1
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Chaston TB, Knibbs LD, Morgan G, Jalaludin B, Broome R, Dennekamp M, Johnston FH, Vardoulakis S. Air pollution mortality benefits of sustained COVID-19 mobility restrictions in Australian cities. Public Health 2024; 226:152-156. [PMID: 38064778 DOI: 10.1016/j.puhe.2023.10.050] [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: 08/30/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Emissions from road traffic, power generation and industry were substantially reduced during pandemic lockdown periods globally. Thus, we analysed reductions in traffic-related air pollution in Australian capital cities during March-April 2020 and then modelled the mortality benefits that could be realised if similar reductions were sustained by structural policy interventions. STUDY DESIGN Satellite, air pollution monitor and land use observations were used to estimate ground-level nitrogen dioxide (NO2) concentrations in all Australian capital cities during: (a) a typical year with no prolonged air pollution events; (b) a hypothetical sustained reduction in NO2 equivalent to the COVID-19 lockdowns. METHODS We use the WHO recommended NO2 exposure-response coefficient for mortality (1.023, 95 % CI: 1.008-1.037, per 10 μg/m3 annual average) to assess gains in life expectancy and population-wide years of life from reduced exposure to traffic-related air pollution. RESULTS We attribute 1.1 % of deaths to anthropogenic NO2 exposures in Australian cities, corresponding to a total of 13,340 years of life lost annually. Although COVID-19-related reductions in NO2 varied widely between Australian cities during April 2020, equivalent and sustained reductions in NO2 emissions could reduce NO2-attributable deaths by 27 %, resulting in 3348 years of life gained annually. CONCLUSIONS COVID-19 mobility restrictions reduced NO2 emissions and population-wide exposures in Australian cities. When sustained to the same extent by policy interventions that reduce fossil fuel consumption by favouring the uptake of electric vehicles, active travel and public transport, the health, mortality and economic benefits will be measurable in Australian cities.
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Affiliation(s)
- T B Chaston
- Environment Protection Authority Victoria, Australia; The University of Sydney, University Centre for Rural Health, Australia; Centre for Safe Air, Australia
| | - L D Knibbs
- Public Health Unit, Sydney Local Health District, Australia; The University of Sydney, School of Public Health, Australia; Healthy Environments and Lives (HEAL) National Research Network, Australia; Centre for Safe Air, Australia
| | - G Morgan
- The University of Sydney, University Centre for Rural Health, Australia; Healthy Environments and Lives (HEAL) National Research Network, Australia; Centre for Safe Air, Australia
| | - B Jalaludin
- The University of New South Wales, Australia; Healthy Environments and Lives (HEAL) National Research Network, Australia; Centre for Safe Air, Australia
| | - R Broome
- Public Health Unit, Sydney Local Health District, Australia; Centre for Safe Air, Australia
| | - M Dennekamp
- Environment Protection Authority Victoria, Australia; Healthy Environments and Lives (HEAL) National Research Network, Australia; Centre for Safe Air, Australia
| | - F H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Australia; Healthy Environments and Lives (HEAL) National Research Network, Australia; Centre for Safe Air, Australia
| | - S Vardoulakis
- Australian National University, National Centre for Epidemiology and Population Health, Australia; Healthy Environments and Lives (HEAL) National Research Network, Australia; Centre for Safe Air, Australia.
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Howe TJ, Claireaux H, Fox H, Morgan G, McMenemy L, Masouros SD, Ramasamy A. Mechanical assessment of proprietary and improvised pelvic binders for use in the prehospital environment. BMJ Mil Health 2023:e002398. [PMID: 37541678 DOI: 10.1136/military-2023-002398] [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: 04/15/2023] [Accepted: 07/07/2023] [Indexed: 08/06/2023]
Abstract
INTRODUCTION Pelvic fractures often result from high-energy trauma and are associated with a 10% mortality rate and significant morbidity. Pelvic binders are applied in suspected pelvic injury to stabilise fractured bone, decrease bleeding and potentiate tamponade. A binder must hold the pelvis with sufficient force for this effect to be achieved. This study aims to quantify the ability of proprietary and improvised pelvic binders to hold a target tensile force over time. METHODS The ability of three proprietary and three improvised binders to hold a binding force for 2 hours was tested. A uniaxial materials testing machine was used to tension each binder to 150 N and then hold the displacement for 2 hours; the drop in tension over time was recorded for each binder. The ability to hold tension above 130 N after 2 hours was set as the metric of binder performance. RESULTS The median tension at 2 hours was above 130 N for the SAM Pelvic Sling II and T-POD Pelvic Stabilisation Device and was below 130 N for the Prometheus Pelvic Splint, field-expedient pelvic splint (FES) and the Personal Clothing System-Multi-Terrain Pattern Combat Trousers binders. The tension in the improvised FES after 2 hours was approximately at the target 130 N; however, in 40% of the tests, it held above 130 N. CONCLUSIONS Binders varied in their ability to maintain sufficient tension to treat a pelvic fracture over the 2-hour testing period. The FES performed well under our testing regime; with relatively low cost and weight, it represents a good alternative to proprietary binders for the austere environment.
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Affiliation(s)
- Thomas John Howe
- Department of Bioengineering, Imperial College London, London, UK
- Army Medical Service 16 Medical Regiment, Colchester, UK
| | - H Claireaux
- Department of Bioengineering, Imperial College London, London, UK
- Army Medical Service, Camberley, Surrey, UK
| | - H Fox
- Department of Bioengineering, Imperial College London, London, UK
| | - G Morgan
- Department of Bioengineering, Imperial College London, London, UK
| | - L McMenemy
- Department of Bioengineering, Imperial College London, London, UK
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
| | - S D Masouros
- Department of Bioengineering, Imperial College London, London, UK
| | - A Ramasamy
- Department of Bioengineering, Imperial College London, London, UK
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
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Castelo-Branco L, Morgan G, Prelaj A, Scheffler M, Canhão H, Van Meerbeeck JP, Awada A. Challenges and knowledge gaps with immune checkpoint inhibitors monotherapy in the management of patients with non-small-cell lung cancer: a survey of oncologist perceptions. ESMO Open 2023; 8:100764. [PMID: 36640544 PMCID: PMC10024152 DOI: 10.1016/j.esmoop.2022.100764] [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: 05/26/2022] [Revised: 11/13/2022] [Accepted: 12/05/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Immune checkpoint-inhibitors (ICIs) are changing outcomes in different cancer settings, notably for patients with non-small-cell lung cancer (NSCLC). There are, however, still important gaps of evidence for clinical practice when using these novel treatments. In this study, we assessed physicians' opinion and experience on challenges for clinical practice with ICIs monotherapy in NSCLC. METHODS A survey was conducted on experienced physicians treating patients with NSCLC with ICIs. Two rounds of pilot tests were carried out for validation among a group of experts. Topics under analysis were in relation to treatment of elderly populations, performance status, brain metastases, use of steroids or antibiotics, the effects of gut microbiome, autoimmune diseases, human immunodeficiency virus infection, solid organ transplants, use of anti-programmed cell death protein 1 versus anti-programmed death-ligand 1 drugs, atypical tumour responses, predictors of response, duration of treatment and a final open question on additional relevant challenges. RESULTS Two hundred and twenty-one answers were collected, including 106 (48%) valid answers from experts for final analysis (physicians who have treated at least 20 patients with NSCLC with ICIs). The vast majority agreed that the selected topics in this study are important challenges ahead and more evidence is needed. Moreover, predictors of response, treating brain metastasis, shorter duration of treatment, the effects of gut microbiome and concomitant use of steroids were voted the most important topics to be further addressed in prospective clinical research. CONCLUSIONS This survey contributed to understanding which are the main challenges for clinical practice with ICIs monotherapy in NSCLC. It can also contribute to guide further clinical research, considering the opinions and experience of those who regularly treat NSCLC patients with ICIs.
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Affiliation(s)
- L Castelo-Branco
- NOVA National School of Public Health, NOVA University, Lisbon, Portugal.
| | - G Morgan
- Skåne University Hospital, Division of Medical and Radiation Oncology, Lund, Sweden
| | - A Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - M Scheffler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Cologne, Germany
| | - H Canhão
- EPIDOC Unit, Comprehensive Health Research Center (CHRC), NOVA Medical School, NOVA University, Lisbon; Centro Hospitalar Universitario Lisboa Central, Lisbon, Portugal
| | | | - A Awada
- Oncology Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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4
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Devnani B, Noronha V, Sirohi B, Bambury K, George R, Pareek V, Morgan G. 429P Cancer and COVID-19 in India: Assessing the impact in a nationwide survey. Ann Oncol 2022. [PMCID: PMC9719675 DOI: 10.1016/j.annonc.2022.10.460] [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: 12/07/2022] Open
Affiliation(s)
- B. Devnani
- Department of Radiation Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - V. Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - B. Sirohi
- Department of Medical Oncology, Apollo Proton Cancer Centre, Chennai, Karnataka, India
| | | | | | - V. Pareek
- Department of Radiation Oncology, National Cancer Institute-AIIMS, Jhajjar, India
| | - G. Morgan
- Oncology Department, Skane University Hospital and Oncoalert Network, Lund, Sweden
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5
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Smith A, Morgan G, Robertson N. Experiences of Female Partners of People Transitioning Gender: A Feminist Interpretive Metasynthesis. J Sex Marital Ther 2022; 48:728-743. [PMID: 35321636 DOI: 10.1080/0092623x.2022.2050863] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The needs of romantic partners of people transitioning gender remain neglected within academia and gender services. Following a systematic search, nine studies relating to female partners' experiences were subjected to a thematic metasynthesis. Four themes were generated and entitled Changes in sexual relationship; New roles and responsibilities; Identity and belonging; and Transformation and loss Results are considered in relation to the dominance of the gender-affirmation discourse. Limitations of the review and reviewed studies are highlighted. Clinical implications for couples and partners of people transitioning gender are offered.
