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Szwast A, Penney C, Sharma P, Rychik J. Role of maternal hyperoxygenation testing to predict need for balloon atrial septostomy in fetal d-transposition of great arteries. Ultrasound Obstet Gynecol 2024. [PMID: 38642340 DOI: 10.1002/uog.27664] [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] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES Predicting whether balloon atrial septostomy (BAS) will be necessary after birth for fetuses with d-transposition of the great arteries (d-TGA) remains challenging. We sought to determine whether measurements obtained during fetal maternal hyperoxygenation (MH) testing can improve our ability to predict need for postnatal BAS. METHODS Forty-one mothers carrying fetuses with d-TGA with either intact ventricular septum or small ventricular septal defect measuring <3mm underwent MH testing between 33-38 weeks gestation. Patent foramen ovale (PFO) size, measured by 2D and color Doppler, patent ductus arteriosus (PDA) shunting (all antegrade versus bidirectional) was assessed in room air (RA) and during MH, blinded to postnatal outcome. BAS status and timing were recorded. RESULTS Postnatally, 23 neonates underwent BAS while 18 did not, and 14 subjects underwent emergent BAS within 3 hours of life. By univariate analysis, PFO size measured both in RA and MH and all antegrade shunting in the PDA during MH predicted BAS. During MH testing, median PFO size by 2D measured 2.5mm (interquartile range, IQR, 2-3mm) in fetuses who underwent emergent BAS versus 4.1mm (IQR 3.4-5mm) in fetuses who did not undergo BAS (p<0.001). By cutpoint analysis, PFO size during MH testing ≤ 3.2mm predicted need for emergent BAS with sensitivity 93% and specificity 78%. CONCLUSIONS In d-TGA, measurement of PFO size and direction of PDA shunting during MH testing improves our ability to predict need for BAS postnatally, although additional study is needed. We propose incorporating third trimester MH testing when planning deliveries of d-TGA fetuses. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- A Szwast
- Fetal Heart Program, Division of Pediatric Cardiology, Children's Hospital of Philadelphia, and the University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - C Penney
- Data Science and Biostatics Unit, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - P Sharma
- Data Science and Biostatics Unit, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - J Rychik
- Fetal Heart Program, Division of Pediatric Cardiology, Children's Hospital of Philadelphia, and the University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Bilyaz S, Bhati A, Hamalian M, Maynor K, Soori T, Gattozzi A, Penney C, Weeks D, Xu Y, Hu L, Zhu J, Nelson J, Hebner R, Bahadur V. Modeling the impact of high thermal conductivity paper on the performance and life of power transformers. Heliyon 2024; 10:e27783. [PMID: 38524528 PMCID: PMC10958363 DOI: 10.1016/j.heliyon.2024.e27783] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
Degradation of insulation paper is a key contributor to the failure of power transformers. Insulation degradation accelerates at elevated temperatures, which highlights the potential for better thermal management to prolong life. While several studies have analyzed the benefits of high thermal conductivity oil for reducing temperatures inside a transformer, this study is an initial assessment of the benefits of high thermal conductivity paper on transformer life. Blending particulates with cellulosic fibers offers a pathway for high thermal conductivity paper (with good dielectric properties), which can reduce internal temperatures. Presently, life extensions that can be achieved by the use of such thermally conducting papers were estimated, with the thermal conductivity of the paper being the key parameter under study. The analytical-numerical thermal model used in this study was validated against experimental measurements in a distribution transformer, adding confidence to the utility of the model. This model was then used to provide estimates of hot-spot temperature reduction resulting from the use of papers with higher thermal conductivity than baseline. Transformer life was predicted conventionally by tracking the degree of polymerization of paper over time, based on an Arrhenius model. Results indicate that increasing the thermal conductivity of paper from 0.2 W/mK (baseline) to 1 W/mK reduces the hot spot temperature by 10 °C. While degradation significantly depends on the moisture and oxygen content, the model shows that such a temperature reduction can increase life for all conditions, by as much as a factor of three.
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Affiliation(s)
- S. Bilyaz
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - A. Bhati
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - M. Hamalian
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - K. Maynor
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - T. Soori
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
| | - A. Gattozzi
- Center for Electromechanics, The University of Texas at Austin, Austin, TX, 78712, USA
| | - C. Penney
- Center for Electromechanics, The University of Texas at Austin, Austin, TX, 78712, USA
| | - D. Weeks
- Center for Electromechanics, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Y. Xu
- Center for Electromechanics, The University of Texas at Austin, Austin, TX, 78712, USA
| | - L. Hu
- Materials Science and Engineering, University of Maryland, College Park, MD, 20742, USA
| | - J.Y. Zhu
- USDA Forest Products Lab, Madison, WI, 53726, USA
| | - J.K. Nelson
- Department of Electrical, Computer and Systems Engineering, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - R. Hebner
- Center for Electromechanics, The University of Texas at Austin, Austin, TX, 78712, USA
| | - V. Bahadur
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA
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Singh S, Penney C, Griffin A, Woodland G, Werdyani S, Benteau TA, Abdelfatah N, Squires J, King B, Houston J, Dyer MJ, Roslin NM, Vincent D, Marquis P, O'Rielly DD, Hodgkinson K, Burt T, Baker A, Stanton SG, Young TL. Highly variable hearing loss due to POU4F3 (c.37del) is revealed by longitudinal, frequency specific analyses. Eur J Hum Genet 2023:10.1038/s41431-023-01358-0. [PMID: 37072551 DOI: 10.1038/s41431-023-01358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
Genotype-phenotype correlations add value to the management of families with hereditary hearing loss (HL), where age-related typical audiograms (ARTAs) are generated from cross-sectional regression equations and used to predict the audiogram phenotype across the lifespan. A seven-generation kindred with autosomal dominant sensorineural HL (ADSNHL) was recruited and a novel pathogenic variant in POU4F3 (c.37del) was identified by combining linkage analysis with whole exome sequencing (WES). POU4F3 is noted for large intrafamilial variation including the age of onset of HL, audiogram configuration and presence of vestibular impairment. Sequential audiograms and longitudinal analyses reveal highly variable audiogram features among POU4F3 (c.37del) carriers, limiting the utility of ARTAs for clinical prognosis and management of HL. Furthermore, a comparison of ARTAs against three previously published families (1 Israeli Jewish, 2 Dutch) reveals significant interfamilial differences, with earlier onset and slower deterioration. This is the first published report of a North American family with ADSNHL due to POU4F3, the first report of the pathogenic c.37del variant, and the first study to conduct longitudinal analysis, extending the phenotypic spectrum of DFNA15.
