic and Translational Genetics Unit, Massachusetts Gen. Hosp., Boston, MA
- Stanley Ctr. for Psychiatric Res., Broad Inst. of Harvard and MIT, Cambridge, MA
- Harvard Med. Sch., Boston, MA
| | - R. K. Walters
- Analytic and Translational Genetics Unit, Massachusetts Gen. Hosp., Boston, MA
- Stanley Ctr. for Psychiatric Res., Broad Inst. of Harvard and MIT, Cambridge, MA
- Harvard Med. Sch., Boston, MA
| | - M. Pirinen
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - M. Kurki
- Analytic and Translational Genetics Unit, Massachusetts Gen. Hosp., Boston, MA
- Stanley Ctr. for Psychiatric Res., Broad Inst. of Harvard and MIT, Cambridge, MA
| | - N. Junna
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
| | - J. Goldstein
- Stanley Ctr. for Psychiatric Res., Broad Inst. of Harvard and MIT, Cambridge, MA
| | - M.P. Reeve
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
| | - H. Siirtola
- TAUCHI Research Center, Faculty of Information Technology and Communication Sciences (ITC), Tampere University, Tampere, Finland
| | - S. Lemmelä
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - P. Turley
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | | | - A. Palotie
- Analytic and Translational Genetics Unit, Massachusetts Gen. Hosp., Boston, MA
- Stanley Ctr. for Psychiatric Res., Broad Inst. of Harvard and MIT, Cambridge, MA
- Harvard Med. Sch., Boston, MA
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
| | - M. Daly
- Analytic and Translational Genetics Unit, Massachusetts Gen. Hosp., Boston, MA
- Stanley Ctr. for Psychiatric Res., Broad Inst. of Harvard and MIT, Cambridge, MA
- Harvard Med. Sch., Boston, MA
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
| | - E. Widén
- Institute for Molecular Med. Finland, Helsinki Institute of Life Sciences., University of Helsinki, Helsinki, Finland
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Shih AJ, Jun T, Skol AD, Bao R, Huang L, Vora S, McNerney ME, Hungate EA, Le Beau MM, Larson RA, Elliott A, Lu HM, Huether R, Hernandez F, Stölzel F, Allan JM, Onel K. Inherited cancer predisposing mutations in patients with therapy-related myeloid neoplasms. Br J Haematol 2023; 200:489-493. [PMID: 36349721 DOI: 10.1111/bjh.18543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022]
Abstract
Some patients with therapy-related myeloid neoplasms (t-MN) may have unsuspected inherited cancer predisposition syndrome (CPS). We propose a set of clinical criteria to identify t-MN patients with high risk of CPS (HR-CPS). Among 225 t-MN patients with an antecedent non-myeloid malignancy, our clinical criteria identified 52 (23%) HR-CPS patients. Germline whole-exome sequencing identified pathogenic or likely pathogenic variants in 10 of 27 HR-CPS patients compared to 0 of 9 low-risk CPS patients (37% vs. 0%, p = 0.04). These simple clinical criteria identify t-MN patients most likely to benefit from genetic testing for inherited CPS.
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Affiliation(s)
- Andrew J Shih
- The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Tomi Jun
- Sema4, Stamford, Connecticut, USA
| | - Andrew D Skol
- Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | - Riyue Bao
- Department of Medicine, The University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - Lei Huang
- Center for Research Informatics, The University of Chicago, Chicago, Illinois, USA
| | - Sapana Vora
- Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | - Megan E McNerney
- Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA.,Department of Pathology, The University of Chicago, Chicago, Illinois, USA
| | - Eric A Hungate
- Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | - Michelle M Le Beau
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Richard A Larson
- Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | | | | | | | | | - Friedrich Stölzel
- Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Dresden University of Technology, Dresden, Germany
| | - James M Allan
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Kenan Onel
- Sema4, Stamford, Connecticut, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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5
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Willey-Courand D, Bui T, Dudley E, Coburn L, Flores D, Dorsett S, Vavrina K, Elliott A, Nieto A. 95 Increasing vitamin D levels and dual energy X-ray absorptiometry screening using a microsystems approach. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00786-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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6
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Daza JF, Cuthbertson BH, Myles PS, Shulman MA, Wijeysundera DN, Wijeysundera DN, Pearse RM, Myles PS, Abbott TEF, Shulman MA, Torres E, Ambosta A, Melo M, Mamdani M, Thorpe KE, Wallace S, Farrington C, Croal BL, Granton JT, Oh P, Thompson B, Hillis G, Beattie WS, Wijeysundera HC, Ellis M, Borg B, Kerridge RK, Douglas J, Brannan J, Pretto J, Godsall MG, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Kirabiyik Y, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter TW, Macklin S, Elliott A, Carrera AM, Terblanche NCS, Pitt S, Samuels J, Wilde C, Leslie K, MacCormick A, Bramley D, Southcott AM, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney CJL, Choi S, Somascanthan P, Flores K, Karkouti K, Clarke HA, Jerath A, McCluskey SA, Wasowicz M, Day L, Pazmino-Canizares J, Belliard R, Lee L, Dobson K, Stanbrook M, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, McAllister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G. Measurement properties of the WHO Disability Assessment Schedule 2.0 for evaluating functional status after inpatient surgery. Br J Surg 2022; 109:968-976. [PMID: 35929065 DOI: 10.1093/bjs/znac263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/17/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Expert recommendations propose the WHO Disability Assessment Schedule (WHODAS) 2.0 as a core outcome measure in surgical studies, yet data on its long-term measurement properties remain limited. These were evaluated in a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) prospective cohort. METHODS Participants were adults (40 years of age or older) who underwent inpatient non-cardiac surgery. The 12-item WHODAS and EQ-5DTM-3L questionnaires were administered preoperatively (in person) and 1 year postoperatively (by telephone). Responsiveness was characterized using standardized response means (SRMs) and correlation coefficients between change scores. Construct validity was evaluated using correlation coefficients between 1-year scores and comparisons of WHODAS scores across clinically relevant subgroups. RESULTS The analysis included 546 patients. There was moderate correlation between changes in WHODAS and various EQ-5DTM subscales. The strongest correlation was between changes in WHODAS and changes in the functional domains of the EQ-5D-3L-for example, mobility (Spearman's rho 0.40, 95 per cent confidence interval [c.i.] 0.32 to 0.48) and usual activities (rho 0.45, 95 per cent c.i. 0.30 to 0.52). When compared across quartiles of EQ-5D index change, median WHODAS scores followed expected patterns of change. In subgroups with expected functional status changes, the WHODAS SRMs ranged from 'small' to 'large' in the expected directions of change. At 1 year, the WHODAS demonstrated convergence with the EQ-5D-3L functional domains, and good discrimination between patients with expected differences in functional status. CONCLUSION The WHODAS questionnaire has construct validity and responsiveness as a measure of functional status at 1 year after major surgery.
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Affiliation(s)
- Julian F Daza
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Brian H Cuthbertson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Mark A Shulman
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Duminda N Wijeysundera
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
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7
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Puri S, Elliott A, Soares H, Lou E, Halmos B, Langer C, Uprety D, Darabi S, Walker P, El-Deiry W, VanderWalde A, Owonikoko T, Liu S. 889MO Comparative expression of driver transcription factors in extra-pulmonary small cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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Horton C, Cass A, Conner BR, Hoang L, Zimmermann H, Abualkheir N, Burks D, Qian D, Molparia B, Vuong H, LaDuca H, Grzybowski J, Durda K, Pilarski R, Profato J, Clayback K, Mahoney M, Schroeder C, Torres-Martinez W, Elliott A, Chao EC, Karam R. Mutational and splicing landscape in a cohort of 43,000 patients tested for hereditary cancer. NPJ Genom Med 2022; 7:49. [PMID: 36008414 PMCID: PMC9411123 DOI: 10.1038/s41525-022-00323-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
DNA germline genetic testing can identify individuals with cancer susceptibility. However, DNA sequencing alone is limited in its detection and classification of mRNA splicing variants, particularly those located far from coding sequences. Here we address the limitations of splicing variant identification and interpretation by pairing DNA and RNA sequencing and describe the mutational and splicing landscape in a clinical cohort of 43,524 individuals undergoing genetic testing for hereditary cancer predisposition.
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Affiliation(s)
- Carolyn Horton
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | - Ashley Cass
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | - Blair R Conner
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | - Lily Hoang
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | | | | | - David Burks
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | - Dajun Qian
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | | | - Huy Vuong
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | - Holly LaDuca
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | | | - Kate Durda
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA
| | | | | | - Katherine Clayback
- Roswell Park Comprehensive Cancer Center, 665 Elm St, Buffalo, NY, 14203, USA
| | - Martin Mahoney
- Roswell Park Comprehensive Cancer Center, 665 Elm St, Buffalo, NY, 14203, USA
| | - Courtney Schroeder
- Indiana University School of Medicine, 975 W. Walnut Street, IB 130, Indianapolis, IN, 46202, USA
| | - Wilfredo Torres-Martinez
- Indiana University School of Medicine, 975 W. Walnut Street, IB 130, Indianapolis, IN, 46202, USA
| | - Aaron Elliott
- Realm IDx. One Enterprise, Aliso Viejo, CA, 92656, USA
| | - Elizabeth C Chao
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA.,University of California, Irvine, School of Medicine, 1001 Health Sciences Rd, Irvine, CA, 92617, USA
| | - Rachid Karam
- Ambry Genetics. One Enterprise, Aliso Viejo, CA, 92656, USA.
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9
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Aguilar-Arevalo AA, Alves DSM, Biedron S, Boissevain J, Borrego M, Chavez-Estrada M, Chavez A, Conrad JM, Cooper RL, Diaz A, Distel JR, D'Olivo JC, Dunton E, Dutta B, Elliott A, Evans D, Fields D, Greenwood J, Gold M, Gordon J, Guarincerri E, Huang EC, Kamp N, Kelsey C, Knickerbocker K, Lake R, Louis WC, Mahapatra R, Maludze S, Mirabal J, Moreno R, Neog H, deNiverville P, Pandey V, Plata-Salas J, Poulson D, Ray H, Renner E, Schaub TJ, Shaevitz MH, Smith D, Sondheim W, Szelc AM, Taylor C, Thompson WH, Thornton RT, Tripathi M, Van Berg R, Van de Water RG, Verma S, Walker K. First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector. Phys Rev Lett 2022; 129:021801. [PMID: 35867467 DOI: 10.1103/physrevlett.129.021801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9 MeV≲m_{χ}≲50 MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.