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Affiliation(s)
- Aimee Smith
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - G Morgan
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - N Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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6
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Vukovic P, Meattini I, Lambertini M, de Azambuja E, Prat A, Aftimos P, Lustberg M, Kruljac I, Morgan G. 316P Attitudes towards the use of stereotactic body radiation therapy in oligometastatic breast cancer: Results of an OncoAlert survey. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.599] [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] Open
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7
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Lim K, Punie K, Oing C, Thorne E, Murali K, Kamposioras K, O'Connor M, Elez E, Amaral T, Lopez PG, Lambertini M, Devnani B, Westphalen C, Morgan G, Haanen J, Hardy C, Banerjee S. 1561O The future of the oncology workforce since COVID-19: Results of the ESMO Resilience Task Force survey series. Ann Oncol 2021. [PMCID: PMC8454455 DOI: 10.1016/j.annonc.2021.08.1554] [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: 11/01/2022] Open
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8
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Chaarani B, Hahn S, Allgaier N, Adise S, Owens MM, Juliano AC, Yuan DK, Loso H, Ivanciu A, Albaugh MD, Dumas J, Mackey S, Laurent J, Ivanova M, Hagler DJ, Cornejo MD, Hatton S, Agrawal A, Aguinaldo L, Ahonen L, Aklin W, Anokhin AP, Arroyo J, Avenevoli S, Babcock D, Bagot K, Baker FC, Banich MT, Barch DM, Bartsch H, Baskin-Sommers A, Bjork JM, Blachman-Demner D, Bloch M, Bogdan R, Bookheimer SY, Breslin F, Brown S, Calabro FJ, Calhoun V, Casey BJ, Chang L, Clark DB, Cloak C, Constable RT, Constable K, Corley R, Cottler LB, Coxe S, Dagher RK, Dale AM, Dapretto M, Delcarmen-Wiggins R, Dick AS, Do EK, Dosenbach NUF, Dowling GJ, Edwards S, Ernst TM, Fair DA, Fan CC, Feczko E, Feldstein-Ewing SW, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Friedman-Hill S, Fuemmeler BF, Galvan A, Gee DG, Giedd J, Glantz M, Glaser P, Godino J, Gonzalez M, Gonzalez R, Grant S, Gray KM, Haist F, Harms MP, Hawes S, Heath AC, Heeringa S, Heitzeg MM, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman E, Howlett K, Huber RS, Huestis MA, Hyde LW, Iacono WG, Infante MA, Irfanoglu O, Isaiah A, Iyengar S, Jacobus J, James R, Jean-Francois B, Jernigan T, Karcher NR, Kaufman A, Kelley B, Kit B, Ksinan A, Kuperman J, Laird AR, Larson C, LeBlanc K, Lessov-Schlagger C, Lever N, Lewis DA, Lisdahl K, Little AR, Lopez M, Luciana M, Luna B, Madden PA, Maes HH, Makowski C, Marshall AT, Mason MJ, Matochik J, McCandliss BD, McGlade E, Montoya I, Morgan G, Morris A, Mulford C, Murray P, Nagel BJ, Neale MC, Neigh G, Nencka A, Noronha A, Nixon SJ, Palmer CE, Pariyadath V, Paulus MP, Pelham WE, Pfefferbaum D, Pierpaoli C, Prescot A, Prouty D, Puttler LI, Rajapaske N, Rapuano KM, Reeves G, Renshaw PF, Riedel MC, Rojas P, de la Rosa M, Rosenberg MD, Ross MJ, Sanchez M, Schirda C, Schloesser D, Schulenberg J, Sher KJ, Sheth C, Shilling PD, Simmons WK, Sowell ER, Speer N, Spittel M, Squeglia LM, Sripada C, Steinberg J, Striley C, Sutherland MT, Tanabe J, Tapert SF, Thompson W, Tomko RL, Uban KA, Vrieze S, Wade NE, Watts R, Weiss S, Wiens BA, Williams OD, Wilbur A, Wing D, Wolff-Hughes D, Yang R, Yurgelun-Todd DA, Zucker RA, Potter A, Garavan HP. Baseline brain function in the preadolescents of the ABCD Study. Nat Neurosci 2021; 24:1176-1186. [PMID: 34099922 PMCID: PMC8947197 DOI: 10.1038/s41593-021-00867-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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] [Received: 12/31/2019] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.
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Affiliation(s)
- B Chaarani
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - S Hahn
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - N Allgaier
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Adise
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M M Owens
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A C Juliano
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D K Yuan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H Loso
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A Ivanciu
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M D Albaugh
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Dumas
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Mackey
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Laurent
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D J Hagler
- University of California, San Diego, La Jolla, CA, USA
| | - M D Cornejo
- Institute of Physics UC, Pontificia Universidad Catolica de Chile, Pontificia, Chile
| | - S Hatton
- University of California, San Diego, La Jolla, CA, USA
| | - A Agrawal
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - L Aguinaldo
- University of California, San Diego, La Jolla, CA, USA
| | - L Ahonen
- University of Pittsburgh, Pittsburgh, PA, USA
| | - W Aklin
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - A P Anokhin
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Arroyo
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S Avenevoli
- National Institute of Mental Health, Bethesda, MD, USA
| | - D Babcock
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - K Bagot
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F C Baker
- SRI International, Menlo Park, CA, USA
| | - M T Banich
- University of Colorado, Boulder, CO, USA
| | - D M Barch
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H Bartsch
- Haukeland University Hospital, Bergen, Norway
| | | | - J M Bjork
- Virginia Commonwealth University, Richmond, VA, USA
| | - D Blachman-Demner
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - M Bloch
- National Cancer Institute, Bethesda, MD, USA
| | - R Bogdan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - F Breslin
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - S Brown
- University of California, San Diego, La Jolla, CA, USA
| | - F J Calabro
- University of Pittsburgh, Pittsburgh, PA, USA
| | - V Calhoun
- University of Colorado, Boulder, CO, USA
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | | | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, USA
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - K Constable
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R Corley
- University of Colorado, Boulder, CO, USA
| | | | - S Coxe
- Florida International University, Miami, FL, USA
| | - R K Dagher
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - A M Dale
- University of California, San Diego, La Jolla, CA, USA
| | - M Dapretto
- University of California, Los Angeles, CA, USA
| | | | - A S Dick
- Florida International University, Miami, FL, USA
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, USA
| | - N U F Dosenbach
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - G J Dowling
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - S Edwards
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - T M Ernst
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Fair
- Oregon Health & Science University, Portland, OR, USA
| | - C C Fan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - E Feczko
- Oregon Health & Science University, Portland, OR, USA
| | | | | | - J J Foxe
- University of Rochester, Rochester, NY, USA
| | | | | | | | | | - A Galvan
- University of California, Los Angeles, CA, USA
| | - D G Gee
- Yale University, New Haven, CT, USA
| | - J Giedd
- University of California, San Diego, La Jolla, CA, USA
| | - M Glantz
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Glaser
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Godino
- University of California, San Diego, La Jolla, CA, USA
| | - M Gonzalez
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - R Gonzalez
- Florida International University, Miami, FL, USA
| | - S Grant
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, USA
| | - F Haist
- University of California, San Diego, La Jolla, CA, USA
| | - M P Harms
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - S Hawes
- Florida International University, Miami, FL, USA
| | - A C Heath
- University of California, San Diego, La Jolla, CA, USA
| | - S Heeringa
- University of Michigan, Ann Arbor, MI, USA
| | | | - R Hermosillo
- Oregon Health & Science University, Portland, OR, USA
| | - M M Herting
- University of Southern California, Los Angeles, CA, USA
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, USA
| | - J K Hewitt
- University of Colorado, Boulder, CO, USA
| | - C Heyser
- University of California, San Diego, La Jolla, CA, USA
| | - E Hoffman
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K Howlett
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R S Huber
- University of Utah, Salt Lake City, UT, USA
| | - M A Huestis
- Thomas Jefferson University, Philadelphia, PA, USA
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, USA
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, USA
| | - M A Infante
- University of California, San Diego, La Jolla, CA, USA
| | - O Irfanoglu
- National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Iyengar
- National Endowment for the Arts, Washington DC, USA
| | - J Jacobus
- University of California, San Diego, La Jolla, CA, USA
| | - R James
- Virginia Commonwealth University, Richmond, VA, USA
| | - B Jean-Francois
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - T Jernigan
- University of California, San Diego, La Jolla, CA, USA
| | - N R Karcher
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - A Kaufman
- National Cancer Institute, Bethesda, MD, USA
| | - B Kelley
- National Institute of Justice, Washington DC, USA
| | - B Kit
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - A Ksinan
- Virginia Commonwealth University, Richmond, VA, USA
| | - J Kuperman
- University of California, San Diego, La Jolla, CA, USA
| | - A R Laird
- Florida International University, Miami, FL, USA
| | - C Larson
- University of Wisconsin, Milwaukee, WI, USA
| | - K LeBlanc
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - C Lessov-Schlagger
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - N Lever
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Lewis
- University of Pittsburgh, Pittsburgh, PA, USA
| | - K Lisdahl
- University of Wisconsin, Milwaukee, WI, USA
| | - A R Little
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Lopez
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Luciana
- University of Minnesota, Minneapolis, MN, USA
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, USA
| | - P A Madden
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Makowski
- University of California, San Diego, La Jolla, CA, USA
| | - A T Marshall
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - M J Mason
- University of Tennessee, Knoxville, TN, USA
| | - J Matochik
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | | | - E McGlade
- University of Utah, Salt Lake City, UT, USA
| | - I Montoya
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - G Morgan
- National Cancer Institute, Bethesda, MD, USA
| | - A Morris
- Oklahoma State University, Stillwater, OK, USA
| | - C Mulford
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Murray
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, USA
| | - M C Neale
- Virginia Commonwealth University, Richmond, VA, USA