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Affiliation(s)
- Sushma Singh
- Communication Sciences and Disorders and National Centre for Audiology, Western University, Elborn College, 1201 Western Road, London, ON, Canada
| | - Cindy Penney
- Centre for Translational Genomics, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, Canada
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Anne Griffin
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Geoffrey Woodland
- Centre for Translational Genomics, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Salem Werdyani
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Tammy A Benteau
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Nelly Abdelfatah
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Jessica Squires
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | | | - Jim Houston
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Matthew J Dyer
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Nicole M Roslin
- The Centre for Applied Genomics, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, Canada
| | - Daniel Vincent
- Canadian Centre for Computational Genomics, McGill University, 740 Dr. Penfield Avenue, Montréal, QC, Canada
| | - Pascale Marquis
- Canadian Centre for Computational Genomics, McGill University, 740 Dr. Penfield Avenue, Montréal, QC, Canada
| | - Darren D O'Rielly
- Centre for Translational Genomics, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Kathy Hodgkinson
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Taylor Burt
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Ashley Baker
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada
| | - Susan G Stanton
- Communication Sciences and Disorders and National Centre for Audiology, Western University, Elborn College, 1201 Western Road, London, ON, Canada
| | - Terry-Lynn Young
- Communication Sciences and Disorders and National Centre for Audiology, Western University, Elborn College, 1201 Western Road, London, ON, Canada.
- Centre for Translational Genomics, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, Canada.
- Faculty of Medicine, Health Sciences Centre, Memorial University, 300 Prince Philip Drive, St. John's, NL, Canada.
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4
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Pater JA, Penney C, O'Rielly DD, Griffin A, Kamal L, Brownstein Z, Vona B, Vinkler C, Shohat M, Barel O, French CR, Singh S, Werdyani S, Burt T, Abdelfatah N, Houston J, Doucette LP, Squires J, Glaser F, Roslin NM, Vincent D, Marquis P, Woodland G, Benoukraf T, Hawkey-Noble A, Avraham KB, Stanton SG, Young TL. Autosomal dominant non-syndromic hearing loss maps to DFNA33 (13q34) and co-segregates with splice and frameshift variants in ATP11A, a phospholipid flippase gene. Hum Genet 2022; 141:431-444. [PMID: 35278131 PMCID: PMC9035003 DOI: 10.1007/s00439-022-02444-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 02/22/2022] [Indexed: 11/20/2022]
Abstract
Sequencing exomes/genomes have been successful for identifying recessive genes; however, discovery of dominant genes including deafness genes (DFNA) remains challenging. We report a new DFNA gene, ATP11A, in a Newfoundland family with a variable form of bilateral sensorineural hearing loss (SNHL). Genome-wide SNP genotyping linked SNHL to DFNA33 (LOD = 4.77), a locus on 13q34 previously mapped in a German family with variable SNHL. Whole-genome sequencing identified 51 unremarkable positional variants on 13q34. Continuous clinical ascertainment identified several key recombination events and reduced the disease interval to 769 kb, excluding all but one variant. ATP11A (NC_000013.11: chr13:113534963G>A) is a novel variant predicted to be a cryptic donor splice site. RNA studies verified in silico predictions, revealing the retention of 153 bp of intron in the 3' UTR of several ATP11A isoforms. Two unresolved families from Israel were subsequently identified with a similar, variable form of SNHL and a novel duplication (NM_032189.3:c.3322_3327+2dupGTCCAGGT) in exon 28 of ATP11A extended exon 28 by 8 bp, leading to a frameshift and premature stop codon (p.Asn1110Valfs43Ter). ATP11A is a type of P4-ATPase that transports (flip) phospholipids from the outer to inner leaflet of cell membranes to maintain asymmetry. Haploinsufficiency of ATP11A, the phospholipid flippase that specially transports phosphatidylserine (PS) and phosphatidylethanolamine (PE), could leave cells with PS/PE at the extracellular side vulnerable to phagocytic degradation. Given that surface PS can be pharmaceutically targeted, hearing loss due to ATP11A could potentially be treated. It is also likely that ATP11A is the gene underlying DFNA33.