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Affiliation(s)
| | - D S M Alves
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Biedron
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Boissevain
- Bartoszek Engineering, Aurora, Illinois 60506, USA
| | - M Borrego
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | | | - A Chavez
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J M Conrad
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R L Cooper
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - A Diaz
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J R Distel
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, CDMX 04510, México
| | - E Dunton
- Columbia University, New York, New York 10027, USA
| | - B Dutta
- Texas A&M University, College Station, Texas 77843, USA
| | - A Elliott
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - D Evans
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Greenwood
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - M Gold
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Gordon
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - E Guarincerri
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - E C Huang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - N Kamp
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Kelsey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Knickerbocker
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Lake
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - W C Louis
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Mahapatra
- Texas A&M University, College Station, Texas 77843, USA
| | - S Maludze
- Texas A&M University, College Station, Texas 77843, USA
| | - J Mirabal
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Moreno
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - H Neog
- Texas A&M University, College Station, Texas 77843, USA
| | - P deNiverville
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - V Pandey
- University of Florida, Gainesville, Florida 32611, USA
| | - J Plata-Salas
- Universidad Nacional Autónoma de México, CDMX 04510, México
| | - D Poulson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - H Ray
- University of Florida, Gainesville, Florida 32611, USA
| | - E Renner
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - T J Schaub
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - D Smith
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - W Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - C Taylor
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - W H Thompson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R T Thornton
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Tripathi
- University of Florida, Gainesville, Florida 32611, USA
| | - R Van Berg
- Bartoszek Engineering, Aurora, Illinois 60506, USA
| | - R G Van de Water
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Verma
- Texas A&M University, College Station, Texas 77843, USA
| | - K Walker
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
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Elliott A, Miras HN. Recent advances in polyoxothiometalate chemistry. J COORD CHEM 2022. [DOI: 10.1080/00958972.2022.2086049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A. Elliott
- School of Chemistry, The University of Glasgow, Glasgow, UK
| | - H. N. Miras
- School of Chemistry, The University of Glasgow, Glasgow, UK
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De Bosscher R, Janssens K, Dausin C, Goetschalckx K, Bogaert J, Ghekiere O, Van De Heyning C, Elliott A, Sanders P, Kalman J, Herbots L, Willems R, Heidbuchel H, La Gerche A, Claessen G. The prevalence and clinical significance of a reduced ventricular ejection fraction in asymptomatic young elite endurance athletes. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council of Australia
Background
Ventricular ejection fraction (EF) is the most widely used parameter to evaluate ventricular systolic function. Endurance athletes presenting with a reduced ventricular EF often raise the question of an underlying dilated or arrhythmogenic cardiomyopathy. The clinical significance of a reduced EF in athletes remains to be elucidated.
Purpose
To investigate the prevalence and clinical significance of a reduced EF in asymptomatic endurance athletes.
Methods
Two hundred eighteen asymptomatic young elite endurance athletes were evaluated at baseline. Cardiac magnetic resonance imaging (CMR) was performed to assess cardiac volumes, left ventricular and right ventricular EF (LVEF and RVEF), mass and fibrosis. Athletes with reduced EF (ATrEF) were defined as those having LVEF<50% and/or RVEF<45%. Ventricular systolic and diastolic function were assessed by trans-thoracic echocardiography. A 12-lead ECG and 24-hour holtermonitoring assessed electrical alterations and arrhythmias. In 145 athletes, LV and RV contractile reserve was evaluated by exercise CMR. Cardiopulmonary testing was performed in all athletes to measure maximal oxygen uptake (VO2max).
Results
Thirty-one ATrEF (14.2%) were compared to 187 athletes with a preserved EF (ATpEF). ATrEF were more frequently males (93 vs 77% male, p=0.033) but did not differ from ATpEF with regard to age (18.8±2.1 vs 18.3±2.1 years, p=0.25). Ten athletes had an isolated reduced LVEF, 10 had an isolated reduced RVEF and 11 had both a reduced LVEF and RVEF. ATrEF had similar end-diastolic volumes and cardiac mass but differed by higher end-systolic volumes.
Peak exercise LVEF and RVEF determined by exercise CMR remained lower in ATrEF (68±3 vs 73±4% and 62±6 vs 69±5%, p<0.001) but contractile reserve was greater (ΔLVEF 18±5 vs 14±4% and ΔRVEF 19±5 vs 15±5%, p<0.01).
A reduced EF was not associated with lower exercise capacity, in fact VO2max was higher in ATrEF than in ATpEF (65±6 vs 62±9mL/kg/min, p=0.020) and the percentage of predicted VO2max by the Wasserman equation were similar (151±14 vs 149±21%, p=0.533).
Fibrosis was present in 3 ATrEF and 18 ATpEF (9.7 vs 9.6%, p=0.993) and was isolated to the RV hinge-points in all but 3 ATpEF who had midmyocardial LV lateral wall fibrosis. LV systolic strain (-17.5±2.0 vs -19±2.1%, p<0.001) was lower in ATrEF whereas RV free wall systolic strain (-24.9±3.7 vs -25.1±3.5%, p=0.776) was similar. Diastolic function was normal in all ATrEF and ATpEF. Pathologic T-wave inversions were present in 2 ATrEF and 13 ATpEF (6.5 vs 7%, p=0.999). Ventricular premature beats (VPB) were infrequent but more prevalent in ATrEF than in ATpEF (2[0-18] vs 1[0-2]/24h, p=0.025; 16.1 vs 2.7% >100/24h, p=0.006).
Conclusion
A reduced ventricular EF is common in asymptomatic young elite endurance athletes, is more frequent in males but is not associated with structural, functional or electrical abnormalities apart from a minor excess in VPB.
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Affiliation(s)
- R De Bosscher
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - K Janssens
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - C Dausin
- University of Leuven, Movement Sciences, Leuven, Belgium
| | - K Goetschalckx
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - J Bogaert
- University Hospitals (UZ) Leuven, Radiology, Leuven, Belgium
| | - O Ghekiere
- Virga Jesse Hospital, Radiology, Hasselt, Belgium
| | | | - A Elliott
- Royal Adelaide Hospital, Cardiology, Adelaide, Australia
| | - P Sanders
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - J Kalman
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - L Herbots
- Virga Jesse Hospital, Cardiology, Hasselt, Belgium
| | - R Willems
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - H Heidbuchel
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - A La Gerche
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - G Claessen
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
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Verdicchio C, Elliott A, Mahajan R, Linz D, Lau D, Sanders P. Greater cardiorespiratory fitness reduces incidence of atrial fibrillation: a meta-analysis. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia affecting 1-2% of the global population, with the prevalence of AF increasing dramatically over the past two decades. Although low levels of cardiorespiratory fitness (CRF) and physical activity are predictive of cardiovascular disease onset and mortality, only recently has this emerged as a potential risk factor for AF.
Purpose
The aim of this meta-analysis was therefore to quantify the relationship between CRF, measured by a symptom limited exercise stress test, and incident AF. We hypothesised that there would be an inverse relationship between CRF and the incidence of AF.
Methods
The systematic literature review was conducted using PUBMED, MEDLINE and EMBASE databases, with seven studies meeting the inclusion criteria. A random-effects meta-analysis was then used to compare the multivariate risk estimates of the lowest CRF group from each cohort with the group of the highest CRF.
Results
Data from 206,925 individuals (55.8% males) was used for analysis with a mean age of 55 ± 2.5 years and a mean follow-up period of 10.3 ± 5 years. The total number of AF events across the studies was 19,913. The overall pooled risk of AF in the high-CRF group versus the low-CRF group showed a significant lower risk of incident AF in those with high-CRF (OR: 0.52, 95% CI, 0.44-0.605, p < 0.001). There was evidence of statistical heterogeneity between the studies (I2 = 81%, p < 0.001). AF incidence rates demonstrated an overall decline in rates across the CRF quartiles from low to high. The mean incidence rate for low-CRF was 21 ± 13.4 compared to 6.9 ± 0.7 per 1000 person-years for the high CRF group (p = 0.03).
Conclusion
There is an inverse association between a lower CRF and an increased risk of AF, with a higher level of CRF protective against AF. This study highlights that low-CRF may be an additional risk factor for AF along with already other established lifestyle-based risk factors such as obesity and hypertension. Exercise interventions should be promoted as a primary prevention strategy in those at risk of developing AF with known risk factors. Future studies are warranted to identify the mechanism(s) through which improved CRF confers a reduction in AF incidence.
Abstract Figure. AF risk between high and low-CRF
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Affiliation(s)
- C Verdicchio
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Adelaide, Australia
| | - D Linz
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Lau
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
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Nath L, Kapusniak A, Elliott A, Hebart M, Stent A, Franklin S. Sudden Cardiac Death in Thoroughbred Horses. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Tu S, Gallagher C, Elliott A, Linz D, Pitman B, Hendriks J, Lau D, Sanders P, Wong C. Alcohol Intake and Bradyarrhythmia Risk: A Cohort Study of 385,670 Individuals. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Malik V, Elliott A, Thomas G, Arnolda L, Lau D, Sanders P. Catheter Ablation of Atrial Fibrillation is Not Associated With Cardiac Volume-regulating Afferent Nerve Disruption. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Griffin A, Thiyagarajah A, Elliott A, Lau D, Sanders P. Incidence of New-Onset Atrial Fibrillation After Cavotricuspid Isthmus Ablation for Isolated Atrial Flutter: A Systematic Review and Meta-analysis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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De Bosscher R, Claeys M, Dausin C, Goetschalckx K, Bogaert J, Van De Heyning C, Ghekiere O, Herbots L, Claus P, Kalman J, Sanders P, Elliott A, Heidbuchel H, La Gerche A, Claessen G. Hinge point fibrosis in athletes is not associated with structural, functional or electrical consequences: a comparison between young and middle-aged elite endurance athletes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The health benefits of extensive endurance training have been debated due to the report of myocardial fibrosis (MF), arrhythmias and temporary post-race cardiac impairment in middle-aged and veteran athletes. The extent of these changes is unknown in elite young athletes.