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, USA
| | - A Nencka
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Noronha
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S J Nixon
- University of Florida, Gainesville, FL, USA
| | - C E Palmer
- University of California, San Diego, La Jolla, CA, USA
| | - V Pariyadath
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - W E Pelham
- Florida International University, Miami, FL, USA
| | | | - C Pierpaoli
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - A Prescot
- University of Utah, Salt Lake City, UT, USA
| | - D Prouty
- SRI International, Menlo Park, CA, USA
| | | | - N Rajapaske
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | | | - G Reeves
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - M C Riedel
- Florida International University, Miami, FL, USA
| | - P Rojas
- Florida International University, Miami, FL, USA
| | - M de la Rosa
- Florida International University, Miami, FL, USA
| | | | - M J Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Sanchez
- Florida International University, Miami, FL, USA
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, USA
| | - D Schloesser
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | | | - K J Sher
- University of Missouri, Columbia, MO, USA
| | - C Sheth
- University of Utah, Salt Lake City, UT, USA
| | - P D Shilling
- University of California, San Diego, La Jolla, CA, USA
| | - W K Simmons
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - E R Sowell
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - N Speer
- University of Colorado, Boulder, CO, USA
| | - M Spittel
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - L M Squeglia
- Medical University of South Carolina, Charleston, SC, USA
| | - C Sripada
- University of Michigan, Ann Arbor, MI, USA
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Striley
- University of Florida, Gainesville, FL, USA
| | | | - J Tanabe
- University of Colorado, Boulder, CO, USA
| | - S F Tapert
- University of California, San Diego, La Jolla, CA, USA
| | - W Thompson
- University of California, San Diego, La Jolla, CA, USA
| | - R L Tomko
- Medical University of South Carolina, Charleston, SC, USA
| | - K A Uban
- University of California, Irvine, CA, USA
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, USA
| | - N E Wade
- University of California, San Diego, La Jolla, CA, USA
| | - R Watts
- Yale University, New Haven, CT, USA
| | - S Weiss
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - B A Wiens
- University of Florida, Gainesville, FL, USA
| | - O D Williams
- Florida International University, Miami, FL, USA
| | - A Wilbur
- SRI International, Menlo Park, CA, USA
| | - D Wing
- University of California, San Diego, La Jolla, CA, USA
| | - D Wolff-Hughes
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - R Yang
- University of California, San Diego, La Jolla, CA, USA
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, USA
| | - A Potter
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H P Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
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9
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Lim KHJ, Murali K, Kamposioras K, Punie K, Oing C, O'Connor M, Thorne E, Amaral T, Garrido P, Lambertini M, Devnani B, Westphalen CB, Morgan G, Haanen JBAG, Hardy C, Banerjee S. The concerns of oncology professionals during the COVID-19 pandemic: results from the ESMO Resilience Task Force survey II. ESMO Open 2021; 6:100199. [PMID: 34217129 PMCID: PMC8256184 DOI: 10.1016/j.esmoop.2021.100199] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 04/25/2021] [Revised: 05/25/2021] [Accepted: 06/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic has resulted in significant changes to professional and personal lives of oncology professionals globally. The European Society for Medical Oncology (ESMO) Resilience Task Force collaboration aimed to provide contemporaneous reports on the impact of COVID-19 on the lived experiences and well-being in oncology. Methods This online anonymous survey (July-August 2020) is the second of a series of global surveys launched during the course of the pandemic. Longitudinal key outcome measures including well-being/distress (expanded Well-being Index—9 items), burnout (1 item from expanded Well-being Index), and job performance since COVID-19 were tracked. Results A total of 942 participants from 99 countries were included for final analysis: 58% (n = 544) from Europe, 52% (n = 485) female, 43% (n = 409) ≤40 years old, and 36% (n = 343) of non-white ethnicity. In July/August 2020, 60% (n = 525) continued to report a change in professional duties compared with the pre-COVID-19 era. The proportion of participants at risk of poor well-being (33%, n = 310) and who reported feeling burnout (49%, n = 460) had increased significantly compared with April/May 2020 (25% and 38%, respectively; P < 0.001), despite improved job performance since COVID-19 (34% versus 51%; P < 0.001). Of those who had been tested for COVID-19, 8% (n = 39/484) tested positive; 18% (n = 7/39) felt they had not been given adequate time to recover before return to work. Since the pandemic, 39% (n = 353/908) had expressed concerns that COVID-19 would have a negative impact on their career development or training and 40% (n = 366/917) felt that their job security had been compromised. More than two-thirds (n = 608/879) revealed that COVID-19 has changed their outlook on their work-personal life balance. Conclusion The COVID-19 pandemic continues to impact the well-being of oncology professionals globally, with significantly more in distress and feeling burnout compared with the first wave. Collective efforts from both national and international communities addressing support and coping strategies will be crucial as we recover from the COVID-19 crisis. In particular, an action plan should also be devised to tackle concerns raised regarding the negative impact of COVID-19 on career development, training, and job security. Compared with survey I, more oncology professionals were at risk of poor well-being (33% versus 25%) and burnout (49% versus 38%). Job performance since COVID-19 (JP-CV) has improved from 34% to 51%. About 1 in 5 who tested positive for COVID-19 felt they had not been given adequate time to recover before return to work. Some 39% expressed concerns that COVID-19 would have a negative impact on their career development or training. More than two-thirds revealed that COVID-19 had changed their outlook on work-personal life balance.
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Affiliation(s)
- K H J Lim
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Department of Immunology and Inflammation, Imperial College London, London, UK; Immunobiology Laboratory, The Francis Crick Institute, London, UK
| | - K Murali
- Victorian Clinical Genetics Services, The Royal Children's Hospital, Melbourne, Australia
| | - K Kamposioras
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - K Punie
- Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - C Oing
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, Mildred Scheel Cancer Career Centre HaTriCs4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M O'Connor
- University Hospital Waterford, Waterford, Ireland
| | - E Thorne
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - T Amaral
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany; Portuguese Air Force Health Care Direction, Lisbon, Portugal
| | - P Garrido
- Medical Oncology, Hospital Ramón y Cajal, IRYCIS, Alcalá University, Madrid, Spain
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - B Devnani
- Department of Radiotherapy and Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - C B Westphalen
- Department of Internal Medicine III, University Hospital, LMU Munich and Comprehensive Cancer Center, Munich, Germany
| | - G Morgan
- Department of Medical and Radiation Oncology, Skåne University Hospital, Lund, Sweden
| | - J B A G Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - C Hardy
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - S Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
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10
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Morgan G, Tagliamento M, Lambertini M, Devnani B, Westphalen B, Dienstmann R, Bozovic-Spasojevic I, Calles A, Criscitiello C, Curioni A, Garcia AM, Lamarca A, Pilotto S, Scheffler M, Strijbos M, Wong R, de Azambuja E, Peters S. Impact of COVID-19 on social media as perceived by the oncology community: results from a survey in collaboration with the European Society for Medical Oncology (ESMO) and the OncoAlert Network. ESMO Open 2021; 6:100104. [PMID: 33838532 PMCID: PMC8038939 DOI: 10.1016/j.esmoop.2021.100104] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/13/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 11/26/2022] Open
Abstract
Background The COVID-19 pandemic has impacted all aspects of modern-day oncology, including how stakeholders communicate through social media. We surveyed oncology stakeholders in order to assess their attitudes pertaining to social media and how it has been affected during the pandemic. Materials and methods A 40-item survey was distributed to stakeholders from 8 July to 22 July 2020 and was promoted through the European Society for Medical Oncology (ESMO) and the OncoAlert Network. Results One thousand and seventy-six physicians and stakeholders took part in the survey. In total, 57.3% of respondents were medical oncologists, 50.6% aged <40 years, 50.8% of female gender and mostly practicing in Europe (51.5%). More than 90% of respondents considered social media a useful tool for distributing scientific information and for education. Most used social media to stay up to date on cancer care in general (62.5%) and cancer care during COVID-19 (61%) given the constant flow of information. Respondents also used social media to interact with other oncologists (78.8%) and with patients (34.4%). Overall, 61.1% of respondents were satisfied with the role that social media was playing during the COVID-19 pandemic. On the other hand, 41.1% of respondents reported trouble in discriminating between credible and less credible information and 30% stated social networks were a source of stress. For this reason, one-third of respondents reduced its use during the COVID-19 pandemic. Regarding meeting attendance, a total of 59.1% of responding physicians preferred in-person meetings to virtual ones, and 51.8% agreed that virtual meetings and social distancing could hamper effective collaboration. Conclusion Social media has a useful role in supporting cancer care and professional engagement in oncology. Although one-third of respondents reported reduced use of social media due to stress during the COVID-19 pandemic, the majority found social media useful to keep up to date and were satisfied with the role social media was playing during the pandemic. More than 90% of the 1076 respondents believed in the role of social media promoting scientific information and education. 41% of respondents had trouble discriminating between credible and less credible information on social media. 61% of respondents used social media to stay up to date with scientific information regarding cancer care and COVID-19. The flow of information on COVID-19 via social media was deemed useful for 49% of respondents but caused stress in 30%. 52% of respondents agreed that virtual meetings and social distancing could hamper effective collaboration.