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Affiliation(s)
- Justin A Pater
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Cindy Penney
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
- Centre for Translational Genomics, Memorial University, 300 Prince Phillip Dr., St. John's, NL, Canada
| | - Darren D O'Rielly
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
- Centre for Translational Genomics, Memorial University, 300 Prince Phillip Dr., St. John's, NL, Canada
| | - Anne Griffin
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Lara Kamal
- Department of Human Molecular Genetics and Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Zippora Brownstein
- Department of Human Molecular Genetics and Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Barbara Vona
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Chana Vinkler
- Institute of Medical Genetics, Wolfson Medical Center, 58100, Holon, Israel
| | - Mordechai Shohat
- Bioinformatic Center, Cancer Research Institute, The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ortal Barel
- Bioinformatic Center, Cancer Research Institute, The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Curtis R French
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Sushma Singh
- Communication Sciences and Disorders, Elborn College, Western University, 1201 Western Road, London, ON, Canada
| | - Salem Werdyani
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Taylor Burt
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Nelly Abdelfatah
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Jim Houston
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Lance P Doucette
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Jessica Squires
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Fabian Glaser
- The Lorry I. Lokey Center for Life Sciences and Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nicole M Roslin
- The Centre for Applied Genomics, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, Canada
| | - Daniel Vincent
- Genome Quebec Innovation Centre, McGill University, 740 Dr. Penfield Avenue, Montreal, QC, Canada
| | - Pascale Marquis
- Canadian Centre for Computational Genomics, McGill University and Genome Quebec Innovation Center, 740 Dr. Penfield Avenue, Montreal, QC, Canada
| | - Geoffrey Woodland
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Touati Benoukraf
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Alexia Hawkey-Noble
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada
| | - Karen B Avraham
- Department of Human Molecular Genetics and Biochemistry, Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Susan G Stanton
- Communication Sciences and Disorders, Elborn College, Western University, 1201 Western Road, London, ON, Canada
| | - Terry-Lynn Young
- Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, Canada.
- Centre for Translational Genomics, Memorial University, 300 Prince Phillip Dr., St. John's, NL, Canada.
- Communication Sciences and Disorders, Elborn College, Western University, 1201 Western Road, London, ON, Canada.
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5
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Dawson LM, Smith KN, Werdyani S, Ndikumana R, Penney C, Wiede LL, Smith KL, Pater JA, MacMillan A, Green J, Drover S, Young TL, O'Rielly DD. A dominant RAD51C pathogenic splicing variant predisposes to breast and ovarian cancer in the Newfoundland population due to founder effect. Mol Genet Genomic Med 2019; 8:e1070. [PMID: 31782267 PMCID: PMC7005661 DOI: 10.1002/mgg3.1070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/29/2019] [Revised: 11/01/2019] [Accepted: 11/11/2019] [Indexed: 12/20/2022] Open
Abstract
Background RAD51C is important in DNA repair and individuals with pathogenic RAD51C variants have increased risk of hereditary breast and ovarian cancer syndrome (HBOC), an autosomal dominant genetic predisposition to early onset breast and/or ovarian cancer. Methods Five female HBOC probands sequenced negative for moderate‐ and high‐risk genes but shared a recurrent variant of uncertain significance in RAD51C (NM_058216.3: c.571 + 4A > G). Participant recruitment was followed by haplotype and case/control analyses, RNA splicing analysis, gene and protein expression assays, and Sanger sequencing of tumors. Results The RAD51C c.571 + 4A > G variant segregates with HBOC, with heterozygotes sharing a 5.07 Mbp haplotype. RAD51C c.571 + 4A > G is increased ~52‐fold in the Newfoundland population compared with the general Caucasian population and positive population controls share disease‐associated alleles, providing evidence of a founder effect. Splicing analysis confirmed in silico predictions that RAD51C c.571 + 4A > G causes exon 3 skipping, creating an immediate premature termination codon. Gene and protein expression were significantly reduced in a RAD51C c.571 + 4G > A heterozygote compared with a wild‐type relative. Sanger sequencing of tumors from two probands indicates loss‐of‐heterozygosity, suggesting loss of function. Conclusion The RAD51C c.571 + 4A > G variant affects mRNA splicing and should be re‐classified as pathogenic according to American College of Medical Genetics and Genomics guidelines.
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Affiliation(s)
- Lesa M Dawson
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,Eastern Health Authority, St. John's, NL, Canada
| | - Kerri N Smith
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Salem Werdyani
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Robyn Ndikumana
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Cindy Penney
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Louisa L Wiede
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Kendra L Smith
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Justin A Pater
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | - Jane Green
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Sheila Drover
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Terry-Lynn Young
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,Eastern Health Authority, St. John's, NL, Canada.,Centre for Translational Genomics, St. John's, NL, Canada
| | - Darren D O'Rielly
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,Eastern Health Authority, St. John's, NL, Canada.,Centre for Translational Genomics, St. John's, NL, Canada
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6
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Hughes J, Penney C, Boyd S, Daley P. Risk of bias and limits of reporting in diagnostic accuracy studies for commercial point-of-care tests for respiratory pathogens. Epidemiol Infect 2018; 146:747-756. [PMID: 29560838 PMCID: PMC9134360 DOI: 10.1017/s0950268818000596] [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: 10/10/2017] [Revised: 01/25/2018] [Accepted: 02/20/2018] [Indexed: 11/06/2022] Open
Abstract
Commercial point-of-care (POC) diagnostic tests for Group A Streptococcus, Streptococcus pneumoniae, and influenza virus have large potential diagnostic and financial impact. Many published reports on test performance, often funded by diagnostics companies, are prone to bias. The Standards for Reporting of Diagnostic Accuracy (STARD 2015) are a protocol to encourage accurate, transparent reporting. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool evaluates risk of bias and transportability of results. We used these tools to evaluate diagnostic test accuracy studies of POC studies for three respiratory pathogens. For the 96 studies analysed, compliance was <25% for 14/34 STARD 2015 standards, and 3/7 QUADAS-2 domains showed a high risk of bias. All reports lacked reporting of at least one criterion. These biases should be considered in the interpretation of study results.