Purpose
To assess the prevalence of MF and its structural, functional and electrical impact in highly trained young endurance athletes (YA, 15–23 years) as compared to middle-aged athletes (MA, 30–50 years). We hypothesised that MF would be more frequent in MA and associated with more structural, functional and electrical abnormalities.
Methods
We prospectively assessed 197 YA and 34 MA. All had ECG, maximal oxygen consumption (VO2max) testing, cardiac magnetic resonance imaging (CMR), echocardiography and 24h-holter. Indexed left ventricular and right ventricular end diastolic volume (LVEDVi, RVEDVi), ejection fraction (LVEF, RVEF), left ventricular mass (LVMi), and MF defined as delayed gadolinium enhancement were assessed by CMR. LV and RV free wall strain (LVSL, RVfwSL) were assessed by 2D speckle tracking echocardiography. Ventricular premature beats (VPB) and non-sustained ventricular tachycardia (nsVT) were assessed by 24h-holter.
Results
YA and MA (18±2 vs 38±5 years [p<0.01]; 78% vs 80% male [p=0.99]) with an elite level of fitness (VO2max 61±8 vs 54±10 mL/min/kg [p<0.01]; % predicted VO2max 150±20 vs 158±30 [p=0.02]) had a large variance in LV and RV remodelling (Figure 1). MF was seen in 28 athletes (12.5%) and more prevalent in MA than in YA (23.5 vs 10.5%, p=0.048). MF was limited to the hinge points in all 8 MA with MF and 17 YA. 3 YA had LV lateral wall subepicardial MF. 27 of 187 (14.4%) male athletes had MF compared to 1 of 50 (2%) female athletes (p=0.01).
MF+ MA(A) and YA(B) as well as MF− MA(C) and YA(D) had similar structural remodelling (LVEDVi 110±14 vs 118±14 vs 113±19 vs 110±16 mL/m2; RVEDVi 120±14 vs 128±17 vs 117±19 vs 125±23mL/m2; LVMi 77±11 vs 83±14 vs 81±14 vs 77±15g/m2, p>0.05). LVEF, LVSL and RVSL were similar (59±3 vs 58±5 vs 61±6 vs 58±6%; −18.8±2 vs −18.8±2 vs −19.8±2 vs −19.3±2%; −26.3±2.4 vs −24.4±2.4; −26.3±3 vs −25.8±3.5% respectively, p>0.05). LVEF <50% was seen in 19 (8.2%) athletes (0 [0%] vs [5%] 1 vs 1 [3.8%] vs 17 [9.6%]; p=0.51). RVEF was higher in D compared to C without further differences between groups (54±4 vs 54±6 vs 53±6 vs 57±5, p=0.005). RVEF<45% was seen 21 (9.1%) athletes (0 [0%] vs 1 [5%] vs 0 [0%] vs 20 [11.3%]; p=0.14). Abnormal T-wave inversion was similar (12.5 vs 5 vs 7.4 vs 6.2%, p=0.93) as was the prevalence of >100VPB/24h (12.5 vs 5 vs 11.1 vs 5.1%, p=0.42). 2 athletes had nsVT, both in D. All had similar exercise capacity (% predicted VO2max 157±26 vs 152±15 vs 147±24 vs 158±32%; p=0.11).
Conclusion
Hinge-point fibrosis was more prevalent in MA, possibly due to repeated hemodynamic stress during exercise, but is not associated with structural, functional or electrical consequences.
Figure 1. Cardiac remodelling in elite athletes
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Fonds voor Wetenschappelijk Onderzoek (FWO)
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Affiliation(s)
- R De Bosscher
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - M Claeys
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | | | - K Goetschalckx
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - J Bogaert
- University Hospitals (UZ) Leuven, Radiology, Leuven, Belgium
| | | | - O Ghekiere
- Virga Jesse Hospital, Radiology, Hasselt, Belgium
| | - L Herbots
- Virga Jesse Hospital, Cardiology, Hasselt, Belgium
| | | | - J Kalman
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - P Sanders
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - A Elliott
- Royal Adelaide Hospital, Cardiology, Adelaide, Australia
| | - H Heidbuchel
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - A La Gerche
- Baker Heart and Diabetes Institute, Cardiology, Melbourne, Australia
| | - G Claessen
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
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McDermott R, Graff J, Antonarakis E, Hoimes C, Tagawa S, Hwang C, Kilari D, Tije A, Omlin A, Vaishampayan U, Elliott A, Wu H, Kim J, Schloss C, De Bono J. KEYNOTE-199 cohorts 4 and 5: Pembrolizumab (pembro) plus enzalutamide (enza) for enza-resistant metastatic castration-resistant prostate cancer (mCRPC). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33171-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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20
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Malik V, Mishima R, Elliott A, Emami M, Roberts-Thompson K, Mahajan R, Arnolda LF, Lau DH, Sanders P. 70Autonomic dysfunction in atrial fibrillation (AF) patients: absent vasomotor reflex to decreased cardiac venous return during af in comparison to sinus rhythm; implications for earlier rhythm control. Europace 2020. [DOI: 10.1093/europace/euaa162.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Dr Malik is supported by an Australian Postgraduate Award Scholarship from the University of Adelaide.
OnBehalf
Centre for Heart Rhythm Disorders, University of Adelaide & Royal Adelaide Hospital
Background
A bi-directional relationship exists between AF and the autonomic nervous system (ANS). Patients with AF studied in sinus rhythm (SR) have impaired vasomotor responses to decreased cardiac volume. Whether autonomic dysfunction worsens during AF itself, is unknown.
Purpose
We examined haemodynamic responses to lower body negative pressure (LBNP) in patients with persistent AF compared to AF studied in SR. LBNP decreases cardiac volume, deactivates atrial stretch receptors and induces a reflex to maintain blood pressure by increasing systemic vascular resistance (SVR).
Methods
21 consecutive patients with paroxysmal or persistent AF were studied; during AF (n = 8) or SR (n = 13). Anti-arrhythmic and anti-hypertensives were withheld for 5 half-lives. Patients underwent LBNP using a custom-made chamber sealing both lower limbs. Negative pressure at sham (-0 mmHg), low (-20 mmHg) and high level (-40 mmHg) was applied for 5 minutes each. Finger photo plethysmography was used for beat-beat-blood pressure. Computation of SVR during AF is not feasible with this method. Therefore, the right forearm was used to perform venous occlusion plethysmography (VOP); non-invasive, well validated with LBNP and impervious to AF: to estimate forearm blood flow (FBF) and SVR (inversely proportional).
Results
Baseline characteristics and responses to LBNP are presented in Table 1. MAP was maintained, and HR rose slightly, in the SR group. MAP and HR decreased in the AF group. VOP demonstrates a reduction in FBF in the SR group (vasoconstriction); whereas the vasomotor response to LBNP was absent during AF. Figure 1 (Panels A-C).
Conclusion
The presence of AF is associated with autonomic dysfunction from impaired cardiac volume regulation. This novel finding may contribute to the known risk of falls and syncope due to AF. Further studies are needed to evaluate whether abnormal cardiac reflexes are involved in atrial remodelling and AF progression.
Table 1 Baseline Characteristics During AF During SR P Value Age 65 ± 5 59 ± 3 0.4 AAD & Anti-HTN medications withheld (%) 75 85 0.6 Resting mean arterial pressure (MAP) 109 ± 9 93 ± 6 0.1 Resting heart rate (HR) 94 ± 6 60 ± 4 0.0001* Haemodynamic response to LBNP % Δ MAP due to LBNP -9 ± 5 +0.5 ± 3 0.2 % Δ HR due to LBNP -6 ± 3 +5 ± 3 0.03* % Δ FBF due to LBNP +75 ± 59 -27 ± 8 0.02* AAD Anti-arrhthmic. HTN: Hypertension. Mean +/- SEM.
Abstract Figure. Vasomotor response to LBNP: in AF vs SR
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Affiliation(s)
- V Malik
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mishima
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M Emami
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - K Roberts-Thompson
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - L F Arnolda
- University of Wollongong, Wollongong, Australia
| | - D H Lau
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
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21
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22
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Benz C, Harvey A, Middleton A, Elliott A. WS07.3 Managing exacerbations in young people with cystic fibrosis through Hospital in the Home physiotherapy via Telehealth. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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McLauchlin J, Aird H, Elliott A, Forester E, Jørgensen F, Willis C. Microbiological quality of raw drinking milk and unpasteurised dairy products: results from England 2013-2019. Epidemiol Infect 2020; 148:e135. [PMID: 32406346 PMCID: PMC7374804 DOI: 10.1017/s0950268820001016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 03/21/2020] [Accepted: 05/11/2020] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to review microbiology results from testing >2500 raw drinking milk and dairy products made with unpasteurised milk examined in England between 2013 and 2019. Samples were collected as part of incidents of contamination, investigation of infections or as part of routine monitoring and were tested using standard methods for a range of both pathogens and hygiene indicators. Results from testing samples of raw cow's milk or cheese made from unpasteurised milk for routine monitoring purposes were overall of better microbiological quality than those collected during incident or investigations of infections. Results from routine monitoring were satisfactory for 62% of milks, 82% of cream, 100% of ice-cream, 51% of butter, 63% of kefir and 79% of cheeses, with 5% of all samples being considered potentially hazardous. Analysis of data from cheese demonstrated a significant association between increasing levels of indicator Escherichia coli with elevated levels of coagulase positive staphylococci and decreased probability of isolation of Shiga toxin-producing E. coli. These data highlight the public health risk associated with these products and provide further justification for controls applied to raw drinking milk and dairy products made with unpasteurised milk.