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Affiliation(s)
- G Morgan
- Department of Medical and Radiation Oncology, Skane University Hospital, Lund, Sweden.
| | - M Tagliamento
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy; Department of Medical Oncology, Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genoa, Italy; Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - B Devnani
- Department of Radiotherapy and Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - B Westphalen
- Department of Medicine 3 and Comprehensive Cancer Center, Ludwig-Maximilians University Munich, Munich, Germany
| | - R Dienstmann
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - A Calles
- Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - C Criscitiello
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Hematology and Oncology (DIPO), University of Milan, Milan, Italy
| | - A Curioni
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - A M Garcia
- Section of Medical Oncology, Dagupan Doctors Villaflor Memorial Hospital, Dagupan, Philippines
| | - A Lamarca
- Department of Medical Oncology, The Christie NHS Foundation, Manchester, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - S Pilotto
- Section of Oncology, Department of Medicine, University of Verona Hospital Trust, Verona, Italy
| | - M Scheffler
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - M Strijbos
- Department of Medical Oncology, GZA Hospitals, Sint-Augustinus, Antwerp, Belgium; Monash University, Eastern Health Clinical School, Box Hill, Australia
| | - R Wong
- Department of Medical Oncology, Eastern Health, Box Hill, Australia
| | - E de Azambuja
- Institut Jules Bordet and l'Université Libre de Bruxelles (U.LB.), Brussels, Belgium
| | - S Peters
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV) and Lausanne University, Lausanne, Switzerland
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11
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Banerjee S, Lim KHJ, Murali K, Kamposioras K, Punie K, Oing C, O'Connor M, Thorne E, Devnani B, Lambertini M, Westphalen CB, Garrido P, Amaral T, Morgan G, Haanen JBAG, Hardy C. The impact of COVID-19 on oncology professionals: results of the ESMO Resilience Task Force survey collaboration. ESMO Open 2021; 6:100058. [PMID: 33601295 PMCID: PMC7900705 DOI: 10.1016/j.esmoop.2021.100058] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/15/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on well-being has the potential for serious negative consequences on work, home life, and patient care. The European Society for Medical Oncology (ESMO) Resilience Task Force collaboration set out to investigate well-being in oncology over time since COVID-19. METHODS Two online anonymous surveys were conducted (survey I: April/May 2020; survey II: July/August 2020). Statistical analyses were performed to examine group differences, associations, and predictors of key outcomes: (i) well-being/distress [expanded Well-being Index (eWBI; 9 items)]; (ii) burnout (1 item from eWBI); (iii) job performance since COVID-19 (JP-CV; 2 items). RESULTS Responses from survey I (1520 participants from 101 countries) indicate that COVID-19 is impacting oncology professionals; in particular, 25% of participants indicated being at risk of distress (poor well-being, eWBI ≥ 4), 38% reported feeling burnout, and 66% reported not being able to perform their job compared with the pre-COVID-19 period. Higher JP-CV was associated with better well-being and not feeling burnout (P < 0.01). Differences were seen in well-being and JP-CV between countries (P < 0.001) and were related to country COVID-19 crude mortality rate (P < 0.05). Consistent predictors of well-being, burnout, and JP-CV were psychological resilience and changes to work hours. In survey II, among 272 participants who completed both surveys, while JP-CV improved (38% versus 54%, P < 0.001), eWBI scores ≥4 and burnout rates were significantly higher compared with survey I (22% versus 31%, P = 0.01; and 35% versus 49%, P = 0.001, respectively), suggesting well-being and burnout have worsened over a 3-month period during the COVID-19 pandemic. CONCLUSION In the first and largest global survey series, COVID-19 is impacting well-being and job performance of oncology professionals. JP-CV has improved but risk of distress and burnout has increased over time. Urgent measures to address well-being and improve resilience are essential.
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Affiliation(s)
- S Banerjee
- Gynaecology Unit, The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
| | - K H J Lim
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK; Department of Immunology and Inflammation, Imperial College London, London, UK
| | - K Murali
- Austin Health, Heidelberg, Australia
| | - K Kamposioras
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - K Punie
- Department of General Medical Oncology and Multidisciplinary Breast Center, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - C Oing
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M O'Connor
- University Hospital Waterford, Waterford, Ireland
| | - E Thorne
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - B Devnani
- Department of Radiotherapy and Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Sciences (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - C B Westphalen
- Department of Internal Medicine III, University Hospital, LMU Munich and Comprehensive Cancer Center, Munich, Germany
| | - P Garrido
- Medical Oncology, Hospital Ramón y Cajal, IRYCIS, Alcalá University, Madrid, Spain
| | - T Amaral
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany; Portuguese Air Force Health Care Direction, Lisbon, Portugal
| | - G Morgan
- Department of Medical and Radiation Oncology, Skåne University Hospital, Lund, Sweden
| | - J B A G Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Hardy
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Hassan N, Slight R, Weiand D, Vellinga A, Morgan G, Aboushareb F, Slight SP. Predicting infection and sepsis; what predictors have been used to train machine learning algorithms? A systematic review. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.022] [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]
Abstract
Abstract
Introduction
Sepsis is a life-threatening condition that is associated with increased mortality. Artificial intelligence tools can inform clinical decision making by flagging patients who may be at risk of developing infection and subsequent sepsis and assist clinicians with their care management.
Aim
To identify the optimal set of predictors used to train machine learning algorithms to predict the likelihood of an infection and subsequent sepsis and inform clinical decision making.
Methods
This systematic review was registered in PROSPERO database (CRD42020158685). We searched 3 large databases: Medline, Cumulative Index of Nursing and Allied Health Literature, and Embase, using appropriate search terms. We included quantitative primary research studies that focused on sepsis prediction associated with bacterial infection in adult population (>18 years) in all care settings, which included data on predictors to develop machine learning algorithms. The timeframe of the search was 1st January 2000 till the 25th November 2019. Data extraction was performed using a data extraction sheet, and a narrative synthesis of eligible studies was undertaken. Narrative analysis was used to arrange the data into key areas, and compare and contrast between the content of included studies. Quality assessment was performed using Newcastle-Ottawa Quality Assessment scale, which was used to evaluate the quality of non-randomized studies. Bias was not assessed due to the non-randomised nature of the included studies.
Results
Fifteen articles met our inclusion criteria (Figure 1). We identified 194 predictors that were used to train machine learning algorithms to predict infection and subsequent sepsis, with 13 predictors used on average across all included studies. The most significant predictors included age, gender, smoking, alcohol intake, heart rate, blood pressure, lactate level, cardiovascular disease, endocrine disease, cancer, chronic kidney disease (eGFR<60ml/min), white blood cell count, liver dysfunction, surgical approach (open or minimally invasive), and pre-operative haematocrit < 30%. These predictors were used for the development of all the algorithms in the fifteen articles. All included studies used artificial intelligence techniques to predict the likelihood of sepsis, with average sensitivity 77.5±19.27, and average specificity 69.45±21.25.
Conclusion
The type of predictors used were found to influence the predictive power and predictive timeframe of the developed machine learning algorithm. Two strengths of our review were that we included studies published since the first definition of sepsis was published in 2001, and identified factors that can improve the predictive ability of algorithms. However, we note that the included studies had some limitations, with three studies not validating the models that they developed, and many tools limited by either their reduced specificity or sensitivity or both. This work has important implications for practice, as predicting the likelihood of sepsis can help inform the management of patients and concentrate finite resources to those patients who are most at risk. Producing a set of predictors can also guide future studies in developing more sensitive and specific algorithms with increased predictive time window to allow for preventive clinical measures.