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Affiliation(s)
- J.M. Hughes
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - C. Penney
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - S. Boyd
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - P. Daley
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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7
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Affiliation(s)
- D C Benton
- National Council of State Boards of Nursing, Chicago, IL, USA
| | - L Cusack
- Adelaide Nursing School, The University of Adelaide, Adelaide, SA, Australia
| | - R Jabbour
- College of Nurses of Ontario, Toronto, ON, Canada
| | - C Penney
- Policy, Practice and Quality Assurance, College of Registered Nurses of British Columbia, Vancouver, BC, Canada
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8
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Pater JA, Benteau T, Griffin A, Penney C, Stanton SG, Predham S, Kielley B, Squires J, Zhou J, Li Q, Abdelfatah N, O'Rielly DD, Young TL. A common variant in CLDN14 causes precipitous, prelingual sensorineural hearing loss in multiple families due to founder effect. Hum Genet 2016; 136:107-118. [PMID: 27838790 PMCID: PMC5215284 DOI: 10.1007/s00439-016-1746-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 08/09/2016] [Accepted: 11/07/2016] [Indexed: 12/16/2022]
Abstract
Genetic isolates provide unprecedented opportunities to identify pathogenic mutations and explore the full natural history of clinically heterogeneous phenotypes such as hearing loss. We noticed a unique audioprofile, characterized by prelingual and rapid deterioration of hearing thresholds at frequencies >0.5 kHz in several adults from unrelated families from the island population of Newfoundland. Targeted serial Sanger sequencing of probands for deafness alleles (n = 23) that we previously identified in this founder population was negative. Whole exome sequencing in four members of the largest family (R2010) identified a CLDN14 (DFNB29) variant [c.488C>T; p. (Ala163Val)], likely pathogenic, sensorineural hearing loss, autosomal recessive. Although not associated with deafness or disease, CLDN14 p.(Ala163Val) has been previously reported as a variant of uncertain significance (VUS). Targeted sequencing of 169 deafness probands identified one homozygote and one heterozygous carrier. Genealogical studies, cascade sequencing and haplotype analysis across four unrelated families showed all subjects with the unique audioprofile (n = 12) were also homozygous for p.(Ala163Val) and shared a 1.4 Mb DFNB29-associated haplotype on chromosome 21. Most significantly, sequencing 175 population controls revealed 1% of the population are heterozygous for CLDN14 p.(Ala163Val), consistent with a major founder effect in Newfoundland. The youngest CLDN14 [c.488C>T; p.(Ala163Val)] homozygote passed newborn screening and had normal hearing thresholds up to 3 years of age, which then deteriorated to a precipitous loss >1 kHz during the first decade. Our study suggests that genetic testing may be necessary to identify at-risk children in time to prevent speech, language and developmental delay.
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Affiliation(s)
- Justin A Pater
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Tammy Benteau
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Anne Griffin
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Cindy Penney
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Susan G Stanton
- Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada
| | - Sarah Predham
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Bernadine Kielley
- Department of Education and Early Childhood Development, Government of Newfoundland and Labrador, St. John's, NL, A1B 4J6, Canada
| | - Jessica Squires
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Jiayi Zhou
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Quan Li
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Nelly Abdelfatah
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Darren D O'Rielly
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada.,Molecular Diagnostic Laboratory, Eastern Health, Craig L. Dobbin Genetics Research Centre, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Terry-Lynn Young
- Craig L. Dobbin Genetics Research Centre, Discipline of Genetics, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada. .,Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada. .,Molecular Diagnostic Laboratory, Eastern Health, Craig L. Dobbin Genetics Research Centre, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada.
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9
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Abstract
Background: The recent British Clinical Standards Advisory Group report on back pain highlighted the importance of primary care in the active management of acute back pain and, at the same time, recommended the establishment of rehabilitation services for those with subacute and chronic back pain. Objective: To describe a new Back Management Service (BMS) in Exeter and to review the first year's results. Methods: Analysis of observational data collected from the clinic and therapy database. Assessments: Clinic outcome assessed by diagnostic and referral patterns as well as by general practitioner questionnaire. The Back Management Programme was assessed by Short Form 36 (SF36), Hospital Anxiety and Depression score (HAD) and Oswestry Disability Index (ODI). Results: In the first year 297 patients were seen in the clinic; clinic triage resulted in confirmation of primary care diagnosis in 235 (79%) of patients, with diagnosis revised in 62 (21%). One hundred and eighty-nine (63.6%) patients were referred for therapy. Of these, 54 were referred for one-to-one therapy and 135 were referred for multidisciplinary review with 29 patients subsequently recruited into the Back Management Programme for rehabilitation. Two out of three outcome measures were significantly improved at the end of the 36-hour, four-week course. Conclusions: A Back Management Service can provide useful diagnostic reassessment of patients with chronic low back pain, and can focus therapeutic effort for the effective management of their pain.