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Affiliation(s)
- J. McLauchlin
- Public Health England, National Infection Service, Food Water and Environmental Microbiology Services, Colindale, London, UK
| | - H. Aird
- Public Health England, National Infection Service, Food Water and Environmental Microbiology Laboratory York, National Agri-Food Innovation Campus, York, UK
| | - A. Elliott
- Public Health England, National Infection Service, Food Water and Environmental Microbiology Laboratory Porton, Porton Down, Salisbury, UK
- Public Health England, National Infection Service, Field Services, South West, Bristol, UK
| | - E. Forester
- Public Health England, National Infection Service, Food Water and Environmental Microbiology Laboratory York, National Agri-Food Innovation Campus, York, UK
- Public Health England, National Infection Service, Field Services, North West Office, Liverpool, UK
| | - F. Jørgensen
- Public Health England, National Infection Service, Food Water and Environmental Microbiology Laboratory Porton, Porton Down, Salisbury, UK
| | - C. Willis
- Public Health England, National Infection Service, Food Water and Environmental Microbiology Laboratory Porton, Porton Down, Salisbury, UK
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24
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Yang X, Leslie G, Doroszuk A, Schneider S, Allen J, Decker B, Dunning AM, Redman J, Scarth J, Plaskocinska I, Luccarini C, Shah M, Pooley K, Dorling L, Lee A, Adank MA, Adlard J, Aittomäki K, Andrulis IL, Ang P, Barwell J, Bernstein JL, Bobolis K, Borg Å, Blomqvist C, Claes KB, Concannon P, Cuggia A, Culver JO, Damiola F, de Pauw A, Diez O, Dolinsky JS, Domchek SM, Engel C, Evans DG, Fostira F, Garber J, Golmard L, Goode EL, Gruber SB, Hahnen E, Hake C, Heikkinen T, Hurley JE, Janavicius R, Kleibl Z, Kleiblova P, Konstantopoulou I, Kvist A, Laduca H, Lee AS, Lesueur F, Maher ER, Mannermaa A, Manoukian S, McFarland R, McKinnon W, Meindl A, Metcalfe K, Mohd Taib NA, Moilanen J, Nathanson KL, Neuhausen S, Ng PS, Nguyen-Dumont T, Nielsen SM, Obermair F, Offit K, Olopade OI, Ottini L, Penkert J, Pylkäs K, Radice P, Ramus SJ, Rudaitis V, Side L, Silva-Smith R, Silvestri V, Skytte AB, Slavin T, Soukupova J, Tondini C, Trainer AH, Unzeitig G, Usha L, van Overeem Hansen T, Whitworth J, Wood M, Yip CH, Yoon SY, Yussuf A, Zogopoulos G, Goldgar D, Hopper JL, Chenevix-Trench G, Pharoah P, George SH, Balmaña J, Houdayer C, James P, El-Haffaf Z, Ehrencrona H, Janatova M, Peterlongo P, Nevanlinna H, Schmutzler R, Teo SH, Robson M, Pal T, Couch F, Weitzel JN, Elliott A, Southey M, Winqvist R, Easton DF, Foulkes WD, Antoniou AC, Tischkowitz M. Cancer Risks Associated With Germline PALB2 Pathogenic Variants: An International Study of 524 Families. J Clin Oncol 2020; 38:674-685. [PMID: 31841383 PMCID: PMC7049229 DOI: 10.1200/jco.19.01907] [Citation(s) in RCA: 221] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2019] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To estimate age-specific relative and absolute cancer risks of breast cancer and to estimate risks of ovarian, pancreatic, male breast, prostate, and colorectal cancers associated with germline PALB2 pathogenic variants (PVs) because these risks have not been extensively characterized. METHODS We analyzed data from 524 families with PALB2 PVs from 21 countries. Complex segregation analysis was used to estimate relative risks (RRs; relative to country-specific population incidences) and absolute risks of cancers. The models allowed for residual familial aggregation of breast and ovarian cancer and were adjusted for the family-specific ascertainment schemes. RESULTS We found associations between PALB2 PVs and risk of female breast cancer (RR, 7.18; 95% CI, 5.82 to 8.85; P = 6.5 × 10-76), ovarian cancer (RR, 2.91; 95% CI, 1.40 to 6.04; P = 4.1 × 10-3), pancreatic cancer (RR, 2.37; 95% CI, 1.24 to 4.50; P = 8.7 × 10-3), and male breast cancer (RR, 7.34; 95% CI, 1.28 to 42.18; P = 2.6 × 10-2). There was no evidence for increased risks of prostate or colorectal cancer. The breast cancer RRs declined with age (P for trend = 2.0 × 10-3). After adjusting for family ascertainment, breast cancer risk estimates on the basis of multiple case families were similar to the estimates from families ascertained through population-based studies (P for difference = .41). On the basis of the combined data, the estimated risks to age 80 years were 53% (95% CI, 44% to 63%) for female breast cancer, 5% (95% CI, 2% to 10%) for ovarian cancer, 2%-3% (95% CI females, 1% to 4%; 95% CI males, 2% to 5%) for pancreatic cancer, and 1% (95% CI, 0.2% to 5%) for male breast cancer. CONCLUSION These results confirm PALB2 as a major breast cancer susceptibility gene and establish substantial associations between germline PALB2 PVs and ovarian, pancreatic, and male breast cancers. These findings will facilitate incorporation of PALB2 into risk prediction models and optimize the clinical cancer risk management of PALB2 PV carriers.
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Affiliation(s)
- Xin Yang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Alicja Doroszuk
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Sandra Schneider
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Jamie Allen
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Brennan Decker
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Cancer Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Alison M. Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology,University of Cambridge, Cambridge, United Kingdom
| | - James Redman
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - James Scarth
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Inga Plaskocinska
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Craig Luccarini
- Centre for Cancer Genetic Epidemiology, Department of Oncology,University of Cambridge, Cambridge, United Kingdom
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology,University of Cambridge, Cambridge, United Kingdom
| | - Karen Pooley
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Lee
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Muriel A. Adank
- Family Cancer Clinic, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Peter Ang
- Laboratory of Molecular Oncology, Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore
| | - Julian Barwell
- Leicestershire Clinical Genetics Service, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Jonine L. Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kristie Bobolis
- Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA
| | - Åke Borg
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Patrick Concannon
- University of Florida Genetics Institute, University of Florida, Gainesville, FL
| | - Adeline Cuggia
- The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
- The Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - Julie O. Culver
- Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | - Orland Diez
- Oncogenetics Group, Clinical and Molecular Genetics Area, Vall d’Hebron Institute of Oncology (VHIO), University Hospital, Vall d’Hebron, Barcelona, Spain
| | | | - Susan M. Domchek
- Department ofMedicine, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Prospective Registry of Multiplex Testing (PROMPT), United States and Europe
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - D. Gareth Evans
- Division of Evolution and Genomic Sciences, University of Manchester; Manchester Centre for Genomic Medicine, St Mary’s Hospital–Manchester University Hospitals NHS Foundation Trust; and Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research “Demokritos,” Athens, Greece
| | - Judy Garber
- Prospective Registry of Multiplex Testing (PROMPT), United States and Europe
- Dana-Farber Cancer Institute, Boston, MA
| | - Lisa Golmard
- Service de Génétique, Institut Curie, Paris, France
| | - Ellen L. Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | - Eric Hahnen
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Christopher Hake
- Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA
| | - Tuomas Heikkinen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Judith E. Hurley
- Division of Medical Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Ramunas Janavicius
- Hematology, Oncology and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
- State Research Institute Innovative Medicine Center, Vilnius, Lithuania
| | - Zdenek Kleibl
- Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petra Kleiblova
- Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research “Demokritos,” Athens, Greece
| | - Anders Kvist
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Ann S.G. Lee
- Leicestershire Clinical Genetics Service, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- SingHealth Duke-NUS Oncology Academic Clinical Programme (ONCO ACP), Duke-NUS Medical School, Singapore
| | - Fabienne Lesueur
- INSERM U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Eamonn R. Maher
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Arto Mannermaa
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rachel McFarland
- Ambry Genetics, Aliso Viejo, CA
- Department of Epidemiology, University of California, Irvine, Irvine, CA
| | - Wendy McKinnon
- Familial Cancer Program, The University of Vermont Cancer Center, Burlington, VT
| | - Alfons Meindl
- Department of Gynecology and Obstetrics, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Kelly Metcalfe
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Nur Aishah Mohd Taib
- University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Jukka Moilanen
- Department of Clinical Genetics, Oulu University Hospital, Medical Research Center Oulu and PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Katherine L. Nathanson
- Department ofMedicine, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan Neuhausen
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA
| | - Pei Sze Ng
- University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- Cancer Research Malaysia, Subang Jaya Selangor, Malaysia
| | - Tu Nguyen-Dumont
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Sarah M. Nielsen
- Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL
| | - Florian Obermair
- Institute of Medical Genetics, Kepler University Hospital Linz and Laboratory for Molecular Biology and Tumor Cytogenetics, Ordensklinikum Linz, Linz, Austria
| | - Kenneth Offit
- Prospective Registry of Multiplex Testing (PROMPT), United States and Europe