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Affiliation(s)
- N Hassan
- School of Pharmacy, Newcastle University, UK
| | - R Slight
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - D Weiand
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - A Vellinga
- School of Medicine, National University of Ireland, Galway, Ireland
| | - G Morgan
- School of Computing, Newcastle University, UK
| | - F Aboushareb
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - S P Slight
- School of Pharmacy, Newcastle University, UK
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13
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Carneiro A, Amaral T, Brandao M, Scheffler M, Bol K, Ferrara R, Jalving M, Lo Russo G, Marquez-Rodas I, Matikas A, Mezquita L, Morgan G, Onesti C, Pilotto S, Saloustros E, Trapani D. LBA66_PR Disparities in access to oncology clinical trials in Europe in the period 2009-2019. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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14
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Banerjee S, Lim K, Kamposioras K, Murali K, Oing C, Punie K, O'Connor M, Devnani B, Lambertini M, Benedikt Westphalen C, Garrido Lopez P, Amaral T, Thorne E, Morgan G, Haanen J, Hardy C. LBA70_PR The impact of COVID-19 on oncology professionals: Initial results of the ESMO resilience task force survey collaboration. Ann Oncol 2020. [PMCID: PMC7506393 DOI: 10.1016/j.annonc.2020.08.2311] [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: 10/28/2022] Open
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15
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Schubert S, Góreczny S, Nordmeyer J, Kramer P, Kühne T, Jenny EZ, Morgan G, Kim SH, Paweł D, Berger F. Results from an International Multicenter Prospective Registry of Cardiac Catheterizations Guided with Fusion of Computed Tomography and Magnetic Resonance Imaging. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705536] [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: 10/24/2022]
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16
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Runyon KD, Moriarty DP, Denevi BW, Greenhagen BT, Morgan G, Young KE, Cohen BA, van der Bogert CH, Hiesinger H, Jozwiak LM. Impact Melt Facies in the Moon's Crisium Basin: Identifying, Characterizing, and Future Radiogenic Dating. J Geophys Res Planets 2020; 125:e2019JE006024. [PMID: 32714725 PMCID: PMC7375055 DOI: 10.1029/2019je006024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 06/11/2023]
Abstract
Both Earth and the Moon share a common history regarding the epoch of large basin formation, though only the lunar geologic record preserves any appreciable record of this Late Heavy Bombardment. The emergence of Earth's first life is approximately contemporaneous with the Late Heavy Bombardment; understanding the latter informs the environmental conditions of the former, which are likely necessary to constrain the mechanisms of abiogenesis. While the relative formation time of most of the Moon's large basins is known, the absolute timing is not. The timing of Crisium Basin's formation is one of many important events that must be constrained and would require identifying and dating impact melt formed in the Crisium event. To inform a future lunar sample dating mission, we thus characterized possible outcrops of impact melt. We determined that several mare lava-embayed kipukas could contain impact melt, though the rim and central peaks of the partially lava-flooded Yerkes Crater likely contain the most pure and intact Crisium impact melt. It is here where future robotic and/or human missions could confidently add a key missing piece to the puzzle of the combined issues of early Earth-Moon bombardment and the emergence of life.
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Affiliation(s)
- K. D. Runyon
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | | | - B. W. Denevi
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - B. T. Greenhagen
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - G. Morgan
- Planetary Science InstituteTucsonAZUSA
| | - K. E. Young
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | - B. A. Cohen
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | | | - H. Hiesinger
- Institut für PlanetologieUniversity of MünsterMünsterGermany
| | - L. M. Jozwiak
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
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Morel E, Deliniere A, Morgan G, London B, Bristow M, Minobe W, Roy P, Chevalier P. Impact of Beta adrenergic receptors polymorphism on the onset of ventricular fibrillation during the acute phase of myocardial infarction. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.169] [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: 10/27/2022]
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18
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Morgan G, Welch H, Jenkins D, Medhurst-Wroe L. Proof of concepts trial of diagnostic ultrasound in the orthopaedic setting. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.214] [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: 10/27/2022]
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Morgan G, Larsson C, Tahin B, Vallon-Christersson J, Häkkinen J, Ehinger A, Malmberg M, Hegardt C, Borg Å, Rydén L, Saal LH, Hedenfalk I, Loman N. Abstract P3-02-02: Concordance between immunohistochemical and gene-expression based subtyping of early breast cancer using core needle biopsies and surgical specimens - experices from SCAN-B. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-02-02] [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: 11/16/2022]
Abstract
Abstract
Introduction: Preoperative chemotherapy in early breast cancer increases the rate of breast preservation and provides prognostic information. Treatment decisions in these cases rely on biomarker assessments and subtyping from tissue acquired through core needle biopsies. Tumor heterogeneity and representativity are pit-falls when limited tissue is available. Biomarker expression may change considerably as a result of preoperative chemotherapy, and in a subset of cases a complete pathological response at time of surgery may even preclude any further assessment. Therefore, the reliability and reproducibility of biomarkers in base-line core biopsies are of utmost importance for patients treated with preoperative chemotherapy.
Material and Methods: In an ongoing population-based study of early breast cancer, the SCAN-B (NCT02306096), patients were identified for whom an ultra-sound guided core needle biopsy was analyzed for biomarkers during primary clinical work-up and the patient was offered primary surgery as initial treatment. Clinical biomarker profiles including immunohistochemical (IHC) determinations of ER, PgR, HER2 and Ki67 were translated to subtypes according to modified St Gallen criteria (2013) and compared with paired samples from surgical specimens. In addition, tumor specimens for biomolecule extraction and RNA sequencing were collected fresh in RNAlater.
Results: IHC data was available from 51 paired samples. The subtype distribution in core needle biopsies was DCIS in 1 case (2 %), LCIS in 1 case (2 %) Luminal A-like in 16 cases (31 %), Luminal B-like (HER2 negative) in 26 cases (51 %), Luminal B-HER2-like (HER2 positive) in 4 cases (8 %), HER2-positive (non-luminal) in 1 case (2 %) and triple negative (ductal) breast cancer in 2 cases (4 %). The subtype distribution in surgical specimens was DCIS in 0 case (0 %), LCIS in 1 case (2 %) Luminal A-like in 18 cases (35 %), Luminal B-like (HER2negative) in 23 cases (45 %), Luminal B--like (HER2 positive) in 6 cases (12 %), HER2-positive (non-luminal) in 1 case (2 %) and triple negative (ductal) breast cancer in 2 cases (4 %). Notably, 5/16 cases classified as Luminal A-like in the core needle biopsy were reclassified as Luminal B-like (HER2-negative) in the surgical specimen, whereas 9/26 cases classified as Luminal B-like (HER2-negative) in the core needle biopsy were reclassified as either Luminal A-like (7 cases) or Luminal B-like (HER2 positive) (2 cases) in the surgical specimen. In all instances, except one, transition between Luminal A-like and Luminal B-like was due to recorded Ki67 expression. One case that was classified as a DCIS in the core needle was reclassified as Luminal B-like (HER2 negative) at time of surgery.
Discussion: In this limited material, discordance between evaluations regarding Luminal A-like and Luminal B-like was considerable. Especially the misclassification of primary HER2-positive breast cancer needs further evaluation. These findings may be caused by tumor heterogeneity, and highlight the risk of both over- and under-treatment upon biomarker assessment from core needle biopsies. Data from gene expression based subtype classifications will be presented during the meeting.
Citation Format: Morgan G, Larsson C, Tahin B, Vallon-Christersson J, Häkkinen J, Ehinger A, Malmberg M, Hegardt C, Borg Å, Rydén L, Saal LH, Hedenfalk I, Loman N. Concordance between immunohistochemical and gene-expression based subtyping of early breast cancer using core needle biopsies and surgical specimens - experices from SCAN-B [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-02-02.
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Affiliation(s)
- G Morgan
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - C Larsson
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - B Tahin
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - J Vallon-Christersson
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - J Häkkinen
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - A Ehinger
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - M Malmberg
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - C Hegardt
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - Å Borg
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - L Rydén
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - LH Saal
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - I Hedenfalk
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
| | - N Loman
- Skåne University Hospital, Lund, Sweden; Lund University, Lund, Sweden; Lund University Cancer Centre, Medicon Village, Lund, Sweden; Skåne Univerisity Hospital, Lund, Sweden; Skåne University Hopsital, Malmö, Sweden
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Marshall CR, Jones A, Fastelli A, Atkinson J, Botting N, Morgan G. Semantic fluency in deaf children who use spoken and signed language in comparison with hearing peers. Int J Lang Commun Disord 2018; 53:157-170. [PMID: 28691260 PMCID: PMC5811791 DOI: 10.1111/1460-6984.12333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/19/2017] [Accepted: 05/27/2017] [Indexed: 05/31/2023]
Abstract
BACKGROUND Deafness has an adverse impact on children's ability to acquire spoken languages. Signed languages offer a more accessible input for deaf children, but because the vast majority are born to hearing parents who do not sign, their early exposure to sign language is limited. Deaf children as a whole are therefore at high risk of language delays. AIMS We compared deaf and hearing children's performance on a semantic fluency task. Optimal performance on this task requires a systematic search of the mental lexicon, the retrieval of words within a subcategory and, when that subcategory is exhausted, switching to a new subcategory. We compared retrieval patterns between groups, and also compared the responses of deaf children who used British Sign Language (BSL) with those who used spoken English. We investigated how semantic fluency performance related to children's expressive vocabulary and executive function skills, and also retested semantic fluency in the majority of the children nearly 2 years later, in order to investigate how much progress they had made in that time. METHODS & PROCEDURES Participants were deaf children aged 6-11 years (N = 106, comprising 69 users of spoken English, 29 users of BSL and eight users of Sign Supported English-SSE) compared with hearing children (N = 120) of the same age who used spoken English. Semantic fluency was tested for the category 'animals'. We coded for errors, clusters (e.g., 'pets', 'farm animals') and switches. Participants also completed the Expressive One-Word Picture Vocabulary Test and a battery of six non-verbal executive function tasks. In addition, we collected follow-up semantic fluency data for 70 deaf and 74 hearing children, nearly 2 years after they were first tested. OUTCOMES & RESULTS Deaf children, whether using spoken or signed language, produced fewer items in the semantic fluency task than hearing children, but they showed similar patterns of responses for items most commonly produced, clustering of items into subcategories and switching between subcategories. Both vocabulary and executive function scores predicted the number of correct items produced. Follow-up data from deaf participants showed continuing delays relative to hearing children 2 years later. CONCLUSIONS & IMPLICATIONS We conclude that semantic fluency can be used experimentally to investigate lexical organization in deaf children, and that it potentially has clinical utility across the heterogeneous deaf population. We present normative data to aid clinicians who wish to use this task with deaf children.