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Affiliation(s)
| | | | | | - C Penney
- Royal Devon and Exeter Healthcare NHS Trust, Exeter, UK
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10
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Abstract
A polysaccharide, chitosan, was chemically modified to form a polyelectrolyte complex membrane with calcium alginate beads. A key factor in membrane for mation was found to be the viscosity average molecular weight (M v) of the chitosan. While unmodified chitosan (Mv = 12.1 x 105) formed thin and weak microcapsule membranes, when the Mv of the chitosan was reduced to 2.4 x 105, the polymer exhibited optimum membrane forming characteristics in terms of capsule strength and flexibility. The degree of deacetylation of chi tosan varied from 94.3% for the unmodified polymer to 93.2% for chitosan of Mv = 1.6 × 105. A substitution reaction sequence was developed in an attempt to modify the pendant amine of the practical grade polysaccharide. Reactive groups were coupled to the chitosan main chain following a two-step process; activation with a bromoacetyl halide and termination with a diamine [(NH2 (CH2)nNH2)] or methyl containing amine compound. Initial studies indicated that thin capsule membranes formed regardless of application of reaction se quence, distance of reactive groups from the main chain, or type of reactive group inserted. The permeability of the chitosan-alginate capsules was assessed, with various diffusing proteins. Membranes formed with chitosan Mv =0.5 × 106 excluded beta amylase, suggesting a membrane molecular weight cut-off of approximately 200,000.
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Affiliation(s)
- C.A. Mcknight
- Dept. of Chemical Engineering Queen's University Kingston, Ontario, Canada K7L 3N6
| | - A. Ku
- Dept. of Chemical Engineering Queen's University Kingston, Ontario, Canada K7L 3N6
| | - M.F.A. Goosen
- Dept. of Chemical Engineering Queen's University Kingston, Ontario, Canada K7L 3N6
| | - D. Sun
- Dept. of Applied Chemistry Tianjin University P.R.C
| | - C. Penney
- IAF Biochem International Inc. Laval, Quebec, Canada H7V 1B7
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11
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Kanlaya R, Sintiprungrat K, Thongboonkerd V, Torremade N, Bindels R, Hoenderop J, Fernandez E, Dusso A, Valdivielso JM, Krueger T, Boor P, Schafer C, Westenfeld R, Brandenburg V, Schlieper G, Jahnen-Dechent W, Ketteler M, Jee W, Li X, Richards B, Floege J, Goncalves JG, Canale D, de Braganca AC, Shimizu MHM, Moyses RMA, Andrade L, Seguro AC, Volpini RA, Romoli S, Migliorini A, Anders HJ, Eskova O, Neprintseva N, Tchebotareva N, Bobkova I, Kozlovskaya L, Simic I, Tabatabaeifar M, Wlodkowski T, Denc H, Mollet G, Antignac C, Schaefer F, Ekaterina IA, Giardino L, Rastaldi MP, Van den Heuvel L, Levtchenko E, Okina C, Okamoto T, Kamata M, Murano J, Kobayashi K, Takeuchi K, Kamata F, Sakai T, Naito S, Aoyama T, Sano T, Takeuchi Y, Kamata K, Thomasova D, Bruns HA, Liapis H, Anders HJ, Iwashita T, Hasegawa H, Takayanagi K, Shimizu T, Asakura J, Okazaki S, Kogure Y, Hatano M, Hara H, Inamura M, Iwanaga M, Mitani T, Mitarai T, Savin VJ, Sharma M, Wei C, Reiser J, McCarthy ET, Sharma R, Gauchat JF, Eneman B, Freson K, Van den Heuvel L, Van Geet C, Levtchenko E, Choi DE, Jeong JY, Chang YK, Na KR, Lee KW, Shin YT, Ni HF, Chen JF, Zhang MH, Pan MM, Liu BC, Lee KW, Jeong JY, Choi DE, Chang YK, Kim SS, Na KR, Shin YT, Suzuki T, Iyoda M, Matsumoto K, Shindo-Hirai Y, Kuno Y, Wada Y, Yamamoto Y, Shibata T, Akizawa T, Munoz-Felix JM, Lopez-Novoa JM, Martinez-Salgado C, Ehling J, Babickova J, Gremse F, Kiessling F, Floege J, Lammers T, Boor P, Lech M, Gunthner R, Lorenz G, Ryu M, Grobmayr R, Susanti H, Kobayashi KS, Flavell RA, Anders HJ, Rayego-Mateos S, Morgado J, Sanz AB, Eguchi S, Pato J, Keri G, Egido J, Ortiz A, Ruiz-Ortega M, Leduc M, Geerts L, Grouix B, Sarra-Bournet F, Felton A, Gervais L, Abbott S, Duceppe JS, Zacharie B, Penney C, Laurin P, Gagnon L, Detsika MG, Duann P, Lianos EA, Leong KI, Chiang CK, Yang CC, Wu CT, Chen LP, Hung KY, Liu SH, Carvalho FF, Teixeira VP, Almeida WS, Schor N, Small DM, Bennett NC, Coombes J, Johnson DW, Gobe GC, Montero N, Prada A, Riera M, Orfila M, Pascual J, Rodriguez E, Barrios C, Kokeny G, Fazekas K, Rosivall L, Mozes MM, Munoz-Felix JM, Lopez-Novoa JM, Martinez-Salgado C, Hornigold N, Hughes J, Mooney A, Benardeau A, Riboulet W, Vandjour A, Jacobsen B, Apfel C, Conde-Knape K, Grouix B, Felton A, Sarra-Bournet F, Leduc M, Geerts L, Gervais