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Laura Ottini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Judith Penkert
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, and Northern Finland Laboratory Centre, Oulu, Finland
| | - Paolo Radice
- Unit of Molecular Basis of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Susan J. Ramus
- School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Vilius Rudaitis
- Hematology, Oncology and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - Lucy Side
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Rachel Silva-Smith
- Department of Genetics, University of MiamiMiller School of Medicine, Miami, FL
| | | | - Anne-Bine Skytte
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Slavin
- Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA
- Department of Medical Oncology, Division of Clinical Cancer Genomics, City of Hope, Duarte, CA
| | - Jana Soukupova
- Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Carlo Tondini
- Unit of Medical Oncology, Department of Oncology and Hematology,Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Alison H. Trainer
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Gary Unzeitig
- Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA
| | - Lydia Usha
- Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA
| | - Thomas van Overeem Hansen
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - James Whitworth
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Marie Wood
- Familial Cancer Program, The University of Vermont Cancer Center, Burlington, VT
| | - Cheng Har Yip
- Cancer Research Malaysia, Subang Jaya Selangor, Malaysia
| | - Sook-Yee Yoon
- Cancer Research Malaysia, Subang Jaya Selangor, Malaysia
| | | | - George Zogopoulos
- The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
- The Goodman Cancer Research Centre, McGill University, Montreal, Quebec, Canada
| | - David Goldgar
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - John L. Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Sophia H.L. George
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Judith Balmaña
- Oncogenetics Group, Clinical and Molecular Genetics Area, Vall d’Hebron Institute of Oncology (VHIO), University Hospital, Vall d’Hebron, Barcelona, Spain
- Prospective Registry of Multiplex Testing (PROMPT), United States and Europe
| | - Claude Houdayer
- Service de Génétique, Institut Curie, Paris, France
- Genetics Department, F76000 and Normandy University, UNIROUEN, INSERM U1245, Normandy Centre for Genomic and Personalized Medicine, Rouen University Hospital, Rouen, France
| | - Paul James
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Zaki El-Haffaf
- Department of Genetics, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Hans Ehrencrona
- Department of Clinical Genetics and Pathology, Department of Laboratory Medicine, Office for Medical Services, Lund, Sweden
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Marketa Janatova
- Institute of Biochemistry and Experimental Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM–The FIRC Institute for Molecular Oncology, Milan, Italy
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Rita Schmutzler
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Soo-Hwang Teo
- University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- Cancer Research Malaysia, Subang Jaya Selangor, Malaysia
| | - Mark Robson
- Prospective Registry of Multiplex Testing (PROMPT), United States and Europe
- Breast Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Tuya Pal
- Vanderbilt-Ingram Cancer Center, Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Fergus Couch
- Prospective Registry of Multiplex Testing (PROMPT), United States and Europe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Jeffrey N. Weitzel
- Clinical Cancer Genomics Community Research Network, City of Hope, Duarte, CA
- Department of Medical Oncology, Division of Clinical Cancer Genomics, City of Hope, Duarte, CA
| | | | - Melissa Southey
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, University of Oulu, and Northern Finland Laboratory Centre, Oulu, Finland
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - William D. Foulkes
- The Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
- Departments of Human Genetics, Oncology, and Medicine, McGill University, Montreal, Quebec, Canada
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
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25
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Landrith T, Li B, Cass AA, Conner BR, LaDuca H, McKenna DB, Maxwell KN, Domchek S, Morman NA, Heinlen C, Wham D, Koptiuch C, Vagher J, Rivera R, Bunnell A, Patel G, Geurts JL, Depas MM, Gaonkar S, Pirzadeh-Miller S, Krukenberg R, Seidel M, Pilarski R, Farmer M, Pyrtel K, Milliron K, Lee J, Hoodfar E, Nathan D, Ganzak AC, Wu S, Vuong H, Xu D, Arulmoli A, Parra M, Hoang L, Molparia B, Fennessy M, Fox S, Charpentier S, Burdette J, Pesaran T, Profato J, Smith B, Haynes G, Dalton E, Crandall JRR, Baxter R, Lu HM, Tippin-Davis B, Elliott A, Chao E, Karam R. Splicing profile by capture RNA-seq identifies pathogenic germline variants in tumor suppressor genes. NPJ Precis Oncol 2020; 4:4. [PMID: 32133419 PMCID: PMC7039900 DOI: 10.1038/s41698-020-0109-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/30/2020] [Indexed: 12/12/2022] Open
Abstract
Germline variants in tumor suppressor genes (TSGs) can result in RNA mis-splicing and predisposition to cancer. However, identification of variants that impact splicing remains a challenge, contributing to a substantial proportion of patients with suspected hereditary cancer syndromes remaining without a molecular diagnosis. To address this, we used capture RNA-sequencing (RNA-seq) to generate a splicing profile of 18 TSGs (APC, ATM, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, MLH1, MSH2, MSH6, MUTYH, NF1, PALB2, PMS2, PTEN, RAD51C, RAD51D, and TP53) in 345 whole-blood samples from healthy donors. We subsequently demonstrated that this approach can detect mis-splicing by comparing splicing profiles from the control dataset to profiles generated from whole blood of individuals previously identified with pathogenic germline splicing variants in these genes. To assess the utility of our TSG splicing profile to prospectively identify pathogenic splicing variants, we performed concurrent capture DNA and RNA-seq in a cohort of 1000 patients with suspected hereditary cancer syndromes. This approach improved the diagnostic yield in this cohort, resulting in a 9.1% relative increase in the detection of pathogenic variants, demonstrating the utility of performing simultaneous DNA and RNA genetic testing in a clinical context.
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Affiliation(s)
| | - Bing Li
- Ambry Genetics, Aliso Viejo, CA USA
| | | | | | | | | | | | | | | | | | - Deborah Wham
- Aurora St. Luke’s Medical Center, Milwaukee, WI USA
| | | | | | - Ragene Rivera
- Texas Oncology, El Paso, Fort Worth, and Austin, TX USA
| | - Ann Bunnell
- Texas Oncology, El Paso, Fort Worth, and Austin, TX USA
| | - Gayle Patel
- Texas Oncology, El Paso, Fort Worth, and Austin, TX USA
| | | | | | | | | | | | | | - Robert Pilarski
- Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH USA
| | - Meagan Farmer
- University of Alabama at Birmingham, Birmingham, AL USA
| | | | | | - John Lee
- Cedars-Sinai Medical Center, Los Angeles, CA USA
| | | | | | | | - Sitao Wu
- Ambry Genetics, Aliso Viejo, CA USA
| | | | - Dong Xu
- Ambry Genetics, Aliso Viejo, CA USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Elizabeth Chao
- Ambry Genetics, Aliso Viejo, CA USA
- University of California at Irvine, Irvine, CA USA
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26
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Kadhim K, Elliott A, Middeldorp M, Hendriks J, Gallagher C, Mahajan R, McEvoy RD, Lau D, Sanders P, Linz D. P3794MOODS: a novel risk score to identify patients with atrial fibrillation and sleep apnoea. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sleep-disordered breathing (SDB) is an important risk factor for developing atrial fibrillation (AF), and treatment of concomitant SDB can improve AF rhythm outcomes. Diagnosis of SDB requires sleep studies which can pose a significant time and resource burden. We sought to develop a prediction score based on clinical characteristics that can help identify AF patients who require further assessment for SDB.
Methods
Prospectively-collected data for 442 consecutive patients treated for AF from 2009 to 2017 were analysed. All patients were considered candidates for rhythm-control and therefore referred for sleep studies. The diagnosis of SDB was confirmed using in-lab polysomnography and classified using the apnoea-hypopnoea-index (AHI), with cut-offs of ≥15/hr and ≥30/hr indicating moderate-to-severe and severe SDB respectively. Patients treated up to 2015 formed the derivation cohort (n=311) and the remainder (n=113) formed the validation cohort. Multivariate logistic regression analysis was used to identify clinical variables predictive of moderate-to-severe SDB. A risk score model was developed based on regression coefficients and tested using receiver-operating-characteristics analyses on the validation cohort.
Results
Overall, mean age was 60±11 years, mean body mass index (BMI) was 30±5 kg/m2 and 69% were men. The prevalence of moderate-to-severe SDB was 33.7%. There were no significant differences in baseline characteristics between the derivation and validation cohorts. Male gender (score=1), overweight (BMI: 25–29 kg/m2, score=2), obesity (BMI≥30 kg/m2, score=3), diabetes (score=1), and stroke (score=2) were significantly independently predictive of moderate-to-severe SDB and formulated the score. The score performed well to predict moderate-to-severe SDB with a C-statistic of 0.73 (95% CI: 0.67–0.79, P<0.001) in the derivation cohort, and 0.67 (95% CI: 0.57–0.77, P<0.001) in the validation cohort. As a rule-out test, a score of ≤3 had a negative predictive value of 77% for moderate-to-severe SDB (91% for severe SDB). A score of ≥4 had an intermediate positive likelihood ratio (PLR) of 2 for moderate-to-severe SDB (2.2 for severe SDB), while a score of ≥5 had a high PLR of 6.5 and 6.8 for moderate-to-severe SDB and severe SDB respectively.
Sensitivity and specificity table
Conclusion
A novel risk score comprising clinical characteristics can identify patients with AF likely to benefit from further assessment for SDB. Application of this model may aid optimise resource utilisation and facilitate timely patient care.