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Affiliation(s)
- C. R. Marshall
- UCL Institute of EducationUniversity College LondonLondonUK
| | - A. Jones
- UCL DeafnessCognition and Language Research CentreUniversity College LondonLondonUK
| | | | - J. Atkinson
- UCL DeafnessCognition and Language Research CentreUniversity College LondonLondonUK
| | - N. Botting
- Language and Communication ScienceSchool of Health SciencesCity University of LondonLondonUK
| | - G. Morgan
- UCL DeafnessCognition and Language Research CentreUniversity College LondonLondonUK
- Language and Communication ScienceSchool of Health SciencesCity University of LondonLondonUK
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Krupickova S, Morgan G, Cheang M, Ghez O, Battista A, Spanaki A, Franklin R, Desai A, Fraisse A. Outcome of symptomatic partial atrioventricular septal defect requiring repair during infancy: a multicentric study. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30335-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: 10/19/2022]
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Jones AC, Toscano E, Botting N, Marshall CR, Atkinson JR, Denmark T, Herman R, Morgan G. Narrative skills in deaf children who use spoken English: Dissociations between macro and microstructural devices. Res Dev Disabil 2016; 59:268-282. [PMID: 27664562 DOI: 10.1016/j.ridd.2016.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/19/2016] [Accepted: 09/13/2016] [Indexed: 06/06/2023]
Abstract
Previous research has highlighted that deaf children acquiring spoken English have difficulties in narrative development relative to their hearing peers both in terms of macro-structure and with micro-structural devices. The majority of previous research focused on narrative tasks designed for hearing children that depend on good receptive language skills. The current study compared narratives of 6 to 11-year-old deaf children who use spoken English (N=59) with matched for age and non-verbal intelligence hearing peers. To examine the role of general language abilities, single word vocabulary was also assessed. Narratives were elicited by the retelling of a story presented non-verbally in video format. Results showed that deaf and hearing children had equivalent macro-structure skills, but the deaf group showed poorer performance on micro-structural components. Furthermore, the deaf group gave less detailed responses to inferencing probe questions indicating poorer understanding of the story's underlying message. For deaf children, micro-level devices most strongly correlated with the vocabulary measure. These findings suggest that deaf children, despite spoken language delays, are able to convey the main elements of content and structure in narrative but have greater difficulty in using grammatical devices more dependent on finer linguistic and pragmatic skills.
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Affiliation(s)
- -A C Jones
- Deafness, Cognition and Language Research Centre, University College London, UK.
| | | | | | - C-R Marshall
- Institute of Education, University College London, UK
| | - J R Atkinson
- Deafness, Cognition and Language Research Centre, University College London, UK
| | - T Denmark
- Deafness, Cognition and Language Research Centre, University College London, UK
| | | | - G Morgan
- Deafness, Cognition and Language Research Centre, University College London, UK; City University, London UK
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Jethava Y, Mitchell A, Zangari M, Waheed S, Schinke C, Thanendrarajan S, Sawyer J, Alapat D, Tian E, Stein C, Khan R, Heuck CJ, Petty N, Avery D, Steward D, Smith R, Bailey C, Epstein J, Yaccoby S, Hoering A, Crowley J, Morgan G, Barlogie B, van Rhee F. Dose-dense and less dose-intense total therapy 5 for gene expression profiling-defined high-risk multiple myeloma. Blood Cancer J 2016; 6:e471. [PMID: 27635734 PMCID: PMC5056975 DOI: 10.1038/bcj.2016.85] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Cox SL, Miller PI, Embling CB, Scales KL, Bicknell AWJ, Hosegood PJ, Morgan G, Ingram SN, Votier SC. Seabird diving behaviour reveals the functional significance of shelf-sea fronts as foraging hotspots. R Soc Open Sci 2016; 3:160317. [PMID: 27703698 PMCID: PMC5043317 DOI: 10.1098/rsos.160317] [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] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/19/2016] [Indexed: 06/06/2023]
Abstract
Oceanic fronts are key habitats for a diverse range of marine predators, yet how they influence fine-scale foraging behaviour is poorly understood. Here, we investigated the dive behaviour of northern gannets Morus bassanus in relation to shelf-sea fronts. We GPS (global positioning system) tracked 53 breeding birds and examined the relationship between 1901 foraging dives (from time-depth recorders) and thermal fronts (identified via Earth Observation composite front mapping) in the Celtic Sea, Northeast Atlantic. We (i) used a habitat-use availability analysis to determine whether gannets preferentially dived at fronts, and (ii) compared dive characteristics in relation to fronts to investigate the functional significance of these oceanographic features. We found that relationships between gannet dive probabilities and fronts varied by frontal metric and sex. While both sexes were more likely to dive in the presence of seasonally persistent fronts, links to more ephemeral features were less clear. Here, males were positively correlated with distance to front and cross-front gradient strength, with the reverse for females. Both sexes performed two dive strategies: shallow V-shaped plunge dives with little or no active swim phase (92% of dives) and deeper U-shaped dives with an active pursuit phase of at least 3 s (8% of dives). When foraging around fronts, gannets were half as likely to engage in U-shaped dives compared with V-shaped dives, independent of sex. Moreover, V-shaped dive durations were significantly shortened around fronts. These behavioural responses support the assertion that fronts are important foraging habitats for marine predators, and suggest a possible mechanistic link between the two in terms of dive behaviour. This research also emphasizes the importance of cross-disciplinary research when attempting to understand marine ecosystems.
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Affiliation(s)
- S L Cox
- Marine Biology and Ecology Research Centre, Plymouth University, Plymouth PL4 8AA, UK; Marine Physics Research Group, Plymouth University, Plymouth PL4 8AA, UK
| | - P I Miller
- Plymouth Marine Laboratory , Prospect Place, Plymouth PL1 3DH , UK
| | - C B Embling
- Marine Biology and Ecology Research Centre , Plymouth University , Plymouth PL4 8AA , UK
| | - K L Scales
- Plymouth Marine Laboratory, Prospect Place, Plymouth PL1 3DH, UK; Institute of Marine Sciences, University of California, Santa Cruz, CA 95064, USA; National Oceanic and Atmospheric Administration (NOAA), Southwest Fisheries Science Centre, Environmental Research Division, 99 Pacific Street, Suite 255A, Monterey, CA 93940, USA
| | - A W J Bicknell
- Environment and Sustainability Institute , University of Exeter , Penryn TR10 9FE , UK
| | - P J Hosegood
- Marine Physics Research Group , Plymouth University , Plymouth PL4 8AA , UK
| | - G Morgan
- RSPB , Ramsey Island, St David's, Pembrokeshire SA62 6PY , UK
| | - S N Ingram
- Marine Biology and Ecology Research Centre , Plymouth University , Plymouth PL4 8AA , UK
| | - S C Votier
- Environment and Sustainability Institute , University of Exeter , Penryn TR10 9FE , UK
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Yong K, Cavet J, Johnson P, Morgan G, Williams C, Nakashima D, Akinaga S, Oakervee H, Cavenagh J. Phase I study of KW-2478, a novel Hsp90 inhibitor, in patients with B-cell malignancies. Br J Cancer 2015; 114:7-13. [PMID: 26695442 PMCID: PMC4716540 DOI: 10.1038/bjc.2015.422] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 07/06/2015] [Revised: 10/12/2015] [Accepted: 10/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND KW-2478 is a novel, non-ansamycin, non-purine heat-shock protein 90 (Hsp90) inhibitor. METHODS In this phase I, multicentre study, KW-2478 was administered intravenously over 1 h at doses ranging from 14 to 176 mg m(-2) once daily on days 1-5 of a 14-day cycle in a standard 3+3 design in 27 patients (22 with multiple myeloma and 5 with non-Hodgkin lymphoma). Patients enrolled had relapsed/refractory disease previously treated with ⩾2 regimens. RESULTS There were no dose-limiting toxicities, thus the maximum-tolerated dose was not reached. KW-2478 was well tolerated and did not manifest significant retinal or ocular toxicity. The most common treatment-related adverse events were diarrhoea (33.3%), fatigue (29.6%), headache (25.9%), hypertension (22.2%), nausea (14.8%), vomiting (7.4%), and dizziness (7.4%). Plasma concentrations peaked at the end of infusion and decayed in a biphasic manner with a terminal half-life of ∼6 h. Target inhibition was inferred from the increase in Hsp70 levels in peripheral blood mononuclear cells at doses ⩾71 mg m(-2). Twenty-four of 25 (96%) evaluable patients showed stable disease, with five being free of disease progression for ⩾6 months. CONCLUSIONS Preliminary clinical response data were encouraging and warrant further investigation of KW-2478 in combination regimens for relapsed/refractory B-cell malignancies.