L, Abbott S, Bienvenu JF, Duceppe JS, Zacharie B, Penney C, Laurin P, Gagnon L, Tanaka T, Yamaguchi J, Nangaku M, Niwa T, Bolati D, Shimizu H, Yisireyili M, Nishijima F, Brocca A, Virzi G, de Cal M, Ronco C, Priante G, Musacchio E, Valvason C, Sartori L, Piccoli A, Baggio B, Boor P, Perkuhn M, Weibrecht M, Zok S, Martin IV, Schoth F, Ostendorf T, Kuhl C, Floege J, Karabaeva A, Essaian A, Beresneva O, Parastaeva M, Kayukov I, Smirnov A, Audzeyenka I, Kasztan M, Piwkowska A, Rogacka D, Angielski S, Jankowski M, Bockmeyer CL, Kokowicz K, Agustian PA, Zell S, Wittig J, Becker JU, Nishizono R, Venkatareddy MP, Chowdhury MA, Wang SQ, Fukuda A, Wickman LT, Yang Y, Wiggins RC, Fazio MR, Donato V, Lucisano S, Cernaro V, Lupica R, Trimboli D, Montalto G, Aloisi C, Mazzeo AT, Buemi M, Gawrys O, Olszynski KH, Kuczeriszka M, Gawarecka K, Swiezewska E, Chmielewski M, Masnyk M, Rafalowska J, Kompanowska-Jezierska E, Lee WC, Chau YY, Lee LC, Chiu CH, Lee CT, Chen JB, Kim WK, Shin SJ. Experimental models of CKD. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft114] [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: 11/12/2022] Open
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12
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Tjepkema M, Wilkins R, Senécal S, Guimond E, Penney C. Mortality of urban Aboriginal adults in Canada, 1991-2001. Prev Chronic Dis 2011; 8:A06. [PMID: 21159218 PMCID: PMC3044017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare mortality patterns for urban Aboriginal adults with those of urban non-Aboriginal adults. METHODS Using the 1991-2001 Canadian census mortality follow-up study, our study tracked mortality to December 31, 2001, among a 15% sample of adults, including 16 300 Aboriginal and 2 062 700 non-Aboriginal persons residing in urban areas on June 4, 1991. The Aboriginal population was defined by ethnic origin (ancestry), Registered Indian status and/or membership in an Indian band or First Nation, since the 1991 census did not collect information on Aboriginal identity. RESULTS Compared to urban non-Aboriginal men and women, remaining life expectancy at age 25 years was 4.7 years and 6.5 years shorter for urban Aboriginal men and women, respectively. Mortality rate ratios for urban Aboriginal men and women were particularly elevated for alcohol-related deaths, motor vehicle accidents and infectious diseases, including HIV/AIDS. For most causes of death, urban Aboriginal adults had higher mortality rates compared to other urban residents. Socio-economic status played an important role in explaining these disparities. CONCLUSION Results from this study help fill a data gap on mortality information of urban Aboriginal people of Canada.
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Affiliation(s)
- M Tjepkema
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada.
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13
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Tjepkema M, Wilkins R, Senécal S, Guimond E, Penney C. Mortality of urban Aboriginal adults in Canada, 1991-2001. Chronic Dis Can 2010; 31:4-21. [PMID: 21176411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To compare mortality patterns for urban Aboriginal adults with those of urban non-Aboriginal adults. METHODS Using the 1991-2001 Canadian census mortality follow-up study, our study tracked mortality to December 31, 2001, among a 15% sample of adults, including 16 300 Aboriginal and 2 062 700 non-Aboriginal persons residing in urban areas on June 4, 1991. The Aboriginal population was defined by ethnic origin (ancestry), Registered Indian status and/or membership in an Indian band or First Nation, since the 1991 census did not collect information on Aboriginal identity. RESULTS Compared to urban non-Aboriginal men and women, remaining life expectancy at age 25 years was 4.7 years and 6.5 years shorter for urban Aboriginal men and women, respectively. Mortality rate ratios for urban Aboriginal men and women were particularly elevated for alcohol-related deaths, motor vehicle accidents and infectious diseases, including HIV/AIDS. For most causes of death, urban Aboriginal adults had higher mortality rates compared to other urban residents. Socio-economic status played an important role in explaining these disparities. CONCLUSION Results from this study help fill a data gap on mortality information of urban Aboriginal people of Canada.
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Affiliation(s)
- M Tjepkema
- Health Analysis Division, Statistics Canada, Ottawa, Ontario.