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Affiliation(s)
- K Kadhim
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M Middeldorp
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - J Hendriks
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - C Gallagher
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R D McEvoy
- Flinders Medical Centre and Flinders University, Adelaide Institute for Sleep Health (AISH), Adelaide, Australia
| | - D Lau
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Linz
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
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27
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Karam R, Conner B, LaDuca H, McGoldrick K, Krempely K, Richardson ME, Zimmermann H, Gutierrez S, Reineke P, Hoang L, Allen K, Yussuf A, Farber-Katz S, Rana HQ, Culver S, Lee J, Nashed S, Toppmeyer D, Collins D, Haynes G, Pesaran T, Dolinsky JS, Tippin Davis B, Elliott A, Chao E. Assessment of Diagnostic Outcomes of RNA Genetic Testing for Hereditary Cancer. JAMA Netw Open 2019; 2:e1913900. [PMID: 31642931 PMCID: PMC6820040 DOI: 10.1001/jamanetworkopen.2019.13900] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Performing DNA genetic testing (DGT) for hereditary cancer genes is now a well-accepted clinical practice; however, the interpretation of DNA variation remains a challenge for laboratories and clinicians. Adding RNA genetic testing (RGT) enhances DGT by clarifying the clinical actionability of hereditary cancer gene variants, thus improving clinicians' ability to accurately apply strategies for cancer risk reduction and treatment. OBJECTIVE To evaluate whether RGT is associated with improvement in the diagnostic outcome of DGT and in the delivery of personalized cancer risk management for patients with hereditary cancer predisposition. DESIGN, SETTING, AND PARTICIPANTS Diagnostic study in which patients and/or families with inconclusive variants detected by DGT in genes associated with hereditary breast and ovarian cancer, Lynch syndrome, and hereditary diffuse gastric cancer sent blood samples for RGT from March 2016 to April 2018. Clinicians who ordered genetic testing and received a reclassification report for these variants were surveyed to assess whether RGT-related variant reclassifications changed clinical management of these patients. To quantify the potential number of tested individuals who could benefit from RGT, a cohort of 307 812 patients who underwent DGT for hereditary cancer were separately queried to identify variants predicted to affect splicing. Data analysis was conducted from March 2016 and September 2018. MAIN OUTCOMES AND MEASURES Variant reclassification outcomes following RGT, clinical management changes associated with RGT-related variant reclassifications, and the proportion of patients who would likely be affected by a concurrent DGT and RGT multigene panel testing approach. RESULTS In total, 93 if 909 eligible families (10.2%) submitted samples for RGT. Evidence from RGT clarified the interpretation of 49 of 56 inconclusive cases (88%) studied; 26 (47%) were reclassified as clinically actionable and 23 (41%) were clarified as benign. Variant reclassifications based on RGT results changed clinical management recommendations for 8 of 18 patients (44%) and 14 of 18 families (78%), based on responses from 18 of 45 clinicians (40%) surveyed. A total of 7265 of 307 812 patients who underwent DGT had likely pathogenic variants or variants of uncertain significance potentially affecting splicing, indicating that approximately 1 in 43 individuals could benefit from RGT. CONCLUSIONS AND RELEVANCE In this diagnostic study, conducting RNA testing resolved a substantial proportion of variants of uncertain significance in a cohort of individuals previously tested for cancer predisposition by DGT. Performing RGT might change the diagnostic outcome of at least 1 in 43 patients if performed in all individuals undergoing genetic evaluation for hereditary cancer.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Suzette Farber-Katz
- Ambry Genetics, Aliso Viejo, California
- now with Merck Research Laboratories, South San Francisco, California
| | - Huma Q. Rana
- Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Samantha Culver
- Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - John Lee
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Sarah Nashed
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | - Deborah Toppmeyer
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick
| | | | | | | | | | | | | | - Elizabeth Chao
- Ambry Genetics, Aliso Viejo, California
- Department of Pediatrics, School of Medicine, University of California, Irvine
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28
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Agbaedeng TA, Emami M, Munawar DA, Rattanakosit T, Khadim KI, Elliott A, Linz D, Mahajan R, Lau DH, Sanders P. P5657Fibrosis detected by late-gadolinium enhancement cardiac MRI is associated with atrial fibrillation and poorer ablation outcome: A meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Fibrosis is a hallmark of atrial fibrillation (AF) substrate. Recent data suggests that fibrosis detected by late-gadolinium enhancement (LGE) cardiac MRI (CMR) can predict AF. However, this relationship is not well described.
Objective
To delineate the association of cardiac fibrosis detected by LGE CMR with AF prevalence, AF recurrence after catheter ablation.
Methods
PubMed, Embase, Web of Science and Ovid MEDLINE were searched through November 2018, using the keywords: LGE AND Fibrosis AND CMR AND AF. Inclusion criteria: 1. LGE CMR of left atrial (LA LGE), ventricular wall (LV LGE) or right ventricular wall (RV LGE); 2. Studies reporting AF or recurrent arrhythmia after ablation; 3. Patient ≥18 years; and 4. ≥50 participants. Included studies were pooled in a random effects meta-analysis and reported as: mean difference (MD); unadjusted risk ratios (RR); adjusted hazard ratios (HR); and 95% confidence intervals (95% CI).
Results
After exclusions, we identified 9 studies (2,307 patients [65.9% males, 34.1% females]) conducted between 2003 and 2015 for LGE and AF. Fibrosis was present in 666 (35.1%) and detected by LV LGE in 7 (78%) and RV LGE in 2 (22%). The presence of AF was higher in patients positive for ventricular LGE than those negative, trending towards significance (RR: 1.51, 95% CI: 0.94–2.45, p=0.09). Pooled LV fibrosis associated with AF progression (RR [NPAF vs. PAF]: 2.2, 95% CI: 1.22–3.94, p=0.009). We identified 8 studies (2,041 patients [65.8% males, 34.2% females]) conducted between 2006 and 2016 reporting LGE and AF recurrence after catheter ablation, with fibrosis detected in 644 (31.6%) by LA LGE in 8 (88.9%, biased towards one centre). After 17.8±14.2 follow-up years, atrial fibrosis was significantly greater in recurrent AF than controls (MD: 4.97%, 95% CI: 1.23–8.7, p<0.01), and predicted 16% increased risk of AF recurrence (RR: 1.16, 95% CI: 1.07–1.26, p<0.05).
Conclusion
Myocardial fibrosis detected by LGE associates with prevalence and progress of AF and is predictive of AF recurrence post ablation. This further supports the proarrhythmic role of fibrosis and selection of patients for ablation therapy based on LGE.
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Affiliation(s)
- T A Agbaedeng
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M Emami
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D A Munawar
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - T Rattanakosit
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - K I Khadim
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Linz
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D H Lau
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
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Linz D, Nalliah C, Baumert M, Kadhim K, Middeldorp M, Elliott A, Lau D, McEvoy D, Kalman J, Sanders P. P661Nocturnal hypoxemic burden in ambulatory patients with atrial fibrillation: a disease-orientated assessment of sleep-disordered breathing severity. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Studies investigating the relationship between sleep-disordered breathing (SDB) and atrial fibrillation (AF) have largely assessed SDB-severity by the apnea–hypopnea index (AHI). However, the AHI does not incorporate nocturnal hypoxemic burden, which may increase the risk of non-paroxysmal AF (nPAF) as the clinical manifestation of more progressed AF substrates. This investigation sought to systematically characterize and compare the composition of AHI and hypoxemic burden with the aim to defining a disease-orientated metric for SDB-severity best associated with prevalent nPAF.
Methods
Polysomnography including overnight oximetry data were obtained in 435 consecutive ambulatory AF patients to determine the composition of AHI (apneas vs. hypopneas), the number of acute episodic desaturations per hour (oxygen desaturation index, ODI) and the composition of total time spent below 90% oxygen saturation (T90Total) attributed to acute desaturations (T90Desaturation). Logistic regression analysis was used to characterize the association with prevalent nPAF.
Results
One hundred sixty-nine AF patients (38%) had nPAF and one third (n=149, 34%) had moderate-to-severe SDB (AHI>15). 82% of the median total AHI (9.4 [3.6–20.1]) could be attributed to hypopneas. Only 29% of events were associated with episodic desaturations, which contributed to 96% (T90Desaturation) of the variation in T90Total. The high variability in durations and nadirs of distinct desaturation events can expose patients to long T90Total, even if the AHI is low. Not AHI, but T90Total and ODI were associated with nPAF independent of gender and age. However, diabetes, hypertension and body mass index contributed more significantly to the overall risk of nPAF.
Conclusions
In AF patients, hypopneas constitute a majority of respiratory events during sleep. Patients with low AHI can still be exposed to high nocturnal hypoxemic burden, which is mainly a cumulative consequence of episodic desaturations. T90Total and ODI, but not AHI, were associated with nPAF independent of gender and age, but concomitant modifiable risk factors made a more significant contribution to the overall risk of nPAF versus PAF.
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Affiliation(s)
- D Linz
- University of Adelaide, Adelaide, Australia
| | - C Nalliah
- Royal Melbourne Hospital, Royal Melbourne Hospital, Melbourne, Australia
| | - M Baumert
- University of Adelaide, Adelaide, Australia
| | - K Kadhim
- University of Adelaide, Adelaide, Australia
| | | | - A Elliott
- University of Adelaide, Adelaide, Australia
| | - D Lau
- University of Adelaide, Adelaide, Australia
| | - D McEvoy
- University of Adelaide, Adelaide, Australia
| | - J Kalman
- Royal Melbourne Hospital, Royal Melbourne Hospital, Melbourne, Australia
| | - P Sanders
- Royal Melbourne Hospital, Royal Melbourne Hospital, Melbourne, Australia
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Fabry G, Doorschodt BM, Grzanna T, Boor P, Elliott A, Stollenwerk A, Tolba RH, Rossaint R, Bleilevens C. Cold Preflush of Porcine Kidney Grafts Prior to Normothermic Machine Perfusion Aggravates Ischemia Reperfusion Injury. Sci Rep 2019; 9:13897. [PMID: 31554887 PMCID: PMC6761287 DOI: 10.1038/s41598-019-50101-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/02/2019] [Indexed: 12/19/2022] Open
Abstract
Normothermic machine perfusion (NMP) of kidney grafts is a promising new preservation method to improve graft quality and clinical outcome. Routinely, kidneys are washed out of blood remnants and cooled using organ preservation solutions prior to NMP. Here we assessed the effect of cold preflush compared to direct NMP. After 30 min of warm ischemia, porcine kidneys were either preflushed with cold histidine-tryptophan-ketoglutarate solution (PFNMP group) prior to NMP or directly subjected to NMP (DNMP group) using a blood/buffer solution. NMP was performed at a perfusion pressure of 75 mmHg for 6 h. Functional parameters were assessed as well as histopathological and biochemical analyses. Renal function as expressed by creatinine clearance, fractional excretion of sodium and total output of urine was inferior in PFNMP. Urine protein and neutrophil gelatinase-associated lipocalin (NGAL) concentrations as markers for kidney damage were significantly higher in the PFNMP group. Additionally, increased osmotic nephropathy was found after PFNMP. This study demonstrated that cold preflush prior to NMP aggravates ischemia reperfusion injury in comparison to direct NMP of warm ischemia-damaged kidney grafts. With increasing use of NMP systems for kidneys and other organs, further research into graft flushing during retrieval is warranted.