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Affiliation(s)
- K Yong
- UCL Cancer Institute, University College London, Huntley Street, London WC1E 6DD, UK
| | - J Cavet
- Department of Haematology, Christie Hospital/University of Manchester, Wilmslow Road, Manchester M20 4BX, UK
| | - P Johnson
- Cancer Research UK Clinical Centre, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - G Morgan
- Myeloma Institute for Research and Therapy, West Markham Street, Little Rock, AR 72205, USA
| | - C Williams
- Centre for Clinical Haematology, Nottingham University Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - D Nakashima
- Kyowa Hakko Kirin Pharma Inc., Princeton, NJ, USA
| | - S Akinaga
- Kyowa Hakko Kirin Co. Ltd, Tokyo Research Triangle Park, Tokyo 194-8533, Japan
| | - H Oakervee
- Department of Haematology, St. Bartholomew's Hospital, West Smithfield, London SE24 9LG, UK
| | - J Cavenagh
- Department of Haematology, St. Bartholomew's Hospital, West Smithfield, London SE24 9LG, UK
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Jones J, Cairns D, Sigsworth R, Collett C, Pawlyn C, Striha A, Melchor L, Kaiser M, Drayson M, Davies F, Gregory W, Boyd K, Owen R, Jackson G, Morgan G. Guidelines for the correct determination of second primary malignancies in myeloma trials. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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San Miguel J, Moreau P, Rajkumar V, Palumbo A, Facon T, Morgan G, Orlowski R, Cavo M, Einsele H, Neumann F, Labotka R, Lonial S, Richardson P. Four phase 3 studies of the oral proteasome inhibitor (PI) ixazomib for multiple myeloma in the newly-diagnosed, relapsed/refractory, and maintenance settings: TOURMALINE-MM1, -MM2, -MM3, and -MM4. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Heuck CJ, Jethava Y, Khan R, van Rhee F, Zangari M, Chavan S, Robbins K, Miller SE, Matin A, Mohan M, Ali SM, Stephens PJ, Ross JS, Miller VA, Davies F, Barlogie B, Morgan G. Inhibiting MEK in MAPK pathway-activated myeloma. Leukemia 2015; 30:976-80. [PMID: 26228812 PMCID: PMC4832073 DOI: 10.1038/leu.2015.208] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- C J Heuck
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Y Jethava
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Khan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - F van Rhee
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Zangari
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Chavan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - K Robbins
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S E Miller
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A Matin
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Mohan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S M Ali
- Foundation Medicine, Inc., Cambridge, MA, USA
| | | | - J S Ross
- Foundation Medicine, Inc., Cambridge, MA, USA.,Department of Pathology, Albany Medical College, Albany, NY, USA
| | - V A Miller
- Foundation Medicine, Inc., Cambridge, MA, USA
| | - F Davies
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B Barlogie
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - G Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Dip CL, Serradilla J, Shi JQ, Cheng Y, Morgan G, Eyre J. Automatic Assessment of Upper-Limb Function for Remote Monitoring During Home-Based Rehabilitation Using Videogames. Am J Occup Ther 2015. [DOI: 10.5014/ajot.2015.69s1-rp205c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 4/17/2015
Automatic in-game assessment of clinically validated, upper-limb function in stroke patients—generated using low-cost, commodity hardware and rehabilitation videogames—demonstrates the potential for remote monitoring of patients during videogame-delivered, home-based rehabilitation programs.
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Goreczny S, Krasemann T, Qureshi S, Rosenthal E, Bedair R, Salih C, Austin C, Anderson D, Morgan G. Comparison of self-expandable and balloon expanding stents for hybrid ductal stenting in hypoplastic left heart syndrome. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394085] [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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Rabin N, Lai M, Pratt G, Morgan G, Snowden J, Bird J, Cook G, Bowcock S, Owen R, Yong K, Wechalaker A, Low E, Davies F. United Kingdom Myeloma Forum position statement on the use of consolidation and maintenance treatment in myeloma. Int J Lab Hematol 2014; 36:665-75. [DOI: 10.1111/ijlh.12205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
Affiliation(s)
- N. Rabin
- Department of Haematology; University College London Hospitals; London UK
| | | | - G. Pratt
- Department of Haematology; Birmingham Hertlands Hospital; Birmingham UK
| | - G. Morgan
- Haemato-oncology; Royal Marsden Hospital; London UK
| | - J. Snowden
- Department of Haematology; Sheffield Teaching Hospitals; Sheffield UK
| | - J. Bird
- Department of Haematology; University Hospitals Bristol; Bristol UK
| | - G. Cook
- St James's Institute of Oncology; Leeds Teaching Hospitals Trust; Leeds UK
| | - S. Bowcock
- Department of Haematology; Princess Royal Hospital; Orpington Kent UK
| | - R. Owen
- St James's Institute of Oncology; Leeds Teaching Hospitals Trust; Leeds UK
| | - K. Yong
- Department of Haematology; University College London Hospitals; London UK
| | - A. Wechalaker
- Centre for Amyloidosis and Acute Phase Proteins; Royal Free Hospital; London UK
| | | | - F. Davies
- Haemato-oncology; Royal Marsden Hospital; London UK
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Morgan G, Smith JG. Disaster management in libraries: the role of a disaster plan. South African Journal of Libraries and Information Science 2014. [DOI: 10.7553/65-1-1502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Straub HL, Morgan G, Ochoa P, Grable I, Wang E, Kharasch M, Plunkett BA. Targeted obstetric haemorrhage programme improves incoming resident confidence and knowledge. J OBSTET GYNAECOL 2013; 33:798-801. [DOI: 10.3109/01443615.2013.816668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pratt G, Bowcock S, Lai M, Bell S, Bird J, D'Sa S, Cavenagh J, Cook G, Morgan G, Owen R, Snowden JA, Yong K, Davies F. United Kingdom Myeloma Forum (UKMF) position statement on the use of bendamustine in myeloma. Int J Lab Hematol 2013; 36:20-8. [PMID: 23615178 DOI: 10.1111/ijlh.12097] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 11/29/2012] [Accepted: 02/25/2013] [Indexed: 11/29/2022]
Abstract
Bendamustine is a unique bifunctional alkylating agent with promising activity in myeloma. Despite the increasing number of studies demonstrating its efficacy in both the upfront and relapse settings, including patients with renal insufficiency, the optimal use of bendamustine, in terms of dosage, schedule and combination with other agents, has yet to be defined. It is currently licensed for use as frontline treatment with prednisolone for patients with myeloma who are unsuitable for transplantation and who are contraindicated for thalidomide and bortezomib. Studies in relapsed/refractory patients are currently ongoing with other combinations. Given the increasing data to date, the UK Myeloma Forum believes that bendamustine with steroids alone or in combination with a novel agent could be considered for patients with multiply relapsed myeloma. This document provides guidance for the use of bendamustine for patients with myeloma until the results of definitive studies are available.
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Affiliation(s)
- G Pratt
- Haematology, Heart of England NHS Trust, Institute for Cancer Studies, University of Birmingham, Birmingham, UK
| | - S Bowcock
- Haematology, South London Healthcare NHS Trust, Haematology Kent, Kent, UK
| | - M Lai
- Myeloma UK, Edinburgh, UK
| | - S Bell
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - J Bird
- Avon Haematology Unit, Bristol Haematology and Oncology Centre, Bristol, UK
| | - S D'Sa
- Department of Haematology, University College Hospital, London, UK
| | - J Cavenagh
- Department of Haematology, St. Bartholomew's Hospital, London, UK
| | - G Cook
- Department of Haematology, St. James's Institute of Oncology, Leeds, UK
| | - G Morgan
- Haemato-Oncology Unit, Royal Marsden Hospital, Sutton, UK
| | - R Owen
- Haematological Malignancy Diagnostic Service Laboratory, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J A Snowden
- Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK
| | - K Yong
- Department of Haematology, University College Hospital, London, UK
| | - F Davies
- Haemato-Oncology Unit, Royal Marsden Hospital, Sutton, UK
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Mayne D, Morgan G, Wilmore A, Bauman A, Jalaludin B, Bambrick H, Rose N, Rodgers B, Bennett C. An objective index of walkability for the Sydney metropolitan region. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Avet-Loiseau H, Durie BGM, Cavo M, Attal M, Gutierrez N, Haessler J, Goldschmidt H, Hajek R, Lee JH, Sezer O, Barlogie B, Crowley J, Fonseca R, Testoni N, Ross F, Rajkumar SV, Sonneveld P, Lahuerta J, Moreau P, Morgan G. Combining fluorescent in situ hybridization data with ISS staging improves risk assessment in myeloma: an International Myeloma Working Group collaborative project. Leukemia 2012; 27:711-7. [PMID: 23032723 DOI: 10.1038/leu.2012.282] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The combination of serum β2-microglobulin and albumin levels has been shown to be highly prognostic in myeloma as the International Staging System (ISS). The aim of this study was to assess the independent contributions of ISS stage and cytogenetic abnormalities in predicting outcomes. A retrospective analysis of international studies looking at both ISS and cytogenetic abnormalities was performed in order to assess the potential role of combining ISS stage and cytogenetics to predict survival. This international effort used the International Myeloma Working Group database of 12 137 patients treated worldwide for myeloma at diagnosis, of whom 2309 had cytogenetic studies and 5387 had analyses by fluorescent in situ hybridization (iFISH). Comprehensive analyses used 2642 patients with sufficient iFISH data available. Using the comprehensive iFISH data, combining both t(4;14) and deletion (17p), along with ISS stage, significantly improved the prognostic assessment in terms of progression-free survival and overall survival. The additional impact of patient age and use of high-dose therapy was also demonstrated. In conclusion, the combination of iFISH data with ISS staging significantly improves risk assessment in myeloma.