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14
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Kadhim S, Penney C, Lagraoui M, Heibein J, Attardo G, Zacharie B, Connolly T, Gagnon L. Synergistic anti-tumor activity of a novel immunomodulator, BCH-1393, in combination with cyclophosphamide. Int J Immunopharmacol 2000; 22:659-71. [PMID: 10884587 DOI: 10.1016/s0192-0561(00)00028-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
N,N-dimethylaminopurine pentoxycarbonyl D-arginine (BCH-1393) is a novel low molecular weight synthetic immunomodulator that has been shown to significantly stimulate cytotoxic T-lymphocyte responses both in vitro and in vivo (Zacharie B, Gagnon L, Attardo G, Connolly TP, St-Denis Y, Penney CL. Synthesis and activity of 6-substituted purine linker amine immunostimulants. J. Med. Chem. 1997;40:2883-94). Prompted by this evidence, we extended evaluation of BCH-1393 for anticancer activity in syngeneic mouse experimental tumor models. Consistent with previous findings, in vitro assessment of BCH-1393 activity demonstrated a significant increase in the CTL responses in the range of 10(-9)-10(-5) M. Treatment of mice with four consecutive daily intraperitoneal injections at 25 and 50 mg/kg resulted in a significant increase of the relative percentage of blood CD4+, CD8+, NK and monocyte subsets without any evidence of toxicity. In vivo anti-tumor activity of BCH-1393 was evaluated, either alone or in combination with subtherapeutic doses of cyclophosphamide (Cy), against weakly immunogenic mouse breast carcinoma DA-3 and strongly immunogenic colon adenocarcinoma MC38. Daily intraperitoneal injection of BCH-1393 at 50 mg/kg alone was well tolerated but produced a relatively weak anti-tumor effect in both tumor models. However, a significant inhibition of tumor outgrowth and suppression of established tumor growth was observed when BCH-1393 was administered in combination with subtherapeutic doses of Cy. Combination treatment of 50 mg/kg BCH-1393 with 100 mg/kg Cy (given as single intravenous bolus injection) starting 2 days prior to DA-3 tumor cell inoculation prevented tumor outgrowth in 70-80% of treated mice. In the remaining 20-30% of mice that had developed tumors, a nearly complete (90%) tumor growth inhibition was observed at days 22-24 post tumor implant. In the MC38 tumor model, combination treatment of established tumors with BCH-1393 and Cy (CTX) at 50 mg/kg resulted in a significant delay in tumor growth compared to CTX treatment alone. The observed concomitant anti-tumor activity of BCH-1393 with cyclophosphamide warrants further investigation of this immunomodulator as an adjunctive treatment of cancer.
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MESH Headings
- Adjuvants, Immunologic/pharmacology
- Adjuvants, Immunologic/therapeutic use
- Animals
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Arginine/analogs & derivatives
- Arginine/pharmacology
- Arginine/therapeutic use
- CD4-Positive T-Lymphocytes/drug effects
- Colonic Neoplasms/drug therapy
- Colonic Neoplasms/immunology
- Cyclophosphamide/pharmacology
- Cyclophosphamide/therapeutic use
- Cytotoxicity Tests, Immunologic
- Drug Evaluation, Preclinical
- Drug Synergism
- Female
- Immunophenotyping
- Immunosuppressive Agents/pharmacology
- Immunosuppressive Agents/therapeutic use
- Killer Cells, Natural/drug effects
- Mammary Neoplasms, Experimental/drug therapy
- Mammary Neoplasms, Experimental/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Monocytes/drug effects
- Purines/pharmacology
- Purines/therapeutic use
- T-Lymphocytes, Cytotoxic/drug effects
- T-Lymphocytes, Cytotoxic/immunology
- Time Factors
- Tumor Cells, Cultured
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Affiliation(s)
- S Kadhim
- BiochemPharma Inc., Que., Laval, Canada
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15
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Yan G, Schoenfeld D, Penney C, Hurxthal K, Taylor AE, Faustman D. Identification of premature ovarian failure patients with underlying autoimmunity. J Womens Health Gend Based Med 2000; 9:275-87. [PMID: 10787223 DOI: 10.1089/152460900318461] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although known causes of premature ovarian failure (POF) include X chromosome deletions, radiation and chemotherapy, and genetic defects of the gonadotropin hormones or receptors, at least one third to one half of cases remain idiopathic. A significant proportion of patients with apparently idiopathic POF have some evidence for an autoimmune etiology. However, the only gold standard for detecting autoimmune causes of immune ovarian destruction has been invasive ovarian biopsy. Serum antibodies to ovarian and other self-tissue have been described in up to one third of women with POF, but the tests are not well standardized, not well correlated with ovarian histology, and highly variable. Recently, specific defects of expression of cell surface markers on peripheral blood lymphocytes have been shown to identify, in population-based studies, individuals destined to develop autoimmune pancreatic destruction and type I diabetes mellitus, even before any other evidence of autoimmunity. We, therefore, sought to test the ability of cell surface marker expression in women with POF to identify autoimmune defects. Seventeen women with POF, 11 of whom had positive antibody titers to ovary, thyroid, or antinuclear antibody, were studied on at least two occasions and compared in blinded fashion with normal controls and patients with autoimmune type I diabetes mellitus. The most useful marker for identifying autoimmunity was the surface density of conformationally correct HLA class I molecules on macrophages, a structure essential for T cell education. Using this marker, 7 of the 9 patients with autoantibodies and 3 of the 8 patients without autoantibodies were identified as having evidence of a defect in self-antigen presentation similar to that of type I diabetics (chi-square, p = 0.03). Subsequent testing identified antismooth muscle antibodies in 1 of the women with a defect of HLA class I molecules but no previously identified autoimmunity. In addition, there were increased numbers of CD8 T cells in both autoimmune POF and insulin-dependent diabetes mellitus (IDDM) patients. Exclusive to POF patients was a statistically significant increase in CD8 density on T cells. This was most prominent in POF patients with an underlying autoimmune etiology. These data further support a role for autoimmunity in POF patients and suggest that the further development of cell surface markers in combination with other diagnostic tests could result in diagnosis before the development of complete ovarian failure. The possibility for disease-specific therapy to prevent further autoimmune ovarian damage in selected POF patients is also envisioned.