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Affiliation(s)
- Gregor Fabry
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany. .,Department of Intensive Care and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - Benedict M Doorschodt
- Institute for Laboratory Animal Science & Experimental Surgery, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Tim Grzanna
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Peter Boor
- Institute of Pathology & Division of Nephrology, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Aaron Elliott
- Informatik 11-Embedded Software, RWTH Aachen University, Aachen, Germany
| | - André Stollenwerk
- Informatik 11-Embedded Software, RWTH Aachen University, Aachen, Germany
| | - René H Tolba
- Institute for Laboratory Animal Science & Experimental Surgery, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Rolf Rossaint
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Christian Bleilevens
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Richardson ME, Chong H, Mu W, Conner BR, Hsuan V, Willett S, Lam S, Tsai P, Pesaran T, Chamberlin AC, Park MS, Gray P, Karam R, Elliott A. Correction: DNA breakpoint assay reveals a majority of gross duplications occur in tandem reducing VUS classifications in breast cancer predisposition genes. Genet Med 2019; 21:1669. [PMID: 30127414 PMCID: PMC7609259 DOI: 10.1038/s41436-018-0276-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Elliott A, Torrens SD, Pendleton A. THE NAIL-BED AS A WINDOW TO DISEASE: THE DEVELOPMENT OF A NURSE LED CAPILLAROSCOPY SERVICE. Ulster Med J 2019; 88:87. [PMID: 31061553 PMCID: PMC6500414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nath L, Curl P, Elliott A, La Gerche A, Franklin S. Cardiac Arrhythmia has a High Rate of Recurrence in the Thoroughbred Racehorse, a Naturally Occurring Animal Model for the Athlete's Heart. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Malik V, Thiyagarajah A, Munawar D, Linz D, Elliott A, Emami M, Mishima R, Mahajan R, Sanders P, Lau D. Abnormal Cardiac Electrical Remodelling in POTS: Mechanistic Insights on Potential Autonomic Dysregulation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gallagher C, Wong C, Hendriks J, Bednarz J, Elliott A, Linz D, Middeldorp M, Mahajan R, Lau D, Sanders P. Predictors of Health Care Resource Utilisation in AF: The REVIEW AF Study. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lu HM, Li S, Black MH, Lee S, Hoiness R, Wu S, Mu W, Huether R, Chen J, Sridhar S, Tian Y, McFarland R, Dolinsky J, Tippin Davis B, Mexal S, Dunlop C, Elliott A. Association of Breast and Ovarian Cancers With Predisposition Genes Identified by Large-Scale Sequencing. JAMA Oncol 2019; 5:51-57. [PMID: 30128536 PMCID: PMC6439764 DOI: 10.1001/jamaoncol.2018.2956] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/04/2018] [Indexed: 12/21/2022]
Abstract
Importance Since the discovery of BRCA1 and BRCA2, multiple high- and moderate-penetrance genes have been reported as risk factors for hereditary breast cancer, ovarian cancer, or both; however, it is unclear whether these findings represent the complete genetic landscape of these cancers. Systematic investigation of the genetic contributions to breast and ovarian cancers is needed to confirm these findings and explore potentially new associations. Objective To confirm reported and identify additional predisposition genes for breast or ovarian cancer. Design, Setting, and Participants In this sample of 11 416 patients with clinical features of breast cancer, ovarian cancer, or both who were referred for genetic testing from 1200 hospitals and clinics across the United States and of 3988 controls who were referred for genetic testing for noncancer conditions between 2014 and 2015, whole-exome sequencing was conducted and gene-phenotype associations were examined. Case-control analyses using the Genome Aggregation Database as a set of reference controls were also conducted. Main Outcomes and Measures Breast cancer risk associated with pathogenic variants among 625 cancer predisposition genes; association of identified predisposition breast or ovarian cancer genes with the breast cancer subtypes invasive ductal, invasive lobular, hormone receptor-positive, hormone receptor-negative, and male, and with early-onset disease. Results Of 9639 patients with breast cancer, 3960 (41.1%) were early-onset cases (≤45 years at diagnosis) and 123 (1.3%) were male, with men having an older age at diagnosis than women (mean [SD] age, 61.8 [12.8] vs 48.6 [11.4] years). Of 2051 women with ovarian cancer, 445 (21.7%) received a diagnosis at 45 years or younger. Enrichment of pathogenic variants were identified in 4 non-BRCA genes associated with breast cancer risk: ATM (odds ratio [OR], 2.97; 95% CI, 1.67-5.68), CHEK2 (OR, 2.19; 95% CI, 1.40-3.56), PALB2 (OR, 5.53; 95% CI, 2.24-17.65), and MSH6 (OR, 2.59; 95% CI, 1.35-5.44). Increased risk for ovarian cancer was associated with 4 genes: MSH6 (OR, 4.16; 95% CI, 1.95-9.47), RAD51C (OR, not estimable; false-discovery rate-corrected P = .004), TP53 (OR, 18.50; 95% CI, 2.56-808.10), and ATM (OR, 2.85; 95% CI, 1.30-6.32). Neither the MRN complex genes nor CDKN2A was associated with increased breast or ovarian cancer risk. The findings also do not support previously reported breast cancer associations with the ovarian cancer susceptibility genes BRIP1, RAD51C, and RAD51D, or mismatch repair genes MSH2 and PMS2. Conclusions and Relevance The results of this large-scale exome sequencing of patients and controls shed light on both well-established and controversial non-BRCA predisposition gene associations with breast or ovarian cancer reported to date and may implicate additional breast or ovarian cancer susceptibility gene candidates involved in DNA repair and genomic maintenance.
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Affiliation(s)
| | - Shuwei Li
- Ambry Genetics, Aliso Viejo, California
| | | | - Shela Lee
- Ambry Genetics, Aliso Viejo, California
- Now with Simcere Pharmaceutical, Jiangsu, China
| | | | - Sitao Wu
- Ambry Genetics, Aliso Viejo, California
| | - Wenbo Mu
- Ambry Genetics, Aliso Viejo, California
| | - Robert Huether
- Ambry Genetics, Aliso Viejo, California
- Tempus, Chicago, Illinois
| | | | - Srijani Sridhar
- Ambry Genetics, Aliso Viejo, California
- Intellia Therapeutics, Cambridge, Massachusetts
| | - Yuan Tian
- Ambry Genetics, Aliso Viejo, California
| | - Rachel McFarland
- Ambry Genetics, Aliso Viejo, California
- Department of Epidemiology, School of Medicine,
University of California, Irvine
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Nath L, Agbaedeng T, Franklin S, Saljic A, Stent A, La Gerche A, Elliott A. Myocardial Fibrosis is Present in Thoroughbred Racehorses with Sudden Cardiac Death. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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38
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Shulman M, Cuthbertson B, Wijeysundera D, Pearse R, Thompson B, Torres E, Ambosta A, Wallace S, Farrington C, Myles P, Wallace S, Thompson B, Ellis M, Borg B, Kerridge R, Douglas J, Brannan J, Pretto J, Godsall M, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter T, Macklin S, Elliott A, Carrera A, Terblanche N, Pitt S, Samuels J, Wilde C, MacCormick A, Leslie K, Bramley D, Southcott A, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney C, Choi S, Somascanthan P, Flores K, Beattie W, Karkouti K, Clarke H, Jerath A, McCluskey S, Wasowicz M, Granton J, Day L, Pazmino-Canizares J, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, Mcallister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G, Melo M, Mamdani M, Hillis G, Wijeysundera H. Using the 6-minute walk test to predict disability-free survival after major surgery. Br J Anaesth 2019; 122:111-119. [DOI: 10.1016/j.bja.2018.08.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022] Open
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Nalliah C, Baumert M, Kadhim K, Middeldorp M, Elliott A, Lau D, Mahajan R, Wong C, McEvoy D, Kalman J, Sanders P, Linz D. Nocturnal Hypoxemic Burden in Ambulatory Patients with Atrial Fibrillation: a Disease-Orientated Assessment of Sleep-Disordered Breathing Severity. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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40
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Mu W, Li B, Wu S, Chen J, Sain D, Xu D, Black MH, Karam R, Gillespie K, Farwell Hagman KD, Guidugli L, Pronold M, Elliott A, Lu HM. Detection of structural variation using target captured next-generation sequencing data for genetic diagnostic testing. Genet Med 2018; 21:1603-1610. [PMID: 30563988 PMCID: PMC6752280 DOI: 10.1038/s41436-018-0397-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 11/28/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Structural variation (SV) is associated with inherited diseases. Next-generation sequencing (NGS) is an efficient method for SV detection because of its high-throughput, low cost, and base-pair resolution. However, due to lack of standard NGS protocols and a limited number of clinical samples with pathogenic SVs, comprehensive standards for SV detection, interpretation, and reporting are to be established. METHODS We performed SV assessment on 60,000 clinical samples tested with hereditary cancer NGS panels spanning 48 genes. To evaluate NGS results, NGS and orthogonal methods were used separately in a blinded fashion for SV detection in all samples. RESULTS A total of 1,037 SVs in coding sequence (CDS) or untranslated regions (UTRs) and 30,847 SVs in introns were detected and validated. Across all variant types, NGS shows 100% sensitivity and 99.9% specificity. Overall, 64% of CDS/UTR SVs were classified as pathogenic/likely pathogenic, and five deletions/duplications were reclassified as pathogenic using breakpoint information from NGS. CONCLUSION The SVs presented here can be used as a valuable resource for clinical research and diagnostics. The data illustrate NGS as a powerful tool for SV detection. Application of NGS and confirmation technologies in genetic testing ensures delivering accurate and reliable results for diagnosis and patient care.