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Affiliation(s)
- H Avet-Loiseau
- Unité de Génomique du Myélome, Laboratoire UGM, University Hospital, CHU Rangueil, Toulouse, France
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Morgan G, Pawlyn C, Davies F. IMIDS: Multiple Pathways but does it Really Work? Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32681-8] [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] Open
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Hong AM, Martin A, Armstrong BK, Lee CS, Jones D, Chatfield MD, Zhang M, Harnett G, Clark J, Elliott M, Milross C, Smee R, Corry J, Liu C, Porceddu S, Vaska K, Veness M, Morgan G, Fogarty G, Veivers D, Rees G, Rose B. Human papillomavirus modifies the prognostic significance of T stage and possibly N stage in tonsillar cancer. Ann Oncol 2012; 24:215-9. [PMID: 22887467 DOI: 10.1093/annonc/mds205] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Despite the association with more advanced nodal stage, patients with human papillomavirus (HPV) positive oropharyngeal cancers have better outcomes. We examined whether the HPV can modify the effect of known prognostic factors in tonsillar cancer. PATIENTS AND METHODS A total of 489 patients from 10 centres were followed up for recurrence or death for a median of 3.2 years. Determinants of the rate of locoregional recurrence, death from tonsillar cancer and overall survival were modelled using Cox regression. RESULTS The prognostic value of T and N stages were modified by HPV as indicated by statistically significant interaction terms. After adjusting for age, gender and treatment, T stage appeared relevant only for HPV-positive cancers (where a higher T stage was associated with worse outcomes). There was some evidence that N stage was a more relevant prognostic factor for HPV-negative than -positive cancers. There was no evidence that the HPV modifies the effect of age, gender or grade on outcomes. CONCLUSIONS This study suggests that the prognostic significance of the conventional staging system in tonsillar cancer is modified by HPV.
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Affiliation(s)
- A M Hong
- Sydney Medical School, The University of Sydney, and Department of Radiation Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
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Morgan G. A revised health impact assessment of increased use of aspirin in Wales. Public Health 2012; 126:719-20. [DOI: 10.1016/j.puhe.2012.02.010] [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] [Received: 04/14/2011] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
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Spencer T, Daniels T, Pollard K, Agent P, Morgan G, Madge S, Bilton D, Peckham D. 85 I-neb Insight Online – a telemedicine option in the treatment of cystic fibrosis. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60255-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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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Gamal M, Morgan G. Autoimmune progesterone vulvitis (APV), a new clinical diagnostic entity. J Reprod Immunol 2012. [DOI: 10.1016/j.jri.2012.03.352] [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: 10/28/2022]
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Richardson PG, Delforge M, Beksac M, Wen P, Jongen JL, Sezer O, Terpos E, Munshi N, Palumbo A, Rajkumar SV, Harousseau JL, Moreau P, Avet-Loiseau H, Lee JH, Cavo M, Merlini G, Voorhees P, Chng WJ, Mazumder A, Usmani S, Einsele H, Comenzo R, Orlowski R, Vesole D, Lahuerta JJ, Niesvizky R, Siegel D, Mateos MV, Dimopoulos M, Lonial S, Jagannath S, Bladé J, Miguel JS, Morgan G, Anderson KC, Durie BGM, Sonneveld P, Sonneveld P. Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia 2012; 26:595-608. [PMID: 22193964 DOI: 10.1038/leu.2011.346] [Citation(s) in RCA: 189] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Peripheral neuropathy (PN) is one of the most important complications of multiple myeloma (MM) treatment. PN can be caused by MM itself, either by the effects of the monoclonal protein or in the form of radiculopathy from direct compression, and particularly by certain therapies, including bortezomib, thalidomide, vinca alkaloids and cisplatin. Clinical evaluation has shown that up to 20% of MM patients have PN at diagnosis and as many as 75% may experience treatment-emergent PN during therapy. The incidence, symptoms, reversibility, predisposing factors and etiology of treatment-emergent PN vary among MM therapies, with PN incidence also affected by the dose, schedule and combinations of potentially neurotoxic agents. Effective management of treatment-emergent PN is critical to minimize the incidence and severity of this complication, while maintaining therapeutic efficacy. Herein, the state of knowledge regarding treatment-emergent PN in MM patients and current management practices are outlined, and recommendations regarding optimal strategies for PN management during MM treatment are provided. These strategies include early and regular monitoring with neurological evaluation, with dose modification and treatment discontinuation as indicated. Areas requiring further research include the development of MM-specific, patient-focused assessment tools, pharmacogenomic analysis of patient DNA, and trials to assess the efficacy of pharmacological interventions.
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Morgan G, Davies F, Gregory W, Szubert A, Bell S, Drayson M, Owen R, Child J. 9202 ORAL MRC Myeloma IX Trial – Characterizing the Biologic and Temporal Basis of Efficacy of Long-term Bisphosphonate Treatment in Patients With Multiple Myeloma. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72467-4] [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: 11/25/2022]
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Kumar SK, Lee JH, Lahuerta JJ, Morgan G, Richardson PG, Crowley J, Haessler J, Feather J, Hoering A, Moreau P, LeLeu X, Hulin C, Klein SK, Sonneveld P, Siegel D, Bladé J, Goldschmidt H, Jagannath S, Miguel JS, Orlowski R, Palumbo A, Sezer O, Rajkumar SV, Durie BGM. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study. Leukemia 2011; 26:149-57. [PMID: 21799510 DOI: 10.1038/leu.2011.196] [Citation(s) in RCA: 593] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Promising new drugs are being evaluated for treatment of multiple myeloma (MM), but their impact should be measured against the expected outcome in patients failing current therapies. However, the natural history of relapsed disease in the current era remains unclear. We studied 286 patients with relapsed MM, who were refractory to bortezomib and were relapsed following, refractory to or ineligible to receive, an IMiD (immunomodulatory drug), had measurable disease, and ECOG PS of 0, 1 or 2. The date patients satisfied the entry criteria was defined as time zero (T(0)). The median age at diagnosis was 58 years, and time from diagnosis to T(0) was 3.3 years. Following T(0), 213 (74%) patients had a treatment recorded with one or more regimens (median=1; range 0-8). The first regimen contained bortezomib in 55 (26%) patients and an IMiD in 70 (33%). A minor response or better was seen to at least one therapy after T(0) in 94 patients (44%) including ≥ partial response in 69 (32%). The median overall survival and event-free survival from T(0) were 9 and 5 months, respectively. This study confirms the poor outcome, once patients become refractory to current treatments. The results provide context for interpreting ongoing trials of new drugs.
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Affiliation(s)
- S K Kumar
- Divison of Hematology, Mayo Clinic, Rochester, MN 55905, USA.
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Harvey PG, Hamlin MW, Kumar R, Morgan G, Spurgeon A, Delves HT. Relationships between blood lead, behaviour, psychometric and neuropsychological test performance in young children. British Journal of Developmental Psychology 2011. [DOI: 10.1111/j.2044-835x.1988.tb01089.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Davies F, Morgan G, Wu P, Gregory W, Bell SE, Szubert A, Navarro Coy N, Drayson M, Owen RG, Feyler S, Ashcroft J, Ross F, Byrne J, Roddie H, Rudin C, Cook G, Jackson GH, Boyd K, Child JA. Are there benefits to long-term bisphosphonate treatment in multiple myeloma (MM)? Insights from temporal analyses of zoledronic acid (ZOL) versus clodronate (CLO) in the MRC Myeloma IX Trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Boyd K, Morgan G, Davies F, Wu P, Gregory W, Bell SE, Szubert A, Navarro Coy N, Drayson M, Owen RG, Feyler S, Ashcroft J, Ross F, Byrne J, Roddie H, Rudin C, Cook G, Jackson GH, Child JA. Does zoledronic acid (ZOL) reduce skeletal-related events (SREs) and improve progression-free survival (PFS) in patients (Pts) with multiple myeloma (MM) with or without bone disease? MRC myeloma IX study results. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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