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Affiliation(s)
- G Yan
- Immunobiology Laboratory, Massachusetts General Hospital-East, Charlestown, USA
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16
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Abstract
The Miller-Dieker syndrome (type I lissencephaly) is a neuronal migration disorder which is associated with microdeletions in the short arm of chromosome 17. Neurofibromatosis type I (NF1) is an autosomal dominant condition associated with mutations in the long arm of chromosome 17, and characterised by neurofibromas, café-au-lait spots and axillary freckling. The neonatal period for a female infant born at 39 weeks gestation by emergency Caesarean section was complicated by frequent epileptic seizures as well as hypotonia. A computed tomography scan revealed evidence of lissencephaly, and chromosomal analysis showed a microdeletion on the short arm of chromosome 17 (17p13.3), confirming the diagnosis as Miller-Dieker syndrome. The child died at the age of 4 years and examination of the brain confirmed lissencephaly with a thickened cortex, deficient white matter, and grey matter heteropias. The mother had café-au-lait spots, and axillary freckling. In addition, the mother's and maternal grandmother's genetic analysis showed identical mutations in the neurofibromatosis I gene on the long arm of chromosome 17, confirming the diagnosis of NF1. The child did not possess the mutation. This case illustrates a rare neuronal migration disorder appearing in a child from a family with a history of NF1.
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Affiliation(s)
- A King
- Department of Neuropathology, Institute of Psychiatry, Denmark Hill, London, UK
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17
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Abstract
An intradiploic extension of a post-traumatic encephalocoele is described in an infant.
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Affiliation(s)
- R Lenthall
- Department of Radiology, King's College Hospital, Denmark Hill, London, UK
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18
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King A, Wilson H, Penney C, Michael W. An unusual case of primary leptomeningeal marginal zone B-cell lymphoma. Clin Neuropathol 1998; 17:326-9. [PMID: 9832260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Primary leptomeningeal lymphomas are rare, and usually follow a rapid clinical course with early systemic involvement. A 60-year-old woman presented with a 3-year history of worsening seizures and memory loss. Neuroimaging showed widespread meningeal calcification. After extensive investigations a meningeal biopsy revealed a low-grade B-cell lymphoma categorized as an extranodal marginal zone B-cell lymphoma, attributed to the same histological group as the MALT (mucosa-associated lymphoid tissue) lymphomas described in the stomach, thyroid, salivary glands and orbit. There was no evidence of systemic involvement. The extensive meningeal calcification would appear to be a novel finding in primary leptomeningeal lymphoma whereas the unusually long clinical history in this case is possibly related to the particular histological type of low-grade B-cell lymphoma.
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Affiliation(s)
- A King
- Department of Neuropathology, Institute of Psychiatry, London, England, UK
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19
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Abstract
BACKGROUND The recent British Clinical Standards Advisory Group report on back pain highlighted the importance of primary care in the active management of acute back pain and, at the same time, recommended the establishment of rehabilitation services for those with subacute and chronic back pain. OBJECTIVE To describe a new Back Management Service (BMS) in Exeter and to review the first year's results. METHODS Analysis of observational data collected from the clinic and therapy database. ASSESSMENTS Clinic outcome assessed by diagnostic and referral patterns as well as by general practitioner questionnaire. The Back Management Programme was assessed by Short Form 36 (SF36), Hospital Anxiety and Depression score (HAD) and Oswestry Disability Index (ODI). RESULTS In the first year 297 patients were seen in the clinic; clinic triage resulted in confirmation of primary care diagnosis in 235 (79%) of patients, with diagnosis revised in 62 (21 %). One hundred and eighty-nine (63.6%) patients were referred for therapy. Of these, 54 were referred for one-to-one therapy and 135 were referred for multidisciplinary review with 29 patients subsequently recruited into the Back Management Programme for rehabilitation. Two out of three outcome measures were significantly improved at the end of the 36-hour, four-week course. CONCLUSIONS A Back Management Service can provide useful diagnostic reassessment of patients with chronic low back pain, and can focus therapeutic effort for the effective management of their pain.
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Affiliation(s)
- S A Rae
- Royal Devon and Exeter Healthcare NHS Trust, UK
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20
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Cram E, Alpen M, Burger M, Cullen L, Halm M, Harrington C, Megivern K, Penney C, Stenger K, Titler M. Restructuring the clinical nurse specialist position to a unit-based role. J Nurs Adm 1996; 26:33-8. [PMID: 8774470 DOI: 10.1097/00005110-199604000-00011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Role restructuring can be the key to maximizing efficiency, productivity, and operational effectiveness. The clinical nurse specialist role was restructured from a divisional project focus to a unit-based design to enhance the care of specific patient populations. The authors describe the process used to make this change, the outcomes achieved, and the lessons learned.
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Affiliation(s)
- E Cram
- University of Iowa Hospitals and Clinics, Iowa City, USA
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21
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Penney C. Stearyl tyrosine. An organic equivalent of aluminum-based immunoadjuvants. Pharm Biotechnol 1995; 6:611-624. [PMID: 7551239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- C Penney
- Immunomodulator Research Project, BioChem Therapeutic, Inc., Laval, Quebec, Canada
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22
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Penney C. Innovations in gastrointestinal diseases. Practitioner 1994; 238:694-699. [PMID: 7991485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- C Penney
- Victoria Infirmary NHS Trust, Glasgow
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23
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Abstract
A simple, rapid in vitro binding assay for measuring the binding of protein preparations to slow release immunoadjuvants is described. This spectrophotometric method requires no unstable radiolabelled or enzyme reagents and replaces the more tedious and subjective indirect hemagglutination procedure. Therefore, it provides a potential supplement to in vivo animal work in adsorbed vaccine production. The assay was used to study the interaction or complexation behaviour of two adjuvants with tetanus toxoid.
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24
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