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Affiliation(s)
- Wenbo Mu
- Ambry Genetics, Aliso Viejo, CA 92656, USA
| | - Bing Li
- Ambry Genetics, Aliso Viejo, CA 92656, USA
| | - Sitao Wu
- Ambry Genetics, Aliso Viejo, CA 92656, USA
| | | | - Divya Sain
- Ambry Genetics, Aliso Viejo, CA 92656, USA
| | - Dong Xu
- Ambry Genetics, Aliso Viejo, CA 92656, USA
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41
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Elliott A, Heskett M, McGwin Jr G, Owsley C. LOWER RATES OF EYE CARE UTILIZATION AMONG VISUALLY IMPAIRED SUBSIDIZED SENIOR HOUSING RESIDENTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - C Owsley
- University of Alabama at Birmingham
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42
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Khokhar KB, Lau D, Elliott A, Mahajan R, Thiyagarajah A, Munawar DA, Stiles M, Linz DA, Agbaedeng TA, Emami M, Kadhim KB, Mishimi R, Harrington J, Sanders P. P1941Association of aortic stiffness and new onset AF- A meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K B Khokhar
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - D Lau
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - A Elliott
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - R Mahajan
- Waikato District Hospital, Cardiology, Waikato, New Zealand
| | - A Thiyagarajah
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - D A Munawar
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - M Stiles
- Waikato District Hospital, Cardiology, Waikato, New Zealand
| | - D A Linz
- Waikato District Hospital, Cardiology, Waikato, New Zealand
| | - T A Agbaedeng
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - M Emami
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - K B Kadhim
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - R Mishimi
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - J Harrington
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
| | - P Sanders
- Royal Adelaide Hospital, Centre for Heart Rhythm Disorders (CHRD), Adelaide, Australia
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Elliott A, Verdicchio CV, Linz D, Stokes M, Gallagher C, Mahajan R, Hendriks JML, Lau DH, Sanders P. P983Mechanisms contributing to exercise intolerance in patients with atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Elliott
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - C V Verdicchio
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Linz
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M Stokes
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - C Gallagher
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - J M L Hendriks
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D H Lau
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
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Richardson ME, Chong H, Mu W, Conner BR, Hsuan V, Willett S, Lam S, Tsai P, Pesaran T, Chamberlin AC, Park MS, Gray P, Karam R, Elliott A. DNA breakpoint assay reveals a majority of gross duplications occur in tandem reducing VUS classifications in breast cancer predisposition genes. Genet Med 2018; 21:683-693. [PMID: 30054569 PMCID: PMC6752314 DOI: 10.1038/s41436-018-0092-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/04/2018] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Gross duplications are ambiguous in terms of clinical interpretation due to the limitations of the detection methods that cannot infer their context, namely, whether they occur in tandem or are duplicated and inserted elsewhere in the genome. We investigated the proportion of gross duplications occurring in tandem in breast cancer predisposition genes with the intent of informing their classifications. METHODS The DNA breakpoint assay (DBA) is a custom, paired-end, next-generation sequencing (NGS) method designed to capture and detect deep-intronic DNA breakpoints in gross duplications in BRCA1, BRCA2, ATM, CDH1, PALB2, and CHEK2. RESULTS DBA allowed us to ascertain breakpoints for 44 unique gross duplications from 147 probands. We determined that the duplications occurred in tandem in 114 (78%) carriers from this cohort, while the remainder have unknown tandem status. Among the tandem gross duplications that were eligible for reclassification, 95% of them were upgraded to pathogenic. CONCLUSION DBA is a novel, high-throughput, NGS-based method that informs the tandem status, and thereby the classification of, gross duplications. This method revealed that most gross duplications in the investigated genes occurred in tandem and resulted in a pathogenic classification, which helps to secure the necessary treatment options for their carriers.
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Affiliation(s)
- Marcy E Richardson
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA.
| | - Hansook Chong
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Wenbo Mu
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Blair R Conner
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Vickie Hsuan
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Sara Willett
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Stephanie Lam
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Pei Tsai
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Tina Pesaran
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Adam C Chamberlin
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Min-Sun Park
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Phillip Gray
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Rachid Karam
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
| | - Aaron Elliott
- Department of Clinical Genomics, Ambry Genetics, 15 Argonaut Drive, Aliso Viejo, California, 92656, USA
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Farber-Katz S, Hsuan V, Wu S, Landrith T, Vuong H, Xu D, Li B, Hoo J, Lam S, Nashed S, Toppmeyer D, Gray P, Haynes G, Lu HM, Elliott A, Tippin Davis B, Karam R. Quantitative Analysis of BRCA1 and BRCA2 Germline Splicing Variants Using a Novel RNA-Massively Parallel Sequencing Assay. Front Oncol 2018; 8:286. [PMID: 30101128 PMCID: PMC6072868 DOI: 10.3389/fonc.2018.00286] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/09/2018] [Indexed: 12/27/2022] Open
Abstract
Clinical genetic testing for hereditary breast and ovarian cancer (HBOC) is becoming widespread. However, the interpretation of variants of unknown significance (VUS) in HBOC genes, such as the clinically actionable genes BRCA1 and BRCA2, remain a challenge. Among the variants that are frequently classified as VUS are those with unclear effects on splicing. In order to address this issue we developed a high-throughput RNA-massively parallel sequencing assay—CloneSeq—capable to perform quantitative and qualitative analysis of transcripts in cell lines and HBOC patients. This assay is based on cloning of RT-PCR products followed by massive parallel sequencing of the cloned transcripts. To validate this assay we compared it to the RNA splicing assays recommended by members of the ENIGMA (Evidence-based Network for the Interpretation of Germline Mutant Alleles) consortium. This comparison was performed using well-characterized lymphoblastoid cell lines (LCLs) generated from carriers of the BRCA1 or BRCA2 germline variants that have been previously described to be associated with splicing defects. CloneSeq was able to replicate the ENIGMA results, in addition to providing quantitative characterization of BRCA1 and BRCA2 germline splicing alterations in a high-throughput fashion. Furthermore, CloneSeq was used to analyze blood samples obtained from carriers of BRCA1 or BRCA2 germline sequence variants, including the novel uncharacterized alteration BRCA1 c.5152+5G>T, which was identified in a HBOC family. CloneSeq provided a high-resolution picture of all the transcripts induced by BRCA1 c.5152+5G>T, indicating it results in significant levels of exon skipping. This analysis proved to be important for the classification of BRCA1 c.5152+5G>T as a clinically actionable likely pathogenic variant. Reclassifications such as these are fundamental in order to offer preventive measures, targeted treatment, and pre-symptomatic screening to the correct individuals.
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Affiliation(s)
- Suzette Farber-Katz
- Translational Genomics Laboratory, Ambry Genetics, Aliso Viejo, CA, United States
| | - Vickie Hsuan
- Translational Genomics Laboratory, Ambry Genetics, Aliso Viejo, CA, United States
| | - Sitao Wu
- Department of Bioinformatics, Ambry Genetics, Aliso Viejo, CA, United States
| | - Tyler Landrith
- Translational Genomics Laboratory, Ambry Genetics, Aliso Viejo, CA, United States
| | - Huy Vuong
- Department of Bioinformatics, Ambry Genetics, Aliso Viejo, CA, United States
| | - Dong Xu
- Department of Bioinformatics, Ambry Genetics, Aliso Viejo, CA, United States
| | - Bing Li
- Department of Bioinformatics, Ambry Genetics, Aliso Viejo, CA, United States
| | - Jayne Hoo
- Department of Research and Development, Ambry Genetics, Aliso Viejo, CA, United States
| | - Stephanie Lam
- Department of Research and Development, Ambry Genetics, Aliso Viejo, CA, United States
| | - Sarah Nashed
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Deborah Toppmeyer
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Phillip Gray
- Department of Research and Development, Ambry Genetics, Aliso Viejo, CA, United States
| | - Ginger Haynes
- Translational Genomics Laboratory, Ambry Genetics, Aliso Viejo, CA, United States
| | - Hsiao-Mei Lu
- Department of Bioinformatics, Ambry Genetics, Aliso Viejo, CA, United States
| | - Aaron Elliott
- Department of Research and Development, Ambry Genetics, Aliso Viejo, CA, United States
| | - Brigette Tippin Davis
- Department of Research and Development, Ambry Genetics, Aliso Viejo, CA, United States
| | - Rachid Karam
- Translational Genomics Laboratory, Ambry Genetics, Aliso Viejo, CA, United States
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46
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Balagani KS, Gasti P, Elliott A, Richardson A, O’Neal M. The impact of application context on privacy and performance of keystroke authentication systems. JCS 2018. [DOI: 10.3233/jcs-171017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Kiran S. Balagani
- Department of Computer Science, New York Institute of Technology, NY, USA. E-mails: ,
| | - Paolo Gasti
- Department of Computer Science, New York Institute of Technology, NY, USA. E-mails: ,
| | | | - Azriel Richardson
- Department of Computer Science, Louisiana Tech University, LA, USA. E-mails: ,
| | - Mike O’Neal
- Department of Computer Science, Louisiana Tech University, LA, USA. E-mails: ,
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47
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Elliott A, Verdicchio CV, Gallagher C, Munawar DA, Linz D, Stokes MB, Middeldorp ME, Mahajan R, Lau DH, Sanders P. P1188Exercise Intolerance in AF Patients: A consequence of rhythm status or myocardial impairment? Europace 2018. [DOI: 10.1093/europace/euy015.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Elliott
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - C V Verdicchio
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - C Gallagher
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D A Munawar
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Linz
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M B Stokes
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M E Middeldorp
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D H Lau
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
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48
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Linz D, Kadhim K, Elliott A, Brooks A, Hendriks JMLH, Lau DH, Mcevoy DH, Hohl M, Baumert M, Sanders P. 1007Diagnostic accuracy of overnight oximetry for the diagnosis of sleep-disordered breathing in atrial fibrillation patients. Europace 2018. [DOI: 10.1093/europace/euy015.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Linz
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - K Kadhim
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Brooks
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - JMLH Hendriks
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D H Lau
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D H Mcevoy
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M Hohl
- Saarland University Hospital, Department of Internal Medicine III, Cardiology, Homburg, Germany
| | - M Baumert
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- South Australian Health and Medical Research Institute, Centre for Heart Rhythm Disorders, Adelaide, Australia
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49
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Agbaedeng TA, Mahajan R, Thanigaimani S, Elliott A, Mclennan E, Lau DH, Sanders P. 589Ventricular structural remodelling in an ovine sheep model of sustained weight gain: Potential role of desmoglein-2 in fibro-fatty replacement and arrhythmogenicity. Europace 2018. [DOI: 10.1093/europace/euy015.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T A Agbaedeng
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - S Thanigaimani
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - E Mclennan
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D H Lau
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Department of Medicine, Centre for Heart Rhythm Disorders, Adelaide, Australia
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50
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Verdicchio C, Elliott A, Mahajan R, Gallagher C, Middeldorp M, Linz D, Lau D, Sanders P. P1189Use of heart rate to guide exercise training intensity in patients with atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Verdicchio
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - A Elliott
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - R Mahajan
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - C Gallagher
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - M Middeldorp
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Linz
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - D Lau
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
| | - P Sanders
- University of Adelaide, Centre for Heart Rhythm Disorders, Adelaide, Australia
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